The National Disability Insurance Scheme (NDIS) is designed to provide support and services to Australians living with disabilities, aiming to enhance their quality of life and independence.

Central to the NDIS is the concept of ‘reasonable and necessary’ supports, which determines the funding and assistance participants can receive.

What does Reasonable and Necessary mean under the NDIS?

Reasonable: The support or service must be reasonable in terms of its effectiveness, appropriateness, and value for money. It should align with the participant’s goals and needs without being extravagant or unnecessary.

Necessary: The support or service should be essential for the participant to live their life independently and achieve their goals. It must address the participant’s disability-related needs and promote their social and economic participation.

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What are some examples of Reasonable and Necessary supports?

Assistive Technology: Devices or equipment like wheelchairs, hearing aids, or communication devices that assist in daily activities or improve independence.

Therapeutic Supports: Services provided by allied health professionals such as physiotherapy, occupational therapy, speech pathology or psychosocial recovery coaching that aim to improve functional capacity.

Home Modifications: Adaptations to the participant’s home environment to enhance accessibility and safety, such as ramps, handrails, or bathroom modifications.

Personal Care Supports: Assistance with daily personal activities like grooming, dressing, or meal preparation, enabling the participant to live independently.

 

What isn’t considered Reasonable and Necessary?

Day-to-day living costs: Expenses unrelated to the participant’s disability, such as groceries, rent, or general household items.

Luxury items or services: Goods or services that are not essential for the participant’s wellbeing or independence.

Supports already funded by other systems: Services covered under health, education, or other government funding schemes.

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How does the NDIS decide what is Reasonable and Necessary in your plan?

The most critical source of information for creating your NDIS plan is you. The planning process is highly personalised and focuses on several key areas:

  • Goals and Aspirations: Understanding what you want to achieve is very important. Your goals could range from improving daily living skills to pursuing higher education or employment.
  • Strengths and Capacity: Recognising your strengths helps in building a plan that leverages what you can do independently or with minimal support.
  • Individual Circumstances: Personal factors, such as your living situation and community engagement, are crucial in tailoring supports.
  • Barriers and Limitations: Identifying the obstacles you face in daily life ensures the supports provided will help you overcome these challenges.
  • Disability Support Needs: This includes specific supports required to manage your disability effectively.
  • Risks and Safeguards: Considering potential risks ensures that necessary safeguards are in place, promoting your safety and well-being.

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Your lived experience is invaluable in the planning process. You are the expert on your own life, and your insights are critical in shaping a plan that truly meets your needs. When gathering information for assessment, you are encouraged to involve anyone you trust, such as family members, friends, or advocates, to help provide comprehensive information about your support needs.

In addition to your input, other sources of information are considered:

  • Medical and Therapy Reports: These documents provide professional insights into your disability and support needs. For instance, an occupational therapist might provide a report on why a specific type of wheelchair is necessary.
  • Assessments: Evaluations from health professionals help determine the extent of your support needs and how specific supports will benefit you.

What goals can I set in my NDIS plan?

Goals are things you want to pursue, and you might need support from the NDIS and other services to help you achieve them. Your goals could include:

  • Building skills and increasing independence.
  • Working or studying, now or in the future.
  • Engaging in social and recreational activities.
  • Building friendships or strengthening family connections.

Goals are crucial because they help the NDIS understand what is important to you. They give you motivation and a sense of direction, and help you measure your progress.

However, it is important to note that setting a goal does not obligate the NDIS to fund the supports needed to achieve that goal. Supports must still meet the reasonable and necessary criteria.

For example, if your goal is to live independently, the NDIS may fund home modifications that address your disability-related needs. However, it will not fund day-to-day living costs like rent or utilities, as these are not considered disability-related expenses. Similarly, if your goal is to have a more accessible home, the supports funded will focus on modifications rather than general living expenses.

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How are supports aligned with my NDIS plan goals?

Your goals are central to the planning process. While not every support in your plan needs to be tied to a specific goal, all supports should help you work towards achieving your goals. When setting goals, it is important to remember:

  • Setting more ambitious goals does not guarantee more extensive supports.
  • The NDIS is not obligated to fund supports solely because they align with your goals.
  • Goals related to specific types or amounts of support do not automatically translate into funded supports.

NDIS plans are dynamic and can be reassessed to ensure they continue to meet your evolving needs. During reassessments, existing supports are reviewed to determine if adjustments are needed. Feedback from your service providers is also considered to understand how current supports are helping you achieve your goals.

Supporting your goals is just one criterion for NDIS funding. To be included in your plan, a support must meet the NDIS funding criteria. This means that even if a support helps you pursue your goals, it might not be considered reasonable and necessary if it does not meet other criteria, such as cost-effectiveness or appropriateness for your situation.

Conclusion

The NDIS planning process is comprehensive and centred around your unique needs and aspirations. Understanding this process empowers you to actively participate in shaping a plan that best meets your needs, helping you lead a fulfilling and independent life.

Goals are an integral part of developing a NDIS plan, but they must be balanced with the criteria for reasonable and necessary supports. The NDIS aims to provide supports that are cost-effective, beneficial, and directly related to your disability needs, ensuring that the funding provided makes the most meaningful impact on your life.

Enhanced Lifestyles can assist NDIS participants with a wide range of supports, from support coordination, personal care, supported independent living (SIL) and in-home supports.

Get in touch with Enhanced Lifestyles today!