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

Overview

This section provides a brief overview of the National Disability Insurance Scheme (NDIS) in Australia. The NDIS is a world-leading, once in a generation social and economic reform. Based on insurance rather than welfare principles, its purpose is to improve economic and social outcomes for Australians with a significant and permanent disability, and to provide them with reasonable and necessary supports. This chapter sets out to describe the NDIS, its terminology and explains how it relates to other parts of the service system. Some other sections in Chapter 13 focus specifically on the NDIS in New South Wales (NSW).

A significant number of people now benefit from the NDIS. The scheme is now fully rolled out in NSW, and over 100,000 people are receiving NDIS packages of which 27% had not received support from either the NSW or Commonwealth programs before. This number includes 7% of people living with psychosocial disability (which is the term used by the NDIS for people living with mental health conditions experiencing psychosocial difficulties and accessing the NDIS) (the scheme).

There is an under representation of people with mental health conditions both in NSW and nationally who should be accessing the scheme. By full roll-out in 2020, in NSW that means about 140,000 people living with all disability types would be accessing the scheme. This chapter can help you think about whether you may like to be part of the scheme, if you are eligible, who can support you make that decision and better understand how it affects other services you may be receiving at the moment.

The Commonwealth Government has committed to providing reasonable and necessary supports for people with a plan, providing participants with the ability to exercise choice and control and to live a more meaningful and satisfying life. These people are now able to choose the services and supports they want and need (based on certain criteria). This marks an important move away from the funding models that existed before the NDIS.

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

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
  • The language used in the NDIS

13A.1: What is the NDIS?

The National Disability Insurance Scheme (NDIS) is an Australia-wide scheme designed to support people with permanent and significant disabilitywhich 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. It is available for all eligible people living in NSW.

The aim of the NDIS is to provide people living with disability with important supports and services to make sure you can make the most of your life. 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 may also be important in helping you achieve your aims and hopes for the future. The NDIS sits alongside other services that you may be receiving from other sources such as mental health care and treatment, and physical health care through your GP or other medical and allied health services.

The values and intentions of the NDIS are built on the idea that people 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 and is why it provides individually tailored plans which are developed to meet a participant’s unique needs and aims.

13A.2: Who runs the NDIS?

 The National Disability Insurance Agency (NDIA) is an independent statutory agency, whose role it is to implement the National Disability Insurance Scheme (NDIS) in order 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 a number of 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
  • Delivering the NDIS;
  • The recovery of debts from persons who were not entitled to receive payments under the NDIS
  • Collecting data and conducting research regarding disability to help develop and enhance the work of the disability sector

In order to contact the NDIA please follow this link which gives you details of all the different ways you can make contact by telephone; mail; online forms; or connect on Twitter; on Facebook; on Linkedin; on YouTube and also find out about events; media enquiries; visiting local NDIS customer service centres and sending feedback and making complaints.

13A.3: What the NDIS doesn’t do

A goal of the NDIS is greater overall inclusion of people with disability in society, however this is a shared responsibility with other government systems. The NDIS is not a replacement for income services or a form of welfare. Assistance from the NDIS has no impact on income support such as the Disability Support Pension and Carers Allowance.

The NDIS is not intended to 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.

In focusing on people living with mental health conditions who experience psychosocial disability, it is the health and mental health systems that are responsible for assisting participants with medical treatment. This includes care while admitted to a public facility such as a mental health in-patient facility/hospital or when accessing public community based services; or when utilising the services of a psychiatrist, psychologist, allied health professional and GP; and when prescribed psychiatric medication and physical health interventions and medications.

13A.4: How the NDIS works with other mainstream systems

The NDIS has been developed to fund supports and services that will assist individuals to perform day-to-day activities and achieve their recovery aims. Wherever possible, the scheme will assist participants to access mainstream systems when they are better suited to meet their needs. The NDIA employs staff who work locally in the community to promote the inclusion of people living with disability. The Agency’s Local Area Coordinators (LACs) 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.

13A.5: The language of the NDIS

The NDIS has been developed to support individuals with disability live a meaningful and contributing life. 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 realise your hopes and aspirations.

13A.5.1: Participant

Having met the eligibility requirements, people who receive an NDIS package are referred to as ‘participants’ by the NDIA. While the 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.

13A.5.2: Psychosocial disability

The term ‘psychosocial disability’ is described in Chapter 12, Key Terms. Used in the context of the NDIS, it describes the challenges and limits that a person may experience as a result of a mental health condition. The social and economic challenges, or impairments, are those which often lead to social isolation and loneliness effecting a person’s overall wellbeing. Not everyone living with a mental health condition has a 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 and mainstream services, as well as your natural network of carers, family and friends.

To read more about psychosocial disability related to a mental health condition follow this link.

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

13A.5.3: Impairment

When considering access to the NDIS for a person living with psychosocial disability, the NDIS determines that impairment must be specifically about loss or damage to ‘mental function’ which relates to perception, memory, thinking, and emotions. Chapter 12 Key Terms in our manual describes the term impairment more generally.

The terms ‘mental health condition’ and ‘impairment’ are distinct but interrelated.

In the NDIS context, a mental health condition (which includes a range of diagnoses) can be thought of as the cause of the impairment (loss of or damage to mental function).

To read more about impairment and mental health and the NDIS follow this link. 

13A.5.4: Significant and permanent disability

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 evidence-based 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 conditionmay still be considered permanent. In short, a permanent disability means that your disability is likely to be lifelong.

13A.5.5: Reasonable and necessary supports

Reasonable and necessary means something that the individual needs and is fair. The NDIS funds reasonable and necessary assistance or products relating to a person’s disability to help them participate in the community and live a meaningful life.

13A.5.6: Choice and control

NDIS participants have the right to direct and make decisions regarding their NDIS plan, service providers and delivery of supports. The NDIS aims to maximise participants’ engagement with decision making and to exercise ‘choice and control’, determining what will enable them to live a fulfilling life, including deciding what supports they may need to assist them.

Section F.2 in this chapter describes decision-making issues for people under guardianship in NSW.

Updated February 4, 2019