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NDIS SERVICE AGREEMENT

 

1. Parties

This Service Agreement is for:

Given Name *                       

Surname*               

Date Of Birth *                   

NDIS Number *                            

Participant in the National Disability Insurance Scheme

(Name of participant below):

 

 

, and is made between:

Company Name:                            The Only Support Coordination

Date:                                             

 

 

2. The NDIS and this Service Agreement

This Service Agreement is made for the purpose of providing supports under the participant NDIS plan.

The parties agree that this Service Agreement is made in the context of the NDIS, which is a scheme that aims to:

  • Support the independence and social and economic participant of people with disability; and

  • Enable people with a disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports.

  • NDIS plan to be provided to The Only Support Coordination

3. Schedule of supports

The Only Support Coordination agrees to provide the Support coordination.

Item Number

Item Name and Notes

    Unit

    National

07_002_0106_8_3

Support Coordination Level 2:

Coordination of Supports

Hour

$100.14

* https://www.ndis.gov.au/providers/price-guides-and-pricing#ndis-price-guide-2020-21

The schedule of supports and their prices are set out by the NDIS in the link above.

All prices are GST inclusive (if applicable) and include the cost of providing the supports.

Additional expenses (i.e. things that are not included as part of a participant NDIS supports) are the responsibility of the participant/participant representative and are not included in the cost of the supports.

4. The Only Support Coordination Responsibilities

The Only Support Coordination agrees to:

  • Review the provision of supports as required by the role, which is provide reports to the NDIS about the plan progression.

  • Communicate openly and honestly;

  • Treat each other with courtesy and respect;

  • Consult the Participant and or nominee on decisions about how supports are provided;

  • Give the participant information about managing any complaints or disagreements and details of The Only Support Coordination cancellation policy;

  • For both parties to listen to each others feedback and resolve problems quickly and provide internal and external complaints process;

  • Give the participant a minimum of 24 hours notice if The Only Support Coordination has to change a scheduled appointment to provide supports;

  • Give the participant the required notice if The Only Support Coordination needs to end this Service Agreement (see "Ending this Service Agreement" below for more information);

  • Protect the participants private and confidential information;

  • Provide supports in a manner consistent with all relevant laws, including the NDIS Act 2013 and Rules, and the Australian Consumer Law;

  • Keep accurate records on the supports provided to the participant; and

  • Will issue invoices and statements of the supports delivered to the participant

5. Responsibilities of the Participant  / participants nominee

The Participant / Participants nominee agrees to:

  • Inform The Only Support Coordination about the service providers and how they wish the supports to be delivered to meet your needs, via email, or text;

  • Treat The Only Support Coordination worker with courtesy and respect;

  • Talk to The Only Support Coordination if the participant has any concerns about the supports being provided;

  • Give The Only Support Coordination the required notice of 24 hours if the client cannot make a scheduled appointment, noting that if the notice is not provided, The Only Support Coordination cancellation policy will apply;

  • Give The Only Support Coordination the required notice if the client needs to end this Service Agreement (see 'Ending this Service Agreement' below for more information); and

  • Let The Only Support Coordination know immediately if the participants NDIS plan is suspended or renewed by a new NDIS plan, or the participant stops being a participant of the NDIS.

  • Participant to reach out to the support coordinator for a request for service via call or email and not limited to text.

6. Payments

NDIA MANAGED - The client has nominated the NDIA to manage the funding for supports provided under this Service Agreement. After providing those supports, The Only Support Coordination will claim payment for those supports from the NDIA.

 

SELF MANAGED - The client / client representative has chosen to self-manage the funding for NDIS supports provided under this Service Agreement. After providing those supports, The Only Support Coordination will send the client / client representative an invoice for those supports for the client / client representative to pay. The client / client representative will pay the invoice by direct debit within 7 days.

 

PLAN MANAGED - The client has nominated the Plan Management Provider to manage the funding for NDIS supports provided under this Service Agreement. After providing those supports, The Only Support Coordination will claim payment for those supports from

 

 

*Please provide the details of the Plan manager below:

 

 

Plan Manager Provider Name *

 

Plan Manager Email Address   *

 

 

Start Date *

 

 

 

 

7. Changes to this Service Agreement

If changes to the supports or their delivery are required, the parties agree to discuss and review this Service Agreement. The parties agree that any changes to this Service Agreement will be in writing, signed and dated by the parties.

8. Ending this Service Agreement

Should either party wish to end this Service Agreement they must give 2 weeks notice in writing.

9. Feedback, complaints and disputes

If the client wishes to give The Only Support Coordination feedback or is not happy with the provision of supports and wishes to make a complaint, the participant can email ndissupport@theonlysc.com.au or complete a Complaint Form.

If the client is not satisfied or does not want to talk to this person, at any time, they can make a complaint to the NDIS Commission. Complaints to the NDIS Commission can be lodged:

  • online at www.ndiscommission.gov.au; or

  • by phone on: 1800 035 544.

10. Goods and Services Tax (GST)

For the purposes of GST legislation, the Parties confirm that:

  • A supply of supports under this Service Agreement is a supply of one or more of the reasonable and necessary supports specified in the statement included, under subsection 33(2) of the NDIS Act, in the client's NDIS Plan currently in effect under section 37 of the NDIS Act;

  • The client's NDIS Plan is expected to remain in effect during the period the supports are provided; and

  • The client / client representative will immediately notify the provider if the client's NDIS Plan is replaced by a new plan or the client stops being a participant in the NDIS.

11. Cancellation Policy

At The Only Support Coordination we value consistent and high quality intervention. If you need to cancel an appointment it is recommended it occur 24 hours before your appointment to avoid a cancellation fee. If you contact The Only Support Coordination on the day of your appointment there may be a cancellation fee of 50% charged to you.

 

12. Contact details

The Client Representative can be contacted on:

Client Representative Name *

 

Alternative contact person

 

 

Address *

 

Phone *

 

Email Address of Client Representative *

 

 

The Only Support Coordination can be contacted on:

Name Roselyn Weereratne

Mobile. 0406 996 573

Email.  ndissupport@theonlysc.com.au

 

13. Schedule of supports

I/we agree to pay for services provided by The Only Support Coordination through claiming against the National Disability Insurance Scheme (NDIS) service plan. Working with the NDIS we have been allocated funding for the service year (enter service dates)

Start Service Date *                           

 

Finish Service Date *                         

 

 

The Provider agrees to provide the client services for the duration of the agreement at the scheduled rate. These include

  • Attendance at team meetings/case conferences

  • Any reports, forms or letters as required by the NDIS or requested by the participant/ participants representative

  • Cancellation charges for late notice or no show appointments

The Only Support Coordination reserves the right NOT to provide service or to cancel any future appointments for the participant if you do not have sufficient funds in your plan or the plan expires. Any service fees not met by NDIS will be covered by the participant / participant nominee.

Frequency of support:

  • As scheduled

 

Where the support will be provided:

  • Phone

  • Digital

  • As scheduled

 

The total funding claimed by The Only Support Coordination over the period of this service agreement, will be a Total Funding as per your NDIS plan. Claimed over 12 months in accordance to your request for services.

 

 

 

 

 

 

 

 

 

 

14. Agreement signatures

The parties understand and agree to the terms and conditions of this Service Agreement. Only one signature is required for the participant / participant nominee;

 

 

 

Signature of NDIS Participant________________________________________________

 

 

Name of Participant ________________________   Date _____________

 

 

AND / OR

 

 

 

 

Signature of Participant

Representative/Nominee______________________________________

 

 

Name of Representative/Nominee______________ Signed Date _________

 

 

AND / OR

 

 

 

 

Signature of Participant

Representative/Nominee______________________________________

 

 

Name of Representative/Nominee______________ Signed Date _________

Ph: +61 406 996 573

ABN: 640 531 954 15
The Only Support Coordination acknowledges, recognises and respects the Ancestors, Elders, and families of the Boonwurrung, Waddawurrung and Wurundjeri of the Kulin who are the traditional owners of this land in Victoria.

©2020 by The Only Support Coordination.