What is the NDIS?
The National Disability Insurance Scheme (NDIS) oversees and implements the provision of Australian Government-funded support to people with a permanent disability aged 0 - 65. Under the scheme participants “develop a plan to achieve outcomes which includes government, informal, community and funded supports to facilitate greater social and economic participation.”¹
For the first time, it has established a single set of standards for disability services across all states and territories.
Launched nationally (except Western Australia) in July 2016 the NDIS will fund, at full roll-out the support and care of around 460,000 ‘participants’ - people with intellectual, cognitive, neurological, psychosocial, sensory or physical impairments.
The scheme is administered by the National Disability Insurance Agency (NDIA) under Federal legislation.
¹ NDIS portal, under New Participant Pathway
NDIS Registered Providers
A provider of disability services can be an individual sole trader, a business or some other organisation, such as a charity or not-for-profit body.
On July 1, 2018, the National Quality and Safeguarding Framework (QSF) began rolling-out across the states and territories, on a phased basis.
Under the QSF, to enjoy the full opportunities offered by the NDIS market, providers first need to register with the NDIS.
They can then provide support to any NDIS participant, so long as they meet the necessary professional standards and agree to be bound by the NDIS Terms of Business.
A condition of ongoing registration is that they undergo regular compliance audits, under the control of the Quality and Safeguards Commission.
Unregistered providers will remain bound by existing State and Territory legislation and standards. This means they will not:
be eligible to provide services to participants with support plans managed directly by the NDIS
be able to demonstrate they meet the national quality standards for care and safety (the QSF).
An NDIS provider is responsible for all aspects of their business and its services, except for rates of payment, which are capped by the NDIS Price Guide. After delivering a service requested by a participant or plan manager, the provider charges the NDIS at the hourly rate agreed in the service agreement with the participant.
When a participant or plan manager books a provider, they enter into a service agreement. This sets out the services to be delivered and the rate of payment, which the provider then claims from the NDIS.
Registered providers are responsible for their staff and contracted workers, and must ensure they are fully screened in line with the QSF. Under NDIS Rules, services can be sub-contracted out to third parties however the contractor remains responsible for the quality of delivery.
The NDIS Registrar (on behalf of the Quality and Safeguards Commissioner) reviews all provider applications against the NDIS Rules, which set out the legal criteria for registration.
Applicants must show they satisfy the requirements of the NDIS Rules and are able to meet the standards of the National Quality and Safeguarding Framework (QSF). These national standards relate to the rights of the participant and the responsibilities of the provider.
Providers are asked to lodge details and supporting documents for:
the services (referred to as ‘supports’) they will provide
the areas where they want to provide them
their experience, qualifications or professional registrations (where relevant)
the processes they have in place to ensure they comply with the QSF.
Some services must, by law, be provided only by people who are suitably qualified and/or have the necessary licence to do so.
The Registrar will check the validity of any required qualifications and licences, according to the services the provider has applied to register for.
The first step to registration is to apply for a PRODA account from the Federal Department of Human Services . Through this account, providers then apply for access to ‘myplace’ - the online portal where they manage all transactions with the NDIS. Registration from 1 July will be handled by the NDIS Quality and Safeguarding Commission, (the Registrar) but only for NSW and South Australia. The other states’ registration applications will continue to be processed by the NDIS.
When they apply, the provider must submit evidence that they:
are financially viable and competent
comply with relevant State and Federal based business requirements
have carried out screening of any employees (including national police checks)
have risk management and complaints processes documented
have suitable facilities and equipment
are fully insured
comply with relevant practice standards
are professionally qualified to offer their services.
The valid supporting documents needed for registration fall into two categories: those needing to be generated by the providers and those gathered from another party.
Documents to be generated by the provider
All of these supporting documents are policies or procedures that have to be originated by the provider. They must be drafted either by a legal or human resources professional, business consultant or can be obtained through the Centro CORE web app.
To be accepted by the Registrar, they must be guaranteed to be legally valid, compliant with the NDIS Rules and the QSF, and documented in writing.
They are the core documents required for registration and compliance audits. The Registrar may ask the providers of some services to submit additional documents.
The documents relate to the provider’s business operations, staffing and services, and must be made readily available to participants, the NDIS and other legitimate stakeholders on request.
|Abuse and neglect||Policy||How to prevent all forms of abuse and neglect with the participants we support|
|Advocacy Policy||Policy||What is advocacy and how we support a participant's right for advocacy services|
|Bullying harassment and discrimination||Policy||Principles to prevent all forms of bullying, harassment and neglect with our workforce and the participants we support|
|Child safe||Policy||Principles for keeping children and young people safe from harm|
|Complaints management||Policy||Who can make a complaint, and how complaints are recorded, categorised and resolved|
|Conflicts of interest||Policy||Ensures personal interests do not influence or compromise services to participants|
|Decision making and consent||Policy||How participants are supported to consent and make decisions that affect them|
|Incident management||Policy||What are incidents, what are serious incidents, and which incidents are reportable|
|Information security||Policy||Information and communications technology security precautions required to protect resources and information|
|Privacy and confidentiality||Policy||How information is collected, what it's used for, and how we protect it|
|Risk management||Policy||Risk management helps to manage risks to our organisation, our workers, and the people we support|
|Worker screening||Policy||Ensures workers are properly qualified with no criminal history|
|Business insurance||Policy||Mandatory insurance requirements to provide services|
|Continuity of supports||Policy||What happens to our services when there are staff shortages|
|Maintenance, records and audit||Policy||What records to keep when providing services|
|NDIS Code of Conduct||Policy||The NDIS Code of Conduct sets the standards for how the organisation carries out provision of supports|
|Participant rights||Policy||Sets a clear context for how supports and services are provided|
|Pricing||Policy||How to price NDIS supports, fees and charges and payment requests|
|Restrictive practices||Policy||What are restrictive practices and when is their use authorised|
|Service agreement management||Policy||What a service agreement should include and how this is best achieved|
|Staff records||Policy||What records and details must be recorded and stored on workers|
|Support provision||Policy||Fundamental guidelines on how our services and supports are provided|
|Work health and safety||Policy||Principles for maintaining a safe working environment across the organisation|
|Manage complaints||Process||How participants can make a complaint, and how complaints are handled, recorded, catergorised and resolved|
|Manage incidents||Process||How to identify, escalate, report, and resolve incidents|
|Manage risks in the workplace||Process||How to manage risks to workers as they perform their tasks of providing supports to participants|
|Manage risks to participants||Process||How to identify, record and manage risks to participants|
|Resolve conflicts of interest||Process||How to identify and manage conflicts of interest so they do not influence or compromise services to participants|
|Screen new workers||Process||How to check prospective new workers for criminal records, working with children checks, and reference checks|
Documents to be gathered from third parties
These supporting documents are issued by professional organisation and public bodies. The NDIS Registrar will advise which of them need to be supplied, according to the services the provider has applied to deliver.
|Proof of an Australian Business Number||Australian Business Register||All applicants|
|Statement or other proof of an active bank account||Bank or other financial institution||All applicants|
|Insurance certificates||Insurer(s)||All applicants|
|Criminal records check certificate||Police service or accredited agency||For every employee, including business owner|
|Professional qualifications||Educational body||Where relevant|
|Professional licences||Relevant licensing authority||Where relevant|
An approval for registration can be limited in scope (covering only a particular class of services or certain qualified staff) and in time period.
A provider’s registration can be revoked on a number of grounds. One is that the provider no longer meets the approval criteria laid out in the NDIS Rules. Others causes of revocation include if a provider becomes insolvent as a business, breaks the law, provides the NDIS with false information or their service poses an unreasonable risk to a participant.
The Quality and Safeguards Commission has the statutory powers to ban providers and to levy fines of up to $150,000 for transgressions against the NDIS Code of Conduct. These measures could be in addition to any criminal penalties applicable under law.
Prior to applying, providers are asked to check that they are ‘NDIS ready’ in seven areas of business practice:
clients and market focus
staffing and skills
information and knowledge management
safeguarding quality management and improvement.
Every service is grouped into one of 36 Registration Groups, based on their compliance requirements under the National Quality and Safeguarding Framework (QSF).
The groups each have specific standards of compliance and different schedules of payment in the NDIS Price Guide. Providers may be offer services in more than one group.
NDIS Price Guide
The Price Guide lists every service as a line item, with the maximum rate the provider can claim from the NDIS once it has been delivered. For some services, a quote must be submitted to the NDIS.
Different line items apply according to the state or territory the service was delivered in, and the remoteness of the location. A premium is often applied when provision took place during unsociable hours, at weekends or on public holidays.
The items are further qualified by the Registration Group of the service, support category, outcome and purpose. This system is fully and explained and simplified by Centro’s searchable NDIS Price List tool.
Services are claimed using various units of measure: per delivery, hourly, daily, weekly, monthly and annually.
When does the QSF roll out?
The NDIS is operational for participants in all states and territories, with Western Australia being the last to benefit, in January 2020.
The roll-out for provider-registration under the NDIS Quality and Safeguards Commission was scheduled on a phased basis across the country.
NDIS in ACT
NDIS in NT
NDIS in NSW
NDIS in QLD
NDIS in SA
NDIS in TAS
NDIS in VIC
NDIS in WA
July 1, 2019
July 1, 2019
July 1, 2018
July 1, 2019
July 1, 2018
July 1, 2019
July 1, 2019
July 1, 2020
Under NDIS legislation, participants have the freedom to choose their service providers, where appropriate.
Each participant with funding under the NDIS has a budget to accomplish an individual plan to support them in achieving their identified goals.
Called “Outcome Domains’ by the NDIS, these goals align with one or more of these areas of their life:
The participant’s funding package is separated into three Support Purposes - Core, Capital and Capacity building – which contains Support Categories that align with their goals.
These components form a funding plan, which is created by the participant (with help from a family member or similar) and a planner from the LAC (Local Area Coordinator) or NDIA. Some plans have funding for a Support Coordinator, who helps the participants find services and assist with any issues arising.
The participant may choose to have their plan managed in one of four ways:
self-management, where a participant manages their own plan, if the NDIA deems them able to do so
professional plan management, by an NDIS-registered plan manager
agency-management, directly by the NDIA
a combination of the above.
Plan managers look after the NDIS funding, claims, budgeting and bill payments to providers. They also assist with the implementation of a care-plan, like a support coordinator does.
Participants are free to choose unregistered service-providers, except when they have an agency-managed plan, in which case only NDIS providers will be chosen.
To liaise with participants who opt not to nominate a support coordinator, a Local Area Coordinators (LAC) is appointed by the NDIS. The LAC meets with the participant to gather information so the NDIS can understand their funding needs.
The National Quality and Safeguarding Framework (QSF)
The QSF is administered by the NDIS Quality and Safeguards Commission, from within the Federal Department of Social Services (DSS) portfolio.
According to the commission, the framework was established “to ensure that capability is built in the new market-based system, the rights of people with disability are upheld and the benefits of the NDIS are realised”.
Once providers have been approved by the NDIS Registrar, management of their registration passes over to the commission, which is responsible for overseeing the standards of services delivery.
The commission’s strategy is informed by the regulatory criteria of the NDIS Rules and incorporated by the framework.
In practical terms, the framework gives the commission oversight of the following components:
Worker screening policy
NDIS code of conduct
Monitoring, investigation and enforcement
Registration and quality assurance
Development and capacity-building
The QSF’s conditions that providers must comply with to become and remain registered with the NDIS are set out in the NDIS Practice Standards.
Transitioning to the NDIS
Registration to the NDIS has been available since June 2016 to most service providers, who at that time were regulated by their state or territory.
The National Quality and Safeguarding Framework (QSF) was launched in July 2018 to supersede this localised approach in which the NDIA was registrar for applications.
Administered by the NDIS Quality and Safeguards Commission, it will bring a consistent set of quality assurance practice standards across all states and territories. The Commission will replace the NDIA as registrar.
States and territories will transition away from local regulation of disability services provision, over to the QSF on a phased basis:
|July 1, 2018||NSW and South Australia|
|July 1, 2019||ACT, Northern Territory, Queensland, Tasmania and Victoria|
|July 1, 2020||Western Australia|
Providers of services to locations under the jurisdiction of the Commission will use the QSF application process to register (see ‘7 Simple Steps to Registration under the QSF' in Centro FREE).
In places where the QSF has not yet been rolled out, providers will continue to apply for NDIS registration according to the requirements of the states and territories they are servicing.
Once the QSF has been introduced, it will replace local state or territory quality and safeguards.
Service providers who are registered with the NDIS prior to the introduction of the QSF in their locality will not need to re-apply. Their registration will be automatically transferred over to the Commission once the QSF comes into force.
However, they will need to comply with QSF practice standards. Compliance with the QSF will also entail regular audits on an annual or three-yearly basis, depending on the provider’s service offering.
Until the QSF is fully rolled out, providers offering services in multiple states will need to meet the registration and compliance requirements of each jurisdiction.
This means for services being provided in the states and territories under the Commission, they will need to comply with the QSF. If they also work in places where the QSF has yet to roll out, then local regulations will apply to those services.
All providers are responsible for managing their own compliance obligations. They must ensure their services comply with NDIS Practice Standards, which are a part of the National Quality and Safeguarding Framework (QSF).
Depending on the potential risk to participants associated with certain activities, there are two types of compliance that require Verification or Certification through an audit. The exact requirements for Verification and Certification are currently under review by the new NDIS Quality and Safeguards Commission.
The risk level of each service is demarcated by their allotted Registration Group. Providers must show they have the necessary specific experience, qualifications, processes and expertise required to minimise the risk associated with their delivery.
The Practice Standards apply to all registered NDIS providers, with additional rules for those that deliver more complex services in areas such as behaviour support, early childhood supports, specialist support coordination and specialist disability accommodation.
The National Disability Insurance Scheme (Registered Providers of Supports) Rules 2013 (known as the NDIS Rules) are part of the original Federal legislation that established the NDIS.
They contain the legal basis for how providers become approved and maintain NDIS registration. The requirements that apply to providers are guided by the following objects and principles, which are incorporated in the legislation:
(a) to enable people with disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports;
(b) to promote the provision of high quality and innovative supports that enable people with disability to maximise independent lifestyles and full inclusion in the mainstream community;
(c) people with disability should be supported to participate in and contribute to social and economic life to the extent of their ability;
(d) people with disability should be supported to exercise choice, including in relation to taking reasonable risks, in the pursuit of their goals and the planning and delivery of their supports;
(e) people with disability have the same right as other members of Australian society to respect for their worth and dignity and to live free from abuse, neglect and exploitation;
(f) people with disability have the same right as other members of Australian society to pursue any grievance;
(g) 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;
(h) people with disability should have their privacy and dignity respected;
(i) innovation, quality, continuous improvement, contemporary best practice and effectiveness in the provision of supports to people with disability are to be promoted.