Running an NDIS Business
NDIS News & Analysis
A PACE update
Step forward, PACE.
What is it? It’s been described as a lot of different things – a new piece of business management software, a new computer system, an updated information and communication system, and probably some more MA+ rated names. Everything which made me cringe straight into another dimension. But it's official name is Participant/Provider Alternative Cloud Environment.
Regardless, it’s the new way the NDIA will interact with providers and participants from 30 October 2023. In the months since Sara’s article outlining all the proposed functions the NDIA was playing with, the final product - and implications for providers - is now clearer. Importantly, I say ‘clearer’ but not ‘clear’. There are still significant unanswered questions about how some very important things will work in practice.
What isn’t changing?
First up, what isn’t changing. We know that these things will stay the same:
The fundamental structure of NDIS Plans
Item Support Numbers
The NDIS Act
The registration process for providers
NDIS Commission obligations including Practice Standards
The PRODA login used to access the current Portal
So that means major elements of the processes and systems that providers use will remain in place. Good news.
What is changing?
However, don’t go popping bottles just yet. There are some big changes on the way regarding how payments are made. This is what we know so far:
Service Bookings do not exist on the new PACE system. Yes, you read that correctly. The NDIA has cited several other methods of making sure a person’s NDIS Plan doesn’t overspend (including check-ins from the National Contact Centre). In the absence of Service Bookings, we expect most of this budget management responsibility to fall back onto providers and participants.
Another method PACE will use in place of Service Bookings is called My Providers, which up until recently named Endorsed Providers. When a participant endorses a provider (either by responding to a query from the National Contact Centre after a service is delivered, or pre-emptively endorsing them at a Planning Meeting) future claims are fast-tracked and paid within 2-3 days. When a provider is not endorsed, or if a participant disputes the claim, the NDIA say they will do some more investigating and so the payment may take longer - around 10 business days. Some services, like Specialist Disability Accommodation and Positive Behaviour Support, must be delivered by endorsed providers. You might hear the NDIS also say ‘record’ a provider, instead of ‘endorse’ – they mean the same thing.
Very importantly, the My Provider requirements are only for Agency Managed funds. The last quarterly report recorded just 11% of participants fully Agency Managing their plan, equating to 37% of all payments. So these changes are not going to directly affect all providers, for all services, all of the time.
No more single claim functions. Right now, a registered provider can jump on the Provider Portal and fire off a single claim manually. This function will be removed from PACE, and all payment claims will need to be made through the Bulk Upload Request template. Single claims can still be made in this template though, so the function still kinda exists - it’s just in a different format.
A new Request for Service function for Support Coordinators and Psychosocial Recovery Coaches, including unregistered Support Coordinators. When a Planner creates a Request, providers will have four business days to accept or reject the request for services. There is also a functionality to put a reason for rejecting a request. Unregistered Support Coordinators, congratulations – you get to endure the Portal just like registered providers!
Support Coordinators and Recovery Coaches will also have some new forms and templates to use, and a space in PACE to upload them.
What we still don’t know about what is changing
Questions remain. And not small ones, either. The biggest ones so far are:
The NDIA is taking this opportunity to spring clean the Support Categories, introducing a few new ones, most interestingly codes 16 Home and Living and 18 Recurring. It seems that the bulk of a person’s Home and Living Supports now go into this Support Category and will be Stated Supports from now on, with any additional Home and Living supports being in flexible Core. The unknown is how the decision will be made on what is included in the Stated Support and what is flexible (especially given the general move in recent years away from home and living supports being stated). Recurring looks just to be General Transport when paid as a periodic payment into the person’s bank account – other billable Transport items remain as they are.
Transition is going to be…interesting. PACE becomes operational on 30 October 2023, with a roughly 18-month transition period. From what we know so far, participants will transition to PACE when they go for Plan Reviews. So, providers should prepare to run dual systems for a long period of time. But given many Plans are multi-year, I reckon we can expect a large number of participants to move to PACE all at once at the end of the 18-month transition period. Watch this space for more details, and don’t be surprised if these timelines change – we know with huge IT transitions like this, the government only really knows how it will work in practice once it goes live.
We don’t have many details about the format (or quality) of the communications to participants from the National Contact Centre. Given these processes are an important part of endorsing providers, changing goals, and generally implementing plans, we hope they are more accessible and flexible than what we’ve seen so far from the NCC.
The NDIA is saying Providers with existing service bookings will be recorded (with some exceptions) but we don’t know for sure whether this means they will automatically be endorsed across all relevant Support Categories, or what those mysterious ‘with some exceptions’ are.
What might be changing
Then there’s all the stuff that might be changing, going off some of the early information about PACE. The release of funding in intervals was originally flagged, but the NDIA has gone strangely quiet on this (although the functionality remains dormant in PACE, according to some technical NDIA documents that are publicly available). Another is the increased reliance on participant check ins - the NDIA says these will have an important role in making sure the person’s Plan implementation and expenditure is going ahead as planned. But how this will align with Plan Reviews, Plan Variations and Plan Reassessments is yet to be determined.
We’ve asked the NDIA these questions, and more, and have had limited responses. Frustrating, but government + IT changes = rarely a smooth road. Though given PACE is scheduled to start rolling out on 30 October 2023, many providers need answers so they can start making significant changes to their systems. It’s not just about IT, the changes will impact provider’s relationships with participants, Service Agreements, support planning, budgeting practices, service continuity measures, etc.
But! If you feel your blood pressure rising as you read this, just recall how many transitions and changes providers have dealt with in the last ten years. Some have been smooth, others less so. But you’re still here. These changes will require some re-adjustments from providers, but it’s nowhere near as bad as we first thought.
We are running some short, sharp workshops to lay out what the changes mean for providers, with a focus on the processes and systems. You can book in to these here.