There are 3 different ways you can approach the financial management of your NDIS plan. The way you choose to manage your plan can impact how you are able to spend your funding and what sort of services you can use.
It is important that you have a good understanding of each model and what will work best in your individual situation. When you start the planning process your Local Area Coordination planner or NDIA planner will probably expect you to know how you want your plan funding managed.
Here is an outline of the 3 models of financial management, how they can work well and who can assist you in your plan management. – if you choose options 1 and 2, then I can be of service to you. – best wishes, Mark
1. SELF MANAGED
During your planning process you will nominate that you want to self-manage your funded plan and will provide the NDIS with the details of a dedicated NDIS bank account. Once you have your plan approved the NDIS will deposit 1/12th of your total funding into your bank account – this will act like “petty cash” for you to purchase services from.
Under the self-managed model you are not restricted to NDIS registered providers but can purchase supports from the most suitable provider, mainstream or disability sector. This can allow you use providers in your local area, smaller “boutique” providers, innovative and alternative services.
They must however have an ABN and you should always look at what additional insurances or qualifications they should hold relevant to the service you are engaging them for. Providers who are not registered with the NDIS are not bound to their regulated price list – this may mean they charge more or could mean they charge less. It is up to you to work out your budget and decide what supports will best help you achieve your goals. You will negotiate the services you want with the provider, they will then invoice you for the services provided. You can pay them straight away from your “petty cash”. You then access your plan via the NDIS Portal, input the details of the invoice, decide what section of your plan you want the funding from come from and then the amount of the invoice. You then need to file your invoices so they are available for review or audit. In 2-3 days the NDIS will deposit your claimed amount back into your bank account.
This model provides the true “consumer experience” with full freedom to purchase the services you feel are best suited to assist you achieve your goals. It is more work, in addition to the freedom to choose you also accept the responsibility of managing the budgets for your funded supports and making informed choices about the services you chose.
Many therapists, in particular psychologists, will not register with the NDIS as their rates are higher than the regulated amount. More control over who you engage can mean a higher expectations from service and higher outcomes.
We have also seen the NDIS work in an “accrual” model for this – they do not advance a percentage of the plan but deposit the invoice amount once it has been claimed on the portal. This usually takes 2-3 days so in this case you need to negotiate a 7 day account with your providers.
Self-Managed plans will usually include support in the “Improved Life Choices” cluster of supports in the form of Supports Connection or Coordination of Supports. This will help you become more confident about how to access, manage and claim against your plan. Support you to connect with providers, negotiate for the services to best suit you and also connect you with other supports in your community. Assist you with budgeting, record keeping and monitoring your services.
2. SELF MANAGEMENT USING A FINANCIAL INTERMEDIARY OR FINANCIAL & SERVICE INTERMEDIARY.
This model gives you all the advantages of the previous self-managed model. You make the choices about who supports you based on what your needs are and you are not restricted to registered providers. In your planning process you will talk to your LAC planner or NDIA Planning Support Coordinator about wanting to engage Plan Management Assistance (PMA). When you get your plan it will include funding for these services.
Once you have your plan in place you will then find a financial intermediary or Plan Manager to assist you. This is the hard part as most PMA is delivered by larger providers and they would also expect to provide other supports in your plan. This is OK as long as you are aware of the potential conflict of interest. There are more independent organisations in the process of registering for PMA so it is worth doing your research to find one that will work positively with you.
As for self-managed, you decide what support will work best for you, you will engage the providers of your choice and they will provide services to you. You can then decide to have the invoices sent to you for approval so you can pass them on to your Plan Manager for payment or you can decide to allow them to be sent to your Plan Manager. They will then claim the invoice from your plan through the NDIS Portal and then pay your providers. This process can take 5-7 days so it is best to work on a 14 day account.
Your Plan Manager will then file and record your invoices, track and monitor your expenditures and provide you with regular updates around how your plan is tracking.
There are 2 levels of plan management. Financial intermediary is simply support to process, claim and pay invoices. Financial and service intermediary provides you with support not just around processing payments but also negotiating with service providers. You will also have access to support from a Supports Coordinator who, as mentioned previously, will work with you to find the best providers to support your goals and also connect you with other supports in your community.
3. AGENCY MANAGED
In this case the Agency is the NDIS – not a service provider.
Once you have your approved plan the funded amount is held by the NDIS. Under an Agency managed plan you can only engage providers that are registered with the NDIS. This means they have satisfied the state government specialist disability provider requirements in order to gain this registration. The number of businesses going through the registration process is increasing but in general they are the more traditional disability providers. You still have the right to choose from the list of registered providers in your area, and to negotiate with them for the supports you want. You can still change providers if you are not satisfied with their services. Registered NDIS providers can only charge a maximum amount for their services as set down by the NDIS in the state/territory price list.
Once you have agreed on service and signed a service agreement the provider will provide the services and is then able to claim directly from the NDIS and your funded plan for the services they have given you. They should still provide you with regular invoices or statements so you can track the services they are claiming for.
This option is a good one for people with large accommodation packages, in home assistance or therapy packages. If you are happy with the way things are working you can just let the service “tick over”, allowing you to concentrate on other things.
Under the new operating model with Local Area Coordination, if you have an agency managed plan you will most likely be expected to rely on the assistance of the LAC officers to implement your plan but you may still be able to request some Support Connection, Coordination of Supports or Specialist Coordination if you can show them the need for this.
It is also important to know that you can use a combination of these models to get the most from you plan.
You may have your in home supports Agency managed then use the Self-Managed model for your 1:1 skill building supports so you can make the most of your funding and get the best outcomes.
One of your key therapists may not be planning to register with the NDIS so you will need to Self-Manage your therapy funding to continue to access their services.
Plan Management Assistance is an excellent option for those wanting to have the maximum of choice but without the financial risk of directly managing their funds.
3 Models, each with their own advantages and challenges that you can make decisions about. It’s your plan, your way.
source: Australian Psychological Society InPsych magazine (latest edition at March 2016)