Aged Care and the NDIS

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• Co-design and Engagement Branch to update post approvals | | Restrictions: | NIL | | Date released: | 12/8/2019 | | Date updated: | 09/01/2023 |

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Aged Care and the NDIS

ndis.gov.au | November 2023

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Acknowledgement of Country

Before we begin, I 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. I pay my respects to their Elders, past present and emerging.

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

Accessibility

Auslan interpreters will be spotlighted. Live Captions are available. There will be questions and answers at the end. Raise your hand if you have any questions. Easy Read resources will be linked. An accessible recording will be made available.

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Privacy statement

The NDIS Act governs the collection, recording, disclosure and use of protected Agency information by all people, including contractors, partners and others who deal with protected Agency information. The unauthorised collection, use, accessing or recording of protected Agency information is a criminal offence.

The Privacy Act also contains penalties for the misuse of personal information.

During this session, please do not:

• share any personal information or protected Agency information; or
• record or share the session without the consent of all attendees.

During this session, only UNCLASSIFIED information (such as details published on the NDIA website, or general matters not containing personal information or protected Agency information) may be discussed.

If you wish to discuss a scenario involving a particular person, please contact the NDIA on: ndis 1800 800 110 or email enquiries@ndis.gov.au for assistance.

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Contents

• Aged care and the NDIS
• Applied Principles and Tables of Support (APTOS)
• Further information

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Aged care and the NDIS

NDIS and Aged Care

The NDIS funds:

• supports assessed as reasonable and necessary but are not funded under the Aged Care system.

What the Aged Care system funds/provides:

• Quality and affordable aged care and carer support services, including subsidies and grants, industry assistance, training and regulation of the aged care sector.

NDIS access is designed for people under the age of 65, as the Aged Care System caters for those 65 and over.

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Aged care services

Aged care services are funded by the Department of Health Aged Care system and include residential aged care and home care services.

Home care services are supports that assist with daily life. They include supports like in home personal care.

Home care services, are funded by the Department of Health Aged Care system.

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Residential age care

Residential aged care services are funded by the Department of Health Aged Care system.

If a participant moves into a residential aged care service permanently for the first time after they turn 65 years of age, they will leave the NDIS.

Supports provided in residential aged care can be different from NDIS supports outside aged care facilities.

Find out more on the Department of Health website.

If a participant leaves the NDIS and moves into residential aged care permanently, they are unable to ask for an internal review.

This is because the law says we must remove you from the NDIS, without us needing to make a reviewable decision.

Learn more about what decisions can be reviewed.

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Case study: Vish

• Vish is 66 and is an NDIS participant. Vish was living by himself but decides to permanently move into residential aged care for the first time.

• The law says Vish then ceases to be a participant and he leaves the NDIS. The aged care system is now responsible for all Vish’s support needs.

• Vish can’t ask for an internal review of this decision.

• Vish also can’t become a participant again, as he is older than 65.

Applied Principles and Tables of Support (APTOS)

Applied Principles and Tables of Support (APTOS)

• Access to mainstream services, community-based activities and other government programs is a shared responsibility across many services.

• All areas work together so people with disability receive support to meet their individual needs.

• A key tool is the Applied Principles and Tables of Support (APTOS).

• APTOS outlines the roles and responsibilities of different sectors that deliver supports to people with disability.

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Responsibility areas — Aged care (APTOS)

Applied Principles — Aged Care

The aged care system will continue to be responsible for access to quality and affordable aged care and carer support services, including:

• through subsidies and grants
• industry assistance
• training and regulation of the aged care sector
• information assessment and referral mechanisms
• needs-based planning arrangements
• support for specific needs groups and carers

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Responsibility areas — Aged care (APTOS)

Applied Principles — Aged Care

Consistent with Principle 6 of the Principles to Determine Responsibilities of the NDIS and Other Service Systems:

a. where a participant chooses to move from the NDIS to the aged care system there will be a seamless approach to the person’s transition between these systems, with the person supported at all points during the transition to ensure people receive appropriate supports as they age

b. the NDIS and the aged care system will recognise their relative areas of expertise and seek to leverage this expertise as appropriate.

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Responsibility areas — Aged care (APTOS)

Applied Principles — Aged Care

A participant can choose to continue to receive supports from the NDIS after age 65 or can choose to take up an aged care place.

a. A person ceases to be a participant in the NDIS when the person enters a residential care service on a permanent basis or starts being provided with community care on a permanent basis, and this first occurs only after the person turns 65 years of age.

b. All parties will fulfill the responsibilities set out under Schedule F of the National Health Reform Agreement in relation to aged care and disability services, to the extent relevant to Parties of the Agreement.

Responsibility areas — Aged care (APTOS)

Applied Principles — Aged Care

An NDIS participant under the age of 65 can choose to purchase support from an aged care provider.

The NDIS will fully meet these ‘reasonable and necessary’ support costs.

Further information

The participant journey

How the NDIS will work with the introduction of a new computer system and improved ways of working.

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Home > About us > Publications

Booklets and factsheets

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On this page:

• Factsheets
• Making connections
• Applying to the NDIS
• Creating your NDIS plan
• Using your NDIS plan
• Changing your plan
• Check-ins
• Children younger than 9
• Information for Aboriginal and Torres Strait Islander participants
• More NDIS information

Resources

What if I start getting supports from aged care services NDIS?

What aged care fees and charges can we fund?

My Aged Care

Department of Health and Aged Care

The Applied Principles and Tables of Support to Determine Responsibilities NDIS and other service

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Questions

National Disability Insurance Agency

1800 800 110 dis.gov.au enquiries@ndis.gov.au (change to specific NDIS email if required)

Find us on Facebook/NDISAus

Follow us on Twitter @NDIS

For people with hearing or speech loss

TTY: 1800 555 677 Voice Relay: 1800 555 727

For people who need help with English

TIS: 131 450

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Frontline Essentials - Creating Your Plan Program Guide

Transition Program V2.0

The contents of this document are OFFICIAL.

Program guide to support the training for the Frontline Essentials Creating Your Plan facilitated modules. This program guide provides additional information to the PowerPoint for facilitators.

OFFICIAL

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The NDIS and Other Government Service Systems

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Other Government Services

State: Here is the list of other Government services which are available to all members of the Australian community, regardless of whether they have a disability or not.

We have aged care listed here, however Aged Care isn’t really considered a ‘mainstream or other Government service system’ for NDIS participants.

Ask: Why not?

Debrief: NDIS continues to fund disability related supports for participants who are aged over 65.

Ask: When might this change?

Answer: If the participant permanently commences accessing Aged Care services after they turn 65.

State: We always need to be aware that the Scheme is intended to build a more inclusive society, where the participation of people with a disability is maximised in the whole community.

The Scheme isn’t intended to replace the supports or services provided by these systems, because those risks isolating participants away from their communities.

Now, we all know that sometimes there are gaps or wait times with other Government services. But whether or not the funding or service is fulfilling its responsibility, remember; that’s not the legal test!

Prior to the launch of the NDIS, the Council of Australian Governments, made up of representatives from each state and territory government and the federal government, put together a table of the supports and the underpinning applied principles to determine which government would be responsible for a variety of supports. This interface, also called the other Government or mainstream interface, covered 11 types of services, from justice and employment to early education. The applied principles and the table of supports outlined when supports are likely to be the responsibility of (and therefore most likely funded by) the NDIS, when they are likely to be the responsibility of another service system.

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Applied Principles and Tables of Support (APTOS)

Not long after the launch of NDIS, these applied principles and the table of supports, called Applied Principles and Tables of Support (APTOS), were entered in the Supports for Participants Rules 2013 as Schedule 1, which means that NDIS decisions makers must take these applied principles and tables of support into account when making reasonable and necessary decisions.

In 2019 the COAG was disbanded and reformed under the National Foundation Reform Council, however the APTOS remains enshrined in our Supports for Participants Rules 2013 under Schedule 1: Considerations relating to whether supports are most appropriately funded through the NDIS.

Delegate decision makers have used and explored the applied principles and table of supports since the Scheme was launched in 2013. To help make decision making clearer, the Agency provided even more guidance through the Operational Guidelines, including putting these principles into a table format in the Planning Operational Guideline (appendix 1), which is informed by the legislation and rules, as well as these principles and Disability Reform Council reforms.

However, there’s some important points we should all remember about the APTOS:

• The COAG Principles were agreed upon before the NDIS was launched in 2013 and these principles were reviewed in 2015
• The Agency was not involved with the development or agreement of the principles
• These were agreed to by the Commonwealth, State and Territory governments;

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Table 2 — Version Control

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