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3.4.27 Working with the National Disability Insurance Scheme (NDIS)

Last Modified: 24-Mar-2022 Review Date: N/A

 ‭(Hidden)‬ Legislation

Overview

The National Disability Insurance Agency (NDIA) is an independent statutory agency funded by the Commonwealth and each Australian State and Territory. The NDIA maintains financial control of funds, approves payment of individualised support packages and administers access to the National Disability Insurance Scheme (NDIS). 

The NDIS is governed by the National Disability Insurance Scheme Act 2013 (NDIS Act) and its primary goal is to provide support to eligible people with intellectual, physical, sensory, cognitive and psychosocial disability in order to help them develop skills and increase independence and capacity over time.

In Western Australia (WA), the NDIS provides people with disability information about, and connections to, services in their community. This helps participants to develop a localised support network.  

The Department of Communities (the Department) is committed to working with the NDIA, its partners, other government agencies and service providers to improve the outcomes for children with disability and their families, across all areas of child protection. This includes ensuring access to reasonable adjustments and disability supports

Note: CEO refers to the Chief Executive Officer of the Department.

Rules

  • A child who is an NDIS participant must be represented by a parent or guardian; except
  • Where a child is in the CEO's care, and the Department is the child's guardian the Department must delegate a Child Representative.

Information and Instructions

  • Eligibility
  • Child representative
  • The NDIS planning meeting
  • The NDIS Plan
  • Implementing the NDIS Plan
  • Reviewing the NDIS Plan
  • Appeal process
  • Eligibility

    Children under seven years

    If a child in the CEO's care has a developmental delay or a suspected delay, they may be entitled to early intervention support. Enquire with the NDIA immediately about whether the child is eligible to receive NDIS support. Discuss what the most appropriate support for the child is, including through Early Childhood Early Intervention (ECEI) partners.

    Early intervention can have a significant effect on the child and the child may not require an ongoing NDIS Plan if they receive the support they need in their early years. The NDIA uses ECEI partners to target children when they are most receptive. In WA Wanslea provides a family-centred program focussed on providing quality information, research and evidence-based support to children and those who care for them. In areas that Wanslea do not cover, the local NDIA office is the contact point for access requests and supports.

    The early intervention program includes funding for:

    • therapeutic support
    • adjustments to encourage healthy development and engagement
    • practical support to help the child optimise learning opportunities, and
    • development of skills they need to take part in daily activities and achieve their best outcomes.

    Access to the NDIS under the early intervention criteria is open to children under seven years with a developmental delay. Developmental delay is when a child's development is not at the level expected for their age and where the delay has a significant effect on their ability to meet the usual daily functional capacity for a child their age, such as; feeding and dressing themselves, talking and communicating; and understanding and being able to follow basic instructions. The specific delay causing these issues may be in relation to physical or mental capacity or a combination of both.

    To access early intervention support, the child must meet the following criteria:

    • Be under 6 years.
    • Have or be waiting for a diagnostic assessment with health services.
    • Show early signs of a disability.
    • Be at significant risk of developmental delay, such as babies born prematurely. This may also include young children who have been exposed to chronic significant abuse, including neglect.

    Children over seven years

    If a child over seven years has not been receiving state-funded disability services and has not previously been eligible, they will be required to demonstrate that they meet the full disability requirements for NDIS participation. The child must have evidence:

    • of a diagnosis that is on the NDIA list of conditions considered to result in permanent impairment and substantially reduced functional capacity
    • that the impairment or condition is likely to be permanent and reduces their ability to take part in activities, perform tasks and learn
    • they live in Australia, and
    • they are an Australian citizen or hold a permanent visa or a protected Special Category Visa.  

    The current NDIS Eligibility Checklist can assist you to determine if a child is likely to meet the eligibility criteria. 

    Refer to Chapter 3.4 Supporting children with disability for further information. 

    Some funding may also be available for home modification, transportation, mobility devices, therapeutic and communication supports.

    Therapeutic and support services may include:

    • Speech therapy.
    • Occupational therapy.
    • Referral to other support services.
    • Support to engage in social and/or civic activities.
    • Life skills and capacity building support.
    • Behaviour management.
    • Support specific to life stages and transitions.

    An older child who meets the above eligibility criteria and registers with the NDIS is referred to as an NDIS 'participant'. Once a participant, the child will gain access to the support and funding provided by the NDIS.

    The process for initiating NDIS support for a child will differ depending on the age and circumstances of the child:

    If…

    Then…

    The child is 15 years or younger and in CEO's care

    Ensure the child has a referral to the NDIS via a General Practitioner (GP) or paediatrician. If a child is under 7 years this referral is to the ECEI partner is in an area covered by Wanslea.

    Call the NDIS to discuss the child's referral, their eligibility criteria and how to prepare for the initial NDIS meeting.

    Provide the NDIS with evidence the child is in the CEO's Care and the Department is their legal guardian.

    Meet with the care team where appropriate to discuss and plan for the NDIS meeting. You may be required to present goals for/with the child.

    ​The child is not in the CEO's care, but you are working with the family because there are child protection concerns

    ​Discuss what barriers have been in place for the family linking-in with the NDIS in the past. Work with them to overcome these barriers.

    Provide practical information and support to help the family seek out a referral and/or call the NDIS where they have shown limited capacity to do so without support.

    Discuss expectations in relation to disability support for the child in Signs of Safety meetings.

    ​If the child is in the CEO's care and over 15 years

    Ask the young person how you can support them to get a referral. Ask the young if they have a GP or Paediatrician, they feel most comfortable with.

    Ask the young person who they feel most comfortable attending an NDIS meeting with. Help them identify someone in their care network if they are struggling to identify someone

    Consult with the NDIS about how to proceed if the young person refuses to engage in the meeting but still requires support.

     

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    Child representative

    ​The NDIS Act assumes that a child or young person under the age of 18 years is unable to make decisions for themselves and requires representation by their parent or an agency that holds parental responsibility. This person is referred to as the 'Child Representative' and is responsible for making decisions in accordance with the child or young person's best interests.

    All children who are NDIS participants must be represented by a parent or guardian.  

    Where a child is in the CEO's care, the Department is the child's guardian and must delegate a Child Representative.


    Complete the NDIS form 'Consent for a third party to act on behalf of a participant', particularly Part C: Third paty details.

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    The NDIS planning meeting

    ​The most important part of developing a child's NDIS Plan is the NDIS planning meeting. This meeting involves the child (where age-appropriate), the family, appropriate support people and the child representative advising the NDIA of the participant's statement of goals and aspirations. That is, if the child had extra help and support, what would they hope to achieve that they are not currently able to.

    The NDIS meeting formalises the NDIS Plan, including the goals in place for the child and what funding and services are required to help the child meet these goals.

    Prior to the NDIS planning meeting, and in collaboration with the child and their care team:

    • At the initial stages advise that the child will require specialist coordination services to help support the child's plan as the child is in the CEO's care.

    • Discuss who will attend i.e. you, the child, family and/or carer.

    • Discuss the child's likes, dislikes, and interests. 

    • Consider the child's disability/developmental delay and what accommodations the child needs to participate in everyday life.

    • Identify supports the child already has in place and determine if they are enough to help them meet their goals. Identify if additional supports outside of family, friends, carers or GP's are required.  Consider bringing a genogram to the meeting.

    • Identify social and/or cultural activities that are important for the child and how their engagement and enjoyment in these activities can be enhanced e.g. a new wheelchair may help the child participate in playing sport, or obtaining access to audio books to help them with opportunities to enjoy stories.

    • Think about what aids a parent or carer might need to support the child. If they have been carrying the child but they have grown and are now too heavy, identify options to assist the child to become more independent and mobile.

    • Discuss with the parents/carers about how they are coping and if they require short break care. Determine if short break carer assessments been completed and if not, identify if the NDIS can support this or if there are any family or other significant people who could be considered and assessed as a short break carer to assist them.

    • Consider what is working well for the child and how this can be sustained.

    Wherever possible, discussions and decisions should be made at care planning meetings and reported back to NDIS planning meetings.

    The NDIS Planner will submit the NDIS Plan to the NDIA for approval. Once the plan is approved, the child will begin to receive NDIS funding.  Ask the NDIS if you have access to the child's NDIS portal. If not, request the final plan be sent as a hard copy and save on the child's file.

    You will act as the Child Representative if the child is in the CEO's care unless the Department has delegated another individual.

    The delegate must be present at all NDIS and care planning meetings to represent the child.

     

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    The NDIS Plan

    ​The NDIS Plan includes:

    • what the child wants to achieve
    • current living arrangements and who plays an important role in the child's life
    • what is working well and how to maintain positive experiences, and
    • what therapeutic, technological and informal support is required.

    The NDIS will fund reasonable and necessary supports that help a child reach their goals, as articulated in their NDIS Plan. These supports are funded by the NDIS in a range of areas, including:

    • education
    • employment
    • social participation e.g. daily personal activities
    • independent living skills e.g. transport
    • living arrangements e.g. home modification and mobility equipment, and
    • health and wellbeing e.g. speech therapy, occupational therapy and physiotherapy.

    The budget for each NDIS Plan is broken into three support categories: Core, Capital and Capacity building.

    1. Core support enables a participant to complete activities of daily living and enables them to work towards their goals and meet their objectives. The core budget is flexible across the four subcategories: assistance with daily living, except where a budget is allocated to Supported Independent Living (which is always agency-managed); transport; consumables; and assistance with social and community participation. Examples include support with personal care needs, assistance to carry out household tasks, assistance to access the community and continence aids.

    2. Capital is an investment, such as for assistive technologies (equipment, home or vehicle modifications) or for Specialist Disability Accommodation. Participant budgets are restricted to specific items identified in the NDIS Plan. Examples include mobility equipment, home modification vehicle modifications and assistive technology.

    3. Capacity building supports enable a participant to build their independence and skills. Participant budgets must be used to achieve the goals set out in the NDIS Plan. These supports include funding for Support Coordination, improved living arrangements, increased social and community participation, finding and keeping a job, improved health and wellbeing and improved daily living skills. Examples include therapist assessments, learning daily tasks and new skills that relate to their goals.

    The NDIS Plan management

    During the planning meeting, the Child Representative will need to indicate how they intend to manage their NDIS funding package. There are several management options available.

    These are:

    Self-management

    The NDIA provides funding directly to the family and the family carry all responsibilities associated with seeking out appropriate supports, negotiating and making payment to relevant services and practitioners. This method of management includes a heavy burden on the family to manage book-keeping and reporting back to the NDIA. This management plan is not appropriate for families who may have multiple difficulties, including financial difficulties, in addition to child protection issues.

    Plan-managed funding

    The NDIA will provide funding in the plan to pay for a professional Plan Manager. The Plan Manager helps you, the family and/or carer keep track of funding, will pay the providers for you and will complete all financial reporting responsibilities. This option may be appropriate for children in the CEO's care where they are settled in a long-term care arrangement.

    NDIA-managed funding

    The NDIA manages the plan directly and the service providers claim payment electronically from the funding. This funding model allows you to only work with registered providers. You can keep track of funding levels and service provider claims via the myplace portal. This should be the method for managing funds for all children in the CEO's care, except where a decision has been taken, in consultation with a district director to accept an alternative plan management option.

    A different funding management option may be more appropriate in regional and remote areas where there are fewer service providers available.  

    NDIA management only allows you to engage with NDIA approved service providers and there may be no or few available in some locations. Another option may allow for greater flexibility with service providers but will need to be considered carefully.   

    Where you are working with a family in the context of a Child Safety Investigation, Intensive Family Support or there are plans for imminent reunification, work with the family to make a funding management choice that is in the best interests of the child. Provide the family with information about the management options, ensuring they fully understand the implications and difficulties associated with each option. See Ways to Manage Your Funding for more information.

    The NDIS will usually recommend NDIA-managed plans for vulnerable families and you should encourage this option when working with families who have difficulties managing their finances or struggle with complicating factors in their lives, such as alcohol and other drug  use and transience. This can spare the family the tasks of processing claims and invoices and tracking plan budgets and ensure all providers have met quality and safety standards.

    See Find a Registered Provider or the List of Registered Providers by Name in WA for information on service providers. 

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    Implementing the NDIS Plan

    Once a child has been approved for NDIS participation and a meeting has occurred with the NDIA to develop their NDIS Plan, the next step is implementation.

    Support coordination

    Support coordination is a funded support to help children and their families implement the NDIS Plan.

    Support coordination can include:

    • initial assistance to link the child to the right providers to meet their needs
    • assistance to source providers
    • coordination where there are a range of supports, both funded and mainstream
    • to help build on informal supports
    • negotiate services and prices, develop service agreements and create service bookings, and
    • support the child and their parent/carer to use the myplace portal.

     

    Support coordination should be requested for vulnerable children and families with complex needs associated with their disability, including children in the CEO's care where this is considered appropriate.

    Prior to attending an NDIS planning meeting with a parent where the child is not in the CEO's care, encourage them to request funding for support coordination be included in the NDIS Plan.

    Where support coordination is not funded, local area coordinator (LACs) will assist with implementation but will not be able to provide the same level of support.

    Local area coordinators

    Local area coordinators (LACs) support all people with disability, regardless of NDIS eligibility, to explore and build an ordinary life within their communities.

    LACs are available to:

    • assist NDIS participants to connect to and build informal and natural supports
    • assist NDIS participants with the planning process and effective implementation
    • work with non-NDIS participants, and
    • work with community, providers and mainstream services to build inclusion and awareness of the needs of people with disability.

    See The Role of Local Area Coordinators for more information.

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    Reviewing the NDIS Plan

    ​Six weeks prior to the end, the NDIS will make contact to discuss and review the NDIS Plan. This can be done face to face, online or via telephone. The review is an opportunity to reflect upon the last 12 months and what has been achieved. If the current plan reaches its end date before the review, the NDIS Plan will automatically be extended for up to a further 12 months.

    If there is a change in a disability-related support needs or circumstances before this date, an unscheduled plan review can be requested. Examples of circumstances accepted as a trigger for a review include a:

    • significant progression or deterioration of a condition
    • change in living arrangements
    • new injury, resulting in a permanent increase in support needs, or
    • permanent decrease in the amount of informal support available.
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    Appeal process

    ​If you are responsible for engaging with the NDIS on behalf of a child in the CEO's care and need to explain the above processes to the family and care team, you may require further information or assistance to request a review or lodge a complaint . See How to Review a Planning Decision and Feedback and Complaints for further information. 

    An NDIA assessor will make decisions related to the NDIS Plan proposals and maintain or overturn initial decisions. The reviewer is always different from the initial assessor to ensure independence in decision-making. Once a decision has been made, the NDIA will contact the child's parent or guardian or the Child Representative.

    If you, the child's carer, or the family are not happy with the NDIS Plan and funding package, review requests should be encouraged.

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