The NDIA determines what services and supports a person will be funded for under their NDIS Plan [National Disability Insurance Scheme Act 2013 (Cth) s 34]. This decision must be consistent with the provisions of the NDIS Act 2013 (Cth), NDIS Rules and NDIS Operational Guidelines.
The services and supports that the NDIS can fund include those relating to education, employment, social participation, independence, living arrangements, and health and wellbeing [National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth)].
For a service or support to be funded, it must be considered to be reasonable and necessary to assist the particular person.
Section 34 of the NDIS Act 2013 (Cth) defines what is meant by a reasonable and necessary support:
- The support will assist the participant to pursue their goals and aspirations as contained in their Plan statement;
- The support will assist the participant to undertake activities that facilitate their social and economic participation;
- The support represents value for money;
- The support is, or is likely to be, effective and beneficial for the participant taking into account best practices;
- The provision of the support takes into consideration reasonable expectations of the care that families, carers, informal networks and the community will provide;
- The support is most appropriately funded through the NDIS and not an alternate system or scheme.
Additional guidelines apply to the provision of particular types of supports, such as assistive technology, vehicle modifications, home modifications, and others. For more information see the Operational Guideline – Including Specific Types of Supports in Plans.
In some instances, a participant may not be happy with the supports funded in their plan or may disagree with a decision as to what is considered a reasonable and necessary support. They are able to seek a review of this decision [s 99], see: Review of NDIA decisions.
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