Here are some of the questions that kept the NDS Helpdesk team busy over the past month.

Questions and Answers

I was wondering what the price changes are going to look like when they come into effect next year.

At the moment, as an example, if we had three participants, and charged two of them 1:2 in a centre, and the other 1:1 because he requires 1:1 support — that is, support with writing, moving, and communicating — how would this change under the new price guide?

Further, if we had a large group of nine all doing the same activity (for example, studying a course) and we have three support workers, charging them all 1:3, what would this look like under the new price guide?

I would really appreciate clarity on this because it all seems so confusing!

To address your question, we assume you are offering group activities under the newly implemented Group Prices. The NDIA has extended the deadline for providers to move to these new group prices to the end of December 2023.

Group Pricing applies to NDIS services delivered to a group of participants. It allows providers to offer supports in a group setting for choice and control, development of skills or for economy of scale. Under this pricing, the hourly rate for group activities is evenly divided among the participants. There is no provision to apportion the rate differently among group members. Where one participant in the group needs higher intensity support and a more skilled support worker, it is recommended that all participants (if they agree) be charged at the higher intensity rate.

Within the new pricing structure, providers and participants have more flexibility to agree on non-face-to-face fees. This reflects the cost of meeting individual participant needs for group-based support. These fees are claimed with the same line item as the relevant direct support. You just select the non-face-to-face claim type to differentiate it from the claim for direct support. For more information on claiming, please refer to ‘Using the myplace provider portal step-by-step guide’ on the NDIS website.

Another thing you could consider is to use Programs of Support for group activities. Programs of Support enable you to apportion costs across the group. Since Programs of Support are not subject to short notice cancellation rules, they can provide a buffer for sudden cancellations. Group-based services typically follow an output-based model and are time-bound (from short-term to 12 weeks), though participation is not compulsory.

For more information about group-based pricing and the transition to the new pricing, there is a range of guides and resources on the NDIS website.

And NDS has recorded a recent webinar where three providers explain how they made the transition, with a question and answer session.

Who authorises a restrictive behaviour support that needs to be in place?

We have a restrictive behaviour support issue that is reportable. I contacted the NDIS Quality and Safeguards Commission, and they directed me to the intake incidents sector because they said the matter was not clear.

The participant has a belt buckle that stops her undoing her wheelchair harness. If she undoes her harness she slumps forward and creates very serious airways issues. She must have this buckle guard otherwise her life is at risk.

The NDIS incident intake officer replied to my email and said the use of the buckle guard is a reportable restrictive behaviour and sends me the link to make the report.

The questions in the reporting link relate to incidents, not to longstanding practices — restrictive though they may be — implemented to safeguard the participant.

It appears that restrictive practices are only reportable if they are not authorised, so who does this authorisation? And how do I apply for such authorisation required for the above safeguard?

The use of all regulated restrictive practices with all NDIS participants is reportable to the NDIS Quality and Safeguards Commission. There are two types of restrictive practice reporting: authorised and unauthorised.

Authorised restrictive practice needs to be part of a behaviour support plan. Plans also need to be submitted to the NDIS Quality and Safeguarding Commission. The use of the practice then needs to be reported monthly.

The use of unauthorised restrictive practice needs to be reported as it occurs.

The practice you describe would fall under the use of a mechanical restraint. If the harness was used therapeutically for postural support without the use of the buckle guard, it would not be classified as mechanical restraint. However, as the buckle guard prevents, restricts or subdues the person’s movement to influence the person’s behaviour, it is considered a mechanical restraint.

Each state and territory has a different process for authorising restrictive practices in behaviour support plans. In NSW, implementing providers who apply mechanical restraints must get approval through a Restrictive Practice Authorisation (RPA) Panel. The RPA panels should be convened by the implementing provider through the Department of Communities and Justice’s Restrictive Practices Authorisation Portal. Providers are required to have a Senior Manager and a DCJ Independent Specialist as part of that panel to review and authorise the use of the restrictive practice.

A positive behaviour support plan, including RPA protocols and a fade-out plan, must be written by behaviour support practitioner. They or their employer must be a registered NDIS provider. Once a behaviour support practitioner is engaged, they must follow strict timelines to develop the plans. Any behaviour support plans that contain restrictive practices must be uploaded to the NDIS Quality and Safeguarding Commission portal by the behaviour support practitioner.

Once the restrictive practice is authorised, the implementing provider should get the right consent for its use. Every month, the implementing provider needs to report the use of restrictive practices to the NDIS Quality and Safeguarding Commission. These reports must be submitted even if a restrictive practice has not been used in the month.

Until the restrictive practice is authorised, it is a reportable incident to the NDIS Quality and Safeguarding Commission, requiring weekly reporting. If it is used regularly, it should be in an authorised behaviour support plan. Service providers are required to keep the NDIS Commission informed on the status of the behaviour support plan.

As well as registration links, there are helpful user guides and tutorials on the Restrictive Practices Portal webpage.

The NDIS Quality and Safeguards Commission has also created a wealth of information and guides on behaviour support and restrictive practices for providers.

We are seeking advice on the NDIS Price Guide and requirements around ‘Therapy for over 7yr olds, Other Professional, line item 15_056_0128_1_3’. We want to understand the requirements for that line item.

The Price Guide direction is:

‘Other Professional — A person who is not one of the types of professionals listed above but who the provider considers to be an appropriate professional to deliver therapeutic supports in line with the NDIS Quality and Safeguarding Commission’s requirements for the Therapeutic Supports Registration Group.’

Our questions are:

Given that the literature says that a provisional psychologist can charge under the ‘Counselling’ line item, what would stop us from charging under ‘Other Professional’?

Given that the provider is the one to decide who is appropriate, what other requirements would need to be met? Looking at the provider registration guide, I cannot see any specific direction around ‘Other Professional.’

Dealing first with therapeutic supports. In both the NDIA Pricing and Pricing Arrangements and Price Limits 2023–24 and the NDIS Quality and Safeguarding Commission Verification Audit information, to claim under the therapeutic support line, therapists must have professional qualifications and be subject to professional regulation as a requirement of their doing business.

This includes regulation through the Australian Health Practitioner Regulation Agency (AHPRA) and other professional bodies that give regulatory oversight of the professions in these guidelines.

Regulation and oversight must include set standards and the monitoring of the person’s competency to practice their profession, including their continuing professional development. There should be professional membership or certification by the governing body or association.

Next, on Allied Health Practitioner (AHP) students and provisional psychologists: The NDIA has guidance on claiming for Allied Health Practitioner (AHP) students and provisional psychologists. Provisional psychologists on clinical placement under supervision (usually an unpaid role) cannot be paid separately from their professional supervising practitioner. The supervisor can claim the relevant professional rate from the NDIS to create and supervise an appropriate program to be delivered by the student, with the participant’s consent.

When working as a paid, unsupervised practitioner, a provisionally registered psychologist can charge at the rate applicable to an Allied Health Assistant Level 2 or as a counsellor.

Finally, taking this information into consideration to answer your questions: Practitioners charging under the Other Professional category should be fully qualified and registered with AHPRA or certified with or members of their relevant professional body.

The NDIS Commission advises that professional supports generally come under verification not certification requirements (this is not true for behaviour support practitioners), because they are subject to professional regulation as a requirement of doing business. Additionally, the NDIA does provide specific guidance on billing for the use of provisional psychologists.

For registration requirements by supports and services, the NDIS Quality and Safeguards Commission has produced a guide in pdf and Word formats.

Complete information and downloadable guides of pricing arrangements are on the NDIS website.

The NDIS has an information page on their website on the use of allied health practitioner students and provisional psychologists, including payment and claiming.

What are the rules for short notice cancellation when my staff are casual?

If staff have been engaged and are needed for other participants, then the participant who made the short notice cancellation can have a claim made against their plan. If the staff can be redeployed or have their shift cancelled, then no claim can be made.

We need some guidance on who to speak to about Auslan funding for DES.

We have engaged with Job Access and read guidelines from all avenues, but their guidance is vague. I am hoping NDS might have a more informed view or reference material to guide us on what can and cannot be claimed for DES in each Auslan 1 or Auslan 2 section.

The team at NDS has done some research and I hope you find the following information helpful.

NDS uses Deaf Connect for our webinars and events. They provide services nationally and have recently taken over Access Plus WA Deaf.

The Employment Assistance Fund assists employers of people with disability to buy a range of work-related modifications and services. This fund is administered by JobAccess. It can be used for workplace training and interpreting provided by a training provider, encouraging employers to recruit deaf and hard of hearing staff.

For more information, you can visit the Job Access website or phone 1800 464 800.

It is our understanding that there is between $6000 to $12,000 for Auslan funding 1 for each deaf participant to get interpreting services.

Then there is DAT (Disability Awareness Training), which is Auslan funding 1 (this includes iPad or live captioning). If an organisation has a deaf employee, it may be eligible to have the costs of this training reimbursed by the Australian Government through the Employment Assistance Fund.

There are many factors that determine the appropriate funding, because there are many different types of deafness. It is specific to the individual, based on what method of communication they use. So, there are many points to consider. For instance, if the participant is deaf or hard of hearing; or if client needs to have it noted within their ESAT, or have an audiology report.

Organisations also need to understand the participant’s work environment, type of work they do, the activities, and the physical and environmental considerations.

The Employment Assistance Guidance Guidelines are available in pdf and Word formats from the Job Access website.

We suggest if you need further advice that you call Job Access (1800 464 800). They are helpful and can give tailored advice.