A simple guide about support the NDIS offers to help you get started

The purpose of this is to help individuals achieve their goals, increase their independence and improve their quality of life.

The scheme offers funding specifically for each person’s goals and needs, but not all support can be provided and that’s where confusion often sets in.

This guide will explain what supports are available under the NDIS and vice versa, to help participants understand the scheme better. 

Services the NDIS covers 

The NDIS funds a number of support services, items and equipment directly related to a person’s disability.

Daily personal activities

For many people living with a disability, everyday tasks like showering or getting dressed are not easy to do alone. That is where NDIS support workers come in, to assist and supervise participants so they can live independently. 

This support is usually for individuals who have physical limitations or chronic illnesses that prevent them from doing daily life tasks on their own. 

This includes:

• personal hygiene, e.g., bathing and grooming;
• assistance with eating, drinking and dressing;
• overnight care, where needed;
• moving and positioning;
• medication reminders or administration.

Assistance with transport or travel arrangements 

Where a person is unable to use public transport independently due to their disability, the NDIS can provide funding for alternative solutions. 

The aim is to help participants get out of the house and remain socially and economically active; whether that means going to work, school or community events.

This includes: 

• provider travel cost;
• travel training to build a participant’s confidence and skills to use public transport safely and independently;
• costs associated with the use of taxis or private transport; and
• support workers accompanying participants on public transport. 

Therapy services 

Supports that provide evidence-based therapy to help participants improve or maintain their functional capacity. That is, an assessment by a health professional for support planning and review as required. 

This includes:

• occupational therapy — to improve motor skills, self care and daily living activities;
• physiotherapy — to build strength, mobility or manage pain;
• assistance with language, communication or swallowing difficulties; and
• psychology or behavioural therapy — to manage behaviour, emotional state or trauma.

These services are often delivered at home, clinics or at schools and may include progress reports and customised therapy plans. 

Exercise and personal well-being activities
NDIS support workers assist participants with physical mobility through personal training and exercise physiology to address the impact of their disability.

This includes:

• delivering service through a qualified professional;
• personalised exercise programs to increase or maintain a participant’s capacity;
• maintenance of muscle strength and balance.

Home modifications 

When a person’s home environment does not meet their physical or safety needs, the NDIS may provide support that assists a participant with complex needs to be able to do high energy activities.

These supports must be provided by a worker with additional qualifications and experience relevant to the participants condition or psychological needs.

This includes:

• installing equipment like ramps, rails or lifts or changing a building’s structure;
• widening doorways or hallways to allow wheelchair access;
• upgrading flooring to prevent falls;
• modifying bathrooms or adjustable sinks.

This process usually begins with an occupational therapist’s assessment.

Support in employment
The NDIS can fund support in employment for participants who need extra help to pursue their employment goals.

This is done through the support of Disability Employment Services. Through this, participants have greater choice and control about where and how they work, including government and non-governmental organisations.

Participants can also choose who provides them support on-the-job. 

Assistive technology
This includes equipment, devices and tools to help participants manage tasks they couldn’t do independently. 

Such as:

• mobility aids — wheelchairs or walkers;
• hearing or vision aids;
• daily living aids — shower chairs and adjustable beds. 

Social and community participation 

NDIS support workers understand that people with disabilities should be able to enjoy fulfilling social lives and stay connected to their community. Thus, it funds programs and activities that encourage participants’ participation.

This includes:

• working with participants to develop their ability to partake in these activities;
• social skill-building classes or recreational workshops;
• mentoring or peer support groups;
• supporting participants during relevant activities.

These activities are not just about fun, but they play a role in reducing isolation, building self-esteem and helping participants engage with others so they don’t feel left out. 

Support coordination and plan management 

Managing the NDIS plan can be confusing, especially for first-time participants or those with complex needs. Therefore, support is provided to connect people with an informal community.

This includes:

• building a participant’s capacity to connect with supports;
• assisting participants to understand and utilise their plan;
• connecting with providers;
• addressing barriers and reducing complexity in the support environment.

Household tasks

NDIS service providers offer assistance with essential household tasks that a participant is not able to do themselves because of their disability.

This includes:

• meal preparation and delivery;
• house or yard maintenance;
• Cleaning and laundry 

Management of support funding

This involves a registered plan manager to oversee the funding given for each support listed in a participant’s plan.

Early childhood intervention 

Early childhood Intervention is for children between the ages of 0 – 9. That is, where a child experiences developmental delay. Support is provided to their families to achieve better long-term outcomes for the child.

This includes:

• therapy by health professionals such as speech pathologists or occupational therapists; and
• a key worker for a child’s family.

Development of daily care and life skills

Training and development activities are provided for participants to increase their chances of living independently. This includes:

• meal preparation;
• managing finances; 
• engaging in social activities;
• improving relationships and social interaction; or
• shopping.

Services the NDIS does not cover

While the NDIS funds a lot of services, it doesn’t cover everything. If a support is not directly linked to a person’s disability or is covered by another government-funded service, it won’t be funded. You can’t also spend your funding on things that are not under NDIS support. 

Here’s a list of supports the NDIS does not cover…

Day-to-day living costs

The scheme is not designed to replace income or cover the standard cost of living that all Australians face, regardless of whether they live with a disability.

• Rent or mortgage payments 
• Purchase of land or house and land packages
• Utility bills — water, gas and electricity
• Clothing, shoes or general household items, e.g., dishwasher, fridge, microwave, etc.
• Internet or phone services 
• Groceries 
• Home security fees and maintenance costs

These expenses are considered personal responsibilities and are not connected directly to a participant’s disability. The NDIS will only fund a support worker to help the participant in cases like food preparation, not the actual cost of food or rent.

Medical treatment and healthcare services 

The insurance scheme does not fund medical-related issues that fall under the responsibility of the public healthcare system, like Medicare or private health insurance.

This includes:

• GP consultation or specialist visits;
• clinical diagnosis;
• medication prescriptions;
• dental treatments;
• health retreats;
• vaccinations;
• ambulance services;
• surrogacy and fertility treatments.

However, if a participant requires ongoing therapy, i.e., speech therapy related to their disability, it may be covered.

Items not related to a participant’s disability 

One of the eligibility requirements is that an individual must have a disability that has a permanent effect on their life. Thus, anything outside of managing the disability will not be funded. 

This includes:

• donations, gifts, loan repayments, fines, taxes, etc;
• education and tuition fees, gift cards and child support fees;
• home renovations for aesthetic purposes;
• gym membership, weight loss products, athletic supplements;
• holidays, hotel stays and entertainment tickets.

Unlawful or risky supports 

The NDIS has a strict obligation to ensure all participants safety and accountability. It will not fund any support that:

• breaks the law;
• puts a participant or others at risk;
• is untested or not evidence based.

This includes:

• gambling;
• alcohol or drugs;
• firearms and weapons;
• sexual services or sex work.

Clothing and beauty-related services

This includes:

• jewelry and watches;
• makeup, cosmetics or cosmetic treatments;
• hair treatments, hair replacements or hair transplants;
• manicures and Pedicures;
• body art, e.g., tattoo and henna.

Note
In some specific circumstances, supports that are not under the NDIS can be funded, which is referred to as replacement support.

What is replacement support?

‘Replacement support’ refers to the services, items and equipment a participant would like to use instead of the NDIS support or the support in their plan.

However, only some supports can be replaced and it must be agreed upon in writing if you can buy such support. 

A replacement support is not an extra support, but to replace an existing NDIS support or support in your plan.

Here are some supports not under the NDIS but may be considered as a replacement support…

Day-to-day living
There may be a replacement support for standard commercial household items, when:

• there is clear evidence that the need for the item relates specifically to the participants’ disability; or
• the item increases independence and reduces the need for NDIS support workers.

Assistive Technology — consumables and smart watches
There can be a replacement option for smart watches, tablets and phones solely for the purpose of communication and accessibility. 

How to apply for a replacement support

To swap out an existing NDIS support for a non-NDIS item or service, follow these simple steps…

1. Check your eligibility
Make sure the replacement support:

• costs the same or less than the cost of the NDIS support or supports already in your plan;
• works the same or better than the support it is replacing.

However, it is important to note that if your request gets rejected, you cannot appeal the decision.

2. Download or request the form

You’ll need to complete the official ‘application for a replacement support’ form. You can get it from the NDIS website. 

3. Complete the form
Depending on who is submitting the request, fill out the relevant sections. However, if someone else will be completing the form for you, then you must give consent. You can do this by:

• calling the NDIS;
• sending a letter or email; or
• submitting a completed ‘consent for a third party to act’ form.

4. Explain the replacement support
Here, you’ll need to:

• tick the type of replacement support you want;
• list the current NDIS support(s) being replaced;
• explain how the new item or service will meet your needs better than the previous; and
• state the cost of replacement.

5. Sign the statement
Sign and date the declaration confirming that:

• the information is true and complete; and
• you understand your responsibilities under NDIS rules.

6. Submit the form
Send the completed form to the NDIA in person or by email. 

You’ll get a phone call to let you know if your request was accepted or not with a confirmation letter sent to your mail.

How to know if a support is reasonable and necessary 

The NDIS uses a set of rules to decide what support would be reasonable and necessary for each participant. 

To be considered for funding, a support or service must:

• be related to a participant’s disability;
• represent value for money;
• must not include day-to-day living costs not related to your disability needs;
• not be funded by another service;
• be effective and would help the participants improve their daily living.

A participant’s reasonable and necessary support will then help to:

• pursue their goals and objectives;
• increase their independence;
• increase workplace participation; and
• develop their capacity to actively take part in community activities.

Conclusion

Understanding what services the NDIS offers and doesn’t can help you make the right decision about your support plan. 

Although the scheme has clear guidelines, there are ways to request for flexibility through replacement support. If a particular item or service isn’t covered but meets your needs don’t hesitate to reach out. 

The more you understand the program, the higher your chances of achieving your goals are. Always speak to your support coordinator or plan manager whenever you get confused.