The National Disability Insurance Agency (NDIA) has announced a new price guide for 2020-2021 for your NDIS supports. These new prices start on the 1st of July 2020.

Participant plan funds will be automatically indexed from 1 July 2020 to take into account the decision of the Fair Work Commission and movement in the Consumer Price Index. This requires a systems update which is expected to occur on 11 July. Indexation will still apply from 1 July.

The Price Guide and Support Catalogue 2020‒21 published 29 June 2020 also reflect the end of some of the temporary arrangements introduced in response to the coronavirus (COVID-19) pandemic.

These documents are available to download:

What you need to know!

Over coming weeks, DIA will review, engage with the NDIA and provide members with further analysis on the annual pricing review, Price Guide and Support Catalogue. The major changes in this release include:

Plan Management

In a disappointing move, the NDIA has ignored the the submission and consultation conducted with Registered Plan Management Providers (RPMPs) as a part of the Annual Price Review, with the billable structure for Plan Management remaining unchanged with the same three line items and structure remaining.

DIA rejects the NDIA’s view that
“there is little evidence that current price limits for plan management are inadequate.”

RPMPs will be able to claim for travel, cancellations and non-face-to-face supports when delivering Capacity Building and Training in Plan and Financial Management by a Plan Manager (14_031_0127_8_3).

From July, RPMP’s will need to inform the NDIA, when requested, which registered providers have made a claim for a Temporary Transformation Payment (TPP) support item. There is no word on the process, structure, regularity or expected time frames of such requests.

DIA has written to the NDIA requesting that the agency re-consider the outcome of the Annual Pricing review to take into consideration:

  1. 47 per cent of Registered Plan Management Providers who respond to DIA’s Australian Disability Intermediaries Sector Report did not make a profit last year, this is before consideration of points 3 and 4 below;
  2. The slim margins Registered Plan Management Providers operate with;
  3. Operating stress experienced by the sector during COVID-19;
  4. Change in NDIA operating policy around Plan Managed Service Bookings resulting in significant staffing and administration cost; and
  5. Limited implementation and use of API’s, with a transition period expected to last  at least 12 – 18 months.

DIA will continue to drive for more appropriate pricing for RPMP’s.

Support Coordination

The temporary Support Coordinator line items in Core Support Category – Assistance with Daily Life – remain for now. This change is temporary until 30 September 2020, with a review before the end of June 2020. DIA is yet to be informed as to a review process or outcome.

As well as direct service provision, these support items can be used to claim for

  • Non-Face-to-Face Support Provision
  • Provider Travel
  • Short Notice Cancellations
  • NDIA Requested Reports.

Providers of this support can also claim for the costs of:

  • Provider Travel – Non-Labour Costs using support item 01_799_0106_1_1 or support item 01_799_0132_1_1, depending on their Registration Group.

Inclusion of Psychosocial Recovery Coaches to the Support Coordination support category (see below).

Psychosocial Recovery Coaches

A welcome inclusion to the Support Coordination support category is the inclusion of Psychosocial Recovery Coaches. The description provided by the NDIA looks to be very similar to Support Coordination and the NDIA appears to expected this function to replace Support Coordination for many people with psychosocial disability:

“These support items provide assistance for participants to build capacity and resilience through strong and respectful relationships to support people with psychosocial disability to live a full and contributing life. This support is designed to be able to maintain engagement through periods of increased support needs due to the episodic nature of mental illness. Recovery coaches work collaboratively with participants, families, carers and other services to identify, plan, design and coordinate NDIS supports.

There are important differences between Support Coordinators and Recovery Coaches which include:

  • The work of psychosocial recovery coaches according to the NDIA requires lived and/or learnt experience. Recovery coaches must have tertiary qualifications in peer work or mental health (minimum of Certificate IV in Mental Health Peer Work or Certificate IV in Mental Health) or equivalent training; and/or a minimum two years of experience in mental health-related work.

  • Recovery Coach price limits vary based on day and time, unlike Support Coordinators. DIA is concerned to see that the Weekday rates are currently sitting 10-20% below the current rates for Support Coordination – Level 2, despite the higher bar for qualifications.

  • There is no reference to how these experience and qualification requirements will be enacted, monitored and enforced, particularly for Self-managed and Plan-managed participants.

Noting these considerations, DIA strongly recomends to those delivering Support Coorindation services to carefully consider there service offering and cost of operation before delivering Recovery Caach services to participants to ensure that prodivers don’t end up delivering Support Coordination like service for a reduced rate.

DIA has heard reteric that were a participant is funded for a Recovery Coach they will not be eledgible to recieve funding for Support Coorindation.

  1. Recovery Coaching is not Support Coorindation (hense the different pricing);
  2. The NDIS Act is very clear that supports can not be declined in this manner, there are a range of skills and serivces that a Support Cooridnator will provide that a Recovery Coach will not, such as exploring housing options, supporting participants with a behaviour support plan and supporting participants with complex needs;
  3. DIA can see examples where a participant could resonabily and nessisarly be funded for both Level 2 Cooridnation of Supports and a Recovery Coach. or Level 3 Specialist Support Coorindation and a Recovery Coach; and
  4. If any provider recieves differing information, direction or advices from the NDIA on this please inform DIA as a priority.
Supported Independent Living (SIL)

Supported Independent living (SIL) will, from July, move from the current quoting and negotiation process to set price limits. Initially the price controls will be based on the price limits for assistance with daily living (while a review of these price limits is undertaken).

Existing plans with agreed SIL quotes will continue until the end of the participants plan, at which point the new SIL price limits will apply.

A new SIL Provider Pack will be released shortly.

Individual Living Options (ILO)

Individualised Living Options (ILOs) has seen the introduction of ‘Explore and Design’ and ‘Support Model’ line items. More information about the funding bands for these types of support will be available in July.

Provider Travel

A welcomed introduction is the clean up of Provider Travel. Providers will be able to charge for the non-labour costs of provider travel (in addition to the worker’s time). Up to $0.85 a kilometre can be charged for the use of a vehicle that is not modified for accessibility and the full cost of other transport or associated costs (such as road tolls, parking and public transport fees).

Establishment Fees (for non PM supports)

The previous rules about establishment fees for personal care, community access and now employment supports can, from 1 July claim a once off, flat fee, for participants they support at least 20 hours a month for three or more consecutive months.

Temporary Transformation Payment (TTP)

Temporary Transformation Payment (TTP) will be reduced. The final figures of this will be released later in June with the rest of the final price control figures.

Fungibility (Funds Flexibility)

At the National Press Club on the 14/11/2019, the Minister for the NDIS, Stuart Robert, announced

“From1 July next year and in line with functional assessments, we’ll aim to remove the distinction between core and capacity building within plans, so the participants and their families can use planned funding more flexibly on those supports that best meet their needs.”

DIA remains excited by the opportunities that greater funds flexibility will deliver for people with a disability . The release of the 2020-21 Price Guide does not give any indication as to how this would happen across line items and support categories. Unfortunately the Price Guide core support section still includes

“Participant budgets often have a lot of flexibility to choose specific supports with their core support budgets, but cannot reallocate this funding for other support purposes (i.e. capital or capacity building supports).”

Centre-based Supports

Previous Price Guides lised centre-based supports with a slightly higher price limit than community-based versions of the support, recognising the costs of running and maintaining the centre. In the new price guide, these costs have been separated and will need to be claimed by a provider under Centre Capital Cost.

Employement Supports

This Price Guide has done away with the old pricing model for employment supports, which up until now been paid as a weekly support. The NDIA have replaced this with a far more flexible approach with hourly price limits based on the day of the week and time of support. Disability Maintenance Instrument (DMI) levels have also been removed and there is no more explicit reference to Australian Disability Enterprises (ADE).

This change is massive win for Participants wanting greater flexibility in their work hours and options. However, it will represent a significant transition and challenge for many employment providers, there is a “Transitional Funding Arrangements” line item under Core supports that will allow a provider, with participant concent, to continue to claim at their current DMI or Average Outlet Price (AOP) for a period of up to 18 months.

Reporting Requirements

DIA is actively engaging with the intermediary market, to understand operating challengers and pain points during COVID-19. DIA openly encourages providers of Plan Management and Support Coordination to contact us to inform us on what you are experiencing.

With the release of the 2020-21 NDIA Price Guide, DIA is aware that some providers are reviewing their operations and considering their business and social objectivies to determin their ongoing position within the market.

In addition to providers seeking to inform DIA of operational and market challenges, NDIS registered providers have a range of reporting obligations under the NDIS Quality and Safe Guards Commission including Section 13A of the NDIS Provider Registration and Practice Standards) Rules 2018. These legislative rules require Registered Providers to  give the Commissioner notice of any of the following events:

  1. An event that significantly affects the provider’s ability to comply with any of the provider’s conditions of registration;
  2. A change that adversely affects access by a person with disability to the supports or services the provider is registered to provide;
  3. An adverse change in the provider’s financial capacity to provide any of the supports or services the provider is registered to provide;
  4. A significant change in the organisation or governance arrangements of the provider;
  5. An event, relating to the suitability of the provider to provide supports or services to people with disability, to which the Commissioner would be required to have regard under any of paragraphs 9(2)(c) to (h) if the provider were an applicant for registration as a registered NDIS provider;
  6. An event, relating to the suitability of the provider’s key personnel to be involved in the provision of supports or services that the provider is registered to provide, to which the Commissioner would be required to have regard under any of paragraphs 10(2)(b) to (g) if the provider were an applicant for registration as a registered NDIS provider.

Notice of such an event must be given to the Commissioner:

  1. On the form approved by the Commissioner (Online Form Here); and
  2. As soon as practicable after the event occurs.

This will included situations where Registered Intermediary Providers are experiencing operating stress and looking to suspend or withdraw from service.