Frequently Asked Questions

1. How do we register as a provider with the NDIS?

If you are new to the NDIS we strongly recommend that you visit the NDIS web site’s pages for providers where the essential information about working with the NDIA is located. Module 2 “Registering as a Provider” in the Provider Toolkit has details pertinent to each jurisdiction. In addition to the Provider Toolkit, this part of the web site includes other detailed information on the following topics:

  • Working with the NDIS
  • Pricing and Payment
  • Market information and Useful Links
  • Specialist Disability Accommodation
  • Frequently asked questions
2. How much to charge: can a provider charge more than the rates, what happens if they do?

Providers may only charge the rate set out in the NDIA Price Guide found on its Pricing and payment page for support services that are part of a participant plan funded by the National Disability Insurance Agency (NDIA). The NDIA states the following in the price guide:

The Price Guide includes a price limit for some supports and services.

Unless stated otherwise, these price levels are the maximum that providers can charge NDIS participants for their services. Price limits are in place to ensure that participants receive value for money in the supports and services that they receive. This is an important measure for many participants, especially in disability support markets that are immature or where there are few options for participants to choose from.

The exceptions to this rule are ‘benchmark prices’ for some of the supports and services that are listed as ‘quotable items’. These benchmark prices indicate the NDIA’s view of efficient service delivery and should be the highest price charged by most providers. Supported Independent Living uses benchmark prices.

All registered NDIS providers should refer to the NDIA Terms of Business, which include details about the application of price limit, and other requirements that providers must comply with when offering and delivering services to Scheme participants.

This pricing requirement applies to registered providers. Only registered providers may claim payment from the NDIA via the provider web-portal. Participants who are self-managing funds do not have their service provision paid using the NDIA provider-portal. They may use those funds to access services from registered providers or providers that are not registered. They may choose to pay a higher fee to a non-registered provider. They are limited to claiming from their package, the maximum NDIS prices or fees for the relevant item of service if it has been separately itemised.

3. How to quote if the price is above the NDIS rates.

See question 2. The NDIA Price Guide requires quotation for various types of supports. For quotable items the Agency may provide templates or guides to indicate its expectations regarding suitable information. The Price Guide states the following:

Quotes are required from providers for a number of specific service offers. This most commonly occurs for the following supports:

 Early childhood intervention services

  • Multidisciplinary programs
  • Customised assistive technology,
  • Home modifications, and
  • Specialist Disability Accommodation.

 If the quote received is higher than the benchmark rate for that support item, specific approval will be required from the NDIA. Identification of supports and approval of quotes could require an assessment by a specialist.

4. As a sole service provider what financial payments will be available for non-client work; e.g. completing forms, doing reports, liaising with other services (e.g. tradespeople for home modifications)?

The NDIA Price Guide sets out descriptors and associated pricing for different types of activities and supports supplied by providers to NDIS participants in accordance with the requirements of their approved plan and service agreement.  Depending on the specific items included in any plan and the role of each provider in implementing the plan payments are made in accordance with the NDIA Price Guide.

Some activities are deemed to be inherent to a specified task in a plan and, therefore, included in the indicative price.  For example, it is assumed that completing a report is an intrinsic part of conducting an assessment of a participant’s ability to drive.  The price covers the cost of completing such a report.

There are various types of establishment and service co-ordination fees that may be payable to providers based on their role or status in the delivery of an individual’s plan.  Such payments are not automatic, however, and providers should seek clarification before entering into an agreement with the NDIA about what is and is not included within a payment if they are in any doubt.

5. NDIS rates and changes to the rates: what are they, how to find out about them?

Go to the NDIS web site page on Pricing and payment. The page contains the current NDIA Price Guide as well as information about prices, latest price increases, GST and more.

If you need to ask for more information the NDIA advises you to direct detailed queries to your local NDIS site Engagement personnel or the NDIA provider support team at provider.support@ndis.gov.au

6. How do we create a billing process which fits with the NDIS?

If you are new to the NDIS we strongly recommend that you visit the NDIS web site’s pages for providers where the essential information about working with the NDIA is located as well as accessing the Provider Toolbox.

The Pricing and Payment section includes:

  • The Price Guide
  • Payment and Assurance information
  • Application of group prices
  • Archive price guides
7. What does an existing business need to do in order to operate in the NDIS market, aside from billing and pricing?

In most cases, you will need to register if you are providing or intending to provide services to more than a small number of people. This is because most people continue to ask that the NDIA manage their payments for at least some of their services. The NDIA will only make payments to registered providers.

Registration requirements vary according to the service type for which you wish to register. It will include requirements related to professional accreditation for therapy services and requirements related to quality and safeguards, such as having relevant Working with Vulnerable People checks done.

The references in the answers to Questions 1 and 6 provide more detail.

8. Will there be enough demand to sustain the business?

The NDIS will lead to a substantial expansion of the disability support sector. It is estimated that approximately 260,000 to 280,000 people with disability currently receive some degree of support through a service funded by a State or Territory Government. That number will rise to around 460,000 people with disability by July 2019. It is expected that the national funding of disability supports through the NDIS will double to $22 Billion (at today’s value).

It is clear that the number of people with disability receiving funded support will increase and the amount of taxpayers funds allocated to disability support will roughly double. This expansion in numbers and funds will be fully implemented by 2019.

For the ACT the expansion is expected to match that in proportionate terms. The number of people eligible to receive support who are resident here will be in the order of 5000 by the second half of 2016 – about double the number receiving support prior to the NDIS.

It is equally clear that profound changes will occur over the next 5 to 10 years in the ways people with disability will expect to be supported. Individuals will have much greater choice and control over the supports they receive. Services will need to be delivered in new ways and this will provide opportunities and challenges.

The move towards a more market-oriented approach to providing disability support services will require every provider to carefully and systematically consider its response to these new and developing circumstances. Precisely where demand will be and how it will be divided and spent is part of the market research every provider or potential provider will want to think about and review. Every organisation will need to determine its own view on business development, sustainability, attitude to risk and strategic objectives.

9. How can we maintain equity of support between NDIS participants and our clients who may not meet the NDIS access requirements?

The ACT Government has stated that:

If you don’t meet the requirements, you won’t be able to enter the Scheme. However you will not be disadvantaged and will still be able to access the same level of supports you already have.

 This does not mean that there won’t be differences in the available funding.  Additionally, there will likely be a need to make decisions made in relation to service support for people who are eligible for the NDIS, but who have not, or who do not, seek support under the NDIS.  Funding is likely to cease for this group at some point.  Each organisation will need to strategically consider how it will address such differences and issues.

 To keep up to date with the ACT Government’s responses to the roll out of the NDIS we recommend visiting the ACT Department of Community Services web pages on the NDIS.

 

10. Which client groups of people with disability are supported by the NDIS in the ACT?

The NDIS is a new way of providing individualised support for eligible people with permanent and significant disability, their families and carers. Unlike many existing disability support systems the NDIS is not limited to working with particular client groups or diagnostic categories based on medical classifications.

In the Australian Capital Territory the access requirements to become an NDIS participant are as follows:

  • You must have a functional impairment arising from a disabling condition that is likely to be permanent and the impairment makes it difficult to take part in everyday activities.
  • You are under 65 years when submitting an access request.
  • You live in the ACT.
  • You meet the NDIS Act 2013 “Disability Requirements” or the “Early Intervention Requirements”
  • You are an Australian citizen or permanent resident or a New Zealand citizen who is a Protected Special Category Visa holder.

More detailed descriptions of the NDIS access requirements are available on the NDIS web site here

11. How does the NDIS operate quality assurance and standards?

Until the NDIS is fully implemented, the NDIA is using existing state, territory and Commonwealth quality and safeguarding systems in making decisions about the registration of support providers. NDIS participants continue to have access to the same avenues for raising concerns and making complaints as operate now in each State or Territory.

Each state and territory has slightly different requirements of disability service providers operating in their jurisdiction. In addition to expected professional requirements and expertise, providers must satisfy and comply with jurisdictional requirements relevant to the state/territory/ies in which they are providing service. Details can be found in module 4 of the Provider toolkit titled: “Guide to Suitability

The DSS conducted a public consultation on quality and safeguarding in the NDIS in early 2015. In November 2016 the consultation report was released and can be found on the DSS web site here.

The Australian, state and territory governments have agreed to work together to develop a national approach to quality and safeguarding for the NDIS. Nationally, the lead agency responsible for this work is the Commonwealth Department of Social Services (DSS). Information about their work in this area can be found on the DSS web site pages on the NDIS Quality and Safeguarding Framework here. It is anticipated that the framework should be in place by July 2018 in the States/Territories who have fully transitioned to the scheme. Commonwealth legislation is expected mid-2017.

12. Is there a list of registered providers available?

Yes. Go to the NDIS web site Provider lists here

13. What training do I need to enter the NDIS as a small business providing professional services?

The NDIA has developed and published guidelines on the criteria it applies to assess the suitability of any organisation seeking to become a registered provider of supports. Review the Terms of Business in Module 3 of the Provider Toolkit and the Guide to Suitability in Module 4.

14. What are the arrangements for making service agreements?

The NDIA sets out guidance for participants and providers on making service agreements on the NDIS web site. Information and advice on service agreements and links to other relevant NDIA resources, is available on the Provider home page and in Module 5 in the Provider Toolkit.   As well as in the participant - Service Agreements with Providers

15. Do NDIS clients need to have their own public liability, workers comp, or other insurance for service providers they engage?

Not unless the participant is self-managing their individual NDIS plan and directly engaging their own staff in which circumstances NDIS participants are subject to the same requirements as any other employer.

If you are providing support to an NDIS participant who is not self-managing an NDIS plan your obligations and legal duties are exactly the same as those for any other client or customer.

16. Can providers access a participant’s plan to facilitate its implementation?

The decision to share some or all of an NDIS individual plan belongs to the NDIS participant. Providers have no right to access a participant’s plan and may do so only with the consent of each participant.

The NDIA gives advice to participants on Sharing your NDIS plan with Providers on its web site.

Access to the participant’s plan – if it is shared – or part of it, can be undertaken on the registered provider claiming portal.

While significant in ascertaining some elements of a person’s goals and expectations, the participant plans are, since 1 August 2015- much more open documents in relation to how a provider may contribute to a participant’s desired outcomes. With the move away from the formerly detailed and prescriptive approach, the plan is becoming more of a part of the information needed rather than a compendium detailing expectations in relation to how the plan might be implemented.

17. How do we inform the NDIA of any issues or problems?

If you are looking for answers to questions about the NDIS we strongly recommend that you visit first the NDIS web site’s pages for providers where the essential information about working with the NDIA is located.

If you can’t resolve issues via web site and need to ask for more information the NDIA advises you to direct detailed queries to your local NDIS site Engagement personnel or the NDIA provider support team at provider.support@ndis.gov.au

If you are a member of ACTCOSS or NDS you can, of course, also raise your concerns through these bodies – which are both members of the ready4 consortium. There are also other peak bodies that provide liaison and submissions in areas such as mental health and early childhood intervention. NDS and ACTCOSS provide for membership in accordance with their constitutions and would be happy to discuss eligibility and benefits with you.

There are specific fora for raising issues in the ACT including the CEO forums with the NDIA hosted by NDS, regular forums with the NDIA by the mental health and early childhood peaks respectively, consultations and training undertaken by advocacy bodies and, for community service providers, various forums led by ACTCOSS. Contact us or visit the ready4 events page for more details.