Key points:
- The government’s NDIS legislation has passed parliament, paving the way for some of the changes recommended by the NDIS Review.
- There will be a new way to build NDIS Plans, with more flexible budgets based on need rather than diagnosis.
- Funding top-ups for people who have overspent on their plans will be limited.
Some of the proposed NDIS changes are set to go ahead after new legislation was passed in Federal Parliament last week. The changes are the result of recommendations from the independent NDIS Review completed in 2023.
Here at Leap in! we know that there is a lot of discussion about these changes which are the most significant in the NDIS since it was established.
Here’s what we know so far.
Why the NDIS changes are being made.
The government is changing NDIS legislation as it implements some of the NDIS Review recommendations. How the NDIS works is guided by law so the laws need to change before some recommendations can be applied.
The new rules will be implemented in stages, although there isn’t a lot of information about when each change will be made.
Budgets will be based on needs rather than diagnosis.
There will be a new planning framework to build NDIS Plans with a reasonable and necessary budget, rather than identifying supports line-by-line.
Budgets will be based on the outcomes of a needs assessment. It’s not certain what the needs assessment process will look like as it has not yet been developed.
- While the assessment itself looks at all of a person’s disability needs, NDIS funding can only be provided in relation to impairments that meet the disability or early intervention requirements
- This change is to give participants more flexibility to use their plan to support their needs without applying to the NDIA for a variation or reassessment
- People already in the scheme will continue to receive funding under the current framework until the new budget framework is rolled out.
NDIS Minister Bill Shorten has reassured participants that the government does not intend to make participants pay for their needs assessment.
More flexible funding.
People with disability on the NDIS will have more choice and control of their supports with a flexible budget.
Flexible funding will be available where a person’s needs assessment indicates they require at least some NDIS supports that are not stated supports.
- Participants will no longer be constrained by line-by-line plans that specify particular supports and support intensity
- Flexible funding may be used for any NDIS supports that meet a person’s support needs, provided they’re most appropriately funded by the NDIS
- The inclusion of flexible funding in a plan is the default position
- In certain circumstances, such as where a participant has a history of over-spending, the NDIS may restrict the spending of some or all of the flexible funding.
Future changes will set out the process by which the budget is determined, and when supports can be stated (as non-flexible items) in plans.
New draft definition of NDIS support.
There has been much discussion about the government’s planned new definition of an NDIS support. The new definition is intended to provide clarity around supports that can be funded by the NDIS and those that can’t.
View the draft list of NDIS Supports.
Funding periods of up to 12 months.
Funding in an NDIS Plan will be divided into funding periods indicating how much flexible and stated funding is available in each period.
Each period will be no more than 12 months to ensure funding is not spent in excess of the total budget. If funding is not spent within one plan period, it will be rolled over into the next, providing it is under the same plan.
Tighter controls on top-ups.
Reforms will limit top-ups for people who have overspent their plan funds. While it is not clear exactly how this will work, it appears that the NDIS will implement tighter controls on plan reassessments, expected to begin in September.
New claiming framework and timeframes.
Claims on NDIS Plans must be made within two years of the support being provided which is the same as payments made under Medicare. This rule applies immediately. There will be a 12 month ‘grace period’ following commencement of the Bill during which no time limit on claims will apply.
There will also be new requirements for making claims. For a claim to be payable, it must be made by the person managing funding under a plan, be made in an approved form and contain all required information. The form has not yet been created.
Early intervention pathways.
- There will be a new early intervention pathway for children who enter the scheme under the early intervention requirements
- The NDIS will work with the disability community to develop the new early intervention pathway.
A needs based assessment is required to enter the scheme.
While there are no changes to eligibility for the NDIS, automatic access will no longer be guaranteed with certain medical diagnoses.
Instead, people entering the scheme will have to undergo a needs based assessment to prove they have significant functional impairment (the impact disability has on a person’s life).
From 1 January 2025, all new participants will receive a notice setting out the kind of impairments they have. Participants will be able to request a variation of this notice.
New foundational supports.
The Australian Government and state/territory governments are working together on developing a new foundational supports model for non-NDIS home and community supports.
Foundational supports are for both NDIS participants and people with disability aged under age 65 who are not eligible for the NDIS.
There will be a phased approach to designing and delivering foundational supports. Services are expected to be commissioned from mid-2025 and progressively scaled to full roll out by mid-2027.
There’s nothing you need to do.
The new laws will come into effect 28 days after the Act is formally approved. Until then:
- All access and planning processes, decisions and supports will continue in line with current operational guidance
- Participants should continue spending in accordance with their plans
- Providers should continue to claim for supports in line with current operational guidance.