The National Disability Insurance Agency (NDIA) has recently announced significant rule changes that may impact a participant's access to ndis support and will affect their overall experience with the National Disability Insurance Scheme (NDIS).
The changes, which are part of the 2024 NDIS Amendment Bill by NDIS, aim to improve compliance, clarify the rules around fund management, and clarify the type of NDIS supports (as a list) that NDIA will fund moving forward.
Some ndis rule changes will be implemented immediately starting October 3, 2024, while others will be rolled out gradually. We encourage everyone to stay informed about these changes, particularly those starting Thursday, 3rd October 2024, and beyond.
A quick Overview of these ndis rule changes are as follows -
First, let's discuss the changes NDIA will implement from 3 October onwards.
New pathways for eligibility—This would mean people applying for NDIS will be assessed based on whether their needs are best met by Disability support or Early intervention support. This new pathway would also aim to assess whether the support can be accessed from the mainstream system; NDIS will not fund those supports.
Limits on making new access requests—This applies to new people applying for ndis and would mean that access requests cannot be made again if a previous request is in place and it is pending a decision.
NDIA introduces a new definition of NDIS supports to clarify what supports are NDIS-approved and what specific support a participant cannot purchase from the funding available in their plan, based on the new NDIS rules. This change will impact the planning and access decisions.
All existing participants will smoothly transition to new framework plans starting in October of this year.
To accurately identify a participant's disability support needs and decide whether to continue supporting a participant with NDIS funding, NDIA can request specific information or require you to do certain things like undergo an assessment.
The NDIA will be empowered to ensure participants spend their funds appropriately and per the plan guidelines.
Suppose there is a need to apply for a change of circumstances before the plan ends. In that case, more substantial evidence will be needed by
The NDIA can consider changing your plan management type in certain circumstances.
A new claims and payment framework will clarify how claims should be made. The framework also indicates that all claims must be made within two years of providing support.
Now, let's look at the changes that NDIA has disclosed but yet to confirm in greater detail, and NDIS will bring those changes in the long run.
Eligibility reassessment would be required for some cohorts in particular circumstances, for example, when children turn nine years old.
The plans will clarify the total funding amount, funding components amount, and funding period. In the immediate implementation stage, most plans will be for 12 months.
A new planning framework will be implemented, aimed at bringing plan structure changes that may include building a flexible budget within a plan determined by a new budget method. The decision to provide such funding will be based on a need assessment.
A complete support need assessment will be undertaken for existing participants. NDIS will not fund those supports that are determined to be the responsibility of the mainstream system. NDIS would fund only those impairments that meet the disability requirements and/or the early intervention requirements.
Below are the details of the changes that will be implemented immediately on or after 3 October and how this change affects you in particular.
The new definition of NDIS supports
The revised definition of NDIS support is designed to clarify eligible fund usage. These updated guidelines, recently issued by the NDIA, will help ensure that expenditures adhere to the approved list, promoting responsible fund utilisation.
It's important to note that from October 3, 2024, any expenses not complying with the approved list will be rejected. The full NDIS support lists are available here.
How does this affect you as an NDIS participant?
Once the new rules take effect, you can only use your funds for NDIS support. However, in some exceptional circumstances, you can request the NDIA to use your funding for non-NDIS supports, known as ‘replacement supports’.
Changes to NDIS plans structure and funding rules.
The format of NDIS plans will be refreshed, and new formats may be introduced. We don’t have all the details currently, but we will update you as we receive more information from the NDIA. All new plans from October 3 will last up to 12 months.
You cannot spend more funding than what’s available in your plan and must use your amount within the set funding period. We will share more information as it becomes available.
How does this affect you as an NDIS participant?
It may be a while before any changes occur, as the transition to the new framework plans is expected to take five years or longer. Rest assured that you will be notified when it is time for your transition.
Support needs assessment
The new planning framework will change the funding approval process. Instead of relying solely on medical diagnosis, a needs assessment will evaluate disability support needs based on impairments that NDIS could best fund according to the new list of supports.
How does this affect you as an NDIS participant?
The impact will become evident once the needs assessment process is developed and the new framework plan is put into action. Although there are still details to be ironed out, the aim is to streamline the process of providing evidence of disability and to expand funding options for greater flexibility.
Early intervention pathway to be introduced for new participants
When you apply for the NDIS, the NDIA will inform you if you are eligible based on two pathways—disability, early intervention, or both.
How does this affect you as an NDIS participant?
Once the new pathways are set up and approved, you will receive assistance along the appropriate pathways according to your NDIS eligibility.
Stricter compliance
The NDIA will have more authority to monitor and adjust plans to ensure the proper use of funds and that participants align to the usage guidelines and the items that are listed within the plan and are within the improved list of supports.
How does this affect you as an NDIS participant?
The NDIA may consider changing a funding amount, shortening your plan period, raising a debt, or changing how your plan is managed if it believes you, your nominee, plan manager, or a child representative aren’t spending your funds in accordance with your plan.
This applies to participants who self-manage or use a registered plan manager.
In the event that the NDIA is considering withdrawing you from the NDIS, they may request information or ask you to undergo an assessment. If you are unable to provide the required information within the specified timeframe (although you can request additional time if needed), your access to the NDIS may be terminated.
More substantial evidence for Change of Circumstance
Starting in October, a participant requesting a change in circumstance will need robust evidence of the need for such an out-of-turn review request made to ndis before the plan reset date.
How does this affect you as an NDIS participant?
If you find yourself in a situation where you need additional funding during your planned period, your request for reassessment will only be considered appropriate by NDIS under specific circumstances, such as:
A crisis or emergency has led to a significant change in your support requirements
You have fallen victim to fraud or financial exploitation
There is a threat to your life, health, or safety
What will happen next?
Following the recent approval of the legislation, the Australian Government is committed to collaborating with the disability community to make necessary updates to the NDIS Rules, with a primary focus on ensuring that participants are central to these revisions. They are carefully assessing the input received from community consultations regarding the preliminary NDIS support list, and an updated version will be made available by NDIS in due time.
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