NDIS set to transform access to disability funding

The NDIS is set to transform the way the disabled get help and this guide explains what's available.

For people with disabilities and their families, getting care and support can take a big financial toll.

In fact, Australians with disabilities have it tougher than their counterparts in many other nations, with our spending on long-term care for those under 65 less than half that of most Scandinavian countries and just over half the UK's.

The employment rate for disabled Australians is low compared with the OECD average, with 45% living in or near poverty.

If disability is a part of life for you or a family member, you want to make the most of the support available.

My daughter Lucy was born with velocardiofacial syndrome (VCFS), a rare genetic disorder, and my wife and I are seeking support through the NDIS, which is going to radically change the way people with disabilities pay for many services.

Disability support pension

People who are unable to work because of a disability may be eligible for the disability support pension (DSP) from the Department of Human Services through Centrelink. The DSP is for people with permanent disabilities who are older than 16 but younger than the age for receiving the age pension.

The DSP is calculated according to the same income and assets tests as the age pension, and it's worth checking with Centrelink to see if you qualify and what you would receive.

As an example, for single people over 21, the current maximum fortnightly DSP payment is $888.30 and for those with partners it's $669.60 (including the pension supplement and energy supplement).

An application is made through Centrelink, and the person's medical history must be submitted. The person is usually then sent for a job capacity assessment and in some cases a disability medical assessment as well.

There is no cost for these assessments as they're carried out by health professionals paid by Centrelink. Using criteria set out in the social security legislation, Centrelink considers the person's medical history and the results of the assessments to determine eligibility.

Carer payment allowance

If you are unable to work because you care for a person with a disability in a private home, you may be able to get a carer payment or carer allowance from the Department of Human Services through Centrelink.

To get the carer payment, the person you are caring for must require a high level of care, to the point it prevents you from spending more than 25 hours working, studying or doing training. Income and assets tested, it's paid at the same rate as the DSP and other social security pensions.

If your income and assets put you over the threshold for receiving the carer payment, you may still be able to get the carer allowance. As it's considered an income supplement, your income and assets are not taken into account. It's for carers who on a daily basis are attending to someone who needs a significant amount of care.

To get either type of support, you will need to be assessed to see if you meet the eligibility criteria. This requires you and a health professional treating the person in your care to fill out questionnaires. It's worth noting that the carer payment or allowance is also available for those caring for people with serious illnesses or the frail aged.

How the NDIS works

The NDIS, for people under 65 who have permanent and significant disabilities, is gradually being rolled out around the country. The National Disability Insurance Agency (NDIA), which runs the scheme, says that by 2019 it aims to provide $22 billion a year in funding for services and equipment for about 460,000 people.

The scheme is designed to complement, not replace, the DSP and carers' benefits. It's not means tested, so all disabled people and their carers - even those who currently don't qualify for pensions and allowances - should check how it may affect them.

An NDIA spokesperson confirms there is no cap on supports that may be funded as part of an NDIS plan. "Instead, the NDIA uses the principles of 'reasonable' and 'necessary' to determine what is appropriate for an individual."

NDIA staff make decisions based on the National Disability Insurance Scheme Act 2013 (NDIS Act) and the rules made under the NDIS Act. The operational guidelines also provide practical guidance for decision makers.

I'm not about to urge you to read the NDIS Act - suffice to say, applying for a new swimming pool to help improve my daughter's gross motor development probably would not be deemed reasonable or necessary.

"Reasonable and necessary supports are funded by the NDIS to help a participant to reach their goals, objectives and aspirations in a range of areas, which may include education, employment, social participation, independence, living arrangements, and health and wellbeing," says the NDIA spokesperson.

Financial impact

Because the NDIS is in its early stages, the jury's still out on the impact it's going to have on wallets, and indeed the impact is likely to vary from one family to the next.

As with any new scheme that has the potential to affect your financial future - just think of the introduction of mandatory superannuation 25 years ago - it's strongly advised that you bone up on the NDIS as soon as possible, and start the ball rolling on getting a support plan (more on this later).

The NDIA argues that the scheme will give a disabled person more personal choice and control over how they access the support they need.

A person works with one of the NDIA's partner agencies in their community to come up with an individualised plan based on the support they need to achieve their goals. Then, if the NDIA agrees to fund those support services, people with disabilities can choose where to buy them.

Self-managed or managed funding

Participants in the scheme can request to manage the finances themselves.

First the NDIA conducts a risk assessment to make sure the person is capable of managing the money.

"Self-management means the participant is responsible for paying and acquitting the invoices related to the supports they have received through their NDIS plan," says the NDIA spokesperson. "They are reimbursed for these expenses, with the money deposited into their nominated NDIS bank account.

"If a participant chooses to self-manage any part of their NDIS budget, they are responsible for ensuring that the relevant invoices for supports are paid on time, and keeping appropriate records and receipts for supports provided, claimed and paid. They also need to report to the NDIA on the amount used and funds spent on the self-managed items of their NDIS plan."

For children, everything is handled by parents, while for people whose disabilities prevent them from making their own plans and handling money, the responsibility falls to what's known as a "nominee" - usually a family member, carer or disability advocate.

Some of the supports in the plans are hard to value in dollar terms.

For instance, the NDIS will provide improved access to information about the best support options, and will organise referrals to the most appropriate service providers or private services in your region such as physiotherapists, occupational therapists and speech therapists outside the NDIS system.

It will also put disabled people in touch with support groups and programs in their local communities, although in the case of my daughter our local district government health service provides these referrals.

The supports the NDIA funds will vary. For instance, a young woman with cerebral palsy might get funding for a new wheelchair, physiotherapy and daily in-home assistance to help her become more independent.

A middle-aged woman with total vision loss could get help with paying for food and vet bills for her guide dog, orientation and mobility training for travelling to new locations, taxi fares, technology for converting text to speech, and home cleaning.

Parents of young children may be offered early intervention support to help identify the most appropriate treatments and services. Some of that support is about connecting parents with the relevant organisations in their community.

Depending on a child's individual plan, the NDIS may provide money to pay for support such as physiotherapy, audiology, occupational therapy, podiatry and therapy to improve speech, language or behaviour.

We've found that young children eligible for the NDIS funding for services such as speech pathology can access this service through non-government organisations (NGOs) or private services in our local area. However, we can no longer access speech therapy from our local area health service for Lucy.

This may be confusing in the beginning for parents but once the NDIS is fully operational, hopefully it should become clearer and easier to access services.

Visit ndis.gov.au or phone 1800 800 110. Visit humanservices.gov.au or phone 132 717.

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