National Disability Insurance Scheme (NDIS) is created to fund care plans for individuals with disability in Australia. The NDIS support funding is related to broad range of supports provided to a person with disability to assist in living a normal life. This includes areas such as social participation, education, employment, living arrangements, independence, health and wellbeing of the participant. However, the funding will be for the support that NDIS considers ‘reasonable and necessary’. What constitutes ‘reasonable and necessary’ support is open to interpretation, which makes it a confusing concept to many people.
As per NDIS, the ‘reasonable and necessary’ support funding should be concerning the participant’s disability, and support them to lead a normal life and fulfils their goals. During your NDIS planning meeting, the Planner will collect information from you to assess if your situation is reasonable and necessary enough for support requests.
For support to be reasonable and necessary, it must:
Be directly related to your disability, which means the reason for NDIS support should be directly related to your disability. Hence, if your disability makes it difficult for you to clean your house, you could avail your NDIS funding to hire the service of a cleaner.
Cannot be related to your day-to-day living cost, which means your disability support requirements should not be related to your living expenses like the cost of groceries,phone bills, public transport tickets. etc.
Be related to your goals, objectives and aspirations, which means the support should help the participant in reaching goals as mentioned in the plan, promote independence, and take active participation in the workplace and community. Hence, it is recommended to have broad NDIS goals that would relate to more useful support. If it is “to learn ways to express through creativity”, then drawing with Oil Pastel could be considered for support.
Be considered value for money, which means it should be priced reasonably, and in no way, it should be above the current NDIS Price Guide benchmark.
Take into account your informal arrangements for support received from family members, partners, carers, government services, networks, and the broader community.
The role of NDIS is to bridge the gap between having a disability and leading a normal life as any other person. Ask yourself, if a person without a disability will have to pay for the reason given for support funding? If the answer is “YES”, then it is likely to be considered by NDIS planners as a mainstream cost. Money spent on housing, vehicles, food, holidays are taken as mainstream costs, as they are not disability specific, and unlikely to be considered as reasonable and necessary.
How do I know if I am eligible for NDIS Support Funding?
NDIS support funding can be accessed based on an NDIA assessment around eligibility, to those who have a recognized disability. Check our blog on eligibility and how to apply to become an NDIS participant.
While it is up to NDIS to decide what constitutes the right funding support, speaking to experts like Envisioning Life Supports (ELS) can help you to find out if the specific support you are seeking based on the type of disability you have can be funded under NDIS and should it be considered as being reasonable and necessary.
How do I know if my purchase of certain support fits the reasonable and necessary criteria?
As mentioned above, for certain items or supports purchased, what constitutes reasonable and necessary is a question that might not have a straight forward answer. You can always use the points mentioned above to determine whether or not your purchase fits the criteria. If still confused, you may wish to give us a ring on 1300 323 399 and we can further assist.
How does NDIA works out what is reasonable and necessary?