I recently attended a session presented by my LAC (Local Area Coordinator), focused on how to make the most of NDIS plans. Now, while I thought I had a good grasp on all things NDIS, I actually learned quite a few things from this session, which I naturally wanted to share with you.
Whether you’re new to the NDIS or an old hand like me, things are always changing. That’s why it’s a good idea to take advantage of NDIS training sessions whenever you can. You can find upcoming session being held near you here.
In the meantime, here are the important points from the information session I attended in Newcastle recently. I hope this information helps you make the most of your plan and better navigate the NDIS system.
How to Make the Most of Your NDIS Plan
Understand the role of the Local Area Coordinator (LAC)
To make the most of your plan, you need to understand the role of the LAC and how they fit into the NDIS.
For participants aged 7 and above, it’s possible you will be referred to one of the NDIA’s partner agencies, who deliver LAC services on behalf of the NDIA (National Disability Insurance Agency). While in the early days of the NDIS agency planners dealt with participants directly, now in most cases, plans and reviews are conducted by LACs, who put together the plan and send through to the NDIA for approval.
While LACs collate and construct the plan with you, they cannot provide approval – this can only be provided by the NDIA. To help the LAC put together the best possible plan, ensure you provide as much information as possible during your review meeting, including therapy and medical reports, quotes for resources, daily challenges and goals for the future.
There are three main ways LACs can provide assistance to NDIS participants.
Help you access the NDIS and get the most out of your funding
LACs are here to help you access the scheme, navigate the system and help you make the most of the support allocated to you by:
- giving you information about entering and applying for the scheme
- meeting with you to help you with your first plan and plan review
- helping to build your review plan and send to NDIA for approval
- assisting you in understanding your budgets
- connecting you to service providers
- showing you how to use the myplace portal
- checking how you are going with your plan
Build your social network and make links with your local community
LACs are here to help you make the most of the connections in your local community by:
- providing information on the community supports available to you
- sharing information about other government services you can access (mainstream supports)
- giving you opportunities to connect with other people
Apply the principle of capacity building
LACs are here to help you build your capacity, which means, building your skills, knowledge and confidence so you can self-direct your supports, be more independent and have more control over your life.
It’s interesting to note that you can also ask your LAC about the supports available in your community, even if you’re not eligible for an NDIS plan (I did not know this).
Understand your funding
NDIS funding can be complicated so it helps to break it down and look at each area one at a time. Here’s some information on plan management, reasonable and necessary supports and the components of your plan budget.
Plan Management Options
There are three plan management options when you enter the NDIS. Your LAC will work with you to identify the best option for you, although you can ask for this to be changed at any point in your plan. The way your supports will be managed should be clearly stated in your plan, as part of the funded supports section. The three plan management options are:
NDIA (agency) managed – where your service providers are paid by the NDIS through the portal (you can only use NDIS registered providers in agency managed plans).
Plan managed – where your plan management provider arranges payments and keeps all records, with a plan management fee included in your budget to pay for this service (you can use registered or non-registered providers in plan managed plans)
Self managed – where you have a hands on role in dealing with all aspects of your plan, including keeping records, making payments and employing your own staff (you can use registered or non-registered providers in self managed plans).
You can also combine elements of these options in a single plan. For instance, one of our plans is agency managed, with a small amount self-managed, so we can access the services of a non-registered NDIS provider. It’s important to understand there is flexibility to change plan management options as you go, based on your circumstances and your ability to access the services you need.
Reasonable and Necessary Supports
This is a contentious area for many NDIS participants. What are reasonable and necessary supports and how are they defined by the NDIS?
According to the NDIS, reasonable and necessary supports help you:
- pursue your goals
- be more independent
- take part in social activities and work
- actively take part in the community
- enjoy an ordinary life
For supports to be considered reasonable and necessary they must:
- be related to the participant’s disability
- not include day-to-day living costs
- represent value for money
- be likely to be effective and beneficial
- take into account informal supports given by families, carers, networks and the community
- compliment (but not replace) other government services (mainstream supports)
If a support doesn’t meet all these criteria, it’s likely it won’t be funded in your NDIS plan. When preparing for your next plan review, keep these points in mind and ensure the supports you’re requesting meet the reasonable and necessary test.
It’s important to know there are other supports available, not only those funded through the NDIS. These can be used in addition to paid supports or represent a reasonable alternative when NDIS funding is not deemed reasonable or necessary. Other supports available include:
- Informal supports – family, friends, neighbours and other significant people in life
- Community supports – sporting clubs, religious groups, social clubs, community relationships and contacts
- Mainstream supports – government services, such as health, school, education, employment, housing, justice, higher education and transport.
Every plan will identify the non-paid supports that you already use or those you could access in the personal profile section. Make sure you are utilising all the supports available to you, paid and non-paid, so you get the most out of your NDIS plan.
Components of Funding
NDIS funding is organised into three support categories – CORE, CAPITAL and CAPACITY BUILDING. Each support category is further divided into budget categories, which determine the services and supports you can access with these budgets.
These support categories, as well as the applicable budget categories, are listed in the funded supports section of your plan. It’s important to understand the difference between these categories, how you can utilise these funds and what flexibility (if any) you have to move funding between different support needs.
CORE: designed to help you with daily living and social and community participation, there are four core budget categories:
1.01 – Assistance with daily life (including self-care, home cleaning, short-term accommodation)
1.02 – Transport (assist with the cost of transport for eligible participants, paid directly into bank account fortnightly)
1.03 – Consumables (including continence aids, low risk assistive technology)
1.04 – Assistance with social and community participation (1:1 support to attend activities, support to attend group activities in the community, support to attend group activities at a centre).
Core budgets are flexible across these areas (except transport), meaning you can use your budget as you wish between assistance with daily living, consumables and assistance with social and community participation. For example, you can use some of your funding for consumables to purchase more assistance with daily life.
CAPITAL: designed to provide you with equipment and/or adjustments for daily living and your home, across two capital budget categories:
2.05 – Assistive technology (motorised wheelchair, prosthesis, hearing aids and communication devices, vehicle modifications)
2.06 – Home modifications and specialist disability accommodation (kitchen and bathroom modifications, SDA funding for eligible participants)
Capital budgets are not flexible, with specific supports stated in your plan and assessments and quotes required.
CAPACITY BUILDING: designed to build your skills and independence and to be linked to a goal, there are nine capacity building budget categories:
3.07 – Support coordination (to help participants with more complex needs)
3.08 – Improved living arrangements (support to obtain/retain appropriate accommodation)
3.09 – Increased social and community participation (life transition planning, skills development in a group, individual skills development and training)
3.10 – Finding and keeping a job (support to build employment skills)
3.11 – Improved relationships (psychology and positive behaviour support)
3.12 – Improved health and wellbeing (exercise advice required due to impact of disability)
3.13 – Improved learning (assistance moving from school to further education)
3.14 – Improved life choices (training in planning and funding for plan management)
3.15 – Improved daily living skills (therapy or support to build independent living skills)
Capacity building funding is only flexible within each of the nine budget areas. For instance, you can change the way you distribute funding for therapists within improved daily living skills but you can’t use that funding outside that budget category.
NDIS Price Guide
The NDIS price guide lists the supports you can purchase under each budget item and the maximum amount that NDIS registered support providers can charge. Even if you are agency managed, it’s important to understand the cost of supports to ensure you have received enough funding in your plan to cover all your needs.
The price guide can help you:
- choose supports so you get the most from your funding
- keep track of what your providers are charging you
- identify any accounting mistakes made by providers
The price guide is updated each year (you may be aware of a recent increase to the price guide announced by the government). I was relieved to learn that current NDIS plans are automatically adjusted to reflect these increases, ensuring no participant is disadvantaged when the price guide is changed mid-plan.
Understand your rights and responsibilities
This was an area I was not familiar with before the information session. As a consumer of NDIS products and services, all participants are covered by Australian Consumer Law, providing rights, guarantees and responsibilities. Providers of NDIS funded products and services also have right and responsibilities under these laws.
If your good or service doesn’t meet these standards, you are legally entitled to a remedy, such as repair, replacement or refund. If you pay for a good or service, you can expect it to be:
- of acceptable quality
- what you requested or ordered
- the same as its description
- delivered with due care and skill
- delivered in a reasonable timeframe
When you purchase goods or services you have the right to:
- take your time
- ask questions
- request a better price
- be treated fairly
- receive all relevant information
- say ‘no’
- speak up if you’re dissatisfied
Protect yourself as a consumer of NDIS products and services by:
- researching products and services before you buy
- keeping all receipts
- retaining warranties
- checking items thoroughly at time of purchase
- never signing contracts before understanding everything in it
Service providers must comply with the NDIS Act and work with you to make a service agreement. This agreement should be made via your preferred means of communication and include the following:
- nature, quality, price and expected outcomes of supports to be provided
- agreed terms and conditions (e.g. cancellation fees)
- clear, accessible complaints and dispute resolution processes
Before signing a service agreement:
- read the agreement in full
- ask for time to look over it
- seek advice if you are unsure
- ask for additional clauses to be included if needed
- ensure the what, how and when of the service is clear, as well as the cost
- don’t start the service until the agreement is signed
- keep a copy of all service agreements
- contact the provider if they are not complying with the terms of the agreement.
Understand the complaints process
As we all know, there will be times when we’ll need to seek resolution to issues or make a complaint about products or services accessed under an NDIS plan. It’s crucial to understand how to make your complaint to ensure it can be resolved as soon as possible.
When to make a complaint
As a consumer of disability services, you have the right to make a complaint if you feel you’ve been treated unfairly, your rights have not been upheld or you are not satisfied with a product or service.
For instance, you have the right to complain if a provider has refused to undertake repairs on a product that was faulty when purchased. Similarly, you have the right to complain if a support worker has been arriving late on an ongoing basis and spending time on their phone instead of supporting you.
Complaints about a provider
The first step is to talk to the service provider about your concerns. Check the complaints policy in your service agreement, organise a meeting and discuss your issue. You can also seek advice from your LAC if you feel you are not making progress.
If your provider is NDIS registered, you can contact the NDIS Quality and Safeguards Commission to escalate the issue:
- 1800 035 544
- NDIS Quality and Safeguards Commission
You can also contact your State Ombudsman for further assistance. The details for the NSW Ombudsman are below:
- 1800 451 524
- NSW Ombudsman Complaints
Complaints about the NDIS
If you have a complaint about the NDIA or your NDIS plan, it’s best to speak to your LAC first. If your issue is still unresolved, contact the NDIS:
- 1800 800 110
You can also contact the Commonwealth Ombudsman for further assistance:
- 1300 362 072
- Commonwealth Ombudsman
Complaints about a LAC
If you’re unhappy about the service you are receiving from your LAC, it’s best to raise this with them first to see if you can resolve the issue. If you do need to escalate your concerns further, you can contact the organisation they represent and see further assistance. If you’re in the Newcastle region, you can use the contact details below:
- 1800 795 626
I hope this information helps you get more out of your NDIS plan. I know I learned more about the system from this session and feel that I will be in a better position to help my kids get the most out of their plans in the future.
This information was sourced from information presented by my LAC and from the NDIS website, based on current information as at April 2019. If you have any questions about the information provided here, it’s best to follow-up with your own LAC or with the NDIS directly.
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You do the best job at this summary of the latest but even my old teacher/principal eyes glaze over at the details and expectations via those who have NDIS funding.
I understand the need for accountability and due process but I wonder if there is consistency. I know it is still relatively new.
I thank you, again, for sharing what you can when you can to help others.
Thanks for linking up for #lifethisweek. Next week’s optional prompt: is “1/3 of 2019 is over” and for me, that IS scary. Hope to see you there. Denyse