This service agreement sets out the terms of the Plan Management Agreement between and Lifeskills Plus Inc. for the National Disability Insurance Agency (NDIA) funding period from (from start date of your current plan) to ongoing until advised to end.

Participant Details

First name:    Surname:

DOB (dd/mm/yyyy):   NDIS Plan Number:  

Mobile number:    Email:

Street address:

Suburb:    State: NSWQLDVICSAWATASACTNT   Postcode:   

Nominee/Plan Representative Details

Full name:   Relation to client:  

Mobile number:   Email:  

Street address:

Suburb:   State: NSWQLDVICSAWATASACTNT  Postcode:  

Parties

This Financial Intermediary agreement is between [esigcf7 formid="5573" field_id="first-name" ] [esigcf7 formid="5573" field_id="surname" ] (hereafter referred to as the Client) whom is a participant in the National Disability Insurance Scheme (NDIS) and their nominee/representative [esigcf7 formid="5573" field_id="Nominee-Fullname" ] (hereafter referred to as Nominee) and Lifeskills Plus Inc.

Consent

I, understand that it is my responsibility and/or my allocated Support Coordinator’s responsibility to:

• ensure that my authorised services are relevant to my NDIS plan and
• advise Lifeskills Plus of applicable NDIS support category/ item reference numbers I authorise for payment
• ensure enough funds are available in my plan to pay for the services taking into account:
  • information from Lifeskills Plus monthly financial statement and
  • myPlace NDIS portal.

I, consent to Lifeskills Plus Inc. obtaining or providing information to the services listed below on my behalf and making payment for tax invoices authorised by me according to my NDIS plan.

• National Disability Insurance Agency
• Support Coordinator  
• My authorised Service providers

I understand that at any time I can add to or delete any of these names listed above. I can do this via email or by a signed hard copy.

Family Consent

I, consent to Lifeskills Plus Inc. obtaining information from the following family members(s) listed below on my behalf, or providing information to family members on my behalf:

Audit Consent

I, consent to Lifeskills Plus Inc. providing the below information to auditing organisations, for the purpose of auditing Lifeskills Plus Inc. I understand that only information required as auditing evidence will be provided, and the information will only be sited by the auditor with no hard copies provided. I understand the information may be referenced in audit reports. I consent to be interviewed during the audit process where I will be asked questions by the auditor.

• National Disability Insurance Agency
• Support Coordinator

I place the following restrictions on my consent:

I understand this form may be shared with other divisions within Lifeskills Plus Inc.

I understand that at any time I can withdraw my consent to any of the above. I can do this via email or by a signed hard copy.

The NDIS and this Service Agreement

This Financial Intermediary Agreement is made for the purposes of managing client’s NDIS funding package under his/her NDIS plan.

A copy of his/her plan is  attached to this Service Agreement. 

Upload your NDIS plan here:

The parties agree that this agreement is made in the context of the NDIS, which is a scheme that aims to:

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

Responsibilities of the Financial Intermediary

Lifeskills Plus Inc agrees to:

• Advise client & nominee that because they are receiving services from Lifeskills plus with Financial Intermediary Support does not mean that they have to access support services from Lifeskills Plus Inc.
• Communicate openly and honestly in a timely manner
• Treat the client with courtesy and respect
• Provide feedback as requested by client and nominee on accounts paid for supports provided.
• Pay accounts as authorised for supports provided to client
• Issue regular invoices or statements to the client
• Give client/nominee information about managing any complaints or disagreements with support services
• Listen to client and nominee feedback and resolve problems quickly
• Give client and nominee two weeks’ notice if Lifeskills Plus needs to end the Financial Intermediary Agreement
• Protect client’s privacy and confidential information
• Provide supports in a manner consistent with all relevant laws, including the National Disability Insurance Scheme Act 2013 and rules and the Australian Consumer Law, keep accurate records on the supports provided to client.
• Issue regular statements of the supports delivered to client.
• Avoid conflicts of interest in Financial Intermediary supports (See Attachment B - Lifeskills Plus Policy on NDIS and Conflicts of Interest)

Responsibilities of Client and Client Representative

Client and Nominee agree to:

• Inform Lifeskills Plus about what services are being provided to client and by what services.
• Authorise service providers and services they are to deliver
• To pay themselves for any amounts charged by service providers that are over and above the price limit as set by the NDIS.
• Treat the Lifeskills Plus staff with courtesy and respect
• Talk to the Lifeskills Plus Inc. if they have any concerns about the service being provided.
• Give the Lifeskills Plus two weeks’ notice if they need to end the financial intermediary agreement.
• Let the Lifeskills Plus know immediately if client’s NDIS plan is suspended or replaced by a new NDIS Plan or client stops being a client in the NDIS

Ending this Plan Management Agreement

Should either party wish to end this financial intermediary Agreement they must give two weeks’ notice email or written unless the reason for ending the agreement is a result of a serious breach as outlined below:

Serious breach by client

• Refuses or fails to comply with any lawful request made by Lifeskills Plus Inc. or
• Failure to provide necessary information to enable Lifeskills Plus to perform their Financial Intermediary duties

Serious breach by Lifeskills Plus Inc.

• Is unable to perform the essential elements of the financial intermediary supports
• Making decisions that are not in client’s financial best interests

If there is an emergency or disaster, Lifeskills Plus Inc. will endeavour to continue to provide service where it is safe to do so. The type of service which can be safely provided will be determined on a case by case basis. If Lifeskills Plus Inc is unable to provide service you will be notified as soon as possible. No charge will be incurred by the client for services missed.

Feedback, Complaints and Disputes

Lifeskills Plus welcomes information and feedback from all individuals, their family, friends and other stakeholders as this assist the organisation to improve the quality of service delivery.

If you wish to give Lifeskills Plus Inc. some feedback you can make contact with the Service Coordinator by phone on 02 6372 6440, write to Lifeskills Plus Inc. PO Box 710, Mudgee NSW 2850 or email [email protected].

Lifeskills Plus Inc. is committed to resolving complaints fairly, equitably and as quickly as possible. If a client, nominee, family member, friend, staff or carer, is dissatisfied or has an issue or concern they would like to raise with the service a member of our management team will listen and try to resolve the problem.

The complaint can be made face to face, by phone, fax, letter or email and will be treated with equal importance. Lifeskills Plus Inc. will provide any support necessary to assist the complainant with making the complaint. The complaint will remain confidential and information will only be available to those who are involved in resolving the complaint.

Complainants will not be disadvantaged or be prevented from continuing to receive supports as a result of making a complaint.

The Complainant may at any point in the complaints process contact the:

• LSP CEO 02 6372 6440 or [email protected]
• Chairperson - LSP Board of Directors 02 63272 6440

If the complaint/dispute remains unresolved, you are not happy with the outcomes of Lifeskills Plus Inc.’s Complaints process you can utilize external providers who can assist you with the complaints process if you prefer.

• National Disability Insurance Agency 1800 800110
• NDIS Quality and Safeguards Commission 1800 035 544 website: www.ndiscommission.gov.au
• National Disability Abuse and Neglect Hotline 1800 880 052 [email protected] website www.disabilityhotline.net.au
• Intellectual Disability Rights Service 0249265643 [email protected] website www.idrs.org.au
• NSW Council for Intellectually Disabled 1800424065 [email protected] website www.nswcid.org.au

Goods and Service Tax (GST)

For the purposes of GST legislation, the Parties confirm that:

• the supports described in this Service Agreement are reasonable and necessary
• supports specified in the statement of supports in the Client’s NDIS plan is expected to remain in effect during the period the supports are provided.

Entire Agreement

This agreement sets out all of the terms of your Financial Intermediary Agreement with Lifeskills Plus Inc. This agreement supersedes and replaces all prior representations, contracts and agreements (whether oral or in writing) detailing your Financial Intermediary Agreement with Lifeskills Plus Inc.

If there are any other matters that you have relied on in your discussions with any representatives of Lifeskills Plus Inc. or other communications to date or there are any other matters you wish to discuss, please let Lifeskills Plus Inc. know before you sign this agreement.

Lifeskills Plus Inc.’s representative may then consider them and discuss them with you. If you agree, the terms set out in the agreement will be amended, to ensure that it contains all the agreed terms. Once you sign this agreement, you are confirming it is complete and no agreed terms are missing.

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Document name: Lifeskills Plus Plan Management Agreement

Unique Document ID: 22e7c84c61fedd9e2631c7a4f6f3eb32414fa0d1

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Timestamp	Audit
May 17, 2022 4:11 pm AEST	Lifeskills Plus Plan Management Agreement Uploaded by Owen Rogers - [email protected] IP 115.64.53.202

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https://lifeskillsplus.com.au/

Audit Trail Serial# 095a2fa3b2016aec98c4c5dc55d5b4f8