The NDIS funding questions that give you power
[Image Description: A woman with short brown hair sits in her wheelchair wearing a red top, she is smiling and holding up her hand.]
In our recent webinar all about navigating NDIS plan changes (catch up on the replay here), our special guest NDIS expert, Sally Coddington, Principal Consultant at DSC, had one word written at the top of her notes to share…. “POWER”.
As Sally put it, “when we go into these reassessment meetings the power balance is stacked against us if we don’t understand the requirements that need to be met in order for something to be funded, and if we don’t have the language to communicate”.
To bring balance to the power equation, it’s so important to have an understanding of the NDIS rules, and the framework that the planner is working within. Because the decisions they make are going to greatly impact your life… in a good way or a bad way.
There’s two sets of questions that Sally believes everyone should familiarise themselves with. She recommends taking the time to answer them for yourself about the supports and services you want to use your plan for. That way, in any conversations you have with someone at the NDIA, you’ll be ready with the answers, the knowledge, and ultimately, the power.
Questions when you are negotiating for something to be funded in your plan
For something to be funded in your plan, the NDIA delegate (such as your planner) must agree that it meets all of the reasonable and necessary criteria listed in the NDIA legislation.
Go into your planning conversation prepared by going through the list of criteria below for the supports you want to have funded. Have answers at the ready as to how you believe the supports meet each of these criteria.
If you are told something is not able to be funded in your plan, ask the question… “which point under section 34 of the Act do you believe this support does not meet?”.
As per Section 34 of the National Disability Insurance Scheme Act 2013:
“Reasonable and necessary supports
For the purposes of specifying, in a statement of participant supports, the general supports that will be provided, and the reasonable and necessary supports that will be funded, the CEO must be satisfied of all of the following in relation to the funding or provision of each such support:
(a) the support will assist the participant to pursue the goals, objectives and aspirations included in the participant’s statement of goals and aspirations;
(b) the support will assist the participant to undertake activities, so as to facilitate the participant’s social and economic participation;
(c) the support 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;
(d) the support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice;
(e) the funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide;
(f) the support is most appropriately funded or provided through the National Disability Insurance Scheme, and is not more appropriately funded or provided through other general systems of service delivery or support services offered by a person, agency or body, or systems of service delivery or support services offered:
(i) as part of a universal service obligation; or
(ii) in accordance with reasonable adjustments required under a law dealing with discrimination on the basis of disability.”
Questions when you have your plan and want to know if you can spend it on something
Once funding has been approved as reasonable and necessary and been included in your plan, you have some flexibility with how you spend it, depending on the type of funding (ie. stated supports are not flexible, but you could use your Capacity Building budget in different ways).
As long as it’s within the rules and you have the funding in the support category required, these questions will help answer whether you can access a particular service or support. If you’re not clear on the different support categories included in your plan, here’s a guide to help you understand what could potentially be covered.
For Sally, the first question below is the most important. Her translation is to ask yourself, “would you be buying this if you didn’t have a disability?”.
Taken from page 15 of the NDIS Guide to self-management:
“You’ll need to use your NDIS funding in line with the supports included in your plan. The following questions can help you do this.
If the answer is ‘yes’ to these questions, the support is likely to be in line with supports included in your plan. If you are unsure you can talk to your support coordinator or My NDIS Contact.
Do you need the support because of your disability?
The support you buy must be related to your disability. You cannot use NDIS funding for day-to-day living costs such as rent, groceries or household bills.
Is the support likely to meet your needs?
You are encouraged to explore supports before deciding what to buy, so you can get the best support available to you. You can talk to your peers and networks about supports, try new things, and change your supports if you feel there is something that could better meet your needs.
Is the cost of the support reasonable?
Is the cost of the support reasonable when you think about the benefit of the support? It should give you good value for money compared to other options. You can choose to pay less and get more supports or pay more for a higher quality support if it best meets your needs.
Can you afford the support within your support budget?
Your NDIS funding needs to last for the length of your plan. The support you buy must fit into your budget. Work out your budget early so you know what you can afford. This will help you to track your funding and make decisions about any changes to your supports during your plan. You might like to use our budget calculator on the NDIS website to help you do this.
Is the support something that should be funded by the NDIS and not other government services?
The NDIS only funds disability-related supports. Other services and supports like dental, health or hospital services, education, housing, and public transport are all provided by other government organisations.
Is the support safe?
You cannot purchase supports that cause harm or put yourself or other people at risk.
Is the support legal?
The support you buy must be legal. The support must not break any Commonwealth or state or territory laws.”
Bringing the power to your NDIS plan
Get to know these questions and feeling confident in answering them, and you’ll bring so much power to your NDIS planning conversations and in using your own funding.
Want to keep growing your NDIS knowledge? Join us in the Kinora community to connect with thousands of other participants and powerful NDIS peeps, ask questions and find answers.
