This article explains changes being mandated by the NDIA in relation to group-based supports and ratios.
This article provides information on:
- the NDIS changes that are driving Lumary to develop release 16.5
- who is impacted
- what Lumary is doing to support you
- when Lumary 16.5 will be available, and
- changes you'll need to make to your environment to adopt Lumary 16.5.
What are the NDIS changes that are driving Lumary to develop
Group-Based Support Functionality
Effective from 1 July 2021, providers will no longer be able to claim for supports using the ratio line item rates but instead will select the relevant 1:1 support item and divide this by the number of participants receiving the group support. Different rates apply depending on the time of day, and day of the week that the support is provided. There are also different rates depending on whether the participant requires standard or high intensity support.
When a support is delivered to more than one participant at the same time then the price will be the applicable price of the service being provided, apportioned between the number of participants in the group. Providers can only claim for supports that are related to the reasonable and necessary needs of each participant and therefore should only claim for the actual time spent with each participant. Providers should also only claim for the time of more than one worker against a participant's plan, if all those workers were involved in the direct support to the participant.
Non face-to-face supports, provider travel and activity based transport in relation to some group supports can also be claimed using the relevant support items as outlined in the NDIS Price Guide.
Non face-to-face supports will now be claimed separately - previously the non face-to-face amount was included in the service line item price.
Claiming for Centre Based Capital Costs
When a group support item in the Assistance with Social, Economic and Community Participation Support Category is delivered in a Centre by a provider in one of the below Registration Groups, then the provider can claim an additional amount for the costs of running and maintaining the facility through the relevant Centre Capital Cost support item.
- High Intensity Daily Personal Activities (0104)
- Specialised Supported Employment (0133)
- Group and Centre Based Activities (0136)
NOTE: These arrangements do not apply to providers who choose to use the transitional arrangements for group-based supports in the Assistance with Social, Economic and Community Participation Support Category, see page 69 of the price guide. The transitional price limits for these supports already have the capital allowance built into them.
Programs of Support
A provider of group-based supports in the below categories can enter into an agreement with a participant, called a ‘Program of Support’.
- Assistance in Shared Living Arrangements - Supported Independent Living section of the Assistance with Daily Life Support Category, or
- Assistance with Social, Economic and Community Participation Support Category, including Supports in Employment, or
- any of the Capacity Building Support Categories.
If a participant has agreed to attend a session within a ‘program of support’, providers can claim for this support even if the participant did not attend, as long as the provider had the capacity to deliver the instance of support.
Supports delivered as part of a program of supports are not subject to the short notice cancellation rules, however, if a participant does not have a program of support in place then the usual short term cancellation rules apply.
Programs of support can only be offered if the duration of the program is no longer than 12 weeks (unless specifically allowed for in the Price Guide). Participants are able to exit from the program of supports without cost, subject to a notice period of no more than two (2) weeks.
Who is impacted?
All Lumary CM customers will need to upgrade to the Lumary 16.5 release, however, the impact to your environment varies depending on the nature of the services that you offer and the current Lumary CM release that you are on.
Any provider who offers SIL services and/or group supports under the Assistance with Social and Community Participation Category either in a centre or within the community will need to align to the new rules and functionality and will have some changes to make in order to successfully adopt 16.5.
If you are not a SIL provider or a provider of group supports then you are not impacted by this change, however, you will still need to adopt release 16.5 into your environment but the impact and effort in your business is likely to be minimal.
What is Lumary doing to support you with the adoption of these changes?
Given the critical nature of this regulatory inclusion; Lumary is committing over and above normal resource capacity to ensure that the development of the release is on time, compliant and of quality.
Lumary understands the scale of impact of these changes and is compiling the supporting documentation of actions and changes that our clients will need to undertake in-house in order to support the changes in the Lumary 16.5 release.
Lumary will be regularly communicating with and providing the necessary resources to support your business in the adoption of this release. This is the first communication of many that will follow over the course of the next few weeks.
Lumary will also be actively working on the necessary manual changes that will need to be made to your environment in order to adopt the Lumary 16.5 release. The next communication scheduled for the 11th of May will provide clarity over what manual changes will be required and what options Lumary will make available to reduce the manual effort on your behalf.
When is the Lumary 16.5 release going to be available?
The Lumary 16.5 release is planned for release into your selected sandbox environment in the 1st week of June and a specific date will be advised in the next communication.
What and when are the changes that I need to make to my environment to adopt Lumary 16.5?
Lumary will share on the 11th of May the alterations that customers will need to make to their data depending on their current Lumary version and solution with specific partnering applications, for example, Skedulo.
Next week we will provide clarity over what manual changes will be required and what options Lumary will make available to reduce the manual effort. Whilst time is against us with the NDIA regulatory direction, rest assured that Lumary will do everything in its power to ensure that your adoption of 16.5 is as easy as possible.
The next communication is scheduled for the 11th of May. Please revisit this part of the Help Centre for updates.