NDIS Legislation Changes

The NDIS has published a list of Approved and Non-approved supports.

The approved support list documents all supports claimable under the NDIS, not all supports will be included in your plan. Generally you can find more information about what types of supports you can access by looking at your plan document and your funding categories (components).

Items on the Non-approved support list are not able to be claimed from your plan. It is important to check if you are unsure to avoid being out of pocket for these expenses.

You can read more on the NDIS website: Supports funded by the NDIS

The NDIS only funds supports that meet the reasonable and necessary criteria.

A support will usually be funded if it meets all of the following:

•     It relates to your disability or early intervention needs
•     It helps you work towards your goals
•     It supports your social and/or economic participation
•     It is value for money
•     It is effective and beneficial for you
•     It helps maintain your informal supports
•     It is considered an approved NDIS support under legislation

Even if you have funding available in your plan, a support must still meet these criteria to be claimable.

No, participants are unable to claim supports from the non-approved supports list unless one of the following situations apply.

• It is a replacement support (please note, this has a set process to follow).
• It is funded in your current plan or supported by a letter from the Administrative Review Tribunal (ART).
• You receive written permission from the NDIA to allow the purchase of the non-approved item.

Some items are generally not approved NDIS supports, but in certain circumstances, you may be able to request them as a Replacement Support.

A replacement support:

• Must be approved by the NDIA in writing
• Is not automatic
• Is not an extra support
• Replaces an existing support in your plan

Important: Replacement supports usually only apply to items such as:

• Standard commercially available household items (for example, a washing machine or dishwasher)
• Smart watches
• Tablet devices
• Smartphones
• An app for accessibility or communication

We cannot process payment unless written NDIA approval is provided. If you are unsure, please contact us before purchasing the item.

This request needs to be sent to the NDIA. You can contact the NDIA through:

• Your MyNDIS contact or planner (written on your NDIS plan)
• Email to enquiries@ndis.gov.au

Unfortunately, the NDIA has confirmed that written authorisation or approval is required to support the claim of items that are no longer approved.

Until written approval from the NDIS is provided to your plan manager, we are unable to process the claim; this is to make sure that you are not asked to pay money back to the NDIS or face other compliance action.

Unfortunately, letters of support from providers, even therapists, is not sufficient evidence to claim a Non-approved item through NDIS funding.

Plan managers are not able to approve a non-approved support claim.

This is because these supports are not available from NDIS funding, and claiming the invoice can put the plan management organisation and the participant at risk of being asked to pay the money back.

The NDIA is increasing their audits on invoices, and it is becoming more common for claims to be checked. If your invoice is checked and the NDIA decides it is not an appropriate use of NDIS funding, they can take compliance action.

This can include:

• Cancelling your claims before the money is sent to the provider.
• Asking you to pay the money back.
• Changing how your plan is managed (i.e. making your funding NDIA managed).

The NDIA is increasing their audits on invoices and it is becoming more common for claims to be checked. If your invoice is checked and the NDIA decides it is not an appropriate use of NDIS funding they can take compliance action.

This can include:

• Cancelling your claims before the money is sent to the provider.
• Asking you to pay the money back.
• Changing how your plan is managed (ie. making your funding NDIA managed).

Your NDIS plan will list the supports included, some parts of your plan have more flexibility than others.

You may be asked for a copy of the plan, or a new copy to allow your plan manager to review the supports and make sure that purchases are in line with your budget.

STR (formerly known as Short Term Accommodation) allows you to have time apart, for at least one night, from your primary informal supports such as family and friends who give you the majority of your unpaid, active, disability-related support.

This provides the opportunity for you to be supported by someone else, while giving your family or friends a short break from their usual caring responsibilities. It lets you try something else and helps you pursue your goals like increasing your independence or building your skills.

Some participant plans have been funded for STR in a group setting.

While there is some flexibility within your core supports, continuing to claim at a lower group ratio or even one on one will likely impact the amount of time you can access STR or impact funding available for other supports. This is because your budget is calculated based on the STR rate for the ratio of support that is listed.

For more information you can speak with your NDIS planner about what has been included.

STR is not typically funded by the NDIA if:

• If you live alone independently and don’t have drop-in supports.
• You get more than 18 hours paid supports in your home each date, regardless of who you live with.
• You’re not having a break from your family or friends who you live with, or give your significant daily drop-in support.
• It’s a day-to-day living cost that anyone is expected to pay, for example your mortgage, rent or utilities.
• You’re waiting for home modifications to be done.
• You’re living in a supported independent living (SIL) arrangement.
• You have funding for primary or supplementary individualised living options.
• You’re in a housing crisis situation (if you are homeless or need somewhere to live you can contact homeless services in your State or Territory).

The NDIA has published more information regarding the use of STR for participants living alone or in SIL.

This shows that participants who live alone or in SIL are unable to use STR supports. This is because if a participant is living alone or in a supported independent living arrangement, they already have time apart from family and informal supports.

Holidays - You can’t use it to go on a cruise or tour or holiday. You can’t use it for accommodation on holidays or airfares or other holiday or travel items, including interstate and overseas travel for holidays. It’s also not for your family or friends to stay in accommodation or to attend programs.

Transport - you can’t use your STR funding to pay for transport to get to your respite accommodation or activity if you can travel or use public transport independently. If you need specialised transport this may be paid for. If your plan includes separate funding for Transport, you can continue to use this funding to travel to and from your STR. The NDIS will not fund a claim for Activity Based Transport where your carer did not stay and support you in your activity in the community.

Meals - If your meals are an extra cost while you’re staying in short term respite, you can’t use your NDIS funding for this. These are day-to-day living costs and are not NDIS supports.

Activities - You can’t use your NDIS funding to pay for activities, such as tickets, entry fees, equipment, or membership fees for yourself, your support worker or your family or friends