Operational Guideline – Planning and
Assessment – The Plan Management Decision
Legislation
1.
Read ss.42 and 43 of the National Disability Insurance Scheme Act 2013 (NDIS Act) and Part 3 of
the National Disability Insurance Scheme (Plan Management) Rules 2013 (Plan Management
Rules).
General principles
2.
The decision about how the funding under a participant's plan will be managed is to be made
having regard to the principles that guide actions under the NDIS Act. In particular:
a.
People with disability should be supported to exercise choice, including in relation to taking
reasonable risks, in the pursuit of their goals and the planning and delivery of their supports.
b.
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.
See s.4 of the NDIS Act
The definition of ‘managing the funding for supports’
3.
A participant's plan must include a statement which specifies how the funding for supports will be
managed.
See s.33(2)(d) of the NDIS Act
4.
Managing the funding for supports in a plan means:
a.
Purchasing the supports identified in the plan (including paying any applicable indirect costs,
such as taxes, associated with the supports), and
b.
Receiving and managing any funding provided by the National Disability Insurance Agency
(NDIA), and
c.
Acquitting any funding provided by the NDIA.
See s.42(1) of the NDIS Act.
The participants plan management request
5.
To maximise choice and control for participants, delegates are to adopt an approach that gives
emphasis to the participant's plan management request and if there is no request, the participant's
wishes.
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6.
A participant who is receiving an existing package of supports may already have an arrangement in
place for the management of the funding for that package and make a request for the management
arrangement to remain unchanged. The delegate should assist the participant to give effect to this
request in keeping with the NDIS Act. For example, where the arrangement is with a third party who
has not registered as a provider of plan management supports, the delegate may need to explain
the process for registration to assist in minimising any disruption to the supports.
If there is no plan management request
7.
If a participant does not make a plan management request, the plan must specify that the funding
for supports is to be managed by:
a.
A registered plan management provider specified by the NDIA in the plan, or
b.
The NDIA.
See s.43(4) of the NDIS Act
8.
If a participant does not make a plan management request, the delegate must have regard to the
wishes of the participant when specifying who is to manage the funding for supports.
See s.43(5) of the NDIS Act
If the participant has made a plan management
request
9.
During the planning process a participant can make a plan management request and specify who
the participant wishes to manage the funding for supports.
10. If a participant makes a plan management request the delegate is to apply the NDIS Act and Plan
Management Rules to determine who and how the funding in the plan is to be managed (see
below). In the end the plan must specify that the funding is to be managed wholly, or partly, by:
a.
The participant, or
b.
A registered plan management provider, or
c.
The NDIA, or
d.
The plan nominee.
See s.42(2) of the NDIS Act and
r.3.2 of the Plan Management Rules
The participants plan management request must be
followed in most cases
11. The NDIS Act requires the delegate to give effect to the plan management request except in limited
circumstances.
12. The only circumstances in which a delegate can specify in a plan that the funding will not be
managed in accordance with the participant's plan management request is when:
a.
The participant is an insolvent under administration – the participant must not manage the
funding for supports to any extent, or
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b.
The participant has a plan nominee - the plan must specify that the funding for supports under
the plan is to be managed in accordance with the terms of the plan nominee's appointment, or
c.
The delegate is satisfied that a participant must not manage the funding for supports to an
extent because to manage the funding to that extent would present an unreasonable risk to
the participant. This requires the delegate to make a decision under s.44(2)(a) of the NDIS
Act.
See ss.43(2), 44(1) and 44(2) of the NDIS Act
The participant is an insolvent under administration
13. The delegate is to establish, as a matter of fact, whether a participant is an insolvent under
administration. Once a delegate establishes that a participant is an insolvent under administration:
a.
The participant must not manage the funding for supports to any extent, and
b.
The plan is to provide that the funding is to be managed by a registered plan management
provider specified by the NDIA in the plan or by the NDIA, and
c.
The delegate is to have regard to the wishes of the participant, so far as reasonably
practicable, when specifying who will manage the funding.
See ss.43(3) and 43(5) of the NDIS Act
The participant has a plan nominee
14. Once a delegate has established, as a matter of fact, that a participant has a plan nominee:
a.
The plan must be written so that the management of the funding reflects the terms of the plan
nominee's appointment, and
b.
If the plan provides that the funding is to be managed by a registered plan management
provider or by the NDIA the delegate is to have regard to the wishes of the participant, so far
as reasonably practicable, when specifying who will manage the funding.
See ss.43(2)(b) and 43(5) of the NDIS Act
Unreasonable risk to the participant
15. Before a participant's plan can specify that a participant cannot manage the funding for supports in
accordance with the participant's request a delegate must make a decision under s.44(2)(a) of the
NDIS Act. This requires the delegate to be satisfied that a participant must not manage the funding
for supports to an extent because to manage the funding to that extent would present an
unreasonable risk to the participant.
See s.44(2)(a) of the NDIS Act
16. The decision that a participant cannot manage the funding for supports will be reviewable by the
Administrative Appeals Tribunal (AAT) as part of the AAT review of the decision to approve the
statement of participants supports made under s.33(2) of the NDIS Act.
See s.99(d) of the NDIS Act
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If a delegate does decide that there is an
unreasonable risk to a participant
17. The plan must not provide that the participant is to manage the funding to an extent that would
present an unreasonable risk.
a.
b.
The plan must provide that:
i.
The funding is to be managed in accordance with the plan management request to the
extent that the participant is not prevented from managing it, and
ii.
The remainder of the funding is to be managed by a registered plan management
provider or by the NDIA.
To the extent that the funding is to be managed by a registered plan management provider or
by the NDIA, the delegate is to have regard to the wishes of the participant, so far as
reasonably practicable, when specifying who will manage the funding.
See ss.43(3), 43(5) and 44(2) of the NDIS Act
Making the decision about whether there is an
unreasonable risk
18. The Plan Management Rules set out different matters that must be considered depending on
whether the participant is a child or has a nominee (see below).
19. If the participant is not a child or does not have a nominee the delegate must have regard to:
a.
Whether material harm, including material financial harm, to the participant could result if the
participant were to manage the funding for supports to the extent proposed, taking into
account the nature of the supports identified in the plan, and
b.
The vulnerability of the participant to:
i.
Physical, mental or financial harm, or
ii.
Exploitation, or
iii.
Undue influence, and
c.
The ability of the participant to make decisions, and
d.
The capacity of the participant to manage finances, and
e.
Whether a court or a tribunal has made an order under a Commonwealth, state or territory law
under which the participant's property (including finances) or affairs are to be managed, wholly
or partly, by another person, and
f.
Whether, and the extent to which, any risks could be mitigated by:
i.
The participant's informal support network, or
ii.
Any safeguards or strategies the NDIA could put in place through the participant's plan.
See r.3.8 of the Plan Management Rules and Operational Guideline - Planning and Assessment – Risk and Safeguards.
20. If the participant is a child or has a plan nominee, the delegate must have regard to:
a.
The capacity of the child's representative or the plan nominee to manage finances, and
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b.
Whether the child's representative or the plan nominee has an interest that could lead a
reasonable person to consider that National Disability Insurance Scheme (NDIS) amounts
within their control might be spent other than in accordance with the participant's plan, and
c.
Whether, and the extent to which, any risks could be mitigated by any safeguards or
strategies the NDIA could put in place through the participant's plan.
See r.3.7 of the Plan Management Rules and Operational Guideline - Planning and Assessment – Risk and Safeguards.
General considerations about unreasonable risk
21. The delegate should explore options for mitigating any risks associated with the participant's
preferred plan management option. Strategies for enhancing the participant's ability to manage the
plan and safeguarding the participant's interests may include setting a shorter period before the
participant's plan is reviewed, setting out regular contacts between the NDIA and the participant, or
providing funding for supports (for example, budgeting training) that would assist the participant to
manage their own plan.
22. Delegates should weigh up the balance of the risks and mitigation strategies to determine if,
following the application of possible safeguards, an unreasonable risk remains.
23. The delegate should consider the level of risk for each individual support identified in the plan, and
only those supports that present an unreasonable risk to the participant should be restricted from
self-management. For example there may be evidence of unreasonable risk to the participant if
managing a highly complex home modification but not in managing the purchase of small assistive
devices for eating.
See Part 3 of the Plan Management Rules
24. If the delegate is considering approving the plan with a plan management option that is contrary to
the request of the participant because of an unreasonable risk, the delegate should consult with
their supervisor to ensure that possible mitigation strategies have been explored.
General considerations for delegates about plan
management
25. The delegate should ensure the participant is fully informed about plan management options and
tasks and responsibilities associated with each to enable them to choose the plan management
option that maximises their choice and control and opportunities for self-determination.
26. Matters the delegate may wish to discuss with the participant include:
a.
Which management option, or combination of options, is likely to achieve the desirable
outcomes for the participant,
b.
Whether some supports are suited to particular forms of management,
c.
practical considerations such as record-keeping and acquittal requirements, processes and
timelines for paying Service Provider invoices and banking arrangements involved in selfmanagement,
d.
Which management option is most consistent with the participant's or nominee's preferred
level of control and acceptance of responsibility, and
e.
Whether strategies could be put in place to enhance the capacity of the participant.
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Table to support decision making on whether there is an
unreasonable risk to a participant (not for child participants or
participants represented by a nominee)
3.8
(a)
Risks as set out in the
Plan Management Rules
Information/factors to consider
Possible mitigation
strategies (not exclusive)
Whether material harm,
including material financial
harm, to the participant
could result if the
participant were to manage
the funding for supports to
the extent proposed, taking
into account the nature of
the supports identified in
the plan
The level of complexity of the
supports and the level of
expertise required in the
management of funding for the
specific supports
Self-management of
supports that are lower risk.
Highest risk supports
required to be managed by
the NDIA
The type and nature of the
supports
The impact on the participant if
supports are not delivered
Participant has experienced
harm as a result of their own
behaviour
Shorter period for plan
review
Use plan management in
order to build the
participant's capacity to selfmanage the items in the
future
Work with participant to
maximise their input into
self-directing rather than
self-management of
supports
(b)
The vulnerability of the
participant to:
i.
physical, mental or
financial harm, or
ii.
exploitation, or
iii.
undue influence
Past history of abuse,
exploitation or undue influence
Level of current vulnerability
question (Question K2.3 in
Assessment Tool)
Strength of the participant
network of support (Question
K2.2)
Funding supports to building
individual safeguards
Strategies to increase
involvement of supportive
network of family and friends
in making decisions
Participant has experienced
harm as a result of their own
behaviour
Evidence from professional
assessment of vulnerability
including undue influence
(c)
The ability of the participant
to make decisions
participant
Past history and experience in
decision making
Capacity to understand the
nature of the decisions that
would be involved in the
management of supports
Provision of funded support
to assist the participant in
decision making
Involvement of supportive
network of family and friends
in making decisions
Training in decision making
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Risks as set out in the
Plan Management Rules
(d)
(e)
The capacity of the
participant to manage
finances
Whether a court or a
tribunal has made an order
under a Commonwealth,
state or territory law under
which the participant's
property (including
finances) or affairs are to
be managed, wholly or
partly, by another person,
Information/factors to consider
Possible mitigation
strategies (not exclusive)
Evidence from professional
assessment of capacity
or related areas that support
a participant to develop skills
in managing supports
Past history of financial
management
Provision of funded support
to assist the participant in
managing finances
Professional assessment of
capacity
Training in managing
supports and financial
management
Capacity to manage finances as
assessed through Questions
K2.5 and K2.6
Short term plan
management to build the
participant's capacity to
undertake financial
management in the future
Questions K2.4 re substitute
decision making
The involvement of the
person appointed by the
court or tribunal in the
development of the plan in
relation to the management
of the funding for supports.
Appointment of guardian and/or
financial administrator (or
equivalent).
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Table to support decision-making on whether there is an
unreasonable risk to a participant – child participants and
participants represented by a nominee
3.7
(a)
Risks as set out in the
Plan Management Rules
Information/factors to consider
Possible mitigation
strategies (not exclusive)
The capacity of the child’s
representative or the plan
nominee to manage
finances
Plan nominee or child’s
representative past history of
financial management
Provision of funded support
to assist the participant in
managing finances
Professional assessment of plan
nominee or child representatives
capacity
Training in supports and
financial management for
plan nominee or child’s
representative
Plan nominee or child
representative’s capacity to
manage finances as assessed
through Questions K2.5 and K2.6
(adult) K2.3 and K2.5 (child)
Appointment of guardian and/or
financial administrator (or
equivalent) for the plan nominee or
child’s representative
(b)
Whether the child’s
representative of the plan
nominee has an interest that
could lead a reasonable
person to consider that
NDIS amounts within their
control might be spent other
than in accordance with the
participant’s plan
Past history of abuse, exploitation
or undue influence by the plan
nominee or child representative
Strength of the participant network
of support (Question K2.2)
Participant has experienced harm
as a result of the plan nominee of
child representative
Evidence from professional
assessment of vulnerability
including undue influence
Evidence of past history of benefits
or resources for the child with
disability being used for the benefit
of other family members or others
Due to the conflict of interest when
the plan nominee is also funded to
provide the supports, selfmanagement in these
circumstances presents an
unreasonable risk
Short term plan management
for the plan nominee or child
representative to build their
capacity to undertake
financial management in the
future
Provision of funded support
to assist the plan nominee or
child representative in
decision-making
Involvement of supportive
network of family and friends
in making decisions
More frequent reviews of
plans
Supports not provided by the
plan nominee may be able to
be considered for selfmanagement by the plan
nominee in the nominee
declares that they will not be
the paid provider of those
supports
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