NDIS scrutiny for STA claims: what you need to know

August 21, 2024myAutonomy NDIS

You may be aware that funding for short-term accommodation (STA) through the NDIS has changed significantly over the past few years.

What was previously known as respite is much more limited than it used to be.

Recently, we’ve been seeing even more NDIS scrutiny for STA claims. Here’s what you need to know before you attempt to make a claim.

Changes to STA claims

Since March 2024, we’ve seen changes to NDIS funding for STA. These changes include:

Payment delays from the NDIS for STA claims

Claims being reviewed or even refused in some cases

Requests for additional information from the NDIS

More requests are being viewed as ‘holidays’ rather than STA claims

This more stringent approach to STA is important for participants and their families to understand.

Claims you make will likely require detailed information to ensure that your request is considered STA by the NDIS. If not, you might have your funding denied, which could leave you out of pocket or owing money to a provider who has already completed services on your behalf.

It’s important to note the NDIA Compliance Review Team has total control over the rejection of claims and there’s no right of appeal. If they decline payment there is no way to reverse their decision. Their reviews are always after services have been provided, so even if you have checked beforehand claims can be denied.

What is considered STA?

To give a participant’s usual carers a break and provide new opportunities for participants, the NDIS provides some funding provision for STA. However, that funding is only available in limited circumstances.

To be covered by the NDIS and considered STA, all of the following must be provided during the stay (as part of a bundled rate), for a participant:

personal care

accommodation

food

activities

transport

STA is usually offered in a 24-hour group setting and only offered individually in limited circumstances.

Like all supports, STA must also be considered reasonable and necessary by the NDIS and align with a goal in the participant’s plan.

It’s important to keep in mind that STA is different to taking a holiday or going on a trip.

STA: what it is and what it isn’t

If you’re not sure what qualifies, considering these examples can help.

Example one: A participant stays in a group home facility for a week that offers 24-hour care, meals, accommodation, and group activities.

This could be considered STA if all criteria are met.

Example two: A participant stays in a hotel for a long weekend––they do not require a support worker, meals or activities.

This would not be considered STA.

Know before you go

Before making a booking, it’s helpful to check in with your Support Coordinator or Local Area Coordinator to help clarify whether your plans align with the provision for STA.

That way you can reduce the chances of difficulties with invoices or claims being rejected down the line by the NDIA Compliance Review Team.

At myAutonomy, we’re only too happy to provide guidance to help you make the most of your funding and avoid any nasty surprises.

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