SupportedIndependent Living Quoting (SIL)
Version 1, January 2018
About this practical guide
This practical guide responds to providers’ frequently asked questions related to the National Disability Insurance Scheme (NDIS) Supported Independent Living quoting process. It outlines the process to develop a quote, what is included, how to complete the templates, the approval process and key provider considerations. A helpful checklist and NDIA regional SIL email addresses are available in the Appendix, found at the end of this guide.
If you have any further questions or require additional assistance please contact Stephanie Worsteling, National NDIS Advisor, at .
Disclaimer: National Disability Services Limited (NDS) believes that the information contained in this publication is correct at the time of publishing. However, NDS reserves the right to vary any of this publication without further notice. The information provided in this publication should not be relied on instead of other legal, medical, financial or professional advice.
What is Supported Independent Living (SIL)?
SIL is 24/7 support provided to a person while living in a home which aims to achieve participant goals and greater independence. It does not mean they have to be home 24/7 but generally means they require some level of support or monitoring when at home. SIL is not Specialist Disability Accommodation (SDA), drop-in support or community participation.
SIL is generally for people living in shared supported arrangements. Participants living on their own requiring 24/7 care may also be eligible for SIL when it is required as a result of high support needs.
SIL is a ‘stated support’ (i.e. not flexible with other supports). Community participation will be funded separately to enable participants to choose other providers if they wish to do so.
SIL makes up approximately one third of the NDIS operating budget at full Scheme.
Background
The National Disability Insurance Agency (NDIA) introduced a new way of processing SIL quotes for first plans or plan reviews in July 2017. A SIL quote is required in all scenarios when it is reasonable and necessary for a participant to receive SIL.The purpose of a SIL quote is to identify.
- The individual supports that will be available for the person, focused on maximising the person’s capacity to be as independent as possible with household decision making, personal care and domestic tasks
- The typical roster of supports that is shared between participants to maximise the efficient use of resources
- What supports are available to all residents to ensure the smooth operation and running of the household
The NDIS Price Guide provides benchmark prices for SIL according to participants’ level of support need (i.e. low, standard and high) and the number people in the residence. These benchmark prices are an indication of the NDIA’s view of efficient service delivery and used as a guide to assess SIL quotes.
When the SIL funding amount is agreed, it is included in the participant’s budget and the NDIA create a Service Booking on the myPlace portal.
The diagram below outlines the NDIS SIL quoting process.
Getting Started
Providers should first read the SIL Provider Toolkit and FAQ on theNDIS website.
Prior to completing any quotes, identify which staff will develop the quote and how they will work together.This is likely to include service delivery and finance staff.
Identify who will authorise quotes, particularly if the organisation operates across multiple NDIS regions. Once the quote is approved, providers are committed to deliver the support at that price until the plan is reviewed.
Nominate the most appropriate contact person(i.e. has detailed knowledge about participants, rostering, and the cost breakdown of each quote).
Providers need to understand what it costs to support individuals in each residence. This is likely to reflect the organisation staff award rate and/or enterprise agreement and other related costs such as overheads. The Agency does not fund vehicles.
Providers may choose to use the relevant support line items in the NDIS Price Guide or their own unit cost to develop their quote. The NDIA assessment of a SIL quote is based on the NDIS Price Guide and the evidence of the support needs for each participant. For example, where there is sufficient evidence that a participant requires more skilled staff (i.e. based on staff qualifications) or if the provider incurs additional staff costs due to the person’s significant disability, the NDIA may fund participants at a higher hourly rate. The quote will require evidence to substantiate the need for a higher rate.
There is an expectation that providers submit quotes 8 weeks before the first plan or plan review meeting. The intention is that it allows for discussions between the NDIA, the participant and provider, for example:
- To review the SIL quote (in the context of non-SIL related supports) in consultation with the SIL provider;
- To allow time for referrals, e.g. Support Coordinator, assessments; and
- To make arrangements for the participant to explore other housing options (e.g. move closer to family or work and/or community programs).
Participant needs and preferences
SIL quotes should reflect a participant’s daily life, and this is likely to be different for each participant. Providers are expected to discuss with each participant, and their family or nominee, their needs and preferencesand the service offering (i.e. what is included in the SIL quote). For example:
- What outcomes they would like to achieve
- When they would like to stay at home (e.g. work Monday to Wednesday, attend community programsThursday and Saturday)
- Preferences (e.g. when they go to bed)
- Quote inclusions and/or exclusions.
Complete the NDIS Provider SIL Pack
If the participant is currently being supported by the provider in a shared accommodation arrangement, the quote is to be prepared on the basis of the detailed knowledge and understanding of the participant’s needs and on the assumption that all of the supports currently provided will continue.
If the participant is unknown to the provider, develop the quote based on the supports available to inform the participant’s living arrangement. Obtain all relevant information to determine the level of support, such as family and provider references, etc.
Complete the following 3 NDIS SIL templates, located at ndis.gov.au/providers/sil.
SIL Quoting Template
The SIL Quoting Template aims to provide the background and rationale of participants’ individual and shared support needs. All relevant information and evidence should be included to assist the NDIA to make a reasonable and necessary decision about the SIL funding requirements.
Where a participant requires a higher level of support (e.g. 2:1), detail the rationale and submit evidence(e.g. behaviour support plans, communication plans, incident reports, staff safety analysis and registered restricted Interventions etc.). Reference all relevant attachments (e.g. two person transfers is recommended in the OT report on page 6).
The more information provided regarding the level of support required will reduce any guess work from planners and arm them with the information they need to make reasonable and necessary decisions. Be succinct and focus on when and why the higher support ratio is required. For example, suctioning, transfers, incontinence support.
The NDIA will always consider independent clinical recommendations. Any evidence that is independent will have a greater impact on their decision than evidence from the provider.
Ideally the evidence should be dated within the last 2 years, however in the absence of anything more current, submit documentation if it still relevant, indicating why it is still relevant.
Identify the need for and benefits of additional funded supports to build participant capacity and/or independence (e.g. assessment for assistive technology or functional behaviour assessment for participants to develop coping strategies to self-regulate behaviours).
Detail proposed capacity building outcomes for first plans, and outcomes achieved for plan reviews.
Roster of Care template
The Roster of Care template should reflect a high-level overview of staffing arrangements (i.e. the ratio of support) in the home in a typical week. It should only indicate when participants receive individualised supports if it’s exclusively for one participant (i.e. the worker is not delivering supports to other participants, even in a supervisory role).
For example, going for a walk would be considered SIL. Although it is not related to the household, it would be unreasonable to think that another provider would want to provide that type of service for only 30mins/1 hour (when they probably have to pay their staff for minimum 2-3 hours). However, going for a hike for say 3-4 hours to the national park for example would be considered community access as there is potential for the participant to choose an alternative provider for this activity. The NDIA want to see greater participant choice and control more and it’s also important to note that community access is flexible whereas SIL is not.
Providers can submit two weeks of this templateif each week is different, (however, this is not a requirement),or average the hours in one week. This template is there to capture what a typical week looks like in terms of supports required. Irregular supports (i.e. unplanned or unexpected supports) are not considered typical so therefore would be excluded. It’s important that providers and participants have service agreements in place to deal with these situations and to determine what will be claimed during these variations.
It is important to include notes on the roster, for example:
- Overnight start andfinish times (i.e. sleepover or active shift)
- House activities with more than one participant (e.g. grocery shopping, meals)
- Transport to or from work and/or community activities
- Attendance at work or other programs and/or services
- Rationale for irregular hours (e.g. the number of days at home during last 6-12 months)
- Regular time spent with family and/or friends
- Regular or planned appointments (i.e. doctor, dentist and specialist appointments)
- Handovers should be included and the time should be divided by the relevant number of residents in the house, at the relevant staff ratio.
SIL Hourly Breakdown template
This template should identify the total weekly hours the participant receives regarding their individual and shared support. The supports in the quote should focus on maximising the individual’s capacity to be as independent as possible.
Irregular supports (i.e. unplanned or unexpected supports) include instances where a participant needs to stay at home due to being unwell or not wanting to go to work or community activity. Forecast the amount of irregular support hours based on providers’ experience with the participant or an expectation of the need for irregular support.
When determining SIL support during holiday periods (i.e. from work or community programs), this will depend on the community access funding (which is flexible). For example, if the participant has 48 weeks of community access funding in their plan then the provider should include SIL for the holiday period as irregular support.However, if 52 weeks has been funded for community access then the participant has the choice to either continue to access the community during this period using the remaining or they may choose to stay home. If they choose to stay home then they may enter into a service agreement with the SIL provider to utilise the remaining funding, or a portion thereof. Therefore the planning meeting and process is crucial. If participants would just like to stay home during the holiday period then they or their guardian should let the planners know so that this can be accounted for properly.
There should not be any ratios of care in the Roster of Care template compared to the SIL Hourly Breakdown template.
There may be instances when the total hours of support (i.e. individual, shared and irregular) might vary slightly between the two templates. For instance if the provider has a different roster for week 1 and week 2, then they may just average the hours in the hourly breakdown template. There may also be instances where by the provider has had to use hourly blocks in the Roster of Care template but are able to use 30 minute or 15minute blocks in the Hourly Breakdown template.
Enter the weekly quote amount - this will automatically create the annualised quote. The template does not automatically calculate the weekly amount, because providers’ hourly rate will vary.
Quote inclusions
SIL reflects supports delivered in the home for 53 weeks.
It includes supports delivered or activities undertaken with all or a number of residents that are not delivered in the home such as going out for a meal, attending doctor’s appointments, etc.
Supports should be included in the SIL quote that would not be appropriate for an alternative provider to deliver (e.g. it would not be appropriate for another provider, other than the SIL provider, to support the residents to undertake weekly grocery shopping).
Staff time to assist participants with transportation during the delivery of SIL supports can be included in the quote. Vehicle costs should not be included as an additional charge.
Quote exclusions
Where a participant has identified that they would like to engage in community activities, providers should detail this in the SIL Roster of Care template (in the notes section under the table). This may be funded under Core Supports if the NDIA determine this could be delivered by another provider.
If the support is not related to the household, the NDIA will determine whether another provider can be reasonably expected to provide that service. The duration of the activity comes into the equation, as it would not be cost effective or realistic to expect an alternative provider to come and pick someone up for a 30 minute 1 hour walk.
SIL quotes should not include supports when a participant is absent from the residence (e.g. hospitalisation or holidays), or for supports covered in other sections of the NDIS Price Guide (e.g. community participation).
Similarly, if a participant is known to be away for periods at a time (e.g. regular hospital visits or staying with family), the provider can include a higher staff ratio for the shared care component in the other residents’ quotes for those periods. This will be a case by case situation and supporting evidence will be crucial.
As SIL supports are a stated support, participants cannot use SIL funding for other purposes (e.g. holidays or associated travel costs), and should not be included in the quote.
The SIL Quoting template gives the provider the opportunity to identify which costs are excluded from the quote. These may include rent, board, maintenance, or other funded supports such as employment support or community participation. If the participant is required to cover some of these costs using their personal funds, the provider will need to discuss this separately with the participant, as NDIA will not cover the cost of daily living expenses.
Providers may need to negotiate supports, other that SIL supports, that the participant will purchase from the provider and include this in their Service Agreement. For example, if the participant accesses transport supports from the SIL provider to attend a community program, the cost will need to be negotiated and included in the Service Agreement.
Submit the completed NDIS SIL Pack to the appropriate contact
Providers are required to prepare and submit the participant quote prior to plan approval. This means that providers need to complete the relevant templates and gather evidence prior to the participant’s scheduled planning or review meeting.
Important to note that any emails that exceed 20MB will be quarantined and may take time to be released. Consider creating a ‘Zip file’ with all documents and attach it to the email.
The NDIA will make a decision to create a Service Booking at benchmark if the NDIA regional office is not able to respond to the quote in a timely manner. This is an interim arrangement to support providers’ to claim while the quote is being assessed.
Providers can request a Service Booking to be applied at the benchmark price if the NDIA has not responded within 30 days since the quote was submitted.
NDIA reviews and assesses the submitted SIL pack
The NDIA will review the templates and evidence and undertake a quality assurance check. The NDIA may request the provider to resubmit with further information and/or evidence.
Quote is agreed
Providers’ experience has highlighted that SIL quotes may take some time to be approved.
NDIA approves quote & creates service booking for the provider
An approved quote should form the basis of the Service Agreement with the participant.
Claiming SIL supports
As SIL is quoted for a 12 month period, the claiming would remain consistent despite some minor variations throughout the year. Circumstances where the NDIA would expect variations in claiming should be negotiated between the provider and participant and detailed in the Service Agreement.