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Understand the draft budget

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FOI 24/25-1912 DOCUMENT 17

Understand the draft budget SGP KP Publishing

Exported on 2025-09-17 05:09:58

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FOI 24/25-1912 SGP KP Publishing – Understand the draft budget

Table of Contents

1 Recent updates …………………………………………………………………………………………………….. 4

2 Before you start …………………………………………………………………………………………………….. 5

3 Review the draft budget ………………………………………………………………………………………… 6

4 Understand how support categories have been added to the draft budget ……………… 7 4.1 Typical Support Package (TSP or PBM in PACE) ……………………………………………………. 7 4.2 High confidence TSP message ……………………………………………………………………………… 8 4.3 Range TSP message …………………………………………………………………………………………… 8 4.4 $0 TSP message …………………………………………………………………………………………………. 9 4.5 Reassessments and plan transitions ………………………………………………………………………. 9 4.6 Manual ……………………………………………………………………………………………………………… 10

5 Understand Flexible and Stated support categories ……………………………………………… 11 5.1 Flexible support categories………………………………………………………………………………….. 11 5.2 Stated support categories ……………………………………………………………………………………. 11 5.2.1 Core ………………………………………………………………………………………………………………………….. 12 5.2.2 Capital ……………………………………………………………………………………………………………………….. 12 5.2.3 Capacity building …………………………………………………………………………………………………………. 12

6 Next steps …………………………………………………………………………………………………………… 13

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FOI 24/25-1912 SGP KP Publishing – Understand the draft budget

This article provides guidance for a planner delegate, planner (non-partnered area) and review officer to:

 review the draft budget  understand how support categories have been added to the draft budget  understand flexible and stated support categories.

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1 Recent updates

5 May 2025 Updated guidance to:  remove and replace links to streamline planning articles  understand the reassessment pathway for a plan transitioning from SAP CRM to PACE.

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2 Before you start

You have read and understood:

 Our Guideline - Creating your plan (external)  Our Guideline - Reasonable and necessary supports (external)  Our Guideline - Supports you can access (external).

You have also:

 reviewed the participant’s information and understood their disability related support needs and related evidence. Go to article Review participant information for a plan approval case  reviewed any request for information. Go to article View and edit a request for information (RFI) task for a plan approval case  reviewed any technical advice in the Technical Advice case, if required.

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3 Review the draft budget

Review the budget to understand the plan duration, the support categories and overall budget amounts.

  1. In the Plan Approval case, select the Draft Budget tab.

  2. Review the Plan Duration. This will be in months. If you need to change this, go to article Change plan duration.

  3. Review the Total Amount of the draft budget.

  4. Select a support from under the Flexible Budget or Stated Budget headings to view:

o Source – this tells you where the budget amount came from, such as TSP (Typical Support Package) or Reassessment.

o Support Budget – Core, Capacity Building or Capital.

Note: for plan reassessments, you should review any Capital supports in the budget and determine whether they’re needed in the participant’s new plan. You may have to remove these from the budget. Go to article Change the draft budget.

o Budget Type – Flexible or Stated. o Instalment type – Regular, Once-off or Recurring. o Frequency – Annual, Once-off or Recurring. o Plan Duration – total period of the participant’s plan. o Amount – the monthly amount for regular funding or the total amount for once- off and recurring funding.

o Current Frequency Amount – the amount for the frequency, if applicable. If frequency is recurring, this is the total amount for the plan duration.

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4 Understand how support categories have been added to the draft budget

In every Plan Approval case, a draft budget will be generated. Refer to the headings below for each support category source. This is where each support category in the budget has been generated from. This will help you decide whether you’ll need to make changes to the support category.

Regardless of how the draft budget has been created, you’ll need to use the Plan Conversation Support Tool (PCST) to help decide the funded amount for each support category. You must use the PCST for all new plans and plan reassessments and attach to the participant record. Go to article Understand and update the plan conversation support tool.

4.1 Typical Support Package (TSP or PBM in PACE)

Note: PBM stands for Personalised Budget Model. This will appear as the support category source for TSP generated supports.

TSPs are for participant first plans only. A TSP budget is created based on several factors including:

 Demographics – age, gender, location.  Disability – primary disability, such as results from PEDI-CAT and WHODAS, functional assessment scores.  Risk – disability stability, compensation, choice and control, streaming type.  Gathered information – informal supports, community and mainstream supports, employment, education, consumables, coordination of supports, assistive technology, home modifications, social and community, continence.  Supports provided to other participants – using reasonable and necessary approved budgets of participants with similar circumstances and disability needs from historical plans.

The TSP Overall status will indicate whether any TSP support categories have been generated in the draft budget. A TSP will always add all Core support categories to the draft budget to allow flexibility of Core support category funding.

The TSP Overall status may be:

 No TSPs were able to be generated.  Some TSPs were able to be generated.  All TSPs were able to be generated.

All TSP generated supports will have a confidence level assigned to them. These levels are Low, Medium and High.

 High confidence level – not likely to change this amount for this support.

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 Medium confidence level – may change depending on the support needs of the participant and any evidence that has been given. You’ll need to review and determine whether the amount is correct.  Low confidence level – likely to be removed or changed based on the support needs of the participant and any evidence that has been provided.

Regardless of the confidence level, you’ll need to use the PCST to help decide the funded amount for each support category. You must use the PCST for all new plans and plan reassessments and attach to the participant record. Go to article Understand and update the plan conversation support tool.

The TSP Message on a support category will help you determine any changes to that support.

To view the TSP message:

  1. In a Plan Approval case, select the Draft Budget tab.

  2. Select a support category from under the Flexible Supports or Stated Supports heading.

  3. The TSP Message will appear below the Support Category name.

4.2 High confidence TSP message

PACE will recommend that high confidence TSP support categories are unlikely to change. You’ll still need to determine the funded amount for the support category using the PCST. You must use the PCST for all new plans and plan reassessments.

  1. Review the TSP Message detail to understand the main information considered for this support.

TSP Message example: The TSP and supporting evidence for [Support Category] have been provided. The TSP is based on the participant’s disability and personal and environmental circumstances and is deemed reasonable and necessary. You’re likely to be able to rely on this estimate.

  1. Review the evidence to make sure it’s consistent with the budget.

  2. Consider evidence that is inconsistent with the budget, such as:

o an assessment that recommends a specific support o additional information that wasn’t considered for the budget.

4.3 Range TSP message

This budget range is consistent with information gathered from the participant and reasonable and necessary approved budgets for similar participants. PACE will show the middle of the range as the budget.

  1. Review the TSP Message to understand the budget range.

TSP Message example: Range: $50 - $100. Review the support category budget and supporting evidence for [support category name] to decide the level of funding that meets NDIS criteria and is based on relevant OG’s, internal guidance and specialist

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advice

  1. Review the evidence to decide if it’s consistent with the middle of the range.

  2. Consider evidence that is inconsistent with the middle of the range estimate, such as:

o an assessment that recommends a specific support o additional information that wasn’t considered for the budget.

4.4 $0 TSP message

  1. Review the TSP Message to understand the reason for the $0 budget. It will be $0 for one of the following reasons:

o This support is not likely to be needed. The TSP for this support category is $0 based on the participant’s disability and personal and environmental circumstances.

o TSP not available for this support category. o This support is [likely/not likely] to be needed. Follow the support category guidance for [support category] to decide the funding that meets the NDIS funding criteria.

o The TSP was not generated due to missing information. o To give claiming flexibility across the 4 flexible core support categories.

  1. Review any evidence to make sure that it’s consistent with a $0 budget. Any evidence that recommends the specific support will need to be considered in the draft budget and whether it meets the NDIS funding criteria.

Go to article Action a plan approval case when access is granted without pre-access information gathering if a $0 TSP has been generated.

4.5 Reassessments and plan transitions

For unscheduled reassessments of a SAP CRM plan, supports in the participant’s first PACE plan are likely to change. The changes will be based on the participant’s change of circumstances and disability support needs.

For s48 plan reassessments, you’ll need to review the supports to make sure that they’re meeting the needs of the participant. All supports from the participant’s current plan will be included in the draft budget.

You’ll also need to consider making changes based on any change to the participant’s situation. You’ll need to:

 review supporting information in the Plan Change case about the change in situation  review existing evidence to make sure it’s still consistent with the draft budget  consider any new evidence and how that impacts existing supports or new supports that may need to be added.

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To learn more, go to article Complete a SAP CRM to PACE plan transition.

4.6 Manual

These supports are added manually to the draft budget by a delegate. They shouldn’t need changing as you’ll have made a reasonable and necessary decision and used evidence to include these supports in the draft budget.

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5 Understand Flexible and Stated support categories

Support categories in the participant’s plan can be flexible or stated.

5.1 Flexible support categories

Core support is the only support type where there’s flexibility across other core support categories. This will allow participants to buy supports from other flexible core support categories. The exception is home and living and YPIRAC – cross billing support categories. For more information, see stated support categories.

Funding in these core support categories can be flexible:

 assistance with daily life  assistance with social, economic and community participation  consumables  transport (not recurring transport).

PACE defaults these support categories to flexible, but you can change them to stated based on the participant’s situation. For example, if you’ve specified consumable supports in the participant’s plan, this means they must buy this type of support.

If you use a different fund management type for each support category in core, the funding can’t be flexible. For example, if the participant is self-managing their consumables category, but their assistance with daily life category is being managed using a registered plan manager. Participants can’t swap supports from one category to the other.

To allow flexibility across the core support categories:

 Confirm that the participant is using the same fund management type.  Include all core support categories in the participant’s plan.  If the support category doesn’t have any support items that meet the NDIS funding criteria (external), add as a $0 support category. This will make all other core support categories flexible.

Note: make sure you talk with the participant about why you’ve included these support categories in their budget. They’ll appear on the participant’s plan as a $0 support category.

5.2 Stated support categories

Stated support categories aren’t flexible. This means participants can only buy supports from the stated support category. For example, the participant can’t use the assistive technology support category to pay for repairs. Instead, they must use the funding in the assistive technology – maintenance, repair and rental category to pay for these.

In core, the home and living category is stated but the supports can be flexible with other home

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and living supports. To learn more about the home and living support category, go to article Support Categories.

These support categories default to stated and must be stated in the participant’s plan:

5.2.1 Core  home and living (Supported Independent Living (SIL), Independent Living Options (ILO), Medium Term Accommodation (MTA))  YPIRAC – cross billing.

5.2.2 Capital  assistive technology  assistive technology – maintenance, repair and rental  home modifications  specialist disability accommodation (SDA).

5.2.3 Capacity building  behaviour support  choice and control  finding and keeping a job  health and wellbeing  improved daily living skills  improved living arrangements  increased social and community participation  lifelong learning  recurring transport  relationships  support coordination and psychosocial recovery coaches.

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6 Next steps

  1. To understand the support categories that have been generated in the draft budget, go to article Support categories.

  2. Once you understand the supports in the draft budget, you’ll need to use the PCST to decide the funded amount for each support category. Go to article Understand and update the plan conversation support tool.

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