Internal Review of a Planning Request Interaction Templates

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FOI 23/24-1232 DOCUMENT 4

The contents of this document are OFFICIAL.

Internal Review of a Planning Request

Interaction Templates

Recording interactions in the NDIS Business System (system) is mandatory. It is essential for information gathering, record keeping and a nationally consistent service delivery approach.

Use these interaction templates when recording interactions for internal reviews (s100). These are recorded in the CRM interactions tab.

Note: Copy the notes of the interaction into the supporting information section of the s100 form.

Select the interaction name in the table below to move to the template. For further guidance on creating, using and searching for interactions refer to Guide to Interactions in the NDIS Business System and Standard Operating Procedure — Create, assign, search and edit an interaction.

Important: When recording interactions make sure the correct channel and status is recorded.

Please Note: Generally only one main interaction is to be created for a s100 review request. All subsequent interactions to be added to the main interaction by using the Edit button.

Interaction Topic | Context

Interaction Topic Context
s100 — Request Received This is the first interaction created when a s100 request has been drawn down. All other interactions regarding the s100 request will be added to this interaction.
$100 — Withdrawn/Created in error Record this interaction when a s100 has been created in error and contact has been made with the participant. The notes in this this template are added to the s100 — Request Received Interaction.
$100 — Request Withdrawn Early Resolution Use when s100 request is withdrawn as you have resolved request through early resolution and participant has agreed. The notes in this this template are added to the s100 — Request Received Interaction.

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Interaction Topic - Context

$100 — Unauthorised Request

This interaction is sent to the creator of the request when there is no consent on the record and the request appears to have been requested by an unauthorised person.

$100 — Contact

Record interaction whenever contact has been made with the participant.

The notes in this this template are added to the s100 — Request Received Interaction

$100 — Unable to contact

Record this interaction if you are unable to make contact with the participant.

The notes in this this template are added to the s100 — Request Received Interaction

$100 — Outcome Decision - Statement of Supports / Plan Variation (S47A)

Use this template to record the outcome of a s100 decision on a Statement of supports request and/or plan variation request (Ss47A).

The notes in this this template are added to the s100 — Request Received Interaction

$100 — Outcome Decision - Reassess a plan (s48)

Use this template to record the outcome of a s100 decision on a reassess a plan request (confirm and set aside).

The notes in this this template are added to the s100 — Request Received Interaction

$100 — Completed - No change to statement of supports (confirmed decision)

Record implementation interaction when s100 is complete, there is no change to statement of supports. This interaction is to advise ND local office that the s100 has been completed.

s100 — Completed - Change to statement of supports - Implementation required with participant (set aside / vary decision)

Record implementation interaction when s100 is complete, there is a change to the statement of supports and Implementation is required with the participant.

This is an open interaction sent to the relevant team for implementation.

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Interaction Topic Context

$100 — Request to complete a plan reassessment

Record implementation interaction when s100 is complete and a subsequent request to complete a plan reassessment is required.

This is an open interaction sent to the relevant ND team to complete a plan reassessment.

$100 — Internal Review Home and Living Advice Required

Record interaction when an s100 decision has been made and the decision impacts on home and living supports (SIL and LASA) in the plan in progress. This interaction must be assigned to the Internal Review Home and Living Teams System Inbox for advice.

$100 — Explanation of Decision

Record interaction when an Explanation of Decision contact has been attempted or Explanation of Decision outcome has been provided.

The notes in this this template are added to the Explanation of decision interaction.

$100 — Higher Decision Delegate Approval level 4

Record Interaction when an s100 requires Higher Delegation Approval from an Assistant Director.

$100 — Internal Review Officer Home and Living Assessed Specialist Disability Accommodation

Record interaction when an s100 Specialist Disability Accommodation (SDA) quote has been processed and approved.

$100 - Legacy Specialist Disability Accommodation

This is to be used for a participant who was accessing Specialist Disability Accommodation funding prior to accessing NDIS.

Record interaction when an s100 SDA quote has been processed.

s100 - Request Received

Category 1 Pathway

Category 2 Internal Review

Category 3 Request review of decision under s100 NDIS Act

Channel Internal Notes Status Completed

Notes: Date: <dd/mm/yyyy> submitted on <dd/mm/yyyy>.

s100 - Withdrawn/Created in error Add notes to the existing s100 Request Received interaction

Notes Date: <dd/mm/yyyy> Pre Contact SMS Sent: , <Yes on dd/mm/yyyy to nominee/child rep/guardian/participant> Add contact details if contact was made: Contact with: <relationship – nominee/child rep/guardian/participant> Phone no.: Consent confirmed: <Yes/No> <who gave consent, how – over the phone/in writing, to whom the consent is being given, for what purpose, for how long the consent is provided>. POI Confirmed: <Yes/No> <3 point security check – full name, address, DOB, email, organisation name, work email, work address, participant’s NDIS no., participant’s DOB etc.> Withdrawal explanation: . Next steps informed: <Option 1: Where the acknowledgement letter has not been sent. Delete this instruction and Option 2.> Advised no withdrawal letter will be provided as this internal review request was created in error.

s100 - Request Withdrawn early resolution

Add notes to the existing s100 Request Received interaction

Notes Date: <dd/mm/yyyy> Pre Contact SMS Sent: , <Yes on dd/mm/yyyy to nominee/child rep/guardian/participant> Contact with: <relationship – nominee/child rep/guardian/participant>. Email/Phone no: . Consent confirmed: <Yes/No> <who gave consent, how – over the phone/in writing, to whom the consent is being given, for what purpose, for how long the consent is provided>. POI Confirmed: <Yes/No> <3 point security check – full name, address, DOB, email, organisation name, work email, work address, participant’s NDIS no., participant’s DOB etc> Withdrawal confirmed by: <relationship – nominee/child rep/guardian/participant> Reason for withdrawal: <Participant/plan nominee/child rep/guardian/decision maker> indicated they have made the decision to withdraw the s100 request as a result of <a scheduled review due in/early resolution> Outcome: Advised the NDIA will not take any further action on their request for internal review, and they will not receive a decision letter. They will therefore not be able to appeal to the AAT to change their plan. They will however still be able to ask the NDIA for a participant requested plan review at any time. Confirmed having received this information, would still like to withdraw the request. Next steps informed: As per this conversation s100 is withdrawn on <dd/mm/yyyy>. Advised withdrawal letter will be sent out to the <postal address/email address abcd@xyx.com> .

s100 - Unauthorised Request

Category 1 Pathway Category 2 Internal Review Category 3 Request review of decision under s100 NDIS Act

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Channel Internal notes

Status Open

Assign to: Employee who submitted (if s100 created by a non NCC staff member).

Notes:

Date: <dd/mm/yyyy>

A review request for an s100 review of a reviewable decision was lodged on <dd/mm/yyyy> by an unauthorised person. <Record the detail of the unauthorised representative, relevant information>. The Internal Review Team has withdrawn the s100 and will take no further action on this request. It was not deemed a valid request as no consent was noted on the record from the participant or authorised representative.

I confirm I have checked this file and the party that submitted the review request does not have authority to act on behalf of the participant or their authorised representative.

If an internal review is required please advise the requestor that they will need to re-submit the s100 with requisite consent. Refer to Internal Review guidelines for who is authorised to request an internal review of a decision.

If a participant or their authorised representative provides consent for the review in the future, the date of the request should reflect the date a valid request was made.

The Internal Review Unauthorised Request Letter has been sent to <Participant/Child Representative/Guardian/Nominee> on . .

s100 - Contact

Add notes to the existing s100 Request Received interaction

Date: <dd/mm/yyyy>

Pre Contact SMS Sent: <Yes on dd/mm/yyyy to nominee/child rep/guardian/participant>

Contact with: <relationship – nominee/child rep/guardian/participant>

Phone no: <number>

Consent confirmed: <Yes/No> <who gave consent, how – over the phone/in writing, to whom the consent is being given, for what purpose, for how long the consent is provided>

FOI 23/24-1232

POI Confirmed: <Yes/No> <3 point security check – full name, address, DOB, email, ourgansiation name, work email, work address, participant’s NDIS no., participant’s DOB etc.> Review requests as confirmed: <Request/s> For example:

  • Core support for 15 hours per day to assist with daily living
  • 30 hours of Therapy per week
  • Funding for Assistance dog.

<Brief notes/any key points from phone conversation/ information relates to review request>. Confirm relevant current evidence on file. All evidence provided for the internal review: <Yes/No>. <If No, provide details of what further information is to be provided>. Further evidence requested by IRO: <Yes/No> Agreed timeframe: Occupational Therapy report/Functional capacity assessment, Letter from specialist to be provided by <dd/mm/yyyy>. Preferred Plan Duration discussed: <24 month/12 month plan end date same as scheduled reassessment>. Preferred Plan Management: Participant wants the new plan to be <Agency/Plan/Self- managed>. Preferred Method of Contact for Internal Review Outcome: <Confirmed as per current information on system by phone/email/mail> <Internal review decision agreed to be communicated by phone/email/mail>. Next steps informed: If no response is received by the due date, a decision will be made based on the evidence available. Details provided to assist with gathering further evidence. Details provided include <provide relevant details about Support Coordinator/Local Area Coordinator or Early Childhood Partner>. Once the internal review decision is made the outcome will be communicated by <phone/email/mail>. . s100 - Unable to Contact

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s100 - Outcome Decision - Statement of Supports/ Plan Variation (s47A)

Add notes to the existing s100 Request Received interaction

Notes: Date: <dd/mm/yyyy>

Decision Outcome: An s100 review was completed on: dd/mm/yyyy

Supports reviewed were:

  • <List support 1>
  • <List support 2, if applicable>
  • <List support 3, if applicable>
  • <If s47A plan variation was also included in your s100 decision, include the support request here and state in brackets at the end of the sentence (s47A request), if applicable>

A decision was made based on the evidence available at the time of review.


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s100 - Outcome Decision - Reassess a plan (s48)

All documents relevant to the decision, including the decision letter are uploaded to CRM inbound documents, ‘s100 internal review request dd/mm/yyyy’ or attached to the s100 form.

A copy of the decision letter has been emailed/posted to participant/nominee/child representative at <insert email address/address> on dd/mm/yyyy. <If email is their preferred method of communication, include the following sentence:> Notification SMS Sent for s100 outcome email sent: <Yes on dd/mm/yyyy to nominee/child rep/guardian/participant>

If not satisfied with the decision they may also apply to the Administrative Appeals Tribunal (AAT) for a further external review within 28 days of receiving the letter.

More details about AAT are included in the letter. (If decision was to set-aside also include the following:)

Plan Duration: Plan Management: .

Notes:

Date: <dd/mm/yyyy> Decision Outcome:

A s100 review was completed on dd/mm/yyyy in relation to the previous decision made to not <conduct a plan reassessment / not to vary the plan>.

A decision was made based on the evidence available at the time of review.

All documents relevant to the decision, including the decision letter are uploaded to CRM inbound documents, ‘s100 internal review request dd/mm/yyyy’ or attached to the s100 form.

A copy of the decision letter has been emailed/posted to participant/nominee/child representative at <insert email address/address> on dd/mm/yyyy. <If email is their preferred method of communication, include the following sentence:> Notification SMS Sent for s100 outcome email sent: <Yes on dd/mm/yyyy to nominee/child rep/guardian/participant>.

If not satisfied with the decision they may also apply to the Administrative Appeals Tribunal (AAT) for a further external review within 28 days of receiving the letter.

More details about AAT are included in the letter. .

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s100 - Completed - No change to statement of supports

(Confirmed decision)

  • Category 1 Pathway
  • Category 2 Planning
  • Category 3 Plan approved ready for implementation

Channel Internal Notes Status Open Assign according to workflow rules

Notes: Date: <dd/mm/yyyy>

<Insert the following sentence if the request requires priority action: This request is identified for priority action due to potential risk or escalation and has been endorsed by <insert logon of Team Leader/Assistant Director> who will provide a handover to for action.>

Risk: <insert, low, medium, high, extreme>

Risk Reason:

The IRT completed a s100 decision on <dd/mm/yyyy> for <Statement of supports/Not to conduct a plan reassessment/Not to conduct a plan variation>. There has been no change to the participant’s statement of supports, the date the plan will be reassessed by or plan management method. For further information refer to the s100 Outcome of Decision letter. The participant may require additional support to access mainstream or community services . .

s100 - Completed - Change to statement of supports -

Implementation required with participant (Set aside/vary decision)

  • Category 1 Pathway
  • Category 2 Planning
  • Category 3 Plan approved ready for implementation

Channel Internal Notes

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s100 - Request to complete a plan reassessment

Status Open Assign according to workflow rules Notes: <Insert the following sentence if the request requires priority action: This request is identified for priority action due to potential risk or escalation and has been endorsed by <insert logon of Team Leader/Assistant Director> who will provide a handover to for action.> Risk: <insert, low, medium, high, extreme> Risk Reason: Date: <dd/mm/yyyy> Plan approved on: <dd/mm/yyyy>

A s100 internal review was completed on dd/mm/yyyy. A decision was made based on the evidence available at the time of review. All documents relevant to the decision, including the decision letter are uploaded to CRM inbound documents, ‘S100 internal review request dd/mm/yyyy’ or attached to the s100 form or s100 feedback form. A copy of the decision letter has been emailed/posted to participant/nominee/child representative at <insert email address/address> on dd/mm/yyyy. Notification SMS Sent for s100 outcome email sent: <Yes on dd/mm/yyyy to nominee/child rep/guardian/participant>.

If not satisfied with the decision they may also apply to the Administrative Appeals Tribunal (AAT) for a further external review within 28 days of receiving the letter. More details about AAT are included in the letter. Additional Delegate notes for plan implementer : . Please accept this as notification the participant’s record is also being returned for implementation of the plan. .

Category 1 Pathway Category 2 Review Category 3 Commence Plan review (full) from IRT

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Channel Internal Notes

Status Open Assign according to workflow rules

Notes: Date: <dd/mm/yyyy>

<Insert the following sentence if the request requires priority action: This request is identified for priority action due to potential risk or escalation and has been endorsed by <insert logon of Team Leader/Assistant Director> who will provide a handover to for action.>

Risk: <insert, low, medium, high, extreme>

Risk Reason:

The IRT completed a s100 decision on <dd/mm/yyyy> and decided a plan reassessment should take place. The reason for the plan reassessment is . It is the responsibility of the Plan Developer to consider all reasonable and necessary supports and approve the new plan within their delegation. Please schedule a reassessment meeting with participant and undertake a plan reassessment. This interaction has been assigned to .

.

S100 - Internal Review Home and Living Advice Required

Category 1 Specialised Category 2 Supported Independent Living Category 3 SIL Interaction

Channel Internal notes

Status Open Assign to: Charles Peters

Notes: Date: <dd/mm/yyyy>

Home and living advice required following s100 Decision

Risk Rating: (Low, Medium, High, Extreme).

Risk Reason: (for example, homelessness in 2 weeks, no funding in current plan).

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FOI 23/24-1232

IRT have endorsed an internal review where home and living supports have been impacted, advice is required prior to plan approval. Internal Review Home and Living Team - please advise if a change to the SIL or LASA calculation is required. . Decision made: (for example, s100 decision to set aside the original decision). Review Request for: (please list reason, for example, changes to SCCP etc.). Please refer to s100 work item XXX and Inbound Documents named XXX for further information. Please update this Interaction Record and/or contact IRT Delegate to discuss advice. .

s100 - Explanation of Decision

Add notes to the existing Explanation of Decision Interaction

  • Category 1 NCC Priority Enquiry
  • Category 2 NCC Priority Enquiry
  • Category 3 Request an explanation of a decision

Channel Internal notes

Status Remain Open until finalising the review and completing closure tasks

Notes: Date: <dd/mm/yyyy> Pre Contact SMS Sent: <Yes on dd/mm/yyyy to nominee/child rep/guardian/ applicant/participant/> Contact with: <relationship – nominee/child rep/guardian/applicant/participant>. Phone no: : Phone/Email contact made to discuss the request for Explanation of decision, no answer, <no message was left/a voicemail message was left with Internal Review Officer’s name.

Explanation of Decision: Review request: Decision made: <confirm/set-aside>

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s100 – Higher Decision Delegate Approval Level 4

Category 1: Pathway Category 2: Planning Category 3: Plan Submitted for Approval

Channel: Internal Notes Status: Open

Notes: Plan submitted for approval on: <dd/mm/yyyy> Review type: s100 Review Plan completed by: : PACE application number: Request ID number:

Outline of s100 request:

Supports proposed to be set-aside/varied as part of this Internal Review Request: • <List support 1 category and volume/frequency> • <List support 2, if applicable> • <Plan management type, if applicable> • <Plan variation decision under Section 47A, if applicable>

Supports proposed to be confirmed as part of this Internal Review Request: • <List support 1 category and volume/frequency> • <List support 2, if applicable> • <Plan management type, if applicable>

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• <Plan variation decision under Section 47A, if applicable>

Plan duration: Inflation percentage: I confirm the participant’s plan management decision has been taken into consideration and they have chosen to Agency Manage/Partially Self-Manage/Plan Manage. I have considered supports which are reasonable and necessary and these supports are funded under s34 of the NDIS Act. I have detailed in justifications my reasoning as to why supports are reasonable and necessary and included a list of materials referred to as part of the s100 decision.

s100 – Internal Review Officer Home and Living Assessment Specialist Disability Accommodation

Category 1: Specialised Category 2: Specialised Disability Accommodation Category 3: SDA Interaction Channel: Internal Notes Status: Closed

Notes: SDA Quote has been processed and approved in CRM by IRO HaL SDA Price for Approval (lowest of below as per SOP - Implement SDA quote): $0.00

IRO HaL SDA Decision: CRM Document ID/ PACE Case: <#XXXXXXXX> Decision Date: <dd/mm/yyyy> SDA Type: Location: Design Category: Building Type: Maximum Price (2022/23): SDA PACE Enrolled Dwelling:

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s100 - Legacy Specialist Disability Accommodation

Category 1: Specialised

Category 2: Specialised Disability Accommodation

Category 3: SDA Interaction

Status: Closed

Notes:

SDA Quote has been processed and approved in CRM by IRO HaL <LOGON ID>.

As per Our Guideline - Specialist Disability Accommodation page,13, where a participant is residing in SDA prior to accessing the NDIS, they are eligible for SDA funding. However, where a participant moves from their accommodation setting, they are still eligible but will require an SDA re- assessment.

Legacy Enrolled Dwelling:

Legacy ID:

Asset Provider:

Address:

SDA Type:

Location:

Design Category:

Building Type:

Max Price:

Feedback

If you have any feedback about this document complete the Internal Review Team Quality and Continuous Improvement Form and email it to the Business Improvement Team. In your email,

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remember to include the title of the product you are referring to and describe your suggestion or issue concisely.

Version control

Version Amended by Brief Description of Change Status Date
10.0 CAP525 DII394 KMM575 Class 1 Approval. Added ‘Decision Outcome (no contact)’ template for decisions where no contact has been made. Added ‘Request Received’ template which will be the first interaction record created by an IRO for the s100 process. Removed interaction templates not required in alignment with SOPs. APPROVED SW006S 2021-11-22
11.0 KMM575 Update made to HDD interaction based on process change. APPROVED SW006S DLL320 2021-12-10
12.0 KMM575 Update to record Pre Contact SMS sent. Removal of NDIS Contact. Removal of HDD Interaction. APPROVED SW006S 2022-03-11
13.0 KMM575 CAP525 LW0022 Updated to document SMS notification sent for email outcomes. Included EOD interaction. Removed SIL templates and included one home and living template for ‘s100 — Internal Review Home and Living Advice Required’. Added in risk and risk reason notes for ‘s100 - Completed - no change to statement of supports’, ‘s100 - Completed change to statement of supports — implementation required with participant’, and ‘s100 - Request to complete a plan review’ interaction templates. Updated categories in home and living interaction template. Changed Internal Review Housing Team name to Internal Review Home and Living Team. Amended EOD Template and SMS outcome notification sentence in APPROVED 2022-11-28

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FOI 23/24-1232

Version Amended by Brief Description of Change Status Date
14.0 JHH925 Updated s100 - Withdrawn/Created in error template to align with Withdrawal of an Internal Review Request SOP. APPROVED 2022-12-09
15.0 KMM575 Updated to include HDD level 4 interaction for AD approval. APPROVED 2023-02-03
16.0 KMM575 Updated to add SDA interactions. APPROVED 2023-04-24
17.0 MWN756 ‘Assign to’ contact in s100 — Internal Review Home and Living Advice required template updated to Charles Peters. APPROVED 2023-10-12

Outcome Decision template. Amended Outcome Decision and Completed Decision interactions to align with s47A and s48(3)(a) legislation amendments.

Updated request to complete a plan review interaction to plan reassessment. Updated assign to steps for workflow rules and not Standard CRM inbox structure to align with IR Planning Decision SOP. Updated contact interaction template to confirm preferred method of contact for internal review outcome communication and other relevant details based on IR AD/TL input. Removed example based on input SWO065.

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