New NDIS Act – What You Need to Know About the Changes

Changes to eligibility assessments

Under the new laws, budgets will be based on an individual’s needs rather than their diagnosis.

At this stage, we are not aware as to how the NDIS eligibility criteria will change, but the law does mean that eligibility will be assessed differently. Budgets will be determined by a needs assessment, which will need to prove the person has a significant functional impairment. It is not yet clear exactly what this assessment will involve, although it will look at an individual’s disability needs across the board. The government has indicated this assessment will be co-designed with the disability community. 

A person will only be able to access NDIS funding for impairments that meet the disability or early intervention criteria.

The government recently admitted that participants may need to pay for this needs assessment.

Once the law comes into effect, this will impact people applying to access the NDIS. It will also affect current participants when they have an eligibility reassessment.

Changes to the definitions of an NDIS support

The new legislation will strictly define what is considered to be an NDIS support. Essentially, there will be two lists:

1. Supports that are ‘NDIS supports’ – which can be funded by the NDIS.

2. Supports that are not ‘NDIS supports’ – which you cannot spend NDIS funding on.

In some respects, this will not significantly change the way NDIS funding can be spent. For example, based on the information currently available on the upcoming changes, it appears that participants will still be able to use their funding for things like assistive technologies, therapeutic supports and home modifications.

Things like gambling, alcohol and day-to-day living costs are still off the funding list.

However, there are many things listed on the ‘no’ list that people have been using to reach their goals for a long time, so this is a concern.

For example, more and more items are being crammed into the non-funded ‘day-to-day living costs’ category, which includes necessities like rent, food, and electricity.

As a result, the only way for a person with disability to get funding for these items (e.g. an air-conditioner) is to prove they need them as a direct result of their disability. Proving this is an extremely difficult process and likely to place additional administrative demands on the participant.

If you want something on the ‘no’ list, you will have to lodge an application form identifying an item on the ‘yes’ list that it replaces. You have to prove the banned support is cheaper and delivers a better outcome than the support on the approved list. It is then up to the CEO to decide whether to grant it.

Several concerns about this change have also been raised by the disability community, including:

• The draft document outlining what is and is not considered to be an NDIS support is incredibly complex.
• The lists do not encourage community inclusion, and instead seem they will increase segregation.
• The lists make NDIS supports sound more like a ‘disability shop’.
• No list is able to capture every item that will be appropriate for every person possible.
• Changes are expected to take effect quite quickly and have not allowed for adequate consultation and communication.

Changes to the NDIS claims and payment framework

To provide more clarity about how claims should be made, the changes will also include a legislative claims and payments framework.

Claims on NDIS plans will need to be made within two years after the support was provided. This will apply as soon as the law comes into effect. However, there will be a 12-month grace period during which the NDIA will honour claims for supports that were provided before the law came into effect.

Under new claiming requirements, claims must meet certain criteria to be eligible for payment. To be payable, claims must:

• be made by the person who is managing the plan funding
• be made in an approved format (the form is yet to be created)
• contain all necessary information.

Other changes

Here are some other things that will change under the new legislation.

• Plan variations – you will be able to make certain changes to your plan without needing to create a new one.
• Revoking the status of a participant – the NDIA can ask you to provide specific information or do certain things (such as undergo an assessment) if they are thinking about revoking your participant status. If you do not comply with their request ‘within a reasonable time’, they may revoke your NDIS access.

The NDIA has promised to work in partnership with participants and the disability community as these changes come into effect.

What do you need to do?

The new legislation will take effect 28 days after it is officially approved by the Governor General.

In the meanwhile, your NDIS access and supports will continue unchanged.

You can find out more at:

The NDIS website – Changes to NDIS legislation

Department of Social Servies – Draft list of NDIS Support

If you’d like to get involved, join the Participant First Engagement Initiative or visit DSS Engage.