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Justifications for NDIS Supports

Do you ever feel overwhelmed when trying to understand and navigate how the NDIS applies to your personal circumstances? It can be tricky, but that's where ISA comes in!

As part of Inclusive Solutions Australia’s services, we provide support to NDIS Participants and their families to help them understand the role of the NDIS and what is funded by the NDIA. To support our participants in achieving their goals we must first assist them in receiving the appropriate level of funding to do so. As a Registered NDIS Service Provider we can support our participant guardian to provide the NDIA with the evidence and justification behind the request for specific levels of funded supports.

A great way to support our participants ahead of their scheduled and/or unscheduled reviews is to document our participants goals, functional impact of disability, level of support given and justification for future requested funded supports.

Participants receive funding for supports (supports meaning assistance or products that help a person in their daily life and help them to participate in the community and reach their goals) from the NDIA through the provision of a participant plan. The requirements for plans are outlined in Section 33 of the National Disability Insurance Scheme Act 2013 (NDIS Act). A key component of a plan, the statement of participant supports, which is prepared with the participant and approved by the NDIA Chief Executive Officer (CEO) specifies any reasonable and necessary supports that will be funded under the NDIS. In deciding the funding for reasonable and necessary supports, the CEO must be satisfied of six criteria outlined in Subsection 34(1) of the NDIS Act.

Decisions on the reasonable and necessary supports to be provided to participants under the scheme are critical to both participant outcomes and scheme financial sustainability. Financial sustainability is a key objective of the NDIS. So our justification for requesting the appropriate funding on our participants’ behalf must be succinct and follow the NDIA guidelines for their Reasonable and Necessary criteria. (Subsection 34(1) of the NDIS Act).

Section 34 - recommendations must be:
  • Related to a participant’s disability.

  • Must not include day-to-day living costs not related to your disability support needs, such as groceries.

  • Should represent value for money.

  • Must be likely to be effective and work for the participant.

  • Should take into account support given to you by other government services, your family, carers, networks and the community.

These supports will help participants to:
  • Pursue their goals, objectives and aspirations.

  • Increase their independence.

  • Increase community and workplace participation.

  • Develop their capacity to actively take part in the community.

How does the NDIA work out what is reasonable and necessary?

The NDIA makes decisions based on which supports would be reasonable and necessary for a particular participant. We refer to the particular operational guideline that relates to each specific support.

EXAMPLE - Justification for Consumables Budget:

Braxton has a goal to improve his independence and increase his social participation. It is reasonable and necessary for the NDIA to provide a provision of funding for the purchase of continence aids. Braxton presents with disability related incontinence and currently uses up to 8 aids per day along with mattress and pillow protectors. Braxton is unable to use the toilet and relies on incontinence aids.

Due to the functional impacts of his disability Braxton relies on his iPad to communicate effectively using the App “Prolo Quo 2 go”. Braxton is also able to verbalise a few words and use some AUSLAN sign language to communicate his needs with his family and supports. A request for a provision of funding to be allocated for Braxton to be able to purchase low-cost level 1 & 2 assistive technologies and/or products that may be recommended to Braxton via his allied health therapeutic supports.

These supports take into account any informal supports already available to the individual (informal arrangements that are part of family life or natural connections with friends and community services) as well as other formal supports, such as health and education. This request also takes into consideration the National Disability Insurance Scheme Act 2013 (NDIS Act) and the rules made under the NDIS Act. The operational guidelines also provide practical guidance for decision makers.

If you need assistance in finding the supports that best match your needs or the needs of those under your care, talk to the friendly and professional ISA team today!

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