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Chapter 12 Section D: Receiving an NDIS plan

Overview

Receiving a National Disability Insurance Scheme (NDIS) plan means that your individual support needs will be managed in a flexible and individualised way. The National Disability Insurance Agency (NDIA) understands that needs and goals are different for every participant in the NDIS.

When you meet with an NDIA or Local Area Coordination planner to develop your plan, you will be asked about your current situation and how you manage everyday activities like taking a shower or cooking your meals. This information helps to work out the supports you need; in what way they are reasonable and necessary; how they would meet your immediate needs, and how the NDIS can help you to work towards achieving your goals.

Once the planning process is completed, you will receive an individualised amount of funding.

This section will provide information about:

  • What is in an NDIS plan?
  • Developing your first NDIS plan;
  • Starting your plan;
  • Managing your NDIS funding;
  • Types of support budgets; and
  • What if my needs change?

12D.1: What is in an NDIS plan?

Your individual NDIS plan is based on your goals and aspirations. Your plan will include information about your disability, your day-to-day activities, where you live, who you live with, or who cares for and supports you. It will also include information about your informal supports, that are not funded, such as your family and friends who assist you in your day-to-day activities and support you work towards your goals. It will include options for mainstream services and supports which you may choose to access or are already using. It will also how much reasonable and necessary supports and services will cost from your NDIS funding.

Usually your first plan will last for twelve (12) months. After the first plan, you may also be offered a longer plan if your needs are unlikely to change. This section includes information about s what to do if your needs change.

If you are not happy with the funding you have been allocated, you have the right to ask for an internal review of your plan by the NDIA.

For more information about the internal review process visit the How to review a planning decision page.

12D.2: Developing your first NDIS plan

If you are successful in your application to access the NDIS, you will meet with an NDIA planner or Local Area Coordination planner to talk about your goals and write down a list of the things you need to help you reach your goals, and develop your first NDIS plan.

Your short-term goals are what you believe can be achieved in under twelve (12) months. These might include getting or keeping a job, learning a new skill, enrolling in education, participating in your community, or making new friends. Medium to long-term goals, which can take a number of years to achieve, might be broken down into various short-term goals which could help achieve your long-term goals in a less overwhelming manner. For example, completing your TAFE course and finding a job related to that training may be a long-term goal.

This process is called a planning meeting. The NDIA will use the information about your existing disability supports to start working with you to develop your first plan.

All participant plans must be approved by the NDIA. After it is approved, you will receive your plan either in person or in the mail.

12D.3: Starting your plan

The NDIA can work with you to put your plan into action, and depending on your situation, there are a range of people who can help you implement your plan and support you to start receiving supports. These would have been discussed with you during your planning process with your Local Area Coordinator. Some people may also have a Support Coordinator funded in their plan to help them get started. You can start your plan by yourself if you are self-managed NDIS participant. For further information about managing supports in your plan, including making service bookings and using the myplace Participant Portal, visit the participants section of the NDIS website.

12D.4: Managing your NDIS funding

All plans are approved by the NDIA, and the individualised funding amount is also determined by the NDIA after working out what supports are needed to help achieve your goals.

There are options available in choosing how you would like to manage accessing and paying your NDIS supported services. All options allow you to exercise choice and control over the providers you use. Your Early Childhood Early Intervention Coordinator, Local Area Coordinator or the NDIA can answer your questions and help you if there are any problems, and assist you if you would like to change how your plan is managed.

To read about different ways to manage your funding read on or click here.

12D.4.1: Self-managed budgets

Self-managing your plan means that you are in charge of your NDIS plan, what you spend your support budgets on, what services you employ, and how much money you spend at a time. You are responsible for purchasing supports within your budget that will best help you achieve your goals.

The providers you choose do not have to be registered with the NDIS. You can employ your own staff or pay someone else to employ them on your behalf. In most cases, family members cannot be employed with NDIS funding to provide support to you.

You can choose to self-manage a part of your budget if you do not feel comfortable self-managing the whole plan. This means you can have a combination of both NDIA registered providers and service providers which you directly employ.

Managing your NDIS funds by yourself means that you will have more choice and control over the disability supports you can buy. It also means taking on some extra responsibilities regarding record keeping, insurance, payment (tax, pay rates, superannuation) and managing police checks and working with vulnerable people checks for your service providers. You will need to keep all the invoices and receipts, as well as bank statements from your nominated bank account for five (5) years. The NDIA can ask to check your records at any time, so it is important to keep them organised so you can show that you have spent your NDIS funds on supports that are helping you achieve the goals in your plan.

To read a guide to self-management, click here.

12D.4.2: NDIA-managed budgets

If you choose to have the NDIA manage your budget, they will pay your support providers directly from your NDIS package. You are able to choose from a range of NDIS registered providers and they will claim payment electronically from your funding. You cannot use unregistered providers. You can look on the myplace portal to see what claims providers are making against your NDIS funding and keep track of your budget. The NDIA will manage your book-keeping and records of your spending. You may decide to choose this option, if you feel you don’t want the responsibility of managing your own budget.

12D.4.3: Plan-Managed

If you choose this option, your budgets are managed by a Plan Management Provider. They will pay your providers for the supports you purchase, help you keep track of your funds, and do any financial reporting for you. Your plan manager must be an NDIS registered provider. With this option, the NDIA will pay your Plan Manager directly for these supports and is funded in your plan. You may choose this option if you prefer to have someone else manage your budget and have a Plan Manager to talk to about your choices.

12D.5: Types of Support Budgets

There are three types of support budgets that may be funded in your NDIS plan:

  • Core Supports budget;
  • Capacity Building Supports budget; and
  • Capital Supports budgets.

Three new support coordination items have been introduced to the NDIS Support Catalogue under Core Supports, Assistance with Daily Life, effective since 25 March 2020. These support coordination line items were added during the COVID-19 pricing update:

  • Level 1: Support Connection
  • Level 2: Coordination of Supports
  • Level 3: Specialist Support Coordination

The new line items duplicate items already claimable under Capacity Building Supports. The new item numbers allow participants to use their funds more flexibly to access these supports from either their Core or Capacity Building budgets.

For more information about support coordination click here.

For more information, refer to the coronavirus (COVID-19) FAQs for participants and providers.

12D.5.1: Core Supports budget

Core Supports help you with everyday activities, your current disability related needs and to work towards your goals. For example, Core Supports budgets can fund:

  • everyday items such as interpreting services, low-cost assistive technology and equipment to improve your independence and/or mobility;
  • assistance with social and community participation, such as a support worker to assist you to participate in social and community activities; and
  • transport assistance if a participant cannot use public transport without substantial difficulty due to their disability.

Transport assistance takes into account any relevant taxi subsidy scheme; but it does not cover transport assistance for carers to transport a family member with a disability for everyday commitments.

12D.5.2: Capacity Building budget

Capacity Building Supports help you build your independence and skills to help you reach your long-term goals and skills for the future. Supports which the Capacity Building budget will fund include:

  • the employment of a Support Coordinator;
  • supports to help you find and maintain an appropriate place to live;
  • development and training to increase your skills to participate in community, social and recreational activities;
  • supports related to employment such as training and assessment that help you find and keep a job;
  • supports which help you develop positive behaviours and interest with others to improve relationships;
  • supports to assist health and wellbeing, such as exercise or diet advice to manage the impact of your disability;
  • supports to improve learning, such as training, advice and help to transition to further education such as TAFE or university;
  • supports to help improve your choice and control in life, such as NDIS plan management; and
  • supports to help improve your daily living, such as assessment, training, or therapy to help increase your skills, independence and community participation in group or individual settings.

12D.5.3: Capital Supports budget

Capital Supports include higher-cost pieces of assistive technology, equipment and home or vehicle modifications, and funding for one-off purchases you may need. The Capital Supports budget will fund:

  • assistance for assistive technology which includes equipment items for mobility, personal care, communication;
  • recreational inclusion such as wheelchairs or vehicle modifications;
  • home modifications such as installation of a hand-rail in a bathroom; and
  • Specialist Disability Accommodation for participants who require special housing because of their disability.

12D.6: Carers and planning

The knowledge and experience of your family members and/or carer is highly valued throughout the planning process in the NDIS. You can bring along a family member, friend, advocate, or anyone else important to you to your planning meeting and to help you make decisions regarding what supports and services you need to achieve your goals, where and when they are provided and by whom. Your family member, friends, advocate, or support person is also permitted to be included in plan review meetings.

12D.7: What if my needs change?

It is important to tell your Local Area Coordinator or the NDIA about any change in circumstances that may affect your plan, such as:

  • changes to your disability needs;
  • significant changes in your care or support provided by family or friends;
  • changes to your living arrangements, such as where you live, if you live with new people, if you move overseas or into an aged care or residential facility;
  • changes to your job or that you are looking for a job; or
  • if you receive or claim compensation for an accident or illness related to your disability.

If you become mentally unwell and need to go to hospital, you can let the NDIA know, as there may be more or other things they can do to support you.

If something does change for you that affects your needs or the supports in your plan, you need to complete a change of circumstances form. If you fail to notify the NDIA of a change in your circumstances and you continue to receive supports that you are not entitled to, you may be asked to repay an amount for the funded support services.

If a service, early intervention support or assistive technology has increased your independence and decreased your need for additional support, you may need less funding, or no longer need any funding through an NDIS plan. This means, you may not need NDIS funding now, but you can re-engage with the NDIS in the future if you need to. People who experience a change in their disability needs may also see their NDIS funding levels change over time. Their disability needs may also be temporary at a particular time; and their funding level changed to meet that need.

Updated November 23, 2020