Access to the NDIS - When a person ceases to be a participant

13. When a person ceases to be a participant

A person ceases to be a participant in the NDIS when:

  • the person dies (section 29(1)(a));
  • the person enters a residential care service on a permanent basis and this first occurs after the person turns 65 years of age (section 29(1)(b));
  • the person starts being provided with home care on a permanent basis and this first occurs after the person turns 65 years of age (section 29(1)(b));
  • the person's status as a participant is revoked by the NDIS (section 29(1)(c)); or
  • the person notifies the NDIA in writing that they no longer wish to be a participant (section 29(1)(d)).

13.1 Person deceased

A person automatically ceases to be a participant upon death (section 29(a)).

13.2 Person enters a residential care service

A person ceases to be a participant if they enter into a residential care service on a permanent basis and this first occurs after the person turns 65 years of age (section 29(b)).

The term 'residential care' is defined in section 41.3 of the Aged Care Act 1997 .

The term residential care means personal care or nursing care that is provided to a person in a residential facility in which the person is also provided with accommodation that includes:

  • appropriate staffing to meet the nursing and personal care needs of the person;
  • meals and cleaning services; and
  • furnishings, furniture and equipment for the provision of that care and accommodation; and
  • meets any other requirements specified in the Residential Care Subsidy Principles 1997 (the Subsidy Principles).

Residential care does not mean care provided to a person in the person's private home, in a hospital, in a psychiatric facility, in a facility that primarily provides care to people who are not frail and aged or care that is specified in the Subsidy Principles not to be residential care.

13.3 Person starts being provided with home care

A person ceases to be a participant if they start being provided with home care on a permanent basis and this first occurs after the person turns 65 years of age (section 29(b)).

The term 'home care' is defined in section 45.3 of the Aged Care Act 1997 .

Home care means care consisting of a package of personal care services and other personal assistance provided to a person who is not being provided with residential care. In addition, the Subsidy Principles may specify types of care that constitutes, or does not constitute, home care.

13.4 Person's status as a participant is revoked

A person's status as a participant in the NDIS may be revoked if the NDIA is satisfied that:

  • the person no longer meets the residence requirements; (section 30(1)(a)); or
  • the person does not meet either of the disability requirements or the early intervention requirements (section 30(1)(b)(i) and (ii)).

All participants must continue to meet the residence requirement. That is, a participant must reside in Australia and be an Australian Citizen, holder of a permanent visa or a protected SCV holder.

Participants must also continue to meet either of the disability requirements or the early intervention requirements.

If a person meets the disability requirements it would generally be expected that in most cases they would continue to do so for their life.

Where a participant was granted access to the NDIS under the early intervention requirements, the NDIA will reassess the person's access when reviewing each plan to assess whether the person continues to meet the early intervention requirements or, if this is not the case, whether they meet the disability requirements. If the person meets neither requirement, their status as a participant may be revoked.

13.4.1 Requirement to provide notice of a decision to revoke a participant's status

A decision to revoke a person's status as a participant can be reviewed, and is known as a reviewable decision (section 99(c)).

The NDIA must notify the prospective participant in writing of the decision to revoke their status as a participant, including the date in which the revocation takes effect and a statement to the effect that the person may request that the NDIA review the decision (sections 30(2) and 100(1)).

Where possible, the NDIA will also attempt to contact the person by telephone to advise them of the decision which has been made (section 7(2)).

13.4.2 Requirement to provide notice of a change in circumstances (section 51 of the NDIS Act)

A participant must notify the NDIA if an event or change in circumstances happens, or is likely to happen, that affects, or might affect, their status as a participant (section 51(1)).

A participant must notify the NDIA as soon as reasonably practicable after he or she becomes aware that the event has happened, or is likely to happen (section 51(2)).

13.5 Person no longer wishes to be a participant

Where a person notifies the NDIA in writing that they no longer wish to be a participant their status as a participant will cease (section 29(d)).

13.6 Person not entitled to be paid NDIS amounts after they cease to be a participant

A person is not entitled to be paid NDIS amounts which relate to reasonable and necessary supports that would have otherwise been funded in respect of a period after the person ceased to be a participant (section 29(2)).

This page current as of
29 March 2019