National Disability Insurance Scheme
What is the NDIS?
The National Disability Insurance Scheme (NDIS) is a new way of providing individualised support for people with a disability. The NDIS is about giving you more choice in how you live your life by allowing you to control the way your support funding is spent.
How does the NDIS work?
If you are eligible for the NDIS, you will receive funding on an annual basis to purchase the supports, services, aids and equipment that are approved in your Individual Support Plan (NDIS Plan).
What are the NDIS key principles?
There are a few key principles that make up the NDIS, these are:
- Funds reasonable and necessary supports
- Individualised
- Fosters informal supports, community supports, and mainstream supports
- Provides more choice and control
- Focuses on early intervention
- Takes a lifetime approach
Are there set package amounts?
No, there are not set package amounts.
An NDIS plan aims to give you the supports you need to be as independent as possible, reducing your need for support over time. The cost of the package is determined by what is deemed reasonable and necessary for you, including considering what your individual goals are.
Who is eligible for the NDIS?
You may be eligible for the NDIS if:
- Your disability is likely to be with you for life and substantially impacts how you manage everyday activities
- You are under 65 years of age
- You live in Australia and are an Australian citizen, or you have the paperwork that gives you permission to live here permanently
Will my NDIS plan affect my Disability Support Pension?
No, the DSP and carer’s pension are separate from the NDIS. The NDIS is designed to work alongside the DSP and other measures. Assistance from the NDIS is not means-tested and has no impact on income support.
Are people with a psychiatric condition eligible for the NDIS?
Yes. This is what is referred to within the scheme as ‘psychosocial disability’. People with psychosocial disability have been recognised by the scheme and are already receiving support.
What are reasonable and necessary supports?
The NDIS will pay for the reasonable and necessary supports that a participant needs to live an ordinary life and to reach their goals.
Reasonable means something that is fair, and necessary means something that you must have. They must be related to your disability, be of good use to you and provide good value.
Reasonable and necessary supports are funded by the NDIS in a range of areas, which may include education, employment, social participation, independence, living arrangements, and health and wellbeing. These supports will help:
- Pursue goals, objectives and aspirations
- Increase independence
- Increase social and economic participation, and
- Develop the capacity to actively take part in the community
What does the term 'early intervention' mean?
Early intervention helps people with a disability that is likely to be with them for life but could be improved by getting some additional support now.
The focus of early intervention is on people getting services and supports now so that they require fewer services and supports in the future and can live a more independent life.
What types of supports are funded by the NDIS?
The NDIS funds many different types of supports that are deemed to be reasonable and necessary. Some examples are:
- Daily personal supports
- Transport (if deemed "reasonable and necessary")
- Help to get or keep a job
- Therapeutic supports, including behaviour support
- Support coordination
- Help with household tasks, to make sure you can keep and look after your home
- Help from skilled personnel for aids and equipment
- Changes to your home
- Equipment to help you get around, and
- Changes to your car
What types of supports are not funded?
There are some supports that the NDIS will not provide funding for. A support will not be funded if it:
- Is not related to your disability
- Doubles up on supports already funded in a different way, e.g. Medicare
- Relates to your day-to-day living costs
- Is likely to cause you or someone else harm
Can I use my NDIS funding to purchase items online?
Yes, if you self-manage your NDIS plan, and the item has been approved in your plan.
If you self-manage, you will need to get an invoice from the place you have purchased the item and supply a copy of this invoice when you make a claim with the NDIA.
Does the NDIS fund transport?
Yes. Under the NDIS, the Centrelink Mobility Allowance will be replaced by funding for transport needs related to a person's disability in individual plans. There are special provisions for travel for participants and providers in remote and very remote communities.
Make sure that you think about your transport needs in the planning process. Transport support might include funding for taxis or buses, or travel training to build your skills and reduce the need for support in the future.
Transport deemed reasonable and necessary will be funded under the NDIS.
Does the NDIS Fund Medication?
Medication is not usually funded in people's plans. Medication falls under the responsibility of the health system and therefore would not be an NDIS funded item.
Does the NDIS fund equipment?
Yes. Assessment to identify the appropriate equipment or technology, written reports and prescriptions, and fitting of equipment when delivered, are all funded by the NDIS. You will also need to consider repairs and maintenance of equipment and whether people working with you will require special training to use the equipment or technology.
The NDIS has a focus on providing equipment and assistive technology that increased independence for people with disabilities. You should ensure that you discuss all options in the planning process.
Does the NDIS fund respite?
The NDIS aims to increase people's independence, including support for activities at home or in the community that result in less reliance on family members or housemates.
Under the NDIS and with the aim of supporting the person with a disability and their family, 'respite' hours become more flexible and will include 'in-home', community-based and facility-based respite.
Facility-based respite can be funded in an NDIS plan where this is the best option to meet the needs of the participant and their family or carers.
Does the NDIS fund specialist disability accommodation?
The NDIS funds the shared component of support in shared supported accommodation. The funding is based on an assessed level of need, from low to standard or complex, and the number of people sharing the accommodation.
Any extra individual support would need to be specific to a person's goals, as part of their plan, and be considered reasonable and necessary support.
You should discuss your accommodation options with your planner. The NDIS also funds support that people require to live independently in the community. Whilst there are not many options currently for affordable accessible accommodation, this will change over time as more people are looking for options in the community.
What is Specialist Disability Accommodation (SDA)?
Specialised Disability Accommodation is one of the supports that may be funded for some participants who have an extreme functional impairment or very high support needs. SDA refers to accommodation for people who require specialist housing solutions, including to assist with the delivery of supports that cater for their extreme functional impairment or very high support needs.
SDA funding is for the dwelling itself and is not intended to cover support costs (such as Supported Independent Living), which are assessed and funded separately by the NDIS.
What is Assistive Technology (AT)?
Assistive Technology can be funded under the NDIS.
Assistive technology, as defined by the World Health Organisation, is ‘any device or system that allows individuals to perform tasks they would otherwise be unable to do or increases the ease and safety with which tasks can be performed’. The NDIS uses this definition.
AT under the NDIS does not include:
- Items for treatment or rehabilitation
- Built environment that is used by all – for example, ramps, pathways and lifts
- Mainstream technology that does not overcome a functional limitation but modifications to this technology could be AT – for example, a car would not be AT but modifications to the car could be AT
- Something that does not include a device – for example, medicine or training
How do I access the NDIS?
If you meet the NDIS eligibility requirements but don’t currently receive disability support, contact the NDIA on 1800 800 110 to gain assistance with accessing the NDIS.
If you are eligible you will work with the NDIA to develop an Individual Support Plan (NDIS Plan). Once this is approved you will access your supports through the NDIS.
What is an individualised support plan (NDIS plan)?
Your first plan is the start of a lifelong relationship with the NDIS. Once you have gained access to the NDIS the NDIA (or NDIA representative) will work with you to develop your first plan.
Your first plan will identify the reasonable and necessary supports you require to meet your immediate needs and start to identify and achieve your goals. Once completed, your first plan will provide you with individualised funding that you control and choose how to use.
How do I get ready for my first NDIS plan?
Firstly, download and print a copy of our NDIS Pre-Planning Checklist, this will let you know exactly what you need to do prior to and at your first planning meeting.
Secondly, download and print our NDIS Pre-Planning Workbook. Complete this workbook and take it with you to your first planning meeting. It asks you a variety of questions making sure you have your answers down on paper to all of the key questions that the NDIA will ask you in your planning meeting. If you have any questions you can contact us on 08 8536 5888 or info@claust.com.au.
Can I bring people with me to my planning meeting?
Yes, you can bring people with you to your planning meeting. In fact, we advise it. Make sure you bring someone who understands your needs, that can make sure that you don’t forget to mention anything important. You are also able to bring a representative from your service provider if you wish.
Can I ask for a face-to-face planning meeting with the NDIA?
Yes, there are multiple options for how you have your planning meeting - it is your decision. If you feel that a face-to-face meeting would be best for you make sure you request this.
How long does an NDIS plan last?
Your plan will be in place for 12 months (1 year) and may include similar supports and services you currently receive. Once the plan is in place you will be able to think about how those supports are working for you and if there are other supports which may help you achieve your goals. Any changes can be discussed with the NDIA representative during the annual review process.
You can extend the review period to 24 months (2 years) if you would prefer.
How do I put my NDIS plan into action?
There are many ways you can access your supports in your approved plan. Some options are listed below:
- Local Area Coordinators (LAC) – The NDIS will establish LAC which you can contact to assist you to find community activities and the mainstream services that help you achieve your goals.
- Self-Direction - This means you have control over your supports and how they are provided.
- Choosing your Providers - You can choose the providers you want to deliver the services you need. You will usually need to have a written agreement with your providers.
- Participant Portal - You can access your plan on the Participant Portal, an online tool available through the MyGov website that keeps all your documents together. The portal can also facilitate payments to providers. You will be given access to your specific details on the Participant Portal when your plan is approved.
- Support Coordinator and/or Plan Manager – you can engage a registered support coordinator or plan manager who will assist you with putting your plan into action.
You need to decide what works best for you.
How can funding in NDIS plans be managed?
You have choice and control over how you use the funded supports in your plan. This includes choice of how the supports are provided and which service providers you use.
There are five ways a plan can be managed:
1. Agency Managed - Providers of your supports claim funding directly from the NDIA
2. Plan Manager - Funding in your plan is allocated to a third party so they can manage the financial transactions in your plan. Community Living Australia is a registered Plan Manager.
3. Self-Managed - You (or your nominee) directly manage the funds - all transactions are completed by the participant for services rendered.
4. Automated Payments (transport only) - These funds can be deposited into an NDIS bank account weekly, fortnightly or monthly.
5. Combination - A combination of the above four options can be used together to meet your individual needs.
What is Support Coordination?
You can ask to have support coordination funding included in your NDIS plan if it is deemed reasonable and necessary to put your plan into action or to build your capacity to do this in the future.
The Support Coordination service could include:
- helping you understand your plan and help you choose and connect with service providers.
- helping you explore and link with the community and mainstream services and help coordinate these as required.
- talking with you and your family about any other options to be considered as the year progresses and will help with developing goals for your next plan.
- Being your NDIS contact person to discuss any questions about your plan.
- supporting you to learn about the NDIS, build your capacity to understand your plan and how to put supports in place, as well as supporting you with the NDIS portal.
What is Plan Management?
You can ask to have plan management funding included in your NDIS plan if it is deemed reasonable and necessary to strengthen your ability to undertake tasks associated with the management of your supports. This could include building your financial skills, organisational skills, and enhancing your ability to direct your own supports and/or develop self-management capabilities.
Plan Management is the financial management of the NDIS Plan and includes:
- Making payments to providers
- Expense claim processing
- Developing monthly statements for participants and claiming payment from the NDIA
- Liaising with providers and participants to implement and manage the plan.
What is Local Area Coordination?
Local Area Coordinators are there to support people with disability to explore and build an ordinary life within their communities. The support they provide may include supporting you to find community activities and mainstream services that help you achieve your goals.
If you are not eligible for NDIS a local area coordinator will be able to assist you to access services and supports within your community.
What can I do if I don't agree with the NDIS plan I was given?
If you think a decision made by the National Disability Insurance Agency (NDIA) about you is wrong, you can submit an application for an internal review of a decision. Any person directly affected by a decision of the NDIA can request such a review.
There is a list of reviewable decisions in the NDIS legislation. Many decisions made by the NDIA are reviewable, including things like being accepted as a participant, the provision of reasonable and necessary supports, and becoming a registered provider of supports.
When you are told about an NDIA decision, you will be told how to request an internal review. A request for an internal review of a decision must be made within three months of receiving notice of the decision from the NDIA.
The staff member who works on the internal review will not have been involved in the earlier decision. They may want to talk to you directly as part of this process.
How do I request an internal review of a decision?
A request for internal review of a decision can be made by:
- submitting a written request to: Chief Executive Officer National Disability Insurance Agency GPO Box 700 Canberra ACT 2601
- talking to someone at an NDIA office
- calling 1800 800 110
- sending an email to: enquiries@ndis.gov.au.
When asking for a review, you should explain why you think the decision is incorrect.
What if my review is rejected? What can I do then?
If you have requested an internal review of a decision and disagree with the result, you can take the matter to the Administrative Appeals Tribunal (AAT). You have to submit your application within 28 days of receiving the decision from the NDIA.
You can find more information on www.aat.gov.au/applying-for-areview/national-disability-insurance-scheme-applicants about:
- What decisions the AAT can review
- How to apply for a review
- How the AAT will conduct the review.
If I am over 65 years of age am I eligible for the NDIS?
No, however people who are aged 65 years and over and aren’t eligible to access the NDIS may be supported under the Commonwealth Continuity of Support Programme.
The Continuity of Support Programme will support people with a disability that are:
65 years and over or 50 years and over for Aboriginal and Torres Strait Islander people, at the time the NDIS commences implementation in their region; and assessed as being ineligible for the NDIS at the time the NDIS commences implementation in their region, and an existing client of state-administered specialist disability services at the time the CoS Programme commences in their region.
For more information on the CoS Programme, you can go to https://agedcare.health.gov.au/programs-services/commonwealth-continuity-ofsupport-programme.
I am over 65 years of age and currently recieve disability support services - what happens to my supports?
If you are over the age of 65 and are currently receiving a disability service, you will be provided with continuity of support or the option to move to the aged care system.
What happens to my NDIS funding once I turn 65 years of age?
A person who is an NDIS participant and is under the age of 65 can choose to remain a participant or transition to the aged care system once they turn 65 (or turn 50 for Aboriginal and Torres Strait Islander people). If you move to the aged care system, you cannot return to the NDIS.
If I self-manage do I need to employ NDIS registered providers?
When you self-manage your plan, you can employ and pay for any service you like as long as it is linked to the outcomes listed in your plan– the provider doesn’t have to be registered with the NDIS.
Am I able to change providers whenever I want?
You can choose the provider that delivers your support. You will negotiate a service agreement when you choose a provider and this may include how you change providers or cease services if you are not happy. If you choose to change providers, then you will be responsible for engaging an alternative or talking to the NDIS about changing your plan.
You are responsible for advising providers of any changes to your plan, when your plan is reviewed, when you want to access more or less service, or support when you want to change how support is delivered, or want to start or stop accessing services.
Can I employ my own staff?
Yes. If you self-manage your funding you can employ anyone - but you need to ensure that you make arrangements for insurance and staff entitlements, such as long service leave.
There is information available from NDIS about how to self-manage a plan and there will be more information about how you can employ your own staff in the Quality and Safeguards framework when it is finalised and published.
Is the NDIS means-tested?
No, the funding under the NDIS is not means-tested. Support is related to a person's disability and the supports they need, not their capacity to pay for support.
Couldn't find the answer you were looking for?
Ask a QuestionFind out more about joining us in helping South Australians achieve their goals.
If you have any other questions, comments or feedback, we’d love to hear from you.