Hifive Community Services Signup Form

To sign up online for Plan Management or Support Coordination, please complete the details below and hit submit. If you have any questions, please call us on 1300 002 221 (between 9am - 5pm Mon-Fri).
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Service Agreement for the provision of NDIS Services Note: A Service Agreement is a document for the Participant and Service Provider. It outlines how they will work together to achieve goals in the NDIS plan. A participant may choose to have a representative (someone close to them such as a family member or friend, or someone who manages the funding for supports under their NDIS plan) to sign the agreement. This service agreement will be in effect for the duration of the Participant’s association with Hifive Community Services, or until we are notified otherwise in writing by the Participant/Participant’s representative.   Plan Management - Financial Administration Services If these services are required, Hifive Community Services agrees to provide the Participant plan management - financial administration services (NDIS Price Guide Support Category 3.14 - Improved Life Choices) to assist in the management of a participant’s NDIS plan. The supports and their prices are set out in the Schedule of Supports below.  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 Participant’s NDIS supports) are the responsibility of the Participant/Participant’s representative and are not included in the cost of the supports.   Support Coordination Services  If these services are required, Hifive Community Services agrees to provide the Participant support “Coordination of Supports” (NDIS Price Guide Support Category 3.07) to assist in the coordination of services and support and ensure each service is working towards achieving your goals. The supports are set out in the Schedule of Supports below, based on what level of support you require. This is to be used in conjunction with the ‘Request for Service: Coordination of Supports’ form provided by the NDIS when the plan is finalised.    All prices are GST inclusive (if applicable) and include the cost of providing the supports. Please note: Time spent coordinating supports might also include other activities, such as travel time to see a participant, making phone calls, writing notes, and time spent contacting service providers on behalf of the client.  Additional expenses (i.e. things that are not included as part of a Participant’s NDIS supports) are the responsibility of the Participant/Participant’s representative and are not included in the cost of the supports (ie. entrance fees, event tickets, meals etc.).  How is my privacy and confidentiality maintained? Hifive Community Services respects a Participant’s right to privacy and is committed to safeguarding a ny personal information provided to us. Please see attached our Personal Information Collection Statement and our Privacy Policy located at. These detail: Why we need to collect information and how it is used Who has access to your information and how your information is stored Who we share your information with and how you can lodge a privacy related complaint By signing this agreement:   You confirm that you have read the Privacy policy document at and understand the information it contains. You agree that Hifive Community Services can record personal information so that they can provide the services contained in this agreement. You understand that you give Hifive Community Services permission and consent to share information with providers with the purpose of coordinating your services (Support Coordination services only). You consent to Hifive Community Services sharing your information with any agency if required to by law. You consent to Hifive Community Services collecting recorded material in audio and/or visual format if Hifive Community Servicesmake you aware before this occurs. You understand that you give Hifive Community Services permission and consent to share information with your plan nominee and anyone else listed in our consent form (please ask us for one of these forms if required). Hifive Community Services conducts certification audits to maintain our NDIS Registration, you consent to our auditors reviewing your file and contacting you to discuss your experience using Hifive Community Services. If you wish not to participate, please let us know by calling 1300 492 214 or email us at [email protected]   Responsibilities of Provider Plan Management supports (if listed above under 'Services to be provided') assists a participant by:  Giving increased control over plan implementation and utilisation with plan financial assistance Managing and monitoring budgets over the course of the plan Managing NDIS claims and paying providers for delivered service  Maintaining records and producing monthly statements showing the financial position of the plan Providing advice on commercial terms within service agreements Providing access to a wider range of service providers, including non - registered providers whilst remaining in line with the price limits contained within the NDIS Price Guide  Protect the Participant’s privacy and confidential information as per the Hifive Community Services Privacy Policy Document (Appendix 1)  Support Coordination supports (if listed above under 'Services to be provided') assists a participant by:  Supporting implementation of all supports in the plan, including informal, mainstream and community, as well as funded supports;  Coordinating assessments, reports and service proposals;  Capturing any required data for the NDIS;  Identifying strategies and solutions for managing risks such as aging carer, sustaining informal supports, sustainability of housing; Identifying and seek relevant assessments and associated service design for participants with risk behaviours and behaviours of concern;  Supporting the participant through identifying and selecting providers, monitoring plan outcomes & plan expenditure;  Strengthening and enhance the participant’s abilities to self-direct their own supports and participate in the community;  Ensuring mainstream services meet their obligations (i.e. housing, education, justice, health);  Providing the NDIA with reports on outcomes and success indicators within the agreed reporting frequency. Please note that Hifive Community Services does not provide an emergency service - contact emergency services on 000 if required. Responsibilities of Participant/Participant’s representative I agree to: take due steps to provide information as requested by Hifive Community Services in a timely manner; treat Hifive Community Services staff with courtesy and respect; discuss any concerns about our service with Hifive Community Services; and advise Hifive Community Services immediately if the Participant’s NDIS plan is suspended or replaced by a new NDIS plan, or the Participant stops being a participant in the NDIS.  Payments  The Provider will seek payment for their provision of supports via the payment method stated on the Participant's plan. It will be either: Self-managed The Participant/Participant's Representative has chosen to self-manage the funding for NDIS supports provided under this Service Agreement. After providing those supports, the Provider will send the Participant or Participant's Representative an invoice for those supports for the Participant to pay. The Participant will pay the invoice by EFT within 14 days. NDIA Managed The Participant has nominated the NDIA to manage the funding for supports provided under this Service Agreement. After providing those supports, the Provider will claim payment for those supports from the NDIA. Registered Plan Manager The Participant has nominated their plan manager to manage the funding for NDIS supports provided under this Service Agreement. After providing those supports, the Provider will claim payment for those supports from their nominated Registered Plan Management Provider. You will never be out-of-pocket for our services - they will always be covered by your NDIS Plan. By nominating Hifive Community Services to provide plan management services and manage the funding we will claim from the NDIA portal for funding up to the amounts specified in the support category and budget approved in the Participant’s current NDIS plan. After these supports are delivered, the service provider or Participant/Participant’s representative will claim payment for those supports from Hifive Community Services by forwarding an invoice to [email protected] or by mail to our postal address.  Contact and Banking details The Participant/Participant’s representative will provide bank details if necessary, to Hifive Community Services for reimbursement. Participant budgets to be managed The Participant/Participant’s representative will provide Hifive Community Services details of their support budgets as per the Participant’s current NDIS plan.  If the support categories or budgets change, the Participant/Participant’s representative agrees that any changes will be submitted immediately in writing to Hifive Community Services. Changes to the Plan The Participant/Participant’s representative, agrees to immediately notify Hifive Community Services and provide relevant plan details in writing, if the Participant’s NDIS Plan is replaced by a new plan, or the Participant ceases to be a participant in the NDIS.  Ending this Service Agreement Should either Party wish to end this Service Agreement they must give 14 days notice in writing. If either Party seriously breaches this Service Agreement or the NDIA directs us to terminate this agreement the requirement of notice will be waived.  Feedback, complaints and disputes If the Participant/Participant’s representative wishes to provide feedback, or is not satisfied with the provision of supports and wishes to make a complaint, the Participant/Participant’s representative can contact the General Manager on 1300 492 214 or by email [email protected] If the Participant is not satisfied or does not want to talk to this person, the Participant can contact the NDIS Quality and Safeguards Commission by calling 1800 035 554, visiting one of their offices in person, or visiting www.ndiscommission.gov.au for further information.  Participant Handbook You will be provided the Hifive Community Services participant handbook via our Welcome Email, which contains important information including our charter of service, your wellbeing and your rights and privacy.   Advocacy An advocate can – give you information about your rights and responsibilities listen to your concerns help you resolve problems or complaints with your service provider speak with your service provider if you wish refer you to other agencies when needed. Hifive Community Services accepts the use of an advocate as representing the interests of the participant. You are able to advise Hifive Community Services of the person you wish to advocate on your behalf by using our 'Authority to Act as an Advocate' form, available on request.  A list of funded disability advocates can be found via the following website:  https://disabilityadvocacyfinder.dss.gov.au/disability/ndap/ Incident Management Hifive Community Services has reporting obligations, by law, to the NDIS Commission in relation to certain reportable incidents. Hifive Community Services has an Incident Management System which we follow in these situations.  Please be aware that Hifive Community Services is required to disclose your details in relation to these incidents and will only share these with the relevant emergency services and/or the NDIS Commission.  Further information on our incident management system is available upon request.  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 National Disability Insurance Scheme Act 2013 (NDIS Act), in the Participant’s NDIS plan currently in effect under section 37 of the NDIS Act;  Hifive Community Services will pay GST as per specified in National Disability Insurance Scheme Act 2013 (NDIS Act)   You will never be out-of-pocket for our services - they will always be covered by your NDIS Plan. * Any prices listed in this service agreement are subject to review/change upon the release of a new NDIS price guide. We will claim the specified prices in the NDIS Price Guide as published at the time the services are delivered. We claim directly from the NDIS and you are never out of pocket for our service. Disclaimer :  Hifive Community Services information is provided in good faith, to the best of our knowledge and is considered to be correct at the time of communicating, however, changes may affect this accuracy therefore Hifive Community Services gives no assurance as to the accuracy of any information or advice given.  Any advice given by Hifive Community Services outside of financial intermediary advice shall be considered general in nature.   Hifive Community Services shall not be liable for any failure of, or delay in the performance of this service agreement for the period that such failure or delay is;  Beyond the reasonable control of a party,  Materially affects the performance of any of its obligations under this agreement, and Could not reasonably have been foreseen or provided against (eg. Government Acts prohibiting or impeding any party from performing its respective obligations under the Service Agreement contract) or (eg. prolonged lack of power supply)  Nothing in the Hifive Community Services service agreement negates or diminishes the statutory guarantees regarding the supply of services the Participant/Participant’s representative receive under The Australian Consumer Law (Competition and Consumer Act 2010 – Schedule 2)  Hifive Community Services takes in good faith the information provided by the Participant/Participant’s representative to be true and accurate, and that claims presented to Hifive Community Services are a true reflection of goods and services provided to the Participant in line with the NDIS guidelines (National Disability Insurance Scheme Act 2013). Personal Information Collection Statement To assist us (Hifive Community Services Pty Ltd - ABN: 18 620 218 209) in conducting our business functions and sending you regular communication, we need to collect personal information about you.  By providing your personal information, you agree to its use and disclosure in accordance with this statement and Privacy Policy. If you do not agree, you must not provide your personal information, and we may not be able to communicate with you or provide certain services to you.   We may disclose your personal information to other parties, including our website host or software application provider for the purposes of operating our website, third parties who provide products and services to us or through us, your authorised representatives/nominees, and representatives, agents or contractors who are appointed by us in the ordinary operation and administration of our business.  From time to time, these third parties may be located (and therefore your personal information may be disclosed) overseas, including to the USA and the Phillipines.   Our Privacy Policy is available at . It contains information about how you may access and seek correction of your personal information, how you may complain about a breach of your privacy, and how we will deal with that complaint.