Requesting changes to supports in Participants’ Plans

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Last week, the NDIS updated their website with information about NDIS Participants requesting changes to the supports in their plans. As Support Coordinators, we share Participants’ frustration with having Change of Situation (S48) or Review of a Reviewable Decision (S100) requests sitting with the NDIA for months at a time. The NDIA is to be recognised for (finally) acknowledging on their website that delays are occurring in processing requests for changes to Participants’ plans.

Two emerging directions from the NDIS are important, and may have significant impacts for some Participants.

Issue 1: Supports won't automatically renew if funds are expended before the end of the plan period.

Keeping to budget

Connect4U Australia Support Coordinators will always work with Participants to help them keep their expenditure within the budget that the NDIS has provided. We do this in the following ways:

  • Listening to the Participant’s priorities for expenditure.
  • Setting a budget based on these priorities.
  • Procuring services that reflect the best value for money.
  • Obtaining service agreements from providers.
  • Tracking expenditure through the Participant’s Plan Manager portal or monthly statements.
  • Facilitating stakeholder meetings to ensure Participant outcomes are being achieved and funding is kept on track.

What happens if the Participant considers that their plan is underfunded and won’t go the distance?

In these cases, Connect4U Australia Support Coordinators will work with Participants to explore all options to have the NDIS reassess the Participant’s plan. This includes obtaining updated assessments, submitting a S48 or S100 form and escalating requests that are not met within the timeframes set out in the NDIS Participant Service Charter.

The latest from the NDIS website…

“We will only reassess a NDIS Plan if there is a change in your life that means you need more, less or different supports, or your plan is coming to an end. We do not automatically renew plans because they are fully spent.”

The NDIS is saying that Participants are expected to stay within their budgets. If the Participant does experience a change in their circumstances, a Change of Situation request is required before a Participant’s Plan is reviewed. And, as always, the NDIS will choose when, and whether or not, to accept this request.

Issue 2: Therapies will not be paid from Core codes without prior approval from the NDIS

Do these scenarios sound familiar?

  • A Participant’s plan has a small Improved Daily Living budget, and the Participant then has to decide to prioritise physiotherapy over psychology, or speech therapy, or maybe reduce the frequency of sessions from fortnightly to monthly.
  • A Participant’s plan has been rolled over for several years and the original therapies budget does not meet the Participant’s current needs.

In both cases, a Change of Situation form may have been lodged with the NDIS, but months later there is no response.

Until now, Participants have been able to use funding from the Core section of their budget, to pay for therapies when their Capacity Building – Improved Daily Living funds were expended.

The latest advice from the NDIS

“It’s important to remember that Core funding can be used flexibly with other Core support types and not with other supports types like Capacity Building”.

The NDIS is saying that therapies (which are in the Capacity Building section of a plan) will no longer be paid from Core, unless a NDIS Planner provides approval to the Participant’s Plan Manager. That means contacting the NDIS and asking for a Planner to email approval to the Plan Manager.

Responding to these changes

These updates may come as cold comfort for Participants and their families. The NDIS phone message (you know, the 90 seconds of your life you will never get back before you get to speak to someone) now says the following: “Plan funds can be used flexibly while you are waiting for your plan change to be processed”. How is adding an extra approval process being “flexible”?

The NDIS could genuinely help Participants better manage their NDIS plan by responding to review requests within their timeframes. We encourage Participants to hold the NDIS accountable to the NDIS Participant Service Charter.

How are Connect4U Australia Support Coordinators getting on the front foot with these changes?

We will:

  • Ensure Participants know the latest processes from the NDIS – whether it is through blogs like these, or Fact Sheets.
  • Keep in touch with Participants about review requests – even if the news is that there is no news, you will know that we are following up.
  • Do our best to reduce the impact of these changes on Participants – we can make that call to the NDIS.
  • Help Participants stay within budget by providing clear advice about what the NDIS considers is “reasonable and necessary” expenditure.

For more information about these changes, go to NDIS – Support budgets in your plan and the NDIS Participant Service Charter for more information on what you can expect from NDIS to improve the NDIS for everyone.

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