Create a plan reassessment (or variation) request (PRR)

This Standard Operating Procedure (SOP) will help you to create a plan change request (section 47A and 48(1)) of the NDIS Act). PRR’s are created where the participant’s circumstances have changed or their current plan no longer meets their needs. Before creating a PRR, you should make sure it is the appropriate action, including referring to the Choose the right request tool (CRRT).

Note: This SOP refers to plan changes (plan reassessments and variations). The NDIS Business System (System) refers to these as plan reviews (renewal, longer term renewal, light touch or full) however this language is for internal use only.

1. Recent updates

Date	What’s changed
November 2022	Document updated to correct minor errors and update broken links.
July 2022	Replaced language from plan reviews to plan change, reassessment, or variation to reflect legislation changes from 1st July 2022.
	Added instructions for partners when actioning plan variation request (NDIS Act s47A).
	SOP name change from Create a plan review request (PRR) to Create a plan reassessment (or variation) request (PRR).

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2. Checklist

Topic	Checklist
Pre-requisites	❑ The participant has an approved plan.
	You have:
	❑ read and understood Our Guideline – Changing your Plan
	❑ made a decision using the CRRT that a PRR is the appropriate action
	❑ attached all evidence and information using the Standard Operating Procedure – Manage inbound documents
	❑ confirmed the reason for the request is not for Assistive Technology (AT) supports, which should be progressed using the Standard Operating Procedure – Initiate an Agency-Initiated plan review more than 100 days from the plan review date.

| Actions | ❑ 3.1 Determine who is making the request | | ❑ 3.2 Consider active internal review requests | | ❑ 3.3 Create a Plan Change Request.

Standard Operating Procedure

For Internal Use Only

3. Procedure

3.1 Determine who is making the request

The NDIA can accept a PRR either verbally or in writing. The National Access and Reassessment Branch (NARB) will consider the reasons for the request and if the current plan needs changing.

If the PRR has been requested by:

• the participant, their plan nominee or child representative, or a court or tribunal appointed decision maker, proceed to section 3.1.1
• a person who has express consent to act on behalf of the participant, their plan nominee or child representative, or a court or tribunal appointed decision maker, proceed to section 3.1.2
• a person who is not an authorised representative, refer to the Standard Operating Procedure – Plan change request from an unauthorised representative. A PRR can’t be accepted from a person without consent.

3.1.1 Request received from the participant

1. Verify identity using the Standard Operating Procedure – Record and verify identity for an individual and the Standard Operating Procedure – Verify identity for a third party organisation.

2. If the person making the request is:

   • the participant or child representative, proceed to 3.2 Consider active internal review requests
   • the plan nominee or a court or tribunal appointed decision maker, check the scope of their role and their authority to request the change using guidance on the General resources Intranet page. For nominees, you can also check the Nominee screen in the System. For more information, refer to the Standard Operating Procedure – Appoint or decline a nominee.

3. Talk to your team leader if you are unsure if the nominee, court or tribunal appointed decision maker has the authority to request a change.

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Standard Operating Procedure

For Internal Use Only

4. Once you have confirmed the plan nominee or court or tribunal appointed decision maker has authority to request a change, proceed to 3.2 Consider active internal review requests.

3.1.2 Request received from a representative with express consent

1. Use the Standard Operating Procedure – Check third party consent or authority to confirm the person making the request has express consent to request a plan change on the participant’s behalf. The person should also have express consent to exchange information with the NDIA.

2. If express consent includes consent to request a change, check the date the consent was given. If it is unclear if the consent is still current, contact the participant or their authorised representative to confirm.

If a third party says they have consent but this is not recorded in the System, you will not be able to proceed. To obtain consent, follow the steps outlined in the Standard Operating Procedure – Record third party consent.

Note: If you are unsure if there is appropriate consent or what the next steps are, speak to your team leader. Your team leader may also seek advice from Privacy@ndis.gov.au

Verify the identity of the person with consent using the Standard Operating Procedure – Record and verify identity for an individual and the Standard Operating Procedure – Verify identity for a third party organisation.

3. Once you have verified identity and confirmed the person making the request has the appropriate consent, proceed to 3.2 Consider active internal review requests.

3.2 Consider active internal review requests

A participant can request a plan change when they have an internal review (s100) in progress. Sometimes we may decide to do a plan change while the internal review (s100) is in progress.

From 1 July 2022 if we approve a new plan or vary the current plan before the internal review decision, the internal review can include the decision that is being reviewed as well as the new decision to approve a new or varied plan. This means that both decisions can be considered as part of the one internal review.

There are current system limitations which will prevent you from initiating a PRR when an internal review is in progress. So, it is important to check for an active internal review.

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Standard Operating Procedure

For Internal Use Only

3.2.1 Check for an active internal review request

Check the participant record for an active “S100 in progress” Alert.

1. Check for an active internal review (s100) request using the Standard Operating Procedure – View or edit an open Request for Internal Review.
2. If there is no active internal review request, go to 3.3 Create a Plan Change Request.
3. If the participant has a pending internal review (pending s100), go to section 3.2.2

3.2.2 There is an active internal review request.

1. Advise the participant that their internal review request remains active and that an internal review officer will be in contact to discuss their plan change request and the next steps.
2. Add an Interaction. Refer to Interaction Templates – Reassessments and Variations – Participant Plan Review – Request Escalated. Complete all required fields.
3. Assign Open interaction to Internal Review Team inbox: CR PED NAT/VIC IRT Planning Incoming. No further steps are required in this SOP.

3.3 Create a Plan Change Request

Note: If the PRR being initiated is to complete a plan variation go to step 1. If the PRR is being initiated for a plan reassessment go to step 2

1. Add a Workflow identifier - Plan Variation to the record. This will ensure that plan variation requests are workflowed to the NARB.

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Standard Operating Procedure

For Internal Use Only

2. From the NDIS Account screen, select Add items.

3. From the menu, select Plan Review Request.

Note: In some situations, the System will prevent you from creating a Plan Review Request. An information message will display to encourage you to discuss the reasons with the participant. Refer to section 5.1 for examples of error messages you may see and the reason.

4. Plan Change Request form displays.

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Standard Operating Procedure

For Internal Use Only

5. The Request date is pre-filled to display the current date.

• If the NDIA received the request within the last seven days, change the Request date to the date the NDIA received the request.
• If the NDIA received the request more than seven days ago, change the Request date to the date seven days ago. Record the actual date received in the supporting information field.

6. Select the drop down list in the Requested By field. You can only select the participant, their plan nominee or child representative from this drop down:

• If a court or tribunal appointed representative or authorised third party with express consent made the request, select the participant details.
• In the Supporting Information field note that a court or tribunal appointed representative or authorised third party with express consent made the request.

7. Select the Channel.

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Standard Operating Procedure

For Internal Use Only

8. You need to select a Reason for request which best aligns with the conversation with the participant or their authorised representative.

Note: If the participant has asked to only edit their participant statement don’t create a PRR request. This can be completed through an administrative change. For more information, refer to the Standard Operating Procedure – Create an administrative change task.

9. Select Add in the Inbound document section to attach documents to the PRR.

10. All the documents which have been uploaded to the participant’s record will display. Select any documents that support the PRR.

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Standard Operating Procedure

For Internal Use Only

Once selected you will be re-directed to the form where the Inbound Document now appears.

: Add Inbound Document Test Upload Created On 29.10.2019 By User name)

Supporting Information is a mandatory free text field to provide the NARB delegate with more information on the change request. You should record:

• the date the NDIA received the request as per step 3
• the details of the authorised representative as per step 4
• the proof of identity details where an authorised third party made the request
• information on the reason(s) for the request, and any other relevant details including:
• • details of the change of situation
• • information on the requested changes to the participant’s plan
• • reasons given for why the plan no longer meets the participant’s needs
• • Information stating if the request has been identified as a plan variation. You should include as much information as possible for the National Reassessment Officer (NRO) to consider. The NRO may contact the participant or their authorised representative to explore, where appropriate, other possible options to reach the desired outcome. This discussion may lead to a request to withdraw the PRR. When this occurs, the NRO will send the Letter-Plan change request withdrawn.

: Add Supporting Information: Add note)

Once all details are complete, select Submit.

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Standard Operating Procedure

For Internal Use Only

14. A confirmation message will display to advise the PRR has been created successfully. Select OK.

Note: Do not re-assign the PRR to an NRO.

15. If you have created a PRR to initiate a plan variation request and added a Workflow identifier you need to add an interaction using the Interaction Template - Plan reassessment and variations - plan variation which explains the reasoning for the PRR.

4. Next Steps

Once you have submitted a PRR, you can view, edit or withdraw it using the Standard Operating Procedure – view, edit or withdraw a plan reassessment request.

Inform the participant or their authorised representative:

• the PRR has been submitted and will be considered by the relevant team
• they may be contacted to provide further information
• they will receive notification of the decision outcome.

A submitted PRR will automatically workflow to the NARB who will consider the reasons for the request. The NARB delegate will:

• determine if the request is approved, declined or if further time is needed to consider the request.
• If a variation is approved, a NRO with complete this with the participant.
• send the corresponding decision letter to the participant
• upload a copy of the sent letter to the System.

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5. Appendices

5.1 Information message glossary

5.1.1 A PRR has already been created

There is already an active PRR in the System. Once you select OK, the System will redirect you to the open request. You should note any updates in the active PRR.

5.1.2 A plan change request is in progress

There is already an open plan change. You should tell the participant or their authorised representative that their plan is currently being reassessed or varied. Record an Interaction on the participant’s record. Unless you need to take further action, close the interaction after recording the conversation.

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5.1.3 When the participant does not have an approved plan

There is no approved plan in the System. A plan delegate will need to approve the plan before you can take further action. You should talk with the participant or their authorised representative about their concerns. Determine if you can address these concerns before plan approval.

The PRR can’t be actioned if the NDIA has revoked the participant’s access or they are no longer an active participant. You should escalate this to your team leader. Note that revocation of access is a reviewable decision (section 99, Item 3 of the NDIS Act).

5.1.4 When an internal review (s100) is in progress

A participant has an open request for an internal review of a reviewable decision. You should follow the process outlined in section 3.2.

Standard Operating Procedure

For Internal Use Only

6. Related procedures or resources

• National Disability Insurance Scheme Act 2013
• National Disability Insurance Scheme Rules
• NDIS Our Guidelines
• NDIA privacy policy
• Standard Operating Procedure – Record and verify identity for an individual
• Standard Operating Procedure – Verify identity for a third party organisation
• Standard Operating Procedure – Check third party consent or authority
• Standard Operating Procedure – Record third party consent
• Standard Operating Procedure – Withdraw or change third party consent
• Standard Operating Procedure – Plan reassessment request from an unauthorised representative.

7. Feedback

If you have any feedback about this Standard Operating Procedure, please complete our Feedback Form.

8. Version control

Version	Amended by	Brief Description of Change	Status	Date
1.0	CW0032	Class 2 Approved	APPROVED	2021-04-12

New resource to replace existing content from the SOP – Plan Review Requests. Updates include:

• More guidance on completing the supporting information field of a Plan Review Request (PRR).
• A new reminder to not re-assign PRRs to NARB delegates.
• More information on NARB process where a decision is made on a PRR
• A new pre-requisite to upload all relevant documentation to Inbound Documents before proceeding.

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Standard Operating Procedure

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Version	Amended by	Brief Description of Change	Status	Date
2.0	BIB217	• Revised formatting for improved readability.
Class 3 approved:	APPROVED	2021-08-20
3.0	CW0032 CH0026 LS0042 AGV957	Guidance updated for addressing active s100 requests and to clarify the scope of an internal review with a participant requested review is submitted.
Replaced language from plan reviews to plan change, reassessment, or variation to reflect legislation changes from 1st July 2022.
Adding instructions for partners when actioning plan variation request (NDIS Act s47A).	APPROVED	2022-07-19
4.0	JS0082	SOP name change from Create a Plan Review Request (PRR) to Create a Plan Reassessment (or variation) Request (PRR).
Class 1 Approval.
Correct minor error in this SOP that was published in July to support the 1 July Legislation Amendments	APPROVED	2022-11-17

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