Helpdesk Top 5: September 2022
The NDS Helpdesk team has chosen the top five responses from the helpdesk on claiming SIL supports, claiming under Supported Employment hours, provider travel, volunteers, and claiming multiple activity types.
Are there limits for claiming SIL supports when there is an absence of more than 28 days, such as for a holiday or extended stay in hospital?
We are aware of the stipulations in the Pricing Arrangements and Price Limits and the new Bereavement Addendum, however, how long can providers claim for SIL supports after a client gives notice and chooses to move out? Does this fall back onto the service agreement timeframes or is there a cap specified by the NDIA?
The issue is for providers with staff on permanent Roster Of Care roster lines and funding where vacancies remained unfilled.
There is no real guidance from the NDIA in terms of how longer-term unplanned absences can be managed in SIL settings where supports are shared and it is anticipated that the participant will return to the SIL setting.
There is the capacity to claim for irregular supports where this is appropriate to the situation. SIL is also considered a program of support, so there is some capacity to apply the Program of Support rules to SIL supports that are outlined in the Pricing Arrangements and Price Limits where this has been agreed upon by the participant.
There are also no specific rules related to the length of notice periods for SIL, however, Programs of Support are subject to a two-week notice period.
The Operational Guidelines and SIL Provider Guidance note: Providers must not increase the price of supports or claim additional funds from other participant’s plans to cover notice periods. Service agreements should include how providers manage notice periods.
Are annual leave, sick leave, and public holidays eligible for claiming under Supported Employment hours? When participants cancel through illness, for example, can claims be made under the short notice cancellation policy of seven days?
The details for which types of leave can and can not be claimed for Supports in Employment are outlined in the NDIS Supports in employment handbook:
In 2020, the NDIA introduced programs of support, designed to simplify claiming arrangements when there is a typical pattern of group-based supports.
Providers can claim agreed programs of support against the related support items, using the typical pattern of support to arrive at the frequency of support within a defined time period, usually a week, which is then claimed as a multiplier of the unit price.
This typical pattern of support, when recorded and agreed with a participant, forms the basis of the service agreement and the program of support between the provider and participant. The agreed program enables the provider to claim a regular weekly amount for delivering supports during a specified period for no longer than 12 weeks.
This reduces the need for providers to record each minor change in hours or support ratios. Planned absences do not form part of a program of support, but providers can claim for unscheduled absences, as long as they had the capacity to deliver the support.
Unscheduled absences include sick leave or failure to arrive at work, but not annual leave, public holidays, long service leave, or extended periods of sick leave.
Is Provider Travel paid from participants’ plans or independently from the NDIA?
NDS understands that the cost of provider travel must be claimed from a participant's plan using a separate line item.The NDIS Pricing Arrangements and Price Limits 2022-23 (p19) outlines how to claim provider travel costs. It indicates that providers can only claim for provider travel from a participant’s plan if a number of conditions are met, including:
- the support is delivered face to face
- the provider explains the activities to the participant, including why they represent the best use of the participant's funds
- the provider has the agreement of the participant in advance (including agreement on the cost of travel to be claimed)
- the provider is a sole trader and is travelling to and from their usual place of work or between participants, or the organisation is required to pay a worker for the time they spent travelling.
Can disability sector volunteers under the supervision of paid staff provide direct support to NDIS participants? If so, is volunteer work eligible to be claimed from an NDIS package?
It is noted that under item ‘Assistance in Coordinating or Managing Life Stages, Transitions and Supports’ in the NDIS Pricing Arrangements and Price Limits 2022-23 there is funding designed to establish volunteer assistance to develop skills. Under item ‘Community Participation Activities,’ providers can claim “to establish volunteer arrangements in the community, mentoring, peer support, and individual skill development”.
NDS understands that funds cannot be claimed for supports from a participant's NDIS plan where a volunteer is providing the supports. Supports can be claimed if a paid worker is providing the supports and a volunteer is assisting.
NDS notes that volunteers working in participant-facing roles (also known as 'Risk Assessed Roles' under the NDIS Commission) need to meet worker screening rules and regulations.
In Victoria, all volunteers will need to hold an NDIS check before they can commence in a Risk Assessed Role. There is a separate application form for volunteers [pdf] applying for an NDIS check in Victoria.
Question 5:In a scenario where a client has a plan which covers Community Participation, Personal Care, and Domestic Assistance and they wish to access all three from a support worker during the one shift:
- are there any restrictions on doing this?
- What item number is included on the claim?
Answer:As Community Participation/Personal Care supports have a different price limit to Domestic Assistance, providers would need to take this into account when claiming. In other words, if the participant was requesting assistance with household activities, the time spent delivering this support would need to be claimed in line with the NDIS Pricing Arrangements and Price Limits 2022-23 if the participant is agency or plan managed.
With Community Participation and Personal Care supports, it may be possible to identify the goal or outcome that the participant is seeking and claim against the relevant line item as opposed to identifying the proportion of time that is spent in each.
If the prime outcome of the support is to increase the participant's community participation, however, when in the community the participant will require assistance with personal care, then agreeing with the participant that supports will be claimed against community participation may be appropriate. It would be important to discuss options of how best to structure the support with the participant and their Plan Manager/LAC.