I will start with the TLDR version - never be afraid to negotiate because there are always options.
Coming into this I realise there are many participants, and almost as many Independents and providers who know a lot about care and supports, but don’t really have a business or finance background.
As a participant there is a budget to manage, juggling allied health, medical care and supports, service agreements, equipment management, hidden fees, extra charges and also changing needs and lets not forget repeatedly proving you still need the help when there is a renewal on the way.
As providers there are budgets and their overheads, fees, training costs, staff costs if you have them, documentation, insurances and registration fees for some.
We are also in a period of uncertainty with the government and media swimming with speculation and droning on about cuts.
With all of this, there are some common themes that come up when it comes to negotiating the costs of services with a provider and some providers trying to work out how to cover their costs while still giving participants good service. There are some providers and independents who have overheads too high to allow them a lot of room to negotiate, but there are others who are able to get a little whimsical with service costs because of their structure so it never hurts to talk. Also don’t be shy about talking, the worst that can happen is that one of you decides to leave the negotiation. With 650,000 participants roughly nationally and over 250,000 providers and independents there are plenty of options and finding the right match for both parties is the aim. So, some common things that people have come to me with:
“I just received my hours from the plan manager and they have only allocated an hour a day, but the providers are insisting on a 2 hour minimum”.
A common problem now coming up is that businesses are having a hard time convincing workers to work a 2 hour or less shift. Some providers are starting to insist on a 3 hour minimum. This often means you have a hard time finding a support worker even if they are an independent. You sometimes don’t have an option to go back to the plan manager to explain this and get more hours. There are a couple of potential solutions to try and combat this. The first one can work with a lot of independents if you are willing to be flexible on time and day and they have other participants in your area. You can ask them what days and times they will already be close by and if they are willing to do and charge the one hour if you agree to have it straight before or after their other client/s that they are already doing on the days that they are there. Some may not be willing, but there definitely are some that are happy to do that. In some cases they may ask to add a travel fee from the first client to you to make it more financially viable for them. It works out to being better than the full 2-3 hours some are asking for. The other option is to go with one of the much larger contractor style providers. It can work but you may need to sift through a few support workers until a good fit comes through as they aren’t always great at matching workers to participant.
“I have my budget for capacity building and I feel like I need assistance a certain number of times per (insert period) but my budget wont cover the cost of an allied health professional coming out each time”
This can be a tricky one. Allied health professionals are important and there are definitely tasks only they can perform. But as most know, your capacity building budget is not always an amazing amount. In this instance you may want to talk to your allied health professional about using a level 2 allied health assistant to perform some of the tasks. For example, your physio has given you an exercise program that you need to do weekly, but your budget would only cover a monthly visit and a support worker may not have the skills to properly support the exercises and report back to the physiotherapist. A level 2 assistant is able and qualified to provide those supports unsupervised while following the allied health professionals directions. The hourly rate is lower than that of the allied health professional. Some allied health professionals have assistants on staff, but you can also opt to hire your own just like with support workers as long as your allied health professional agrees to work with them. A bonus tip is that some independent allied health assistants are happy to work for the support worker rate rather than the allied health assistant rate if your budget is lacking funding for allied health but does have support worker funding. And some are happy to combine support work hours and therapy hours if you have limited daily hours available.
“I have a lot of activities in the community that I like to attend but I don’t have the budget to attend all of them with a support worker, is there a way that I can make the budget spread further so I can do more?”
There is but it doesn’t always work for various reasons. I encourage participants to befriend other participants who enjoy similar activities (I facilitate this for clients by hosting get togethers but there are definitely many ways to meet up). The simplest way to get more out of your budget for community access is to attend with another participant (or more, up to 5 in fact) who also wanted to participate so that the amount that is invoiced by the support worker is divided by the number of participants going along.
In cases of 2:1 supports, higher needs 1:1 supports or social anxiety issues this isn’t a feasible choice. For those participants I recommend talking to the provider and seeing if you can negotiate a lower rate in exchange for ensuring a number of hours per month outside of holidays and other events. There are quite a few independents who are happy to charge less if it means they will have regular work. Another option is negotiating a flat rate. This can help if some of your hours are in the evening and if there is transport involved. Trying to calculate afternoon rates and dollars per km is easy for some but not so easy for others. There are some independents who are willing to charge a flat hourly rate on weekdays in exchange for regular shifts. This can make it a lot easier for a participant who can then just say they will be charged X amount for Y hours regardless of the time of day and whether there is transport involved. Those providers do tend to charge the max day rate though so it is best to sit and do a calculation yourself before the negotiation to see if you will be financially better off based on your normal activities.
“My funding is being whittled down by cancellation charges”
This is one where it is really important to look at the service agreement. Many providers say that they make it all clear and it is up to the participant. But not a lot of participants realise that cancellation policies are negotiable too. Each provider is also different. Some use 7 day policies, some 48 hours, 24 hours and some 3 hours. It all depends on their structure. Some will also wave cancellation charges under certain conditions (hospitalisation of participant or if they can find other work for example). Some charge travel fees as part of cancellation, some don’t. Some charge the full amount of the session, some only half. It is important to look at their policies and then look at your circumstances. Is the planned time they will come in the morning and you are not a morning person making you more likely to cancel? Are there periods where you will be in hospital short notice and will they excuse you from fees in those circumstances etc. There are many variables to consider. You should try to negotiate one that will lean in your favour.
I will leave it at that as it’s already a long post, I do ramble a bit. If anyone thinks of one and wants to see if any providers can come up with a creative solution feel free to post. Happy negotiating.
Hehe
). Because she said that capacity was low but there was also personal care funding I offered the standard $67 which is less than a standard evening rate, less than the therapy rate and because of the nature of the disability I was willing to wave cancellation and travel fees. She refused this saying she did not want to pay the “max NDIS rate” and I asked her what her ideal would look like, because if we are close we might be able to come to an arrangement. She offered $30 an hour and some people would see that as reasonable compared to some incomes outside this industry. Ignoring overheads and taxes etc. I had to walk away, because even if I had no skills, no qualifications, no experience and I went to work for the absolute worst paying provider, I would still be getting $35 an hour. She was asking for a high skill worker to provide demanding specialised services for less than the minimum in the award. Financially for me it was not a viable long term contract and I would be giving up time I could give to much better arrangements.