Understanding The NDIS

Understanding The NDIS

Most people are well aware of the National Disability Insurance Scheme (NDIS), a scheme designed to help Australians living with a significant and permanent disability. The problem is, many of us are also well aware that it can be quite difficult to navigate, particularly at times when stress levels are already high due to your family members not having the essential services they need.

To help point you in the right direction, Central West Mums have put together this simple NDIS guide to get you started. In this article we’ll be looking at:

  • Who runs the NDIS? 
  • How to apply for the NDIS? 
  • What if you need help to apply? 
  • What happens when your application is accepted/not accepted?
  • What does the planning process involve once accepted? 
  • Receiving your approved plan
  • What if you disagree with what’s on your plan? 
  • How do you manage your NDIS funding? 
  • How do you spend your NDIS budget? 
  • Who benefits from NDIS funding? 

This article has been prepared as a guide only, please refer to www.ndis.gov.au for further information, or contact your Local Area Coordinator prior to making any NDIS decisions.

Who runs the NDIS?

The NDIS is delivered by The NDIA, the National Disability Insurance Agency. It is the NDIA that makes decisions about whether someone is eligible to become an NDIS participant, and if so, how much funding they receive. These decisions are based on the National Disability Scheme Act 2013.

Other organisations who help deliver the NDIS are referred to as Partners in the Community and Early Childhood Partners. Partners in the community employ Local Area Coordinators (LAC). For most people aged seven years and older, an LAC will be their main point of contact for the NDIS. Early Childhood Partners employ Early Childhood Early Intervention (ECEI) Coordinators, who are the main point of contact for families with a child accessing NDIS who is aged 0 to 6.

The LAC or ECEI Coordinator are there to assist you if you require help at any stage on your NDIS journey, and no question is off limits.

How to apply for the NDIS

Before applying for the NDIS, you need to assess your eligibility. Recipients must be Australian Citizens or permanent residents under 65 years of age, and have a permanent disability that affects their ability to take part in everyday activities.

Once eligibility is determined, the application process starts by completing section 1 of the Access Request Form. There may be some supporting documentation needed, which will be outlined on the form. Book an appointment with your treating professional (for example your GP, psychologist or paediatrician) so they can fill out Section 2 of the Access Request Form, then return it to the address provided on the form. It’s a good idea to keep a copy of your application and evidence for your own records.

What if you need help to apply? 

If you need help to apply, do not hesitate to contact your Local Area Coordinator or NDIA Office. Part of their role is to assist you during the application process.

What happens when your application is accepted/not accepted? 

Once you’ve provided the necessary information, the NDIA will make a decision about your eligibility for the NDIS. If you have provided all the required information and completed a valid request, you can expect the NDIA to respond within 21 days. If you are found eligible for the NDIS, you will be contacted by an NDIS representative to arrange a planning meeting to discuss your support and funding needs.

If you are not found eligible for the NDIS, you can:

  • Contact your Local Area Coordinator to see what other supports and services can be provided.
  • If your situation changes, or you have new evidence about the impact of your disability or developmental delay, you may need to complete a new Access Request Form.
  • You have the right to ask the NDIA for an internal review of your access decision.
  • If you are not happy after the internal review, you can apply for an Administrative Tribunal (AAT) review. This is a tribunal outside the NDIA.
  • As NDIS is a federal government initiative, you could also speak to your local federal member to ask if they can assist.

What does the planning process involve once accepted? 

If you are eligible for the NDIS, you will be contacted for a planning meeting. You will be asked to bring your participation booklets, and you will need to fill out Booklet 2 (the planning booklet) prior to your meeting. During the planning meeting you will discuss all the information you’ve outlined in the planning booklet, including your current support system, the aspects of your life where you require extra support, your goals and more.

This is your planning meeting, and it’s an important part of your NDIS journey, so remember that you can ask questions at any time. It’s also ok to ask the person doing your planning meeting to stop, repeat, or explain things.

It’s a good idea to bring something to take notes, and feel free to bring a friend to your planning meeting for support, and to help you remember to ask questions. If there is anything important that you forget to mention, you can email or call your early childhood partner, LAC or NDIA Planner on the number they gave you.

Your early childhood partner, LAC or NDIA planner will let you know the next steps and how long it will take to receive your approved plan.

Receiving Your Approved Plan

Your NDIS plan will be based on the discussion you had in your planning meeting. Your plan will be available on the NDIS portal called ‘myplace’ about 24 hours after it has been approved. ‘myplace’ is a secure website portal on the Australian Government’s myGov website where you or a person you trust (a nominee or child representative) can access your NDIS information. You will also receive a printed copy of your plan either in person or in the mail in your preferred format or language.

Your plan will include:

  • Basic information about your disability, your day-to-day activities, where you live, who you live with, or who cares for you.
  • Information about the support you get from family and friends to help you work towards your goals.
  • Information about services and supports funded and delivered by community or other government services like support groups, health centres, libraries and public transport.
  • The current goals you would like to pursue as part of your plan and the long-term goals you have identified for your life.

What if you disagree with what’s in your plan?

If you are not happy with your plan you have the right to ask for an internal review by the NDIA. For more information about the internal review process visit the how to review a planning decision page. If you are still not happy after the internal review of the decision, you can apply for an Administrative Appeals Tribunal (AAT) review.

If you are not satisfied with the way the NDIA carried out its decision-making, or how the NDIA dealt with you during the review process, you can make a complaint.  You can also contact your local federal member to see if they can assist.

How do you manage your NDIS Funding? 

There are three options to manage your NDIS funding: self-managed, plan-managed and NDIA-managed. You can also choose a combination of the three options. Your early childhood partner, LAC or NDIA planner will explain each of the options and ask you how you would like to manage your NDIS funding during your planning meeting, so you don’t need to choose on your own. Note that NDIA managed is the most restrictive, as you are only allowed to use NDIS registered providers. If you choose the self-managed or plan-managed options, you can use services from both registered and unregistered providers.

How do you spend your NDIS budget? 

There are three types of support budgets that may be funded in your NDIS plan: Core Supports budget, which helps you with everyday activities and your current disability related needs; Capacity Building Supports budget, which helps you build your independence and skills to help you pursue your goals; Capital Supports budget, which includes higher-cost pieces of assistive technology, equipment and home or vehicle modifications, and funding for one-off purchases you may need (including Specialist Disability Accommodation). What’s included in your plan will depend on what needs were identified during your planning meeting, so not all of these support budgets will be included in every NDIS plan.

The Core Supports budget provides funds for assistance with daily life (e.g. household cleaning), consumables such as continence products or low-cost assistive technology, assistance with social and community participation (e.g. a social worker to assist you participate in social activities), and transport.

The Capacity Building Supports budget provides funds for: a support coordinator to help you use your plan; support to help you find and maintain an appropriate place to live; development and training to increase your skills so you can participate in the community;  support for finding and keeping a job (e.g. training and assessments); support for improved relationships, improved health and wellbeing (but excluding gym memberships), improved learning, and more.

The Capital Supports budget provides funds for higher cost assistive technology, such as equipment for mobility, personal care, communication and recreational inclusion such as wheelchairs and vehicle modifications. It also includes home modifications such as the installation of a handrail in the bathroom, or specialist disability accommodation for participants who require special housing because of their disability.

You can find out more about these supports on the NDIS website, or speak to your Local Area Coordinator or NDIA office.

Who benefits from the NDIS? 

Of course, the NDIS mostly benefits participants who are deemed eligible for funding. However, there are criticisms in terms of how this funding also “lines the pockets” of service providers, some of whom don’t always place client’s needs as a priority. Some say that the NDIS has provided a means for profit-focused entities to improve their bottom line, without genuine care for the quality of what they’re offering.

A recent article about Afford, a registered provider under the National Disability Insurance Scheme (NDIS), highlights one such example. According to this article, since the launch of the NDIS in 2013, Afford has “more than doubled its clients to more than 4,000 and increased its annual revenue from less than $50 million in 2015 to almost $120 million last financial year.” Ultimately, one would expect an increase in service provisions to lead to an increase in profits. But when profits increase so exponentially, you have to wonder if the system is structured in the best possible way. Furthermore, a certain level of care is to be expected, which according to this article was allegedly not always provided to clients, leading to the question of oversight – is the NDIS adequately overseeing their registered providers?

While there are certainly improvements that could be made to the NDIS, it’s a system that has already been an immeasurable benefit to many participants, both locally and beyond. If you meet the eligibility criteria, it is certainly worth applying.

Denise Mills

Denise Mills is a writer and accountant based in Central West NSW. Her words have featured in The Guardian, Brevity, Epoch and more.

Read Posts