Supported Independent Living Quoting (SIL) - National Disability ...
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Supported Independent Living Quoting (SIL)
This practical guide responds to providers’ frequently asked questions related to the National Disability
Insurance Scheme (NDIS) Supported Independent Living quoting process. It outlines the process to develop
a quote, what is included, how to complete the templates, the approval process and key provider
considerations. A helpful checklist and NDIA regional SIL email addresses are available in the Appendix,
found at the end of this guide.
What is Supported Independent Living (SIL)?
SIL is 24/7 support provided to a person while living in a home which aims to achieve participant goals and
greater independence. It does not mean they have to be home 24/7 but generally means they require some
level of support or monitoring when at home. SIL is not Specialist Disability Accommodation (SDA), drop-in
support or community participation.
SIL is generally for people living in shared supported arrangements. Participants living on their own requiring
24/7 care may also be eligible for SIL when it is required as a result of high support needs.
SIL is a ‘stated support’ (i.e. not flexible with other supports). Community participation will be funded separately
to enable participants to choose other providers if they wish to do so.
SIL makes up approximately one third of the NDIS operating budget at full Scheme.
Background
The National Disability Insurance Agency (NDIA) introduced a new way of processing SIL quotes for first plans or
plan reviews in July 2017. A SIL quote is required in all scenarios when it is reasonable and necessary for a
participant to receive SIL. The purpose of a SIL quote is to identify.
• The individual supports that will be available for the person, focused on maximising the person’s
capacity to be as independent as possible with household decision making, personal care and domestic
tasks
• The typical roster of supports that is shared between participants to maximise the efficient use of
resources
• What supports are available to all residents to ensure the smooth operation and running of the
household
The NDIS Price Guide provides benchmark prices for SIL according to participants’ level of support need (i.e.
low, standard and high) and the number people in the residence. These benchmark prices are an indication of
the NDIA’s view of efficient service delivery and used as a guide to assess SIL quotes.
When the SIL funding amount is agreed, it is included in the participant’s budget and the NDIA create a Service
Booking on the myPlace portal.
Version 1: January, 2018 1
The diagram below outlines the NDIS SIL quoting process Version 1, January 2018 2
Getting Started
Providers should first read the SIL Provider Toolkit and FAQ on the NDIS website.
Prior to completing any quotes, identify which staff will develop the quote and how they will work together. This
is likely to include service delivery and finance staff.
Identify who will authorise quotes, particularly if the organisation operates across multiple NDIS regions. Once
the quote is approved, providers are committed to deliver the support at that price until the plan is reviewed.
Nominate the most appropriate contact person (i.e. has detailed knowledge about participants, rostering, and
the cost breakdown of each quote).
Providers need to understand what it costs to support individuals in each residence. This is likely to reflect the
organisation staff award rate and/or enterprise agreement and other related costs such as overheads. The
Agency does not fund vehicles.
Providers may choose to use the relevant support line items in the NDIS Price Guide or their own unit cost to
develop their quote. The NDIA assessment of a SIL quote is based on the NDIS Price Guide and the evidence of
the support needs for each participant. For example, where there is sufficient evidence that a participant
requires more skilled staff (i.e. based on staff qualifications) or if the provider incurs additional staff costs due to
the person’s significant disability, the NDIA may fund participants at a higher hourly rate. The quote will require
evidence to substantiate the need for a higher rate.
There is an expectation that providers submit quotes 8 weeks before the first plan or plan review meeting. The
intention is that it allows for discussions between the NDIA, the participant and provider, for example:
• To review the SIL quote (in the context of non-SIL related supports) in consultation with the SIL provider;
• To allow time for referrals, e.g. Support Coordinator, assessments; and
• To make arrangements for the participant to explore other housing options (e.g. move closer to family or
work and/or community programs).
Participant needs and preferences
SIL quotes should reflect a participant’s daily life, and this is likely to be different for each participant. Providers
are expected to discuss with each participant, and their family or nominee, their needs and preferences and the
service offering (i.e. what is included in the SIL quote). For example:
• What outcomes they would like to achieve
• When they would like to stay at home (e.g. work Monday to Wednesday, attend community programs
Thursday and Saturday)
• Preferences (e.g. when they go to bed)
• Quote inclusions and/or exclusions.
Complete the NDIS Provider SIL Pack
If the participant is currently being supported by the provider in a shared accommodation arrangement, the
quote is to be prepared on the basis of the detailed knowledge and understanding of the participant’s needs and
on the assumption that all of the supports currently provided will continue.
If the participant is unknown to the provider, develop the quote based on the supports available to inform the
participant’s living arrangement. Obtain all relevant information to determine the level of support, such as family
and provider references, etc.
Complete the following 3 NDIS SIL templates, located at ndis.gov.au/providers/sil.
SIL Quoting Template
The SIL Quoting Template aims to provide the background and rationale of participants’ individual and shared
support needs. All relevant information and evidence should be included to assist the NDIA to make a
Version 1, January 2018 3reasonable and necessary decision about the SIL funding requirements.
Where a participant requires a higher level of support (e.g. 2:1), detail the rationale and submit evidence (e.g.
behaviour support plans, communication plans, incident reports, staff safety analysis and registered restricted
Interventions etc.). Reference all relevant attachments (e.g. two person transfers is recommended in the OT
report on page 6).
The more information provided regarding the level of support required will reduce any guess work from
planners and arm them with the information they need to make reasonable and necessary decisions. Be
succinct and focus on when and why the higher support ratio is required. For example, suctioning, transfers,
incontinence support.
The NDIA will always consider independent clinical recommendations. Any evidence that is independent will
have a greater impact on their decision than evidence from the provider.
Ideally the evidence should be dated within the last 2 years, however in the absence of anything more current,
submit documentation if it still relevant, indicating why it is still relevant.
Identify the need for and benefits of additional funded supports to build participant capacity and/or
independence (e.g. assessment for assistive technology or functional behaviour assessment for participants to
develop coping strategies to self-regulate behaviours).
Detail proposed capacity building outcomes for first plans, and outcomes achieved for plan reviews.
Roster of Care template
The Roster of Care template should reflect a high-level overview of staffing arrangements (i.e. the ratio of
support) in the home in a typical week. It should only indicate when participants receive individualised supports
if it’s exclusively for one participant (i.e. the worker is not delivering supports to other participants, even in a
supervisory role).
For example, going for a walk would be considered SIL. Although it is not related to the household, it would be
unreasonable to think that another provider would want to provide that type of service for only 30mins/1 hour
(when they probably have to pay their staff for minimum 2-3 hours). However, going for a hike for say 3-4 hours
to the national park for example would be considered community access as there is potential for the participant
to choose an alternative provider for this activity. The NDIA want to see greater participant choice and control
more and it’s also important to note that community access is flexible whereas SIL is not.
Providers can submit two weeks of this template if each week is different, (however, this is not a requirement),
or average the hours in one week. This template is there to capture what a typical week looks like in terms of
supports required. Irregular supports (i.e. unplanned or unexpected supports) are not considered typical so
therefore would be excluded. It’s important that providers and participants have service agreements in place to
deal with these situations and to determine what will be claimed during these variations.
It is important to include notes on the roster, for example:
• Overnight start and finish times (i.e. sleepover or active shift)
• House activities with more than one participant (e.g. grocery shopping, meals)
• Transport to or from work and/or community activities
• Attendance at work or other programs and/or services
• Rationale for irregular hours (e.g. the number of days at home during last 6-12 months)
• Regular time spent with family and/or friends
• Regular or planned appointments (i.e. doctor, dentist and specialist appointments)
• Handovers should be included and the time should be divided by the relevant number of residents in the
house, at the relevant staff ratio.
SIL Hourly Breakdown template
This template should identify the total weekly hours the participant receives regarding their individual and
shared support. The supports in the quote should focus on maximising the individual’s capacity to be as
Version 1, January 2018 4independent as possible. Irregular supports (i.e. unplanned or unexpected supports) include instances where a participant needs to stay at home due to being unwell or not wanting to go to work or community activity. Forecast the amount of irregular support hours based on providers’ experience with the participant or an expectation of the need for irregular support. When determining SIL support during holiday periods (i.e. from work or community programs), this will depend on the community access funding (which is flexible). For example, if the participant has 48 weeks of community access funding in their plan then the provider should include SIL for the holiday period as irregular support. However, if 52 weeks has been funded for community access then the participant has the choice to either continue to access the community during this period using the remaining or they may choose to stay home. If they choose to stay home then they may enter into a service agreement with the SIL provider to utilise the remaining funding, or a portion thereof. Therefore the planning meeting and process is crucial. If participants would just like to stay home during the holiday period then they or their guardian should let the planners know so that this can be accounted for properly. There should not be any ratios of care in the Roster of Care template compared to the SIL Hourly Breakdown template. There may be instances when the total hours of support (i.e. individual, shared and irregular) might vary slightly between the two templates. For instance if the provider has a different roster for week 1 and week 2, then they may just average the hours in the hourly breakdown template. There may also be instances where by the provider has had to use hourly blocks in the Roster of Care template but are able to use 30 minute or 15 minute blocks in the Hourly Breakdown template. Enter the weekly quote amount - this will automatically create the annualised quote. The template does not automatically calculate the weekly amount, because providers’ hourly rate will vary. Quote inclusions SIL reflects supports delivered in the home for 53 weeks. It includes supports delivered or activities undertaken with all or a number of residents that are not delivered in the home such as going out for a meal, attending doctor’s appointments, etc. Supports should be included in the SIL quote that would not be appropriate for an alternative provider to deliver (e.g. it would not be appropriate for another provider, other than the SIL provider, to support the residents to undertake weekly grocery shopping). Staff time to assist participants with transportation during the delivery of SIL supports can be included in the quote. Vehicle costs should not be included as an additional charge. Quote exclusions Where a participant has identified that they would like to engage in community activities, providers should detail this in the SIL Roster of Care template (in the notes section under the table). This may be funded under Core Supports if the NDIA determine this could be delivered by another provider. If the support is not related to the household, the NDIA will determine whether another provider can be reasonably expected to provide that service. The duration of the activity comes into the equation, as it would not be cost effective or realistic to expect an alternative provider to come and pick someone up for a 30 minute 1 hour walk. SIL quotes should not include supports when a participant is absent from the residence (e.g. hospitalisation or holidays), or for supports covered in other sections of the NDIS Price Guide (e.g. community participation). Similarly, if a participant is known to be away for periods at a time (e.g. regular hospital visits or staying with family), the provider can include a higher staff ratio for the shared care component in the other residents’ quotes for those periods. This will be a case by case situation and supporting evidence will be crucial. Version 1, January 2018 5
As SIL supports are a stated support, participants cannot use SIL funding for other purposes (e.g. holidays or associated travel costs), and should not be included in the quote. The SIL Quoting template gives the provider the opportunity to identify which costs are excluded from the quote. These may include rent, board, maintenance, or other funded supports such as employment support or community participation. If the participant is required to cover some of these costs using their personal funds, the provider will need to discuss this separately with the participant, as NDIA will not cover the cost of daily living expenses. Providers may need to negotiate supports, other that SIL supports, that the participant will purchase from the provider and include this in their Service Agreement. For example, if the participant accesses transport supports from the SIL provider to attend a community program, the cost will need to be negotiated and included in the Service Agreement. Submit the completed NDIS SIL Pack to the appropriate contact Providers are required to prepare and submit the participant quote prior to plan approval. This means that providers need to complete the relevant templates and gather evidence prior to the participant’s scheduled planning or review meeting. Important to note that any emails that exceed 20MB will be quarantined and may take time to be released. Consider creating a ‘Zip file’ with all documents and attach it to the email. The NDIA will make a decision to create a Service Booking at benchmark if the NDIA regional office is not able to respond to the quote in a timely manner. This is an interim arrangement to support providers’ to claim while the quote is being assessed. Providers can request a Service Booking to be applied at the benchmark price if the NDIA has not responded within 30 days since the quote was submitted. NDIA reviews and assesses the submitted SIL pack The NDIA will review the templates and evidence and undertake a quality assurance check. The NDIA may request the provider to resubmit with further information and/or evidence. Quote is agreed Providers’ experience has highlighted that SIL quotes may take some time to be approved. NDIA approves quote & creates service booking for the provider An approved quote should form the basis of the Service Agreement with the participant. Claiming SIL supports As SIL is quoted for a 12 month period, the claiming would remain consistent despite some minor variations throughout the year. Circumstances where the NDIA would expect variations in claiming should be negotiated between the provider and participant and detailed in the Service Agreement. Quotes requiring re-submission • No evidence or out of date evidence submitted for above benchmark quotes • Missing templates (most commonly the quoting template) • Providers entering too many hours for a day or week • Providers including community access (e.g. day programs) in SIL • Missing notes on the roster of care • Roster of care contradicts hourly breakdown – e.g. different ratios, hours, staffing levels, etc. • Providers sending their own version of the tools (or PDF versions) Version 1, January 2018 6
• Misunderstanding of 1:1 care • Missing quote amount • Incorrect ratios used • Incomplete templates (e.g. no outcomes, contact details, etc.) • Participants not being consulted during the process If you have any further questions or require additional assistance please contact Stephanie Worsteling, National NDIS Advisor, at stephanie.worsteling@nds.org.au. Disclaimer: National Disability Services Limited (NDS) believes that the information contained in this publication is correct at the time of publishing. However, NDS reserves the right to vary any of this publication without further notice. The information provided in this publication should not be relied on instead of other legal, medical, financial or professional advice. Version 1, January 2018 7
Appendix 1
Checklist: Creating a SIL quote
Cost your model of support
Understand your unit costs for SIL supports, per participant per residence. The SIL quoting templates do
not automatically calculate these amounts.
Consider the NDIS benchmark prices and NDIA’s expectations in relation to overheads and efficient
operations (e.g. the Reasonable Cost Model).
Review staff rosters (implications of employee awards or enterprise agreements that attract loadings
and/or penalties to the whole shift).
Determine inclusions and exclusions and include any relevant information in the Service Agreement.
Review the NDIS SIL Pack Training Guide and FAQ.
Discuss the SIL quote with the participant and their family or guardian
Include the participant throughout the SIL quoting process, where appropriate i.e. goal identification,
reviewing outcomes, discussing inclusions and exclusions etc.
Discuss what the participant would like to achieve with their plan in relation to independent living skills
(e.g. learn to cook).
Identify what the participant would like their week to look like.
Complete the SIL Quoting template
Fill-out the participant and property profile.
Include the participant’s capacity building goals and reflect on any outcomes achieved in the previous
year - these should relate to independent living skills developed in the home.
Fill-out the breakdown of the total sum of the quote into individualised, shared and irregular supports -
providers will need to calculate the quote and fill out the ‘SIL Hourly Breakdown template’ prior to
completing this section of the quote.
Include and reference evidence of the participant’s support needs (e.g. Behaviour Support Plans,
registered Restrictive Interventions, specialist reports (e.g. occupational therapy reports), details of
incidents and risks, Staff Safety Analysis etc.
Identify the appropriate SIL quote contact and their details in the template (page 5).
Ensure the SIL quoting template reflects the participant’s support needs detailed in the Roster of Care
and SIL Hourly Breakdown.
Complete Roster of Care template for the residence
This needs to be filled out once for each residence, and submitted with each participant quote.
The template should reflect the current overall staffing ratios for a typical week or required levels of
support.
Include any non-NDIS residents, if applicable - these should be indicated using non-identifying
information (e.g. non-NDIS A).
Use the colour legend on the template to indicate what level of support each participant receives and
reflect active overnights.
If you use a different staff to participant ratio, add the different staffing ratios to the legend (i.e. do not
replace existing options in the legend).
Version 1, January 2018 8Use approximate one-hour blocks (e.g. if the participant receives 30 minutes of 1:1 supports in the
morning, and again in the afternoon, this should be reflected in one hour block for the entire day).
Indicate when participants receive individualised supports, for example, if there are four residents in the
home who require support from 2 staff during the day, this should be reflected in the template.
If a participant requires 1:1 support, the template should reflect this.
Include notes at the bottom of the template to provide further context (e.g. sleepovers are active shifts,
rationale for irregular supports, and details of shared support if it is not captured in the template).
Any specifics of a participant’s support (e.g. a staff handover) that is not easily captured in the template
should be reflected in the SIL Hourly Breakdown template and detailed in notes section under the table.
Leave the template blank when a participant accesses other supports during the day, including when
they visit their family or access the community.
The Roster of Care be consistent with the SIL Hourly Breakdown in terms of staff ratios.
Detail when the sleepover time begins? (i.e. this should reflect when the residents are inactive and
associated award requirements).
Complete the SIL Hourly template for each participant
Detail individualised and shared support, using the appropriate column under ‘direct care’ and ‘shared
care’.
The total hours per week are calculated individually for each participant. For example, if a participant
receives 20 hours of support at a 1:3 ratio between 8pm-12am Monday to Friday, the participant’s SIL
Hourly Breakdown should state 20 hours under the relevant column.
If your support model involves a different care ratio, use a combination to achieve your ratio of care, for
example, if the staffing ratio is 3:2, use a combination of 1:1 care and 1:2 care to achieve 3:2 care. This
means that providers would enter 10 hours under 1:1 care and 10 hours under 1:2 care. The result
would be 10 hours of 3:2 care. Alternatively, use the new ratio converter tool – the NDIA will release
this shortly.
Include information about handovers. For example, if during the week there is a total of 2 hours of 3:4
care (where the usual staffing ratio is 2:4) due to handovers, each participant SIL Hourly Breakdown
should include 30 minutes of 3:4 care to reflect the handover.
Use the irregular supports and public holiday calculator to determine the weekly average hours of
irregular supports and public holidays.
Ensure the irregular support hours are included in the SIL Hourly Breakdown template, even if it is
reflected in the calculator.
Check your calculations only reflect supports delivered to the individual and are correct.
If the participant is new to the provider
Check with the participant if they have a housing goal in their plan, whether or not alternate housing
options have been explored and if a support coordinator is involved. A SIL model is the last resort model
for the Agency and participants will not receive SIL funding unless it is the most appropriate model
based.
Develop a quote based on all relevant evidence, including documentation from other providers,
Occupational Therapy reports, Behaviour Support Plans, parent testimonials etc. Involve the support
coordinator.
Consider if further assessments are required - the NDIA may fund these.
Version 1, January 2018 9Submit the completed NDIS SIL Pack
(including SIL Quoting Template, Roster of Care and Individual Hourly Breakdown) ideally 6-8 weeks prior to the
first plan or plan review meeting
(see Appendix 1: Regional SIL Contacts)
If files exceed 20 MB, create a ‘Zip file’ with all documents and attach it to the email.
Confirm NDIA received the quote.
If the quote is taking more than a month to approve
Request NDIA to create a Service Booking at benchmark, if required.
Check the Portal - the NDIA may have created a Service Booking at benchmark to enable you to claim
until the quote is approved.
Regularly check the progress of your quotes.
Contact regional NDIA staff regarding any concerns related to quote delays.
If the NDIA requires further information
Review evidence submitted.
Have you included:
Information about the model of support?
The rationale regarding the proposed model of support?
Sufficient evidence to support the provision of higher ratios of care (i.e. 1:1, 2:1)?
Risk management strategies, and staff safety risk analysis?
If you do not feel the quote is appropriate:
Contact NDIA for further clarification regarding the reasonable and necessary decision.
Check other supports in the participant’s plan (e.g. funding during the day on weekdays and/or
weekends may have been included in Core Supports to allow greater flexibility for the participant to
access supports from other providers).
Version 1, January 2018 10Appendix 2: SIL Regional Contacts Location Email address Australian Capital Territory silquotes.newsouthact@ndis.gov.au New South Wales North sil.nswnorth@ndis.gov.au New South Wales Sydney nswsydneysil@ndis.gov.au New South Wales Central sil.nswcentral@ndis.gov.au New South Wales South silquotes.newsouthact@ndis.gov.au Northern Territory servicedeliverynt@ndis.gov.au Queensland Central sil.queenslandcentral@ndis.gov.au Queensland South sil.qldsouth@ndis.gov.au Queensland North, Cairns region sil.cairns@ndis.gov.au Queensland North, Mackay region sil.mackay@ndis.gov.au Queensland North, Rockhampton region sil.rockhampton@ndis.gov.au Queensland North, Townsville region sil.townsville@ndis.gov.au South Australia sil.southaustralia@nds.gov.au Tasmania tasengagement@ndis.gov.au Victoria East viceast@ndis.gov.au Victoria North silquotes.vicnorth@ndis.gov.au Victoria West vicwestsil@ndis.gov.au Western Australia wasil@ndis.gov.au Version 1, January 2018 11
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