From the 19th April 2022, a provider can now claim for supported independent living regular supports by either using the hourly claiming process or the weekly claiming process.
Weekly claiming process
The weekly claim accounts for the package of assistance with daily life supports that will be provided for both shared and individual supports.
This bundled support includes all planned supports within a typical week in the shared living environment that is agreed to via a typical schedule of supports.
There are no adjustments for weekdays, weekends or public holidays, as the weekly amount claimed includes an annualised uplift for public holidays.
Weekly claiming provides greater flexibility for participants to negotiate with providers how their supports will be delivered over the week within a typical schedule.
If a provider wishes to move to weekly claiming they will need to meet with a participant and agree a typical schedule of supports to be delivered, which should be included as part of a new service agreement.
If a provider is using a using a Program of Support approach and wants to move to weekly claiming, the provider and participant should negotiate a new service agreement to agree the typical schedule of supports and transition to using the new weekly line item.
- To claim weekly, a provider must use the new weekly line item called ‘Assistance in Supported Independent Living - Weekly’ for all regular supported independent living supports if the conditions specified in the NDIS Pricing Arrangements are met.
- A service agreement must be in place between the participant and the provider, which specifies:
- an agreement to claim weekly amounts
- the agreed typical schedule of supports to be provided for the weekly amount claimed.
- Without a service agreement in place, providers cannot claim for supports delivered using the weekly line item.
- The weekly amount that can be claimed is specified in the decision email sent to providers and should equal 1/52 of the annual regular supported independent living budget.
- For more information on the detailed process, refer to the myplace provider portal step-by-step guides.
Hourly claiming process
The hourly claiming is for support provided to each person living in the shared arrangement in accordance with their need at each interval across the day.
- To claim hourly, a provider should continue to follow the standard process as documented in the myplace provider portal step-by-step guides
Note: Providers should not use a combination of Weekly and Hourly claiming for supported independent living supports for a participant. A provider can either use the Weekly claiming for supported independent living support or the Hourly claiming for supported independent living support for a participant, but not both.
Refer to the claiming rules in the NDIS Pricing Arrangements and Price Limits.
Irregular Support Claiming Process
Irregular supported independent living supports are intermittent or unplanned events that disrupt supports initially planned for in the supported independent living plan budget.
Examples of situations where irregular supported independent living supports would be required include a participant falling ill or the cancellation of a day program, so that participants are in their home and require supported independent living supports for a period that was not initially planned and rostered for.
Claims for irregular supported independent living supports are made using the relevant support item, using the “Irregular SIL Support” claim type when claiming.
This is process is the same for ‘Assistance in Supported Independent Living - Weekly’ line item when providers are claiming weekly.
Supported independent living providers are only permitted to claim from a participant’s plan for irregular supported independent living supports if all of the following conditions stipulated in the NDIS Pricing Arrangements and Price Limits are met.
The Operational Guideline – Supported Independent Living provides more detail about the types of services that are included and excluded from the provision of SIL supports.