RE: SLT out of session paper - Scheme Sustainability Measures | FOI document library

DOCUMENT 4

From: redacted: s22(1)(a)(ii) - irrelevant Peggie

To: redacted: s22(1)(a)(ii) - irrelevant Corri; redacted: s22(1)(a)(ii) - irrelevant Prue

Cc: redacted: s22(1)(a)(ii) - irrelevant Shilpa

Subject: RE: SLT out of session paper - Scheme Sustainability Measures [SEC=OFFICIAL:Sensitive]

Date: 03 April 2025 10:58:57

Attachments: image001,png

Hi Corri

We’re updating the s33 policy to reflect SLT’s decision last week to implement ‘default’ 3 month funding periods for old framework plans.

’ve set out a Summary of the consultation undertaken for both old and new framework below, external consultation is in blue. We’ve not specifically tested 3 month periods for either old or new framework plans with stakeholders, just funding periods generally.

We’re proposing to consult with NPRAG on funding periods for s33 old framework if possible in the time available, based on feedback that there may be particular impacts for this cohort relating to funding period duration and proportion of funds in each funding period.

Please let me know if you think further external consultation for old or new is required, noting this will push back finalisation of the policy and its implementation (which SLT have noted is scheduled for May).

Very happy to chat through PT

Consultation – funding periods for old framework plans (section 33)

Policy Branch was involved in development of the legislative amendments and drafting for the Old Framework Plans Determination 2024 concurrent with development of the s33 policy. Engagement with DSS on the instrument commenced April 2024. Worked closely with legal, service design delivery, service delivery, service guidance, strategic communications throughout legislative development.

• S33 Policy to RPF in June, Sept and Oct 2024. • Consultation with participants, support coordinators and plan managers about proposed changes to s33 and how to implement the changes – including to help participants understand funding amounts and funding periods (led by Co-Design and Engagement Branch – concurrent with legislation and policy development in 2024). • DSS led engagement with states and territories on legislative reforms (DSOG) • IAC consultation and responses to questions on legislative amendments • Evaluation of s10 and s33 (led by Participant Outcomes, Evidence and Evaluation – ongoing) • Internal stakeholders - MDT for ‘FB467 Funding Periods and Funding Amounts’ (led by Strategic Change – ongoing)

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• Forward plan for engagement to update s33 policy following SLT decision 31/03 proposed as per table below. Engagement with Neurodegenerative, Palliative care and Rare Diseases Advisory Group proposed

redacted: s22(1)(a)(ii) - irrelevant material

Peggie redacted: s22(1)(a)(ii) - irrelevant

Branch Manager, Scheme Policy

National Disability Insurance Agency

M: redacted: s22(1)(a)(ii) - irrelevant material | E: peggie.redacted: s22(1)(a)(ii) - irrelevant@ndis.gov.au

From: redacted: s22(1)(a)(ii) - irrelevant material Corri <Corri.redacted: s22(1)(a)(ii) - irrelevant material@ndis.gov.au>

Sent: Wednesday, 2 April 2025 10:26 AM

To: redacted: s22(1)(a)(ii) - irrelevant Peggie <Peggie.redacted: s22(1)(a)(ii) - irrelevant@ndis.gov.au>; Coroneos, Prue <Prue.redacted: s22(1)(a)(ii) - irrelevant material@ndis.gov.au>

Cc: redacted: s22(1)(a)(ii) - irrelevant Shilpa <Shilpa.redacted: s22(1)(a)(ii) - irrelevant@ndis.gov.au>

Subject: Re: SLT out of session paper - Scheme Sustainability Measures [SEC=OFFICIAL:Sensitive]

Thanks Peggie - can you please clarify for me - are we updating the s33 policy to reflect the policy position on funding periods for new framework plans? Or is this required in order to reflect the NFP position on funding periods for old framework plans?

The timeline below looks good to me - appreciate it is very tight - and appreciate your recommendation about commencement on 1 July (also noting this is actually really just 6 weeks from likely commencement of funding periods).

redacted: s22(1)(a)(ii) - irrelevant material

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Many thanks

Corri

From: Tobin, redacted: s22(1)(a)(ii) - irrelevant

Sent: Tuesday, April 1, 2025 6:42 PM

To: redacted: s22(1)(a)(ii) - irrelevant material Corri; redacted: s22(1)(a)(ii) - irrelevant material Prue

Cc: redacted: s22(1)(a)(ii) - irrelevant Shilpa

Subject: RE: SLT out of session paper - Scheme Sustainability Measures [SEC=OFFICIAL:Sensitive]

Hi Corri and Prue

Just coming back on your query re timeframe for updating s33 policy –

The team has put together a pretty expedited process for getting the policy updated by mid-May (see below), we are a bit limited by public hols in April. I note also that the policy position on funding periods for new framework plans is going to SLT next week, and proposes we put a 3 month default into the rule.

Some of the key policy questions for us to finalise for s33 include:

• Can we have an outright ‘default’ position in operational policy where Act is discretionary?

What can we learn from case law to frame consistent application of 3 months as a defensible policy position? • Are there circumstances where longer funding periods may be required?
Potential impact on participants with degenerative conditions?
Best approach to supports that currently have ‘yearly’ as the unit of measure in PAPL (HEN products and Transport in Core)?
Other? • What are the likely ‘front-loading’ requirements - drawing on ADA analysis on distribution of funds? • What data points will be available for delegates in making the ‘risk assessment’ about funding periods on ‘day 1’, and which could we build quickly / how does this integrate with the risk profile and safeguarding initiative?
This includes identifying non-compliance, and alignment with other policy (i.e. plan management) on whether person is ‘unlikely to comply’ with section 46. • How will participants respond to shorter funding periods? (no scheme experience to date, rolling out in May 2025)

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I also think SLT should give consideration to announcing the intention to start using 3 month periods in old framework from 1 July, just to give stakeholders time to adjust. We will consult with Service Delivery and Comms and can include that advice in our Policy Committee paper.

Please let me know if you have any concerns with this proposal or the timeframes.

Kind regards

Peggie

Funding periods for old framework plans (section 33) – proposed timing

*Takes into account public hols

Step / action	Timing	Est completion	Status
Engage with NDIA legal on leg parameters (default / discretion)	1 day	1/04/2025	Complete
Re-draft positions on funding period length and funding period proportions (‘drafting phase’)	2 week	15/04/2025	Underway
Legal to consider case law on ‘default’ positions where Act discretionary	1 week	During drafting phase	Requested
Consider ADA analysis on current use / distribution of funds for key support types to inform ‘front-loading’ position	3 day	During drafting phase	Underway
Consider insights from focus groups on funding periods for new framework plans	TBC	During drafting phase	Underway
Test and amend draft position with key content SMEs: • NDIA legal • Service design delivery • Service delivery • Integrity • Home & Living / Employment • Service guidance • Safeguarding initiative (risk profile) • ADA • Neurodegenerative, Palliative care and Rare Diseases Advisory Group	2 week	During drafting phase	Not yet started

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Requirements ahead of session TBC

Peggie redacted: s22(1)(a)(ii) - irrelevant

Branch Manager, Scheme Policy

National Disability Insurance Agency

M: redacted: s22(1)(a)(ii) - irrelevant material | E: peggie.redacted: s22(1)(a)(ii) - irrelevant@ndis.gov.au

From: redacted: s22(1)(a)(ii) - irrelevant material Corri <Corri.redacted: s22(1)(a)(ii) - irrelevant material@ndis.gov.au>

Sent: Monday, 31 March 2025 10:40 AM

To: redacted: s22(1)(a)(ii) - irrelevant material Prue <Prue.redacted: s22(1)(a)(ii) - irrelevant material@ndis.gov.au>; redacted: s22(1)(a)(ii) - irrelevant Peggie <Peggie.redacted: s22(1)(a)(ii) - irrelevant@ndis.gov.au>

Subject: Fw: SLT out of session paper - Scheme Sustainability Measures [SEC=OFFICIAL:Sensitive]

FYI, per teams message.

Note proposed assumption for interval payments policy.

What’s timeline on this?

Page 47 of 186

Many thanks

Corri

From: McNAUGHTON, SCOTT

Sent: Friday, March 28, 2025 4:26 PM

To: Falkingham, Rebecca; redacted: s22(1)(a)(ii) - irrelevant Samuel; redacted: s22(1)(a)(ii) - irrelevant David; redacted: s22(1)(a)(ii) - irrelevant Penelope; redacted: s22(1)(a)(ii) - irrelevant material Corri; redacted: s22(1)(a)(ii) - irrelevant material Janine; redacted: s22(1)(a)(ii) - irrelevant Amity; redacted: s22(1)(a)(ii) - irrelevant material Matthew; redacted: s22(1)(a)(ii) - irrelevant material David

Cc: redacted: s22(1)(a)(ii) - irrelevant material Andrew

Subject: SLT out of session paper - Scheme Sustainability Measures [SEC=OFFICIAL:Sensitive]

Hi all

An action item from this week’s Scheme Projections meeting was to come back to SLT for endorsement on a suite of measures designed to further address scheme sustainability. These measures have previously been discussed at Scheme Projections.

We will use time at the SLT SoW on Monday to discuss.

Any questions please reach out.

have a nice weekend

cheers

Scott McNaughton

Deputy CEO

Service Delivery

National Disability Insurance Agency

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OFFICIAL

Working Group – s33 Policy Changes and Funding Periods in PACE

ndis.gov.au | 4 March 2025 | 1

OFFICIAL

Acknowledgement of Country

Before we begin, I would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea, and community. I pay my respects to their Elders, past present and emerging.

I would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples here today.

OFFICIAL

Decisions required

• Approach to Plan Duration

Our recommendations for participants younger than 9, and 9 years and over (slide 6)

• Approach to Funding Periods

Our recommendations (slide 8)

• Implementation Plan

Time off Tools (slide 12)
Timeline (slide 13)

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OFFICIAL

Applying s33 in practice – Plan Duration decisions

Children younger than 9, and participants aged 9 and over

ndis.gov.au | Month 2025 | 4

OFFICIAL

Applying s33 in practice – Plan Durations

Legislation and Policy parameters

The legislation and Ministerial determination are silent on recommending plan durations.

The s33 Policy promotes and encourages longer plan durations with the introduction of Funding Periods. Plan Durations settings should be based on when the NDIA is required to reassess a plan and not used as a safeguard to support compliance with s46 or utilisation of a plan funds.

The matrix to support delegate to assess risks and preferences when making their Funding Period decisions is detailed on the next page.

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OFFICIAL

Applying s33 in practice – Plan Durations

Two cohorts:

• Participants younger than 9 default to 2 years duration, with exceptions (see below) • Participants aged 9 years and over default to 5 years duration, with exceptions (see below)

Exceptions	Reason for exception	Decision/Notes
Early Intervention – Participants younger than 9 likely to exit due to the benefits of Early Intervention	The participant is likely to exit due to the expected benefits of the intensive early intervention approach	1 year
Participants younger than 9 with a diagnosis of developmental delay	Requires a formal diagnosis	1 year
Participants younger than 9 who are receiving intensive supports e.g. Capacity Building funding above $35,000 per annum	To review the outcome of the intensive early intervention supports	1 year
Participants with a Positive Behaviour Support Plan (PBSP) in place with restrictive practices	Restrictive Practices need to be reviewed yearly.	1 year
Hospital discharge plans	Temporary plans to support the transition from Hospital.	Discretionary based on anticipated hospital discharge
Participants reaching life milestones (starting school, transitioning from Primary School to High School, finishing school, or moving out of home)	Would constitute a known change in circumstances.	Discretionary based on timing of life milestone
Compensation Reduction Amount (CRA) or State and Territory Statutory Schemes (SATSS) plans	To align with the known CRA or SATSS review date	Discretionary based on CRA or SATSS review date
Early Intervention – Participants aged 9 years and over	The participant is likely to exit due to the expected benefits of the early intervention approach	2 years
Degenerative conditions, and Terminal Illness and Disability pathway (not streamed YPIRAC)	The participant’s needs are expected to change.	2 years
Participants streamed as YPIRAC and under 65 with a goal of moving out of aged care	Temporary plans to support the transition from Aged Care. To support Cross Billing.	Discretionary based on when the participant is likely to move out of aged care

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OFFICIAL

Applying s33 in practice – Funding Period decisions

Mandatory and recommended funding periods

ndis.gov.au | Month 2025 | 7

OFFICIAL

Applying s33 in practice – Funding Periods decision

Funding Periods Default Settings: Starting point is 3 months plan durations, with the following exceptions as 1 month plan durations:

• Identified or demonstrated risks • Kinds of support • The participants preference

Apply Funding Periods differently to each individual funding component in a participants plan

For example, SIL would have 1 month Funding Periods and Assistive Technology would have 12-month Funding Periods

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OFFICIAL

Applying s33 in practice – Funding Periods Decisions

Section 7(2)(a-j) of the National Disability Insurance Scheme (Old Framework Plans) Determination 2024 sets out the 10 matters the delegate must take into account when setting the Funding Period. The approach to supporting delegates to assess the risks and preferences is detailed below:

Matters to be taken into account	1 month	3 months	12 months
Unlikely to comply with s46	Concerns: Is currently insolvent under administration Has over utilised previous plans Has submitted multiple requests for plan changes with no evidence of funded support need changes Has not complied with s46	No concerns: Is not currently insolvent under administration Has not over utilised previous plans Has not submitted multiple requests for plan changes with no evidence of funded support need changes Has complied with s46
The participant being at risk of experiencing fraud or financial exploitation
The participant experiencing physical, mental, or financial harm
If the participant, their nominee, or child representative is currently insolvent under administration
A payment would exceed the amount in the Funding Period
Has not complied with s46 in any of the participant’s plans
Repeated requests for variations or reassessments without evidence of a change in circumstances impacting support needs
Kind of support (where the funding period is for a funding component amount).	Mandatory 1 month Funding Periods: Supports with regular cadence: • Home and Living (SIL, ILO) • Choice and control • Specialist Disability Accommodation • Cross billing payments for residential aged care subsidies and supplements.		Recommended 12 month Funding Periods: for claims and payments purposes • HEN products in Core • Consumables • Transport in Core
Participant preference	The participant requests 1 month	The participant requests 3 months
Plan value		Default regardless of value

If there is a strong requirement or request for 6 month Funding Periods discuss this with your Practice Lead.

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Additional information

ndis.gov.au | Month 2025

Attachment 1 — Applying s33 in practice — Funding Periods

Ministerial determination

The Ministerial determination specifies matters that delegates need to consider when making Funding Period decisions. These include:

Unlikely to comply s46	Financial Risk	Physical, mental or financial harm	Insolvency	Repeated requests
Whether s46 is unlikely to be complied with (person unlikely to spend NDIS funds only on NDIS supports or in accordance with the plan) in relation to the plan even after taking an educative approach.	Whether the participant is at risk of experiencing fraud or financial exploitation.	Whether a funding period of a particular duration would likely result in the participant experiencing physical, mental or financial harm	Whether the participant, the plan nominee or the child representative is an insolvent under administration	Whether there have been repeated requests for a plan variation or reassessments without information or documents demonstrating a change in the participant’s circumstances.

Risk of payment exceeding funding amount	Plan value	Kind of support	Participant preference	Previous s46 compliance
Funding for reasonable and necessary supports will be exhausted earlier than anticipated.	The value of the total funding amount. For example, a higher amount may require a shorter funding period.	The nature and cost of the reasonable and necessary supports specified in the plan. For example, whether the support is to be provided as a once-off purchase, is a high-cost item, or a recurring support.	Any preference the participant has expressed as to the duration of the funding periods.	Whether s46 has not been complied with in any of the participant’s previous plans.

Attachment 2 — Discussions with Working Group

Considerations made when reaching decisions of:

Starting point is 12 month plan durations (unless a risk, kind of support, preference, or value of First Plan Core flexible supports is identified)
Apply Funding Periods differently to each individual funding component in a participant’s plan

Decisions	Discussion	Decision/Notes
What is our default Funding Period position? Do we start at 1 month or 12 months?	- If we start at 1 month, these are reviewable decisions under s100 as part of the Statement of Supports. Unsure how we’d be able to demonstrate that we have made a 1 month default decision based on evidence. - 1 month feels like a ‘penalty rate’ and not the starting point unless you have SIL etc - We should start with a view of trust and then work through with education first, then move to shorter funding periods if the educative approach doesn’t change behaviours.	Decision made: 12 months is the default position. If the Risk Assessment identified risks then the Funding Period is shortened accordingly. First Plans are included in this approach.
Do we want to encourage a consistent application of Funding Periods, or varied?	- A consistent approach removes or reduces flexibility. - Everyone is different and will use their funds in different ways. For example, Self managed participants might buy in bulk for continence products and be able to save money by having funds available for that. - When the varied Funding Periods functionality is live (likely October) this will have an impact, however at this point from a system perspective it is not simple to apply a blanket approach.	Decision made: Funding Periods are varied depending on the participant’s circumstances. The decision for each Funding Component is independent.