Have The NDIS Legislation Changes Held Up?
Written by: Amy Osborne | Plan Management Team
We are six months down the road after the National Disability Insurance Scheme (NDIS) Legislation changes came into effect on 3 October 2024.
A few changes have been welcomed with open arms and are explained in black and white without mincing words, which makes our jobs as NDIS Plan Managers easier, as we can copy and paste the legislation sections and NDIS information directly into emails for supporting explanations. It allows us to offer an informative response to a client’s query without confusion.
Other changes have left NDIS Plan Managers scratching their heads at times, and we can feel as though we are letting our clients down by not being able to give that black and white response.
NDIS Plan Legislation Changes + Consumables Budget
The Consumables budget is a funding line that is still creating a lot of uncertainty.
The majority of NDIS Plans have a consumables budget, but with no clear explanation on how or what to utilise the funds for, it can make it difficult to claim against an NDIS Plan. As stated in our previous blog, Understanding The New NDIS Plan Legislation Changes, NDIS Participants may have previously been able to purchase a standard item that could assist in aiding their disability, sometimes with supporting information from their allied health practitioner, such as an item to regulate emotions, like a weighted blanket.
However, as of 3 October 2024, whilst sensory items remain a great area, anything that is deemed to be an everyday item is “out”.
So, what can the Consumables budget be used for, and how does an NDIS Plan Manager navigate this funding line without clear instructions from the NDIS?
Of course, the consumables budget can be used to assist in the purchase of continence aids or PEG or PEJ feeding products. These have never been questioned by the NDIS or NDIS Plan Managers and are easy to justify as they are directly related to an NDIS Participant’s disability. But what happens when we receive a request for noise-cancelling headphones? This has happened several times over the past six months, and at Canny Plan Management, we struggled with this a bit, to be honest, as we had no clear directions. Noise-cancelling headphones may be disability-related for an individual, however, they are mainstream items, not disability specific or modified items.
After conferring with Disability Intermediaries Australia, the NDIS Plan Management and Support Coordination peak body, we have been advised that noise-cancelling headphones are classified as an everyday item, but an NDIS Participant can apply to the National Disability Insurance Agency (NDIA) to use their NDIS Funds for a pair as Replacement Support, which is a form that can be submitted to the NDIS directly by the NDIS Participant.
Another option is that Canny Plan Management requests that an NDIS Participant gain written consent from their NDIS Planner or Delegate that they can purchase noise-cancelling headphones using their NDIS plan funds.
As a matter of fact, this option is given to all NDIS Participants who wish to use their NDIS funds to purchase “everyday items”. Unless an item has been modified specifically to suit someone with a disability, it will not be compliant with to process. The safest way forward and to limit the risk to ourselves as NDIS Plan Managers and to our clients is to ensure we either have written consent, a Replacement Support form is submitted or that the item is specifically listed within the NDIS Plan.
Your NDIS Plan + “Out” Supports
The National Disability Insurance Agency (NDIA) previously stated that Music and Art Therapy was going to be an “out” support.
It then announced that these two therapies would be reviewed, with the review slated to conclude in March 2025. On 14 March, the NDIA announced an extension to the Review until 17 April 2025, after which all submissions will be assessed and a decision made.
Canny Plan Management is hoping, with all our fingers crossed, that both Art and Music therapies remain as an approved NDIS Support, delivered by appropriately qualified and registered Art and Music Therapists.
Until the review is finalised and a decision handed down by the NDIA, art and music therapies can still be claimed as an NDIS Support if they meet the required guidelines and are claimed in compliance with the NDIS Participant’s NDIS Plan.
The NDIS is focused on creating a separation between Mainstream Supports and Capacity Building Supports. As we explained in a previous blog, it appears the NDIS is slowly phasing out psychology and/or dietitian supports from NDIS Plans.
Of course, if an NDIS Participant requires specific support in these two areas, we are seeing NDIS Plans come through with psychologists and dietitians specified in their NDIS Plan with a set number of hours or a specified monetary amount that can be utilised for these supports. We are not seeing these as commonly specified supports in the new NDIS Plans. It is important for NDIS Participants to discuss these and any other specific supports during their planning meeting.
NDIS Plans + Over-Expenditures
The Plan is the Plan, and the Budget is the Budget
The National Disability Insurance Agency (NDIA) has been advising NDIS Plan Managers that “the Plan is the Plan, and the Budget is the Budget“, and we all, NDIS Plan Managers, NDIS Participants, support coordinators and providers, need to begin to think this way.
We are seeing less approval of NDIA Payment Enquiry requests when an NDIS Participant has over-expenditures. Of course, there are some situations when a Change of Circumstance does not get approved in a timely fashion, and the funds are exhausted before the NDIS Plan expires, and a Payment Enquiry claim needs to be submitted and is subsequently approved. However, if an NDIS Participant has any over expenditures because they are not mindful of their spending, the Payment Enquiry request may be rejected because the “Budget is the Budget”.
As for the “Plan is the Plan”, we are seeing more specific NDIS Plans come through in the past six months, which is a double-edged sword.
When an NDIS Plan is vague and does not have designated supports within the category, it’s great for the NDIS Participant as they have the freedom to choose their supports freely, as long as it aligns with the funded disability and is in line with the intention of the NDIS Plan, and is an approved NDIS Support.
When an NDIS Plan has been designed with the listed detailed supports, the NDIS Participant must adhere to the supports outlined within the NDIS Plan.
Sometimes, this is amazing, and the NDIS Participant feels secure in claiming support as there is little room for misinterpretation, and we, as the NDIS Plan Managers, have a clear line to follow when processing claims against the NDIS Plan. However, if a NDIS Plan has nominated supports listed, it can be a tough discussion to have with an NDIS Participant as they might feel that a Counsellor is a better support option than a Social Worker that is listed in their NDIS Plan.
If a support is claimed but not a support identified in the NDIS Plan, the NDIS Plan Manager, the NDIS Participant, and the provider are at risk of being non-compliant. Where this is the case, as NDIS Plan Managers, to mitigate the risk for all, we direct our clients to gain written consent from their NDIS Planner or Delegate to have that support amended.
Canny Plan Manangement + Your NDIS Plan Management Needs
In conclusion, the National Disability Insurance Scheme (NDIS) will continue to implement rules associated with the updated Legislation, update the Pricing Arrangements and Price Limits, and create definitions with the intention of ensuring the NDIS is a viable and vital asset in the Australian landscape.
We, as a nation, are very lucky to have a scheme that is designed to assist those with disabilities and to provide support they may not have the means to access. I will acknowledge that there is room for improvement, like a lot of room, but we are fortunate that the NDIS exists, despite issues with clarity.
Get in touch if you need help understanding or navigating your NDIS Plan!
