NDISF 012.

01
SIL Service Agreement Template

The following is a Service Agreement for Supported Independent Living under the
National Disability Insurance Scheme or Continuity of Support Program.1

Agreement Details
Parties: This is an agreement between the following parties

Participant’s Name Service Provider’s Name

ACN / ABN

Length of this Service Agreement: Minimum Duration

Agreed Start Date Agreed End Date

The NDIS and this Service Agreement

NDIS
This Service Agreement is to provide supports funded by: COS
Other (specify):
Attach a copy of my NDIS or COS Plan to this document as Attachment 5

Your Living Arrangements

Address

Accommodation Provider
Date of Accommodation
Agreement
Your Supports and Board: See Attachment 1

I understand the supports I will receive.

I give consent for the Provider (or staff) to enter my room to provide supports
I give consent for the Provider (or staff) to use other areas of the dwelling to provide
supports where necessary and appropriate.
I want to receive Board. I do not want to receive Board.

Responsibilities:

I understand the Provider’s responsibilities

I understand my responsibilities

Conflict of Interests:
The Service Provider has no relationship

1
Note: Parties to this agreement should seek legal advice as required in respect of the terms
contained in this Agreement. Parties should also refer to the NDIS Terms of Business (including
any updates) at the time of signing this Agreement and other operational rules from time to time.
 Accommodation Provider and Service Provider are
the same
the following relationship Accommodation Provider and Service Provider have
with the Accommodation the same management
Provider who is managing
Accommodation Provider and Service Provider are
the property
part of a joint venture

Other relationship (give details):

I understand and am comfortable with this relationship

House Rules

I understand how the House Rules will be created and agree to the process.

Payments

I understand how my Support Payments are calculated and I agree.

I understand how my Board Payments are calculated and I agree (if applicable).

I understand how my Transport Costs are calculated and I agree.

My agreed contribution to Transport Costs is:

I understand that there are ‘additional’ and ‘personal’ expenses that will not be
covered by Support Payments or Board Payments and I agree.
Changing / Ending this Service Agreement
I understand how changes can be made to this Service Agreement, and how it can
be ended, and I agree.
Record Keeping – Privacy – Feedback and Complaints
I understand how records of my supports will be kept, and my right to see those
records.
I understand the Service Provider’s Privacy Policy. The provider must follow the law
when collecting, storing and sharing my information.
I understand that I can provide feedback or make a complaint at any time by using
the contact details below, or by talking to a staff member, or by contacting the Service
Provider. I can also make complaints to the NDIS Commission. I have received a copy
of the Service Provider’s Complaints Policy.
Goods and services tax (GST)
I understand which supports include a charge for GST, and that I must notify the
Service Provider if my NDIS Plan is replaced by a new plan or I stop being a participant
in the NDIS.

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Contact Details: NDIS Participant
Please contact my representative. Their name is:
Phone: B/H Phone: A/H Mobile

Email
Address
Contact Details: Service Provider
Name
Phone: B/H Phone: A/H Mobile

Email
Address
Contact Details: Accommodation Provider
Name
Phone: B/H Phone: A/H Mobile

Email
Address
Contact Details: NDIS Commissioner (Complaints)
Phone: Phone: TTY Web: Complaint form
1800 035 544 133 677 www.ndiscommission.gov.au
Cost
Total weekly costs for services (or see Attachment 1)
Agreement Signatures
The Parties agree to the terms and conditions of this Service Agreement.
Participant (or representative) Name

Signature Date

Service Provider Representative Name

Signature Date

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Parties
This Service Agreement is for you (named above), a participant in the National Disability
Insurance Scheme.
The Agreement is made between you and the Service Provider (named above).

Length of this Service Agreement

This Service Agreement will start on Agreed Start Date (see Agreement Details, above) and
continue until the Agreed End Date unless you or the Service Provider ends the
Agreement earlier (see ‘Ending this Agreement’).
This Agreement will terminate automatically if:
 the Service Provider is de-registered by the NDIA; or
 the Accommodation Provider has terminated the Accommodation and Service
Provider Agreement and the Service Provider can no longer access the property;
or
 the Accommodation Agreement between yourself and the Accommodation
Provider is terminated for whatever reason.

The NDIS and this Service Agreement

This Service Agreement is made for the purpose of providing supports under your
National Disability Insurance Scheme (NDIS) plan or your Continuity of Support (COS)
plan.
A copy of your NDIS plan or COS plan or equivalent can be attached to this Service
Agreement.
The Parties agree that this Service Agreement is made in the context of the NDIS or COS,
which are schemes that aim to:
 support the independence and 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.
If, from time to time, the provisions within this Service Agreement differ from any
requirements specified by the NDIA in respect of supports or the Service Provider, the
Service Provider agrees that it will satisfy, as a minimum, all such requirements set by
the NDIA.

Your Living Arrangements

You have signed an Accommodation Agreement with the Accommodation Provider to live
at the address listed in the Agreement Details (above).

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Page 5 of 19
Your Supports and Board
The Service Provider agrees to provide you with Supported Independent Living services or
COS services while you are living at your address. These are the “supports”. The supports
are listed in Attachment 1, along with any arrangements needed to make sure the
supports can be provided to you.
A general guide on the supports your Service Provider may provide and how you might
pay for these are shown in Attachment 2.
The Service Provider can also provide you with Board. If you agree, the activities and
items included in Board, which are paid for out of your Board payment, are also listed in
Attachment 1.
The Service Provider may need to access your room at any time to provide the supports
to you. Your Accommodation Provider has given the Service Provider the right to use the
shared areas in your home and the office (if there is an office in your home). To receive
those supports, you must provide your consent (in the Agreement Details).

Responsibilities of Service Provider

The Service Provider agrees to:
 treat you with courtesy and respect;
 include you in discussions about how your supports are provided;
 review your supports with you at least once a year;
 communicate openly and honestly in a timely manner;
 give you information about managing any complaints or disagreements;
 listen to your feedback and resolve problems quickly;
 write to you and/or your representative within five (5) business days if the contact
details shown in this Agreement change;
 give you the required notice if the Service Provider needs to end the Service
Agreement (see ‘Ending this Service Agreement’ below for more information);
 protect your privacy and confidential information;
 provide supports in a way that complies with all relevant laws, including the
National Disability Insurance Scheme Act 2013 and rules, and the Australian
Consumer Law;
 comply with all professional standards, quality requirements and codes of conduct;
 keep accurate records of the supports provided to you and provide these at your
request;
 issue invoices and statements of the supports delivered to you as required under
relevant consumer laws and if requested by you;
 account for all expenses covered by the Board Payments monthly and annually
and provide the statement to you if requested;
 temporarily reduce Board whilst you are on holidays or other planned absences;
 will assist you to contact the NDIA or Support Coordinator (or Department of
Health) when asked to by you;
 will assist you to attend a hearing or other NDIS or government complaint body
where you are making a complaint about the Accommodation Provider;

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  will assist you, should you wish to move out of the home, to find alternative
accommodation;
 have all necessary insurances to provide you with supports; and
 take all necessary steps to fulfill its obligations to workers and other people in the
home under the Workplace Health and Safety legislation.

Your Responsibilities
You agree to:
 inform the Service Provider about how you wish the supports to be delivered to
meet your needs;
 treat the Service Provider with courtesy and respect;
 make the payments required for the supports;
 talk to the Service Provider if you have any concerns about the supports being
provided;
 notify the Service Provider if you are planning any holidays or other absences;
 give the Service Provider the required notice if you need to end the Service
Agreement (see ‘Ending this Service Agreement’ below for more information); and
 let the Service Provider know immediately if your NDIS plan is suspended or
replaced by a new NDIS plan or you stop being a participant in the NDIS.

Conflict of Interest and Relationships

The Service Provider is required to have an agreement in place with the Accommodation
Provider who is managing the property. In some instances there may be a relationship
between the two providers which means they are not completely independent. You need
to be comfortable with the relationship between the Service Provider and the
Accommodation Provider before you sign this Agreement.
The relationship between the Service Provider and the Accommodation Provider is
recorded in the Agreement Details (above).

House Rules
The Service Provider must assist you and the other occupants of the property to prepare
and agree House Rules within the first 3 months of this Service Agreement.
The House Rules should cover the issues that are important to you about living at the
property, and a template has been provided in Attachment 4. You can use these headings
or change the document to suit you.
The House Rules should say how you will make important decisions about your supports
and the way you behave in your home. Your NDIS Support Planner may be able to give
you more information about these types of decisions.
The Service Provider must ensure that the House Rules (and any changes to the House
Rules) are consistent with any other house or building rules which the Accommodation

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Provider must comply with, including the building rules under the lease.
You agree that no House Rules (or changes to the House Rules) will be proposed or
considered unless such rules are consistent with any other house or building rules which
the Accommodation Provider must comply with.
The Service Provider will keep a copy of the House Rules and will also give a copy to the
Accommodation Provider. The Service Provider and Participants who live in the House will
review and update the House Rules once a year.

Payments
Support Payment
The Service Provider will seek payment of the Supported Independent Living payment
from the NDIA in accordance with the relevant NDIS rules, guidelines and terms of
business, or the Service Provider will seek payment for COS from the Commonwealth
Department of Health

Board Payment
If the Service Provider will not be providing you with Board under this Service Agreement,
then you will not be required to pay Board Payments. If the Service Provider will be
providing you with Board under this Service Agreement, then the following paragraphs in
respect of Board Payments will apply.
You agree to pay a Board Payment to the Service Provider to cover daily household living
expenses. The Board Payment will typically be 50% of the base rate of the Disability
Support Pension that would apply to you assuming you are eligible to receive the
Disability Support Pension, plus the energy supplement.
Because your Board Payment is a percentage, it will change when the amount of either
the Disability Support Pension and/or energy supplement change. You agree to pay the
increase when notified by the Service Provider who will let you know at least 28 days
before the increase occurs.
If you are not eligible for either a Disability Support Pension or Commonwealth Rental
Assistance then your Board Payment will be calculated as 50% of the base rate of the
Disability Support Pension applicable for your circumstances.
Board Payments will cover food, utilities and living expenses. A general guide on Board
and contributions which you may be asked to pay are shown in Attachment 2.
The Board Payment will be made each fortnight by EFT to the Service Provider.

Written Receipts
The Service Provider must provide written receipts to you within two weeks of any
payment.

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Additional Expenses
Additional expenses (i.e. things that are not included as part of your NDIS supports) are
the responsibility of you or your representative and are not included in the cost of the
supports. Examples include entrance fees, event tickets, personal shopping etc. Other
examples of additional expenses are listed in the “Personal” expense table in Attachment
2.

Changes to this Service Agreement

If changes to the supports or their delivery are required, you (and/or your representative)
and the Service Provider agree to discuss and review this Service Agreement. The Parties
agree that any changes to this Service Agreement will be in writing, signed, and dated by
the Parties.

Ending this Service Agreement

The minimum duration and Agreed End Date of this Service Agreement is recorded in the
Agreement Details (above).

How you (or your representative) may end this Service Agreement
After the Agreed End Date of this Service Agreement, you may end this Service Agreement
at any time on 14 days notice if you choose to leave the accommodation.

Ending this Service Agreement prior to its Agreed End Date

The Service Provider may not terminate this Service Agreement prior to its Agreed End
Date, except if one of the following occurs:
a. You carry out an illegal activity within the home;
b. You have not paid the Service Payment or the Board Payment and do not pay
these amounts within 14 days of receiving an overdue notice;
c. You cease to be a Participant in the NDIS or COS;
d. The Accommodation Provider terminates your access to the home; or
e. The Service Provider is unable to support you to remain at the Property without
serious risk of harm to yourself, other residents or staff in the home or a breach of
the Service Provider's workplace health and safety obligations.
If the Service Provider deems it necessary to end this Service Agreement prior to Agree
End Date because of any of the reasons above, then the Service Provider will immediately
request that the NDIA determine appropriate reasonable and necessary support to assist
resolution. If the NDIA determines that it is not appropriate for you to remain at the
property, the Service Provider will work with the NDIA to find you alternative
accommodation and will end this Service Agreement by providing notice.

Ending this Service Agreement

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After the Agreed End Date of this Service Agreement, the Service Provider may end this
Service Agreement by providing you with the appropriate notice period specified by the
NDIS (which is currently 90 days minimum notice). However, the Service Provider may
end this Service Agreement with less notice if:
a. You carry out an illegal activity within the home;
b. You have not paid the Service Payment or the Board Payment and do not pay
these amounts within 14 days of receiving an overdue notice;
c. You cease to be a Participant in the NDIS or COS;
d. The Accommodation Provider terminates your access to the home; or
e. the Service Provider is unable to support you to remain at the Property without
serious risk of harm to yourself, other residents or staff in the home or a breach of
Service Provider’s workplace health and safety obligations.
Regardless of the reason for ending this Service Agreement, the Service Provider will
immediately notify the NDIA and will work with the NDIA to find you alternative
accommodation and/or alternative daily living supports.

Continuity of Supports
Before giving notice to end this Service Agreement for any reason, the Service Provider
will arrange a meeting with you, your representative (if you have one), the Accommodation
Provider, an NDIS Support Coordinator or COS Support Coordinator and other relevant
support staff to consider whether you require additional supports to enable you to remain
at the property or whether the Service Provider can support you in a different home.
If approved corrective action or additional reasonable and necessary supports have been
implemented to rectify the cause for proposing to end this Service Agreement, then the
Service Provider will allow sufficient time to monitor that the cause no longer applies and
agrees not to end this Service Agreement if the Service Provider is satisfied that the cause
no longer applies.

Record Keeping
The Service Provider agrees to keep full and accurate accounts and financial records of
the supports delivered to you, along with records of service agreements, household
expenses and any complaints which they have received for five years from the date each
record is received.
The Service Provider confirms that the way they hold these records complies with the
NDIS Terms of Business or equivalent for COS, all relevant statutes, regulations, by-laws
and requirements of any Commonwealth, State, Territory or Local Authority.
If you would like to view the records held by the Service Provider, contact them using the
contact details listed in the Agreement Details section.
The Service Provider will provide you access to view the records they hold within five (5)
business days of your request, unless to do so could or would breach the law.

Privacy
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The Service Provider agrees to comply with all relevant Privacy Laws in the way it holds,
uses and shares your personal and health information (including your NDIS plan).
The Service Provider may ask that you sign a written consent which allows the Service
Provider to share your personal and health information with the Accommodation Provider
or another person/entity.
You do not have to sign this consent form. And if you do sign, you can always withdraw
your consent later on.
If you do not provide your consent to share your personal and health information, it does
not mean that the Service Provider can’t share your personal and health information, but
without your consent, they must comply with the relevant Privacy Laws before they share
your information.

Feedback, complaints and disputes

The Service Provider will give you a copy of their Complaints Policy at the time you sign
this Service Agreement.
If you wish to give the Service Provider feedback, you can talk to any staff member or
contact the provider using the contact details supplied.
Attachment 3 to this Agreement provides more information on who to complain to for
different types of problems.
If you have a NDIS plan and you are not satisfied or do not want to talk to the Service
Provider’s contact person, you can contact the National Disability Insurance Agency:
Free call: 1800 035 544
Web: www.ndiscommission.gov.au

If you have a COS plan and you are not satisfied or do not want to talk to the Service
Provider’s contact person, you can contact the Commonwealth Department of Health:
Free call: 1800 020 103
National Relay: 1300 555 727
Web: http://www.health.gov.au/enquiries

Goods and services tax (GST)

If you receive supports as detailed in an NDIS plan, 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 your NDIS plan currently in effect under section 37 of the NDIS Act;
 your NDIS plan is expected to remain in effect during the period the supports are

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 provided; and
 you or your representative will immediately notify the Service Provider if your NDIS
Plan is replaced by a new plan or you stop being a participant in the NDIS.
If you receive supports as detailed in a COS plan, for the purposes of GST legislation,
these may or may not be GST free. The Service Provider agrees to let you know which
supports will include a charge for GST.

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Attachment 1: Details of Supports

Supported Independent Living services or Continuity of Support services:

Add lines as required

Cost (where cost varies according to a formula, the formula is

stated in Attachment 2)

Board (includes):

Add lines as required

Cost (where cost varies according to a formula, the formula is

stated in Attachment 2)

Rent:

Notes:

Cost (where cost varies according to a formula, the formula is

stated in Attachment 2)

Total Weekly Cost

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Attachment 2: Participant’s and Household’s Expenses
Rent

Rent (if leased premises) Shared area furniture (lounge suite, dining
setting, TV, Stereo) Whitegoods
Window coverings
What contribution Connection charges for Utilities/ Internet/Phone
will cover Initial kitchen/laundry set up (laundry basket, cookware, flatware, cutlery)
Repairs to building, furnishings, appliances
Council rates
Building insurances

Client contribution [Insert formula for calculating cost] 25% of pension, 100% rent assistance

Accommodation Provider: Utility connections are the responsibility of the

Collected and Accommodation Provider who cannot impose further charges to
managed by: participants to recoup the cost of providing these connections.

Board (day to day expenses for the household)

Groceries
Household cleaning items
Home help (subcontractors for garden and cleaning)
What contribution
Minor domestic purchases (additional kitchenware, flatware, cutlery)
will cover
Group mobility aids (eg wheelchair for occasional use)
Motor vehicle expenses (including lease fees, maintenance, fuel)
Usage charges for Utilities/Internet/ Phone

Client contribution [Insert formula for calculating cost] 50% of pension

Service Provider

(Monthly reconciliation must be provided to Participants on requested)

Collected and
managed by: Note: If the Participant only uses medically prescribed meal replacements,
then contribution should be reduced to exclude household food and
groceries. Contributions can be temporarily reduced for absences longer
than 1 week.

Personal Expenses

Toiletries Clothes Footwear

Pharmaceuticals / Medications Personal food/meal replacements Personal
appliances (e.g. iPod, radio, hair drier)
What contribution
Recreational and leisure activities, including cultural and sporting activities
will cover
Eating out or takeaway Travel, holidays, excursions Hobbies, Gifts
Linen Replacement/maintenance of personal furnishings (eg bed, mattress,
bedding, wardrobe, etc)

Client contribution [Client cost or insert formula for calculating cost]

Collected and Participant (reimbursed to Service Provider where necessary).

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 managed by:

Special Participant Equipment

What contribution Any necessary medical aids, eg specialist wheelchair, chair, shower chair,
will cover bed. These equipment are considered personal to the participant.

Client contribution Paid for by Health, NDIS or other government Program

Collected and
Support Plan Manager
managed by:

Note: where an office is supplied in a home, the Service Provider will not pay rent for the area
but will contribute to electricity, internet and water usage charges, equivalent to what one
resident will pay, e.g. if five resident occupy a group home, the Service Provider and each
resident will pay one sixth of the utility usage charge (that is the number of residents + Service
Provider equals the number of shares a utility charge will be split into).

Note: A participant may also be eligible for a daily living support payment (SIL Payment). This
payment may appear in a participant’s plan but be provided directly to the Service Provider.

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Attachment 3: Making Complaints
Problems How to complain and who to complain to

Furniture, blinds, curtains If it is dirty, ask the Service Provider

If it is broken, ask the Accommodation
Provider

My room, the garden, bathroom, shared If it is dirty, ask the Service Provider
areas
If something needs fixing in it, ask the
Accommodation Provider

Another participant Talk to your housemate about the problem or

ask the Service Provider to talk to your
housemate to fix the problem.
If this doesn’t work then talk to the
Accommodation Provider.

A support worker Tell the Service Provider what you don’t like
about what the worker has done. The
Service Provider must try to fix the problem
first.
If the problem doesn’t get better, then talk to
your Support Coordinator or housemates to
see if other people also think this is a
problem. You can also talk to the
Accommodation Provider to help solve the
problem. If it is really bad, you may be able
to change the Service Provider.
If all this doesn’t work and you need more
help to fix the problem, then call the NDIS or
Commonwealth Department of Health (if you
have a COS plan).

A worker who comes to repair something Tell the Accommodation Provider

Food Tell the Service Provider what you like to

eat. Speak to your housemates about what
they like to eat and see if you can change
the menu.

Too much noise Talk to the Service Provider first to see if

they can fix the problem.
If this doesn’t work then talk to the
Accommodation Provider.

Other problem Talk to the Service Provider or your Support

Coordinator first

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Page 17 of 19
To discuss a matter listed above with the Service Provider, use the contact details provided in
the Agreement details (above) or speak with a Service Provider worker.
To discuss a matter listed above with the Accommodation Provider, use the contact details
provided in the Agreement details (above).
If you need help in making a complaint and don’t want to ask your Service Provider worker or
Accommodation Provider, you can call your Support Coordinator or NDIS directly.

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Attachment 4: Sample House Rules
Introduction
House Rules are about the quiet use, enjoyment and management of shared housing.
Each house member must comply with these house rules.

General House Rules

1. No smoking is allowed inside. Smoking is only allowed in the marked off outside area.
2. No pets are allowed unless approved and agreed by the Accommodation Provider and
all other residents.
3. Parking of cars is only allowed in marked areas.

House Rules for Residents

1. Residents and their guests must not interfere with the peace, comfort and privacy of
other residents.
2. Residents must keep their rooms clean in a way that does not interfere with the comfort
of other residents and in a way that does not create a fire or health hazard or attract
vermin. The Service Provider will help residents to keep their rooms clean.
3. Residents must not intentionally or recklessly damage or destroy any part of their room
12
or of any common area or of any shared3 area.
4. Residents must make sure that their guests understand and follow these house rules.
5. Residents must not change or destroy a door lock for their room and for the main doors
of the home. They must not give the main door key to anyone who doesn’t live in the
house.
6. Residents agree to help with housework as described in the weekly roster.
7. If a resident is allowed to keep a pet, he/she must take responsibility for all care and
any disturbance that the animal makes. The Service Provider will help residents with the
care of the pet.

House Rules for Service Providers

1. The Service Provider will respect the right of the resident to privacy in their room or in
private areas.
2. The Accommodation Provider will make sure that the home (including the shared
areas), appliances and equipment are kept in good repair.
3. The Service Provider will make sure all rooms and shared areas are kept clean and
safe (for example by changing used light bulbs), notifying the accommodation provider of
all required repairs as needed.
2
Common areas are areas that are shared with other households, e.g. gardens that are shared with
co-located dwellings.
3
Shared areas are areas that are shared with other residents of the home, e.g. bathroom, toilet,
kitchen, lounge, dining room, corridors, patios, gardens.

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Changes to House Rules
House members and the service provider can suggest changes to house rules but each
change must be voted on and agreed to by at least two-thirds of all voters. The service
provider gets one vote.

Total voters Two-thirds

6 4
5 4
4 3
3 2
2 2

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Attachment 5: NDIS or COS Plan

19. INDIVIDUAL EMERGENCY AND DISASTER MANAGEMENT

PLAN
If an emergency or disaster occurs, organisation name will do the following:

 Contact you to advise of the emergency/ disaster

 Check on your immediate safety, and link you with immediate supports if needed

 Tell you if the emergency/ disaster may change the supports you receive

 Offer you alternative options for accessing support:

o Send a different worker if your usual worker is not able to come

o Change your in person appointment to a phone or video appointment

o Change the location of the appointment if the usual place has been affected

by the emergency/ disaster

o Change the time/ date of the appointment

 If you rely on organisation name for daily living needs, high intensity supports, or if

you live on your own and receive support from a sole worker only, organisation

name will make sure you continue to receive this support (tick below as

appropriate)

o Reliance on organisation name for daily living needs

o High intensity supports

o Lives alone and access support from sole worker

 Organisation name will ensure that all services you receive follow recommended

guidelines regarding infection control/ prevention, social distancing, and other

recommended emergency/ disaster management guidelines

 Organisation name will keep you updated on how the emergency/ disaster is

affecting services, and when we expect services to return to normal

 Other arrangements - please specify:

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