NDIS – National Disability Insurance Scheme

The National Disability Insurance Scheme is the new way of providing individualised support for eligible people with permanent and significant disability, their families and carers.

The NDIS will replace current state and territory disability systems. It will be a person centered support system that provides targeted supports aligned to need. NDIS funding goes directly to people with disabilities and so there should be more choice and flexibility for people with disabilities and their families. The scheme is portable and entitlement to support will be the same wherever a person lives in Australia.

The NDIS will give you more choice and control over how, when and where your child’s supports are provided.

The NDIS is now enshrined in law and it’s going to happen! This insurance will give us all peace of mind – disability could affect anyone. The scheme is currently being rolled out in several trial sites across Australia. Learnings from these sites will feed back into the scheme to ensure it is the best it can be.

The NDIS is coming – We don’t know exactly when the NDIS will be here however it is expected to be sometime between July 2016 and July 2018.

The NDIS was devised and recommended by the Productivity Commission in July 2011 in response to the unmet needs of people with disability and families and carers across Australia. The National Disability Insurance Agency (NDIA) is the governing body of the Scheme.

The NDIS reforms will change the disability sector

Disability Services Now

  • State or Territory funded programs and services
  • Organisations (such as Treehouse) are funded to provide services to people living with disabilities
  • Welfare and charity model of disability funding

Under the NDIS 

  • One uniform, nationally funded scheme
  • Individuals living with disabilities receive funding based on their need
  • Embedded in law – ensures all Australians who meet the eligibility criteria are legally entitled to NDIS funding for all ‘necessary and reasonable’ supports.

Treehouse is registering to be an NDIS provider | We are getting ready and will ensure that you are too.

The NDIS will fund Early Intervention supports for eligible children aged 0 to 6 living with disability or developmental delay.

How is Early Intervention Funded under the NDIS?

The NDIS recognises the value of Early Intervention supports for children aged up to six years of age and funds these supports in a different way to all other age groups with packages of support called Transdisciplinary Early Childhood Intervention. To learn more about this model visit:

The NDIS has clear guidelines outlining the eligibility requirements to access the scheme and the evidence that needs to be gathered to support your application. The scheme recognises both diagnosed disabilities and significant development delays.

If eligible, the NDIS will work with you to identify the supports your child needs to live their life. They will help you to design a package of supports that achieve goals in many aspects of your family and child’s life, including independence, involvement in your community, education and health and wellbeing. An individual package of supports will then be funded for your child.

What will be funded?

The NDIS provides ongoing funding for all ‘reasonable and necessary’ disability equipment, care and support services. Generally the supports and services provided to your family and child will need to assist you to:

  • achieve identified goals for your family and child
  • support your child to become as independent as possible
  • develop your child’s skills for day-to-day living
  • support your child to participate in the community

In practice this means providing support, as and if required, in areas including:

  • mobility
  • communication
  • self-care and self-management
  • social interactions
  • learning

The NDIS’s Transdisciplinary Early Childhood Intervention packages are designed to address many of these supports. When thinking about what you may need or want in your child’s own individualised NDIS plan, you need to consider all your child and family’s daily activities and the aids, equipment, training and/or support that would make life easier, whether currently provided or not.

Will my child be eligible?

The NDIS uses a series of eligibility and planning assessments to determine allocated funding. The more information you can provide the better. An NDIA staff member called a Planner will carry out these assessments using formal systems and tools designed to ensure consistency, fairness and objectivity. If necessary, there is also scope for NDIA staff to also call on specialist advice.

Children with disability

Your child may be eligible for NDIS funded Early Intervention supports if they have an impairment or condition that is likely to be permanent and there is evidence that getting supports now will help by:

  • reducing how much help they will need in the future and
  • improving or reducing deterioration of their functional capacity or
  • helping your family and carers to keep helping your child

Children with developmental delay

Your child may be eligible for NDIS funded Early Intervention supports if they are under 6 years of age with developmental delay which results in:

  • substantially reduced functional capacity in one or more of the areas of self-care, receptive and expressive language, cognitive development or motor development and
  • the need for a combination and sequence of special interdisciplinary or generic care, treatment or other services which are of extended duration, and are individually planned and coordinated.

Get started – read, watch, talk, network and learn

Try these helpful links to get you started:

National Disability Insurance Scheme Get to know the NDIS’s official website, it’s packed with information.

Every Australian Counts is here to make sure the NDIS is delivered as promised and is the best it can be.

My Choice Matters – are here to work with people with disability and their families to live their life their way and get the most out of the changing disability system. They provide free workshops and their goal is to help you learn and practice new ways of doing things and develop and grow your skills in Choice, Voice and Control.

National Disability Services – is the Australian peak body for non-government disability services.

YouTube there are over 2000 videos on YouTube about the NDIS.

NDIS Grassroots Discussion  – this closed group on Facebook is for members to share information and have conversations around the NDIS – it’s a great source of information, both positive and critical, of peoples experiences in the trial sites.

Getting prepared…

Key steps to getting prepared to access the NDIS when it arrives.

Don’t worry, NDIS and Treehouse staff can support you at every step

Step One Establish availability – find out if the NDIS is likely to be available to your child. NDIS Access Checklist
Step Two Get prepared –

  • Learn about the NDIS by reading, attending information sessions and talking to our staff.
  • Understand what supports you get now and what supports you want and need in the future.
  • Keep your records up to date – access to the scheme requires evidence of eligible disability or developmental delay.
Step Three Apply – when the scheme is here you will formally apply for your child to become a participant of the scheme by submitting an application for an eligibility assessment.
Step Four Pre-planning – If eligible you will start the planning process by thinking about what support needs your child has and what goals you have for your child and family. You will use the NDIS Planning Guide and Workbook
Step Five Planning – Meet with your NDIS personal planner, to have a conversation about your child and family life including the things you have noted in the workbook. If you want to, you can bring a support person to this meeting.
Step Six Plan Development – using the information gathered during your planning meeting, your planner will determine which supports will best meet your child and family’s needs and help you achieve your goals. Your planner will then write up your plan of supports.
Step Seven Approve your Plan – your planner will send you a copy of your plan for approval, you can either approve your plan or request a review. At this stage you will reach final agreement on your plan, how it is managed and decide on review dates.
Step Eight Implement your Plan – it is now time to choose service provider/s that best suit your child and family’s needs and start working towards your identified goals.
Step Nine Review your Plan – each plan has an agreed review cycle of between 6 and 12 months. This is your opportunity to review your plan with your planner and discuss what is and isn’t working, amend your goals and objectives and adjust supports that respond to how your life changes over time.
Step Ten Implement and review cycle – will continue for as long as you are eligible for NDIS. For example, children with developmental delay are only eligibility for Early Intervention supports which stop to age 6.

How will the NDIS work for my family?

Working with your NDIS Planner

One of the central principles of the NDIS is that agency planners and participants work together to identify what current and future supports will be required to make progress on each participant’s goals. This process results in a ‘Statement of Participant Supports’ that sets out what supports will be funded by the NDIS, based on what is considered ‘reasonable and necessary’ to enable a good life. This could involve one-off and/or ongoing funding.

What does ‘reasonable and necessary’ mean?

The NDIA has put a great deal of effort and thought into defining as precisely as possible what is meant by  ‘reasonable and necessary’, since this definition fundamentally determines the entire scope of what the NDIS provides and its future costs to and, potentially, the scheme’s very financial and economic viability.

According to the agency, ‘reasonable and necessary’ means that the NDIS will provide individual participants with whatever is necessary to achieve their life goals and aspirations and participate in the community to the fullest extent possible, whilst at the same time ensuring the support provided “represents value for money, in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support”.  So for example, the NDIS will fund a wheelchair if that is what you need for mobility, but would refuse to pay for any “frills” such as decorations or special colours.

Commonly available disability supports and services the NDIS covers include aids and equipment, home and community care, personal care, domestic assistance, respite, home and vehicle modifications and community access. However, supports which are already available from other mainstream services, including from health, housing, education and aged care sectors, are most unlikely to be covered by the NDIS.

Will I have choice and flexibility in how I use my child’s NDIS funds?

Your child’s funding may be divided into two parts – fixed supports and flexible supports.

Fixed supports – this funding needs to be spent on specified supports such as equipment, home modifications and certain types of early intervention therapy services. Generally speaking, ‘fixed supports’ are those services deemed necessary to ensure participants’ goals or desired outcomes can be met, or those which require certain skills or qualifications from the provider involved. If a certain amount is allocated for a new power wheelchair, it will need to be spent on a new power wheelchair.

Flexible supports – this funding includes recreational, community access and home-based support activities and will be funded in more general terms, enabling participants to switch funding from one item to another, depending on their personal needs from week to week.

Will I be able to choose who provides support for my child?

A key principle underpinning the design of the NDIS is to give Australians with disability far greater choice and control over the supports and services they receive.

Each individualised funding package gives you the right to choose who provides the supports identified in your child’s package, and you are entirely free to change service providers if they do not adequately and satisfactorily meet your child and family’s needs.

If you wish or need to, you can also get support from intermediaries to support you to make your choices or handle administrative tasks. You can even choose to manage your child’s funds yourself so that you can directly purchase supports.

How do my child’s plan funds get managed?

Once your child’s individualised plan has been drawn up and formally agreed to, you have three choices as to how your child’s plan funds get managed. Regardless of your choice, you will receive a monthly statement of account so you can keep track of your funding.

Common tasks associated with managing plans include paying supplier invoices, developing service agreements with providers, assisting you with the hiring and paying of staff and preparing reports and reconciliations on how NDIS funds are being used. You can choose to:

  1. Self-manage – You will do all necessary financial and administrative processes yourself. If you choose to self-manage your funds, you are also entitled to request a “plan nominee” to support you with these processes. You can choose to manage part or all of your funds. One of the benefits of self-managing is you can choose to use service providers who are not registered with the NDIS.
  2. A plan management service – this is an independent business or organisation that is registered under the scheme to undertake all financial and administrative processes involved on your behalf. Treehouse is considering registering as a Plan Management Service. Plan Management Service providers are payed by the NDIA so funds do not come out of your child’s package.
  3. National Disability Insurance Agency – The agency will make all the payments necessary to any care and/or support provider that you choose, provided they are registered with NDIA as a provider.

What types of supports and services will not be funded?

Supports that will NOT be funded, under any circumstances, include those that are:

  • medical because Medicare already covers health and medical costs
  • part of day-to-day living expenses incurred by the general public and not related to disability support needs (e.g. rent, groceries, household bills)
  • unrelated to the participant’s disability
  • duplicate other supports provided under alternative funding
  • likely to cause harm to the participant or pose a risk to others
  • related in any way to income replacement.

What happens if my application for NDIS funding is unsuccessful?

If your child’s application is unsuccessful, there is also a formal review and appeals process. This starts with an NDIS internal review process. If the outcome is still unsatisfactory you have full rights of appeal to the Commonwealth government’s Administrative Appeals Tribunal.

People who are ineligible for an individualised funding package can still get general advice and information from the NDIA.

What exactly does the word ‘insurance’ mean?

The National Disability Insurance Agency (NDIA) explains the scheme’s key insurance principles as follows: Government welfare schemes have a very short-term focus on minimising costs in a particular budget year. In contrast, the NDIS will seek to minimise support costs over a person’s lifetime and maximise their opportunities.

The NDIS will therefore invest in tailored early intervention services and nurture and support families and carers in their roles.

There is therefore a much closer alignment of interests between people with disability, their families and carers and the NDIS, compared with the previous welfare-based approach to disability support services.

As part of its insurance-based governance model and longer-term approach, the NDIS will also invest in research and encourage innovation.

Insurers, like the NDIA, can act at the systemic level as well as fund individual support needs.

This includes building community capability and social capital, which will be especially important for people with disability who are not participants, their families and carers. 

For the NDIA, another very high priority will be encouraging the full inclusion of people with disability, their families and carers in mainstream community life, through increased social and economic participation. This will benefit individuals and the nation and according to the Productivity Commission is expected to add close to 1% to GDP.

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