Access, eligibility and planning consultation papers

Access and eligibility

At the moment, people with disability are required to seek information about the impact of their disability from a variety of health professionals, including doctors and allied health professionals. Not only can wait times be long, but appointments to see doctors and specialists can also cost a lot of money.

The current process can also result in inconsistent decision making and a high number of review requests.

Now that the NDIS is available across Australia, we need to replace existing processes with a transparent and consistent national approach to determining access to the Scheme and decreasing the financial cost to apply.

We will replace existing processes that are used to decide if someone is eligible for the NDIS, with a more transparent and consistent approach. Under the new policy, we will no longer rely on the access lists.

From the middle of 2021, we will introduce independent assessments to the access process. The results of the independent assessment will be used to inform the access decision.

You can read more about independent assessments.

No. The Access and Eligibility Policy is not final.

We are seeking feedback to ensure the implementation of this policy will work well for all participants.

Community and sector consultation is important to us.

In our Participant Service Charter, we committed to empower participants by including people with disability and the community to help us develop and test our processes.

The policy and independent assessments will come into effect in the middle of 2021 for all applicants 7 years of age and older.

Separately, we are considering our policy approach to children under 7 years of age who are supported through the Early Childhood Early Intervention (ECEI) Approach. We are also considering raising the age of children able to access NDIS ECEI support to 8 years old (currently 0-6 years and the future 0-8 years) .

You can read more about our approach to early childhood intervention in our paper on Supporting young children and families early, to reach their full potential.

Under the new policy, we will no longer rely on the access lists. The current lists will be removed from our Operational Guidelines from mid-2021.

These lists were used during the trial and transition period to manage the large volume of people transitioning from state and territory service systems to the NDIS.

The new access process will replace the lists to deliver an equitable experience for everyone, regardless of diagnosis.

The consultation paper is available for download on the Have your say page. The paper is also available in Easy Read.

There are a number of questions we are seeking feedback on at the end of the paper.

To give feedback, make a submission on the Have your say page by 10.00am ADST Tuesday 23 February 2021.

Planning, personalised budgets and plan flexibility

We know the planning process can be made simpler and faster for participants in the NDIS.

The current process for building plan budgets has resulted in inconsistent decision-making and a high volume of reviews.

For example, participants with similar levels of functional capacity and who live in in similar environmental contexts, may have received very different levels of NDIS funding.

We have also heard that the current support budget categories and sub-categories in plans are confusing, and are restricting how participants can use their budget to best pursue their goals.

This policy will introduce new ways of working that will address these issues, improve equity and consistency in planning decisions, and provide more choice and control for participants.

Once a person is found eligible for the NDIS, information from their independent assessment will be used to develop a personalised budget.

Participants will receive a draft plan (including a draft budget), before their planning meeting. The planning meeting will remain to talk more specifically about the person, finalise the personalised budget, and focus on supporting participants to use their NDIS plan to pursue their goals.

A personalised budget will be included in a participant’s NDIS plan, which will be far more flexible.

Plans will be set up for longer periods of time, and regular check-ins will be scheduled to make sure plans still suit participant’s needs.

Participants will need to complete a new independent assessment from time-to-time, and at different stages of their lives, to make sure they continue to get the right funding in their NDIS plans.

Independent assessments focus on capability, rather than disability.

This shifts the focus from assumed function based on diagnosis, to a more holistic assessment based on a person’s functional capacity and environment.

This means NDIS funding is better aligned to a participant’s actual capacity and reasonable and necessary support needs and that planning can focus on how this funding can best be used to meet their disability related support needs and pursue their goals

Read more about independent assessments.

A personalised budget is the total reasonable and necessary funding included in a participant’s NDIS plan.

In future, a participant’s budget will no longer be based on the total of the individual reasonable and necessary supports included in their plan.

Rather, the funding provided in a personalised budget will be informed by the participant’s individual circumstances. This includes their age, where they live, their functional capacity, and any relevant environmental factors, such as available informal supports.

The outcomes of the participant’s independent assessment will inform their personalised budget.

A participant’s goals and aspirations will remain an important part of a participant’s plan.

The personalised plan budget is the NDIS funding a participant can use, alongside informal and mainstream supports to pursue their goals and meet their disability-related support needs.

Goals will still be determined by the participant, and can be changed at any time.

Plan flexibility is the term we use to explain how participants will have more choice and control over their plan and NDIS funding in future.

NDIS funds will be flexible, except in limited circumstances. Participants will be able to use their flexible budget for the duration of their plan in ways that allow them to meet their disability-related support needs and pursue their goals.

We know that the annual plan review process can be a source of stress and anxiety for some participants. Instead, we’ll check-in with participants to discuss how their plan is going, and what type of review is needed.

Through the participant check-in approach, we will move away from plan length dictated by arbitrary dates. Instead, plan duration will be based on life stages.

We will check-in with participants on their progress to make sure the supports in place continue to meet the participant’s functional capacity and needs. We will also begin a conversation to discuss whether a participant needs a new plan, some minor tweaks, or a renewal of their existing plan.

No. The Planning Policy for Personalised Budgets and Plan Flexibility is not final.

We are seeking feedback to ensure the implementation of this policy will work well for all participants.

Community and sector consultation is important to us.

In our Participant Service Charter, we committed to empowering participants by including people with disability and the community to help us develop and test our processes.

Starting in late 2021, this policy will progressively apply to all participants over 7 years of age, in line with the gradual rollout of independent assessments and subject to the passage of legislative amendments.

Separately, we are considering our policy approach to children under 7 years of age who are supported through the Early Childhood Early Intervention (ECEI) Approach.

We are also considering raising the age of children able to access NDIS ECEI support to 8 years old (currently 0-6 years and the future 0-8 years) .

You can read more about our approach to early childhood intervention in our paper on Supporting young children and families early, to reach their full potential.

Participants will experience a new NDIS planning process.

Information from their independent assessment will be used to develop a personalised budget.

Participants will receive a draft plan (including a draft budget), before their planning meeting.

A personalised budget will be included in a participant’s NDIS plan and will be more flexible than current budgets.

Plans will be set up for longer periods of time, and regular check-ins will be scheduled to make sure plans still suit participant’s needs.

Participants will need to complete a new independent assessment from time-to-time and at different stages of their lives to make sure they continue to get the right funding in their NDIS plans.

The consultation paper is available for download on the Have your say page. The paper is also available in Easy Read.

There are a number of questions we are seeking feedback on at the end of the paper.

To give feedback, make a submission on the Have your say page by 10.00am ADST Tuesday 23 February 2021.

Access, eligibility and planning consultation papers

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