Plan Variations: Theory vs Reality

Lisa explores how plan variations are playing out on the ground. Spoiler alert: There are inconsistencies between theory and reality.

By Lisa Duffy

Updated 15 Apr 202429 Mar 2023

The NDIS continues to be an ever-changing beast.

Amendments to the NDIS Act 2013 that became active on 1 July 2022 included the introduction of plan variations. Prior to that date, if people wanted to apply to have one section of their plan reviewed, their whole plan would be reviewed – not just the bit/s that weren’t meeting their needs and goals. This often led to the good bits of plans being tampered with, even when they had nothing to do with the review request. People often felt that they needed to make a risk vs benefit decision.

Many people welcomed the new option of plan variations because, in theory, it offers more flexibility for some NDIS participants while reducing the fear and uncertainty that people had experienced when requesting a plan review. The introduction of plan variations brought with it the hope that only specific parts of a plan would be reviewed- not the ‘good bits’.

But is reality matching the theory? How are plan variations really playing out? Here’s what we’re hearing is happening on the ground.

What is a plan variation?

A plan variation is an update or relatively minor change to a participant’s current plan that does not involve a full plan reassessment or a brand new plan.

Plan variations can potentially:

1.    Revise or correct a minor or technical error in the plan;

2.    Change the plan reassessment date;

3.    Change how the funding in the plan is being managed;

4.    Update who must provide a support or how a support must be provided;

5.    Change the statement of participant supports (including changes to funding in the plan).

If a participant requests a plan change via the Change of Details or Change of Situation form, the NDIA must decide within 21 days if it will approve the plan change. The NDIA can:

  • Decide to vary the plan as requested;
  • Decide not to vary the plan;
  • Notify the participant that it needs more time to decide;
  • Decide than a full plan reassessment is required;

Plan Variations: Theory vs Reality

Overall, the introduction of plan variations has brought with it a sense of flexibility and increased choice and control. However, as with all significant changes to large systems, there are bound to be some hiccups and inconsistencies.

The following lays out some potential hiccups to help people feel more educated and better prepared to respond to their individual plan variation experiences.

Let’s take a look at what support coordinators across Australia are seeing on the ground.

Lack of awareness

There appears to be a lack of awareness about the option of a plan variation. Both planners and LACs are not always giving a full explanation of plan variation vs plan reassessment during participant check-ins, thus reducing the potential for informed decision-making. Some support coordinators reported that participants may have a short check-in phone call and then receive a new plan without understanding how or why.

On a positive note, support coordinators are taking the current state of affairs as an opportunity to build participant capacity. They are regularly educating people on the new plan variation and reassessment pathways and what to look out for in terms of communication from the Agency. This has also helped make some people more confident about self-advocating when contacted by the NDIA.

However, capacity building around these new concepts needs to happen before people are contacted for a check-in. This can be difficult due to the fact that there are currently no standard operating procedures for when check-ins will occur during a person’s plan period.

Delays, delays, delays

Unfortunately, plan variation decisions are not always happening within the NDIA’s stated timeframes. For example, one support coordinator commented that she is supporting 2 participants who have been waiting 2 months without an outcome or resolution.

Changes to unrelated parts of the plan

Support coordinators also spoke about cases where a participant’s request for a minor plan variation led to significant and unrelated plan changes. In other words, the good bits of the plan have been tampered with.

For example, one person requested a plan variation to change their plan-managed general transport into a periodic payment to their bank account. The varied plan came back with a significant reduction to the Core budget, which was completely unrelated to the variation request. Another individual asked for a plan variation to have their reassessment date changed, but the varied plan that emerged had an enormous cut to their capacity building budget.

However, there were also examples where plan variations related only to the changes requested.

Pressure on participants

There were reported cases where a participant felt that the assessor was pushing for a plan reassessment rather than a plan variation, particularly if there was a significant underspend in the current NDIS plan. This is likely because a large underspend may signal to a planner that there may have been some significant changes, rather than minor ones, to the person’s support needs or goals since the last planning meeting.

In these situations, evidence for budget underspends must clearly justify the reasons and barriers to anticipated plan spending. Otherwise, there is a risk that the “underspend” could be interpreted as “original funds no longer required”.

Extending a plan is creating a new plan

Many people who request a plan variation to extend the duration of their plan will have the same amount of funding replicated on a prorated basis. In these situations, although the participant is not receiving a new plan (they have simply varied the reassessment date of their current plan) the NDIA system sees it as a new plan. Consequently, unspent funds cannot be carried over. The NDIS website explains this as a side effect of their computer system not being updated yet. These varied plans will also show a new start date.

However, if a person has a plan extended for 12 months after receiving a letter offering the participant a “plan continuation”, a new plan is not created. Any unspent funds will carry over to the new plan period. In theory, this situation is neither a plan reassessment nor a plan variation!

What’s next?

The general consensus from the support coordinators we spoke to is that the theory and reality of plan variations are not yet quite in alignment. The most effective way to remedy this situation is to empower participants with information.

Building the capacity of participants and their support networks to understand the new language and their rights is critical. All participants should know about their right to delay a check-in until their chosen supports can join them. And of course, they have the right to ask questions and have these new processes explained.

As always in the world of the NDIS, knowledge is power and can facilitate informed decisions and outcomes.

So, please pass this article on to participants and their support networks so that they know what is happening on the ground and what they can do to be informed and prepared!

Big thanks to all the support coordinators we spoke to for their contributions.

Authors

Lisa Duffy

Explore DSC