Helpdesk Top 5: June 2020
Can providers still claim 100% of the service charge from short notice cancelations?
Yes, providers can still recoup 100% when eligible within the definition of 'short notice cancelation'. The definition of short notice changed from 2 days to 10 days as an interim measure to support provider. The newest iteration of the NDIS Price Guide has seen the short notice cancellation definition revert to the original 2-day period. Refer to the Price Guide for other requirements and further details.
Is the 10% COVID-19 loading still applied to the new NDIS Price Guide?
The 10% COVID-19 loading will be removed from 1 July 2020, meaning that these line items/prices will not be available for providers or participants who are Agency or Plan Managed for supports delivered after 1 July 2020 regardless of whether you have a service agreement in place.
Have ratios for group-based supports been removed from the NDIS Price Guide?
Yes. In the new price guide the has seen a removal of the ratios for group based supports and the same line item is supports provided in the community and centre based supports. The hourly rate (different price limits for different times of day and days of the week) is divided amongst the number of participants supported by a staff member.
Additionally, providers can now charge for non-direct services, if services are provided in a centre a centre capital cost loading applies, provider travel –both time and non-labour costs and short notice cancellations.
Where the final version of the price guide was released on 26 June, it also contained information about the ability for providers to take until the 30 June 2021 to transition to these new billing rules.
This enables providers to use the pricing arrangements and support items that were in place in 2019-20 whilst they assess impact, renegotiate agreements with participants and make the necessary administrative changes to accommodate the changes.
A provider must use the same approach (transitional or new) for all the group and centre based supports that they deliver. Once a provider commences to use the new pricing arrangements, they may no longer use the transitional pricing arrangements. Please see p.64 20_21 Price Guide.
Given the new price guide and additional information under Independent Living Options (ILO), can participants who are self-managed or plan managed purchase ILO services from non-NDIS registered providers?
Yes, participants who are self-managed or plan managed can purchase supports from an unregistered ILO provider with consideration of the NDIS Commission requirements.
Mandatory registration is required for NDIS service providers of SDA, behaviour support practitioners, and for services implementing behaviour support plans that utilising restrictive practices. Additionally participants who agency manage their plans can only purchase services from registered providers.
Providers delivering Individualised Living Options, like those delivering Supported Independent Living can operate as an unregistered provider when they are not implementing behaviour support plans that include the use of restrictive practices.
Can you provide some information to clarify what non-face-to-face supports can be claimed when delivering Group Based and Community Based Supports and 1:1 Support?
The new 2020-2021 Price Guide allows for non-face-to-face supports to be claimed against some support categories. At this stage, the NDIA has only provided some general guidance on what can be claimed under non face-to-face supports. Generally, the activities need to be related to delivering a specific support item as opposed to general administrative tasks such as rostering and claiming.
The Price Guide (p.16) provides the example of writing reports for co-workers and other providers about the client’s progress with skill development.
Other examples related to group and community based and 1:1 supports could include:
- developing a particular program of supports for an individual
- completing items such as communication logs/case notes and other documentation related to participants and their supports and the outcomes achieved
- conducting a risk assessment for a participant prior to an specific support being delivered
- setting up for a particular support activity
The NDIA have been more specific in terms of the type of non face-to-face activities that are UNABLE to be claimed under the new non face-to-face line items. The Price Guide (p. 16-17) notes the following:
‘Time spent on administration, such as the processing of NDIS payment claims for all clients, should not be claimed from a participant’s budget as a Non-Face-to-Face support. The NDIS price limits include an allowance for overheads, including the costs of administration tasks.’
Examples of administrative activities that are covered by the overhead component of the support price limits and that should not be billed as Non-Face-to-Face supports include, but are not limited to:
- pre-engagement visits;
- developing and agreeing Service Agreements;
- entering or amending participant details into system;
- making participant service time changes;
- staff / participant travel monitoring and adjustment;
- ongoing NDIS plan monitoring;
- completing a quoting tool; and
- making service bookings and payment claims.
The Price Guide also notes that training and upskilling staff, and staff supervision, are not considered billable Non-Face-to-Face supports.
In order for a provider to claim for non face-to-face supports, the provider must explain the value of these activities to the participant the participant must agree to the non face-to-face supports being claimed. This also needs to be specified in the service agreement.