A key principle of the National Disability Insurance Scheme (NDIS), is that people with disability are empowered to exercise choice and control and access a wide range of mainstream and community-based support, both formally and informally. This will require greater connectivity, integration and collaboration between suppliers across all market segments within the sector.   Collaborating through service partnerships is a critical element of the success and sustainability of the NDIS. These service partnerships are established not only between two or more service providers providing NDIS funded services to participants but also between NDIS services providers and mainstream service providers providing integrated services to a person with a disability. In those organisations which provide both NDIS and mainstream services, effectively managing this internal collaboration is important. As cautioned by the Council of Australian Governments (COAG) Disability Reform Council “… It is important that the NDIS does not become responsible for support that is not within its scope, and equally important that mainstream services do not become responsible for support that is the intended responsibility of the NDIS. Effective interaction between the NDIS and mainstream services is critical to ensure smooth transitions for participants and to avoid cost-shifting, duplication and the emergence of service gaps…”. This workshop firstly considers the need, benefits and risks of developing collaborative service partnerships between your organisation and one or more service providers providing NDIS funded services to the same participant who exercises their right to choose and control who provides the whole or part(s) of their NDIS funded supports. In addition, the development of collaborative service partnerships between NDIS and mainstream services is outlined.

WORKSHOP OBJECTIVES Reviewing the statutory scope and conditions of NDIS funded supports NDIA’s facilitation of the participant’s plan of all supports Limitations for NDIS funded “reasonable and necessary supports” Negotiating with participants choosing multiple service providers Setting up collaboration agreement with other service providers Effectively managing risks in collaborating with participant’s other providers of NDIS services Collaborating with mainstream service providers to avoid cost- shifting, duplication and service gaps

Reviewing the statutory scope and conditions of NDIS funded supports National Disability Insurance Scheme Act 2013 National Disability Insurance Scheme Rules (pursuant to sec. 17 of Act) Relevant this workshop: Supports for Participants Plan Management Nominees Registered Providers of Supports NDIA’s CEO “Operational Guidelines” (pursuant to a Rule under the Act) Relevant this workshop: P&A – Supports in the Plan P&A – Risks & Safeguards P&A – Plan Management Decision Nominees – Appointing a Nominee Nominees - Duties & Removal of Nominees

Reviewing the statutory scope and conditions of NDIS funded supports NDIS Act 2013 (Cwth) – sec. 3 – Objects of the Act: (extracts only) Provide reasonable and necessary supports for participants in the NDIS launch (s.3(1)(d)) Enable people with disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports (s.3(1)(e)) Adopting an insurance-based approach, informed by actuarial analysis, in the provision and funding of supports for people with disability (s.3(2)(b)) In giving effect to the objects of the Act, regard is to be had to … the need to ensure the financial sustainability of the NDIS (s.3(3)(b))

Reviewing the statutory scope and conditions of NDIS funded supports People with disability have the same right as other members of Australian society to be able to determine their own best interests, including the right to exercise choice and control, and to engage as equal partners in decisions that will affect their lives, to the full extent of their capacity. (NDIS Act s.4 (8)) Participant’s Plan must include any general or reasonable and necessary supports that will be provided or funded as part of the plan. Supports must provide value for money (s.34 ) Delegate documents statement of reasons for the decision (the letter that accompanies the provision of the plan) and provide a copy of the plan to the participant within 7 days.

NDIA’s facilitation of the participant’s plan of all supports “There are four ways you (participants) can manage the funding for your supports: 1. Self-managed 2. Registered plan management provider 3. NDIA managed 4. A combination of the above. “ (NDIA Factsheet “Managing your supports and NDIS funding” p.1)

NDIA’s facilitation of the participant’s plan of all supports – NDIA MANAGED PLAN

NDIA’s facilitation of the participant’s plan of all supports – SELF-MANAGED PLAN (Participant or Nominee)

NDIA’s facilitation of the participant’s plan of all supports – PLAN MANAGEMENT PROVIDER

Limitations for NDIS funded “reasonable and necessary supports” (See separate handout p. 2 of 48) a. The support will assist the participant to pursue the goals objectives and aspirations included in the participant’s statement of goals and aspirations, and b. The support will assist the participant to undertake activities, so as to facilitate the participant’s social and economic participation, and c. The support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support, and d. The support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice, and e. The funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide, and f. The support is most appropriately funded or provided through the NDIS, and is not more appropriately funded or provided through other general systems of service delivery or support services offered by a person, agency or body, or systems of service delivery or support services offered: i. As part of a universal service obligation, or ii. In accordance with reasonable adjustments required under a law dealing with discrimination on the basis of disability, and g. The support is not a support mentioned in Part 5 of the Supports for Participants Rules as a support that will not be funded or provided by the NDIS. See s.34 of the NDIS Act and Part 5 of the Supports for Participants Rules.

Negotiating with participants choosing multiple service providers (See separate handout pp 19-21 of 48) Participants’ right to choose one or more service providers for same or different categories of NDIS-funded supports Benefits and challenges - multiple service providers contracting, delivering and invoicing for same categories of supports – cost- shifting; duplication; service gaps, opportunities to synergise the strengths of more than one service provider etc. (others?) If possible copy of Plan and disclosure of multiple service providers If possible – written service agreement to include permission to coordinate service information with other formal and informal service providers (particularly privacy policy and use of information release) Regular monitoring of portal (for NDIA managed plans) service data visible to you as registered service provider under a service agreement with participant.

Setting up collaboration agreement with other service providers (Handout – example to critique) Essential that NO collaboration between service providers without permission (written?) of participant/nominee If possible any “collaboration” agreement should be signed by participant and the collaborating service providers. Risks and challenges??

Setting up collaboration agreement with other service providers: levels of collaboration

Effectively managing risks in collaborating with participant’s other providers of NDIS services Continuous monitoring quality services to participants Setting risk appetite for “poor” economies of scale (not enough critical mass to justify providing services with multiple providers) Defining and continuously monitoring exact limits of what is included (and not included) in your services agreed under the Service Agreement (risk of “service- creep” and resultant cost blow out in service agreement compliance) OTHER TIPS AND TRAPS??

Collaborating with mainstream service providers to avoid cost-shifting, duplication and service gaps (See separate handout p. 11 of 48 – General Supports) 54. The term ‘general support’ is defined in the NDIS Act to mean a service provided by the NDIA to a person, or an activity engaged in by the NDIA in relation to a person, that is in the nature of a coordination, strategic or referral service or activity. It includes a locally provided coordination, strategic or referral service or activity. See s.13(2) of the NDIS Act. 55. If a participant would like assistance to identify suitable general supports and community resources, allocation of a Local Area Coordinator (LAC) may be appropriate as a general support in the plan. In this way, the support a LAC can provide a participant is very similar to the support they provide non- participants. See Operational Guideline – Gateway – Local Area Coordinators 56. A key general support for participants will be referral to other sources of supports. In arranging a referral, NDIA officers or LACs should ensure the referral reflects the participant’s choice and obtain informed consent to provide information about the participant to the provider. NDIA officers or LACs should describe the information that will be exchanged, and how and when the support will be implemented. 57. The referral should only contain information related to the provision of the support requested. If there is a risk to the service provider, the delegate or LAC is to ensure that the service provider is appropriately informed without breaching the participant’s privacy. 58. NDIA officers or LACs should check that the referral has been accepted and the support implemented.

Final questions? Thank you