Access the NDIS

Why this is important

This page features key information for legal and court professionals on understanding and accessing the National Disability Insurance Scheme (NDIS) for people with disability. It covers:

  • Who is eligible?
  • What is the NDIS?
  • How NDIS funding works
  • How to access the NDIS
  • Requesting a plan review

See NDIS assistance for who to contact with NDIS eligibility, access and plan enquiries.

Who is eligible?

The NDIS is available to people who meet the following criteria:

People over 65 should go to My Aged Care, which is the entry point for federally funded aged care services, including disability services.

What is the NDIS?

The NDIS is an insurance scheme designed to help improve disability services and provide greater control and decision-making to people with disabilities in Australia.

The NDIS supports people with a permanent and significant disability that affects their ability to take part in everyday activities.

It is a new model of funding and delivering supports for people with disability in Australia. It takes an insurance-based approach and moves from the previous system of providing funding to state-administered disability service providers to a fee-for-service, market-based approach. It is based on the premise that people with disability each have different support needs and should be able to exercise choice and control over the supports they receive.

The NDIS is one means of getting an individual access to ongoing support beyond their contact with the criminal justice system. While the NDIS does not provide specific 'justice' supports, it is a means of accessing funding for services, such as specialist disability accommodation, transport, community access, home modifications and disability workers.

Challenges accessing services through the NDIS can create a number of issues for clients that may affect their justice involvement.

From July 2019, the NDIS has started roll out across Victoria. This means that most disability services that were previously managed and delivered by the Department of Families, Fairness and Housing (DFFH) and the Department of Health or other State and Federal Government funded programs will be transferred to the NDIS model.

For information on finding justice-specific disability supports, see Access support services.

How NDIS funding works

Funding for eligible services is distributed to participants through 'NDIS plans'.

An NDIS plan is an official document from the National Disability Insurance Agency (NDIA) that states an individual’s goals and circumstances, and the approved funding they will have access to.

An NDIS plan has three parts:

Part I: Profile ('about me')
Part II: Goals
Part III: Supports

Part I and II are created by the person with disability. Part III is decided by the NDIA and should reflect I and II.

Once approved, an NDIS plan will set out the amount of funding allocated for each support need. The participant can spend this on eligible services with disability service providers.

Funding is allocated according to what the NDIA considers ‘reasonable and necessary’ to achieve the participant’s goals.

Information on the formulas that are used to determine the amount of funding in plans can be found in the NDIS price guides.

What the NDIS funds

The National Disability Insurance Scheme (NDIS) can provide funding packages for participants to spend on supports that are 'reasonable and necessary'.

What does 'reasonable and necessary' mean?

Disagreements about what is 'reasonable and necessary' can create issues for people with disability seeking to exercise their rights under the NDIS.

The NDIA considers a support or service to be reasonable and necessary if it:

  • is related to a participant’s disability;
  • does not include day-to-day living costs that aren’t related to the participant’s disability support needs
  • represents value for money
  • is likely to be effective and work for the participant
  • takes into account the other support the participant currently receives from government services, family, carers, networks and the community.

If a person's plan is not adequately addressing their support needs, they can appeal. Depending on the stage of the issue, you may need to contact a disability advocate or a lawyer who specialises in NDIS appeals for assistance.

If you have issues or questions see NDIS assistance.

The NDIS tailors funding to individuals to reflect their goals.

Some of the things that an NDIS plan can provide funding for:

  • 'Core supports' – including assistance with activities of daily living and with social and community participation (including transport)
  • 'Capacity-building supports' – to build independence and skills, like behaviour support to improve relationships, and help to find and keep a job
  • 'Capital funding' – for equipment and home modifications related to the person's disability

Funding amounts are determined by the goals a person with disability has put in their NDIS plan.

The NDIA will determine what is reasonable and necessary support funding to achieve these goals.

A detailed list of the types of funding that is available through NDIS plans can be found on the NDIS price guides.

What the NDIS does not fund

The NDIS will not provide funding for services that are available from another government department.

For example:

  • Education (e.g. integration aids in Schools)
  • Health (e.g. things that are available through Medicare)
  • Justice-specific supports

The NDIS will not fund personal expenses, and it does not replace the Disability Support Pension.

What are 'justice-specific' supports?

For more information on what the NDIS considers justice-specific supports refer to:

For justice-specific supports that are connected to a person’s disability, DFFH continues to provide Forensic Disability Services. See Access support services for more information.

How to access the NDIS

See NDIS assistance for who to contact if you have enquiries about NDIS eligibility, access and plans.

Complex Support Needs Pathway

The NDIS has been rolling out a Complex Support Needs Pathway within the NDIA. This process provides access to a specialist planner for people with personal and situational factors that make it harder for them to engage with the NDIS. This includes criminal justice involvement.

The Pathway’s team of Complex Planners work with participants and support coordinators to develop, implement and monitor NDIS plans. Referrals to this Pathway come internally from within the NDIA.

To find out more about the program, contact:

See NDIS complex support needs and crises for services to contact for assistance. 

If already receiving government supports

If a person with disability is already receiving supports from a government-funded service that will be transitioned to the NDIS, they may be eligible for a fast-track assessment.

An NDIS Local Area Coordinator (LAC) can tell you if you are eligible for a fast-track assessment. See NDIS assistance for contact information.

New applicants

The NDIS website has a guide to Applying to Access the NDIS and is a good place to start.

For people with disability who have not been transferred to the NDIS through the roll-out, the first step in accessing the NDIS is obtaining a medical report.

Read: VALID’s guide on what to include in an NDIS medical report

Once a person has a medical report, the process is as follows:

Step 1. Contact the Local Area Coordinator (LAC)

Go to NDIS assistance for Local Area Coordinator (LAC) contact information.

This starts the process. Once a person is accepted as eligible, they will be allocated a planner and become a participant on the scheme.

If the LAC decides a person is ineligible for the NDIS, the person can appeal the decision. See NDIS assistance to contact a disability advocate for help with this.

Step 2. Meet with an NDIA planner

An NDIA planner will meet with a person with disability to develop their NDIS plan.

Planners can meet with people face to face or by phone. This meeting is important for determining the amount of funding and scope of the NDIS plan. The person with disability can decide where the meeting will be held.

It is a good idea to prepare for this meeting by working out ahead of time what is needed and possible out of an NDIS plan.

Step 3. Wait for plan to be approved

Waiting times for plan approvals vary and delays are common.

If a participant is concerned about how long the approval process is taking, they can seek assistance from a disability advocate or contact the LAC.

Step 4. Activate NDIS plan

Once a plan is approved, the participant will need to activate their plan by choosing their preferred service providers.

NDIS service providers, such as Clickability, can help you find services. There are also lists of service providers on the NDIS website.

If a person is having difficulty activating their plan or locating services in their area, a support plan coordinator or disability advocate may be able to assist.

Requesting a plan review

A plan review is an opportunity to increase the supports available in an NDIS plan.

If a person’s NDIS plan is not supporting their needs, in particular where they have justice involvement due to support failures, they can make an application through the Local Area Coordinator for a plan review.

Plan reviews occur after 12 months of an NDIS plan being active. A participant can also request a plan review at any time if their plan is not meeting their needs.

For assistance preparing for a plan review, contact a disability advocate via the Department of Social Services’ list of National Disability Advocacy Program (NDAP) providers.

Further reading

Disability Advocacy Resource Unit (DARU) – guides to the NDIS review and internal appeals flowchart

Scope – factsheets and explainers about the different entry points for NDIS participants.

The Illusion of Choice and Control – this 2018 report by the Office of the Public Advocate illustrates the challenges for clients with complex needs presented by the roll-out of the NDIS

Victorian Advocacy League for Individuals with Disability (VALID) – resources produced for people with intellectual disability and their supporters, including Get NDIS Savvy videos

Supporting Justice

Supporting Justice © Centre for Innovative Justice, RMIT University, 2019

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