When NDIS Planning Goes Wrong, What Happens?

The NDIS is in its early years, and like any toddler, it is a contradictory mix of fond memories and sleepless nights, joy and tears. The Scheme is designed to provide Participants with the support they need for everyday living while building their capacity and helping them reach their individualised goals. When a Participant gets an NDIS plan that does this, it can produce fantastic results. However, it is no secret that planning does not always go well, and when it goes wrong, it can cause a lot of stress, confusion and frustration for everyone involved.

The planning process has proven itself to be a teething nightmare. Providers, therefore, need to be on the lookout for common problems that can produce poor results for Participants and the people in their lives.

So, what can go wrong? (hint a lot!)

 

Problem 1: The Participant has less funding than before.

When a Participant gets their plan, they may discover that a support they previously received has either been left out or will not be funded by the NDIS.

This may occur because Participants are unaware of what supports to ask for in planning meetings. Prior to the NDIS, people may have received funding from a variety of Federal and State sources. Some of these supports would have been individualised, but others would have been block funded. If block funded, a Participant may be unaware that they were even accessing a service. Consequently, it gets left out of a plan, resulting in a lengthy process to get it back.

Furthermore, a support that a Participant previously received may not be funded under NDIS. While some States have implemented a “no disadvantage” rule, this only applies to supports that NDIS will fund.

If a support is no longer funded by the NDIS, there is an expectation that the LAC or NDIS Planner will notify the Participant and help them explore other options.

 

Problem 2: Participants cannot use a provider of their choice.

Usually, if a Participant cannot purchase a support from a provider, it is because that provider is not NDIS registered.

There are three ways to manage NDIS funds- Agency Management, Plan Management and Self Management.  If a Participant wants to use unregistered providers, they must be either Plan or Self Manage those funds. If this is not adequately understood in the planning meeting, it can lead to problems once the plan is in place.

 

Problem 3: Participants are either not shown or do not understand their plan

The NDIS plan rightly belongs to the participant. It is their choice whether to share it with service providers or other supports in their life. However, for choice and control to work properly, Participants need to be able to understand their plan and what to do with it. Unfortunately, plans have a language of their own. It may take Participants a while to understand what they have been funded for, leading to a lot of confusion and delays.

Moreover, providers are not always notified when a new NDIS plan takes effect. They must rely on their relationship with the Participant to stay informed of changes that occur. This can lead to a range of problems including significant setbacks in getting the plan set up, invoices being reissued, service bookings and agreements being changed, and delays in payments and supports.

 

Problem 4: Participants don’t know how to access the Portal or find services and supports.

The NDIS Portal can be a great source of information for the participant on their plan, how much they have spent, their service bookings, and what services are available.

That is, when it is working. In order to access the Portal, Participants are required to link their MyGov account to the NDIS through an activation code. If you have ever tried to link anything to a MyGov account, then you know how much can go wrong. For one thing, the activation code is time-limited. Often by the time the Participant has worked out what they need to do it has expired, requiring them to get a new one. This small but significant step can be delay the Participants understanding of their plan, especially if they do not hear from NDIS in the weeks following their plan going live.

 

Problem 5: Plan reviews can take a (very!) long time.

When a plan does go wrong, Participants can request an internal review.  This triggers the creation of a whole new plan, as plans cannot be adjusted, only replaced.

The delay between the initial plan and the review can be anywhere from a few days to a few months. Lengthy review times put everyone in a tricky position. Participants can be unsure whether to continue with existing supports or stop altogether. Providers are forced to decide whether to proceed with a service and risk not getting paid.

 

Ways providers can assist participants

Of course, these are just some of the problems that Participants and providers may experience. However, there are ways you as a provider can assist Participants to meet these challenges.

Participants have a number of options available to them to solve their problems. The most common two are making a complaint and/or asking for a review. Assisting Participants with these steps can improve their outcomes and lead to less delays for you as a provider. 

Here is how you may choose to support participants:

 

Help Participants understand their plan and explain the review and complaint processes.

Participants may be relying on you to help them understand their plan and the review/complaints processes. Here are three processes you want to get your head around:

  1. Making a complaint: https://www.ndis.gov.au/about-us/contact-us/feedback-complaints
  2. Requesting an Internal Review: https://www.ndis.gov.au/participants/reasonable-and-necessary-supports/decision-review
  3. Understanding the plan and Supports https://www.ndis.gov.au/participants/understanding-your-plan-and-supports.html

 

Provide training and support to frontline staff on the review and complaints processes.

Frontline staff are already working with Participants everyday, so why not train them to support Participants through these processes? Giving frontline staff the right training and resources can save everyone valuable time and energy.

 

Creating an action plan with Participants to work towards their goals.

When a Participant starts a new plan, it can make a big difference to them if you create an action plan that highlights how the plan will be put in place. This will allow them to track progress towards their goals.

 

Put the Participant in touch with the right people to support them.

Sometimes, no matter how much you might want to, you will not be able to provide the Participant with the support they need. If that is the case, you should consider putting them in contact with an advocate.  Dana have a list of advocacy organisations that maybe be able to help.

 

If the participant has less funding, brainstorm creative solutions together.

At times, you might have to be creative to help a Participant get the most value out of their plan. Are their opportunities for the participant to share their support dollars to reach common goals? Can you support the participant with problem solving and planning skills to enable them to look at other alternatives?

 

Having a provider willing to help you navigate the rapidly changing and diverse NDIS world can be life changing. Sometimes it is that little bit of extra support that can be the difference between a good and a great provider.