Navigating NDIS Plan Changes and PACE: Everything you need to know - Webinar Replay

Webinar Replay

15 Feb

This webinar is all about demystifying the NDIS plan change process and to get you acquainted with the new NDIS computer system, called PACE.

Together with our special guest NDIS expert, Sally Coddington, Principal Consultant at DSC, we delve into:

The terminology, time frames and processes of NDIS plan reassessments, variations, check-ins and change of situations requests.
Some tips on being prepared for your planning conversations, that will help ensure a balance of power between you and the planner.
What to do if you are not happy with an NDIA decision about your plan.
An overview of the biggest impacts the new PACE system will have on participants.

- The NDIA should respond to your request for a change within 21 days, and putting the requests in writing helps to keep track of the communication dates. Make sure you have evidence to supply about any changes that impact your support needs. Think about the most appropriate type of evidence to show that change. It won't always be an OT report, and there's no harm in supplying things like carer statements.
- Do your pre work and be clear on how the supports you want funded meet all the reasonable and necessary requirements.
- If you are requesting an internal review of what has been included in your plan, use the 3 month request deadline to gather as much evidence as you can to build a strong case. This will make it more likely to be successful and avoid a painful administrative appeals tribunal experience.
- In PACE, endorsing a provider as "My Provider" can happen instantaneously over the phone with the NDIS call centre, stay on the line as they do it for you straight away.
So hello everyone and welcome to our webinar Navigating NDS Plan changes and pace everything you need to know.
My name is Erin and I'm part of the team here at Kinora. I'm also joined by Yvette who will be manning the chat. If you're Kinora member, you might already know as coach is within the community today. We are extremely fortunate to be joined by Sally Coddington who is a Principal Consultant at DSC. Hi Sally.
Now DSC are experts in all things NDIS. They provide training and consultation services within the disability sector and they have kind of become the go to place for news when anything big happens in the NDIS at least I know I always head straight to DSC to get their take on any big changes. Which is why I am so excited to have Sally here today with us to delve into not only NDIS plan changes, but changes to the NDIS system as a whole and how it might affect you. So just before we get started, a brief background on Kinora.
If you're not already a member, Kinora is a safe and supportive online community where you're able to get support for your NDIA questions from us coaches and our community of thousands of other NDIS participants, support coordinators, families as well as service providers who are experts in their fields.
If you've been to one of our webinars before, you might know that we record these sessions to share the video replay and any resources that we mentioned within the Kinora community.
If you're not already a member, though, don't worry, we'll send you the replay and resources direct to your inbox. But of course, we'd love to have you as a member. If you do want to join, it is totally free.
If you need closed captioning today, you can turn that on by clicking More Actions at the top of your screen and then select Turn on Live Captions and also at the top of your screen if you hit that chat button. This is where you can introduce yourself, Pop in any comments or ask any questions as we go. That will be monitoring the chat for any questions that come up, and we'll answer those at the end of the session. Any that we don't get time to get to today, we will make sure we'll put the answers within the Kinora community and provide you with direct feedback.
Finally, before we jump right into it, I'd like to make an acknowledgement of country. In the spirit of reconciliation. Kinora acknowledges the traditional custodians of country throughout Australia and their connections to land, sea and community. We pay our respect to their elders, past, present and future. We acknowledge the culture, diversity, knowledge and experiences of first sorry First Nations people, and celebrate their contributions and specifically those living with disability, their families, carers and individuals dedicating themselves to a career in supporting people with disability.
If you're just joining us, the goal of today's webinar is to demystify the whole plan change process and to get you acquainted with the new NDS computer system called PACE. Because most new plans will be rolling over onto place onto PACE, Sorry, since the rollout began late last year.
So let's let's face it, change can be a bit nerve wracking. And right now there seems to be a whole lot of change going on in the NDIS. So not only have the NDIS moved on to this whole new computer system, but we've also had the NDIS review recommeNDIAtions come out and there's a bit of uncertainty about what's going to come out from that.
In the midst of all these big NDIS updates. You might also have a regular planned reassessment coming up or perhaps a major life transition that's going to affect what supports you need in your plan. So it is no wonder if you're feeling confused or even a bit scared in all of this uncertainty.
Change is inevitable and we can't dodge it, unfortunately. What we can do, though, is prepare ourselves by understanding the ins and outs of the NDIS, the language, the processes, the systems, and getting past all of the jargon and misinformation out there. Because knowing what lies ahead and what to expect is the best way to navigate through any kind of adjustment.
So my hope for today is that you'll walk away with a clearer understanding of the processes involved in planned reassessments and variations, some practical tips to help prepare for them, and a solid understanding of how pace fits into your NDS. And I really hope that this makes you feel more confident and in control and that it makes those inevitable changes a lot less bewildering when they do crop up.
I'm just gonna get rid of this screen here. It's, uh, there we go. Sorry. Button is always moving around on me. There we go. Alrighty. So without further ado, let's get started. Sally, thank you so much for joining us here today.
Really excited to have you welcome for having welcome, welcome, Thank you for having me. And I just have to say that I have the most amazing storm right above my head right now. So. So fingers crossed, the Internet stays and everything's great. But thank you for having me, Erin. And I just wanted to add, you know, a little bit to my bio is that one of my three daughters, Nikki, was one of the very first NDIS participants. And so I often bring the perspective of UH, the mom of a participant and definitely interested in seeing um participants and families having spectacular NDS outcomes. So you're gonna get a little bit of a biased point of view from me.
That's good. That's exactly the point of view we want to have, Sally. So, thank you so much.
So I think the terminology around plan changes can get a bit confusing. I know myself I still go back to plan reviews all the time and just flip back and forth. Yeah. So I think it really confusing. So I think to start with we should just level set a bit, go through what the different types of plan changes are and sort of when they might happen. So do you just want to talk us through first what a planned reassessment is and when and why this might occur? Yeah, sure. So
I'll just start by saying that, you know that the reason why the NDIA changed their language is because they recognised that this term plan review had meant so many different things. And So what they're trying to do now is they're trying to change the language, but not everybody's got the memo. And so you will still find a lot of us who've been in the NDIA for a long time using the wrong language, a lot of planners ironically using the wrong language.
Um, but you're right. So, um, two types of changes, a variation and a reassessment. And we'll start with the reassessment. Um. So you know, there are times when plants need to change for a whole variety of reasons.
And it might be that has entered into a new life stage. Uh, it might be that a persons goals have changed and it might be that you know as the person gets older, their support needs change. You know, sometimes the impact of your disability changes on your everyday living as you get older. And so a plan reassessment is kind of what we used to call a full plan review. It is a completely new plan being built from scratch. So a reassessment is when the NGO goes back to the drawing board and they rebuild a new plan from scratch, right?
Yeah. And is that going to happen? Obviously at the end of a plan. But it could also occur at other times. Yeah, it's, it's, it's a good question. So reassessments can be initiated by participants and their families, but they can also be initiated by the NGA as well. And so ypically speaking, UH, we no longer call the end of a plan the plan end date.
We now call it the reassessment date. And so as the reassessment date approaches, the NDIA may choose to do a reassessment or they might choose to do a plan extension. And in fact we, we used to call it a plan extension, rollover or continuation. Those are now all examples of planned variations. So we can talk about that when we come to a planned variation.
So as the reassessment date approaches, they might choose to do a plan reassessment to build an entirely new plan from scratch or they might just say, you know what, we're gonna extend this existing plan by 12 months. We're gonna add an additional 12 months of funding on and in fact the reassessment doesn't occur in that particular case. So the NDIA might decide to the to do that. They may also decide based on any additional information that they received from us or from our support coordinator or our local area coordinator, or who else is in their life.
They might decide that a reassessment would it be a good idea so they can actually initiate A reassessment at any point in time, but also participants and their families can request a reassessment as well. So there's a new form called Change of Details and Change of Situation form, a multi-purpose form that can be used to request a reassessment or a variation, which we'll talk about in a tick. I do suggest using the form. Now, I know that there are different ways that you can request a reassessment.
So you can do it with an email. You could do it over the phone. You could ask your local area coordinator. But I find it's always good to have these things in writing. It's good to have evidence that you submitted the request. And the reason why I think the form is a great way of doing it is because it's giving the NGIA the information they need to be able to determine, yeah, is it a good idea to do a reassessment now or or not. So a reason request for a reassessment can come from the NDIA.
It can also come from of the participant. Yeah, yeah, OK And so that form really guides people on what the NDIS needs to know to help them make their decision as to whether or not they'll agree to a reassessment, right. Yes, that's right. A little, a little bit extra That I wanna add to it, if you don't mind, is that there's something called the participants service guarantee. Google that Yvette and see if you can add it.
Fabulous resource. And for any people who don't are unaware of the Participant Service Guarantee, there are certain time frames around various processes that the NDIA is required to meet. And in in in the context of a reassessment, if you request a reassessment, they're actually required to respond to that request within 21 days. So I think it's really helpful for you to know that and hold the NDIA accountable to that as well. So you shouldn't be waiting for months and months and months and months and months.
You should be getting that response within 21 days. Yeah. Now, like how you said to put it in writing. So if you're emailing that form or something, you've got definitive proof there of the date that you sent it. And you could even put it in your caleNDIAr for 21 days from then or something. You know, check, Have I got a response yet? If not, follow up. That's probably a good idea. Yeah. So what is the difference then between a reassessment and a variation? Right. So a variation is a change to an existing plan and a reassessment is an entirely new and being built from scratch.
And actually the reason why, um, we now have the option of a variation was because partway through 2022, there was an update to the NDIS Act, which gave the NDIA the authority to vary a plan. And if we can put something through as a variation, it's a really, really good outcome. So there's a number of reasons why we can request a variation. So the NDIA can do a variation to extend an existing plan.
So that's an example of the variation. Um, we can request a variation if we get a plan back and there's an error in there. So that error can now be fixed with a variation. UH we can use a variation to change funds management type. So if we are let's say we are agency managing our therapy budget and we just cannot find a registered OT with capacity, we could then request a variation to have that therapy budget plan managed instead so that we can tap into the non registered OT market.
There are other reasons as well. So that is add items of assistive technology and funds for home modifications to make it change to an existing data support UH and UH in times of crisis or emergency we're funding needs to be added that may be added with a variation keeping in mind that it needs to be a disability related need.
So variations are are a great option and we use the same form, so the same form that we would use to request a reassessment we can also use to request a variation and again the NDIA's required to respond to the 21 days. So you know, helpful to know about those forms and also helpful to know that the NSA has those time frames that they that they need to make.
So at any point in time you can request a variation and I think my favourite is being able to change funds management type at any point in time. That can become really handy. Yeah, yeah, yeah, I know people that have been self managed that maybe it was you know a bit too much work all of the admin side of things.
So then have changed over to plan management halfway through. So handy on that form, I'm interested, do you have to say whether you would prefer a reassessment or a variation or are you just saying what the change is and then the ND IA decides which way to go with it?
Fabulous question, right. So you do you, do you have the option of saying I want a variation, I wanna reassessment or I don't know what I want, but it is important to know that a request for a variation could lead to a reassessment. We're all a little bit nervous about reassessments, aren't we?
I know that, I know sometimes reassessments can be a bit stressful and a request for a reassessment could lead to a variation. So the NDIA might look at your request for a reassessment and say you know what, we don't have to do an entirely new plan.
We could push this through as a a variation and that's a good outcome. But yeah, the form will ask but but that doesn't stop the NDIA from deciding if there might be a more appropriate response than what you've asked for. Yeah, yeah. OK. So just with those time frames obviously leading up to the end of the plan, they have started these check in calls now as part of that process to towards a reassessment. Just wanna talk through what a checking call is and what the outcome of that might be as well.
Yeah, good, good, good. So um, uh and and I think later on we're going to talk a little bit about PACE, which is this new IT system. So what you're probably gonna find is that the check in process is going to become a very regular part of how the NDIA engages with participants and their families under PACE. So you'll see it most likely under PACE, but they are using it a little bit ad hoc elsewhere otherwise, and so they'll be two types of check-ins.
There will be what is called a scheduled check in which will happen at least once a year.
It might happen more often if a participant has a particularly complex life or particularly complex support needs. So it could be a quarterly, it could be twice a year better, It'll be at least once a year. So that's the the schedule check in.
Then there's something called a discretionary check in. It's kind of like the the pop quiz of the check in world. And and so there are there are going to be certain red flags I guess at the NDIA that might initiate a discretionary check in.
And that could be something like um if you're spending your funding too quickly and the NGA is getting a little bit nervous or you know just as equally of concern if you're not spending your funding at all and the NDIA is getting a bit nervous. So scheduling services or something. That's right. That's right. Could be any of those things. And so there's two types of check-ins. And they will typically be a phone call, but you can of course request them to be in other formats.
And that's appropriate because they need to be in formats that are are accessible to people. And typically that phone call will come from your NDIS key contact. So if you are a child aged under 9, then that's likely to be your early childhood partner. Otherwise, it will either be a local area coordinator or it will be an NDIA planner. But whoever is your key contact will be making those checking calls. Yeah. OK. Yeah, Fantastic.
So you ask me another question. Yes. I'm sorry. So, so this is where Erin's, like, really, this woman could talk about anything forever. And the truth is that when it comes to the NDIA, really could. So the question that you asked me was about like, what's the conversation, What are we talking about in this checking call? And that's a really good question because I don't know about you, but I'm not a big fan of phone calls where I don't know what it's about. And so I think it's really helpful to know what this check in coal is all about. Absolutely.
Ultimately what the NDIA is wanting to do is use the checking calls as a way of determining how well is this funding, how well is this plan working for you and if it's not working 100% perfectly, do we need a variation or do we need a reassessment. So the kinds of questions they're going to be asking is, is the funding in the plan currently meeting your disability related needs? How are you progressing towards the goals in your plan and are these the goals that you want to continue with or do you want to adjust those?
And they are going to ask about how well you're connecting with community and mainstream supports. Because remember, the NDIA doesn't wanna be responsible for everything and they shouldn't be either, right? We should be connecting with a wide variety of supports and services. So be ready to tell them about all the community supports you're connecting with and all of the mainstream supports. And I'll just clarify that mainstream supports and services are those supports and services that are funded by government. That's not the NDIS. So that might be education, health, mental health, child protection, that's the size kinds of things.
Um. And then they're going to ask you, um, has your situation changed in any way or is it likely to change in the near future in any way? And as you can tell from those questions, they're really just trying to get a sense of, you know, how well will this plan work for you in the in the current to near future And do we need to make any tweaks or do we need to go back to the drawing board and build a new plan from scratch? Yeah, OK Yeah, Yeah. You said they should be calling.
Once a year, I know she didn't say once a plan because obviously plans can be longer than a year. So at this point it's not exactly sort of tied to that reassessment process. Is that right? Like it, it might be leading up to that reassessment date, but it might not.
Yeah, so, so, so, so look, I want to clarify and I probably should like we should probably have our own little disclaimers that we say at the very beginning and that would be this. But sometimes the implementation of policy is sporadic, right. And so we know that's that's a polite way of saying it, right. And so there's no, we know what the NDIA says they're gonna do, but your experience could be a little bit different.
What they are saying they intend to do, let's put it that way, they intend to have the in the last year of the plan. And I will say that at the moment the default length is 3 years. So you can request a a plan of a different length, but the default is is 3 years. And if it's a plan that's working for you, God, I want a three year plan, that's for sure. If you're in that third year, their plan is to contact you with that checking call about four months towards the reassessment date and towards the end of the plan.
So they did. I say three months, I know I meant four months. I meant four months. Sorry. Well, I may have said three months or four months. Well, there you go. Well have to. We'll have to rewind it to find something. Let us know in the comments because I can't remember four months, a little while before the end of the plan. That's enough time to sort of, you know, to a little bit of preparation. And if you are going to have a reassessment as a result of that checking call, like if they, if they do recognise that there are some big changes, you've got a bit of time to sort of get things in place. Yes, Yes. So what kind of things can people do leading up to that reassessment meeting if the plan is going to be fully reassessed?
What kind of things can people do to prepare for that meeting? Yeah, Yeah. So. So I I think what's really important here, um, is to clarify um, anything that might have changed for you since you last had this kind of conversation with the NDIA. And you need to make sure that the anything that's changed for you, which has implications for what would be funded in the new plan that you're taking some sort of evidence or that you've presented some sort of evidence to the NDIA to kind of back that up to let them know that that that you that your needs have changed or indeed that your needs have not changed as well. And I think that that's really important as well is to be ready to to say, you know three years ago you determined that these supports were reasonable and necessary for me.
And I'm happy to tell you nothing has changed. And then look, fingers crossed you don't end up with a plan that's all that's dramatically different. But it is really important to be prepared and and I guess that that that might bring us to also talk a little bit about internal reviews as well. Did you want me to get to that?
Let's just talk a little bit more about preparation first and then we'll go on to what happens if you're not happy with the outcome and what to do then. But when you talk about evidence to take to the reassessment, obviously any doctor's reports, you know, therapist reports, anything like that, maybe quotes for assistive technology. Is there anything else sort of out of the box that you would recommend?
Because obviously a lot of people don't want to spend their funding on getting reports because that that can be a huge issue in itself. What other types of things can people be using as evidence in these cases when they're trying to get things funded or show their needs?
Yeah, Yeah. So it's, it's a really good question. And I think, I think that, um, it it's, it's a difficult question to answer because it really, it depends on the reason for the change in support needs and the requirement for the change in support needs. And also that, you know, you hear varying degrees of whether or not the NDIA is willing to accept some forms of evidence over other forms of evidence. And well I don't want to feed into any of the misinformation.
I think that there's no harm in especially when you're not paying a lot of money there's no harm in presenting evidence. For example one of the considerations and so this is for the parents in the room one of the considerations for the NDIA when they determining reasonable and necessary. So those are the six criteria that they need to use to determine if they can or they can't fund something.
One of those criteria is that they need to take into account what's reasonable to expect families, carers, informal networks and the community to provide. And one of the things that planners need to consider when evaluating that is the impact that that caring role has on the well being of the carer and the sustainability of that that that freely given support that the care is given. And so in a case like that, you know, carer statement might be important.
Now some people would say to me, Sally, they're not gonna read a career statement. But you know what? I I think that if part of the support that needs to be added is additional support to make that caring role sustainable, which has, you know, implications on the safety for the participant, of course. And, you know, being surrounded by people who care for them and love them. But I think there's no harm in submitting something like a career statement.
So you know, I think that I think the most important thing is when you are preparing for that reassessment conversation and you think about the the kinds of changes that you want to highlight to the NDIA, consider what would be the most appropriate way of evidencing this. And it won't always be an OT assessment. I think sometimes we lean a bit heavily on functional capacity assessment without appreciating actually how intrusive it is to get those done. And you know, people with disability constantly wanna be evaluated and prodded to get these assessments. So it won't always be an OT assessment. You sometimes you do have to get creative about, you know, what's the best way of evaluating the the person's needs have changed.
Yeah. Yeah. OK And part of the UM, you mentioned the reasonable and necessary criteria there, just about, you know, the parents or the caring question in there. Um, would you recommend people get familiar with that criteria before going into a reassessment so they sort of have a bit of an expectation about what they might or might not fund, like what might be reasonable for them? Yes. Oh my gosh, 100%. In fact, I think that is the fouNDIAtion. So, you know, I've got some nights in front of me and at the very top of my notes, I had the power.
The reason why I had the word power is because, um, you know, when we go into these reassessment meetings, I've got my mum had on right now, everybody, when we go into these reassessment meetings, the power balance is stacked against us. It's stacked against us if we don't understand the requirements that need to be met in order for something to be funded and if we don't have the language to communicate. One of the reasons why I think reasonable and necessary is so powerful
is because it is the six criteria that must be met in order for something to be funded in an NDIS plan.
And and if you only make four of those criteria won't be funded. Five of those criteria won't be funded. And so you need to be ready in a planning meeting to speak to how the things you want funded. Meet all of those criteria. And you know sometimes what will happen is you might for example and I feel like I'm going to put a cat amongst the pigeons but this fun.
But you might go into a planning meeting and you might say, for example, I'd like to have horse therapy funded to help manage the complex behaviour associated with my child's autism. And planners have a habit of coming back and saying things like Oh no, oh I don't know why I always put a voice in. I can't help it. But I oht no, the NDIS weren't fun. That's what planners sound like. Sorry, I don't mean to be disrespectful. I'm just trying to get some about he's talking here character.
And if I haven't done my pre work, if I haven't considered how does horse therapy in my particular child's case meet these criteria, then when the planner says to me, Oh no, the NDIS doesn't fund horse therapy. Well, if you're me, you cry, you have a little cry, right? Because you're like, oh it's so helpful and I'm so frustrated by that. But if I have done my pre work, I can say to the planner will which element it's reasonable and necessary.
Do you have concerns with And then the planner might come back and they might say, well we don't think it's effective and beneficial having regard to current good practise. And I can say I'm glad that you brought that up because ABC and so power dynamics, I mean we're not looking to overpower people but we're looking to to have equal power. We're looking to be able to have those balanced power and those equal conversations around you like does it or does not meet meet the requirements. And so, um, to answer your question, yes, reasonable, necessary.
I think UH is is a profoundly helpful UM for for people when they're negotiating with the NDIA. Yes, absolutely. And in our chat, but just before this started, you mentioned the guide to self management that has that list on page 15. Was it? Yeah. So then put a link to that so that anyone can download that and have a look as well.
It it says it's for plan management, it's applicable to all participants, right? Management says but I wanna clarify. I'm sorry, I would just wanna clarify quickly how the importance of this and how it works, but bear with me for a tick. I'm gonna do some little hand visuals. What is what is funded or negotiated or listed in a plan, and how that plan can be spent are two completely separate things, and they're also two completely different checklists.
So when we are negotiating to have something funded in a plan, we use reasonable and necessary. That's Section 34 of the NDIS Act. But what the NDIS Act also says is that only the NDIA and its delegates have the authority to determine reasonable and necessary. Now, delegates are employed by the NDIA and not all employees of the NDIA delegates, but planners are. We are not delegates. Participants are plan managers, support coordinators, family members. None of us are delegates.
So we don't actually have the authority to determine reasonable necessary. We use it when we're negotiating with the planner because we want to show the delegate how the thing we want funded meets those requirements, right? But we don't have the authority. So the NDIA has published a completely different list of seven questions that are designed to support us.
To answer the question, what can I spend my funds on? Can I buy this with my GIS funds? Can I buy that with my NDS funds? And you will find it on page 15 of the Guide to Self Management. And as Aaron said, even though it's called the Guide to Self Management and it's in there on page 15, it doesn't just apply to self managed funds, it applies to all funds. So when you are attempting to answer the question, well what can I spend my funds on, Can I spend it on this or can I spend it on that?
Those are the questions to refer to. And I think that the most important question of all of those, if I was just to choose one of those questions is do you need the support because of your disability. And I think this is such an important question because I think this is often this is where we kind of fudge things up a little bit, is the question I kind of like to translate it into a different place question. The question I like to ask is would you be buying this if he didn't have a disability?
And I think it has to be honest with ourselves, um, uh, that if the answer is yes, if we would be buying it if we didn't have a disability, it's probably not a disability related need and we probably shouldn't be spending our NDS funds on it. And so just really, really fabulous questions that we can use. So what what's funded in the plan and how that plan is spent are two completely different things and and I think it's helpful to know.
Yeah. Yes, very helpful. And I'm sorry to anyone that I confused with that. So just to recap, two different lists, one that you should get to know before going into the reassessment conversation about what they can decide to have included. And then the other one, once you've got that funding included, how do I spend it? That's right, exactly. Exactly. And it can be spent differently than the way it was funded in the plan so long as you spend it within the rules and you check out those questions. Yes, perfect.
Now that does lead us back to what you brought up before, which was internal reviews. So let's say you go through this process, you bring up horse therapy in the reassessment conversation. Even though you're prepared and you have answers to all those questions, they still don't include it.
What kind of recourse does someone have after they've got their new plan? It doesn't seem like the NDIA was listening at all in that meeting and it doesn't include what they wanted, doesn't, you know, cover their support needs or anything. What happens then we'll just quickly go through that process.
How do you question that? Yeah, Well, I think the first thing that's important to know is that you can actually request to get details of the calculations behind your plan. So I think that's the first thing to do is to is you wanna you wanna say to the planner hey you know what I know I've got the right Freedom of Information I've got the right to see you know what was the thinking.
I think we wanna do that first so that we we're getting ourselves fully ready to kind of point out exactly where they might have made an error and then we can we've got three calendar months from when we get that plan we've got three calendar months to request what's called an internal review of the what's been funded and in fact there's a whole bunch of decisions that the NDIA can make that we have the right to request an internal review of but probably the most common one is what's funded in a plan and so we've got three calendar months to request that but it is important to know that we only get one shot at it.
We only get one shot at an internal review for each plan and so or for each you know decision and so we wanna we want to use that time to collect evidence of of you know to really reinforce why that is a distinct error And and you know I think the thing about anytime that we're having to um uh work with the NDIA more than we really need to is unpleasant unnecessary time. And so I think it's fair to say that and so you know I, would encourage you to think very creative and creatively and flexibly before you ask for an internal review.
You know ask yourself you know are there other ways that we can fund the horse therapy for example or are there other ways that we can use our funding if we if we fully appreciate the creativity and flexibility available to us and if the answer is no then put in a request for an internal review. But you know, I I certainly don't engage with the NDIA, with those kinds of things in any more than I absolutely need to.
Yes. And there's a form for that as well, isn't it? Would you suggest people just like with the change of situation, they use that form to guide them on what to tell the NDIA? Yep, yes I would. I would suggest that that they use that form as well. The only other thing that I would add, and you know this, people don't always like it when I when I say this, but I'm gonna say it anyway because I think it's important is that you know the answer isn't always more funding.
Sometimes there are, there are, there are other ways and we do have a habit to fill the lives of people with disability, with paid supports and we know that a life filled with paid supports isn't necessarily the best life. And so I also think that it's important to explore other ways, you know other ways of doing things that aren't necessarily NDIS funded. So filling light, filling people's lives with community connections and. And friends and other things that we're doing.
Yeah. Yeah, that's really important, isn't it, to. Yeah. Get outside of that paid support. Yeah. Well, you know, social isolation is a really big issue for adults with disability. And. And often it is because we've put too much emphasis on paid supports and. And paid supports are not friends. They never will be.
Friends can be friendly, but they're not friends. Yes, very good point. Uh. Now I don't want to get too far down this rabbit hole because I can see the clock ticking and I really want to get to pace, but I just want to quickly bring up that you've still got options. If after that internal review the decision is still the same, you can then go externally, can't you?
Yes, the Appeals Tribunal. But if you think it's difficult working with the NDIA no pretty unpleasant experience and while we are very very grateful to any participants that pursue cases through the AH cause it often gives some really interesting insight into interpretation of reasonable and necessary. It is very very onerous. So I and I, I think that's that is an extra motivation for getting that internal review right, doing it as well as we possible evidence before you put in that application and yeah, absolutely.
All right. So let's move on to PACE now because you know after all of these reassessments not a variation I'm assuming, but you have a reassessment, it's likely going to be moved on to the Pace platform, is that right?
That's what they say at this point. So you know, I've heard of it not happening yet actually as of the end of February I think. So they did have some time frames but they I don't think, I don't think they're meeting all those time frames but technically speaking at any new plans will be built in the PACE system.
But we are seeing a lot of plan extensions where it just doesn't maybe the the NDIA is not quite ready yet. Yeah, OK. Yeah. So you just want to let us know a bit about what pace is, how it differs. I know there's a whole lot of anxiety out there online about, you know, this is gonna have huge impact and stuff, but I think it's important to just see what it's going to impact on like a day to day level.
It's probably really not that scary once you know what's actually happening. So yeah, let's just talk through what the impacts to participants in their plans will be. But yeah, if you just want to let us know first of all what it is, yeah. OK, so so it is a new IT system and and if you're geeky. In your love IT systems, then we are transitioning from an SAP system, uh, to a Salesforce system. I don't know what that means. That doesn't mean anything to me, but that's for the cakes in the room. He love that kind of stuff.
But it it is a it's a new system. Uh, and the thing is well, it's a more flexible system. So um, it's gonna give the NDIA the opportunity to evolve the NDIS over time and not to be held back by their system and but they're using the opportunity to implement some other changes. And so goodness, I'm thinking best place to start, best place to start is the changing role of Local Area Coordinators. And so Local Area Coordinators, UH will no longer be building plans.
All plans would be built by the NDIA, but local Area Coordinators and Early Childhood partners will continue to play a role in helping to collect and upload information to the pay system so that the NGA can build the plants. So that's one change that you will see that your local area coordinator and there's no point anymore negotiating with them as well, not that they ever had any decision making authority, but you know, so. So that's the first change.
Um, there is a little bit of change to the structure of funding. And so, um, you may or may not be aware that, you know in the current system that we have 3 buckets of money. They're called support types or support purposes. So core capital and capacity building under the new pay system, we've got a new one called recurring and that in itself is is not a, not a big change, but under our call bucket, we've got a little bit of a change here. So under not cold bucket home and living funding under the current system is part of flexible core support. So we can use that funding flexibly with our other core supports. But under Pace we've got a new support category.
And so a support category is kind of like a a sub bucket, a little bucket within the big bucket and we've got a new one called home and living and and what you're going to find under Pace is in that home and living support category, you're going to find funding for supported independent living, SIL, HMM, ILO, individualised living options and medium term accommodation.
Now those three things are currently part of flexible core supports, but under Pace those three things are being pulled out of flexible core supports. We've still got flexible core supports. Don't worry, that's not going away. It's just that the home of living funding is no longer part of it and that will now sit in this new home and living support category and that funding will not be flexible with the rest of the core support.
And I think of all of the changes that's probably the biggest one in terms of flexibility. The other thing that's important to note is that there is something called my providers and so I'll come back to my providers in Attic. So maybe I'll kind of flip flip between but home and living funding that support category, that funding must have a mini provider allocated. If you are plan managing your funding um then your plan manager can be the my provider.
But if you are self managing or agency managing the funding you will need to have a my provider allocated for that home and living funding. And so it doesn't need to be a registered provider but it does need to be allocated as a my provider. So let's come back to MY providers then.
So you would be aware that under the current system when you're agency managing your funds, providers must create what's called a service booking. And that essentially means that they come in and they quarantine funds and that makes them feel confident that they're going to get paid for the supports that they deliver.
Service bookings are going away under pace. So service bookings will no longer exist under pace and they will be replaced by what's called My providers. And so the language that we're using is that you endorse a mini provider, so agency managed funds will no longer have service bookings.
They'll have My providers. Um, you do not need to have a My Provider allocated for your agency managed funds, except for home and Living funding, SDA, Specialist Disability Accommodation and Behaviour Support funding. So those are those are the only areas where you need to have a might provider.
And of course for SDA and behaviour support you also need to have a registered provider. That's not a change but it's important to know. But uh you for agency managed funds you have the option of endorsing a provider as a My Provider and simply what that means is that when they submit payment or request for payment to the NDIA as they do now, they will automatically be paid.
So you basically head to the I trust this provider or pay them, but it's not. It's all it's all that. Also not necessarily that. I want to clarify that because except for those three things, SDA, behaviour, support and home and living, you don't need to have a My provider allocated.
And if a if your agency managing your funds and a provider submits a request for payment for one of those other supports and they're not endorsers of my provider, then the NGA is gonna send you a text message to say, hey Sally, um, this provider has requested payment for this.
And if you disagree, let us know. And if we don't let them know within seven days that post process, that payment will be processed. But if we do look at that and go, oh, I don't know who these people are all. Well that seems like it was more than I was expecting.
Then we can get in touch with the National Call Centre, then one 800 number and we can say, hey, put a hold on that because I'm not very happy about it. And I think that you know what this is all about is that the NDIA isn't is it is attempting with the transition to PACE to give a little bit more power back to participants and their families and a little bit more control.
So providers aren't gonna love it, but participants, you know, you have the option if you are the kind of person that would love to see every payment before it gets processed. You have the right to choose not to endorse providers except for the SDA behaviour support and home and Living. And don't feel pressured to do it. You know, don't feel it is in your provider's best interest for you to endorse them because they their payment will happen a lot faster.
But I think that until you feel comfortable, until you know that provider and you feel like you know what, I'm ready for them to have their payments processed automatically. Don't feel pressured to endorse them until you're ready to do that. Yeah yeah wait till you got that really good relationship, you're happy with what they've been putting through.
Then give them that chick of approval and make it easier on them. Then one more thing that I want to add quickly and that is how do I do it? How do I endorse the provider? Um yes. And so you can do that in your planning conversation. You can do it in your reassessment conversation. You can do it in your check in.
You can do it via your local area coordinator or your early childhood partner or NDIA planner. Your support coordinator cannot do it for you. Don't let them tell you that they can. They do not have the authority to do that for you, and you can also do it by calling the national call centre or sending an email.
Um, here's the thing that I want you to know about it, though. It can be done instantaneously. So a big frustration that people are finding in the transition process is that the national call centre is going, hmm, I don't know anything about this. I won't tell the person on the phone, but I'll just say to them, yes, we're on it. Well, yeah, you know, we'll make it happen. And then they're hanging out the phone and it's nothing's happening, right? Frustrating. Who wants to call the National Call Centre more often than you have to?
And so I know that you can sit there on the phone and say, I know that this can happen instantaneously. So I'm just gonna wait until you tell me that it's done. Yeah, don't hang up the phone until they've said it's done very good and you can change that at anytime. Like if you get a new provider, they should just be able to straight away change it over anytime, anytime. Yeah, fantastic.
A little bit more. Little bit more. Um, and so um, you will also then need to have your plan manager. If you're plan managing your funds, you'll need to have your plan manager endorsed as a My Provider as well. And the same process happens. You can do it in the planning conversation, you can do it through your LAC, you, you can do it by calling the National call centre. And again, it's instantaneous. So don't let anyone say to you, yeah, we'll work on it and you know, you'll see. No, I'm gonna sit here. That's fine until you tell me that it's done.
So, and on top of that, support coordinators will need to be endorsed as my providers. And in order for them to be able to see the funding information in your plan in place. On top of endorsing them, you're also going to need to give consent for them to see your plan information. And I think it's important, I think it's helpful for support coordinators to see the funding information. Same process for giving consent to the support coordinator to see the funding information. Yeah, right. And would you recommend giving that consent to anyone else other than a support coordinator or are they the only ones that would be that nobody else.
So regular providers can no longer get access to to funding in it's via Pace. And you know what? Look, personally I'm not a fan of sharing my funding information with my service providers. I often relate it to, you know if I went shopping for a car and I walked into the car lot and the car sales person said, well, Sally, show me your bank you count details. I can't sell you before I see you bank account details. I'd be like, whoa, yeah. So you know, I’ve got a model that matches exactly what's in your account. I know, right? It's miraculous.
Or even worse, saying no, I'm not gonna let you test drive that car because you can't afford it. It's like, yeah, it's a bit rough, very rough. I'm conscious of time in case we have any questions but is there any other major impacts that people should know about with pace that we haven't gone over. Look, I think that that's probably that that's probably the big stuff it I think the biggest impact is gonna be on people who agency manage their funds because you're gonna need to make those decisions about endorsing providers or not endorsing providers and if you choose not to endorse providers you need to be ready for some pretty gummy text messages away. You know I haven't yet seen one but I'm very curious to see the kind of plans that they use.
So I I think the biggest impact is on people who agency manage their funds and people with home and living funding. I think those are probably the the biggest impacts. Yeah, OK. Most of the other impacts are gonna be just like changes to terminology, slightly different processes but pretty much the same. Or there was one other thing, the funding being released in increments, did you just want to mention what that's about? Yeah, that's it.
Thanks for reminding me of that one. So what we are seeing and we were expecting it is that the ND IA if you have a multi year plan, if you have a three year then you can expect that funding will be released in one year increments. Now there are ways that you can then request additional funding to be added and it might make sense. We don't always use our funding in a linear way but you need to be ready then to explain why you would need additional funding added and that's really because the service bookings are going away. People are a little bit nervous about budgeting and so really releasing it in increments of a year at a time is just to help with the budget in. Yeah. Yeah. OK.
Thank you. Make it easier to sort of know plan it out year by year, I suppose as long as you don't have those big purchases in one year that might make it a bit, yeah, tricky. But they're assistive technology mostly or high modifications and those things would be, you know, on top of your normal supports. Yeah, true. Yes, very good point. Alrighty. Let's see if I've got any questions. I have seen the chat going off a little bit, Yvette.
It's mostly been me, great conversation guys. It's been really amazing listening to, um all of this really useful information. I'm sure for all the participants. I've got four questions so far. I'll just start at the beginning. Um, Janet commented that she's only ever had 12 month plans in the five years that she's been a participant. Is the move towards longer three year plans across the board or is that an as needed thing or yeah what do you think the trend is there?
I'm OK I can only speculate um I'm not the NDIA um but um but for children whose support needs will change you know quite a bit from one year to the next it makes sense to have shorter plans. And if and of course if you have a disability and your impairment is is changing a lot from one year to the next. You know maybe you have Ms and it's changing a little bit you're going through that stage or it's changing a bit then it would make sense to have a one year plan as well. So I think that the that the longer plans are intended for people who have stability in their support needs. Um and and you can always request it, you know ask, don't ask, don't get. So without knowing your situation, yeah you know it could be one of those things but you could request a three year plan and see how you go. Yeah, pros and cons for both I'm sure.
Yeah. Second question came from Lubosch and I think it kind of builds on what you were talking about Sally with the on horse therapy um in that can participants request alternative therapies if mainstream are supports aren't necessarily getting the outcomes they're looking for in their reassessment meetings? Yes you can. I I think The thing is that we need to remind ourselves that the NDIS is an insurance game and so you know it's run by actuarial that's not the word is it whatever that word is Maths nerds right and and so that the maths needs to make sense for them and so I think one of the things that you can do is collect so one of the requirements of reasonable and necessary is that the support is what what's the language is takes into account. Oh no. Here we go. Effective and beneficial for the participant having regard to current good practise and sometimes and how the NDIA evaluates current good practise as either as evidence based practise.
And so you know that the research has been done and found that statistically speaking it's good practise and then um, there's another measure of current good practise and that is that the support is or is likely to be good practise for that individual participant. So if you do wanna have alternative therapies funded, it works in your favour to have some sort of evidence that you can use to show the planner that that therapy is or is likely to be good practise for you.
So that might include trialling it for a couple of months. Yeah, you might have to pay for that yourself. You're trying it for a couple of months keeping records in in partnership with your therapist that shows the impact and then using that as evidence.
And then so it becomes integrated as part of your ongoing plan for sure. That's right. That's right. Yeah. Yeah. Amazing. Yes. You can also use your, you know, you can of course use your funding flexibility also to purchase some of those therapies. But here word of warning around that you know if you've been allocated for funding an under improved daily living and you choose to spend it on an alternative therapy but it's actually been popped there to support you to get an OT assessment for home modifications.
If you go away and you spend it on hippotherapy horse therapy, you're not going to get the funding again for the home modifications. And so you've got to make an informed. You got to make a clever decision about how you're gonna use it if you're gonna get creative with it. Yeah, for sure.
Philip has asked in conjunction working with his OT. Um, his note is suggested getting some railings in his home changed for his safety. How would he initiate that process? Not currently funded in his plan. Yeah. So. So, you know, if you've got a local area coordinator in your life, they should be able to help you to put in a request for a variation with that. So you know, you would that that would that typically would fall into a variation.
And so you would just specify what it is that you wanted included in that variation. Submit the request for a variation the NDIA should respond to in 21 days to let you know what they think. They're responding one of three ways. They'll say, Yep, cool, here's the money for it.
Or they respond, you're saying, actually, no, we're not gonna do that. And that's a decision that you can request an internal review of. Well, there might come back and say we need more time to think about it. But because that, that's one of the reasons you can ask for a variation is to add items of assistive technology or home modifications. Yeah, yeah, alright, awesome. Um, now one of the more recent questions towards the end here as we were getting into the technicalities of Pace and the required the like the onus on the participant to endorse providers and stuff.
Um, I can't remember your name. I'm sorry you asked the question, but oh Erica said. What happens if a participant doesn't have the capacity to understand the new process with PACE and what's required of them with PACE?
Yeah, I always tiptoe a little bit about around capacity. Um, right, Because it's our job to assume capacity, people have the right for us to, you know, assume that they've got capacity. But we all need help with things sometimes. And so there's absolutely no problem with the with the press and getting a bit of support with that. But I think that it's important that we do things with people and not for people.
And certainly if we are a friend or a family, remember I'm supporting a participant to do something like that. We do need to, we need to be careful that that the person has given consent for us to do that stuff on their behalf and all of those things. But there are ways that people can get support from, from friends and family to request those kinds of things.
Yeah. Yeah, Lots of resources on, say, supported decision making and that sort of thing. Yeah. To to implement in that sort of situation, I'm sure. And just a final question that's come up towards the end. Grace has said my client is now under pace. Which states funding will be released in 12 months increments. Though in the plan management portal there's access to the entire plan. The plan manager couldn't explain this but do you know why? Yeah no can't explain it. And and you know The thing is it's not really funny but well, it is. Well you got if you don't laugh, you cry. Yeah. And so I'm running Pace Workshop. So I consider myself to be a little bit of a pace expert, and I distinguish between features and bugs. And I would call that a bug.
Yeah, for sure. Well, that's all of the questions. Thank you very much, Sally. I'll disappear again. Nice saying. Thank you and thank you for all of those good questions everyone. Some good extra information there at the end. So we have made it to the end of our webinar now, but we always say the conversation doesn't have to end here. You can join us in Kinora and continue the conversation there. It's free to join. If you're not a member already, just jump in and ask any other questions you have or share your experiences about planetary assessments. Pace anything like that, we'd love to hear all of your experiences.
Thank you so much for joining us today, Sally, you've just had incredible insight on everything. And I really feel like everyone watching this is just going to feel so much more prepared going into reassessments and onto pace. Like just all of that anxiety taken out of the air about what it's going to mean. So thank you so much for joining us.
Thank you for having me. And thank you everyone else for being here today. As I said at the top, we'll be sending out an email to everyone with a link to this video later this week. And we'll post the video and all links to resources and everything in the Kinora community as well. I'm Erin and that was Yvette in the chat. And we've been joined today by Sally Coddington from DSC. Thanks again everyone and hope to see you in Kinora soon. Bye.