The National Disability Insurance Scheme (NDIS) provides support for people with permanent functional impairment as a result of their disability or mental health issue. It is a major reform in the disability sector, aiming to provide community inclusion and individualised support for people with permanent and significant disability. The NDIS provides people with a permanent and significant disability the option to have the 'reasonable and necessary' supports they need to enjoy a flourishing life.

The NDIS aims for people with disabilities and functional impairments to have the right support according to their needs and goals. Goals of the NDIS is to allow people with disabilities, their families and carers to:

  • Increase independence

  • Be supported to participate socially and economically

  • Provide individualised support

  • Fully participate in community life

  • Participate in learning & education

  • Participate in the workforce

  • Live Independently

  • Improve health and wellbeing 

  • Be enabled to fulfill their potential

  • Connect with disability and mainstream supports in the community

National Disability Insurance Scheme (NDIS)

National Disability Insurance Agency (NDIA)

The National Disability Insurance Agency (NDIA) is an independent statutory agency that aims to implement the National Disability Insurance Scheme (NDIS). The agency aims to build relationships with mainstream service providers and the local community to improve their understanding about how they can assist people with disability. The NDIA is the independent Commonwealth agency responsible for implementing the NDIS. The NDIA:

  • Empower and inform people with disability

  • Allow service providers to grow their businesses and respond to need

  • Provide information and referrals

  • Link people to services and activities, individualised plans and funded supports to participants

  • Raise community awareness about the NDIS

  • Encourage greater inclusion access for people with disability to mainstream services, community activities and other government initiatives.

Local Area Coordinators

Local Area Coordinators are people employed by the  NDIA to link people with disability to services they require and help other agencies organise to consider how people with disability can access their service. Local Area Coordinators:

 

  • Link people with disability to services, both mainstream and NDIS registered

  • Conduct first plans with participants and scheduled reviews

  • Help other organisations to consider how people with disability can access their services.

  • Provide information for mainstream services about how to make suitable adjustments to ensure their service or organisation is inclusive.

  • Assist participants to make contact and discuss their needs with appropriate health, housing and employment providers

  • Assist participants to make contact and discuss their needs with landlords

  • Assist participants to make contact and discuss their needs an

NDIS PLANS

An NDIS plan is the supports and funding that NDIS participants receive. An NDIS plan may include three support budgets depending on a participants support needs - core supports, capital and capacity building. The plan includes the supports NDIS will fund for participants and those supports which are responsible of the mainstream services. There are four ways to manage the plan funds:

  • Self-management: the participant pays for service providers with their NDIS funds and is responsible for communicating with providers, whether or whether they are NDIS registered. With self-managed plans, the participant can shop around for providers of their choice to get the best price. The participant must pay for the service up front with a back payment being received through the portal. Operating like a small business, a person who is self-managing their plan must keep a record of all transactions, keeping invoices and receipts to provide proof of payments.  

  • Financial Plan-management: a plan manager pays service providers with the participants NDIS funds. The participant signs a service agreement with a 3rd party and the financial manager makes transactions on behalf of a participant. Through a financial planner there is one central person controlling funds and the participant does not have to see NDIS agreed agencies as long as the provider has a valid ABN.

  • Agency-management: the NDIA pays service providers with a participants NDIS funds. This requires a service agreement between the participant to engage with any registered service provider. A participant can also switch to use other registered service providers if they want to.

Eligibility Criteria

There is an eligibility criteria to become a participant of the NDIS. To become an NDIS participant, a person must:

  • Have a permanent disability that significantly affects their ability to take part in everyday activitiex

  • Be aged less than 65 when they first enter the NDIS

  • Be an Australian citizen or hold a permanent visa or a Protected Special Category visa

  • Live in Australia where the NDIS is available

NDIS PRoviders

NDIS providers are individuals or organisations that deliver a support service or product to NDIS participants. The participant has the choice of which provider to purchase supports from.

General practitioners and other health professionals may be asked to provide evidence to support a request to access the NDIS. This involves completing the NDIS Supporting Evidence Form or sections of the access request form. They must document that the person has or is likely to have a permanent disability and provide copies of reports or assessments relevant to the diagnosis that outline the extent of the functional impact of the disability

Reasonable and Neccessary

The key component of the NDIS is 'reasonable and necessary' support. This is a determination of whether a participants desired support can be more appropriately funded by the NDIS or another mainstream service. In order to be considered reasonable and necessary, a support must:

  • Be related to the participant's disability

  • Not include day-to-day living costs that are not related to a participant's disability support needs

  • Represent value for money

  • Be likely to be effective and beneficial to the participant, and

  • Take into account informal supports given to participants by families, carers, networks, and the community.

 

Reasonable and necessary support should support people with disabilities to:

 

  • Pursue their goals, objectives and aspirations 

  • Maximise their independence

  • Live independently

  • Be included in the community as fully participating citizens

  • Develop & support capacity

  • Undertake activities that enable them to participate in the mainstream community and employment

  • Enable participant's social and economic participation

  • Enhance living arrangements

Choice and Control

Choice and control is about people with disability, their families and carers having control over the course of their lives. This includes the flexibility to make decisions about the disability services and supports they use. Under the NDIS this means decisions around things like:

 

  • The type of supports and services they use

  • Who provides them

  • How they are designed and provided

  • How resources are able to be used

  • How their funding is managed

NDIS participants have choice and control over their NDIS plan. They have flexibility to ensure they can choose how to spend their funds and live the life they want. The NDIS aims to maximise opportunities for people with disability to plan and design their support arrangements, choose how much control they want over their funding, supports and service providers, and be able to change this control over time.

NDIS DOmains

There are 8 domains in the NDIS outcomes framework to help participants think about goals in different areas of their lives and assist planners to explore where supports in these areas already exist and where further supports are required. These include:

  • Daily Living: all aspects that assist someone with a disability in their daily lives. This include assistance with daily living, transport, consumerables, assistive technology, improved daily living skills and assistance with self care

  • Home: modification of homes and vehicle, specialised disability accommodation (SDA), improved living arrangement, supported independence living (SILS) and short-term accommodation

  • Health and Wellbeing

  • Lifelong Learning

  • Work

  • Social and Community Participation

  • Relationships

  • Choice and Control

Mainstream Services

Mainstream services are the government systems providing services to the Australian public. This includes all Australian governments, non-government organisations, business and the wider community, all in which have an important role. These include:

  • Health

  • Mental Health

  • Education

  • Justice

  • Housing

  • Child Protection

  • Employment

Core Supports

Core supports enable a participant to complete activities of daily living, enabling them to work towards their goals and meet their objectives. A participant may choose how to spend their core support funding but cannot reallocate core support funding to other support purposes.

  • Assistance with daily living

  • Supported Independent Living

  • Assistance with social, community and civic participant

  • Consumables

  • Transport

  • Short-term accommodation and assistance

  • Assistance with self-care activities

Capital

Capital is an investment that is restricted to specific items identified in the participant’s plan. It includes all aids or equipment supports that assists participants to live independently or assist a carer to support the participant. The funding will, as needed, include assessment, delivery, set up, adjustment and maintenance costs. Most items require quotes so that providers negotiate a price with a participant in accordance with the specifications usually developed by an assessing therapist. Types of capital supports include:

  • Assistive Technologies

  • Homed Modifications

  • Vehicle Modifications

  • Specialist Disability Accommodation (SDA)

Capacity Building support

Capacity building is a support that enables a participant to build their independence and skills. Participant budgets are allocated at a support category level and must be used to achieve the goals set out in the plan. Capacity building supports include:

  • Support Coordination

  • Plan Management

  • Improved living Arrangements

  • Increased social and community participation

  • Finding and keeping a job

  • Improved relationships

  • Improved health and wellbeing

  • Early Intervention

  • Improved daily living skills

Informal Supports

Informal supports are people who are part of the family's personal social network. They might be related to the family or they might be a friend, a neighbour, a colleague from work, or members of a faith-based community

 

Families and carers provide help and support that cannot be provided by formal services or paid support workers. It is therefore important that the views and experiences of informal supports influence the planning process for the NDIS because they have a unique understanding of the person you care for. If a participants requests it, informal supports will play a vital role when the person one cares for enters the scheme, helping with decision making about ongoing support needs, goal setting, assessment and the planning process.

Activities of Daily Living

The NDIS will fund supports that assist a participant to undertake activities of daily living where required due to a person's disability. This includes supports such as:

  • Assistance with planning and decision making

  • Assistance with household tasks

  • Assistance to build capacity to live independently and achieve their goals (such as social relationships, financial management & tenancy skills)

  • Supports to participate in community activity such as recreation, education, training & employment

  • Aids and equipment such as wheelchairs, hearing aids and adjustable beds

  • Items such as prothetics and artificial limbs

  • Home modifications

  • Personal care

  • Domestic assistance

  • Allied health and other therapy where this is required as a result of the participants impairment including physiotherapy, speech therapy or occupational therapy

Independent Living

The NDIS will fund supports to assist them to live independently in the community or move back into their own home. The NDIS may contribute to the cost of accommodation in situations where the participant has a need for specialised housing due to the disability. The NDIS will only assist with this cost where it is higher than the standard rental cost that the participant would otherwise incur. To live independently the NDIS will assist participates including:

  • Home modifications to the participant's own home or private rental property to make a participant's home accessible

  • Home modifications to access social housing on a case-by-case manner

  • Support with personal care (such as assistance with showering, dressing or assistance preparing meals and cleaning)

  • Help around the home where the participant is unable to undertake these tasks due to the disability (such as assistance with cleaning and laundry)

  • Supports that build people's capacity to live independently in their community

Early Intervention

The NDIS will fund supports that asist a participant to undertake activities to reduce the participant's future need for support.  Early intervention supports children aged 0-6 years who have a developmental delay or disability and their families/carers as well as supports families to help children develop the skills they need to take part in daily activities and achieve the best possible outcomes throughout their life.

Community Living

The NDIS will help people living in inappropriate settings to move into the community or into their home where participants are living in residential aged care, hospital or rehabilitation units are awaiting discharge or having completed treatment. The NDIS can fund:

 

  • Home modifications to make a participant's home accessible

  • Help participants live independently with supports such as personal care (e.g. to help with showering or dressing)

  • Assistance with preparing meals and cleaning

Aged Care

People under 65 living in residential aged care will be eligible to receive NDIS support. Aged care related NDIS supports may include:

  • Planning & assessment support to explore alternative age-appropriate living arrangements to make progress towards goals

  • Assistance with care-related costs charged by aged care provider

  • Supports to access age-appropriate social, civil and community activities

  • Supports to sustain informal support networks with family, friends and carers

  • Therapy and allied health supports that has been shown to improve independence, social and economic participation in the community or to instruct delegated support workers to manage highly complex needs

  • Specialised equipment supports related to a person's on-going functional impairment which are not part of residential aged care package

Employment

The NDIS funds supports to help participants with employment where these are beyond the requirements of employment services and employers. The NDIS will also fund supports the participant would require regardless of the activity they are undertaken and assist participants to (re)enter the workforce including:

  • Assisting participants who are not eligible for Disability Employment Services (DES) or Job Services Australia (JSA) to build their skills and capacity to participate in employment as well as help to find and maintain employment

  • Personal care or assistance with transport where the participant requires these supports regardless of the activity they are undertaking

  • Assistance technology (such as wheelchairs, personal communication devices or a hearing aid)

  • Supported employment (such as services operated by Australian Disability Enterprises)

Early Childhood

The NDIS will fund early interventions supports that include a child's functional capacity or prevent deterioration of functioning. This include

  • Early interventions

  • Allied health or other therapies such as speech therapy or physiotherapy

  • Individualised supports to enable a child to attend an early l earning service where a child has very significant and complex needs that are beyond a reasonable expectations for early learning to provide

  • Physiology

  • Audiology

  • Occupational therapy

  • Podiatry

  • Speech Pathology

  • Language Pathology

  • Behaviour support such as creating a plan to reduce or prevent behaviours of concern 

Transport for Children

Transportation supports for children most appropriately funded through the NDIS include:

  • Supports that enable independent travel by the parent and child including training and support to use public transport and transport related aids and equipment (e.g. mobility aids such as wheelchairs and some scooters)

  • Modifications to a private vehicle to transport the child with disability and their equipment

  • Transitional plan arrangements for taxis or other private transport options for children with on-going functional impairments who are not able to travel independently due to their disability

EArly Childhood

The NDIS will fund early intervention supports that improve a child's functional capacity or prevent deterioration of function. This includes:

  • Early interventions, allied health or other therapies such as speech therapy or physiotherapy

  • Individualised supports to enable a child to attend an early learning service. This is only in situations where a child has very significant and complex care needs that are beyond reasonable expectation for early learning services to provide (e.g. a child requiring ventilation which must be supervised by a trained carer or nurse)

Family Support

The NDIS funds supports that families need as a result of a family member's disability as well as supports hat enable sustainable caring by family members. This includes:

  • Family support and counselling due to a family members disability

  • Building the skills and capacity of other family members to manage the impact of a participant's disability on family life

  • Supports that increase the participants independence

  • Supports that enable the participant to enjoy social and community activities independent of their informal carers

  • Supports aimed at increasing the sustainability of family caring arrangement including personal care and domestic assistance related to the person's disability

  • The child's disability-related supports such as aids, equipment, therapies, transport or community access.

School Education

The NDIS will fund supports that enable participants to attend school education where these supports are required by the participant to engage in a range of community activities. This includes:

  • Assistance with self-care at school related to the participant's disability (such as assistance with eating or mobility)

  • Specialised transport required because of the student's disability

  • Equipment that is transportable (such as a wheelchair, personal communication device or a hearing aid)

  • Specialised or intensive support to transition between schools, or from school to post-school options.

Mental Health

The NDIS funds supports that help a participant in which there is a permanent and significant functional impairment as a result of their psychosocial disability or mental health issue. These may be centre-based services, in-home, day services, community access and outreach services including:

  • Assistance with planning and decision making 

  • Assistance with household tasks

  • Assistance to build capacity to live independently and achieve their goals (such as building social relationships as well as financial management and tenancy management skills)

  • Supports to participate in community activities such as recreation, education, training and employment

Housing

The NDIS will provide access to affordable, appropriate and secure housing as well as additional housing needs as a result of their disability to assist participants to live independently. This includes:

  • Supports that build capacity to live independently in the community

  • Supports to improve living skills

  • Supports to improve money and household management

  • Supports to improve social and communication skills

  • Behavioural management support

  • Home modifications to the participant's own home or a private rental property

  • Social housing on a case-by case basis

  • Support with personal care (such as assistance with showering and dressing

  • Help around the home where the participant is unable to undertake these tasks due to their disability (such as assistance with cleaning and laundry)

  • Contribution to the cost of accommodation in situations where the participant has a need for specialised housing due to their disability

Higher Education & Vocational Education & Training

The NDIS provides additional support as a result of their disability in order to undertake higher education, vocational education and training (VET), apprenticeship or training course. This includes:

  • Personal care on campus related to the participant's disability (such as assistance with eating or self-care)

  • Assistance with transport to and from campus required because of the participant's disability

  • Aids and equipment that is transportable (such as a wheelchair, personal communication device or a hearing aid)

  • Specialised or intensive support to transition into higher education VET or transition once the participant finishes studying

Health

The NDIS funds supports that assist a person to undertake activities of daily living required due to the person's disability. It will assist participants exiting the health system to live independently in the community or move back into their own home. Health supports may include:

  • Aids and equipment (such as wheelchairs, hearing aids and adjustable beds)

  • Items such as prosthetics and artificial limbs

  • Home modifications

  • Personal care

  • Domestic assistance

  • Allied health and other therapy where this is a result of the participant's impairment including physiotherapy, speech therapy or occupational therapy

 

The health system is responsible for these supports if they are required as part of rehabilitation from an accident or injury or as part of treatment for medical conditions.

Services the NDIS Will NOT Provide

NDIS participants remain responsible for meeting their day-to-day living costs and have a responsibility to fund and provide some supports. 

·         Purchasing school uniforms

·         Paying school fees and excursion fees

·         Renting a home in the private housing market

·         Home ownership

·         Social housing

·         Daily living costs such as rent, groceries and utility bills

·         Telephone and internet costs

·         General houseold items such as a bed, fridge or cooking utensils

·         The diagnosis, assessment and treatment of health conditions

·         Clinical services such as general practitioners

·         Hospital admissions

·         Surgery

·         The cost of medical specialists

·         Dental care

·         Medications & pharmaceuticals

·         Palliative care

·         Nursing Care

·         Wound management

·         Course fees or other student fees

·         Funding early learning and education activities (such as childcare fees, general educational resources and excursion fees)

·         Medical services

·         Appointments with medical professionals

·         Care in hospital

·         Pharmaceuticals

·         Surgically inserted devices such as pacemakers, metal pins and rods

·         Ensuring transport options are accessible to a person with disability, including through the funding of concessions to people with disability to use public transport

·         Compliance of transport provides and operators with laws dealing with discrimination on the basis of disability (including the Disability Standards Accessible Public Transport 2002)

·         Transport infrastructure (including road and footpath infrastructure) where this is part of a universal service obligation or reasonable adjustment (including managing disability parking and related issues

·         Support to compensate for the lack of a public transport system

·         A child day-to-day living costs and costs that are the responsibility of a parent (such as groceries, utilities, telephone and internet costs)

·         Emergency or in-patient transport

·         Transport that is a substitute for parental responsibility

There are some limited circumstances where the NDIS may make a contribution to these costs such as

  • Where the participant only incurs the cost

  • Because of their disability or their costs are substantially higher because of their disability

  • A participant has limited mobility

  • Modified bed to prevent bed sores

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