Working with the NDIS model

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Working with the NDIS model

The National Disability Insurance Scheme (NDIS) established by the Australian Government and being progressively rolled out across Australia, is a market-based approach towards helping some people living with a disability.

The funding models for any type of organisation involved in supporting people living with a disability are highly likely to be affected by the NDIS rollout. Working with, and within the NDIS, requires organisations to be aware of the scheme’s fundamental impacts on their organisation. The NDIS is complex and can be difficult to come to grips with for organisations.

This guide is only a brief introduction for organisations working with the NDIS or intending to do so. It is recommended that you seek further information and become very familiar with the NDIS website and resources, including the Provider Toolkit.

Some organisations may continue to support people living with a disability and not be highly engaged with the NDIS.

What does the NDIS mean for your organisation?

You may already be working with the NDIS as a registered or unregistered provider. Registered providers must demonstrate they have met specific quality and safeguards requirements as part of their marketing to potential participants. They can connect to a much wider range of participants and potentially more funding through the NDIS.

The way the NDIS manages the care planning, support payments and related actions will potentially have the most impact on your business planning and operations. You may need to consider a new market approach to adapt to the NDIS environment.

Understanding the business of disability

There are around 4.3 million Australians who have a disability. When it is fully rolled out, the National Disability Insurance Scheme (NDIS) will provide about 460,000 Australians aged under 65, who have a permanent and significant disability with funding for supports and services (click here for What is the NDIS?). This plan effectively means that 89% of Australians who have a disability may not participate in the NDIS scheme by the time it’s fully rolled out.

This raises several questions as to the impact of the NDIS on your organisation as a business. The NDIS aims to provide general information and address systemic issues that are of benefit to a much wider audience than just those people who have a contractual relationship with the system (the c. 11%).  These additional attributes of the NDIS rollout may also be relevant to your organisation as a business if you continue to service the needs of non-NDIS clients.

Getting the fundamentals right

If you are already participating in the NDIS or plan to do so, some of the fundamental issues you now face are:

Being aware that the insurance scheme controls payments for and on behalf of the insured and how this will affect your business

The market is limited to those who are eligible (potentially 11% of people with a disability in Australia)

You are funded by the NDIS to progress a client forward in life, help them transition towards independence, and progress towards their goals

The NDIA (National Disability Insurance Agency) has business rules that affect what is termed a valid transaction. You need to know the business rules that affect your service claims

Your market scale and service responses need to be clarified and re-defined (over time)

Your business systems may need to change if you have not been operating within a per client transaction model for costs and in turn payments

Increased mobility of clients and care/support services under the NDIS will create both interruptions and opportunities for your business activity

Unless you have enough revenue sources, you may no longer be able to conduct some activities that helped systemic issues for people living with a disability (noting that industry, governments and the NDIS also have this and other matters on their radars)

Other ‘How to Guides’ in this suite focus on specific areas of impact on your planning and operations. Have a look through these for topic related support.

Understand the cash flow implications

If you are already part of the NDIS, your cash flow may alter dramatically from all the upfront money required to undertake a service, then claim and get paid. The amount necessary upfront may be impossible to predict. This impact will vary from organisation to organisation depending upon the scale of the operation and the ratio of NDIS funded clients to non-NDIS funded.

If your mission and purposes are still relevant and capable of being funded under this new model of support, you will need to continue to evolve with the market.

Managing issues

The NDIS has many business rules, so it is likely you will need assistance in interpreting these and clarifying issues that might potentially affect your service delivery a good place to start is the NDIS publish a service charter.

The NDIS encourages direct contact and feedback via a variety of formats. It is vital to quickly clear up any issues you may be having with the system, and any impact this is having on your support to clients.

If you have specific issues that affect your service delivery, you may wish to raise them via the Contact and feedback form.

If you experience problems with the NDIS website, provide your feedback via Website feedback.

Conduct a review

It is likely that many organisations involved with the NDIS will need to take stock of their business model and conduct a structured review of their mission and purpose.

Strategic reviews and other planning tactics are handy for not for profit organisations in helping them align with markets. They become excellent platforms for client and stakeholder feedback.

Consider the timing of any interaction with the NDIS and the impact on your organisation. It may be wise to conduct a strategic review before your organisation reaches a critical point with service delivery.

Resources

NDIS Service charter - https://www.ndis.gov.au/about-us/policies/service-charter

The NDIS website provides a comprehensive toolkit for service providers and specific provider portal with resources, information and links.

https://www.ndis.gov.au/providers

NDIS Provider Toolkit - https://providertoolkit.ndis.gov.au/