The Participant Journey and Eligibility Reassessment

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DISCLOSURE LOG - FOI 24/25-0764 DOCUMENT 3

The Participant Journey and Eligibility Reassessment

Scheme Eligibility Branch

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Acknowledgement of Country

Before we begin, | would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea, and community. | pay my respects to their Elders, past and present.

| would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples here today.

OFFICIAL

Facilitator notes:

*Say*

Before we begin, | would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea, and community. | pay my respects to their Elders, past and present.

| acknowledge that | am facilitating this training from the lands of the [insert name] people.

| would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples here today.

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Learning outcomes

This session has been designed to help you:

  • understand the participant journey, including leaving the NDIS
  • gain insight into what Eligibility Reassessment (ER) is, why it’s important, and how it relates to the participant journey
  • recognise the stages of the ER process
  • develop a broad understanding of the NDIS eligibility criteria

OFFICIAL

Facilitator notes:

*Say*

In this session, we will be learning more about the ‘participant journey’ with the NDIS, and where your role in the Scheme Eligibility Branch (SEB) fits within this.

This session has been designed to help you:

  • understand the participant journey, including leaving the NDIS

  • gain insight into what Eligibility Reassessment (ER) is, why it’s important, and how it relates to the participant journey

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  • recognise the stages of the ER process

  • develop a broad understanding of the NDIS eligibility criteria

Please feel free to ask questions throughout the session by raising your hand. Let’s get started.

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OFFICIAL

Introduction to Eligibility Requirements

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Facilitator Notes

*Say*

Now that we understand a little more about what an Eligibility Reassessment is and why it is important, let’s explore the NDIS eligibility requirements.

Remember, this is a broad introduction to the main concepts and eligibility requirements we look at in ER. We will continue to explore these further as we progress through training.

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Exploration activity

NDIS website (external)

Leaving the Scheme (external)

Our Guidelines: Leaving the NDIS (external)

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Facilitator notes:

*Say*

Before we go any further, let’s do a quick exploration activity into our eligibility requirements, and why a person may leave the scheme.

[Remind learners that this is just an exploration activity to get them looking at our external website and start thinking about our eligibility requirements. They are not expected to understand all of the NDIS Act and Rules or OGs.]

[Direct learners to go to: www.ndis.gov.au for this activity. Paste the first two questions in the chat and give learners a few minutes to answer.]

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Questions:

  1. If you were a participant wanting to find out more about our eligibility requirements, where would you look?
  2. How many requirement categories are there, and what are they?

*Say*

  1. A: Go to: www.ndis.gov.au, go to Am I Eligible.
  2. A: Four. Age, residency, disability and early intervention.

This page provides information on gaining access to the scheme but is also useful for understanding each criteria more broadly.

However, some eligibility requirements in ER are a little different. For example, there are no age requirements in ER.

For more specific information on Eligibility Reassessments and Leaving the NDIS, does anyone know where a participant might find this?

*Click*

They could access the ‘Leaving the Scheme’ page on the NDIS website, or the ‘Leaving the NDIS’ section of Our Guidelines. Using the links to these pages on the slide, answer the following questions.

[Facilitators may direct learners to find page pathways: www.ndis.gov.au > For participants > Changing your plan > Leaving the Scheme; or Understanding the NDIS > Our guidelines > Leaving the NDIS]

[Paste the remaining questions in the chat and give learners 15 mins to answer questions. Let learners know they can ask questions or for assistance by raising their hand or via the chat.]

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Questions:

  1. What are some reasons why a participant might leave the NDIS?

  2. Paul just turned 65 years old and has recently moved permanently into a residential aged care facility. Is he still eligible for NDIS support? What if he moved into aged care before turning 65?

  3. Malik is an Australian citizen but spends most of his time in Thailand where his parents work. Does he still meet the residency requirements?

  4. Sienna originally came onto the scheme under early intervention for a developmental delay. She just turned 5 years old. Does she still meet the eligibility requirements?

[Bring the group back to share answers and discuss (answers located below).]

*Click* [to go to next slide]


Answers:

  1. Participants may leave the NDIS if they no longer meet the eligibility criteria or can choose to leave voluntarily.

  2. You’ll leave the NDIS if you move into a residential aged care service permanently for the first time after you turn 65. If you were already living in residential aged care before you turn 65, you can still be an NDIS participant after you turn 65.

  3. Participants need to live in Australia to stay on the NDIS. If they leave Australia permanently, or live overseas

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the majority of the time, they won’t be eligible anymore, and we may decide to revoke their participant status.

  1. Sienna is still eligible for the scheme as she is under 6 years old. If a child met the early intervention requirements for developmental delay, they’re usually no longer eligible after they turn 6.

This is because they will no longer meet the eligibility criteria under developmental delay. To remain a NDIS participant after they turn 6, the child will need to have an impairment that’s likely to be permanent. They will also need to meet either the disability requirements or the early intervention requirements.

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Residence requirements

Australian citizen or permanent resident.

Lives in Australia.

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Facilitator notes:

*Say*

A participant must meet the residence requirements to remain eligible for the NDIS.

This means the participant:

  • is an Australian citizen or permanent resident, and
  • lives in Australia.

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Disability requirements

  • The NDIS supports people who have a disability caused by a permanent impairment.

  • The impairment may be intellectual, cognitive, neurological, sensory, physical, or psychosocial.

  • The impairment results in a substantially reduced functional capacity.

  • The person is likely to require NDIS supports for their lifetime.

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Facilitator notes: Say

To meet the disability requirements, a participant must have evidence of a permanent impairment. This impairment may be intellectual, cognitive, neurological, sensory, physical, or psychosocial.

The impairment must substantially reduce the person’s functional capacity, and the person must be likely to require NDIS supports for their lifetime.

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Early intervention requirements

Reduces future need for support

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Facilitator notes: Say

For early intervention, we must decide whether receiving early intervention supports means a participant will likely need fewer disability supports in the future.

We need to know that early intervention supports will help them with at least one of the following:

  • addressing the impact of their impairment on their ability to move around, communicate, socialise, learn, look after themself and organise their life.
  • preventing their functional capacity from getting worse.
  • improving their functional capacity.
  • strengthening their informal supports, which includes building their skills to support the participant.

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We also need to know that the early interventions supports that would be likely to benefit the person are NDIS supports.

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The eligibility requirements

  • Residence (section 23) and:

  • Disability (section 24); or

  • Early intervention (section 25)

Facilitator notes: Say

So to recap, a participant will remain eligible for NDIS support if at the time of the ER they meet the following eligibility requirements, as outlined in the NDIS Act:

  • Residence requirements (section 23) and the:
  • Disability requirements (section 24); or
  • Early intervention requirements (section 25)

In Eligibility Reassessment, a participant only needs to meet the criteria for either the disability or the early

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intervention requirements – not both.

This differs from Access, where under current legislation, an applicant can meet both disability and early intervention requirements.

Remember - we will cover the eligibility requirements for ER further as we move through training.

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Questions

Facilitator notes: Say This concludes our training on the participant journey, and our introduction to eligibility reassessment.

We’ve only just scratched the surface of our training, and will provide more support to understand your role, and our legislation and guidelines, over the course of training.

Does anyone have any questions before we move on?

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Version control

Version Approved by Brief Description of Change Status Date
V1.0 CH0026 Class 2 approval APPROVED 2024-11-04

Hidden Slide — Version Control

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