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 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

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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 for 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 NDIS 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. These are capped by the NDIA and can be found in NDIS Price Guide and Support Catalogue. 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 will be handled by the NDIS Quality and Safeguarding Commission, (the Registrar).

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.

From 1 December 2020, all service providers Australia wide register under the NDIS with the NDIS Quality and Safeguards position.

All of these supporting documents are policies or processes that have to be originated by the provider. They can be obtained through the Centro ASSIST 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.

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.

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:

• strategy

• corporate governance

• clients and market focus

• financial sustainability

• 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.

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 in Centro FREE.

Services are claimed using various units of measure: per delivery, hourly, daily, weekly, monthly and annually.

The NDIS is now fully operational for participants in all states and territories.

The roll-out for provider-registration under the NDIS Quality and Safeguards Commission was scheduled on a phased basis across the country.

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 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:

• Complaint handling

• Reportable incidents

• Worker screening policy

• NDIS code of conduct

• Behaviour support

• 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 transitioned away from local regulation of disability services provision, over to the QSF on a phased basis:

Providers of services to locations under the jurisdiction of the Commission will use the QSF application process to register (see ‘Preparing for NDIS Registration' in Centro FREE).

The QSF replaced local state or territory quality and safeguards for a nationally consistent approach.

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.

For guidance on registering and complying with the National Quality and Safeguarding Framework, join Centro FREE or subscribe to one of our products. Access our product comparison page for more information.

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 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:

Objects

(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;

Principles

(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.