Provider Choice PACE Upcoming Changes User Manual

Provider Choice PACE Upcoming Changes

Product Information

Specifications

• Product Name: PACE (Participant and Provider Access to Care and Support)
• System Change: SAP CRM to PACE Salesforce system
• Portal: New portal for participants and providers

Product Usage Instructions

Participant Journey under PACE

1. Make Connections
   For new potential participants, the first point of contact will be Partners like LACs or ECPs. Partners can create a ‘Community Connections plan’ or ‘Early Supports plan’ for those not yet ready for the scheme.

2. Applying to the NDIS
   NDIS partners will assist participants in applying to the scheme and gather information earlier, which will be used in the planning process.

3. Changing an NDIS Plan
   Two months before a plan ends, a reassessment will be done. Reports from support coordinators and recovery coaches are crucial during this check-in.

FAQ

• Q: When is the change to PACE happening?
  A: Participant groups are moving to PACE from October 30th, 2024.
  

Introduction

PACE and upcoming changes to the NDIS: An overview for support coordinators and recovery coaches

New system
NDIS is changing from a SAP CRM to a PACE Salesforce system and introducing a new portal for both participants as well as providers.

Scheme changes
NDIS is operationally changing in how participants, providers (both registered and unregistered), support coordinators, LACs / ECI partners engage and interact with the scheme.

Why is the NDIA making these changes?

NDIA has built PACE to improve the experience for those involved in the NDIS, support more consistent decisions, focus on participant outcomes, reduce admin burden, and make it easier to implement scheme legislative and operational changes.

When is the change happening?

Participant groups moving to PACE from October 30th

• Any new participants entering the scheme.
• Any existing participant with an active plan that needs a change of circumstance.
• Any existing participant with an expiring plan between November 2023 and February 2024 that requires major changes in their new plan.

Participant groups moving to PACE from February 2024

• All other participants in the NDIS, progressively. As their plans expire, new plans will be built in PACE.

Participant journey under PACE

1. Make connections

   • For new potential participants the first port of call will now be the Partners: LACs, ECPs.
   • Partners can create a ‘Community Connections plan’ or ‘Early Supports plan’ for those not ready or eligible for the scheme.

2. Applying to the NDIS

3. Providing reports earlier: NDIS partners will work directly with participants to help them apply to the scheme and gather information earlier (which will be used as inputs to plans, if accepted).

4. Creating your NDIS plan

   • New participants: Budgets will start to be developed before planning meetings, based on evidence provided in earlier stages.
   • Existing participants: Reliance on existing plan and budgets as a starting point for discussions, as well as reports provided from support coordinators and recovery coaches.
   • All participants: Will have a ‘planning meeting’ with their NDIS planner who approves their plans (and any changes to it).

5. Using your NDIS plan

   • Plan implementation: After plan approval, participants will be offered an implementation meeting to learn how to best use their plan.
     This will also be an opportunity for requests for service to support coordinators and recovery coaches to be made.

6. Check ins

   • Scheduled check-ins will become a more common checkpoint to assess how a participants’ current plan is (or not) working for them. These will happen once a year between a participant and their MyNDIS contact. Carers, family members or supporters are also welcome.
   • It’s important to note that reports from support coordinators and recovery coaches may be needed.
   • The NDIA may also conduct un-scheduled check-ins, due to under or overspending by a participant.

7. Changing an NDIS plan

   • Scheduled reassessment: Two months before a participant plan is ending, the NDIA will do another check-in and begin preparing the participant for their re-assessment.
   •  Reports from support coordinators and recovery coaches will be important during this check-in, along with any other evidence if a change is needed.

Changes around NDIS support types and categories

1. New support types and categories
   There will be 1 new support type (Recurring) and 6 new support categories under PACE (21 in total, instead of the current 15).

2. New names for categories
   Some existing categories are having names changed to make them more understandable.

3. No changes to line items
   There will be no changes to line items even with these new categories.

4. Longer plans
   Plans will be longer under PACE, on average around 3 years or more (except for children under 9 who will commonly have 1 year plans).

• Plans will have the annual amount available to draw down
• As a general rule every year plans will be topped up to reflect the annual budget

Agency managed participants and the new My NDIS Provider Portal

There will be two providers portals during the transition

• My NDIS Provider Portal: This is the new portal for providers to access information on their participants, once they’ve transitioned to PACE.
• My Place Provider Portal: This will still need to be used by providers (including SupCos and recovery coaches) for claims and other financial transactions (e.g. submitting claims, raising payments or cancelling claims).

PACE does not have service bookings for agency managed participants

• This is intended to create more choice and control by not locking in funds for one provider.
• In practice, it means that participants could have multiple providers and these providers will have less visibility of funding, meaning that these participants (and their SupCos or recovery coaches) will need to invest more time into budget management.

Service bookings will be replaced with ‘My Providers’ under PACE Endorsement

• A new PACE participant or nominee will need to inform the NDIA of their endorsed Agency-managed provider; they can do this through contact with their NDIS partner (LAC, ECI) or the National Contact Centre.
• Endorsement can happen at any time or at key touch points in the journey, such as the planning meeting, implementation session, check-ins and reassessments.

Payments for agency managed participants / funding will look different under PACE

• Payments for ‘My Providers’ will move straight to processing and occur within 3 business days.
• For all providers not listed as ‘My Providers’, payments can take up to 10 business days. This is because participants or their nominees will need to ‘approve’ each claim with the NDIA.
• Bulk upload claims: Providers will need to go through the bulk upload process and not the single claim process for all participants under PACE.

Visibility of plans is changing for agency-managed participants

• With consent from the participant, support coordinators and recovery coaches will be able to see key information for a participant in the MyProvider Portal, such as basic details, goals, nominee details, provider roles, live budgets etc.
• Even if you are a ‘My Provider,’ consent needs to be explicitly given to the NDIA by the participant or nominee for information access.

No changes for self-managed or plan managed

• For self-managed and plan managed funding, general providers will not be required to create service bookings (as is today) or be set up as a ‘My Provider’.
• Plan managers will need to be set up as a ‘My Provider’ for their participants.

Key callouts for support coordinators and recovery coaches

1. Request for service
   • Every participant (new to the scheme or transitioning to PACE) will need to create a new ‘request for service’, where they have relevant funding in their plan.
   • Support coordinators and recovery coaches (registered and unregistered) will need to accept a ‘request for service’ (within 4 days of receiving it) in order to work with that participant under PACE.
   • Participants can create a ‘request for service’ at many touch points, including implementations, reassessments, check-ins or proactively by contacting the NCC.
   •  Once a support coordinator or recovery coach accepts a ‘request for service’ they get tagged as a ‘My Provider’ for that participant.
2. The new My NDiS Provider Portal
   • Both registered and unregistered support coordinators and recovery coaches will get access via a PRODA account. If you’re unregistered, for the first time, you’ll be able to set up a PRODA account and get the relevant system access.
   • The portal is where you’ll be able to accept or deny requests for service from participants in the scheme.
   • Once your participant has given consent (by informing the NDIA), you’ll be able to view key information about their plan within the portal.
3. Reporting requirements
   • Support coordinators and recovery coaches will need to create and submit reports in new, standardised templates to the NDIA. This will happen across the life of the plan, generally at set times.
   • The two main types of reports will be progress and implementation reports. Both will focus on the participants’ support needs, the support they’re receiving and their progress towards goals.
   • You’ll be able to track when reports are due and directly submit them in the new My NDIS Provider Portal. Therefore access to the portal is critical for support coordinators and recovery coaches.

Provider Choice is a national plan manager with a focus on providing proactive support to participants and their support coordinators. Our systems, processes, plan managers and community engagement managers are all PACE ready.
If you would like help  preparing for the transition,  you can get in touch with your local community  engagement manager:

By email
hello@providerchoice.com.au
Or online
www.providerchoice.com.au/contact

References

• HeyHubble | Connect With Quality NDIS Providers

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