DOCUMENT 7 Standard Operating Procedure Planning For Internal Use Only
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Include Psychosocial Recovery Coach support in a plan
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Previous Step: Pre-planning tasks are completed in the System
Next Step: Complete the Determine Plan Management task in the System
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1. Purpose
This Standard Operating Procedure (SOP) will support you to consider and include reasonable and necessary psychosocial recovery coach (recovery coach) support in a participant’s plan.
2. Index
- 6.1 Navigate to the support calculator
- 6.2 Include recovery coaching support in a plan
- 6.3 Next steps
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- Supporting material
3. To be used by
- Plan Developers
- Planners
- Partners in the Community (Local Area Coordinators [LACs])
- NDIA plan delegates
4. Scope
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A recovery coach will support the participant to foster hope and build capacity. A recovery coach will provide support to people with psychosocial disability to engage with the NDIS, build confidence and motivation to achieve their goals and gain maximum benefit from their plans. The participant will be supported to take more control of their life and to manage the complex challenges of day to day living. A recovery coach is a qualified mental health worker and through their own training and lived experience, understands mental health and its impacts. A recovery coach will also support the participant to understand how the NDIS operates within a broader ecosystem of supports including mainstream and community supports. For further information on recovery coaches refer to the Practice Guide – Psychosocial Disability.
4.1 When to include a recovery coach in a participant’s plan
The inclusion of recovery coach support in a participant’s plan must be determined to be reasonable and necessary. A recovery coach will be available to participants across all streams – General, Supported, Intensive and Super Intensive. Generally, if a participant’s primary disability is psychosocial disability then a psychosocial recovery coach should be considered if you identify that the participant requires support to link and maintain engagement with informal, community, mainstream and funded supports; and to build capacity, including strengths and resilience.
The provision of recovery coaching should be prioritised for the first five years of a participant’s involvement in the Scheme. The level of funding should consider both the period of engagement with the NDIS and functional capacity of the participant.
Effective recovery coaching will result in improved engagement in recovery, self-management and capacity building. The rate of improvement will vary based on the individual, their life circumstances and the patterns of their mental health condition. However, it is reasonable to expect progress over a five year period.
4.1.1 Support coordination
Generally, the participant should not have funding for both recovery coach support and support coordination included in their plan. If the participant has had funding for support coordination included in their previous plan, then discuss the recovery coach role with them and the support
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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 change to support provided by a recovery coach.
Support coordination may be considered reasonable and necessary in addition to funding a recovery coach in limited circumstances. For example, funding for a specialist support coordinator may be considered reasonable and necessary if the participant identifies a goal of finding suitable housing. Refer to the Standard Operating Procedure – Support Coordination for guidance on including specialist support coordination in a plan if needed.
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.
4.2 Levels of recovery coach support
You should take into account the participant’s individual circumstances when you determine the level and number of hours to be included in their plan, consider existing informal supports and any additional complexity factors. The following should be used as an indicator of the levels of recovery coaching required. Provision of recovery coach hours should be based on the needs and expressed preferences of the participant and feedback from their support network.
There are three indicative levels of funding for a psychosocial recovery coach:
- Level 1: 100 hours per year
- Level 2: 50 hours per year
- Level 3: 30 hours per year.
These levels are a guide for reasonable and necessary decision making. Participants generally require level 1 funding, if:
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- this is their first plan with recovery coach funding included
- it is during the first three years of engagement with the NDIS.
Funding may be adjusted to level 2 and 3 after this period. The level of funding may then be able to be reduced over time as the participant builds on their strengths and capacity.
4.2.1 Factors to consider when determining level of funding
Factors to consider when determining reasonable and necessary level of funding include:
- Level of support required to link and maintain engagement with informal, community, mainstream and funded supports. Consider historical levels of engagement with supports and if recovery coaching supports are required to maintain engagement and/or to support with re-linking after a period of disengagement. Consider the level of support required to ensure other funded supports are working in a recovery-oriented way.
- Period of time in Scheme. The provision of recovery coaching should be prioritised in the first five years of a participants’ involvement with the Scheme. Effective recovery coaching should build participant capacity in engagement, self-management and use of recovery plans and clinical supports.
- Level of engagement with clinical supports. For example, a participant engaged with an appropriate level of coordinated clinical supports will generally require a lower level of recovery coach supports.
- Level of social isolation. For example, a participant with low levels of social and economic participation will generally require increased levels of recovery coaching to address barriers, identify and build strengths and increase motivation.
- Fluctuating needs. Many people with psychosocial disability experience fluctuating needs. Consider what level of recovery coaching support is needed for the duration of the plan period to address fluctuating needs (rather than a static consideration of recovery coaching support at the time of planning or review). An increase in funding may be required for some participants who experience an acute episode of mental ill-health to address further decline in functional capacity.
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4.3 Monitoring progress
A progress report by the recovery coach with an optional report from the participant will be required every 12 months. Formal reviews of progress will be undertaken in years 3 and 5 of their participation in the Scheme. The level of recovery coaching required will be assessed at these reviews.
5. Prerequisites
- You have had a planning conversation with the participant to understand and identify their current and potential support needs, as well as identifying any preferences for the type of recovery coach, specific providers to provide recovery coach services.
- You have completed all relevant pre-planning tasks in the System.
- You have read the Practice Guide – Psychosocial Disability.
6. Procedure
Please note: Data in screenshots is fictional and intended for instructional purposes only.
6.1 Navigate to the support calculator
- From the Home screen select My NDIS.
- Search for and select the Participant. For more information, see the Standard Operating Procedure - Search the NDIS Business System.
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OFFICIAL Standard Operating Procedure Planning For Internal Use Only
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You need to add recovery coach funding in the Support Coordination budget. Select the expand icon in the Support Coordination price field.
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The Support Calculator will open. Select anywhere in the Product field.
6.2 Include recovery coaching support in a plan
- Navigate to the Support Calculator following the steps above. Once the Select a Product screen is open, search for Psychosocial Recovery Coaching.
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- Select Psychosocial Recovery Coaching – Weekday Daytime.
Note: You must include the support in the plan at the weekday day time rate. It is up to the participant to discuss with their recovery coach when it suits them best to use the support. A recovery coach will be able to claim a weekday daytime, evening, night, weekend and public holiday rate, refer to NDIS Pricing Arrangements and Price Limits for further information.
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- Use reasonable and necessary decision making to adjust the Quantity as guided above. The Quantity should be the number of hours considered reasonable and necessesary.
- At How Often select Per Year.
- Select Done.
Note: The support should not be stated.
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In the Comment field record the following: Psychosocial recovery coaches will provide support to people with psychosocial disability to build on their strengths, take control of their lives and address barriers to achieving their goals.
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Once complete, navigate back to the Support Type screen and select Submit.
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When the form has been submitted, a success message appears. This success message will ask Are the funded supports 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.
- If you select Yes, you will continue as usual.
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6.3 Next steps
6.3.1 Determine Plan Management
Complete the Standard Operating Procedure – Complete the determine plan management task before finalising and approving the plan.
6.3.2 Finalise and approve the plan
Complete the Standard Operating Procedure – Review and Submit a Plan for Approval OR the Standard Operating Procedure – Finalise and Approve a Plan task. You will need to include justification for including recovery coach support in the plan.
6.3.3 Complete request for service
Once the plan has been approved, link the participant with a recovery coach provider.
- Check with the participant if they have any preferred providers of this support.
- You will also need to check with providers, prior to completeing the request for service, if they provide recovery coach support and have the capacity to take on new participants.
- The plan developer completes the Request for Service. Refer to the Standard Operating Procedure – Request for Service – Make a request.
6.3.4 Implementation
When a recovery coach is funded in a plan is it critical to introduce, explain and promote the support during the planning, plan review and implementation stages. As a new support item, participants will not know what to expect from this support and will require information to understand how this support will enable them to work towards their goals. Make sure you:
- discuss with the participant how a recovery coach will work with them to support them in their recovery
- refer to the further information in the Practice Guide – Psychosocial Disability specifically section 4.2 Psychosocial Recovery Coach and section 6.1.1 Recovery Coach about the role and implementation of the support.
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7. Supporting material
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.
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Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
Agency Insurance Disability National the by 1982 Act Information of Freedom the under released been has document
FOI 23/24-0065
ndis Standard Operating Procedure
For Internal Use Only
| Disability Requirements – Substantially reduced functional capacity, Section 24(1)(c) | Details |
|---|---|
| - Needing periodic assistance to check compliance with medications - Showing limited interest in self-care and sometimes failing to wash and change clothes regularly - Reliance on commonly used items (such as glasses, walking sticks, non-slip bath mats, bathroom grab rails, stair rails, age-appropriate child safety locks, simple adapted kitchen utensils and dressing aids). |
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| 26. Is there evidence the participant is unable to socialise without disability-specific supports? - Socialising – how the participant makes and keeps friends, or interacts with the community, or how a young child plays with other children. We also look at their behaviour, and how they cope with feelings and emotions in social situations. - Disability-specific supports include: - a high level of support from other people, such as physical assistance, guidance, supervision or prompting - assistive technology, equipment or home modifications that are prescribed by their doctor, allied health professional or other medical professional. - Also consider the following before answering this question: - What the participant cannot do, but also what they can do, even if with limitations. - If the participant is unable to access the community independently, without support from another person. - By themselves, one or more of the following would be unlikely to be considered substantial: - Occasional assistance required to access community activities - If they do not have many friends. |
☐ Yes (they are substantially impacted), go to question 30 ☐ No |
| 27. Is there evidence the participant is unable to complete | ☐ Yes (they are |
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| Disability Requirements – Substantially reduced functional capacity, Section 24(1)(c) | Details |
|---|---|
| self-management activities without disability-specific supports? - This does not apply to children younger than 7 years. - Self-management – how the participant organises their life. We consider how they plan, make decisions, and look after themselves. This might include day-to-day tasks at home, how they solve problems, or manage their money. We consider their mental or cognitive ability to manage their life, not their physical ability to do these tasks. - Disability-specific supports include: - a high level of support from other people, such as physical assistance, guidance, supervision or prompting - assistive technology, equipment or home modifications that are prescribed by their doctor, allied health professional or other medical professional. - Consider if the participant is 18 years of age or above with one of the following: - formal guardianship order in place - family member or friend making major life/financial decisions. - By themselves, one or more of the following would be unlikely to be considered substantial: - At times, may make poor financial decisions (may on occasion to spend entire weekly income) - Lack of motivation to clean the house - If the participant self-manages their plan without disability-specific supports. |
substantially impacted), go to question 30 ☐ No ☐ Not applicable (the participant is younger than 7 years) |
| 28. Is there evidence the participant is unable to communicate without disability-specific supports? - Communicating – how the participant speaks, writes, or uses sign language and gestures, to express themselves compared to other people their age. We also look at how well they understand people, and how |
☐ Yes (they are substantially impacted), go to question 30 ☐ No |
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| Disability Requirements – Substantially reduced functional capacity, Section 24(1)(c) | Details |
|---|---|
| others understand them. - Disability-specific supports include: - a high level of support from other people, such as physical assistance, guidance, supervision or prompting - assistive technology, equipment or home modifications that are prescribed by their doctor, allied health professional or other medical professional. |
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| 29. Is there evidence the participant is unable to complete learning activities without disability-specific supports? - Learning – how the participant learns, understands and remembers new things, and practises and uses new skills. - Disability-specific supports include: - a high level of support from other people, such as physical assistance, guidance, supervision or prompting - assistive technology, equipment or home modifications that are prescribed by their doctor, allied health professional or other medical professional. - This is not related to educational supports. It relates to the capacity to learn or ‘re-learn’ everyday tasks. - For example, the ability to learn a new bus route to get from home to work without assistance, or the ability to learn simple tasks (such as how make a sandwich or a very basic meal). |
☐ Yes (they are substantially impacted) ☐ No (they meet the EI requirements and access status change is not required, do not refer to NARB If selected, do not complete remainder of checklist. |
| Disability Requirements – Lifetime NDIS support, Section 24(1)(e) | Details |
|---|---|
| 30. Is there evidence the participant is likely to require support under the NDIS for their lifetime? - A person must require NDIS support for a lifetime to be |
☐ Yes (they may meet the disability requirements, refer to NARB for potential access status change (EI to |
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| Disability Requirements – Lifetime NDIS support, Section 24(1)(e) | Details |
|---|---|
| eligible for the NDIS under the disability requirements. - Refer to Will you likely need support under the NDIS for your whole life? in Our Guideline – Applying to the NDIS. - There are 2 parts to this question: - Consider the overall circumstances to determine if the participant requires support relating to a permanent impairment under the NDIS for their lifetime. - If support is required for their lifetime, consider whether the support relating to a permanent impairment is the responsibility of the NDIS. - A participant is unlikely to require support for their lifetime if the evidence indicates: - there are interventions that are likely to improve the participant’s functional capacity to a point where they no longer require disability-specific supports effectively move around, communicate, socialise, learn, or undertake self-care or self-management tasks. - Supports relating to a permanent impairment are unlikely to be the responsibility of the NDIS if: - they are the responsibility of another service system. Refer to Our guideline - Mainstream and community supports. - For example, if the supports arise from a health condition and are most appropriately provided through another service system (that is, the health system), they will not require support under the NDIS for their lifetime. Rather, they will require support under the health system. Refer to Our Guideline – Mainstream and Community supports. |
Disability) ☐ No (they meet the EI requirements and access status change is not required, do not refer to NARB |
2.2 Attach completed checklist to participant’s record
- Attach the completed checklist to the participant’s record.
- If required, send the referral using SOP – Refer the participant for an Eligibility Reassessment (ER) or Access Status Change.
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3. Related procedures or resources
- Our Guideline – Applying to the NDIS
- Our Guideline – Mainstream and Community supports
- SOP - Ask for an Access Request to be withdrawn
- SOP - Finalise the plan before a participant leaves the NDIS
- SOP – Cease the participant status to leave the NDIS
- SOP – Refer the participant for an Eligibility Reassessment (ER) or Access Status Change
4. Feedback
If you have any feedback about this guidance material, please complete our Feedback Form.
5. Version control
| Version | Amended by | Brief Description of Change | Status | Date |
|---|---|---|---|---|
| 1.0 | TS0036 CW0032 LS0042 AGV957 CM0032 |
Class 2: NAR BM review and approval Class 2: SGP BM review and approval Class 2: ND review and approval Class 2: PP BM review and approval Class 2: ECS BM review and approval Simplified from 4 checklists into 2 checklists |
APPROVED | 2021-11-10 |
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| Version | Amended by | Brief Description of Change | Status | Date |
|---|---|---|---|---|
| 2.0 | CH0026 CW0032 LS0042 SGV957 LKM022 |
Class 2: NAR BM approval Class 2: SGP BM approval Class 2: ND approval Class 2: PP BM approval Class 2: ECS BM approval Align with Our Guideline – Applying to the NDIS Updates based on SGPB EL2 feedback: include new question (2) to identify participants who are over 65 years and in residential aged care or receiving an aged care package. |
APPROVED | 2022-04-07 |
| 3.0 | EMN960 | Class 1 approval. Updates to align with Our Guideline – Leaving the NDIS. |
APPROVED | 2022-07-21 |
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