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Agency Add or update self-care and community access supports in a plan approval case Insurance

This article provides guidance for a planner delegate to:

add assistance with self-care or community access funding
update assistance with self-care or community access funding
consider when to include high intensity supports.

National Recent updates the by October 2023 Current guidance 1982 Act Before you start

You have:

read and understood Our Guideline - Reasonable and Necessary Supports (external) of
read and understood Our Guideline – Social and Recreation Support (external)
referred to the NDIS Pricing Arrangements and Price Limits (external) Freedom • read and understood article Understand the product catalogue the • read and understood article Support Categories. underAdd assistance with self-care or community access fundingIf you have received evidence the participant may need high intensity supports, refer to the released section in this article Consider when to include high intensity supports. was To add assistance with self-care or community access funding to a draft budget, complete the following PACE steps:
1. In a Plan Approval case, select the Draft Budget tab.

SGP Knowledge Article Template

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Instructions for Creating Support Categories:

Steps to Follow:

Step 1: Select New Support Category.

Step 2: Enter ‘assistance’ or ‘community’ into the Support Category field.

Step 3: Select Assistance with Daily Life or Assistance with Social, Economic and Community Participation from the drop-down list. Note: The Support Budget will be locked to Core.

Step 4: Select the Budget Type from the drop-down list.

Step 5: Select Regular in Instalment Type. Disability Plan Duration field will be locked. 36 months (3 years) is the default plan duration.

To change the plan duration, refer to article Change plan duration.

Step 6: Enter the Amount for this support. The Note: This is the monthly amount. PACE will calculate the frequency amount based on this figure. You can use the Plan Conversation Support Tool to guide your decision making. Find the Plan Conversation Support Tool in the Tasmania Resource Library.

Step 7: Record the TSP Variance Reason from the drop-down box.

Step 8: Record Additional Description about why this support is needed. Note: This comment will not display on a participant’s plan. This description can be used as part of a discussion about funded supports in the plan approval meeting.

Information Step 9: If the support meets all of the NDIS funding criteria under the Justifications heading, of select the checkbox.

Step 10: Record Justification in the free text field. For some supports, this might automatically populate. For more information about recording justifications, refer to article Add budget justification. Note: This field has a character limit of 3000. Certain special characters in this field may cause an error, this is generally caused when copying justifications from SAP CRM into PACE. If you see the characters |% you will need to change these before you can select save.

Freedom the released was document

Step 11: If you’re using evidence to support your justification, select the Evidence Used checkbox.

Step 12: Select the Evidence Type from the drop-down list:

If you select Document, go to step 14
If you select Other, go to step 15.

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Enter Evidence Link Name and Explanation

Enter the Evidence Link name. You can view linked evidence on the Evidence tab of the Plan Approval case. To learn more about linking evidence, refer to article Add and Agency link evidence to a case.
Enter the Evidence Explanation into the free text field.
If you need to add more evidence to support your justification, select the checkbox Add Insurance further evidence links and repeat from step 13.
Select Save.

Disability Update assistance with self-care or community access funding National Update assistance with self-care or community access funding the byIf you have received evidence the participant may need high intensity supports, refer to the section in this article Consider when to include high intensity supports.

1982 To update self-care and community access supports in a draft budget, complete the following ActPACE steps:

1. Select the Assistance with Daily Life or Assistance with Social, Economic and
 Community Participation support category under the Flexible Budget heading.
2. Enter the adjusted Amount for the support.

Information of Note: The system will show the change from the original amount to the new amount. It will also show the change in the total amount over the duration of the plan. You can use the Plan Conversation Support Tool to guide your decision making. Find the Plan Conversation Support Tool in the Tasmania Resource Library. Freedom document under 3. If the change to the amount is outside the threshold for the support category, PACE will
display the TSP Variance Reason. Select the relevant TSP Variance Reason from drop-down list.

4. Record Additional Description about why this support is needed.

  Note: These comments will not display on a participant’s plan. Use these comments to

don’t discuss funded supports as part of a plan approval meeting. 5. If the support meets all of the NDIS funding criteria under the Justifications heading, select the checkbox.

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6.

Record Justification in the free text field. For some supports, this might automatically populate. For more information about recording justifications, refer to article Add budget justification.

Note: This field has a character limit of 3000. Certain special characters in this field may cause an error, this is generally caused when copying justifications from SAP CRM into PACE. If you see the characters |% you will need to change these before you can select save.

7.

If you’re using evidence to support your justification, select the Evidence Used checkbox.

8.

Select the Evidence Type from the drop-down list:

If you select Document, go to step 9
If you select Other, go to step 10.

9.

Enter the Evidence Link name. You can view linked evidence on the Evidence tab of the Plan Approval case. To learn more about linking evidence, refer to article Add and link evidence to a case.

10.

Enter the Evidence Explanation into the free text field.

11.

If you need to add more evidence to support your justification, select the checkbox Add further evidence links and repeat from step 8.

12.

Select Save.

Remove assistance with self-care or community access funding

to remove assistance with self-care or community access funding, complete the following FreedomPACE steps:

In the Plan Approval case, select the Draft Budget tab.
Select the Assistance with Daily Life or Assistance with Social, Economic and Community Participation support category under the Flexible Budget heading.
You will not have the option to remove budget item. In Amount type $0.00.
Record Additional Description about why this support is needed. Note: These comments will not display on a participant’s plan. Use these comments to discuss funded supports as part of a plan approval meeting.
If the support meets all of the NDIS funding criteria under the Justifications heading, select the checkbox.

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Record Justification

In the free text field. For some supports, this might automatically populate. For more information about recording justifications, refer to article Add budget justification.

Note: This field has a character limit of 3000. Certain special characters in this field may cause an error, thi\s i$ generally caused when copying justifications from SAP CRM into PACE. If you see the characters |% you will need to change these before you can select save.

Consider when to include high intensity support

Consider high intensity supports when the participant needs one or both of the following:

frequent (at least once each shift) assistance to manage challenging behaviours that require intensive positive behaviour support
assistance from a disability support worker who has one or more of the high intensity support skills specified in the NDIS Commission’s Factsheet: NDIS Practice Standards: skills descriptors (external).

Developing a plan with high intensity supports The plan does not change by including high intensity support. Thi5 means you will continue to develop the plan as normal. Participants with complex needs may need some or all of their supports provided by higher skilled workers. You will need to make a decision based on the NDI$ funding criteria to determine if the participantsupport needs are standard or high intensity. Support items are explained in the NDIS pricing arrangements and price limits (external). You can use the Plan Conversation Support Tool to guide your decision making. Find the Plan Conversation Support Tool in the Tasmania Resource Library. Information from the participant, their providers, functional assessments, therapy reports, behaviour reports and medical information may help in determining if the participant has higher intensity support needs. Standard support: Participants without high intensity support needs would generally require a support workerwith standard skills. High intensity support: Participants with high intensity support needs will generally require a mix of support workerswith standard skills and high intensity skills to have their support needs met.

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For example, a mixture of standard and high intensity support may be required when a participant: Agency

only needs a support worker with high intensity skills for their disability related health

supports (DRHS) that occur at a certain time of the day • has two workers at all times, one supporting the participant and one monitoring Insurance behaviours who is also available to provide support to the other support worker if

required. In these situations, it may be appropriate to provide one support worker Disability with standard skills and one support worker with high intensity.

In some situations, the participant will always need a support worker with high intensity skills to provide all their supports. Talk to your team leader if you need help to decide what level of National worker is needed.

Registered nurse (RN) delegation of care by

Registered nurse (RN) delegation of care allows an RN to delegate high level care to another suitably trained person.

Participants who meet the criteria for DRHS may need a support worker who is skilled to meet this need. The provision of these supports could be delegated by the RN to a support worker who has the required high intensity support skills. The number of hours needed will depend on the tasks required. When determining the number of hours to fund for DRHS, information fromthe following sources will help you to make sure the support meets the NDIS funding criteria Information (external):

the participant
heir providers Freedom the • functional assessments
therapy reports
behaviour reports under
medical information.

Refer to Our Guideline - Disability-related health supports (external) and article Calculate disability-related health supports and meal preparation supports for further information. released was document

Plan Changes

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A plan change should only be considered where necessary. The participant should talk to their provider first to understand their supports and the price control being claimed. The My NDIS Agency Contact or support coordinator who implemented the plan may help to:

determine if there is enough funding in the plan to cover any increased costs
re-arrange their supports to better meet their needs.

You should support the participant to seek a plan change if they are considerably disadvantaged and unable to purchase their supports because of the change in price controls. The prioritisation of the plan change will be considered in line with the current prioritisation process.

Implementation Encourage the participant to discuss with their providers how the delivery of their supports can be improved to create the most efficient use of their plan. Providers are encouraged to help the participant to arrange their supports within the available plan budget to deliver efficient service and value. This includes where higher skilled workers may be appropriate for some supports. The participant’s My NDIS Contact, or support coordinator, supports the participant to implement the plan and develop their service agreements.

Providers The price controls are the maximum price that can be charged for each support. Refer to NDIS Price guides and information (external) for more information on price controls. This enables the participant to use their plan budget to purchase an appropriate mix of supports, including higher skilled workers if necessary.

Service bookings and claims will be subject to audit. Providers may be required to provide proof that the staff member who delivered a support was subject to the high intensity price control and had the relevant skills or experience.

If the participant has concerns about their provider and the use of the price controls, they should escalate these to the local provider engagement team.

Next steps

If you have added or updated assistance with self-care or community access supports, you will need to make a fund management decision. Refer to article Make fund management decision.
If you need to add further support, refer to article Change the draft budget.
If you’re ready for the plan meeting, refer to article Prepare for the plan meeting.

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SGP Knowledge Article Template

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Article topics and case names – internal use only

Agency Topics

This article relates to the following topics:

Insurance • t_createaplan

t_planchanges
t_reasonableandnecessary Disability
t_socialandrecreationsupport

Case names

You can use this guidance for the the

dc_case_planapproval by
dc_case_planchange 1982 ActVersion control

Version Amended Brief Description of Change Status Date by Information 1.0 CS0074 Class 1 approval APPROVED 2022-11-18 of

1.1 THG520 Updating high intensity support levels DRAFT 2023-03-17 information Freedom 1.2 BCK161 Peer review DRAFT 2023-03-27 the

1.3 THG520 Actioned peer review DRAFT 2023-03-28 under 1.4 DD0014 EL1 review and edit DRAFT 2023-03-30

1.5 JLL673 Continuous improvement update – DRAFT 2023-07-04 transferred to new template and begun SGP released consistency check. was 1.6 MSM312 Peer review DRAFT 2023-07-07 document

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Version	Amended	Brief Description of Change	Status	Date	By
1.7	JLL673	Action peer review	`redacted`	2023-07-07	`
Clean for VT`
Insurance
1.8	JLL673	Action VT feedback	DRAFT	2023-07-07
Number of long sentences: 20 (16.53%) Number of Passive Sentences: 14 (11.57%) Readability: 47 Grade Level: 8.9
Sent for EL1 review RWN540 Updates to align with DRHS resources. DRAFT 2023-10-06
The System steps added.
by
1.9	RWN540	Updates to align with DRHS resources.	DRAFT	2023-10-06	the
System steps added.
by
1.10	DD0014	EL1 review	DRAFT	2023-10-10	1982
Act
1.11	RWN540	EL1 feedback actioned	DRAFT	2023-10-11	Act
1.12	DD0014	EL1 review	DRAFT	2023-10-13
Information
1.13	RWN540	BiL feedback actioned	DRAFT	2023-10-17	of
1.14	DD0014	EL1 review	DRAFT	2023-10-17	`
of`
1.15	RWN540	EL1 feedback actioned	DRAFT	2023-10-18
Freedom under
released was
document
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