Are you confused about what you can buy with your National Disability Insurance Scheme (NDIS) funding, or what your plan covers? Do you worry about incurring debt by making purchases that the National Disability Insurance Agency (NDIA) won’t pay for?
If that sounds familiar, you’re not alone!
With new legislation tightening up spending in the NDIS, and the disability landscape shifting shape once again, keeping on top of which supports the Scheme will and won’t fund is no easy task.
That’s why it's more important than ever to be proactive and ask for the supports you need, so they can be stated in your plan and funded accordingly.
Linda Grant, one of our national team of Community Engagement and Partnerships Managers, previously worked as a support coordinator and has extensive experience of helping people with disability to secure vital funding.
We spoke with her to find out how ask for the funding you need. Here’s what Linda had to say.
Previously, there seemed to be a lot more flexibility in how ‘reasonable and necessary’ was interpreted. We saw the likes of the NDIS ‘Can I buy it?’ checklist – a layperson’s guide of legislation s34 – Reasonable and Necessary, which made it easier to understand what people could and couldn’t use their NDIS funding for.
The NDIS supports lists, which were recently introduced, have created a lot of uncertainty for participants, their families, service providers, and support coordinators – pretty much everyone. I expect the intention of this change was the appropriate use of NDIS funds, but now there’s a real hesitancy around spending, and many worry the changes have created such fear that some people may be going without necessary supports because they’re unsure if they meet the NDIA’s requirements.
The good news is, there are steps you can take to spend funding with confidence.
We’re seeing plans coming through that are a lot more prescriptive than they were in previous years, meaning there’s less flexibility around how funding can be utilised. When supports are written into a plan from the start, there’s certainty that the NDIS will fund them.
There’s more focus now on getting the planning right to ensure participants are set up for success in their new plans.
It’s difficult to give a definitive list of supports to request, as everyone’s support needs are different. If a participant requires supports that are on the list of ‘Supports that are not NDIS supports’, I highly recommend working towards having those written into a plan.
When I was a support coordinator I’d often ask: ‘If you could put your disability aside, could you complete the task independently?’. If they could, then it was evident support was required as a direct result of disability.
Also, it’s great when participants have strong support at home, work and in the community. We want to support, for example, an adult child and their mother to have the relationship they’d have if the child didn’t have disability. Would you still be performing personal care for your 22-year-old son if he didn’t have disability? Not generally, so it’s about making sure he has choice.
If you’re in doubt about a support, but unsure about whether or not it will be funded, I say ask for it, because it’s always better to have a support funded and ready for when and if you need it.
Talk to your support network and find out what supports might assist you – such as therapies (like occupational therapy and physiotherapy), support workers, meal preparation and transport. Think about what’s worked well and what hasn’t. Then work with your support coordinator or others in your support network to ensure those supports are considered for the new plan period – and make sure to allow sufficient time for reporting (i.e. functional capacity and end of plan reports) from allied health professionals. It’s important that reports are written in a way that identifies any gaps in supports, how supports can assist, and why they’re most appropriately funded by the NDIS. This approach ensures you’re heading into a plan reassessment fully equipped to leave with a plan that best suits your needs.
There are some great guides out there to assist providers with report writing, including these two:
Tips for excellent NDIS report writing
Three to four months before a plan reassessment is the best time to start, but many plans are automatically rolling over. In short, flag the change in support needs as soon as you can. If the support needs are due to a change in circumstances, you can contact the NDIA to discuss what option may be best for you.
A support coordinator (if you have one) is a great person to assist and if you have a significant change in a particular area, such as housing, there are specialist support coordinators out there who can help.
Participants who don’t have funding for support coordination can liaise with a Local Area Coordinator, Early Childhood Early Intervention partner, or the NDIA directly, as well as turning to family members, friends, and the community. And don’t forget, your plan manager can assist too.
Fundamentally, all supports need to be approved by an NDIA delegate, but many alternative supports can assist you to navigate that pathway, so you’re set up for success.
My Plan Manager’s NDIS experts support people to understand their plans, how they can use them, and how to manage their funding, and participants can also get support from our online community – Kinora – which connects people with disability and their supporters to peers, NDIS experts, disability sector professionals and service providers.
There are some amazing resources available on the NDIS website to support you with preparing for your planning meeting and creating your NDIS plan. If you’re already connected with providers, work with them to source the evidence you need – current functional capacity assessments are always a good option to take along to your planning meeting (current usually means less than two years old). Be sure any reports you present from your providers highlight any gaps in supports, include recommendations on how to fill them, and detail what those supports will help you to achieve.
Under the new legislation that came into effect on 3 October 2024, the NDIA has compliance powers for circumstances where it believes a provider and/or a participant wrongly spends NDIS funding. This includes the ability to raise a debt. The NDIA has previously been able to raise a debt, however the new legislation makes the Agency’s powers clearer. The long and the short of it is that you should do everything you can to have the supports you need included in your NDIS plan, so you know they’ll be funded.
The NDIS educators at DSC have explored the topic of debt in an informative article you can find here.
And don’t forget, at My Plan Manager we’re here to help. We’re all about uncomplicating the NDIS, and if you have a tricky question about your plan – like how to use it or what it can fund - our friendly team is ready to assist. You’re never alone with us in your corner!
You can email us at enquiries@myplanmanager.com.au or call us on 1800 861 272 from 8am-6pm (SA time), Monday to Friday.
