QF115K Service Agreement - NDIS with Safeguards
This Service Agreement is made for the purpose of providing agreed supports as specified herein.
EL: Enhanced Lifestyles LAAS: Lifestyle Assistance and Accommodation Service NDIS: National Disability Insurance Scheme NDIA: National Disability Insurance Agency ACIA: Australian Community Industry Alliance
The Service Agreement is for the purpose of engaging services between the following parties:
Customer/Client’s Representative on behalf of Customer/Client (as stated above)
Enhanced Lifestyles / Lifestyle Assistance and Accommodation Service, represented by
This Service Agreement will commence on and end on . This Service Agreement will remain in place for the duration of your NDIS plan. Where an NDIS plan has finished, a review has taken place and a new NDIS plan is yet to be received by the customer, this Service Agreement will remain in place for that period of time until a new NDIS plan is provided to the Customer/Client. Until such time, all terms and conditions of this Service Agreement must be abided by. When the Customer/Client receives their new NDIS plan, the Customer/Client is required to provide EL/LAAS with (at a minimum) the required billing information as well as sign a new Service Agreement to ensure continuity of services.
Please ensure the following information is correct. All bills will be emailed unless an email address is not supplied.
The way my bills are paid is by:
EL/LAAS supports Customers/Clients right to privacy and as such understands that people have the right to choose which information they provide. Please be aware that if you are NDIA Agency Managed, we do require at a minimum your NDIS number, plan start and review date and your date of birth to be able to submit invoices for payment within the NDIS portal.
Please speak to one of our Customer Relations Officers if you have any concerns or require further clarification about the information required.
Date of Birth:
Plan start date:
Plan review date:
Whilst it is not compulsory EL/LAAS strongly encourages the Customer/Client to provide a copy of their NDIS plan
The Customer/Client agrees to allow EL/LAAS to discuss billing issues with NDIS on your behalf from the commencement of service provision for the duration of this agreement
The Customer/Client agrees to allow EL/LAAS to claim an establishment fee from NDIS for Customers/Clients who are new NDIS participants
The Customer agrees to allow EL/LAAS on your behalf to contact the NDIS regarding your plan and permission to obtain a copy including if an appeal is required
The Customer/Client agrees to allow EL/LAAS on your behalf to contact your Plan Manager regarding your service
The Customer/Client agrees to allow EL/LAAS on your behalf to contact your Support Coordinator regarding your service
The Customer/Client wishes to opt out of sharing their plan goals with EL/LAAS
The Customer/Client wishes to opt out of their plan goals being monitored and reported on by EL/LAAS
The Customer/Client wishes to opt out of the NDIA viewing their customer file and contacting them during an audit
The Customer/Client wishes to opt out of the ACIA viewing their customer file and contacting them during an audit
The Customer/Client wishes to opt out of using a physical Communication Book
The Customer/Client wishes to opt out of having a care plan and associated clinical charts within the home
The Customer/Client wishes to sign up as a Member of Enhanced Lifestyles
Please indicate any high intensity daily personal activities that you require us to provide you as a part of your supports:
The Customer is only supported by a single Lifestyle Attendant and understanding the risks factors involved wishes to only have a single Lifestyle Attendant.
Please indicate which risk factors apply to the Customer:
The Customer also understands that their choice to only have a single Lifestyle Attendant requires that Enhanced Lifestyles create a plan with the Customer with the following safeguards as required by the NDIS:
EL are required by the NDIS to make records about the services we provide, these are called Progress Notes. Progress Notes link our services and progress to the Customer NDIS plan, goals and individual strategies agreed upon between the Customer, the NDIS and EL as your service provider.
Progress Notes and other record keeping strategies also allow EL to help protect our Customers from abuse, neglect, exploitation and discrimination by helping us identify when things are going wrong.
There are a number of tools we may use to support our record keeping, such as:
Customers have the right to view the personal information we record about their services.
In determining the appropriate Lifestyle Attendants to support the Customer consideration will be made to the:
Based upon these criteria we will select or recruit for the Customer potential Lifestyle Attendants with the appropriate qualifications and training. These Lifestyle Attendants will have to attend a meet & greet with our Customer which will allow them an opportunity to become acquainted and during which they may assess the Lifestyle Attendant by their own criteria. EL support the Customer to have complete choice on who is best suited to support them as their Lifestyle Attendant.
Skills development activities are provided when EL/LAAS is engaged by the Customer/Client to provide non face to face support to assist Customers/Clients to effectively access services.
Any activities provided will be billed to the most appropriate support item. Skills development can include but is not limited to:
EL/LAAS will not charge for rostering and other administration support as per non face to face guidelines. Any skills development activities will be discussed and approved by Customer/Client prior to them being delivered and billed for.
Transport costs incurred whilst a Lifestyle Attendant provides service are not covered within the hourly charge and will be invoiced as additional charges. Transport will be charged at $0.85 per kilometre. Lifestyle Attendants will claim for this expense by providing EL with vehicle logs detailing the kilometres travelled.
EL/LAAS agrees to:
The Customer/Client’s representative agrees to:
EL/LAAS will ensure:
The organisation mandates the use of TeleClock and Customers/Clients are required to be compliant to assist the organisation to accurately bill Customers/Clients and maintain a transparent system that can be easily audited and identify suspicious transactions.
This Service Agreement will be regularly reviewed to ensure that the supports being delivered are continuing to assist the Customer/Client in their daily life and achieving their goals.
These reviews will be conducted over the phone with the Customer/Client or representative and will examine their needs, budget, goals and satisfaction.
In the event changes to support and delivery of services are required these changes to the service agreement will follow process outlined below.
If changes to the supports or their delivery are required, the parties agree to discuss and review this Service Agreement. The parties agree that any changes to this Service Agreement will be communicated, discussed and agreed to by both parties.
Your service agreement will end as per the end date or if your NDIS plan is extended when your new NDIS plan comes into effect. Until such time, all terms and conditions of the service agreement must be abided by.
Should either party wish to end this Service Agreement they must first give 14 days’ notice to exit under normal circumstances, unless in the case of outstanding payments when EL/LAAS can give 5 days’ noticeof termination.
If either party seriously breaches this Service Agreement the requirement of notice will be waived. However, where outstanding monies are owed to EL/LAAS the Customer/Client is still required to make payment within 14 days from the end date of the service.
If the Customer/Client wishes to give EL/LAASFeedback, the Customer/Client can talk to the Service Delivery Team or the appropriate manager on 8340 2000 or submit a Feedback form (secured from an EL/LAAS employee) by email or post. There are four categories of Feedback a Customer/Client can submit:
Feedback and complaints are a vital part of the process for improving the services of EL/LAAS and will be treated with deserved respect.
Personal Information includes but is not limited to your name, address, contact details, age, date of birth, employment details, bank details and any other information required under the Anti-Money Laundering and Counter Terrorism Financing Act 2006 (Cth).
Sensitive Information refers to your medical information, racial/ethnic background and sexual preferences or practices.
You consent to EL/LAAS:
All Customers/Clients must provide formal notification and an appropriate reason of any unexpected or unscheduled cancellation of service at least 24 hours prior to the commencement of an assigned shift. Where this occurs, there will be no cancellation charge to the Customer/Client.
Where a Customer/Client provides notification of a cancellation of service providing between 12 and 24 hours’ notice before the commencement of the shift, the Customer/Client may be charged 1 hour at 90% of the applicable rate.
Where a Customer/Client provides notification of a cancellation of service with less than 12 hours’ notice before the commencement of the shift, the Customer/Client may be charged the amount equivalent to 90% of the total hours of service at the applicable rate.
The term ‘Cancellation’ includes:
It is understood that emergencies may arise that where a Customer/Client is not able to notify EL/LAAS within the required period and exemption from cancellation payments can be approved by the Service Manager.
In these instances, the Customer/Clientmay be required to provide a written reason for the cancellation as well as documentation or evidence to confirm.
The Customer/Client(or Customer/Client’s representative) can be contacted on:
Phone (Business Hours):
Phone (After Hours):
Emergency Contact Person:
Emergency Contact Phone:
2nd Emergency Contact Person:
2nd Emergency Contact Phone:
Name of Customer/Client or name of Customer/Client representative
Name of authorised person EL/LAAS
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: QF115K Service Agreement - NDIS with Safeguards
Agree & Sign