The Provider Loft

Supporting small and medium NDIS and health providers in Australia

David Kinnane

Change to short notice cancellations under the NDIS Pricing Arrangements and Price Limits 2022-23

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On 22 June 2022, the National Disability Insurance Agency (“NDIA”) published pricing arrangements for the National Disability Insurance Scheme in its NDIS Pricing Arrangements and Price Limits 2022-23 (“Pricing Arrangements”), to take effect on 1 July 2022.

Amongst other things, the NDIA has modified the definition of short notice cancellation in the Pricing Arrangements.

(1) Short Notice Cancellation

A short notice cancellation is defined in the Pricing Arrangements as when a NDIS participant:

  • doesn’t show up for a scheduled support within a reasonable time (e.g. in the event the NDIS participant should be attending a clinic where the NDIS provider is located); or
  • is not present at the agreed place within a reasonable time when the NDIS provider is travelling to deliver the support (e.g. in the event the NDIS provider provides the support at the NDIS participant’s home or a third party location),

and

  • has given less than seven clear days’ notice for a support.

This means an NDIS participant should give an NDIS provider at least seven clear days’ notice of the cancellation of a support.

The definition has been simplified from a two-tier system (two or five clear business days) notice, depending on the duration and cost of the support under the 2021-22 arrangements, to a single definition based on the number of days (rather than business days).

(2) Claiming for a Short Notice Cancellation

In the event of a short notice cancellation, an NDIS provider is able to claim 100% of the agreed fee associated with the support from the NDIS participant’s plan, provided that all of the following conditions are met:

  • the Pricing Arrangements set out that NDIS providers can claim for short notice cancellations in relation to the relevant support item; and
  • the proposed charges for the activities comply with the Pricing Arrangements; and
  • the service agreement between the NDIS provider and NDIS participant specifies that short notice cancellations can be claimed; and
  • the NDIS provider was not able to find alternative billable work for the relevant worker and was required to pay the worker for the time that would have been spent providing the support.

Takeaways

In order to claim for a short notice cancellation, NDIS providers should:

  • check that short notice cancellations can be claimed in relation to the relevant support item under the Pricing Arrangements;
  • ensure that their charges comply with the Pricing Arrangements;
  • check that the service agreement between them and an NDIS participant specifies that short notice cancellations can be claimed (and, if required, amend the service agreement with a variation signed by the NDIS participant and NDIS provider); and
  • be able to show that they could not find alternative billable work for the relevant worker and was required to pay the worker for the time that would have been spent providing the support.

The definition of short cancellation notice includes the concept of “within a reasonable time”. NDIS providers should consider what, in the circumstances of the provision of a particular support, is a reasonable time to wait when a NDIS participant does not show up for a support prior to making a claim for a short notice cancellation under the NDIS participant’s NDIS plan.

As good practice, NDIS providers should remind NDIS participants of the need to provide 7 clear days notice of a cancellation of a support (so as to not be impacted by short notice cancellations).

Our NDIS Service Agreement and NDIS Provider and Health Provider Booking and Cancellation Policy templates have been updated to respond to the changes to the Pricing Arrangements with respect to short notice cancellations.

Disclaimer: we have done our best to ensure that this article is correct as at the date of publication (1 July 2022). It may not reflect any changes to the Pricing Arrangements or other NDIS rules or guidelines after the date of publication. The article is intended to provide general information and is not legal advice. Formal legal and/or accounting advice should be sought for particular circumstances and transactions, or for matters arising from this article.

The new NDIS Provider Emergency and Disaster Management Plan Framework

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Resource update: An emergency and disaster management framework template for small- and medium-sized NDIS Providers.

In late 2021, the National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 were amended and the National Disability Insurance Scheme (Quality Indicators for NDIS Practice Standards) Guidelines 2018 were compiled to create additional NDIS practice standards. One of the key new requirements was a new practice standard for emergency and disaster management.

Among other things, this new standard requires NDIS providers to prepare, prevent, manage and respond to emergency and disaster situations whilst mitigating the risks to and ensuring the continuity of supports that are critical to the health, safety and wellbeing of NDIS participants.

In this 16-page resource, we provide a template framework designed to help small- and medium-sized NDIS providers to develop emergency and disaster plans and think through management issues associated with emergencies and disasters, and to assist NDIS providers to demonstrate compliance with the new emergency and disaster management NDIS practice standard.

purchase the ndis provider emergency and disaster management plan framework

ALOFT March 2021: the future of work after COVID-19, the status of workers in the gig economy, and defining your risk culture

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ALOFT: Advances. Legal Updates. Organisation. Frameworks. Tips.

In this month’s ALOFT, we focus on the future of work after COVID-19, ongoing legal skirmishes about the status of workers in the gig economy, and what it means to define and improve your risk culture. We also provide some useful tools for communicating the story of your business to others, and highlight a free course to get yourself going again when it all seems too hard and you want to give up. 

At The Provider Loft, we’re focused on giving your quick, practical tips you can use to improve your provider business. Let’s go!

Advances

COVID-19 has had a dramatic impact on the way we work. While it’s too early to tell whether some of these changes are permanent, it would take a brave person to bet against trends towards remote work, digitisation and automation. Check out this provocative infographic from the corporate consulting fortune-tellers at McKinsey: 

Legal updates: UK guidance of the rights of gig economy workers – the Uber case

The line between who is an employee and contractor has always been fuzzy, and never more so than now, with the gig economy. While tax authorities, legal commentators, and others have different views, it’s better to be safe than sorry – especially as most of the legal, tax and financial risks of getting it wrong fall on providers (as hirers). This month, we’ve been looking at the recent UK Supreme Court decision about the status of the Uber worker. Natasha Bernal, of Wired Magazine, has an interesting take on the implications of the decision for gig workers in the UK and internationally here.

Organisation success: how to define and improve your risk culture

To thrive in uncertain times, you need a strong risk culture. This requires a clear acknowledgement of your exposure to risk, and a commitment to manage it. A provider’s success may also depend on its commitment to values like responsiveness, transparency, and respect. 

According to Richard Higgins and colleagues, defining your risk culture involves thinking about your organisation’s confidence, openness, challenges, speed of response, level of care, communication practices, tolerance for risk, level of insight, adherence to rules, and your team’s ability to cooperate. Once you’ve measured your organisation’s current status for each of these elements, you can address any shortcomings, using an influence model composed of four elements: understanding and commitment, role modelling and leadership, capability building, and formal reinforcement mechanisms. For a detailed blueprint for how to do this, read more here.

Frames of mind to improve your marketing

Way back in 1991, Kenn Adams developed the “Story Spine” – an 8-sentence basic structure that underpins thousands of human stories – everything from classical myths, to Pixar movies, to marketing campaigns. This framework can be adapted easily for a provider’s traditional marketing efforts, social media, blogs, YouTube videos, staff training days  – any material that tells your story. Just remember: the hero of your story should be your client – not you! Thanks to @alexgarcia_atx for this practical summary: 

To hear more about this useful model from Kenn himself, check out this short video.

Tips for practice

Procrastination, perfectionism, and the imposter syndrome are all forms of resistance – invisible forces that get in the way of us sharing our best work with our clients and participants, and the world. To overcome resistance, it helps to have a mentor – someone to push you on when you want to turn back or give up. There’s no-one better placed for the fight than Steven Pressfield, author of “The War on Art” and “Turning Pro”. If you are coming up against a blank page, or something else that stops you from doing the work that matters, I recommend Steven’s free audio course, which you can access here: Steven Pressfield’s The War of Art.

That’s it for this month’s ALOFT.

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ALOFT February: Managing Staff

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ALOFT: Advances. Legal Updates. Organisation. Frameworks. Tips.

For NDIS providers and health providers, people management is a constant challenge. High turnover and attrition rates make it hard to build teams and systems to support them. In this month’s ALOFT, we focus on managing staff. As usual, we include practical tips you can use to improve your provider business:

Advances

Leading a distributed or remote team is challenging. Home and work boundaries have increasingly blurred into each other, making it harder to act in different ways with different people. COVID-19 has hastened and intensified these trends. But digital transformation also creates new opportunities for managers to lead and for teams to work together more effectively. In this report, Michael Schrage from the MIT Sloan School of Management and his colleagues, look at the trends and make some recommendations for managers to make their staff feel more valued.

Legal updates

Australian workers fall into two broad categories: employees and independent contractors. But the line between them is often hard to draw, with courts looking at the whole relationship and testing whether the worker is in fact carrying out a business of their own. Many workers are hired as contractors, but may in fact be employees, and getting it wrong exposes providers to legal (and tax) risks. The growing gig economy is challenging traditional employee/contractor categorisation in Australia and many other countries In this article, the lawyers at Norton Rose Fulbright look at the employee/contractor distinction in several countries, including Australia, in the context of growing government interest in better protecting on-demand workers and contractors from exploitation.

Organisation success

People who have a strong sense of purpose tend to be better in times of crisis and uncertainty, and, on average, live longer and happier lives. Purpose is also linked to higher levels of employee engagement, stronger commitment to employers, and increased feelings of wellbeing. This provocative article by Naina Dhingra and colleagues at McKinsey, explores the employer’s role in helping employees define their purpose, using a model identifying nine types of purpose: achievement, conservation, caring, freedom, respect, tradition, enjoyment, stability, and equality and justice. They then provide some practical ideas about how to help connect an employee’s purpose to work, including through guided conversations, personal reflection, and helping employees to take action toward achieving their purpose. 

Frames of mind

Check out this graphic summary of McKinsey model for identifying an individual’s purpose, with short descriptions of characteristics associated with each purpose:

It’s a useful tool for recruitment, onboarding, and performance development of your people (not to mention self-reflection and imporvement).

Tips for practice

“Talk less, and listen more.” Advice often given to managers, not easy to follow in practice. Research tells us that people who talk for more than 30 seconds are often perceived as too chatty. In this article, Mark Goulston suggests training yourself to stop talking for more than 40 seconds to encourage better turn-taking and listening. 

Finally, a coaching tip from legendary music producer Rick Rubin (via the Brian Koppelman Podcast, “The Moment” ): One of your challenges as a leader is to raise the standard for the team, while simultaneously lowering the pressure. The whole podcast is well worth a listen for tips about getting the best out of people without micromanaging them.

ALOFT January 2021

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ALOFT: Advances. Legal updates. Organisation. Frameworks. Tips.

Happy New Year! We wish all our readers – regular and new – a happy, healthy and successful 2021.

Now let’s get on with the show, with some practical tips you can use to improve and how your provider business:

Advances

Are you kicking off 2021 thinking about building a scalable health business in the digital health space? The big brains at McKinsey & Company have identified six, interconnected building blocks required to build a scalable digital health business, including talent, a clear value proposition, robust/compliant products, a “delightful customer experience”, proven value, and a scalable model.

The authors summarise five business models, giving examples of startups using each model – prescription digital therapeutics, employer-as-customer solutions, payer-as-customer, healthcare providers as the customer, and direct-to-consumer – and include examples of providers who have switched strategies. Read it in full here.

Legal updates

When participants are unhappy with NDIA decisions about their supports, they can appeal to the Administrative Appeals Tribunal (AAT). But not everyone is in a position to go through the appeal process. Some people with disabilities don’t have the money, time, energy, communication access, or other resources to go to the AAT, even though there are some law firms that offer free representation to clients seeking to challenge the support plans in the scheme.

The AAT’s 2019-20 Annual Report disclosed that almost two-thirds of agreements for NDIS matters that were reached before an AAT finding, saw a change to, or a complete overturning of the NDIA decision (compared to 16% for Centrelink decisions). This contributes to the perception that the NDIA will give way if challenged – albeit at the last minute. 

Fortunately, this lamentable state of affairs has received some mainstream press coverage, including this piece from Rick Morton in The Saturday Paper from mid-December last year.

Organisation success

Success as a provider is based on a bunch of skills that are learnable. Yuri Elkaim, of HealthPreneur, has distilled 10 core tenets of a health business. Many are relevant for all providers. Paraphrasing for providers, here they are:

  1. You are responsible for your business (not others).
  2. The letters behind your name and how smart you are don’t entitle you to a successful provider business. (Conversely, a lack of letters after your name does not mean you can’t thrive.) 
  3. The better you market, the less you have to sell.
  4. Your success is determined by your systems.
  5. The more you earn, the more you can contribute. The more you contribute, the more you will earn. Money is a by-product of the value you create in the world.
  6. Your provider business is more than a business – it can change your community for the better.
  7. “If it’s all in your head, your business is dead.” Learn to extract your knowledge into training, frameworks and systems that others can replicate.
  8. You can get ahead by just being a little bit better than your competition.
  9. Business growth follows personal growth. 
  10. Isolation hurts. Don’t stay solo. 

For more detail on each of these ideas, check out Elkaim’s article here.

Frames of mind

This year, I’m making several resources about my areas of expertise (NDIS and health providers). But I’m outsourcing everything I have no expertise in, from hedge trimming to blog artwork. Why?  

The “Circle of Competence”.

It’s a term coined by investor Warren Buffet, and a useful model to reduce your team’s risk, and to develop training plans. As you look to grow your provider business, monitor your team’s circle of competence. You can’t be an expert on everything. You need to know what you know, and what you are an expert in, and know where the boundaries of your competence lie. You can expand your circle with experience, reading, training and effort; or shrink it by failing to keep learning in areas of expertise. The model suggests you are better off focusing on deepening your expertise and expanding your circle by building on existing strengths, and outsourcing the rest.

As Shane Parrish, of Farnam Street puts it in this excellent overview of the model:

“So, the simple takeaway here is clear. If you want to improve your odds of success in life and business, then define the perimeter of your circle of competence, and operate inside. Over time, work to expand that circle but never fool yourself about where it stands today, and never be afraid to say “I don’t know”.

Tips for practice

Two quick tips for this month:

It can be challenging to avoid wasting energy and time arguing with people on social media, and I don’t know many people who have ever changed their mind based on a Tweet or post. You only have so much energy – don’t waste it. I recently came across this Marcus Aurelius quote, which I’m now using as a mantra as I scroll through my various feeds:

“You always have the option of having no opinion.” 

Did you know that NDIS Providers need waste management policies and procedures to comply with the National Disability Insurance Scheme Practice Standards and Quality Indicators? Don’t have one yet? We’ve got you covered.

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