We have pulled together a number of Frequently Asked Questions in relation to the NDIS. We haven’t covered everything here but hopefully these help and of course get in touch if there is anything we have not covered off here.
What is the National Disability Insurance Scheme (NDIS)?
The National Disability Insurance Scheme (NDIS) is a government funded system to provide supports to people with disabilities, their families and carers. Packages are individualised and focus on the person’s needs and goals to achieve the life they want. Plans are generally reviewed and made once a year, so as the person’s life changes so will the supports. Participants have choice and control as the packages go to the individual to decide what services and supports they want to use.
NDIS also helps participants to
· Access mainstream services such as health, housing and education;
· Access community services such as sports clubs and community groups; and
· Maintain informal supports such as family and friends.
What is National Disability Insurance Agency (NDIA)?
The National Disability Insurance Agency (NDIA) is an independent Commonwealth agency that administers the NDIS to participants.
Who is eligible for NDIS?
Eligibility for NDIS includes that a person must live in Australia and
· Have a permanent and significant disability that affects a person’s ability to take part in everyday activities;
· Be under 65 years of age when first accessing the NDIS; and
· Be an Australian citizen or hold a permanent resident visa or hold a Protected Special Category Visa.
How do I access the NDIS?
There are two pathways for accessing the National Disability Insurance Scheme (NDIS) depending on if you are currently accessing government funded disability services or not.
Yes, I am already accessing services
If you are already accessing government funded services, you should be contacted directly by the National Disability Agency (NDIA) by phone or letter. However, if you have not been contacted by the NDIA and the NDIS has rolled out in your area, it is important to call the agency on 1800 800 110.
No, I am not accessing any funded disability services.
To access the NDIS you will need to fill out an Access Request Form. The form is only available by contacting the NDIA directly. They can be reached on 1800 800 110.
What is funded / not funded?
The NDIS funds reasonable and necessary supports and services to help participants meet their goals. This may include goals related to learning, gaining employment, increasing social participation, developing greater independence, and improving health and wellbeing. In order to be considered reasonable and necessary, a support must
· be related to the participant’s disability;
· represent value for money;
· be likely to be effective and beneficial; and
· take into account other supports the participant has from other government services and informal supports.
The NDIS does not fund supports that are
· not related to the participant’s disability;
· the responsibility of another government or community service;
· day-to-day living costs; and
· likely to cause harm.
What information is needed for the planning meeting?
To help prepare for your planning meeting, there are many useful tools to collect all the information you will need. The Down Syndrome Qld resource A Pre-Planning Resource for NDIS Participantsis a useful tool to help you gather information for your planning session. Another useful resource is the Carer's Checklistdeveloped by Carer’s Australia. This checklist is useful for family or friends in an unpaid caring role to assess their role as a carer and the support required to assist the participant.
During the planning session the planner will ask questions about the following:
This will include things like your name, age, where you live, who you live with, and any hobbies or interests you have.
Community and Mainstream Supports
This include supports from family, friends and the local community. Community supports includes things like
· sporting or other clubs,
· church groups,
· health services,
· school or education,
· drama or music groups, and
· social groups.
How you manage your everyday activities
This includes all the activities you are currently doing. The planner will ask about what supports (paid and unpaid) you currently have in place and how well they are working. If there are things that are not working well, think about changes you would like to make to improve them.
Writing down all the things you do in a typical few weeks is a good way to get all your activities in once place to talk with the planner. There is a weekly schedule in the planning resource to help you collect this information.
If you are already accessing therapy services, it is beneficial to bring any reports from your therapists with their assessment and what goals they are working on.
The planner will ask you questions if there are any areas in your life where you may feel unsafe and need extra help.
The planner will ask what your goals are for the next twelve months and longer term goals. The funding you receive in your plan will relate to your goals. The Life Stages Fact Sheets provides ideas for goals specific to the participants age group:
Starting your plan
The planner will ask you how you want to manage your plan. There are four ways to manage your plan:
· NDIA managed,
· Plan managed,
· Self-managed – by you or your nominee (such as Mum and Dad), and
· Combination of the above.
For more information on each of the them, please refer to the section “What are my plan management options”
Who attends the planning meeting?
The participant can bring along anyone they would like to the planning meeting. This can include family, friends, support workers, and advocates.
What if I do not agree with what is in my plan?
If you do not agree with any aspect of your plan you can request an internal review of the decision by the NDIA. If you do not agree with the outcome of the review, you can request a review of the matter by the Administrative Appeals Tribunal (AAT).
For more information and the application process see NDIS website Internal Review of a Decision
If you have requested a review of your plan you are able to continue using the plan until you get a decision.
Legal Aid Queensland can give legal advice to clients with an internal review decision wanting to apply for an external review to the AAT.
What are my plan management options?
Plan management refers to how the funds in the plan are managed. There are four ways to manage your plan.
· Having an agency managed budget is having the NDIA manage your funds for you. You choose the providers that you want to use. Your providers claim their payments directly to the NDIA, and the NDIA pays the service provider. With an agency managed plan, you have to create Service Bookings to reserve funds for each service provider. You can only choose providers that are NDIS registered, and you cannot pay more than the benchmark fees set out in the
Having a self-managed budget is the participant or nominee paying the service providers and claiming the fees back from the NDIS. You are able to choose any provider you want. They do not have to be NDIS registered, and you can pay above the NDIS benchmarks. Skill and capacity building to be able to self-manage budgets can also be part of your NDIS plan. Service Bookings are not required with this option.
If you are self-managed there are a few ways to manage how you pay and receive re-imbursement from the NDIS. You can pay your provider as soon as you receive the invoice and then claim the re-imbursement from NDIS. Another alternative is to discuss the terms of payment with your service provider. Once you receive the invoice you can request payment from NDIS, and when you receive the funds you can pay your service provider.
Being self-managed you have to keep records of all invoices. You do not have to upload invoices on the NDIS website to get re-imbursement, but you need to keep them as you can be audited by the NDIS.
For more information on self-management refer to the NDIS Guide to: Self-Management
A plan managed budget is having a third person, known as a plan manager, manage financial transactions for you. They pay the service providers and then claim the fees back from the NDIS. Being plan managed you can choose any provider you want. They do not need to be NDIS registered, but you are limited by the NDIS pricing benchmarks. If you are interested in being plan managed, funding is included in your plan to pay the plan manager. It does not affect any of your funding for other supports. It is in addition to your supports and funded specifically for plan management.
You can also choose to have a combination of the above three options to be used for your plan.
What is support coordination?
Support Coordination is a funded support to assist participants to help build skills to implement and manage their NDIS plans. A Support Coordinator can assist with many things including:
· helping you understand your plan and answer any questions;
· assisting you to find service providers to meet your needs;
· developing Service Agreements with your providers;
· making service bookings with your providers;
· connecting you with community and mainstream services;
· helping you to register on the myGov website to see your plan on the NDIS myplace portal;
· showing you how to navigate the NDIS myplace portal;
· helping you monitor your plan as you use it; and
· reviewing your plan as the year progresses to help you prepare for your next planning meeting.
If you are interested in having assistance from a Support Coordinator you can discuss this with your planner in your planning session to seek funding for this support.
Will my Mobility Allowance be affected?
Yes. NDIS funding replaces the Mobility Allowance, so it is important to discuss transportation during your planning meeting. Your NDIS plan will include reasonable and necessary transport related supports. Once your NDIS plan is approved, you are no longer eligible for the Mobility Allowance.
For more information about transportation funding through NDIS see Participant Transport Information
What transportation options are available with NDIS?
Your NDIS plan will include reasonable and necessary transport related supports. It is important to discuss your transportation needs at the planning meeting. For information about transport funding and the levels of support offered by the NDIS please refer to the Participant Transport Fact Sheet.
Will my Disability Support Pension be affected?
No. NDIS is separate from the Disability Support Pension, and it will not be affected if you have a NDIS package.
What is Assistive Technology (AT)?
NDIS uses the World Health Organisation definition of assistive technology (AT) as ‘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.’ NDIS will fund supports you need that can range from home modifications, wheelchairs, talking appliances to apps that can remind you to do certain tasks.
There are complexity levels for AT which include the following:
Level 1 (basic): this includes low-cost, low-risk items that participants can identify and source themselves.
Level 2 (standard): this includes ‘off the shelf’ that participants can test and trial before purchasing the item.
Level 3 (specialised): AT that is similar to Level 2 but may require some modification.
Level 4 (complex): AT that is custom made or ‘off the shelf’ but needs specific modification for the participant.
Do I need an assessment to have AT included in my package?
Level 1 items that are low-cost, low-risk do not need an AT assessment.
Levels 2-4 require an AT assessment. If AT is required for a package, funding will be provided for an AT assessment for Levels 2-4 to help assist the participant and NDIA understand the AT solutions to best support the goals in the plan.
More information about Level 1 Low-Cost Low-Risk AT
Low-cost items are those that are <$500 each. Low-cost, low-risk AT is funded in the Core Budget in a plan under ‘consumables’ and is usually around $1000. With low-cost, low-risk you do not need to have an AT assessment and if you Self Manage your plan (see FAQ ‘What are my Plan Management Options’) you can select and purchase the items you need as long as they are ‘reasonable and necessary’ and relate to the goals in your plan. If you are Plan Managed you can have your plan manager purchase the item/s for you.
For ideas of low-cost, low-risk items please refer to the following information sheet
What consumables can I include in my package?
Consumables is a support category that funds items you use every day. The support you need for consumables will need to relate to your disability and need to be reasonable and necessary.
An example of a consumable you can request in your package is if a child with Down syndrome is not toilet trained by the age of a typical child, you can request to have nappies included in your package.
If you receive Level 1 Assistive Technology (low-level, low-risk) in your plan, it will be listed in your consumables budget. See FAQ ‘What is Assistive Technology (AT) for more information.
There are many new terms that are used by the NDIS, and it is useful to become familiar with them for your planning. The following is a link to a glossary of words commonly used by the NDIS