National Disability Insurance Scheme

The NDIS, or National Disability Insurance Scheme, is Australia’s first national scheme for people with disability which provides funding directly to those individuals eligible to participate. The scheme funds Reasonable and Necessary Supports needed to achieve participant goals. The scheme also takes into account the support provided by family, friends, and other community and government services.

The NDIS aims to give people with disability better choice and control over services and supports to suit their needs and goals. A Participant Plan is developed for each person and it outlines the supports the NDIS will fund.  It can seem a little daunting at first but, if you are supporting your brother or sister to access the NDIS, try to get as much information as you can, take it a step at a time and seek extra help if you are struggling with understanding the process.

Much of the information and resources needed regarding the scheme and getting started on a Plan can be found on the NDIS website. Information is broken down and visual resources and videos assist user navigation around the website.

Some other useful people and places to go to for help, include: NDIS partners (the people responsible for rolling out the NDIS), GPs and Health professionals, Advocacy groups such as Every Australian Counts , and Disability organisations. Some NDIS providers can offer assistance and resources as well. It is advised to gather information from a variety of sources and seek clarification at all times.

Joining a peer support forum such as Sibchat on our website and asking questions can help as well! 

To access the NDIS, the National Disability Insurance Agency (NDIA) who runs the NDIS will need to know some information about your brother or sister, who they call ‘the participant’. There are key people who can help with this, including an NDIS Local Area Coordinator (LAC), a General Practitioner (GP) or other health professionals. If your brother or sister currently receives disability supports, their provider may be able to assist and provide necessary documentation to the NDIS.

If your brother or sister receives no current services or supports, you will need to contact the NDIA.
You can do this by:

As part of the process, your brother or sister or you may be required to complete an Access Request Form or provide further information that gives evidence of their disability. The emphasis here is on the FUNCTIONAL IMPACT of their disability not necessarily the diagnosis (meaning, how your brother’s or sister’s disability impacts on them on a day-to-day basis). It is essential, if there are multiple disabilities, to include them all.

On receipt of the completed Access Request Form, the NDIA:

  • May seek additional information about the disability from a current service provider.
  • Will confirm receiving the form.
  • Will begin the decision process to determine if the person meets the participant requirements within 21 days.

If your brother or sister is not eligible to be an NDIS participant they will be referred to a Local Area Coordinator, or other relevant contact, who will provide links with mainstream services and broader community supports. For example, this could be a local community group or local health services.

If your brother or sister is eligible for the NDIS, an NDIS Representative (a Planner or Local Area Co-ordinator) will contact your brother or sister (or you) to outline what the next steps are to create a First Plan, including making a time to meet. First Plans may be completed by phone or face-to-face. If you would like a face-to-face meeting be clear about your reasons for requesting it.

This first plan will provide the reasonable and necessary supports your brother or sister can use to achieve their goals. Remember, you can ask for a review at any time with change of circumstances.

 It is a good idea for people with disability and families to start thinking about their goals and what they might want in their plan before they meet with a planner or LAC. The NDIS website has useful information and resources that will help you prepare for your planning meeting, including a participant booklet and checklist.

The NDIS gives you a chance to think broadly about your brother or sister’s support needs and be more creative about who can help out.

“Sue’s brother, Matthew, has an intellectual disability. He lives with their parents about an hour away from Sue, but would like to develop some more independence. In the morning he gets up and needs help with shaving, showering and dressing. He can eat his breakfast himself. He is overweight and would like to exercise more – he likes to walk but cannot go on his own. He would like to learn how to cook for himself – again he needs help to attend cooking lessons. He also needs assistance to get to his workplace. On the weekends he watches sport on television and sometimes he and his parents visit friends or they visit Sue, her husband and two children. Matthew is quite lonely.”

Supports might include help with shaving, washing clothes, home modification e.g. ‘grab rail’, communication device, and a support worker to help to participate in the community, develop relationships, learning e.g. cooking or independent travel, a physio or trainer to help with gym.

Every person’s Participant Plan will be different. The amount of funding your brother or sister receives will depend on their level of disability and support needs, their goals, what is in their plan and what the NDIS determines is ‘reasonable and necessary’ supports for them.

The support given must be related to your brother or sister’s disability and must be good value for money. The NDIS will not fund something a member of the community would generally pay for themselves e.g. the NDIS would not buy a car for someone, but they might pay for disability-specific modifications. They would not fund a movie ticket but might cover the costs of a support person to go with your brother or sister to the movies.

The NDIS aims to help people with disability throughout their life. As your brother or sister’s needs change, their plan can be reviewed and their support changed to better meet their needs. For example, a review would be necessary if/when your brother or sister moves out of the family home, or when your parents age or pass away. You can also call NDIS and ask for an immediate review if there is a sudden change, e.g., a death in the family. Otherwise, it is expected their NDIS plan will be reviewed annually. For more detail see the NDIS page on Supports, or this nice summary through Ability Options.

Before beginning the process for the NDIS, it is important to consider your brother or sister’s decision-making capacity. See the information under Sibling Roles. For the NDIS, people with limited decision-making capacity can have one or more ‘nominees’ to carry out various roles with regard to the planning and managing of their Plan. It may be beneficial to have more than one nominee (for example if one nominee is ill).

However, many people with limited capacity can still make some choices. Even if you, or a parent, are a nominee or joint nominees, your brother or sister should be encouraged and supported to, where possible, contribute to discussions about goals and supports they would like. A service provider or NDIS representative should be able to assist you with this process.

A nominee will have input into the Plan development and monitor and manage ongoing supports. They may also manage the payment of support services out of the funding package the person with disability receives.

Under the NDIS ACT, the NDIA must ‘have regard to’ any person already empowered under a guardianship order or other appointment which gives them power to make decisions for the person with disability. An ‘other appointment’ can include a sibling, where he or she is a nominee for Centrelink on behalf of their brother or sister. So, if you already have Power of Attorney or Guardianship, or are a Centrelink nominee, you may easily be appointed as ‘nominee’ under the NDIS. If not, you can apply to be a nominee.

Where there is a clear agreement about a decision to be made, then this decision will be respected unless the NDIA has concerns the decision (or lack of one) constitutes a significant risk to the personal and social wellbeing of the person with disability. State and territory laws on guardianship and administration are only used when there is conflict or disagreement amongst informal supports or where there are no informal supports.

There are two types of nominees and one person may perform both roles:

  • A correspondence nominee can undertake all activities a participant would undertake, except for preparing, reviewing or replacing the participant’s NDIS plan; and/or managing the NDIS funding.
  • A plan nominee can undertake all activities a participant would undertake under the Scheme including preparing, reviewing or replacing the participant’s NDIS plan; and/or managing the NDIS funding. Anything done by the plan nominee has the effect as if it had been done by the participant.

A nominee is not subject to any criminal liability in relation to anything done in good faith. Nominees must find out the wishes of the participant and make decisions to maximise their wellbeing.

More information about nominees and guardians can be found here.

There are four options for managing your brother or sister’s NDIS funds:

  • Self-management – the NDIA will pay your brother or sister or their nominee for the supports in their NDIS plan. Your brother, sister or their nominee then manages the funding themselves and pays the service providers for the support provided.
  • Provider Plan Management – in this case, certain agencies can act as a financial intermediary. They can organise the financial and administrative aspects of an NDIS plan, e.g. paying invoices, developing service agreements with providers, preparing monthly reports on how funds are being used.
  • Agency management – the NDIA will directly pay service providers on behalf of the person with disability.
  • A combination of the above – e.g. you might have an agency manage some aspects of a Plan and you might manage any other aspects

If a participant has their funds managed by the NDIA (agency managed) then NDIS registered providers must be used. If the funds are self-managed or plan-managed by another agency you can choose any providers you like.

It is important to think through how you wish to manage the funds as it impacts on the flexibility and choices you have. The general community opinion seems to be it is best to go with Plan management and/or self-management for the majority of the Plan, especially in rural areas.

Regardless of how the Plan is managed, each participant receives a monthly plan statement from the NDIS which outlines which supports have been claimed by which providers. 

You can find more information on NDIS fund management here.

FAQs

The NDIS is not means tested. It does not affect the Disability Support Pension, Carer’s Allowance, or employment income. At the end of a Plan meeting people are asked certain demographic questions (including income), but it is for data/statistical purposes only.

If you think the NDIS has made the wrong decision about your brother or sister being accepted into the NDIS, or about what supports are being provided under the NDIS, you can apply for an internal review of a decision. You may believe the funding is not enough. Any person directly affected by the decision can apply. This needs to be done within three months of the decision made by the NDIS.

If you are still not happy after the internal review you can apply for a review by the Administrative Appeals Tribunal (AAT). An application for an AAT review must be made within 28 days, but extensions can be granted. Organisations in each state and territory have been funded to assist with NDIS external appeals. These organisations can provide access to a skilled advocate who acts as a support person, and access to legal services – where a case raises complex or novel legal issues. 

Further information about appealing an NDIS decision can be found here.

Definitions

National Disability Insurance Agency

National Disability Insurance Scheme

Local Area Coordinators help participants to develop and implement their plans. They also conduct community capacity and awareness building activities, and assist, if necessary, in the coordination and sourcing of participant supports.

Myplace is a secure website portal for participants or their nominee to view their NDIS plan, request payments and manage services with providers.

A plan is a written document which will identify the goals and objectives of a participant, plus the reasonable and necessary supports they require to meet their immediate needs. A plan provides individualised funding that is controlled by the participant.

An individual whose access request has been determined eligible, and is a recipient of NDIS funding.

A person who formally represents an NDIS participant as a correspondence or plan nominee.

This could be an NDIA Planner, Local Area Co-ordinator or other partner of the NDIS.

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