The NDIS have made another major change to its Pricing Guide, this time expanding the scope of what can be funded under the NDIS.

 

From the 1st of October, you’ll be able to use your NDIS funds to cover disability-related health supports.

 

This change is a big step in the right direction, putting an end to lots of uncertainty amongst NDIS participants about where funding for these supports is coming from.

 

WHICH HEALTH SUPPORTS ARE COVERED?

The first thing to make clear is that the NDIS will only fund health supports that are directly related to your disability and are considered ‘reasonable and necessary’, just like all other NDIS funded supports.

 

In addition, the health supports have to be related to ongoing conditions. In other words, if you slip in the shower and hurt yourself, you won’t be able to use your NDIS funds to pay for the doctor’s visit; but if you have diabetes, you can fund the implementation of a diabetic management plan.

 

Covered by the NDIS	Covered by the health system
Health supports that are… Required on a regular basis, and  Related to a person’s disability and considered ‘reasonable and necessary’   For example: Swallowing therapy associated with dysphagia Nutritional meal plan PEG feeding Wound and pressure care Catheter maintenance and care Epilepsy seizure monitoring Diabetic management support	Health supports that are… Not required on a regular basis Not related to a person’s disability Acute and provided in a hospital or other health setting   For example: Emergency services Outpatient care Preventative health care Dental care and other clinical treatments

 

For a full overview of the types of health supports covered, visit the NDIS website: https://www.ndis.gov.au/understanding/supports-funded-ndis/disability-related-health-supports

 

WHO CAN PROVIDE THESE HEALTH SUPPORTS?

The disability-related health supports can be delivered by the same providers that have been delivering these services to you before. The only difference is, the NDIS requires support workers and nurses to be appropriately trained to support people with a disability.

 

In the new Price Guide, the NDIS have now also introduced 5 categories of nurses.

 

HOW ARE THESE SUPPORTS FUNDED?

The updated price guide includes over 90 disability-related health supports. These supports will not receive a new support category of their own, but will rather fit into the existing categories.

 

The table below shows which health support is funded by which category. For a full breakdown of what’s now covered under the NDIS, see the updated NDIS Price Guide.

 

Health Support Type	Funded by support category
Disability-related health support that’s provided by a disability support worker	CORE funding category 1 – Assistance with Daily Living
Health related Assistive Technology (under $1,500)	CORE funding category 3 – Consumables
Health related Assistive Technology (over $1,500)	Category 5 – Assistive Technology. (The NDIA will likely need to approve a quote before providing funding)
Disability-related health support that’s provided by a nurse or therapist	Category 15 – Improve Daily Living. NOTE: If you don’t have funding for Category 15 you are able to use CORE funding category 1 – Assistance with Daily Living (this is a temporary measure and will be removed once the NDIA has reviewed all plans).

 

It’s important to note that you won’t immediately receive any additional funding to cover these disability-related health supports, so you’ll need to keep an extra close eye on your NDIS budgets to ensure you don’t run out early. If you’re a Plan Partners customer, our online Dashboard is a powerful tool for helping you track your budgets.

 

WILL THIS CHANGE AFFECT NDIS PLANS?

The NDIS won’t be updating existing plans in light of these changes, so if you’d like to use your funding for disability-related health supports, you will need to carefully consider how it aligns with your overall support and budgets.

 

If you feel you need additional funding in your NDIS plan for disability-related health supports, you can request a review of your plan. Read more about requesting a plan review here.

 

All plans issued post-October 1 will take into account the inclusion of disability-related health supports and provide funding accordingly.

 

HAS PLAN PARTNERS INCORPORATED THE CHANGES?

Yes, our teams have incorporated the changes. If you receive Plan Management, we will continue processing your invoices as normal. If you receive Support Coordination, your Support Coordinator can help you understand how health supports can be funded in your NDIS plan. 

 

WOULD YOU LIKE MORE INFORMATION?

Contact your Local Area Coordinator or the NDIS on 1800 800 110 if you would like to know what impact the new prices can have on your plan.

 

If you’d like to know more about how the price increases impact our services, or would like some independent advice, call our friendly team on 1300 333 700 or leave your details here. At Plan Partners, Australia’s leading expert in NDIS Plan Management and Support Coordination, we have supported thousands of NDIS participants and their service providers navigating the NDIS.

 

For service providers

Click here to read our article for service providers about the new Price Guide changes.

 

TOP TIPS

• You can start purchase disability-related health items and services under the NDIS immediately from 1st October 2019 (note that the NDIS won’t cover any health items or services purchased before 1st October)
• Only health supports that are ongoing and related to your disability can be covered by the NDIS, so make sure you can always justify why you purchased these supports.
• The NDIS has not increased funding in your plan to accommodation this change, so you will need to consider how it aligns with your overall support and budgets.
• Plan Partners’ online dashboard can help by allowing you to monitor your spending and stay on top of your budgets
• Just like any other support, make sure to have a service agreement with your provider to ensure you know exactly what support you’ll get for which budget, and avoid any misunderstandings along the way.
• If you don’t have sufficient funds in your plan to purchase these disability-related health supports, consider requesting a plan review.