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The yes, no and maybe of NDIS funding

Two people chatting in a park.

‘Would the NDIS fund it?’.

We hear this question every day from people asking about purchases they wish to make for assistive technology – vital supports that can help you to do things you might otherwise find difficult because of your disability.

Perhaps you want to buy an iPad to help you to communicate better, or modified cutlery for a child who’s learning to cut up their own food? Maybe you need a new wheelchair, a bedstick or a washing line to assist you to live more independently?

Whatever purchase you have in mind, if you’re anything like most of our clients, you’re probably wondering whether the National Disability Insurance Scheme (NDIS) will fund it, and where to turn to next. If you’re not sure, checking the National Disability Insurance Agency’s (NDIA) rules is a great first step!

Assistive technology covers a broad range of supports that fall into three categories:

  • Low-cost assistive technology – items under $1500, like laundry and washing line adaptors or non-slip bathmats.
  • Mid-cost assistive technology – items from $1500 to $15,000, like a customised shower chair.
  • High-cost assistive technology – items costing more than $15,000, like powered wheelchairs.

What determines if the NDIS will fund assistive technology?

Like all NDIS supports, assistive technology must meet the reasonable and necessary criteria that we explain here. The NDIS Act – specifically Section 34 – explains what the reasonable and necessary criteria are and sets out the rules of the NDIA.

The Agency has also developed rules that support the implementation of the NDIS Act, like the Assistive Technology Guidelines that break down low, mid and high cost technology, and what’s considered low and high risk.

Because these documents are quite complex, the NDIA has broken them down into simpler terms, and quicker and easier to understand information can be found on pages like ‘Would we fund it’ on the NDIS website.

The problem is, this simplified information contains rules of thumb – broadly accurate ‘rules’ that may not apply every time.

If you’re not sure if the NDIS will fund a support you want to purchase, here are five questions that might help you to find out:

1. Does the support help you to achieve the goals in your plan?

If the answer is ‘yes’, and the purchase is disability related, then the NDIS is more likely to fund it. However, it doesn’t have to be disability specific.

The value of the NDIS is that the supports it funds don’t have to be made especially for people with disability to help them achieve their plan goals.

For example, many Australians have an iPad lying around their home. To them, their tablet helps them connect with friends via social media or watch their favourite TV shows. To some people with disability, the same tablet is a vital support that enables them to communicate with those around them.

This is a fundamental feature of the NDIS: access to mainstream products and services means better choice and value for money.

Recently, a client asked us if the NDIS can fund a Vegepod – aka a portable raised vegetable garden – and the answer is: ‘it depends’.

If a participant with cerebral palsy has a goal of maintaining independence in their home and has difficulty getting down on their hands and knees in the garden, having a raised garden may increase their independence and support them to achieve their plan goals. In this case, the NDIS may fund the Vegepod.

2. Is the support safe?

The NDIS classes assistive technology into two additional categories:

  • Low risk assistive technology products that are easy to set up and safe to use – like a washing line adaptor; and
  • High risk assistive technology products that are known to have caused harm, and require professional advice, set up or training for safe use – like a customised wheelchair.

If you’re looking to make a purchase that’s considered high risk, we may ask you to provide a letter of recommendation from an allied health professional – like an occupational therapist. They’re well placed to make an assessment about the item, whether it can help you achieve your plan goals safely, and whether it’s value for money – i.e. that the cost is within the NDIS Pricing Arrangements and Price Limits – to help us determine if the NDIS will fund it.

3. Is the support more appropriately funded by a mainstream service?

The NDIS won’t fund items that are provided by mainstream services – like medication that’s typically covered by the Pharmaceutical Benefits Scheme.

However, if you seek a mainstream support and feel it’s directly related to your disability, you should speak to your support coordinator or Local Area Coordinator (LAC). They might know if similar supports have been covered by the NDIS for others in the past (e.g. pharmaceuticals are sometimes approved by NDIA planners).

4. Does the support provide value for money?

The NDIS Pricing Arrangements and Price Limits are a good indicator of what’s considered value for money for a large number of supports. It’s also important to check if you have sufficient funding in your NDIS plan budget to afford the support you want to purchase.

Another good test is to ask how the item stacks up against the cost of other supports you might be accessing. For example, an assistive technology purchase might look expensive, but if it’s going to help reduce your overall support needs and increase your independence, it might actually represent great value for money.

5. What budget will the support come out of?

Low-cost assistive technology priced under $1500 can come out of your Core Supports budget, which is designed to be flexible.

Assistive technologies priced over $1500 will need to be written into your plan by the NDIA. When funds are written into your plan, there will usually be a description of how they are designed to be used and how much they cost.

We’re here to help

If you’re unsure if the NDIS will fund a particular support, you can call us on 1800 861 272 from 8am-6pm (SA time), Monday to Friday, or email us at [email protected].

We’ll happily assist you and may advise you to request a letter of recommendation from an allied health professional who’s equipped to understand the value for money items you need to help you achieve your plan goals safely.

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My Plan Manager acknowledges the objectives of the United Nations Convention on the Rights of Persons with Disabilities.

My Plan Manager acknowledges the Traditional Owners of Country throughout Australia, and their continuing connection to land, sea and community. We pay our respects to them and their cultures, and to Elders both past and present.
© My Plan Manager 2020
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