What is reasonable and necessary support?
A participant’s reasonable and necessary supports consider any informal supports already available to the individual (informal arrangements that are part of family life or natural connections with friends and community services) as well as other formal supports, such as health and education.
The NDIA will fund reasonable and necessary supports in a range of areas including education, employment, social participation, independence, living arrangements and health and wellbeing. These supports will help participants to:
• pursue their goals, objectives and aspirations
• increase their independence
• increase social and economic participation, and
• develop their capacity to actively take part in the community.
How does the NDIA know what is reasonable and necessary?
The NDIA makes decisions based on the National Disability Insurance Scheme Act 2013 (NDIS Act) and the rules made under the NDIS Act. The operational guidelines also provide practical guidance for decision makers.
When the NDIA makes decisions about which supports would be reasonable and necessary for a particular participant, we refer to the particular operational guideline that relates to each specific support. In order to be considered reasonable and necessary, a support must:
• be related to the participant’s disability
• not include day-to-day living costs that are not related to a participant’s disability support needs
• represent value for money
• be likely to be effective and beneficial to the participant, and
• take into account informal supports given to participants by families, carers, networks, and the community.
What types of supports are funded?
The types of supports that the NDIS may fund for participants include:
• daily personal activities
• transport to enable participation in community, social, economic and daily life activities
• workplace help to allow a participant to successfully get or keep employment in the open or supported labour market
• therapeutic supports including behaviour support
• help with household tasks to allow the participant to maintain their home environment
• help to a participant by skilled personnel in aids or equipment assessment, set up and training
• home modification design and construction
• mobility equipment, and
• vehicle modifications.
There are some kinds of supports that will not be funded or provided by the NDIS
The NDIS Act and the rules made under the NDIS Act also tell us which supports will not be funded by the NDIS. A support will not be funded if it:
• is not related to the participant’s disability
• duplicates other supports already funded by a different mechanism through the NDIS
• relates to day-to-day living costs that are not related to a participant’s support needs, or
• is likely to cause harm to the participant or pose a risk to others.
What choice and control do I have over my funded supports?
You have choice and the control over how you use funded supports in your plan. That includes choosing how the supports are given and which service providers you use.
In some cases, the NDIA or others will manage the funding for supports. For example, where there is an unreasonable risk to a participant.