Standard Operating Procedure

Include Support Coordination in a plan

Previous Step: Pre-planning tasks are completed in the National Disability Insurance Scheme (NDIS) business system (System)

Next Step: Complete the Determine Plan Management task in the System

1. Purpose

This Standard Operating Procedure (SOP) will support you to consider and include reasonable and necessary support coordination in a participant’s plan and should be used alongside the Standard Operating Procedure – Complete the determine funded supports task.

2. Index

• 6.1 Navigate to the support calculator
• 6.2 Include Support Connection in a plan
• 6.3 Include Coordination of Supports (support coordination) in a plan
• 6.4 Include Specialist Support Coordination in a plan
• 6.5 Training in planning and plan management
• 6.6 Next steps
• 7. Supporting material

3. To be used by

• Plan Developers:
  • Planners
  • Partners in the community (early childhood partners and local area coordinators [LACs])
• NDIA plan delegates.

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Standard Operating Procedure

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4. Scope

Support coordination is a broad term used to describe the three levels of support (support connection, coordination of supports and specialist support coordination). This support can be included in the participant’s plan to support them to connect with services whilst strengthening their ability to pursue their goals and aspirations. The provision of support coordination will also help the participant understand how the NDIS operates within a broader ecosystem of supports including disability organisations and mainstream and community supports.

To provide a high quality service to participants, planners and partners are reminded successful planning is centred on the following principles:

• Valuing and respecting the goals and aspirations of the participant.
• Understanding the importance, role and opportunity that may be afforded to the participant by connecting with mainstream, community and informal supports.
• Applying reasonable and necessary judgements in developing and determining the funded supports to assist the participant to pursue their stated goals.
• Determining and assessing the suitability of funded supports against the generated Typical Support Package (TSP).
• Quality interactions which demonstrate empathy and understanding of the participant’s disability and needs.

4.1 Levels of support coordination

There are three levels of support coordination which may be included in the plan in the support coordination budget. Use your reasonable and necessary decision making and take into account the goals and aspirations of the participant. Streaming is an important factor to determine the level of support coordination a participant needs. However, it’s important that plan developers also take into account a participant’s individual circumstances. When you determine the type, level and number of hours to be included in the plan, consider existing informal supports, any additional complexity factors as well as the participant’s streaming outcome.

The generated TSP will also guide you in determining the funded supports. The following is provided for guidance only and is not intended to be used as a rule.

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Standard Operating Procedure

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If the TSP is exceeded by more than 10% because of a reasonable and necessary decision,

clear evidence from a relevant professional must be attached as an inbound document in the NDIS Business System (System). Justification for any changes, in line with the attached evidence, must be recorded in the Review and Submit Plan for Approval task.

Note: If support coordination is included in the plan, discuss with the participant if they have any preferred providers for this support and gain their consent for the NDIA to make a referral on their behalf. This information will be required for plan implementation. For further information refer to the Standard Operating Procedure – Make a request for service (support coordination and recovery coach).

4.1.1 Support Connection

Support connection is typically delivered by a participant’s Local Area Coordinator (LAC) or Early Childhood Partner. Support connection is a time-limited assistance to strengthen the participant’s ability to connect with mainstream and community supports, and establish service agreements and bookings with support providers. The aim is to increase the participant’s capacity and ability to maintain relationships, negotiate with service providers and respond to minor service delivery issues.

Participants who reside in an area that is supported by an LAC or Early Childhood Partner, should generally not require additional funding to be included in their plan as this is the primary role of the partner. This is, however, dependent on the level of support the participant needs to implement their plan. You will need to consider all information available to you to make this decision as each participant’s circumstances are different.

For participants streamed General or Supported:

• If supported by a partner, you can remove the funding generated in the Support Coordination budget. In doing so, you should assess if the participant requires referral to a specific support connector, such as a CALD organisation or a preferred Aboriginal and Torres Strait Islander provider.

If not supported by a partner, amend the generated Support Coordination budget to reflect your reasonable and necessary consideration. As a guide, this would typically be an hour a month (around 12 hours for a 12 month plan) of support connection.

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Standard Operating Procedure

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4.1.2 Coordination of Support (formerly support coordination)

Coordination of support is delivered by a support coordinator. Consider including coordination of support in a participant’s plan to assist in strengthening the participant’s capabilities to connect to and coordinate informal, mainstream and funded supports in a complex service delivery environment. Participants requiring this level of support will have usually been streamed at the Intensive level. This may include resolving points of concern, unexpected service delivery issues, developing capacity and resilience in a participant’s network and coordinating supports from a range of suppliers or providers.

The support coordinator should focus on addressing barriers and reducing complexity in the support environment, while ensuring that the participant is supported to connect with, and build their capacity and resilience. It may also involve development of an intervention plan which will be delivered by disability support workers.

There may not be enough funding in the generated TSP to meet the participant’s coordination of support needs. You may need to adjust the coordination of support funding to enable the participant to receive the right level and type of support to implement their plan and address any complexities in their life.

Note: When a support coordinator is providing capacity building supports, immediately moving to a partner - LAC or Early Childhood may disadvantage the participant. In this case you can include 3 months of coordination of support in the new plan, with a request that the support coordinator completes a ‘warm handover’ to the partner at the end of those 3 months.

The below provides some guidance for including funds for coordination of support in the plan however you will need to consider all information available to you when making your reasonable and necessary decision.

• Low (1-2 hours a month/approx. 24 hours per year) for example, this could be considered when the participant:
  • has elderly parents who are needing to explore and establish a range of supports including housing options and future planning issues for their son/daughter
  • lives in a group home or large residential facilities and has a strong informal support network with no identified risks

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Standard Operating Procedure

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• is adjusting to vision, hearing and other sensory loss type conditions. • Medium (3-6 hours a month/approx. 48-72 hours per year) for example, for participants who:
  • have a managed psychosocial diagnosis and are well connected to clinical supports. For example, may be accessing treatment options to understand their condition, trial medications and create a recovery plan.
  • have a support network that may be at risk
  • are at mid stages of a degenerative condition
  • may require assistance to transition to alternative living arrangements. • High (approximately 7-9 hours a month) for example, participants who:
  • are experiencing an unstable psychosocial disability and have a history of long-term hospitalisation and/or history of tenancy instability
  • have limited family and social networks
  • have very low levels of community participation
  • in the absence of support, have difficulty living in the community and are at high risk of hospitalisation or homelessness
  • identify as Aboriginal or Torres Strait Islander and may be living in remote communities
  • are involved with other services such as child protection or justice
  • are living with a diagnosis of a degenerative condition such as; younger onset dementia, Huntington’s disease, multiple sclerosis (MS), muscular dystrophy or motor neurone disease (MND). As a result they require support to engage with specialist support organisations to assist with understanding their condition and connecting with available supports. Required where multiple providers are involved.
  • mild to moderate levels of intellectual disability or acquired brain injury and are residing alone and need to make sure proactive supports are in place. They may require assistance to access and maintain community activities, budgeting, shopping, or similar activities ensuring successful maintenance of their independence.

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Standard Operating Procedure

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Note: For all levels, these are examples only and you must use your reasonable and necessary decision making when including supports in a plan.

4.1.3 Specialist Support Coordination (typically up to 100 hours for a 12 month plan)

Participants who have been streamed as Super Intensive may require specialist support coordination as they may have multiple complexities in their circumstances, multi-jurisdictional involvement and limited support networks. This could involve a specialised and/or intensive response within a specialist framework if the participant has high risks in their life situation and/or environment. These could include:

• risk of homelessness due to their behaviours of concern
• interface with justice, housing and/or other complexities
• children living outside the family home under formal voluntary out of home care arrangements as acknowledged by the relevant state or territory authority and the NDIA. Refer to Practice Guide – Children living in a formal voluntary arrangement outside their family home.

This approach is expected to:

• address barriers and reduce complexity in the participant’s environment
• assist to connect the participant with multiple complex supports
• assist to build the participant’s capacity and resilience.

You will need to use your reasonable and necessary decision making to determine how many hours will need to be included for specialist support coordination and consider the guidance under the heading of Specialist Support Coordination above. When deciding how many hours, make sure there is enough funding to support the participant as well as to allow the support coordinator to fulfil their reporting requirements.

4.1.4 Referral for Complex Support Needs

When determining the level of support coordination you may identify the participant has complex support needs that require referral into the Complex Support Needs (CSN) Pathway. The CSN Pathway aims to provide specialised support for people with disability who experience personal and situational factors that are beyond the scope of the typical NDIS Pathway. To refer a participant for assessment by the CSN branch, refer to Standard

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Operating Procedure – Referral for complex support needs. For more information on the CSN Pathway refer to Practice Guide – Complex support needs pathway.

4.2 Support Coordination Roles

The role of the LAC, Early Childhood partner (support connection) or support coordinator is to assist the participant to implement their plan. They will make sure the participant can exercise choice and control to, link with the right providers, pursue their goals and locate and coordinate a range of supports. Generally, this will include mainstream, community and funded supports while building on informal networks. They will provide participants with strategies for how to use their support budgets to pursue their goals. Support coordination activities can include supports to build participant resilience in their own network and community.

A support coordinator will need to complete implementation and progress reports as part of their role in supporting the participant. Plan developers should make sure that additional hours are included in the support budget to allow for this to be completed. You will need to use reasonable and necessary decision making to make sure all required inclusions are in the participant’s plan.

4.3 Psychosocial Recovery Coach

From 1 July 2020, a new support called psychosocial recovery coach (recovery coach) will be available for NDIS participants and is included in the NDIS Pricing Arrangements and Price Limits.

Generally, if a participant’s primary disability is psychosocial disability then you should consider including the support of a recovery coach. Recovery coach support should be included if, in your discussions with the participant, you identify that they require support to link to and maintain engagement with informal, community, mainstream and funded supports; and to build capacity, including strengths and resilience. A recovery coach is available to participants across all streams – General, Supported, Intensive and Super Intensive.

Generally, the participant should not have funding for both recovery coach support and support coordination included in their plan. Support coordination may be considered reasonable and necessary in addition to funding a recovery coach in limited circumstances. For example,

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Standard Operating Procedure

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Funding for a specialist support coordinator may be considered reasonable and necessary if the participant identifies a goal of finding suitable housing.

If the participant had funding for support coordination in their previous plan, discuss the supports a recovery coach can provide. Explain that a recovery coach will be able to provide targeted support for the participant in relation to their psychosocial disability and can support them in their recovery journey.

If the participant is already linked with a support coordinator they can exercise their own choice and control to decide if they want to use their recovery coach funding to continue receiving support from their support coordinator, or they may wish to change to support provided by a recovery coach.

Note: As this is a new support the market may be limited to provide this service. Until the market matures there may not be any recovery coach providers available in the participant’s local area. If this is the case and the participant has support coordination included in their plan they can continue to be provided with support through their LAC or support coordinator.

If recovery coach support is included in the plan you must complete the Request for Service System task during plan implementation. Refer to Standard Operating Procedure – Make a request for service (support coordination and recovery coach).

For further information refer to Practice Guide – Psychosocial disability, Standard Operating Procedure – Psychosocial recovery coach support.

4.4 Children 15 and Under

As of 15 September 2017, the System no longer auto-generates funding for support coordination for participants aged 15 years or under, even if it has been indicated as required in the Guided Planning Questionnaire. Apply reasonable and necessary decision making when determining if funding for support coordination is required. Consider the participant’s circumstances and context (including their informal support networks and parental responsibility) and if the support meets reasonable and necessary criteria. Record adequate justification to support and document the decision.

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Standard Operating Procedure

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5. Prerequisites

• You have had a planning conversation with the participant to understand and identify their current and potential Assistive Technology (AT) support needs, as well as identifying any preferences for specific providers to provide support coordination services.
• You have completed all relevant pre-planning tasks in the System.
• You have read the Standard Operating Procedure – Complete the Determine the Funded supports task.

6. Procedure

Note: Data in screenshots is fictional and intended for instructional purposes only.

6.1 Navigate to the support calculator

1. From the Home screen select My NDIS.
2. Search for and select the Participant. Refer to Standard Operating Procedure – Search the NDIS Business System.

Standard Operating Procedure

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3. From the pathway tab, select the In Progress Application.

4. Select Planning.

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5. The Planning page displays. Select Determine the Funded Supports.

6. The Determine the Support Needs screen opens.

7. Complete the Determine the Funded Supports task. Refer to Standard Operating Procedure – Complete the Determine the Funded Supports task.

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8. Once the plan’s funded supports have been completed, select the Save button.

9. Select the Capacity Building support type.

10. The two Capacity Building sub types are displayed.

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Standard Operating Procedure

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11. Manually remove any funding auto-generated for Support Coordination.

12. Select the expand icon in the Support Coordination price field.

13. The Support Calculator will open. Select anywhere in the Product field.

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The Select a Product screen will open.

Add support using:

• Include Support Connection in a plan
• Include Coordination Of Supports (formerly support coordination) in a plan
• Include Specialist Support Coordination in a plan
• Training in planning and plan management.

6.2 Include Support Connection in a plan

1. In the support calculator, select Support Connection.

Standard Operating Procedure

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2. Use reasonable and necessary decision making to adjust the Quantity as guided above.

• At How Often select Per Year. • Select Done.

3. In the Comment field record the following: XX hours of support connection to help me connect with my chosen service providers.

4. Select Submit when completed.

5. When the form has been submitted, a success message appears. The success message will ask Are the funded supports types correctly aligned to the goals listed in the Participant Statement?

• If you select No, you will be taken directly to the Participant Statement to review the goals section and make sure the correct support type boxes have been ticked.

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Standard Operating Procedure

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• If you select Yes, you will continue as usual.

Include Coordination Of Supports (formerly support coordination) in a plan

Note: In the System support coordination is referred to as coordination of supports.

1. In the support calculator, select Coordination Of Supports.

Select a Product
Support Connection 07_001_0106_8_3
Coordination Of Supports 07_002_0106_8_3
Training In Planning And Plan Management 07_003_0117_8_3
Specialist Support Coordination 07_004_0132_8_3

2. Use reasonable and necessary decision making to adjust the Quantity as guided above.

Support Calculator
+ Product Price Unit How Often Frequency Total
- Coordination Of Supports 96.04 Hour Per Year 2.00 $10180.24
Item Type Stated
Quote Required
Quote Received

• At How Often select Per Year.
• At Item Type select Stated.
• Select Done.

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3. In the Comment field enter the following text: XX hours of support coordination to support me to connect to, engage with and coordinate my chosen service providers.

4. Include any other reasonable and necessary supports using the Support Calculator.

5. When you are satisfied that all supports in the plan are reasonable and necessary, select Submit.

6.4 Include Specialist Support Coordination in a plan

1. In the support calculator, select Specialist Support Coordination.

Standard Operating Procedure

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2. Use reasonable and necessary decision making to adjust the Quantity as guided above.

• At How Often select Per Year. • At Item Type select Stated. • Select Done.

3. In the Comment field record the following: XX hours of specialist support coordination to support me to connect to, engage with and coordinate my chosen service providers.

4. Include any other reasonable and necessary supports using the Support Calculator.

5. When you are satisfied that all supports in the plan are reasonable and necessary, select Submit.

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Standard Operating Procedure

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6.5 Training in planning and plan management

You can include supports in the participant’s plan aimed at building their capacity to self- manage their NDIS funded supports. The line item Training in Planning and Plan Management sits in the Support Coordination support category and can be included on a time limited basis if considered reasonable and necessary.

This support does not have to be provided by a support coordinator, however the provider must be registered for this category.

Plan and financial capacity building support may also be provided by a plan manager where there is no coordination of supports funded in the participant’s plan. Refer to Standard Operating Procedure – Include financial administration capacity building supports.

6.6 Next steps

6.6.1 Determine Plan Management

Complete the Standard Operating Procedure – Complete the Determine Plan Management task before finalising and approving the plan.

6.6.2 Finalise and approve the plan

Complete Standard Operating Procedure – Review and submit a plan for approval OR Standard Operating Procedure – Finalise and approve a plan. You will need to include justification for including coordination of supports in the plan.

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Standard Operating Procedure

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7. Supporting material

• National Disability Insurance Scheme Act 2013 (section 34)
• National Disability Insurance Scheme (Supports for Participants) Rules 2013
• Practice Guide — Participants streamed as Intensive or Super Intensive
• Standard Operating Procedure — Complete the Determine the Funded Supports task
• Planning Operational Guideline

8. Process owner and approver

General Manager, Participant Experience Design.

9. Feedback

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

10. Version control

Version	Amended by	Brief Description of Change	Status	Date
5.0	MBO056	Class 2 approved. Included reference to Practice Guide — Complex Support Needs Pathway and Standard Operating Procedure — Referral for Complex Support needs. Included new section on psychosocial recovery coach role.	APPROVED	2020-06-18

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Version	Amended by	Brief Description of Change	Status	Date
6.0	EMN960	Updated recovery coach guidance to clarify: - when a support coordinator may be considered reasonable and necessary in addition to a recovery coach - a participant can continue with their current support coordinator using their recovery coach funding if they choose to.	APPROVED	2020-07-27
7.0	CS0074	Class 1 Approval
Updated links relating to the NDIS Business System.	APPROVED	2021-01-18
8.0	JSO082	Class 1 Approval	APPROVED	2022-02-23

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