New Price Guide for 2020-21 Released!

Update 12 June: The NDIA’s initial Price Guide included a change to the way shifts should be billed according to the time of day. The updated Price Guide has removed this rule, allowing a support for a single participant by a single worker that crosses a shift boundary can be billed at the single higher rate.

The NDIA released the 2020/21 Price Guide this morning with some massive announcements inside. Notably missing from this release is the updated price limits – while the newly released Price Guide outlines the updated structure, the sector will need to wait for the outcome of the Annual Wage Review to see how prices are updated across the board. So what do we know so far?

SIL IS NOW SUBJECT TO PRICE LIMITS

Perhaps the biggest change in this release is the move away from price quoting and negotiation in Supported Independent Living (SIL). SIL is now subject to price limits based on the time of day, day of the week and intensity of support. Many SIL providers will be anxiously wondering what these new prices are and while they are yet to be finalised, our first impressions are not good - it appears that the “lower” classification has been removed and the pricing has been shifted downwards so that a “higher” rate is now priced where “standard” was and “standard” is where “lower” used to sit.

Existing quotes will continue until the end of their 12 month term, at which point the provider will need to switch over to the set SIL pricing limits. The NDIA will release more information in the new SIL Provider Pack which will be available in the coming weeks.

NEW LINE ITEMS FOR INDIVIDUAL LIVING OPTIONS

And while we’re talking about in-home support, Individual Living Options (ILO) fans will be pleased to see the inclusion of ILO “Exploration and Design” and “Support Model” line items. More detail is still to come in July – stay tuned.

EMPLOYMENT SUPPORTS PRICING SHAKE UP

This Price Guide has thrown out the old pricing model for employment supports, which has up until now been paid as a weekly support. In its place is a far more flexible approach with hourly price limits based on the day of the week and time of support - now in both Finding and Keeping a Job and Core supports (see below for more detail). DMI levels have also been removed and there is no more explicit reference to Australian Disability Enterprises (ADE).

While this represents a significant transition and challenge for many employment providers, it is a massive win for Participants wanting greater flexibility in their work hours and options. There is a “Transitional Funding Arrangements” line item under Core supports that allows provider to continue to claim at their current Disability Maintenance Instrument (DMI) or Average Outlet Price (AOP) for a period of up to 18 months.

PSYCHOSOCIAL RECOVERY COACHES

This Price Guide includes a welcome addition to the Support Coordination support category in the form of Psychosocial Recovery Coaches. The description of this role sounds very similar to Support Coordination:

These support items provide assistance for participants to build capacity and resilience through strong and respectful relationships to support people with psychosocial disability to live a full and contributing life. This support is designed to be able to maintain engagement through periods of increased support needs due to the episodic nature of mental illness. Recovery coaches work collaboratively with participants, families, carers and other services to identify, plan, design and coordinate NDIS supports. 

There are a few important differences between Recovery Coaches and Support Coordinators that we can see so far:

• Recovery Coaches must have lived and/or learnt experience, including a min. Cert IV qualification in peer work or mental health or equivalent training and/or two years experience in mental health related work

• Unlike Support Coordinators, who are paid a flat rate regardless of the time of support, Recovery Coach price limits vary. While prices are still not final, we are concerned to see that the Weekday rates are currently sitting 10-20% below the current rates for Support Coordination – Level 2, despite the higher bar for qualifications.

CORE AND CAPACITY BUILDING ARE STILL NOT FLEXIBLE

In what we can only hope is a momentary delay, this Price Guide does not make any changes to the flexibility of core and capacity building supports, as Minister Robert announced it would late last year. Sadly, the Core support definition still reads “Participant budgets often have a lot of flexibility to choose specific supports with their core support budgets, but cannot reallocate this funding for other support purposes (i.e. capital or capacity building supports).”

PROVIDER TRAVEL MAY NOW ALSO INCLUDE NON-TIME COSTS

Bringing it in line with the rules around Activity Based Transport, providers who are allowed to charge for travelling to/from a participant may now also claim for the costs associated with the trip (in addition to the worker’s time). This may include road tolls, parking fees and vehicle running costs.

Charging these costs will be subject to negotiation with each participant. The price recommendation (not limit) is currently the same as Activity Based Transport:

• up to $0.85 a kilometre for a vehicle that is not modified for accessibility; and

• other forms of transport or associated costs up to the full amount, such as road tolls, parking, public transport fares.

And in news that will be music to the ears of providers in many remote areas, capacity building providers can now create their own agreements with participants to cover the costs of remote travel.

ASSISTANCE WITH SOCIAL & COMMUNITY PARTICIPATION HAS BEEN TURNED ON ITS HEAD

We’re still wrapping our heads around all the ways that the structure of Core supports has changed. There are some massive adminstration and rostering considerations from this shift which we will be unpacking in another article soon but here’s what we can see so far:

• The number of line items in Assistance with Social and Community Participation has gone from 225 to 87.

• “Supports in Employment” can now be claimed from either Finding and Keeping a Job or Assistance with Social and Community Participation. Prices are in line with other support work line items in that support category.

• Line items that refer to specific ratios are gone. The NDIA now expect providers to do their own math and claim the relevant fraction of the price limit e.g. if the price limit of a support is $58, providers delivering 1:2 will need to claim .5 of the maximum (ie. $29) using the same line item code. While the prices are still not finalised, it looks like this will mean a massive cut to the revenue at higher ratio levels.

• “Centre based” and “community based” line items have been removed and replaced by line items that do not name the support location. The idea now is that providers delivering a support in a centre will make a claim with two components: the support time (e.g. Group Activities - Standard - Sunday) and the newly introduced “Centre Capital Cost” - currently sitting at $2.31 per hour in non-remote areas with the final price to be confirmed.

Update 26 June: The NDIA have announced that group support providers will have 12 months to transition to this new pricing arrangement.

ESTABLISHMENT FEES ARE NOW CONSISTENT

Replacing the previous rules about establishment fee pricing is a flat fee of $528.50 (non-remote, non final price). Providers of personal care, community access or employment supports can claim this fee once for participants they support at least 20 hours a month for three or more consecutive months. Note that employment supports is a new addition to that list. 

TEMPORARY TRANSFORMATION PAYMENT WILL BE REDUCED

But you guessed it – we don’t know the final rates yet.

PLAN MANAGERS CAN NOW CHARGE FOR TRAVEL AND NON FACE-TO-FACE TIME

Between the half dozen Price Guide updates and COVID-19, Plan Managers saw an unprecedented increase to their workload in FY2019-20 with only the slightest increase to their revenue (an increase so slight, in fact, that it would have cost most Plan Managers more to change their service booking to claim it than they would have earned). While we still don’t know the final 2020-21 price limits, the introduction of allowing travel and non-F2F supports seems, frankly, kind of insulting given that Plan Management is typically funded as a combination of two stated supports (a set up fee and monthly fee) with no flexible funding to go towards these extra costs.

REMOTE RECLASSIFICATIONS

In updating from the Modified Monash Model 2015 to 2019, a number of locations has been reclassified as either regional (MMM5 - no loading, just slightly improved travel rules), remote (MMM6 - a 40% loading on all supports) or very remote (MMM7 - a 50% loading on all supports). These changes will come into effect on 1 October 2020:

From 1 October - classified as more remote:

• From regional to remote: NSW and in QLD: Coochiemudlo Island, Dunwich, Glenden, Karragarra Island and Lamb Island.

• From remote to very remote: Penneshaw (SA), Carnarvon, Kununurra (WA)

• Classified by NDIA as remote: Ravenswood (NSW) and Warren (NSW)

From 1 October - classified as less remote:

• From very remote to remote: Bourke (NSW), Cobar (NSW), Injune (QLD), Broome (WA), Gunbalanya (NT)

• From very remote to regional: Magnetic Island (QLD) incl. Arcadia Bay, Horseshoe Bay, Nelly Bay and Picnic Bay

• From remote to regional: Hopetoun (VIC), Green Head (WA), Leeman (WA) and QLD: Cardwell, Duaringa, Hideaway Bay – Dingo Beach, Nebo

TEMPORARY COVID MEASURES ARE COMING TO AN END

A number of the temporary measures introduced to support providers and participants through COVID-19 will be coming to an end in from 1 July in what is being dubbed "the first stage of a post-coronavirus NDIS".

• Changes include:
  Removal of 10% COVID-19 loading on certain core and capacity building supports

• Return to standard short-term cancellation definition (ie. 2 clear business days)

• Medium Term Accommodation returned to original policy of 90 days (down from 180).

THE FORMAT HAS IMPROVED… SLIGHTLY

Those of you who remember the days of a Price Guide that was even remotely accessible will be pleased to see the reintroduction of those blue and white tables that clearly layout what the support is and how much it costs. Look, we’re not saying it’s a perfect document but we’ll take this over the size 3 font of the last Support Catalogue any day.

In typical NDIA fashion, this Price Guide release is far from the final one. We’ll keep publishing as we have more information. We’ll also be going through all these changes (and the ones still to come) in a webinar on 2 July – read more about that here.