A Beginners Guide to the NDIS
Welcome! This guide is designed to shed light on the National Disability Insurance Scheme (NDIS). If you or a loved one are navigating the NDIS, this guide will answer a lot of your questions, including:
What is the National Disability Insurance Scheme (NDIS)?
What does the NDIS pay for (funding)?
How to get NDIS funding?
How much does NDIS cost and how do you pay service providers?
Where can the therapies funded by NDIS take place?
What is the National Disability Insurance Scheme (NDIS)?
Living with a disability can be emotionally draining, expensive, and often requires lots of support from loved ones. The National Disability Insurance Scheme (NDIS) was launched in 2013 to provide funding and support for individuals living with disabilities. It aims to empower participants by offering financial assistance for personalized services, such as therapy, assistive technology, and community programs. The NDIS operates on a person-centered approach, giving individuals more choice and control over their support. Administered by the National Disability Insurance Agency (NDIA), it is designed to help people with disabilities achieve their goals and participate in the community.
What Does the NDIS Pay for?
The NDIS recognises the importance of comprehensive support for individuals living with a disability. We like to break the funding down into 3 categories:
Support with day to day living (core supports): These supports are considered essential for daily living and maintaining a person’s health and wellbeing. It may include assistance with daily activities, personal care, transportation, consumables, and assistance with social and community participation. This may also include Supported Independent Living (SIL) solutions.
Home and vehicle modifications and equipment (capital supports): The NDIS may provide funding for items or equipment that are considered a long-term investment to support the needs of someone living with a disability. This may include modifications to a person’s home or vehicle. They may also fund assistive technology items.
Increasing functional capacity (capacity building supports): This category focuses on building a person’s skills and independence to participate more fully within the community. The NDIS may provide funding for areas such as improved daily living skills, employment-related support, and social and community participation. Allied health services fall under this category and aim to increase a person’s functional capacity and independence. It funds a wide range of therapies aimed at enhancing physical, cognitive, and social capabilities. The most common therapies include;
Occupational Therapy: Focuses on improving daily living skills (including emotional regulation) to promote independence.
Physiotherapy: Aids in enhancing and restoring physical function, developmental milestones, mobility, and reducing falls risk.
Speech Therapy: Targets communication challenges, including speaking, listening, understanding language, reading, writing, social skills, and swallowing.
Psychology: Offers therapy and counselling to support emotionally, psychologically, and behaviorally.
This provides an overview of what the NDIS can fund. It’s just as important to understand what cannot be funded - The NDIS guidelines state that they will not fund things that aren’t related to a persons disability, that do harm, or normal day to day living expenses. The other big area the NDIS will not fund is a support that is the responsibility of another government system or community service. This includes Medicare, outpatient health services, certain medical procedures and any Centrelink arrangements.
How do you get NDIS funding?
To obtain funding through the NDIS, individuals must go through a process that includes the following steps:
Check Eligibility: Ensure you meet the criteria regarding age, residency, and disability or early intervention requirements. Generally, eligibility is for those under 65 years of age, Australian citizens, permanent residents, or New Zealand citizens who are Protected Special Category Visa holders, with a permanent and significant disability.
Make an Access Request: Contact the NDIS to make an access request. This can involve filling out an Access Request Form and providing evidence of your disability, which may include reports and assessments from health professionals. https://www.ndis.gov.au/media/2323/download?attachment
NDIS Assessment: The National Disability Insurance Agency (NDIA) will review your access request to determine whether you are eligible for NDIS funding. This may involve further assessments to understand your needs.
Plan Development: If you are deemed eligible, an NDIS planner or Local Area Coordinator (LAC) will work with you to develop a personalised NDIS plan. This plan outlines your goals and the reasonable and necessary supports funded by the NDIS to help you achieve them. It will also include a budget allocated to cover the cost of the support.
Plan Approval: Once your plan is developed, it will be reviewed and approved by the NDIA. After approval, you will receive funding according to the supports agreed upon in your plan.
Choose Service Providers: With your NDIS plan approved, you can choose service providers that meet your needs and align with your goals. This includes finding providers for any funded support, therapies, equipment, or home modifications.
Plan Review: Your NDIS plan is typically reviewed annually to ensure it continues to meet your needs. You can request a review earlier if your circumstances change.
It's important to provide detailed and accurate information throughout the process and to engage with NDIS planners or coordinators to ensure your plan accurately reflects your needs and goals.
How Much Does the NDIS Cost?
A fundamental principle of the NDIS is that accessing and using the NDIS incurs no direct cost to the participant. This means that eligible individuals receive financial support without any personal expense, ensuring that disability services and supports are accessible to those who need them, regardless of their financial situation. The goal is to ensure equitable access to essential support services without financial strain on individuals with a disability or their families.
When an individual becomes a participant in the NDIS they receive their NDIS plan that outlines the supports and services deemed reasonable and necessary for the participant. The plan includes a budget that is allocated to cover the costs of these supports. The budget is carefully calculated to ensure that it aligns with the participant's needs and goals.
A cornerstone of the NDIS is providing participants with the power of choice and control. Once a plan and its budget are approved, participants have the freedom to select the providers they believe will best meet their needs and help them to achieve their goals. This choice extends to all services covered by their NDIS plan, from occupational therapy and physiotherapy to support workers and equipment suppliers.
Participants are not limited to a pre-approved list of providers. Instead, they can opt for any provider that meets NDIS quality and safety requirements, including both NDIS-registered providers and non-registered providers (depending on the participant's plan management option). This flexibility ensures that participants can seek out services that are most appropriate for their unique circumstances, preferences, and objectives.
The cost of NDIS-funded services can vary based on several factors, including the type of service required, the duration of sessions, if the participant lives in a remote area, and the therapist's qualifications. Generally, the NDIS provides a price guide that outlines the amounts that service providers will charge. This guide can be found here: https://www.ndis.gov.au/providers/pricing-arrangements .
After a service provider or therapist completes the service for the participant, the service provider will send the invoice to the participant or NDIS plan manager. It will then be submitted to the National Disability Insurance Agency (NDIA) who will pay the invoice directly.
In summary, the NDIS offers a revolutionary model of disability support that prioritises the needs, choices, and goals of individuals with a disability. With funding that incurs no direct cost to the participant and the freedom to choose their own providers, the NDIS ensures that every participant can access the high-quality support they need to live an empowered and fulfilling life.
Where Can the Therapies Funded by NDIS Take Place?
One question many participants don’t ask is, where can my therapist provide the service? They can take place in a variety of settings to accommodate the diverse needs and preferences of participants. The flexibility in service delivery is designed to ensure that individuals can access therapeutic support where it's most effective and convenient for them. Here are some common locations where NDIS-funded therapies can be provided:
Participant's Home: Mobile therapists offer services directly at the participant's home. This is particularly beneficial for individuals with mobility issues, severe disabilities, or those who prefer the comfort and convenience of receiving support in their own living space. This is also a great option to ensure therapy gels with a participant’s everyday routine and environment. It is important to understand how travel charges will affect the NDIS plan budget.
Therapist's Clinic: Therapy sessions can take place in a therapist's clinic, which may be required if bulky equipment is necessary for treatment.
Community Settings: Therapy sessions can also be conducted in various community locations, such as community centers, libraries, or parks. This approach can be especially useful for social skills training, community engagement activities, or when the therapy aims to improve the participant's ability to navigate public spaces.
Educational Institutions: For children and young adults, therapy sessions might occur at schools, preschools, or childcare facilities. This setting allows therapists to work collaboratively with educators and integrate therapeutic goals with educational objectives.
Online (Telehealth): With advancements in technology, many therapists now offer sessions via telehealth. This method of delivery can be particularly useful for participants living in remote or rural areas, or when circumstances (such as public health considerations) limit face-to-face interactions.
The choice of therapy location is determined by several factors, including the type of therapy, the participant's goals, and personal preferences. Selecting a provider that can provide the service at the participants preferred location is important. The NDIS's emphasis on choice and control allows participants and their families to work with their providers to choose the most appropriate and effective settings for their therapies.
Summary
We hope this guide helps you to understand the key aspects of accessing therapy services through the NDIS.
Explore the benefits of the NDIS to enhance independence and quality of life. Start by verifying eligibility and submitting an access request. For comprehensive guidance and support, visit the NDIS website or reach out to a Local Area Coordinator. Empower yourself or your loved ones by tapping into the resources and support offered by the NDIS.
At Rewired Therapy we focus on driving outcomes for participants by focusing on clinical excellence. Our team of therapists include qualified and experienced physiotherapists whose main goal is to support you in creating new pathways to a better tomorrow. Read more about us here.