Before you switch providers, read the new NDIS high-intensity service agreement for six things. It should name each support task exactly. It should explain how workers are trained and signed off for your family member specifically, and give the support item and rate. It should set out cancellation terms, emergency arrangements, and how either side can change or end the agreement. If any of these is vague, ask for it in writing before you sign.
Families often treat the agreement as paperwork to get through on the way to the real work of care. We read it the other way. For someone who needs enteral feeding, complex bowel care or seizure monitoring, the agreement is the only place where the provider’s promises get written down and can be checked. It’s also the first thing you’ll go back to if something goes wrong. Switching providers is a good moment to read one properly, because you can compare it against the agreement you’re leaving and see what has improved and what hasn’t.
Why high-intensity agreements need closer reading
Every registered provider has to have a written service agreement. The NDIS Practice Standards describe it as an agreement between the provider and the participant about the supports to be delivered and the conditions attached to them. The provider and participant are expected to work it out together, explain every condition and why it exists, in a way the participant can understand. Both parties sign, and the participant keeps a copy.
That baseline applies to everyone. High Intensity Daily Personal Activities (HIDPA) sit on top of it, with additional requirements for providers who deliver them.
The Commission’s skills descriptors cover a defined set of tasks:
- complex bowel care
- enteral (PEG) feeding
- severe dysphagia management
- tracheostomy management
- urinary catheter management
- ventilator management
- subcutaneous injections
- complex wound management
Here’s what that means in practice. A provider might be registered and still not be registered for the particular high-intensity support your family member needs. A generic agreement can’t show you that. A well-written high-intensity agreement can.
HIDPA work doesn’t have to be done by a nurse either. The skills descriptors describe what competent support workers (people who aren’t health or allied health practitioners) are expected to know, and those workers are trained and assessed as competent for the individual participant. So the questions that matter most are who trains the workers, who signs them off, and whether that sign-off covers your family member’s own procedures.
The clauses to check in an NDIS high-intensity service agreement
Go through these one at a time, with your current agreement next to the new one.
The supports, named precisely
“Personal care, 24 hours” is not a description of high-intensity support. The agreement should name each HIDPA task, such as enteral feeding via PEG, complex wound management or seizure monitoring, and say what outcome the support works towards. The best agreements also refer to a participant-specific support plan or procedure, written with input from the participant’s treating doctor, nurse or allied health team, and attach it or name it.
Precise naming protects both sides. It shows the provider has thought about what the work involves, and it gives you something concrete to point to if a shift is staffed by someone who hasn’t been trained for it.
Competency and sign-off for this person
This is the clause families most often skip and later wish they hadn’t. The agreement should describe the worker competency sign-off process for this participant’s supports, including who assesses them. A registered nurse, a clinical lead, or another qualified person are all possibilities. It should also say what happens when a worker who hasn’t been signed off is the only one available.
Look for a commitment that untrained staff won’t deliver high-intensity tasks. Also look for a plan for keeping enough trained workers on the roster to cover leave, illness and turnover. Ask how many workers will be trained for your family member before the first shift. One trained worker is a single point of failure.
An agreement that can’t tell you who signed off the worker standing beside your family member’s feeding pump isn’t finished yet.
Price, support items and rate changes
The agreement should list the NDIS support item numbers, the rate for each, and how different times of day, weekends and public holidays are charged. NDIA pricing documents are updated regularly, so if your current agreement refers to an outdated version, that isn’t a breach. It’s a sign nobody has reviewed the agreement recently.
Check two more things. First, the agreement should say plainly that rates for an existing participant change only after a conversation and a written update you agree to. Second, if the agreement mentions travel charges, it should explain how they’re calculated. Neither of these should come as a surprise on an invoice.
Plan management type matters too. Agency-managed participants must use registered providers. Plan-managed and self-managed participants can use unregistered providers within price limits. For high-intensity work, we think registration is the right default whatever your plan type, because registration is the thing that brings the HIDPA module and its audit requirements with it.
Cancellations and short notice
Families care about this clause more than almost any other, and with good reason. A participant with complex health needs can become unwell overnight, and an unexpected hospital admission can wipe out a week of planned shifts.
NDIS short-notice cancellation rules are set nationally and have changed over time, so don’t rely on what a previous provider told you. The agreement should state the current rule from the 2026-27 Pricing Schedule in plain words: what counts as short notice, what can be charged, and how to cancel (by phone, text, email or app). Ask the provider to show you where their cancellation clause comes from. A good provider will happily do this. If the clause is harsher than the NDIA rule, or doesn’t explain what happens during a hospital stay, raise it before you sign.
Review, changes and ending the agreement
The NDIA expects a service agreement to cover how long it lasts, how it’s reviewed, what each party is responsible for, how complaints are handled, and how either side can change or end it. For high-intensity support, ask for a review whenever the participant’s health changes, plus a scheduled review at a set point such as every 12 months or at each plan reassessment.
The complaints clause deserves more than a passing line, given the risks involved in enteral feeding, tracheostomy and ventilator care. It should explain how to raise a complaint with the provider, who handles it and how quickly, and confirm your right to complain directly to the NDIS Quality and Safeguards Commission. It should also say how the provider records incidents involving high-intensity supports, such as a dislodged PEG tube or a missed suction, and how and when your family will be told.
Read the exit clause especially carefully when you’re switching. It tells you the notice you owe your current provider, and the notice your new provider would owe you. A short notice period with no handover commitment on the provider’s side is a weakness for families relying on 1:1 or 24-hour support.
What good looks like, clause by clause
Use this table as a side-by-side checklist when comparing your current and new high-intensity agreements. Print it out or take it to your meeting with the new provider, and tick off each clause as you go.
| Clause | What a strong agreement says | Red flag |
|---|---|---|
| Supports | Names each HIDPA task and links it to a participant-specific plan | “Personal care” or “daily living” with no detail |
| Competency | Explains who assesses workers and that sign-off is specific to this participant | No mention of training, or “all staff are qualified” |
| Registration | HIDPA supports match the provider’s certificate of registration | Provider can’t say which high-intensity supports they’re registered for |
| Pricing | Item numbers, rates, time-of-day loadings, travel method, consent before any change | Rates “subject to change” with no conversation required |
| Cancellation | Current NDIA rule in plain English, including hospital admissions | Terms stricter than national rules, or silent on hospital stays |
| Complaints/incidents | How to complain to the provider, the right to go to the NDIS Commission, and how incidents are recorded and reported to the family | No complaints process, or nothing on telling families about incidents |
| Emergencies | Cyclone, flood and evacuation arrangements, and backup staffing | Nothing beyond “call 000” |
| Exit | Clear notice periods and a handover commitment from both sides | Long lock-in for you, short notice for them |
Clauses that city templates leave out in Far North Queensland
Most service agreement templates are written in a capital city. In Cairns, Townsville and the wider Far North, the gaps show up at the worst possible times.
Emergency and disaster planning is the biggest one. Up here that means the wet season. Ask what happens when a cyclone warning is issued, when roads to the home flood, or when the power goes out and a feeding pump, suction unit or air mattress needs a backup. Who stays with the participant if the regular worker can’t get there? How is medication and equipment carried in an evacuation? These answers belong in writing, not in a phone call you have to remember.
Travel and distance come next. For families outside Cairns city, travel time and kilometres can add up to a large share of plan spending, and some parts of Far North Queensland attract remote loadings under NDIA pricing. Ask whether the agreement uses the right location classification for the home address and how travel is charged.
Hospital coordination is the third. Participants with complex needs may see specialists in Cairns or travel to Brisbane. The agreement, or the support plan it refers to, should say whether workers attend appointments or hospital stays, how information is handed over to clinical staff, and how this is billed.
Switching providers without a gap in care
The riskiest point in any change of provider is the handover. A participant who relies on trained workers for feeding, catheter care or seizure monitoring can’t go a weekend without them while paperwork catches up. Our firm advice is to sign nothing with the new provider until competency training is booked, and not to give notice to the current provider until that training has dates.
A sensible order looks like this:
- Talk to your support coordinator about timing, plan budget and whether service bookings need adjusting.
- Ask the new provider for a draft agreement and its participant-specific support plan, and check them against the table above.
- Arrange for the new team to meet the participant, review existing procedures, and complete training and sign-off with the relevant health professionals.
- Agree an overlap period where possible, so new workers can shadow before they work on their own.
- Give notice to your current provider under the exit clause, and ask for a written handover of routines, preferences and recent health changes.
- Book a review with the new provider four to six weeks after the start, while it’s still easy to adjust things.
If something about the agreement involves plan management, guardianship or a dispute with your current provider, get advice from your plan manager, support coordinator, an independent advocate or the NDIS Quality and Safeguards Commission. Those are their areas of expertise, and having an independent view protects the participant.
Why we read agreements the way families do
Advanced Disability Management was started in Cairns in 2018 by parents who cared for their own child with Sanfilippo Syndrome. They know what it’s like to hand over a high-needs routine to someone new and wonder whether the person reading the care plan really understands it. That’s why our agreements name each support, link to participant-specific procedures, and describe our competency process openly.
We’re a registered NDIS provider. Our high-intensity personal care, including PEG feeding, wound management and seizure monitoring, is delivered by trained workers under registered nurse oversight. We run regular training workshops for each client and work alongside occupational therapists, physiotherapists, speech pathologists, dietitians and psychologists. Our team includes carers from a range of cultural backgrounds, including Pacific Island communities, and families tend to notice the difference that consistent training, experience and individual commitment make. A good agreement doesn’t replace that kind of relationship, but it makes the relationship easier to trust and to hold to account.
If you’re thinking about switching and want someone to read through a high-intensity agreement with you, call us on 0425 168 053, email [email protected], or use the contact page on our website. We’re happy to talk through your family member’s needs, with no pressure and no obligation.
Can I ask a provider to change their standard service agreement template?
Yes. The Practice Standards expect providers to develop service agreements together with participants, so a template is a starting point and not a final offer. You can ask for clauses to be reworded, add detail about specific supports, or attach a participant-specific procedure. If a provider refuses any changes at all, take that as useful information about how flexible they are likely to be later on.
Does my family member need to sign the agreement themselves?
The agreement is between the provider and the participant. Where a participant has a nominee, guardian or other authorised decision-maker, that person may sign on their behalf, depending on the legal arrangements in place. Even then, the agreement should be explained to the participant in a way they can understand. If you’re unsure who has authority to sign, check with your support coordinator or a guardianship body.
What if the new provider is only registered for some of the high-intensity supports we need?
Ask which supports they can deliver and which they can’t, then talk with your support coordinator about whether those other supports can be arranged with a second registered provider. When two providers share care, both agreements should say clearly who is responsible for each task and how the teams share information, so nothing falls between them.
Should allied health recommendations be included in the service agreement?
The service agreement usually refers to a separate support plan instead of listing clinical detail itself. Recommendations from a speech pathologist, dietitian, physiotherapist or other treating professional belong in that plan and in any participant-specific procedures. What you should check is that the agreement commits the provider to following those plans and updating training whenever recommendations change.
