1. What is the NDIS? Is it for me?

What is the National Disability Insurance Scheme?

The National Disability Insurance Scheme (NDIS) is a new way of funding eligible people to purchase supports to increase their independence, manage their everyday tasks, and to achieve their goals and aspirations.

The NDIS does this by working with individuals to develop an 'individually funded package' or 'NDIS Plan'. When an NDIS Plan is being developed, individuals choose the type of supports they need to purchase and who they purchase those supports from.

If you are eligible for the NDIS, you will receive funding on an annual basis to purchase the support, aids and equipment that you have been assessed as needing from the service provider/s of your choice.

Who is involved?

There are various people and organisations involved at the different stages of your NDIS journey. Some of the people might be friends, family, health professionals, community workers, social workers and carers. They may be able to help provide evidence to support your application. It's your choice as to who will be involved and to what extent.

The National Disability Insurance Agency, Local Area Coordinators and support providers are essential to the process and will be involved to varying degrees in your NDIS journey.

The National Disability Insurance Agency (NDIA)

The National Disability Insurance Agency (NDIA) is the independent agency responsible for implementing the NDIS. They will assess your application to see if you're eligible. If you are eligible they will assign a Local Area Coordinator to you to assist you to develop your NDIS plan.

If the NDIA thinks that you are not eligible for NDIS funding, they will let you know why. You can request to have your application reviewed; this may involve providing more evidence to support your application or clarifying something in your application.

Local Area Coordinators

If you are NDIS eligible, a Local Area Coordinator will work with you to develop your NDIS Plan and to help you find and engage support providers.

If you're not eligible for the NDIS, the Local Area Coordinator will work with you to connect you with supports and services to assist you while you are in need of them.

Support providers

Support providers are individuals and/or organisations that provide the formal support that you require to live a fulfilled life and to achieve your goals. They may be community support providers that are available to everyone such as sports clubs, community groups or bushwalking clubs, or they may be supports that are specific to your needs and related to your disability. For example, a support provider may assist you in managing your budget, assist you to get around, or help you resolve problems with other services you are linked with.

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How does the NDIS work?

Before you start the process of collecting evidence, applying for the NDIS and developing an NDIS plan, you may be asking yourself "How does the NDIS work, in practice, for me?"

It works by helping you to identify the supports you need to live a fulfilled life and to reach your goals and aspirations. It gives you choice and control about what your supports look like – it's not a one-size-fits-all approach.

You can choose who provides your supports and when they provide it, and you can choose how involved you want to be in hiring and managing your support providers.

Read on for a short description of what happens during each stage. A more detailed overview of each stage can be found in the following chapters.

If you decide to apply for the NDIS, there are a series of stages:

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What happens in the "Applying for the NDIS" stage?

To apply for the NDIS you will need to complete an Access Request form. This form will ask you to provide evidence of your disability. You can obtain an Access Request form by calling the NDIS on 1800 800 110.

When applying for the NDIS, you may want to involve people/organisations who can advise you on the type of evidence you will need to include in your application and to help you collect it.

Who can help you determine what evidence you may need?

  • The National Disability Insurance Agency (NDIA) can provide advice on people or organisations that can advise you on the type of evidence you need and any supporting information required (eg. a diagnosis and information about how you are impacted)
  • A Local Area Coordinator (LAC). Ask the NDIA for the contact details of your LAC.
  • Your healthcare provider/s
  • Friends, family, social and/or community workers may also be able to help you find out what you need, help you collect the evidence and may also be able to provide evidence to support your application.

Once you have the evidence that you need, you will be able to complete and submit an Access Request form with the evidence you have collected. If you are accepted, you will next need to develop an NDIS Plan.

More information on why you might want to apply is covered in Chapter 2, and information on how to apply is covered in Chapter 3.

Remember -- there's no such thing as too much evidence

What happens in the "Developing your NDIS Plan" stage?

At the planning stage you will work with your Local Area Coordinator and develop your NDIS Plan.

This will include identifying the supports you need to increase your social and economic participation, manage your everyday tasks, and achieve your goals and aspirations.

In the planning stage meetings and conversations with your Local Area Coordinator, feel free to include and involve anyone who you think can help you. They may be able to assist you in generating ideas; identifying the best supports to be included in your NDIS Plan, or advising on the best way to have your NDIS Plan managed.

Your NDIS Plan will include the number of hours for each types of support you need and the cost of this. The NDIS has a price guide that shows the maximum amount that the NDIS will pay for each type of support provided. This is available on the NDIS website at http://www.ndis.gov.au/providers/pricing-and-payment. More information on developing your NDIS Plan is covered in Chapter 4.

At this stage, you will also think about and decide on how you want your NDIS Plan to be managed. There are different options and they are covered in the 'Which Plan Management Option' section in Chapter 5.

Once your NDIS Plan is developed, it will be submitted to the NDIA for approval. If approved, the next stage is the implementation stage.

What happens in the "Implementing your plan" stage?

At the implementation stage you will work with your Local Area Coordinator and anyone of your choice to identify and purchase your supports.

Once you have decided on your supports, generally Service Agreements are prepared and signed by all parties involved. Who signs these depends on which plan management option you have decided works best for you. There is more information about plan management in Chapter 5.

What happens in the "Review your Plan" stage?

Twelve months after your first NDIS Plan is implemented, you'll meet with your Local Area Coordinator to review your plan and adapt it if it's not meeting your current needs. After the first year your plan will be reviewed every two years unless there's something that needs changed before then. See Chapter 6 for more information.

Who is the NDIS for? Who is eligible?

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The NDIS is for people with a disability that is likely to be with them for life and that substantially impacts on their capacity to manage everyday activities.

You may be eligible for NDIS funding if you meet the criteria below:

  • Be under 65 years of age
  • Be an Australian Citizen or permanent resident or someone who holds a Protected Special Category Visa
  • Have a disability that is likely to be with you for life and which substantially impacts how you manage everyday activities
  • Live in an area where the NDIS is available.

On the NDIS website there is an Access Checklist you can use. See: www.ndis.gov.au/ndis-access-checklist

Your answers will help you determine whether you are NDIS eligible.

Is mental illness included in the NDIS?

Mental illness is included in the NDIS under the name psychosocial disability, but not everyone with a mental illness will have a level of impairment that is considered a psychosocial disability.

Mental illness is considered a psychosocial disability if the mental illness is significant, makes it difficult to do everyday tasks such as getting around, looking after yourself or working; and you are likely to live with the mental illness the rest of your life. The illness can be ongoing or episodic.

Does my income affect my eligibility for the NDIS?

Generally your income from paid employment, a Centrelink benefit or self-employment does not impact on your eligibility to receive NDIS support. Meeting the NDIS eligibility criteria is what determines whether or not you are NDIS eligible, not your income levels or income source.

What the NDIS does not cover

The NDIS does not fund current services such as:

  • education
  • income support
  • public/social housing
  • employment
  • public transport
  • health services

These will continue to be funded by State or Commonwealth Governments.

It also does not cover living expenses such as:

  • rent or mortgages
  • vehicle payments/registration
  • public transport fares

What the NDIS may be able to do is fund supports that help people access and connect with these types of services. For example, if someone needs travel to be able to get to doctor appointments or university, the NDIS may be able to provide funding so you can access financial counselling to assist with managing living expenses.

Why might I apply for the NDIS?

The NDIS changes the way services and supports are funded and provided. You may be uncertain about whether or not to apply for the NDIS, or you may just want to know more about the NDIS before making a decision.

There are a few key things you may like to consider in making your decision:

  • Many of the supports people currently receive will be funded through the NDIS in the future and to continue to receive these supports you may have to apply for the NDIS.
  • The differences between the new and old ways of supports being funded may also impact on your decision to apply. The new way of funding will be based on an NDIS Plan that is tailored to meet your needs. The NDIS is not just about getting services but about having a life where opportunities are provided to assist you to reach your goals and aspirations.
  • If you are successful in applying for the NDIS, you will have greater choice and control in the type of supports that can be provided to you and who provides them. If, for some reason, you're not happy with the support or the provider you can change them.

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Who can help me with the NDIS?

Your Local Area Coordinator

A Local Area Coordinator (LAC) provides support to NDIS participants to engage with the NDIS process. The NDIS is new and like all new ways
of doing something it takes time to learn how to navigate through the various components. The Local Area Coordinator will assist you in doing this.

Some of the ways they can assist you with this is through:

  • Pre-planning
  • Gathering information for your NDIS plan
  • Developing your NDIS Plan with you
  • Connecting you with support providers to implement your plan.

The NDIS is also new in the community and it will take time for support providers and the broader community to adapt to the changes and continue to be more inclusive of people with disability.

One of the outcomes of the NDIS is to work towards developing a culture of inclusivity, where people living with disabilities are able to participate in all aspects of community life. The Local Area Coordinators will be working alongside the local community to help achieve this.

Your Nominee

There are two types of nominees that you can appoint:

Plan nominee

A Plan nominee can act on your behalf in all areas that relate to:

  • your NDIS Plan, and
  • the management of funding of your supports under your NDIS Plan.

Correspondence nominee

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A Correspondence nominee can act in all areas on your behalf except when it relates to:

  • your NDIS Plan, and
  • the management of funding of your supports under your NDIS Plan.

Generally it is up to you whether or not you want a Plan nominee or a Correspondence nominee. On rare occasions the NDIA will appoint a nominee. This will only happen when a NDIS participant is unable to make a decision unassisted.

If you decide you would like to appoint a nominee, talk to them about it and let them know the duties they have in relation to you and the NDIA.

Duties a nominee has to you and the NDIA may include:

  • Working with you to find out what you want in your NDIS Plan and how you would like it to be managed.
  • Promoting your personal and social wellbeing.
  • Increasing your capacity to the level that you no longer want or require a nominee.
  • Only doing what you are unable to do.

Community and Social Workers

Community and Social Workers may be able to assist you in navigating parts of the NDIS. If you have been working with them or attending programs they run, they may be able to provide evidence to support your application. They may also be able to provide information about community activities that you may want to participate in and include in your NDIS Plan.

Family, friends and carers

The support of people that you trust and/or that provide you with informal support may be able to assist you with all or parts of your NDIS journey as well as provide suggestions about local activities and possibly evidence of how your disability impacts on your life.

Health Professionals

Your Occupational Therapist, GP, Psychologist, Psychiatrist, Mental health team or other health professionals may be able to provide you with the evidence you need to access the NDIS. They may also be able to help you navigate your way through your NDIS journey.