Understanding NDIS funding and Plan Management

To make the most of the benefits of funding provided by the National Disability Insurance Scheme (NDIS), it is important to understand how it all works.

It begins with your NDIS application which needs to document the impact of your disability on your daily life supported with evidence from your support team.

If eligible, your NDIS plan may fund a range of personalised supports and services that enhance your day-to-day life. There are a variety of types of supports that can help. There are of guidelines about what is, or is not fundable under the NDIS.

The NDIS has three ways to manage your funding depending on your situation and capabilities. You can let the National Disability Insurance Agency itself manage your funds. Alternatively, you can do it all yourself and be self-managed. Or there is a third option where you use a plan manager to do all the invoice admin and government paperwork. You keep choice and control regarding which service you use and when you want to use that service.

A plan manager is funded separately to your plan and can help you with advice to help you get the most from you NDIS plan.

Understanding NDIS Funding

The NDIS is a government-funded program designed to provide support to Australians who meet its eligibility criteria. The primary goal of NDIS funding is to assist participants in achieving their life goals, fostering independence, and actively engaging in their communities.

Guided by the principle of individualised support, the NDIS Plan Management can be tailored to meet the unique needs of each participant, ensuring they have access to appropriate resources and assistance.

Quick Links:

• Comprehensive Services and Support Under NDIS Funding
• Exclusions: Services and Support not covered by NDIS
• Eligibility for NDIS Support
• Applying for NDIS Funding
• Benefits of NDIS Funding
• Managing Your NDIS Funding Effectively
• Preventing NDIS Fraud

Comprehensive Services and Support Under NDIS Funding

The NDIS covers a wide range of services and supports that address participants’ needs, including areas such as housing, employment, hobbies, and social connections. 

Furthermore, the NDIS provides opportunities for participants to learn new skills, enhance their independence, and receive support for investment and accessibility requirements. Each participant has the freedom to allocate their funding according to their priorities and preferences, enabling them to customise the support they are receiving based on their individual needs.

The services and support offered under NDIS Plan Management  funding can be broadly categorised into three main areas:

Core Support

Core support and services cater to participants’ essential daily living requirements, including bathing, dressing, eating, and mobility accessibility. Personal support can be provided by a family member, friend, or support worker, tailored to address the reasonable and necessary needs of each participant.

The Core budget offers the most flexibility and can be allocated to the following:

• Consumables: Everyday items like continence aids, diapers, syringes, etc.
• Daily Activities: Assistance is provided throughout the day by a caretaker in self-care activities.
• Assistance with Social and Community Participation: Opportunities for participants to engage in social circles and recreational activities.
• Transport: Provision of transportation services for participants who are unable to use public transport.

The Core budget also allows for specific purposes, such as compensation, in-kind support (e.g., school transport or therapy), and assistance in shared living arrangements. 

Furthermore, NDIS funding covers Specialised Disability Accommodation for participants with high support needs or significant functional impairments, ensuring they have access to individualised support and specialised housing.

What adaptive and accessible sports can you play?

Many sports today have adapted programs and equipment to accommodate people with a range of disabilities. What you choose to play will depend on your interests, physical or cognitive abilities, and goals. Some of the more popular adaptive sports include:

• Wheelchair Basketball: A fast-paced sport played by people who use wheelchairs.
• Wheelchair Rugby: A physically demanding contact sport for individuals who use wheelchairs.
• Adapted Tennis: A racket sport that can be played by people with various disabilities, including physical and visual impairments.
• Sitting Volleyball: A version of volleyball played by people who are unable to stand.
• Para-Cycling: A sport adapted to cyclists with disability or additional needs.
• Para-Equestrian: A sport that involves horseback riding for individuals with disability, including physical and visual impairments.
• Adaptive Surfing: May need extra assistance, an adapted surfboard or specialised equipment.
• Goalball: A team sport specifically designed for individuals who are blind or visually impaired.
• Adaptive swimming: May include a range of modifications, such as the use of special flotation devices or prosthetics, or changes to the rules of the sport.

These are just a few examples of the many adaptive and accessible sports available. It’s best to check with local disability organisations or sports clubs to find out what adaptive sports are available in your area.

Capital Support

NDIS services also offer capital support to facilitate participants’ personal and professional growth. Capital Support can be further divided into two main categories:

• Assistive Support: This includes assistive technology devices or equipment that aid individuals with disabilities in performing daily activities. It encompasses a broad range of solutions, from low-tech tools like reachers and wheelchairs to high-tech communication devices or motorised wheelchairs. NDIS funding is available for reasonable and necessary assistive technology that helps participants achieve their goals.

• Home Modifications: These modifications aim to enhance participants’ daily activities and overall quality of life. They can range from simple additions like handrails in bathrooms to customised modular ramps at home entrances.

Capacity Building

This aspect of NDIS support focuses on providing services that help participants enhance their skills and live more independently. A key component of capacity building is therapy services, which include physiotherapy, occupational therapy, speech therapy, and psychology services. 

These services aim to improve participants’ physical, cognitive, and emotional well-being. NDIS funding covers therapy services that are considered reasonable and necessary for participants to achieve their goals.

To facilitate decision-making regarding funding approval, the NDIS has sub-divided these categories into 15 specific areas, such as Assistance with Daily Life, Transport, Consumables, Assistance with Social & Community Participation, Assistive Technology, Home Modifications, Coordination of Supports, Improved Living Arrangements, Increased Social and Community Participation, Finding and Keeping a Job, Improved Relationships, Improved Health and Wellbeing, Improved Learning, Improved Life Choices, and Improved Daily Living.

Participants also have the flexibility to negotiate fees or seek higher rates from service providers who offer high-value services. Detailed information on NDIS Pricing Arrangements and Price Limits, formerly known as the NDIS Price Guide, can be found on the NDIS website. These arrangements ensure participants receive value for their funding, while the Support Catalogue provides an exhaustive list of available support options for providers. 

Additionally, the Pricing Arrangements outline appropriate price limits, claim types, and maximum prices for registered providers, empowering participants to manage their NDIS services funding effectively.

Exclusions: Services and Support not covered by NDIS

While the NDIS program offers a vast range of support, it is essential to be aware of services that fall outside its scope. The following categories are not funded by the NDIS:

• Support unrelated to the participant’s disability.
• Support similar to services provided by other funding schemes distinct from the NDIS.
• Support that constitutes day-to-day living expenses unrelated to the participant’s support needs.
• Support that may pose harm to the participants, those around them, or the general public.
• Support that is more appropriately delivered by other agencies, such as school systems or health organisations.

For more detailed information on excluded support and services, refer to the NDIS Act and the NDIS Rules.

Eligibility for NDIS Support

To determine eligibility for NDIS support, consider the following criteria:

• Age Requirement: Participants must be between the ages of 9 and 65. Local area coordinators can provide assistance in understanding the NDIS and coordinating with other government and community support services. Families with children below 9 can seek additional support and guidance from early childhood partners, while individuals over 65 can access different types of support available through different channels.

• Residency: Participants must be Australian citizens, permanent residents, or Protected Special Category Visa holders.

• Disability: Eligibility is open to Australians with a disability resulting from a permanent impairment, encompassing intellectual, physical, cognitive, sensory, neurological, or psychosocial conditions. Participants requiring disability-specific support for their daily activities are also eligible.

• Early Intervention: Participants currently requiring support to improve their independence and reduce future support needs are eligible for NDIS funding. The support must aim to enhance functional capacity, prevent deterioration, address impairment impact (including mobility, communication, independence, and socialisation), and assist with managing one’s life. Informal support and capacity building are also considered. Factors such as potential changes in impairment over time, duration of impairment, potential improvements, and upcoming changes in support services (e.g., finishing school) are taken into account.

• Family Support: Support that helps families develop skills to assist the participant in the future is eligible for NDIS funding.

Applying for NDIS Funding

The application process for NDIS services and support funding involves several steps. Begin by contacting the National Disability Insurance Agency (NDIA), the organisation responsible for administering the NDIS. They will guide you through the application process and assess your eligibility. During the application, provide detailed information about your or your loved one’s disability, support needs, and goals.

Supporting documentation is also important when applying for NDIS funding. Include medical reports, assessments, and any relevant information that demonstrates the impact of disability on daily life. These documents will assist the NDIA in assessing eligibility and determining the appropriate level of support required.

Benefits of NDIS Funding

The NDIS funding program offers a wide range of benefits to eligible individuals in Australia. With its focus on personalised support and empowerment, NDIS funding has the potential to transform lives and create more inclusive communities. NDIS participants can enjoy benefits such as:

• Enhanced Access to Support and Services

One of the primary benefits of NDIS funding is increased access to essential support and services. Participants have the freedom to choose from a diverse range of service providers, ensuring they receive the specific assistance they need. 

• Holistic Approach to Individual Needs

NDIS funding operates on the principle of individualised support, acknowledging that each person has unique goals and requirements. Through a comprehensive assessment process, participants work with planners and support coordinators to develop personalised plans that address their specific needs. 

• Fostered Independence and Choice

With NDIS funding, participants have greater control over their lives and decision-making processes. They have the freedom to choose their service providers, set goals, and determine how their funding is allocated. This level of autonomy promotes independence, allowing individuals to make choices that align with their preferences and values. NDIS funding empowers participants to shape their own lives, fostering a sense of ownership and self-determination.

• Social Inclusion and Community Participation

Participation in social and community activities is essential for overall well-being and a sense of belonging. The funding can cover the costs of transportation, assistive technology, and other support required for participants to participate in community life fully. By facilitating community inclusion, NDIS funding helps individuals build social connections, develop new skills, and enjoy a more fulfilling life.

• Improved Health and Well-being

The NDIS recognises the importance of holistic well-being, encompassing physical, mental, and emotional health. NDIS funding supports participants in accessing therapy services, such as physiotherapy, occupational therapy, speech therapy, and psychology services. These services aim to improve participants’ overall well-being, enhance their functional abilities, and address any specific challenges they may face. 

• Family Support and Respite

NDIS funding extends support to families and carers, recognising the vital role they play in the lives of participants. The program offers respite services, allowing families to take breaks from their caregiving responsibilities and recharge. Additionally, NDIS funding may cover family support services, equipping families with the necessary skills and resources to provide ongoing support to their loved ones. This support ensures that both participants and their families receive the assistance they need to thrive.

• Financial Assistance

Managing the financial costs associated with disability can be a significant challenge. This financial support relieves the financial burden on participants and their families, enabling them to access the necessary services without worrying about the cost implications.

Managing Your NDIS Funding Effectively

Once your NDIS funding has been approved, effective management becomes essential to ensure you make the most of the allocated funds. By following key steps and strategies, you can optimise the utilisation of your NDIS funding and access the support and services that will truly enhance your life. Here’s how you can manage your NDIS funding effectively:

• Create a Personalised Plan: There are different ways to manage your NDIS funding depending on your needs and preferences — NDIS-Managed, Plan-Managed, and Self-Managed. Collaborate with a skilled planner or support coordinator to develop a comprehensive and personalised plan. With an NDIS Plan Management system that aligns with your unique circumstances, you can establish a clear roadmap for achieving your goals.

• Choose Providers Carefully: As an NDIS participant, you have the freedom to select the service providers that best meet your requirements. Take the time to research and evaluate potential providers based on their qualifications, experience, and reputation within the disability sector. 

• Regularly Review and Adjust Your Plan: Life is ever-changing, and so are your needs and circumstances. As you progress on your journey, consult with your NDIS plan manager, support coordinator or planner to evaluate the adequacy of your plan and make any necessary adjustments. Open and consistent communication with your support coordinator, NDIS plan management provider, and other relevant stakeholders is also vital for the effective management of your NDIS funding.

• Stay Informed About NDIS Policies and Updates: The NDIS landscape is constantly evolving, with policies and guidelines being updated regularly. Stay informed about these changes to ensure you remain up to date with the latest information. 

Preventing NDIS Fraud

While the NDIS funding scheme aims to support individuals with disabilities, it is also crucial to remain vigilant against potential fraud or scams. Here are some tips to protect yourself:

1. Recognising Potential Scams

Stay informed about common scams targeting NDIS participants. Exercise caution when receiving unsolicited calls or emails requesting personal information or promising additional funding in exchange for payment. The National Disability Insurance Agency (NDIA) will never ask for your financial details over the phone or via email.

2. Protecting Personal Information

Safeguard your personal information to prevent identity theft or misuse. Avoid sharing sensitive details, such as your NDIS participant number or banking information, with unknown individuals or organisations. Regularly monitor your accounts and promptly report any suspicious activity to the authorities.

Conclusion

The NDIS funding program opens doors to a world of support and services, empowering individuals with disabilities to lead fulfilling lives. By fully understanding the extensive range of offerings and effectively managing your NDIS funding, you can make the most of this invaluable program. 

Whether it’s accessing essential daily living support, embracing assistive technology, or enhancing your capacity through therapy services, NDIS funding provides the tools you need to thrive and actively participate in your community.

With AIIM Choices, you can have your dedicated NDIS plan manager, who can also act as an accountant and bookkeeper to help you manage your NDIS fund. AIIM also comes with a Phone App to help you access your budget, providing information such as budget totals, invoice approval, invoice tracking, payment to service providers, and so much more. For non-native English speakers, support is also available in 15+ different languages. 

Learn more about services and support covered by NDIS Plan Management funding and how you can maximise and enjoy your NDIS experience with AIIM Choices. Contact us today.