Reasonable and necessary supports’: what this means for your NDIS Plan review or new NDIS plan.
As you get ready for your NDIS plan assessment or seek a new plan, you will likely encounter the phrase “reasonable and necessary supports.”
This concept serves as a crucial criterion for the NDIS in determining which supports are eligible for funding. However, it is often not well understood. Familiarising yourself with this term will help you effectively advocate for the supports included in your NDIS plan!
The legal definition of “reasonable and necessary supports” is outlined in the National Disability Insurance Scheme Act 2013. If you’re willing to navigate the complex legal language, you can find the Act on the Federal Register of Legislation. Look for “Chapter 3 – Participants and their Plans,” and then scroll to section 34. In practical terms, this can be summarized simply as follows:
- To receive funding for supports through an NDIS plan, the NDIA needs to ensure that the support is closely linked to an individual’s disability or early intervention requirements.
- Setting clear objectives is essential for the success of your plan. Dedicate time to define these aims. The NDIA wants to ensure that the funding is closely connected to the goals specified in your plan, enabling you to participate more effectively in daily life, community activities, and educational or job environments.
- The NDIA wants to be sure that funded supports provide good value for money. They need to know that the costs are reasonable compared to the benefits and the costs of other support options. This is a tricky issue when we consider real people with different support needs!
- Attention will also be paid to what can be reasonably anticipated from family, caregivers, informal support systems, and the community. It’s important to advocate not just for direct funding but also to recognise caregiver exhaustion and the effects on this essential support network.
In summary, the NDIA will be working on funded supports being clearly linked to a functional need, support individual goals, are evidence based and cost effective.
Typical obstacles to obtaining reasonable and necessary supports
There are several common blockers where meeting the standard of ‘reasonable and necessary supports’ may be challenging. This includes (but is unfortunately not limited to);
- Evidence which limits the focus on the diagnosis rather than the person and their functional ability. Go beyond the diagnosis so that any evidence is person-centred and relates to how you manage the day-to-day, what are the risks and what supports are needed for you.
- Again, I can’t stress enough the importance of championing your goals as a part of your NDIS planning. Where goals are not clear or not connected to the supports requested, this can result in supports being reduced or not funded.
- Be prepared to provide evidence which is current, specific, person-centred and clearly articulates your support needs.
- It is also important to remember that NDIS funding decisions are made by people who are not clinicians. Clinical evidence needs to clearly link assessment findings to the supports being requested so that these connections are easy to understand.
Getting ready to secure reasonable and necessary funding in your NDIS plan review or new plan
- Allied health professionals are vital in assisting you with preparing for a review of your NDIS plan or creating a new one.
- Their purpose is not to dispute with the NDIA, but to facilitate well-informed and significant funding choices by providing clear, evidence-based information tailored to your specific support requirements.
- Effective goal setting is integral to your plan review or new NDIS plan, as your objectives should guide the decisions regarding the supports included in your plan.
- It is essential to seek advocacy and support if you require assistance in navigating the process, preparing for a review, or addressing plan outcomes.
Navigating the NDIS planning process can be challenging, especially when outcomes seem detached from everyday experiences. Gaining clarity on how ‘reasonable and necessary supports’ are evaluated, gathering appropriate evidence, and articulating your objectives can ensure that the planning process remains focused on your priorities.
As you prepare for your NDIS plan review or pursue a new plan, you will likely come across the term “reasonable and necessary supports.” This concept is crucial for the NDIS in determining which types of assistance qualify for funding.
Unfortunately, it is often misunderstood. By becoming acquainted with this term, you will be better equipped to advocate effectively for the support you require under your NDIS plan!