Plan Management Intake

Personal Details

Participant Full Name(Required)

Date of Birth(Required)

Phone Number(Required)

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NDIS Fund Management Type

NDIS Number(Required)

Email Address(Required)

Address(Required)

Street Address City State Post Code

Plan Nominee

Name

Relationship to Individual

Phone Number

Email Address

Address

Street Address City State Post Code

Medical

Primary Disability:(Required)

Secondary Disability:

Medical Conditions (If any)

Allergies (If Any)

Specific Support Needs

Interpreter required?(Required)

Yes

No

Easy Read Documents required?(Required)

Yes

No

Preferred method of communication(Required)

Email

Phone

Post

Face to Face

Any other Information?

Cultural Requirements

Do you speak a language other than English(Required)

Yes

No

Do you identify as(Required)

Aboriginal

Torres Straight Islander

Aboriginal and Torres Straight Islander

Neither

NDIS PLAN

Please attach a copy of your / client NDIS Plan(Required)

Accepted file types: pdf, jpg, png, Max. file size: 5 MB.

Plan Management Service Agreement

Plan Management Service Agreement between Yumba Bimbi Support Services, and:(Required)

Agreement Start Date(Required)

Who is Yumba Bimbi

At YBSS, you will direct your support. We will work alongside you to identify your strengths, interests, and goals, providing just the right amount of support to allow you to live the life you choose. We treat support as a partnership. We will actively work with you to ensure a successful partnership. We work hard to ensure we employ only the best Plan Managers. You can be certain that your support will be provided by Plan Managers who share YBSS’s values. Your Plan Managers will be trained, including training specific to their role, ready to provide you with the quality of support YBSS is renowned for.

How do you like to give and receive information?

How YBSS will deliver your support may vary depending on your needs. Meetings and communication about your services can be provided face to face, via the telephone, email, virtual platform like Zoom or Teams or in your preferred method of communication.

Please let YBSS know if you have specific communication aids or if you or any of your support people need a translator. If you want to have these agreements in a different format, please let Yumba Bimbi know, and they can work with you to achieve this.

Conflict of Interest

As a registered provider of support under the NDIS, YBSS is responsible for managing conflicts of interest. YBSS will act in the best interests of NDIS participants, ensuring that they are informed, empowered and able to maximise choice and control. Staff members will not (by act or omission) constrain, influence or direct decision-making by a person with a disability and/or their family to limit that person’s access to information, opportunities, and choice and control.

NDIS participants will be presented with various choices about support providers, not only YBSS. Staff will not seek to influence participants to select YBSS for their services.

To help eliminate the conflict of interest that can occur in having more than one service with a provider, YBSS has created separate Service Agreements for each service. You will receive this Agreement and the relevant agreements for each service. If you want to change any of your services, YBSS can do this without impacting the others.

How do the agreements work?

This Agreement is made for the purpose of providing Plan Management services under the Participant’s NDIS plan. The parties agree that this Agreement is made in the context of the NDIS, which is a scheme that aims to:

Support the independence and social and economic participation of people with disability, and
Enable people with disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports.

All parties entering into agreement

Are at least 18 years old.
Have the right, authority and capacity to enter into this Agreement as the participant or on behalf of the Participant.
Must promptly let us know if you are no longer acting as the Authorised Representative of the Participant; and
Will abide by the terms of this Agreement and any relevant policies and rights and responsibilities of this Agreement; and
Have plan management funding included as part of your NDIS plan.

Ending your Service Agreements

This service agreement will continue with the procurement of future NDIS plans. The service agreement will automatically end when Capacity Building – Improved life choices is no longer funded for the participant

To end your service agreements prior, you must give two weeks’ notice in writing. If YBSS wants to end the Service Agreement, they must provide two weeks’ notice. They will also contact relevant people to ensure you can arrange alternative services. If either you or YBSS seriously breaches this Agreement, the notice period will be waived.

Problem-solving, disputes and grievances

YBSS will listen to your feedback and nominate a person you can talk to if you have any concerns about your support and how YBSS delivers those supports to you.

We will discuss any concerns, disputes and grievances arising with you. We will resolve them quickly and fairly, so that you and YBSS are satisfied with the outcome.

If we cannot solve the problem together, YBSS has a Complaints Procedure that YBSS will follow. If you want a copy of this procedure, please let YBSS know.

If you are still dissatisfied, you can seek advice from an independent advocate or contact the NDIS Quality and Safeguard Commission by phoning: 1800 035 544 (free call from landlines) or TTY 133 677. Interpreters can be arranged. National Relay Service and ask for 1800 035 544. Completing a NDIS complaint contact form. Visiting one of their offices in person or visiting www.ndis.gov.au for further information.

Responsibilities of people involved in this Agreement.

Responsibilities of Yumba Bimbi

Yumba Bimbi agrees to:

Provide financial intermediary services. including processing invoices between the NDIS and providers. Providing you with monthly statements of expenditure. Tracking expenditure against you NDIS plan budget.
Provide you with supports you have identified that assist you in achieving the goals in your NDIS plan.
Respect your right to choose the services you wish to utilise to best assist you to achieve your identified goals, within the requirements of the NDIS.
Review the service as required and when a new NDIS plan has been instigated or at a time requested by you or YBSS
Communicate with you openly, honestly, and promptly and consult you on decisions about how support is provided.
Protect your privacy and confidential information as per the requirements of the Privacy Act 1988 and YBSS Privacy Policy
Give you information about managing disagreements or complaints and provide you with relevant Yumba Bimbi policies on request. Listen to your verbal or written feedback and quickly work with you to resolve any concerns you may have.
Ensure that our employees who work with you are professional and treat you with courtesy and respect.
Keep accurate records on the communication/tasks in which have been done with you or on your behalf.
Provide support consistent with all relevant laws, including the National Disability Insurance Scheme Act 2013, the National Disability Insurance Scheme Rules, the NDIS Code of Conduct and the Australian Consumer Law.

Responsibilities of you and your representative

You agree to the following:

Participate in identifying your desired services, linking these services with your goals in your NDIS plan.
Let us know how you want us to support you so you can best meet your needs and achieve your goals.
Purchase supports in line with your NDIS plan. Seek clarification from the NDIS if you are unsure if the purchase meets the requirements of an NDIS support.
Disclose information, including your NDIS goals and other information which will assist us in helping you to achieve your goals.
Participate in a review of services as and when required with YBSS or as requested by either party.
Ensure you and any of your friends, family or other supports treat our staff/volunteers courteously and respectfully.
Talk to us as soon as possible if you have concerns about the support being provided.
Advise YBSS immediately if your plan is under review, has been reviewed by the NDIA, or you are no longer a participant funded by the NDIS; and give prompt notice of any change in circumstances which will lead to a possible review with the NDIA.
Authorise Yumba Bimbi Plan Management to pay all invoices submitted to us on your behalf.
Understand that you have access to the Careview Advantage App where you can view details of your budget and approve invoices at your discretion. you will communicate your request at any time to have access to this app.

Authorise Yumba Bimbi Plan Management to pay all invoices submitted to us on your behalf. I elect to:(Required)

Automatically approve all invoices submitted.

Approve invoices via the Careview advantage app within a period of 48 hours, unless I will be disputing the charges. If a dispute is being made, I will inform Yumba Bimbi Plan Management with in the 48-hour period. It will be assumed that any invoices not disputed within the 48-hour period are automatically authorised.

Confirmation(Required)

I have read the information outlined on this page.

What will your support cost?

YBSS will work with you to understand what support you want and need and the cost of this support.

Each of the services you receive from YBSS will use a Service Agreement to clearly show the charges that will be associated with that service.

You will need to make sure that you let YBSS know if your NDIS funding or goals change. Changes to your funding may mean making changes to your support. You will also need to update the NDIS with evidence of your support needs regularly. Some of this evidence and reports can be funded through your NDIS plan.

How will you pay?

Your NDIS money will come from the NDIA directly.

The prices YBSS will charge for this service are those published at that time by the NDIS by the National Disability Insurance Agency (NDIA). This will be in accordance with any price changes as and when/if they occur.

Yumba Bimbi Support Services will seek payment for their provision of Plan Management support, after the delivery of the service at the end of every month.

Claiming For services Delivered

We Claim Payments in line with the fees outlined by the NDIS Pricing arrangements, Services can include and are not limited to:

Plan Management Monthly Fees – $104.45 per month

Processing and payment of invoices on behalf of the client
Processing of reimbursement claims
Tracking expenditure against client budget
Monthly budgets
Trouble shooting

Optional Service – $98.32 per hour
Capacity Building and Training in Self-Management and Plan Management, Assistance With Decision Making Daily Planning and Budgeting

Support the participant to strengthen their ability to self-manage their funds
Budget development.
Client Liaison
Build capacity to undertake aspects of plan administration and management
Building organisational skills
Build capacity to Engage providers
Build capacity to direct their supports
Build capacity to Develop and understand service agreements
Building financial skills
Build capacity to Maintain records
Build capacity to pay providers and claim payment from the NDIS

Confirmation(Required)

I have read the information outlined on this page.

Audit

As a registered provider, YBSS will regularly undertake an audit. As part of this audit, each person can provide feedback about the services they receive. This review is to make sure YBSS is complying with the NDIS Practice Standards.

As part of the audit process, you may be contacted by an audit team for an interview and/or may have your files, records or plans reviewed by an auditor. You have the right to opt out of the audit process, meaning you do not wish to be interviewed and/or do not wish to have your records reviewed by an auditor. If you do not want to be involved, please let YBSS know.

Emergency Planning

In an emergency, if Yumba Bimbi supports you, they will continue to provide support for as long as you need it in these circumstances. YBSS has strategies in place to ensure continuity of financial intermediary services in the event of an emergency or disaster.

Liability

Yumba Bimbi Plan Management will make every effort to support participants to use their plans in line with the NDIS guidelines and to manage the budget effectively. Yumba Bimbi is not liable for the cost of any service that cannot be paid due to the exhaustion of funding or purchases outside of the guidelines of NDIS funded supports. This includes any debt raised by the NDIS that have been deemed a misuse of funds. Payment of such debts will be the responsibility of the participant.

Agreement(Required)

I understand that my Plan Manager will make a service booking on My Place Portal or are endorsed on the My NDIS provider portal to assist in completing their service.

Confirmation(Required)

I have read the information outlined on this page.

Consent & Acknowledgment

Consent(Required)

I consent to Yumba Bimbi Support Services collecting and storing my personal information in accordance with their privacy policy.

Date Signed

Signature(Required)

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Personal Details

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Cultural Requirements

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Plan Management Service Agreement

Who is Yumba Bimbi

How do you like to give and receive information?

Conflict of Interest

How do the agreements work?

Ending your Service Agreements

Problem-solving, disputes and grievances

Responsibilities of people involved in this Agreement.

Responsibilities of Yumba Bimbi

Responsibilities of you and your representative

What will your support cost?

How will you pay?

Claiming For services Delivered

Audit

Emergency Planning

Liability

Consent & Acknowledgment

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