Working with self-managed participants under the NDIS

Please find below responses to questions Speech Pathology Australia (SPA) members frequently ask about working with self-managed participants the NDIS. The information contained in this document is of a general nature. For specific advice tailored to your individual needs private practitioners are encouraged to seek independent legal or professional advice.

If you have further questions please do not hesitate to contact Speech Pathology Australia on 03 9642 4899 or 1300 368 835 or office@speechpathologyaustralia.org.au

Plan management options

The NDIS allows participants to manage their plans in three different ways. NDIA managed, or ‘agency managed’ means the participant’s funding is managed by the agency, and they must use registered providers.

‘Plan managed’ means that the participant’s plan is managed by a third party plan manager, who pays providers on the participant’s behalf. These participants can see registered or unregistered providers.

‘Self-managed’ participants are those that manage their own funds and pay their own providers directly. They can access registered or unregistered providers.

Can self-managed participants manage all of the supports in their plan?

Certain aspects of plans have been deemed to be ‘High risk’ by the NDIA, including Specialist Behaviour Supports and Disability Accommodation. These supports cannot be self-managed, and must be delivered by registered providers i.e. Participants cannot seek these supports from non-registered providers. Participants are able to self-manage all other types of therapy supports in their plans.

Please note that whilst early childhood is deemed to be a high risk category, at present this can still be self-managed, i.e. self-managed participants can continue to see both registered and un-registered providers.

Do self-managed participants have to stick to the price limits in the price guide?

No, the price guide does not apply to self- managed participants, and they can negotiate the prices for their supports with their provider of choice.

Please note this is different from NDIS managed participants, who cannot be charged beyond the prices set out in the price guide. Plan managers are also bound by the price guide, and therefore will not be able to pay providers (registered or un-registered) beyond the prices set out in the price guide.

Do I have to make a service booking or payment request if I am seeing a self-managed participant?

No, you would issue them with an invoice and then they would arrange payment. Alternatively, they may arrange to pay on the day and then be reimbursed. Self-managed participants are responsible for their own funds and payment of providers and must keep records of these invoices and receipts.

Do I have to write a service agreement if I am working with a self-managed participant?

Service agreements are not required by the NDIA, however it may be considered good practice to discuss certain aspects of the service that is to be delivered, such as frequency and cost, and have these agreed to in writing. Additionally, there is an ATO requirement under section 38-38 for there to be an agreement in writing between the provider and participant in order for the services to be GST free. Please see the ATO website for further information on these requirements.

Does a self-managed participants have to disclose that they have an NDIS plan?

No. Self-managed participants do not have to disclose that they are using an NDIS plan. It is prudent, however, to ask all potential/new clients if they are accessing the NDIS in order to fulfil the ATO GST requirements described above.

Self-managed clients are required to provide reports regarding their progress at their annual plan reviews in the same way as NDIA or plan managed participant, so it is likely that they will be seeking a report from you in preparation for their planning session.

Though self-managed participants do not have to provide their plan, it is useful to discuss with them in a respectful and transparent way why it would be beneficial to do i.e. while they may not wish to share the plan in its entirety, it is helpful for them to share the goals to enable you to align your speech goals to their plan, as you need to report on the progress made towards these goals at review.

What if I do not find out my client is a self-managed participant until I am asked to write a report for the plan review?

In the case of those clients who are self- managing, where this is not disclosed until a ‘progress report’ is requested for the review meeting, consider asking for a copy of the plan. Dependent on the goals within the plan, it may or may not be appropriate for you to provide a report, as they may not be goals that have been addressed in your therapy. The parameters of what you will be able to provide in terms of this report, the time it might take to prepare, and associated costs should be discussed and agreed upon with the family, preferably in writing.

Can I charge my usual cancellation fee, or travel charges to self-managed participants?

Yes. As self-managed participants are not bound by the price guide, the limitations around the amount of travel that can be charged, and cancellation policy do not apply. Private practitioners (whether registered with the NDIA or not) who are working with self-managed clients are able to charge according to their existing policies.

How can I get further information or support?

The NDIS website has a self management page which has a range of guides, including one in easy English for participants and providers to access. There are also a range of different resources on the NDIS page of the SPA website.

Members can join the disability member community on Facebook, for regular updates regarding the NDIS. Specific questions can be emailed to the NDIS and Practice Advisor or National Disability Advisor, or directed to National Office on 1300 368 835.

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Original: February 2019

Updated: July 2020

Disclaimer: To the best of the Speech Pathology Association of Australia Limited’s (“the Association”) knowledge, this information is valid at the time of publication. The Association makes no warranty or representation in relation to the content or accuracy of the material in this publication. The information in this publication is of a general nature; it does not apply to any specific circumstances.  The information does not constitute legal or other advice. The Association expressly disclaims any and all liability (including liability for negligence) in respect of the use of the information provided. The Association recommends you seek independent professional advice prior to making any decision involving matters outlined in this publication.

 

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