Client incident management system (CIMS) information technology intention
Department of Families, Fairness and Housing

Please complete this compulsory survey as soon as possible to facilitate the onboarding process

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* 1. Are you an NDIS Service provider?

Yes

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* 2. Are the supports and services you provide funded solely by the NDIS?

Yes
Do not continue with survey. Your organisation is not in scope to report incidents in CIMS. From 1 July 2019, incidents which occur in connection with NDIS supports and services are to be reported to the NDIS Quality and Safeguards Commission. Further information is available at https://www.ndiscommission.gov.au/providers.

No
Please proceed with survey.

Not applicable.
Please proceed with survey.

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* 3. Name of your organisation as specified in your service agreement

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* 4. Is your organisation currently Ebusiness registered?

Yes

Unsure

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* 5. Contact details of the person completing this survey

Your full name

Your role title

Your email address

Your phone number

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* 6. What technology solution is your organisation intending to use to support the CIMS policy?

The department's CIMS IT solution (client incident register)

Our own incident management system and integrate via the CIMS Application Program Interface (API)
NOTE: You may need to use the department's CIMS IT solution in the interim, if your system isn't immediately combatable for integration via the API.

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* 7. How does your organisation currently store records of client incidents?
(please select all that apply)

Electronically via incident management system

Excel spreadsheets, Access database etc

Paper Files

Other (please specify)

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* 8. If you intend to use your own incident management system in the future, provide the details of the incident management system that you intend to use.

Name of the incident management system

Name of organisation that supports the incident management system (for example, internal IT department or name of a third party vendor)

Full name of your primary contact from the organisation that supports the incident management system

Email address of your primary contact from the organisation that supports your incident management system

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* 9. If your organisation intends to use your own incident management system and integrate via the CIMS Application Program Interface (API), has your organisation commenced making changes to IT systems to accommodate the CIMS policy?

Yes - we have completed or near completed the required changes

Yes - we have made some progress in making the required changes

No - we have not made any progress in making the required changes

No - we have an incident management system but our IT vendor has advised us that they will not be making changes at this point in time.

No - we didn't know that we needed to make changes

No - we intend to use our own incident management system but have not made a decision about the system that we will use

Other (please specify)

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* 10. How many staff in your organisation are involved in the approval of client incidents?
(Note: This does not include staff involved in the identification and reporting of client incidents.)

0-5

6-10

11-20

21-30

31-50

50+

Question Title

* 1. Are you an NDIS Service provider?

Question Title

* 2. Are the supports and services you provide funded solely by the NDIS?

Question Title

* 3. Name of your organisation as specified in your service agreement

Question Title

* 4. Is your organisation currently Ebusiness registered?﻿

Question Title

* 5. Contact details of the person completing this survey

Question Title

* 6. What technology solution is your organisation intending to use to support the CIMS policy?

Question Title

* 7. How does your organisation currently store records of client incidents? (please select all that apply)

Question Title

* 8. If you intend to use your own incident management system in the future, provide the details of the incident management system that you intend to use.

Question Title

* 9. If your organisation intends to use your own incident management system and integrate via the CIMS Application Program Interface (API), has your organisation commenced making changes to IT systems to accommodate the CIMS policy?

Question Title

* 10. How many staff in your organisation are involved in the approval of client incidents?(Note: This does not include staff involved in the identification and reporting of client incidents.)

* 4. Is your organisation currently Ebusiness registered?

* 7. How does your organisation currently store records of client incidents?
(please select all that apply)

* 10. How many staff in your organisation are involved in the approval of client incidents?
(Note: This does not include staff involved in the identification and reporting of client incidents.)