CARE PLAN MANAGEMENT – CLIENT CONSENT AGREEMENT
- By ticking the check box, I hereby ensure and have acknowledged that I am aware and understand that, Care Plan Management may need to collect and disclose personal information to third parties (as a requirement) under The National Disability Insurance Scheme Act (NDIS Act) 2013 to provide an improved level of support in accordance with my Service Agreement with Care Plan Management. *
Care Plan Management will work closely with other agencies to coordinate the best support for you. This means your informed consent for the sharing of information will be sought and respected in all situations unless:
- We Are Obliged By Law To Disclose Your Information Regardless Of Consent Or Otherwise;
- It Is Unreasonable Or Impracticable To Gain Consent Or Consent Has Been Refused; And The Disclosure Is Reasonably Necessary To Prevent Or Lessen A Serious Threat To The Life, Health Or Safety Of A Person Or Group Of People.
- As A Participant, I Am Aware Of My Rights To Withdraw My Consent At Any Time. *
- As A Participant, I Also Nominate That My Personal Information May Be Collected From And Also Disclosed To The Agencies Or Persons Listed Below: *
- I Have Acknowledged And I Understand Why Certain Information About Me May Need To Be Provided To Other Service Providers In Order To Coordinate The Best Support For Me.
- I Have Acknowledged And I Understand Why Certain Information About Me May Need To Be Provided To Other Service Providers In Order To Coordinate The Best Support For Me.
- I Understand That My Provider Must Comply With Relevant Privacy Laws And I Will Contact The Organisation Immediately If I Feel That These Laws Have Been Breached. *
CARE PLAN MANAGEMENT – SERVICE AGREEMENT
The NDIS and this Service Agreement
This Service Agreement is made for the purpose of providing supports under the client’s 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 client 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 Care Plan Management.
3. Schedule of supports
Care Plan Management agrees to provide the client plan management services. The supports and their prices are set out in the attached Schedule of Supports. 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 client NDIS supports) are the responsibility of the client / clients representative and are not included in the cost of the supports.
4. Care Plan Management is responsible for the following and agrees to:
- Review The Provision Of Promised Support At Least Annually With The Client;
- Once Agreed, Provide Supports That Meet The Client's Needs At The Client's Preferred Times;
- Communicate Openly And Honestly In A Timely Manner;
- Treat The Client With Courtesy And Respect;
- Consult The Client On Decisions About How Supports Are Provided;
- Give The Client Information About Managing Any Complaints Or Disagreements And Details Of Care Plan Management Cancellation Policy;
- Listen To The Client’s Feedback And Resolve Problems Quickly;
- Give The Client A Minimum Of 24 Hours Notice If Care Plan Management Has To Change A Scheduled Appointment To Provide Supports;
- Give The Client The Required Notice If Care Plan Management Needs To End This Service Agreement (See "Ending This Service Agreement" Below For More Information);
- Protect The Client's Privacy 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 Client; And Will Issue Invoices And Statements Of The Supports Delivered To The Participant As Per The NDIA Terms Of Business For Registered Providers As Requested
5. Responsibilities of the client / client representative
The client/client’s representative agrees to:
- Inform Care Plan Management about how they wish the supports to be delivered to meet the client needs;
- Treat Care Plan Management workers with courtesy and respect;
- Talk to Care Plan Management representative, if the client has any concerns about the supports being provided;
- Give Care Plan Management, the required notice if the client cannot make a scheduled appointment, noting that if the notice is not provided, *Care Plan Management cancellation policy will apply;
- Give the required notice if the client needs to end this Service Agreement (see 'Ending this Service Agreement' below for more information); and Let Care Plan Management know immediately if the client NDIS plan is suspended or replaced by a new NDIS plan, or the client stops being a participant in the NDIS.
6. Payments
Care Plan Management will seek payment for their provision of supports after the supports have been delivered.
- FOR PARTICIPANTS ON 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, [Practice Name] 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 / EFT within 7 days.
- FOR PARTCIPANTS ON NDIA MANAGED - The client has nominated the NDIA to manage the funding for supports provided under this Service Agreement. After providing those supports, Care Plan Management will claim payment for those supports from the NDIA.
- FOR PARTICIPANTS ON 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, Care Plan Management will claim payment for those supports provided to the client.
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. If either party seriously breaches this Service Agreement the requirement of notice will be waived.
9. Feedback, complaints, and disputes
If the client wishes to give Care Plan Management feedback or is not happy with the provision of supports and wishes to make a complaint, the participant can talk to Kaleem Ulah on 08 7117 1409 or email us on admin@careplanmanagement.com.au
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 Care Plan Management, we value consistent and high-quality intervention. If you need to cancel an appointment it is recommended it occur before 5 pm on the day before your appointment to avoid a cancellation fee. If you contact Care Plan Management after 5 pm the day before your appointment or on the day of your appointment there will be a cancellation fee of 90% charged to your account and payment due at your next appointment.
Where Care Plan Management cancels support due to operational reasons, the service will be rescheduled at no penalty to either party. Where multiple cancellations or no-shows occur in a 3-month period, We will initiate contact with the family and their support network to establish the supports we are providing are best suited to the family dynamics and the needs of the child.