Understanding the Intention of Your NDIS Plan: Why It Matters More Than Ever

It is clear that the NDIA is tightening the way participants can spend their NDIS funding. Recent amendments to the NDIS Act have set a precedent for these changes, significantly altering how the scheme operates.

A key focus of these changes is ensuring that participants use their funding in accordance with their NDIS plan. This means that a participant can only use their funding if:

1. The support is on the "Yes" list (i.e., it qualifies as an NDIS Support).

2. The support aligns with the intended use of the participant's plan.

Understanding what the intention of your plan means is crucial. Misinterpreting it could result in the NDIA withholding or cancelling payments for supports or services, leaving you to cover the costs yourself.

To determine the intention of your plan, consider the following:

1. What was discussed in your planning meeting?

2. Your funded supports.

3. What is explicitly written in your plan?

4. How the NDIS Transitional Rules apply to your plan and its supports.

Discussions in your planning/implementation meeting.

The discussions in your planning or implementation meeting with your my NDIS Contact (Early Childhood Partner, Local Area Coordinator, or NDIS Planner) set the foundation for your plan. The supports and services you requested, along with reports from allied health or medical professionals, influence what is approved in your plan.

These discussions provide a strong indication of what your plan was intended to cover. However, not everything discussed in these meetings will necessarily be funded. Your NDIS Contact or delegate should inform you if a requested support was excluded and explain why.

Your Funded Supports

Your plan's funded supports section outlines the categories you have been allocated funding for and what each category covers. Not all participants receive funding across all categories—your plan is tailored to your individual needs.

Funding is allocated based on what is reasonable and necessary, considering the support available from family, friends, community, and other government services. You can only use your funding for supports that:

• Are NDIS Supports (i.e., on the "Yes" list).

• Are directly related to your disability.

What is explicitly written in your plan.

The wording in your plan determines how you can use your funding. Even small differences in phrasing can significantly impact flexibility.

Here are examples of how the Improved Daily Living (IDL) budget might be structured in different ways:

Example 1.

• No flexibility. The participant can only use their IDL budget for occupational therapy and psychology.

• The funding is strictly allocated: $9,311.52 for occupational therapy and $4,013.82 for psychology (including required reports).

Example 2.

• Limited flexibility. The participant can engage with an occupational therapist, physiotherapist, or speech pathologist.

• They can decide how much to allocate to each therapy but must stay within the total budget.

• Therapists must provide a progress report six weeks before the next plan reassessment.

Example 3.

• Full flexibility. The participant can choose any therapy support within the IDL category that is on the "Yes" list.

• They can distribute their $18,817.08 budget as needed across the therapists they choose.

• Therapists must still submit a progress report six weeks before the next plan reassessment.

Looking at the transitional “In” and “Out” lists and their rules.

The "In" and "Out" Lists define what is considered an NDIS Support and what is not. These lists are temporary and will remain in place until at least July 2025 while final rules are developed.

However, simply knowing what is on these lists isn't enough, you also need to understand the transitional rules that determine how the lists are applied. These rules are written in a more legalistic format than previous NDIS guidelines, making them harder to interpret.

To break them down:

1. Start with Column 1 – This lists the support category (e.g., Improved Daily Living, Core Supports). There are 37 approved categories and 15 non-approved categories.

2. Move to Column 2 – This explains the function of the support.

3. Check Column 3 – This provides details on who can access the support and any specific conditions that apply.

Reading the transitional rules alongside your NDIS plan ensures you can correctly interpret the "Yes" list and understand whether specific supports apply to you.

A Plan Managers Role

The role of a Plan Manager has never been to make decisions on whether something is reasonable and necessary and, therefore, whether it can be funded or not. At the end of last year, the NDIA released updated information about what role a Plan Manager plays for a participant. Stating:

 "A Plan Manager's role is to ensure a plan is implemented as intended, including ensuring funds are being spent in accordance with the plan."

In Summary

The NDIA is placing greater emphasis on ensuring that participants use their NDIS funding according to the intended purpose of their plan. This shift means that funding can only be spent on supports that are both approved under the NDIS ("Yes" list) and aligned with the specific way a plan was designed to be used.

With the introduction of transitional "In" and "Out" lists and more structured rules around funding, participants must carefully interpret their plan’s wording and funding allocations to avoid payment issues. Misalignment with the plan’s intention may result in the NDIA withholding or rejecting invoices, leaving participants responsible for covering costs themselves.

When in doubt reach out to your my NDIS Contact and then if further clarity is needed speak with the NDIS delegate who was responsible for approving your plan. Other people within the scheme can help guide you, for example, if you have a Support Coordinator or your Plan Manager if you were plan managed but ultimately only these roles can give you.