How to access the NDIS

 

Overview. The National Disability Insurance Scheme is the new national scheme, currently operating within the Mid North Coast to support people with disabilities to achieve their goals, take part in daily life and choose their own supports and services.

  

Application to become a participant. To benefit from this scheme a person with a disability must first apply to become a participant, or a guardian applies on their behalf. To request access to the scheme, a person needs to complete an access request form. The NDIS may also request the person completes a supporting evidence form with the assistance of a treating doctor or specialist. Information required here includes the nature of the person’s impairment, documentation of previous assessments of the impairment (eg. letter of diagnosis from a paediatrician) and the functional impact of the impairments.  Functional impacts occur when an impairment affects a person’s mobility, communication, social interaction, learning, self-care or self-management.

 

Planning. Where the NDIS agrees that a person meets all the criteria for support, the person becomes a participant and is then contacted by a Local Area Coordinator (LAC) or Early Childhood Early Intervention Coordinator (ECEI Coordinator) from a non-government organisation (eg. Social Futures for most school-aged and all adult participants or Northcott for children under seven).  The LAC or ECEI Coordinator and the participant have a planning conversation to define the current situation, goals and supports.  They documents this information in a plan, which a planner from the National Disability Insurance Agency (NDIA) then reviews and either approves with a specified budget for supports or asks for additional information. 

 

Funding Decisions. The budget for a person with ASD is typically determined by level of support specified at diagnosis (eg. ASD Level 2).  The budget for a person under the age of 22 with an intellectual disability or disability and complex needs is typically determined following a Paediatric Evaluation of Disability Inventory (PEDI-CAT) and Functional Independence Skills Handbook (FISH) assessment with a LAC or ECEI coordinator.  This interview-based assessment is completed on a computer or tablet with the parent or caregiver answering questions about the participant’s day-to-day functioning.  Depending on the nature of the person’s needs, the funding may be for between six months and two years at the end of which the participant, LAC and planner create a new plan.

 

Managing your funds. The participant or person acting on behalf of the participant must clearly outline how the funding will be managed. Management options include self-managed by the participant or the person acting on their behalf, management by the NDIA or management by a registered plan management provider such as a supports coordinator.  Where the NDIA is chosen to manage the funds, all providers of support services (eg. speech pathologist, occupational therapist, respite) must be registered with the NDIS.  For self-managed participants, the person accesses services consistent with the supports in their plan, pays for the services and then submits receipts through the NDIS online portal for reimbursement. Families often self-manage funding for therapy supports but may prefer to use a supports coordinator to organise access to respite services or source a care worker.

 

Early Childhood Early Intervention

The NDIS also provides support for children under the age of seven who do not have a diagnosed disability yet have difficulty in two or more functional domains.  These include mobility, communication, social interaction, learning and self-care.  This support is through the Early Childhood Early Intervention (ECEI) pathway, where a NDIS approved ECEI provider assesses needs using the PEDI-CAT and FISH, gives advice and may provide funding for intervention and assistance. 

 

During this time a family may also be on a diagnostic pathway, accessing allied health assessments or specialist assessments under the direction of a paediatrician.  Where a paediatrician gives a diagnosis (e.g. Fragile X syndrome, ASD) or a child is found to have an intellectual disability following a cognitive assessment with a psychologist, the child may become a NDIS participant.        

 

 

 

Your NDIS journey at Jack and Jill

 

We endeavour to understand your child’s goals and supports, and we talk with you about those within our scope. For goals outside our scope, we collaborate with others who can contribute (eg. occupational therapists and psychologists).  Where a lead agency may be involved, again, we collaborate. Consistent with our family-centred philosophy, we provide families with progress reports and ensure that families take a central role in deciding how and to whom reports are distributed.  We communicate closely with all team members involved, in order for everyone to be involved in helping your child achieve his or her goals.  These preferences are negotiated at the outset when we talk through your service agreement.  We talk with you about how speech, language and communication develop, in order that you can make informed decisions about your child’s further goals, and we acknowledge that it may take a period of time for us to get to know each other, and how your child best works. Also as part of your child’s service plan, we focus on your child’s strengths and routines, and we aim to develop a management plan that is as cohesive and holistic as possible.  We ensure your child’s service plan also includes the ‘nitty gritty, whether Paul or Chris will be working with you and your child, how often and where appointments will take place. We make it clear to parents and caregivers that funding plans within the service agreement may change over the life of the plan, differing from the initial ‘quote’, depending on your child’s progress.  We continually review your child’s progress and discuss any changes with you.  

 

 

How to speak the NDIS language

 

With a new scheme, comes new terminology. Below is a summary of some key words and phrases that you might come across when reading about the National Disability insurance Scheme or interacting with the National Disability Insurance Agency.

 

National Disability Insurance Agency (NDIA). The agency set up and funded by the Australian Government to implement and run the Scheme.

 

Access checklist. A tool that can be used to work out if a person may be able to access the NDIS. This can be found on the NDIS website.

 

Access request. An access request is how you apply for and take part in the NDIS. A potential participant will usually need to complete an Access Request Form (ARF) with Part F needing to be completed by a health professional.

 

Assistive Technology. Any device or system that allows individuals to perform tasks they would otherwise be unable to do or increases the ease and safety with which tasks can be performed.

 

Capacity Building. Increasing people's knowledge, skills and abilities. This might apply to an individual - perhaps developing their skills in a certain area to allow them to live more independently.  Or it might apply to the community as a whole — for example, building the capacity of organisations to be more inclusive.

 

Carers. Family members or friends who provide support to a person with a disability.

 

Carer statement. A written document where carers describe the support they provide and what support they need to continue caring.

 

Choice and control. A participant has the right to make their own decisions about what is important to them and to decide how they would like to receive their supports and who from.

 

Child’s representative. Someone who makes decisions for a child with disability or who acts on their behalf. This could be a child's parent or guardian.

 

Continuity of support. Continuity of support means that a person will continue to get the supports and outcomes they were getting before the NDIS started.

 

Early intervention. Supporting a person with a disability well in the early stages so they won't need as much support later on. Early intervention can also help children younger than 6 who need support to have the best start in life.

 

Early childhood early intervention ECEI. Nationally consistent approach to early intervention based on best practice, for children 0-6 years old, which will provide appropriate individualized support for each child based on their needs. Provide support early in life to reduce the effects of disability and to improve the person's functional capacity.

 

Early Childhood Partner / ECEI transition provider. See children referred to them through the ECEI pathway. Provide families with information and linkages, may provide short-term intervention and/or assist the family to request access to the NDIS when there are long-term needs.

 

Eligible. Meeting all of the criteria needed to get support. Not all people with a disability will be eligible. For more information on eligibility, please refer to National Disability insurance Scheme: Eligibility Guide, on the NDIS website.

 

Funded supports. Types of support that cost money and that the NDIS agrees to pay for.

 

Guardian. Someone who has been given the legal responsibility to make decisions for a person who is not able to make their own decisions.

 

Informal support. Any support that is provided by a family member or friend, not a paid service, paid worker or formal volunteer.

 

Information, linkages and capacity building  (ILC). ILC is part of the NDIS. ILC is a set of activities that will increase the capacity of people with disability, their families and carers to achieve their goals and increase the capacity of the community to be more inclusive. Originally, ILC was known as Tier 2.

 

Local area coordinator. People who work in the local community who may assist the participant and the NDIA to prepare their plan. They will also assist with capacity building within the community to help people with disabilities be more independent and to assist with inclusion.

 

Mainstream services. Services and programs usually funded by Commonwealth, State or Local governments that everyone in the community can use such as health, education or transport. For information on how the NDIA and mainstream services may work together, please visit the NDIS website and refer to Operational Guidance for NSW mainstream services on the interface with the National Disability Insurance Scheme.

 

Manage. The method of organising support, for example finding service providers, keeping records and receipts or paying support workers. For information regarding different plan management options, please refer to National Disability insurance Scheme: Plan Management, on the NDIS website.

 

My first plan. Entry point into the NDIS. The ’My First Plan’ may include the supports and services that a participant receives at the time of planning and will also include more support if needed as well as the participant's goals. It will typically last for 12 months.

 

National access team (NAT).  NDIA staff members who work in locations around Australia to review NDIS access applications and decisions relating to a participant's eligibility for the NDIS.

 

Nominee. A person who has permission to act or make decisions on behalf of the participant.

 

Participant. A person with a disability who has met access requirements and is approved to receive funded supports via an NDIS plan.

 

Participant statement. Information setting out a participant's living arrangements, relationships, supports, description of day to day life as well as their short and longer term goals.

 

Plan. A document which lists what services and supports a person has already, what their goals are, what supports they need and what funded supports they will get. Plans are sometimes referred to as individual funding packages.

 

Planner. A person who works for, or on behalf of, the NDIA and assist to create a plan. They may work directly with the participant, or they may just approve the plan once a Local Area Coordinator has worked directly with the participant.

 

Planning session. A meeting where the planner/local area coordinator, the participant and any other person the participant chooses, talk about creating the participant's plan.

 

Reasonable and necessary supports. Something that the NDIA agrees a participant needs to reach their goals and participate in the community. Reasonable and necessary supports are determined based on their reflection of Section 34 of the NDIS Act (2013).

 

Significant, permanent disability. A disability that a person will have for the rest of their life and that makes it difficult for the person to do everyday things without help.

 

Support Coordination (or coordination of supports).  Support coordination is a capacity building support to implement all supports in a participant's plan, including formal, mainstream, community and funded supports. It also may include resolving points of crisis, developing capacity and resilience in a participant's network and coordinating supports from a range of services. Funding for a support coordinator will be itemised separately in a person's plan and will not have a negative impact on the amount they receive for other funded supports.

 

Support worker. A person who is paid to provide care and support to a person with a disability.

 

Technical Advisory Team (TAT). A team of experienced clinicians who provide information to planners in order to aide their decisions regarding what support might be reasonable and necessary.

 

 

We partner with

Coffs Harbour Paediatric Clinic

Schools and early education centres

Support workers

A range of local allied health providers

... to name a few.

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