Stretching Core Budgets Without Cutting Hours

The plan is approved, the needs are real and the arithmetic doesn't work, and it is one of the hardest conversations to coordinate. The apparent choices within the current arrangement are all poor: reduce hours the participant requires, limit supports throughout the year, or begin making the case for additional support while the participant is getting by.

While the other three options receive attention, a fourth option is rarely mentioned, but deserves it: keep the hours and change what they cost. The core budgets are utilized in a sequence of decisions regarding service model, rates, scheduling and claiming, and are built with some leeway in all plans. A coordinator who examines the structure of spending before taking out the hours is likely to discover the year within the current budget.

Where the slack usually hides

The rate itself. Supports should be at the price range specified in the price limits of the NDIS, but the price limits are not set prices. Traditional providers tend to offer at or close to the top end price, as their model has organisational cost. Independent workers set their own rates, and an agreed rate in direct working is often just a sensible amount lower for the same support item. The difference between the near-ceiling rate and an agreed independent rate over a year of hours is a measure of the number of extra weeks of support provided in the same budget. It is not about the price of labour, it is about not paying an organisation's overhead on supports which do not require an organisation.

The service model mix. Not all funded hours require the same type of provider. Generally, plans will include specialist-provider rates for fully generalist supports, such as social access and household duties, since the plan was submitted to a single organisation for ease of administration. The alternative is to "split the mix", where all of the generalist slots are booked by independent workers and only those that are truly required are booked by the specialised providers, re-pricing the bulk of the week but not changing what it is.

Scheduling structure. Any shift that is short, or has a lot of travel, or loading after hours, all come to more dollars per useful hour. Assessment of the participant's needs will determine whether the same outcome can be achieved as fewer, longer visits rather than more visits in premium time. The test is always the participant's need, not the tidiness of the roster: some supports are shorter, more frequent or after hours, and those are left exactly as they are.

Claiming hygiene. Budgets leak through the mundane: cancellations taken at full rate even when shorter notice arrangements can be made; travel taken at full rate; duplicated establishment charges. By having the claiming pattern skimmed quarterly, together with the plan manager (if there is one), the leaks are identified in their infancy.

Running the audit

This is the order, because the order is the ethics. If it is repricing, it changes what an hour costs, not what the participant gets, so it needs no review. If it is restructuring, then they must also consent, because hours are their life, not a spreadsheet. And if none of that is enough, then prioritising hours, which is what they need, is the only thing left. That evidence is also the type of evidence a plan reassessment request requires.

Be clear with those involved all throughout. Meanwhile, the conversation that participants know and are usually receptive to, and that helps keep all hours, is "We can keep all your hours by changing who delivers some of them, and what those hours are worth."

How this plays out in practice

Consider someone who has eighteen hours of core supports per week, all delivered by one provider at near ceiling rate, and the funding runs out in the 9th month. A review could determine 12 of those hours are generalist: meals, household duties, community access. Moving them back to an independent worker for an agreed lower rate, leaving the six specialised hours as they are, and replacing two short visits that have been spread around with one whole block, puts the year back into the budget with all 18 hours. The participant's week is the same. Only the spreadsheet changes.

Next steps

Choose the three plans on your caseload tracking to complete early, and conduct the four-part audit on each before anyone says, "you're cutting hours." The order is: rate, mix, schedule, claiming.