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Background

The Participant has agreed to engage the Provider to obtain its services on the terms and conditions set out in this Agreement.

The Participant agrees, upon acceptance of this Agreement, the Participant/Nominated Representative, will provide their NDIS plan details, NDIS number and other relevant details as requested on this agreement, to the Provider.

1. Definition and Interpretation

1.1. Definitions

In this Agreement, unless context otherwise requires:

Agreement means this Service Agreement.

Participant means person as specified in Item 1 of Schedule 1.

Commencement Date means the date specified in Item 2 of Schedule 1.

Confidential Information means:

(a) all confidential information treated by any party as confidential and including, but not limited to:

(a)(i) Personal information
(a)(ii) Personal, financial and other information concerning any party’s personnel and customers

(b) confidential information does not include any information that was public knowledge at the date of this Agreement or became so at a later stage (other than as a result of a breach of confidentiality by, or involving, a party to this Agreement).

End Date means the date as specified in Item 3 of Schedule 1.

NDIA means National Disability Insurance Agency.

NDIS means National Disability Insurance Scheme.

Personal Information has the meaning given by the Privacy Act.

Privacy Act means the Privacy Act 1988 (Cth).

Provider means My Care Planner (ABN 43 128 390 634).

1.2 Interpretation

In this Agreement unless the context otherwise requires:

(a) references to clauses are to clauses of this Agreement.

(b) headings are for convenience only and do not affect interpretation.

(c) references to any document include references to such document as amended, novated, supplemented, varied or replaced from time to time.

(d) references to any legislation or to any provision of any legislation include any modification or re-enactment of that legislation or legislative provision or any legislation or legislative provision substituted for, and all regulations and instruments issued under such legislation or provision.

(e) the Annexures and Schedule to this Agreement form part of this Agreement.

(f) the Background is correct and forms part of this Agreement.

(g) words denoting the singular number include the plural and vice versa.

(h) words denoting any gender include all genders.

(i) where a word or phrase is defined, other parts of speech and grammatical forms of that word or phrase have corresponding meanings.

(j) words denoting natural persons include bodies corporate and vice versa.

2. Commencement

2.1. This Agreement will come into effect on the Commencement Date and will continue in force until the End Date or on such other date as agreed in writing between the parties.

3. Termination

3.1. Parties can only terminate this Agreement by providing a written notice of termination to the other party at least 30 days prior to termination.

3.2. This Agreement can be terminated at any time by mutual written agreement between the parties.

3.3. If either party breaches a material term under this Agreement, the non-defaulting party may terminate this Agreement immediately.

3.4. Except as otherwise provided in this Agreement, the obligations of the Provider will end upon the termination of this Agreement.

4. Services

4.1. The Provider agrees to render Services to the Participant in connection with Support Coordination as set out in Schedule 1.

5. Fees and Payments

5.1. The supports and their prices are set out in Schedule 1.

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

5.3. Additional expenses (i.e. expenses that are not included as part of a Participant’s NDIS supports) are the responsibility of the Participant or Nominated Representative and are not included in the cost of the supports.

5.4. The Provider will claim directly from the NDIA, nominated plan manager or Participant, depending upon how the plan categories are being managed, an agreed fee for the provision of supports as agreed in Schedule 1 upon acceptance of the agreement. The Participant agrees to any changes made to Schedule 1 that occur in accordance with the NDIA price guide.

5.5. Payments are applied depending on how the plan categories are managed, being either one or a combination of the below:

(a) If the funding for any of the supports provided under this Agreement is managed by the Participant, the Provider will send the Participant an invoice to pay after providing those supports. The Participant will pay the invoice by cash/cheque/eft within a reasonable time (7 days); and/or

(b) If the funding for any of the supports provided under this Agreement is managed by a plan nominee, the Provider will send the Participant’s nominee an invoice to pay after providing those supports. The Participant’s nominee will pay the invoice by cash/cheque/eft within a reasonable time (7 days); and/or

(c) If the funding for any of the supports provided under this Agreement is managed by the NDIA, the Provider will claim payment for those supports from the NDIA; and/or

(d) If the funding for any of the supports provided under this Agreement is managed by a plan management provider, the Participant will be required to provide details of the plan management provider to the Provider at the time of booking. After providing those supports, the Provider will claim payment from the plan management provider.

5.6. If funds are declined due to exhausted funds or expired plans, the Participant acknowledges they are liable for payment of supports rendered. The Provider often does not have visibility over the allocation or usage of a Participant’s funds, and therefore cannot take responsibility for the management of a Participant’s budget. The payment terms in this instance will be 14 days after issuance of the invoice.

5.7. Travel costing is determined via the NDIS guidelines, charged in 5-minute increments based at the therapist hourly rate. This is capped at a maximum of 30 minutes.

6. Goods and Services Tax (GST)

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

(a) a supply of supports under this 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 National Disability Insurance Scheme Act 2013 (NDIS Act), in the Participant’s NDIS plan currently in effect under section 37 of the NDIS Act;

(b) the Provider will pay GST as specified in the NDIS Act.

7. Responsibilities of the Provider

7.1. The provider agrees to:
- review the provision of supports as the Participant’s circumstances change.
- communicate openly, honestly and in a timely manner.
- treat the Participant with courtesy and respect.
- consult the Participant on decisions about how supports are provided.
- give the Participant information about managing complaints and the Provider’s cancellation policy (if relevant).
- listen to the Participant’s feedback and resolve problems quickly.
- give the Participant the required notice if the Provider needs to terminate the Service Agreement.
- protect the Participant’s privacy and confidential information.
- provide supports in a manner consistent with all relevant laws, including the National Disability Insurance Scheme Act 2013 and rules, and the Australian Consumer Law.

8. Conflicts of Interest

8.1. We recognise a conflict of interest can arise by providing more than one service to you. We mitigate this by:

- declaring the potential conflict of interest and affirming that the organisation will act as directed by the participant and in the best interests of the participant.
- providing participants with a range of choices and not only the supports provided by My Care Planner.
- ensuring that Support Coordinators and Specialist Support Coordinators report only to the Senior Manager, Support Coordination.
ensuring that Plan Managers report only to the Senior Manager, Plan Management.
- informing participants of any relevant conflicts where service providers may have a relationship with My Care Planner.
- providing staff regular training around the importance of mitigating conflict of interest risks.
- ensuring staff do not seek to influence participants to select My Care Planner for supports and services.
- recording a permanent entry in our Conflict of Interest Register in the event of a conflict of interest to note this conflict.

9. Responsibilities of the Participant/Nominated Representative

9.1. The Participant agrees to:
- inform the Provider about how they wish the supports to be delivered to meet the Participant’s needs.
- treat the staff of the Provider with courtesy and respect.
- talk to the Provider if the Participant has any concerns about the supports being provided.
give the Provider a minimum of 24 hours’ notice if the Participant cannot make a scheduled appointment; and if the notice is not provided, the Provider’s cancellation policy will apply.
- give the Provider the required notice if the Participant needs to end the Service Agreement (see ‘Ending this Service Agreement’ below for more information).
- let the Provider know immediately if the Participant’s NDIS plan is suspended or replaced by a new NDIS plan or the Participant stops being a participant in the NDIS.

10. Cancellation

10.1. The Participant/Nominated Representative must provide 24 hours’ notice if they cannot attend a scheduled appointment. If the participant fails to give 24 hours’ notice, the scheduled appointment will be billed from the supports on the Participant’s NDIS plan.

11. Changes to the Plan

11.1. The Participant/Nominated Representative agrees to immediately notify the Provider and provide relevant plan details in writing if the Participant’s NDIS plan is replaced with a new plan, or the Participant stops being a participant in the NDIS.

12. Feedback, Complaints and Disputes

12.1. If the Participant/Nominated Representative wishes to provide feedback or make a complaint regarding the supports they receive, the Participant/Nominated Representative can contact key management personnel of the Provider.

12.2. All feedback, complaints and disputes will be managed in accordance with the Complaints Management Policy.

13. Modification of Agreement

13.1. Any amendment or modification of this Agreement or additional obligation assumed by either Party in connection with this Agreement will only be binding if agreed in writing by each Party or an authorised representative of each Party.

14. Governing Law

14.1. The Laws of the State of South Australia govern this Agreement and the parties submit to the non-exclusive jurisdiction of South Australian courts.

15. Severability

15.1. Any provision of this Agreement which is unenforceable or party unenforceable is, where possible, to be severed to the extent necessary to make this Agreement enforceable, unless this would materially change the intended effect of this Agreement. In any event, the remainder of this Agreement will be construed to ensure that it remains effective to the greatest extent possible.

16. Waiver

16.1. A waiver of any provision of, or right or obligation under, this Agreement is effective only to the extent specifically expressed in writing.

1. Schedule of Supports

1.1. Provided that NDIS funds are available for My Care Planner to access on the NDIA portal relevant to the Client, My Care Planner agrees to provide the supports to the Client as set out in Schedule 1.

2. Our Responsibilities

By entering into this Agreement, My Care Planner agrees to:

2.1. Treat the Client/Authorised Representative with courtesy and respect

2.2. Assist the Client/Authorised Representative to understand what is considered reasonable and necessary

2.3. Maintain accurate records regarding the supports delivered to the Client

2.4. Reconcile NDIS funding balances

2.5. Facilitate payments of invoices on behalf of the Client

2.6. Process approved reimbursement claims to the Client

2.7. Track expenditure on Provider supports against the Client’s budget

2.8. Make budget information available by:

2.8.1. Making relevant budget information available via the Careview Advantage app

2.8.2. Making monthly statements available via email to the Client/Authorised Representative

2.9. Facilitate Client/Authorised Representative communication via emails, phone calls, video calls and other formats as preferred by the Client/Authorised Representative

2.10. Listen to the Client/Authorised Representative’s feedback and resolve problems quickly

2.11. Protect the Client’s privacy and maintain confidentiality of personal information in accordance with My Care Planner’s Privacy and Confidentiality Policy

2.12. Liaise with providers regarding any invoice discrepancies on behalf of the Client/Authorised Representative as required

2.13. Give the Client/Authorised Representative information about making complaints and providing feedback, including information about contacting the NDIS Quality and Safeguards Commission

2.14. Observe and investigate any incidents that occur and comply with the NDIS (Incident Management and Reportable Incidents) Rules 2018

3. Your Responsibilities

By entering into this Agreement, the Client/Authorised Representative agrees to:

3.1. Treat My Care Planner staff with courtesy and respect

3.2. Inform My Care Planner immediately regarding any concern the Client/Authorised Representative has about the support being provided by My Care Planner

3.3. Accept responsibility for all purchases made

3.3.1. Where the Client/Authorised Representative wishes to purchase low-cost/low-risk assistive technology and consumables items that may be considered an everyday expense, the Client/Authorised Representative is responsible for obtaining supporting evidence and retain this information to be provided to the NDIA if requested

3.4. Accept responsibility for determining whether a support is reasonable and necessary and accept that if the NDIA determines that a support does not meet the reasonable and necessary criteria, that the Client/Authorised Representative may be required to repay the NDIA for the item or support

3.5. Monitor budget information made available by My Care Planner to reduce the risk of overspending in relation to the Client’s NDIS Plan

3.6. Inform My Care Planner if the current NDIS Plan is suspended or replaced by a new NDIS Plan, or the Client ceases to be a Participant of the NDIS

3.7. Advise My Care Planner of any changes to personal contact details

3.8. Give My Care Planner the required notice if the Client/Authorised Representative needs to end the Agreement

3.9. Not engage in conduct or knowingly provide My Care Planner with misleading or incorrect information which may reasonably be expected to:

3.9.1 Expose My Care Planner to reputational, regulatory, or financial risk

3.9.2 Present a work, health, and safety risk to any My Care Planner staff, which extends to and covers any verbal or written abuse

3.9.3 Be contrary to NDIA rules, guidelines, legislation, or relevant policies and/or any other documents or publications as may be issued by the NDIA from time-to-time

3.9.4 Be contrary to, or cause My Care Planner to potentially breach, the National Disability Insurance Scheme Act 2013 (Cth) or any other law or regulation (including conditions which relate to the registration requirements of My Care Planner)

4. Fees

4.1. My Care Planner will directly claim establishment and monthly fees against the Client’s NDIS Plan from the NDIA for the provision of plan management or individual capacity building supports as set out in Schedule 1.

4.2. The prices set out in Schedule 1 includes the fees for providing the stated supports. The fees will be automatically updated from time-to-time in line with changes to the NDIA Price Limits and/or other documents or publications issued by the NDIA. No action will be required by you.

5. Service Provider Claims

5.1. My Care Planner will claim from the NDIA portal for funding up to the amounts specified in the support category and budget approved in the Client’s current NDIS Plan.

5.2. After supports are delivered by the Client’s providers, the provider or Participant will claim payment for those supports from My Care Planner by forwarding a compliant tax invoice to accounts@mycareplanner.com.au.

5.3. Reimbursements can be claimed by forwarding a receipt and bank details to accounts@mycareplanner.com.au.

6. Invoice Processing

6.1. My Care Planner adopts a ‘Standing Approval’ process in which My Care Planner processes invoice payments automatically on the Client’s behalf when an invoice is successfully submitted to accounts@mycareplanner.com.au.

6.2. The Client/Authorised Representative can choose to opt-out of the ‘Standing Approval’ process, and in doing so, approve or reject each invoice individually. This process is called ‘Review for Approval’.

6.2.1. Approval or rejection of an invoice is predominately completed using the My Care Planner app, Careview Advantage.

6.2.2. Once a provider submits an invoice, the invoice is loaded into the My Care Planner system and a notification is sent to the Client/Authorised Representative via Careview Advantage.

6.2.3. The Client/Authorised Representative can approve or reject the invoice by responding via Careview Advantage within 2 business days. If the invoice is not actioned within 2 business days, My Care Planner will automatically process the invoice and payment will be made to the provider.

6.2.4. If the Careview Advantage app is not preferred, the Client/Authorised Representative can ask service providers to send invoices to the Client/Authorised Representative directly. The Client/Authorised Representative can then forward approved invoices to My Care Planner for payment.

6.3. After each invoice is successfully submitted and approved by the Client/Authorised Representative via ‘Standing Approval’ or ‘Review for Approval’, My Care Planner will bill the NDIA on the next business day.

6.4. Once funds have been released by the NDIA, My Care Planner will pay the Client’s provider on the following business day.

7. Changes to This Agreement

7.1. Any changes to this Agreement will be made in writing, signed, and dated by the Client/Authorised Representative and My Care Planner. Alternatively, verbal agreement can be provided by the Client/Authorised Representative.

7.2. If the Client/Authorised Representative exercises their right to not sign changes to this Agreement, the Client/Authorised Representative understands that they accept the changes to this Agreement if they continue to accept the provision of plan management services after it has been made clear to the Client/Authorised Representative that the terms of this Agreement have changed.

8. Ending This Agreement

8.1. Either Party may end this Agreement at any time by giving the other party at least seven (7) days’ notice in writing, unless agreed otherwise by the Parties.

8.2. If a Party materially breaches this Agreement, the other Party may terminate this Agreement immediately by notice in writing to the other Party.

8.3. My Care Planner will notify your Support Provider(s) of the cessation of this Agreement if we receive an invoice for services after the End Date.

8.4. To ensure a smooth transition of your Plan Management support, My Care Planner will provide the Client/Authorised Representative a summary statement of remaining funding.

9. Conflict of Interest

9.1. My Care Planner recognises a conflict of interest can arise by providing more than one service to the Client/Authorised Representative. As a provider of Plan Management and Support Coordination services, My Care Planner mitigates the risks of conflict of interest by ensuring that:

9.1.1. Advice given to the Client/Authorised Representative about support options is transparent and promotes choice and control

9.1.2. The Plan Management team is responsible for Plan Management only

9.1.3. The Support Coordination team is responsible for Support Coordination only

9.1.4. The Client/Authorised Representative is informed of the Conflict of Interest Policy including an explanation of the conflict of interest for supports that are provided by My Care Planner

9.1.5. The Client/Authorised Representative is made aware of their right to include a support person or advocate in the decision-making process

9.1.6. The Client/Authorised Representative is asked within this Agreement to acknowledge that conflict of interest has been explained to them and that they were not influenced in their choices

9.1.7. The Client/Authorised Representative is presented a range of choices about providers of supports other than My Care Planner

9.1.8. Staff do not seek to influence the Client/Authorised Representative to select My Care Planner

9.1.9. Brief notes are made in the Client’s file confirming the advice given to the Client/Authorised Representative the other choices provided, and the choices made by the Client/Authorised Representative

9.1.10. A permanent entry is made in the Conflict of Interest Register in the event of a conflict of interest

10. Feedback, Complaints, and Disputes

10.1. If the Client/Authorised Representative wishes to provide feedback or make a complaint regarding the services they receive from My Care Planner, the Client/Authorised Representative is encouraged to contact My Care Planner by emailing feedback@mycareplanner.com.au, calling 1800 954 480, or sending mail to PO Box 220, Magill SA 5072.

10.1.1. Complaints made to My Care Planner undergo an internal process of investigation. Complaints are acknowledged within 2 business days, and all efforts are made to achieve an effective resolution within 30 business days or as soon as practicable.

10.2. If the Client/Authorised Representative is unhappy with the response from My Care Planner or feels uncomfortable about raising their complaint directly with My Care Planner, the Client/Authorised Representative can contact the NDIS Quality and Safeguards Commission by calling 1800 035 544 or visiting www.ndiscommission.gov.au/about/complaints.

10.2.1. When the Commission receives a complaint, a complaints officer will get in touch with the Client/Authorised Representative to discuss the complaint.

10.3. If the Client/Authorised Representative would like support to give their feedback, My Care Planner encourages them to seek support from family, a friend, or an independent advocate. An independent advocate can be found by visiting www.askizzy.org.au/disability-advocacy-finder.

10.4. All feedback, complaints, and disputes will be managed in accordance with the Complaints Management Policy.

11. Goods and Services Tax (GST)

11.1. For the purposes of GST legislation, My Care Planner confirms that a supply of supports under this 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 National Disability Insurance Scheme Act 2013 (NDIS Act), in the Participant’s NDIS plan currently in effect under section 37 of the NDIS Act.

11.2. My Care Planner will pay GST as specified in the NDIS Act.

12. Miscellaneous

12.1. Force Majeure

12.1.1. My Care Planner shall not be liable for delay or failure to perform its obligations under this Agreement if the cause of the delay or failure is beyond its control.

12.2. Waiver

12.2.1. Failure by My Care Planer to enforce any of the terms and conditions contained in this Agreement shall not be deemed to be a waiver of any of its rights or obligations under this Agreement.

12.2.2. A waiver of any provision of, or right or obligation under, this Agreement is effective only to the extent specifically expressed in writing.

12.3. Severability

12.3.1. If any provision of this Agreement shall be invalid, void or illegal or unenforceable, the validity, existence, legality and enforceability of the remaining provisions shall not be affected.

12.4. Jurisdiction

12.4.1. These terms and conditions and all matters concerning the relationship between My Care Planner and the Client/Authorised Representative shall be governed by the law of the State of South Australia and the parties submit to the exclusive jurisdiction of the Courts of South Australia for the conduct of any litigation.

12.5. Disclaimer

12.5.1. My Care Planner information is provided in good faith, to the best of our knowledge and is considered to be correct at the time of communicating, however, changes may affect this accuracy therefore My Care Planner gives no assurance as to the accuracy of any information or advice given.

12.5.2. Any advice given by My Care Planner outside of financial intermediary advice shall be considered general in nature.

12.5.3. Nothing in this Agreement negates or diminishes the statutory guarantees regarding the supply of services under Schedule 2 of the Competition and Consumer Act 2010.

12.5.4. My Care Planner takes in good faith the information provided by the Client/Authorised Representative to be true and accurate, and that claims presented to My Care Planner are a true reflection of goods and services provided to the Client in line with the NDIS guidelines.

12.5.5. The Client/Authorised Representative will not hold My Care Planner responsible for any loss or damage suffered as a result of, or in connection with, the conduct of any other third party.

12.5.6. Subject to the rights of the Client/Authorised Representative under Schedule 2 of the Competition and Consumer Act 2010, My Care Planner shall not be liable for any loss or damage of any kind whatsoever, arising from this Agreement or otherwise, including consequential loss whether suffered or incurred by the Client/Authorised Representative or another person and whether in contract, tort (including negligence), equity or otherwise.

12.5.7. My Care Planner’s aggregate liability under or in connection with this Agreement will not exceed the amount of fees paid for Plan Management services in the previous twelve (12) months.