This review is for a SIL home with three participants, Sally, Tiffany and Tamara.

In this instance we were able to identify a scenario in which the level of support rostered being provided was within the funding for the participants, however, it was significantly less than the weekly claim being made. This is important as it leaves the provider open to a potential Back Pay risk where it had claimed for services that were not delivered, but also more importantly meant that the participants may not have been receiving additional support that was required.

Please note that names, addresses, and exact amounts have been changed for privacy purposes.

INITIAL ANALYSIS
Our analysis identified the total funding for the house was $15,144 per week, however, the total claimable roster cost was $13,898 per week (actual staff cost was $9,895) and the provider was claiming $15,008 per week

As a result of these current practices, there was $1,110 in underservicing, which the provider would be at risk of having to pay back to the NDIA for the period this has occurred.

The claimable roster cost is the hours of support multiplied by the applicable hourly rate as opposed to the staff cost which is the actual cost paid to staff as wages.

Following our initial investigation, we met with the client services team to determine where the additional funding could be best allocated. We soon learnt that the 3 participants were able to benefit from additional support in the morning where their needs were struggling to be met.

INCREASE IN ROSTER
Following the collaboration period we were able to agree on a new roster that included additional support but importantly, was still within the participants’ funding and needs.

CLAIM ADJUSTMENT
Once the roster was put into place we ensured that the claiming documentation was now aligned to the new roster so that the house was compliant.

The result for this house was increased support for the three participants and we mitigated any future Back Pay risk for the provider by aligning the support delivered with the claim made, within the funding budget for the house.