1. NDIS: GOVERNANCE IMPLICATIONS FOR BOARD AND EXECUTIVES
Presented by Linda Hayes, Managing Director Corporate Synergies Australia Pty Ltd

2. Implementing NDIS - CSA Pty Ltd
Workshop Objectives
This workshop reviews service providers’ governance structures, policies, procedures and controls that are essential elements for NDIS registration as a service provider and are key elements in all NDIA compliance reviews of registered service providers.
A general governance model for NDIS registered service providers
Governance structures, policies, procedures and controls for NDIS registration
NDIS Terms of Business implications
Implications of the proposed NDIS Quality and Safeguards Framework
Surviving a NDIA compliance review of your governance elements
Linda has over 25 years experience in business strategy and development across private, government and community sectors. More recently, Linda has been noted for her work in the Community sector, assisting organisations to transition business practices to those more sustainable under the emerging government funding models.
Linda is a preferred business mentor and advisor to Bendigo Bank - Community Banking (NSW and QLD), professional contributor to NDS Qld, QCOSS and Better Boards Australasia, trainer with TDSA and CSDS, and in the past held advisor panel contracts with the Commonwealth Department of Social Services (Aged Care), and NSW Aboriginal Affairs.

3. The Emerging Environment
CSA© 2017
The Emerging Environment
Managers and board members of organisations who are, or are seeking, registration under the National Disability Insurance Scheme (NDIS) as a registered provider of supports and/or as a registered Plan Management provider are directly impacted by the NDIS’s Terms of Business including governance oversight mechanisms.
The National Disability Insurance Scheme (Registered Providers of Support) Rules - states that registered providers must agree to the NDIS Terms of Business, which includes “Providers are to comply with all applicable Commonwealth, State and Territory laws in relation to conducting a business and governance arrangements.”
NDIA is currently finalising a NDIS Quality and Safeguarding Framework that includes service level quality safeguards: “A quality provider will usually have strong governance, policies and procedures, and a corporate culture that fosters respect and openness.”
At the same time, the ACNC and the ATO are providing stronger frameworks on best practice governance, while our Human Service Quality Frameworks are requesting stronger evidence of our policy and procedures, and the Board’s role in the governance of these.

4. Learnings from the real world…
A significant planned outcome of the National Disability Insurance Scheme (NDIS) is to develop a national competitive market for the provision of disability supports.
This increasingly competitive environment requires all for-profit and not-for-profit service providers to be more effective and efficient across all areas of business practice – from client management to marketing.
One of the key learnings from roll out sites to date is the amount resources (people, time and tools!!) required to transition clients to individual service agreements and financial transactions.
Our biggest fear was delay in payment from the NDIS. However, our own policies and processes across client intake, data management, resource management, accounts and payments created the most delays.
Ineffectual implementation of essential business practices directly affects our viability under these new models. We need timely processes that maximise the outcomes for our clients, staff and cash flow.
THESE PROCESSES COME FROM THE POLICY DECISIONS OF THE BOARD!

5. NDIA Act, rules and guidelines
The facts

6. 3 levels of legislative practice
National Disability Insurance Scheme Act 2013
National Disability Insurance Scheme (subtitle) Rules 2013 (pursuant to sec. 17 of Act)
NDIA’s CEO “Operational Guidelines” (pursuant to a Rule under the Act) eg: Operational Guideline – Registered Providers of Supports NDIS Terms of Business for Registered Support Providers
Forms, assessment tools, policies etc.

7. National Disability Insurance Scheme
NDIS Act 2013 (Cwth) – sec. 3 – Objects of the Act: (extracts only)
Provide reasonable and necessary supports for participants in the NDIS launch (s.3(1)(d))
Enable people with disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports (s.3(1)(e))
Adopting an insurance-based approach, informed by actuarial analysis, in the provision and funding of supports for people with disability (s.3(2)(b))
In giving effect to the objects of the Act, regard is to be had to … the need to ensure the financial sustainability of the NDIS (s.3(3)(b))

8. Cont…
People with disability have the same right as other members of Australian society to be able to determine their own best interests, including the right to exercise choice and control, and to engage as equal partners in decisions that will affect their lives, to the full extent of their capacity. (s.4 (8))
Participant’s Plan must include any general or reasonable and necessary supports that will be provided or funded as part of the plan.
Supports must provide value for money (s.34 )
Delegate documents statement of reasons for the decision (the letter that accompanies the provision of the plan) and provide a copy of the plan to the participant within 7 days.

9. Act - section 73…
(2) The National Disability Insurance Scheme rules may make provision in connection with registered providers of supports, including by prescribing:
(a) the consequences of registered providers of supports failing to comply with this Act, the regulations or the National Disability Insurance Scheme rules; and
(b) requirements with which registered providers of supports must comply, including in relation to the following:
(i) governance;
(ii) business practice;
(iii) accounting practice; and
(c) the obligations of registered providers of supports in relation to the monitoring of compliance; and …
(e) auditing requirements in relation to registered providers of supports.

10. Meaning of governance in NDIS context
CSA© 2017
Meaning of governance in NDIS context
In establishing the NDIS, the Federal and State governments adopted the Productivity Commission’s definition of governance:
“Governance is how an agency or system manages its functions. … it includes the processes and internal culture that gives different people power in the organisation; monitors the utilisation of support services and outcomes; creates incentives for its performance; provides information for good decisions and verification of performance; maintains probity and accountability; and manages its finances. It also includes how an organisation chooses to structure itself: what it chooses to do itself and what it might contract to other parties, and the basis for these boundaries.” (Productivity Commission 2011 report “Disability Care and Support” p. 402 – “NDIS 2011 Report”).

11. NDIS Rules 2013: Governance Implications (eg)
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NDIS Rules 2013: Governance Implications (eg)
3.12 For an applicant for registration in relation to the provision of supports the applicant is to be a suitable person or entity …:
(a) the qualifications and approvals relevant to the provision of those kinds of supports held by the applicant and the applicant’s staff …;
(b) the applicant’s capacity to provide those kinds of supports;
(c) the applicant’s experience in providing those kinds of supports;
(d) if the applicant proposes to provide supports to a particular participant whether that participant has stated that he or she considers the applicant to be suitable to provide those supports.
3.13 For an applicant for registration in relation to managing the funding …:
(a) the qualifications and approvals relevant to the management of funding …;
(b) the applicant’s capacity to manage the funding for supports;
(c) the applicant’s experience in managing the funding for supports;
(d) if the applicant proposes to manage funding for a particular participant whether that participant has stated that he or she considers the applicant to be suitable to manage that funding.
HANDOUT 1 (extract)

12. Operational Guidelines – Registered Providers of Supports
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Operational Guidelines – Registered Providers of Supports
19. An application may seek approval for a person or entity to be a registered provider to provide specific supports set out in the application or for kinds or clusters of supports set out in the application.
20. A cluster of supports is a broad kind or category of supports and may contain a number of more specific support items.
21. A delegate must be satisfied that the applicant meets the criteria set out in the Registered Providers of Supports Rules in relation to each specific support or each cluster of supports (as the case may be). ….
22. The NDIS Act sets out that a delegate must approve an applicant as a registered provider if:
a. The delegate is satisfied that the applicant meets the criteria to be a registered provider (set out in the Registered Providers of Supports Rules), and
b. The delegate is satisfied that the applicant is suitable to provide supports or manage funding (as the case may be) applying the criteria and having regard to the matters set out in the Registered Providers of Supports Rules.
HANDOUT 2 (extract)

13. NDIS Provider Toolkit Module 4: Guide to Suitability
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NDIS Provider Toolkit Module 4: Guide to Suitability
Until the national NDIS quality and safeguards framework is in place, or 30 June 2019, whichever is sooner, Queensland’s quality and safeguard framework will apply to NDIA providers delivering specialist disability services in Queensland.
Providers registering with the NDIA to deliver specialist disability services in Queensland must meet the requirements of the NDIA provider registration process and:
• adhere to the safeguards as set out in the Disability Services Act 2006 (DSA) and other Queensland state government legislation;
• submit with their NDIA registration, evidence of compliance with the Queensland Human Services Quality Framework; and
• have, maintain, implement and act in accordance with policies consistent with the Queensland state government Abuse, Neglect and Exploitation Policy.
RESOURCE

14. Human Services Quality Framework
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Human Services Quality Framework
Governance and management
Expected outcome
Sound governance and management systems that maximise outcomes for stakeholders.
Context
The organisation maintains accountability to stakeholders through the implementation and maintenance of sound governance and management systems.
These systems should reflect the size and structure of the organisation and contribute to maximising outcomes for people using services.
…….. (see HSQF handout for specific indicators)
HANDOUTS 3 (extracts)

15. NDIA Quality & Safeguards Framework
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NDIA Quality & Safeguards Framework
Governments have agreed to the development of a national approach to quality and safeguards as part of the National Disability Insurance Scheme (NDIS).
There is agreement that the national framework should maximise the opportunities for people with disability to make decisions about their supports while also enabling them to live free from abuse, neglect and exploitation. The framework should also promote innovation, continuous improvement and best practice in the provision of supports.
A nationally consistent quality and safeguards framework should mean that people interacting with NDIS can expect consistent standards and safeguards wherever they live in Australia.
The Commonwealth Government, in collaboration with the NDIA and state and territory governments, is leading the work to develop a system of quality assurance and safeguards, which will include complaints and critical incidents management.
HANDOUTS 4 and 5 (extracts)

16. Surviving a compliance review of your governance requirements
It’s all in our Terms of Business

17. NDIA Rights under Terms of Business
CSA© 2017
NDIA Rights under Terms of Business
Registered Providers may be reviewed by the Agency in relation to supports funded for a NDIS participant. Registered Providers must cooperate fully with the Agency officers who are undertaking review activities.
As part of any review, or as otherwise reasonably requested by the Agency in carrying out its rights and obligations under law, a Registered Provider must give the Agency or persons authorised by the Agency (‘those permitted’) access to premises where accounts and records associated with the provision of services to participants are stored and allow those permitted to inspect and copy all records associated with the provision of services to participants.
A Registered Provider must provide all reasonable assistance requested by those permitted including making available all accounts and records relating to the provision of services to participants at the Registered Provider’s registered office or the Registered Provider’s principal place of business or other place.

18. NDIS Terms of Business for Registered Support Providers
Compliance (page 5)
Registered Providers must comply with each of the following:
The NDIS Act, Rules, all relevant guidelines and all policies issued by the NDIA
Own Code of conduct, Code of Ethics or Service Charter
Any Commonwealth, State or Territory laws applicable (Privacy Act, Australian Consumer Law, Quality Assurance, WH&S, Disability Services Act….)
In Queensland, our quality and safeguarding arrangements are under HSQF.
RESOURCE

19. NDIS Terms of Business for Registered Support Providers
Service Agreements (page 6)
Registered Providers should establish a written agreement with each Participant in the participant’s preferred form of communication
the expected outcomes and the nature of services
quality and price of supports to be provided
and any agreed terms and conditions.
the provider must ensure that the participant is regularly provided with details of services delivered
Providers must also abide by relevant consumer laws regarding the provision of receipts and itemised bills.
Service agreements must include a time frame for the notice of termination of services by the provider. Minimum notice period is 14 days.

20. NDIS Terms of Business for Registered Support Providers
Conflicts of Interest (page 7)
Registered Providers must ensure that they proactively manage perceived and actual conflicts of interest, including through the development and maintenance of organisational policies – which must specify how :-
Ensure organisational values do not impede on choice and control
Manage, document and report individual conflicts
Ensure advice is transparent and promotes choice and control

21. NDIS Terms of Business for Registered Support Providers
Payments & Pricing (page 8)
Registered Providers must:-
Adhere to the NDIA Price Guide
Declare relevant prices to participants before delivering service including notice periods and cancellation terms
Only make a payment request once support as been delivered.
Submit a payment request within a reasonable time

22. Maintaining records (page 9)
NDIS Terms of Business for Registered Support Providers
Maintaining records (page 9)
A Registered Provider must keep full and accurate accounts and financial records of the supports delivered to NDIS participants, along with records of service agreements.
The accounts and financial records must be maintained on a regular basis and in such detail that the Agency is able to accurately ascertain the quantity, type and duration of support delivered.
IF A REGISTERED PROVIDER MAKES A FRAUDULENT CLAIM, THE NDIA HAS THE RIGHT TO COMMENCE CRIMINAL AND/OR CIVIL PROCEDINGS.

23. NDIS Terms of Business for Registered Support Providers
Complaints (page 10)
A Registered Provider must have clear and accessible complaints handling and dispute resolution processes.
Records must be maintained for at least five years or as required by law
Providers are responsible for ensuring they remain compliant with all Commonwealth, State and Territory legislation.

24. The ndis process Impacts on our goverance and business practices
CSA© 2017
The ndis process
Impacts on our goverance and business practices

25. General Governance Model in NDIS context
CSA© 2017
General Governance Model in NDIS context

27. The Transition Process

28. NDIS Service Categories
(Plan Management)
CORE
Assistance with Daily Life
Transport
Consumables
Assistance with Social & Community Participation
CAPITAL
Assistive Technology
Vehicle modification
Home modification
CAPACITY
Co-ordination of Supports
Improved Living Arrangements
Increased Social & Community Participation
Finding and Keeping a Job
Improved Relationships
Improved Health & Wellbeing
Improved Learning
Improved Life Choices
Improved Daily Living Skills
NDIS Service Categories

29. Administering the process
CSA © 2017
Implementing NDIS - CSA Pty Ltd
Administering the process
INTEGRATED SYSTEMS FRAMEWORK
Client Management
Client enquiry
Client intake
Client data
Client notes
Client service agreements
Conflict of Interest
Complaints
Records management
Service Delivery
NDIA Service Booking
Service scheduling
Staff selection
Staff recruitment
Staff rostering
Staff timesheets
Staff activities against NDIA items (fraudulent claims)
Financial Management
Payroll
General Ledger
Creditors/Debtors (bad debt)
Job/Activity based costing (by client)
Client invoicing
Budgeting and forecasting
Asset Management
Claims and and Reporting
Myplace Portal interfacing
Payment requests (Price Guide)
Client and stakeholder reporting
Internal controls
External audit
Policies, Procedures, Practices and Processes
Operations & Services
Administrative and Management

30. HSQF Standards Governance & Management Service Access & Delivery
Implementing NDIS - CSA Pty Ltd
HSQF Standards
Governance & Management
Governance Charter
Policy 1 – CEO Delegated Authority
Policy 2 – Strategic Management
Policy 3 – Risk Management
Policy 4 – Contracts & Financial Management
Policy 5 – Information Management
Policy 6 – Conflict of Interest
Policy 7 – Business Practices Under NDIS
Service Access & Delivery
Policy 8 – Purpose of Service
Policy 9 – Service Access and Agreements
Policy 10 – Service Delivery Framework & Outcomes
Policy 11 – Partnership & Collaborations
Policy 12 – Management of Operations
Policy 13 – Plan Management
Policy 14 – Co-ordination of Supports
Policy 15 – Stakeholder Reporting
Individual Safety & Well-being
Policy 16 – Management of Complaints and Appeals
Policy 17 – WH&S
Policy 18 – Discrimination, Harassment & Bullying
Policy 19 – Termination of Services
Sustainable Resource Management
Policy 20 – Management of Human Resources
Policy 21 – Management of Financial Resources
Policy 22 – Management of Administrative Process
Policy23 – Management of Capital Assets
Policy 24 – Management of Information Technology

31. + changes in stakeholder reporting
e.g. Members AGM, board, management, participants, Australian Charities and Not For Profits Commission (ACNC)
Annual Report disclosure commentary – NDIS impact on participants, members, operations, management
Financial Statements disclosure and commentary – material change in revenues, costs, assets, liabilities and benchmark ratios due to NDIS
External audit disclosure – material change in funding sources from Govt. grants to participants’ service agreements revenues
Provision for bad/doubtful debts
Decision on recognising material “Work in Progress” (WIP) in financial statements.

32. + impact on the General Ledger
Within the National Standard Chart of Accounts
General Ledger Account Codes for NDIS services revenues (NSCOA)
Example - NDIS Item Assistance with self-care activities: weekday day
e.g
General Ledger Organisational Activity Codes (using e.g. MYOB Category Code function)
e.g. 106 Mobility assistance
108 Meals assistance
General Ledger Client Codes (using e.g. MYOB Job Cost Code function)
e.g. 407 Chris Brown

33. + other considerations
Providers now have to compete with all other providers that provide the same type of support as our own.
All enquiries will need to be treated as potential new clients.
Providers will need to be able to say what makes us the best – quality, price, approach, other???
Providers will need information on hand and a system in place as to how we manage this.
SO WHAT DOES THIS LOOK LIKE FOR OUR WHOLE ORGANISATION??

34. Implementing NDIS – CSA Pty Ltd
EXERCISE: SWOT
Conduct a quick SWOT of your organisation, based on the key points of the Terms of Business.
Areas of STRENGTH
Needs Improvement

35. Implementing NDIS - CSA Pty Ltd
Are you NDIS ready?
The essentials

36. Implementing NDIS - CSA Pty Ltd
Tips and Traps
Review the nature and extent of ALL governance structures - e.g. board charter, code of conduct, terms of reference subcommittees, meetings’ minutes, delegations, board approved policies
Do not wait for a NDIA review – periodically check your internal controls and board monitoring of HSQF Governance and Management indicators – and take corrective action as necessary
Review completeness and integrity of ALL documentation and records of NDIS funded services – ensure easy access
Assign a senior manager with overall responsibility for interfacing with NDIA officers
Ensure all relevant key staff are appropriately briefed at all stages of the review – pre- during and post-review – and follow up actions

37. Tips and Traps Know your services and service delivery model
CSA © 2017
Tips and Traps
Know your services and service delivery model
Know your true unit costs of service delivery and cash flow restrictions
Be prepared to invest in time and resources for client transition
Be prepared to invest in time and training for ALL staff
Forecast required hours, skills, resources and hidden costs to the organisation
Have all policies and procedures up to date and implemented
Ensure finance systems are ready to go and report at an individual level
Be ready to make regular payment requests to ensure optimum cash flow
And remember… the best plans come from the best preparation – by everyone!!

38. Any questions?