A tale of two NDIS plans: plan vs self management

Let me start with Mr H, our beautiful 7yo. He has multiple challenges, including Cerebral Palsy, Autism and ADHD. He has 7 goals in his plan, which cover areas like fine and gross motor skills, communication, self care, emotional well-being, independence, and mainstream education.

We have been self managing his plan from Day 1, and love the flexibility, and control we enjoy. There haven’t been any problems, although there have been times when I would fall behind in making claims. I don’t recommend this! When your child sees multiple therapists, like Speech, OT, Physio, and Psychologists, it is easy to lose track of where your claims are up to. It’s simple enough to look back over claims and see where you left off, but it does take more time. And spare time isn’t something we have a lot of, right? I find that when I make claims straight away, rather than waiting for a bunch to pile up, it is much easier. I am also pretty happy about the changes to the NDIS portal, which is making claims super easy these days (but that’s another blog post!). It is worth noting that if we were Plan Managed, these invoices and payments would be managed for us; a definite benefit of Plan Management over Self Management.

Let’s go back to those therapists for a minute. All of Mr H’s regular therapists are registered providers, but we do go to America once a year for a specialised therapy camp, and because we are self managed, we can claim those hours through his plan. This is really important to us. And because NDIS is Australia specific, you won’t find registered providers overseas. If we were Agency Managed, we couldn’t claim the USA therapy, or the orthotic footwear we sometimes buy online from overseas. We would also have less choice of providers for things like continence or sensory products. We couldn’t buy nappies at Woolworths or Coles; we’d need to buy from a disability specific business, and I have always found those products to be more expensive that way. At the moment I stock up on nappies when they are on sale, which means our $$ go further, which is a good thing; it means we can either buy more of the same product, or have money spare to spend on other things.

There is definitely more admin involved in self managing Mr H’s plan, which means it’s more time consuming, but to be fair, if you keep on top of your invoices and claims, it’s not a heap more time. For those of you who are great with systems, there are lots of options for how you keep organised. I don’t do spreadsheets or the like, I just keep copies of all invoices/receipts, and know where to find them if I am audited. As a self manager the onus is on me to keep copies of all receipts for 5 years. Again, if you are Plan Managed, this isn’t something you need to be mindful of as you won’t ever be audited.

At our last plan meeting, I was tempted to go Plan Managed for Mr H. The thought of not having to pay invoices, make claims and transfer funds was appealing, I won’t lie!

I wasn’t so fussed about being out of pocket by paying invoices, because we either pay immediately with credit card (and have funds claimed and card paid off before interest is due) or we receive a 7 day invoice which gives us time to claim the cost and receive the funds from NDIS before the invoice is due. For me, it was a control thing! More on that in a minute.

So, Mr C’s NDIS funds are Plan Managed, and our experience has been painless. I contacted them early on, and was pretty clear about what was important to us, and I got a good feeling that we wouldn’t run into any hurdles. From what I have heard from other parents, it is essential to have a good Plan Manager who doesn’t take on a ‘gatekeeper’ role. I don’t feel comfortable when I hear other people telling NDIS participants that they should always get permission from their Plan Manager before deciding to spend funds on this or that. I have also heard of some Plan Managers not allowing some claims. And that was the deal breaker for me. I much prefer to be able to make those decisions. I can refer to the questions in the Self Management guide, and decide myself if we should claim through NDIS or not. 

So, when we recently claimed funds from Mr H’s Core budget for specialist adaptive clothing, namely a jumper and jeans, I felt confident we met the criteria to claim. It related to a specific goal (independence/self care), it was definitely related to his disability (we wouldn’t need the assistive features if Mr H didn’t have Cerebral Palsy), and we weren’t blowing the budget. Should it be funded by another body; no. Is it a parental responsibility? Well clothing generally is, so I took off the $$ we would typically spend on mainstream clothing, and claimed the rest. We do the same for shoes. If Mr H didn’t have special shoe needs, we would probably be buying $25 sneakers from Target. So when we need to buy two different sized shoes to fit the AFO, or supportive orthotic shoes he wouldn’t otherwise need, we follow that same thinking, and claim the portion above typical needs. I feel confident with that call. I am also confident that I know my child best, I know his journey to this day, his challenges, needs, what works for him and what doesn’t, and the detail behind his goals, which means I am the best person to be making those calls. Likewise, anyone who doesn’t know all of that information (including Plan Managers, in my opinion) is not in a position to make those calls. 

Although, in the end we decided to continue self managing Mr H’s plan, all was going pretty seamlessly with Mr C’s plan, and we didn’t foresee any areas that could become an issue, so we decided not to switch to self managing, but to continue plan managing his funds. 

Because Mr C joined our family midway through a plan, there was some admin involved, updating our bank details, introducing our providers, and approving services. 

When the new plan was approved, I emailed the new plan to our Plan Manager (as an aside, of all providers, a Plan Manager is the only one who NEEDS a copy of the whole plan, including budgets), and we spoke briefly about changes from the last plan, and what we were wanting to do with funds over the next twelve months.. then we were off and running. 

The only drama we have had was when invoices from our OT went into our Plan Managers spam folder, and more than $1,000 was overdue! I did step in and alert the Plan Manager who then liaised directly with our OT to get it sorted. I could have asked the OT to contact the Plan Manager directly, but our OT is a long standing provider and I wanted to make sure it was sorted quickly (I did say I was a control freak! Lol). 

So, back to Mr C; the sweetest 2yo, who also has multiple challenges and diagnosis, including deafness and Global Developmental Delay. He currently sees a Feeding Specialist, Speechie, Physio, OT and Music Therapist. All are registered providers, except one, who has recently dropped registration (this doesn’t impact us because we can use registered or unregistered providers, but if we were Agency Managed we simply could not use that provider. That is one of the deal breakers for me around Agency Management; far less choice, control and flexibility for my liking). If you are reading this and your child’s plan is Agency Managed, be aware that providers dropping NDIS registration is expected to be a growing trend amongst smaller businesses who can’t justify the extra costs and admin involved in being a registered provider.

Again, Mr C has Core and Capacity Building budgets in his plan. We have found a lovely support worker with her own ABN, and negotiated a pay rate below the price guide. This is great for us because it means we can stretch our budget further. Because budgets are determined based on the price guide, any difference in what we pay vs what we are funded, equals stretching our dollars further. This is a benefit of being self or plan managed. 

Our therapists simply send Mr C’s invoices directly to the Plan Manager, and I get an sms notification that an invoice has been received and will be paid. Our Plan Manager has just released an app which helps me track activity, but I don’t find myself referring to it much. I can also see activity in the NDIA portal, but again, I don’t refer to it much, although this is what alerted me to the previous problem with invoices not being paid, because the portal said there were no outstanding invoices, so I knew there must be a problem. Other things we have claimed from Mr C’s Core budget have been pilot caps (goal around hearing support), specialist spoons and drinking cups (goal around feeding), Key Word sign books (goal around communication), HEN products (goal around nutrition and growth), and supportive footwear (goal around mobility). In all cases, I have been happy to order and pay for products, then send the receipt to our Plan Manager for reimbursement. But I know some providers have a ‘request invoice’ button on their website, and this would mean you wouldn’t need to pay yourself, but instead get an invoice sent directly to the Plan Manager to pay. Not all providers do this, but even if they don’t seem to, it would be worth a quick email to ask for an invoice to be sent, especially if you don’t want to pay for items up front. 

Recently, we visited a new inclusive play gym, and were able to cover the entry cost for both boys through their NDIS plans. For Mr H, we paid, and lodged a payment claim on the portal, and for Mr C, they emailed the invoice directly to the Plan Manager. In this case, it was simpler under Plan Management.

And that’s about it. Both plan and self management have worked well for us. The benefits of choice, flexibility and control, that we have under each child’s plan is important to us, and our experience of Self Management and Plan Management has been pretty straightforward and painless. I have been surprised that there haven’t been more stand out benefits of self management over plan management (at least in our case), but I remain convinced that Agency Management is to be avoided at all costs!

By Jennifer Williamson.

Jennifer is mum to two boys with a disability. She is passionate about her boys living an inclusive life, and being the best little people they can be! She loves to connect with other parents to learn from each others experiences, successes and strategies.

Jennifer has a keen interest in all things NDIS and developed and facilitated numerous workshops at Plumtree for families to learn about the NDIS, prepare for a plan meeting and self-manage their child’s funding package.