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Chapter 12 Section A: The National Disability Insurance Scheme (NDIS)

Overview

The National Disability Insurance Scheme (NDIS or ‘the scheme’) is an Australia-wide scheme that assists people with disability including, psychosocial disability. People with a disability that significantly impacts their life and is likely to be permanent may qualify for NDIS support. The scheme provides funding directly to eligible participants enabling them to purchase the services they need.

The NDIS provides people in Australia who live with a permanent and significant disability the reasonable and necessary supports they need to live “an ordinary life”. This section describes the NDIS, NDIS terms and explains how it relates to other parts of the service system. Some other sections in Chapter 12 focus specifically on the NDIS in New South Wales (NSW).

NDIS is for people who experience significant difficulties with activities such as communication, mobility, social interaction, self-care and self-management. A significant number of people now benefit from the NDIS including people living with psychosocial disability. Psychosocial disability is a disability that may arise from a mental health issue. Not everyone who has a mental health condition will have a psychosocial disability, but for people who do, it can be severe, longstanding and impact on their recovery.

Many people who may be eligible for the NDIS, for a number of reasons, may not be accessing the NDIS.

Chapter 12 can help you think about whether you may like to be part of the scheme, find out whether you are eligible, and who can support you make that decision. You will find information about how or whether the NDIS affects other services that you may be receiving at the moment.

People accepted into the scheme will get an individual plan and an individually funded package of supports to manage. They should have the ability to exercise choice and control in the services and supports they want and need (based on certain criteria).

The NDIS can bring about important improvements to the day-to-day lives of people living with psychosocial disability. The NDIS is a major opportunity to set up a network of coordinated services to support you to improve your quality of life. The NDIS can provide real benefits for you, your carers and family.

For people whose disability does not involve a substantial reduction in their ability to perform daily task or when is not likely to be permanent, the NDIS can provide them with information and referrals.

In this section, there is information about:

  • What is the National Disability Insurance Scheme (NDIS )?
  • Who runs the NDIS ?
  • How the NDIS works with other mainstream systems
  • What the NDIS doesn’t do
  • NDIS Terms

12A.1: What is the NDIS?

The National Disability Insurance Scheme (NDIS) is an Australia-wide scheme designed to support people with permanent and significant disability. It replaces the previous disability support system. It was established by the Commonwealth Government to meet some of the challenges that people living with disabilities and their families face and make sure that they are well supported in the community.

The aim of the NDIS is to provide people living with disability with important supports and services to make sure they can make the most of their lives. This may include services that can help you develop a more independent lifestyle, increase social and community involvement and improve your day-to-day living skills.

The NDIS also provides you, your carers and family members with information and referrals to other services in the community that aren’t funded by the NDIS, but that may also be important to helping you achieve your aims and hopes for the future. The NDIS is in addition to other services that you may be receiving, such as mental health treatment and physical health care through your general practitioner.

The NDIS is built on the idea that people living with disability should have the same rights as other Australians, who exercise choice and control over their lives and decide what services might improve their general wellbeing. The focus of the NDIS is on equal access to services. This is why it provides individually tailored plans which are developed to meet a participant’s unique needs and aims. Participant is the word used to describe a person receiving a NDIS package.

13A.2: Who runs the NDIS?

The National Disability Insurance Agency (NDIA) is an independent statutory agency, whose role is to implement the National Disability Insurance Scheme (NDIS) to support a better life for hundreds of thousands of Australians living with a significant and permanent disability, their families and carers. The NDIA make decisions related to the NDIS, including:

  • deciding who can access the NDIS;
  • approving, suspending and reviewing participant plans;
  • decisions relating to the selection, suspension and cancellation of nominees of participants;
  • delivery of the NDIS;
  • recovery of debts from persons who were not entitled to receive payments under the NDIS; and
  • collecting data and conducting research regarding disability to help develop and enhance the work of the disability sector.

To contact the NDIA, this link gives you details of the different ways you can make contact them (i.e. telephone, mail, online forms, Twitter, Facebook, Linkedin). You can also find out about events, visiting local NDIS customer service centres and sending feedback or making complaints.

12A.3: What the NDIS does not do

When you receive assistance from the NDIS this has no impact on your ability to receive income support such as the Disability Support Pension or Carers Allowance. The NDIS is not a replacement for income services or a form of welfare.

The NDIS does not replace the services provided by the health, mental health, early childhood development, child protection and family support, education, employment, housing, transport, justice and aged care systems.

Health and mental health services are still responsible for assisting medical care and treatment for people living with mental health conditions who experience psychosocial disability. For example, if you access NDIS, you can still receive care in a public mental health facility, hospital, or public community based services. Similarly, if you access NDIS, you can still see a psychiatrist, psychologist, allied health professional and general practitioner.

12A.4: How the NDIS works with other mainstream systems

The NDIS has been developed to fund supports and services that will assist people with disability to perform day-to-day activities and achieve their recovery aims. Wherever possible, the scheme will assist participants to access mainstream services when they are better suited to meet their needs. If for example you become unwell and need to see a medical practitioner, the scheme will assist you access that service.

The NDIA employs staff who work locally in the community to promote the inclusion of people living with disability. The NDIA’s Local Area Coordinators can link people to mainstream services and assist other organisations to include people with disability.

More detailed information on the responsibilities of mainstream systems such as education and health is available on the NDIS website.

12A.5: Important terms in the NDIS

As a person living with a mental health condition, you may not identify as a person with disability. However, this is the language used by the NDIS to describe a diversity of experiences, including mental health and co-existing conditions and the functional, economic and social consequences that may arise from the condition/s. The NDIS uses the descriptions ‘disability’ and ‘significant and permanent impairment’ to understand and evaluate your needs and to identify the best services and supports to help you to fulfil your hopes and aspirations.

12A.5.1: Participant

A participant is someone who is eligible and receives a NDIS package.

While this manual generally uses the term ‘consumer’ to describe people engaging with mental health and related services, for the purposes of this NDIS chapter, the terms participant and prospective participant are used.

12A.5.2: Psychosocial disability

The term ‘psychosocial disability’ used in the NDIS describes the challenges and constraints that a person may experience as a result of a mental health condition. The social and economic challenges often lead to social isolation and loneliness, affecting a person’s overall wellbeing. Not everyone living with a mental health condition experiences psychosocial disability. However, for people who do experience challenges, there are many opportunities to lead a meaningful and fulfilling life with the support of NDIS alongside mainstream services, as well as your network of carers, family and friends.

Psychosocial disability is also described in an NDIS Glossary available here.

12A.5.3: Impairment

When considering access to the NDIS for a person living with psychosocial disability, impairment refers to a loss or damage to mental function such as perception, memory, thinking, and emotions. An impairment may be caused by a mental health condition (which includes a range of symptoms).

To read more about impairment, click here.

12A.5.4: Significant disability and permanent impairment

A significant disability is regarded as having a substantial impact on a person’s ability to achieve daily tasks and goals.

A permanent impairment is an impairment for which there is no known, available or appropriate treatment or intervention that may remedy the impairment. While an individual’s mental health condition may be episodic, the impairment/s as a result of the mental health condition may still be considered permanent. In short, a permanent disability means that your disability is likely to be ongoing.

12A.5.5: Reasonable and necessary supports

The NDIS funds a range of supports and services which may include education, employment, social participation, arrangements to improve independence, living arrangements and health and wellbeing.

‘Reasonable and necessary’ supports are assistance that the individual needs to participate in the community and live a meaningful life. For example, the support or service:

  • must be related to a participant’s disability;
  • must not include day-to-day living costs not related to disability support needs, such as groceries;
  • should represent value for money;
  • must be likely to be effective and work for the participant; and
  • should take into account support given to you by other government services, your family, carers, networks and the community.

12A.5.6: Choice and control

A participant’s choice and control is a very important part of the NDIS. The NDIS provides funding to people with disability, so that they can then choose how best to use those funds on the supports and services that will help them to meet their needs and goals. NDIS participants have the right to make decisions regarding their NDIS plan, service providers and delivery of supports.

Follow this link to read about decision-making issues for people under Guardianship in NSW.

Updated November 19, 2020