EC PEC – Carers – Sustaining informal supports | FOI release material

FOI 26/27-0110 DOCUMENT 1

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s47E(d) - certain operations of agencies

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s47E(d) - certain operations of agencies

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s47E(d) - certain operations of agencies

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OFFICIAL DOCUMENT 2

Knowledge Article

For Internal Use Only

The contents of this document are OFFICIAL.

Understand transport supports

Guidance in this document is not approved for use unless you view it in PACE.

This article provides guidance for a planner delegate, planner (non-partnered area) or review officer to:

decide the level of transport supports
find the right support category
understand what to consider if transport supports are part of community participation. Recent updates

16 June 2025

Guidance updated to reflect changes in mandatory Technical Advice and Practice Improvement Branch (TAPIB) advice for transport supports.

19 May 2025

Guidance updated to include:

additional PACE user roles, planner (non-partnered area) and review officer
additional participant budget update article, Action a budget update with funding periods
application of funding periods to core and recurring transport funding. Before you start

You have read and understood:

Our Guideline – Reasonable and necessary supports (external)
Operational Guideline - Including specific types of supports in plans – transport (external)
article Support Categories. Decide the level of transport supports

To help you decide how much funding to include in the participant’s plan, use the levels of transport assistance below:

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Level 1 - $1,784 per year for participants who are not working, studying or attending day programs but are seeking to enhance their community access.
Level 2 - $2,676 per year for participants who are currently working or studying part-time (up to 15 hours a week), participating in day programs and for other social, recreational

or leisure activities.

Level 3 - $3,456 per year for participants who are currently working, looking for work, or studying at least 15 hours a week, and are unable to use public transport because of

their disability.

Note: you must use the exact value for each transport funding level outlined in the Operational Guideline - Including specific types of supports in plans – transport (external).

Technical Advice and Practice Improvement Branch (TAPIB) advice is no longer mandatory for any transport level. If you receive a request for transport funding that’s significantly above Transport Assistance Level 3, or isn’t related to activity based transport, talk with your team leader or practice lead to see if they can help. You may decide a non-mandatory advice request is needed. To learn more, go to TAPIB’s Mandatory and Non-Mandatory Advice Requests page on Confluence.

Find the right support category

Transport can be funded in the Core or Recurring support budget under the Transport or Recurring Transport support categories.

When transport is funded in the core supports budget for plans approved after 9 October 2024:

funding periods will be applied at the funding component level
support categories will be grouped into funding components
core flexible support categories will be grouped into funding components based on fund management type
all core flexible support categories must have the same funding period length
the funding period length for core transport supports will default to 3 months. When transport is funded in the recurring support budget for plans approved after 9 October 2024:
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funds will be paid in regular instalments during the funding period
you aren’t required to add a funding period
you won’t be able to edit the funding period for recurring transport. Note: you must check the person account reflects the correct bank details for

recurring payments. Go to article View bank account details.

Use article Support Categories to choose the correct support category.

What to consider if transport support is part of community participation

A participant might request transport support as part of community participation. Participants can use their transport budget funding for a support worker to:

help them participate in community activities
help with transport from their home to the community. Providers claim these labour costs at the relevant community participation hourly rate. For example, at individual or group rates.

You must also consider non-labour costs when you decide how much funding to include. Providers can claim non-labour transport costs to help the participant:

access community participation supports
access or maintain employment
access or maintain higher education. Non-labour costs associated with participant transport can include:
public transport fares
road tolls
parking fees
reasonable vehicle running costs
taxi or ride-share fares. To learn more about provider travel – labour and non-labour costs, go to the NDIS Pricing Arrangement and Price Limits (external).

Next steps

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Use the plan conversation support tool (PCST) to calculate transport supports. Go to article Understand and update the plan conversation support tool. It’s optional to use the PCST when completing a budget update. However, you must use the PCST for all new

plans and plan reassessments.

To add transport supports to the participant’s plan as part of a: e Plan Approval case, go to article Change the draft budget

e Plan Change or Participant Budget Update case where the plan was approved before 9 October 2024, go to article Action a budget update

e Plan Change or Participant Budget Update case where the plan was approved on or after 9 October 2024, go to article Action a budget update with funding periods.

Article labels

PACE user role names

No change.

Topics

No change.

Case names

No change.

Ownership

No change.

Version control

Amended

Version by Brief Description of Change Status

EL2 Review

6.0 207 pn Updated user role labels to reflect | aDpROVED | 2025-05-14

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Included second Participant

Budget Update article for approving budget update with funding periods Included information about application of funding period to core and recurring transport support budgets

Class 1 Approval

Guidance updated to reflect

s47F - personal privacy     changes in mandatory Technical 7.0                                       APPROVED  2025-06-04

Advice and Practice Improvement

(TAPIB) advice for transport supports.

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OFFICIAL DOCUMENT 3

Knowledge Article

For Internal Use Only

The contents of this document are OFFICIAL.

Submit a referral to the Complex Support Needs (CSN) Branch

Guidance in this document is not approved for use unless you view it in PACE.

This article provides guidance for a local area coordinator, early childhood partner, planner delegate or complaints officer to:

understand complex support needs (CSN) and pathway factors
consider a referral to the CSN branch
complete the CSN Referral Form. Recent updates

1 July 2026

updated short term respite (STR) to short term accommodation (STA)
updated OG links with heading jump links
repaired link to article Review the escalation and prioritisation matrix
minor updated to grammar and formatting. Before you start

You have read and understood:

Our Guideline – Reasonable and necessary (external)
Our Guideline – Your plan (external)
Complex Support Needs Branch
article Identify risks and vulnerabilities
article Complete personal and environmental circumstances case
article Complete a streaming case (streaming and restreaming) You’ve identified the supports the participant may need to engage with the NDIS and other government services. For example, justice, health, correctional services or child protection.

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Understand complex support needs

We define complex support needs (CSN) as:

A situation where a participant has extraordinary support needs because of personal and situational factors.
These factors need coordinated support from multiple services. The term complex doesn’t relate to the complexity of a participant’s disability, it describes:
the interaction of the personal and situational factors in the participant’s life
the intensity of the factors
how they impact the participant’s ability to navigate the NDIS and coordinate their supports.

CSN Branch

The CSN pathway provides specialised support for participants who have personal and situational factors that are outside the scope of the usual NDIS pathway. The CSN team includes planners and staff who have experience working with specific complex support cohorts such as children, justice, psychosocial and allied health.

Consider a referral to the CSN branch

To work out if a referral to the CSN branch is needed, you must identify which personal and situational factors are impacting the participant. The factors may include:

Accommodation

homelessness, or risk of homelessness
current accommodation at risk due to loss of primary informal supports
increased use of short term accommodation (STA)
unable to identify suitable specialist disability accommodation (SDA) or supported independent living (SIL).

Behaviours of concern

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identified behaviours of concern or regulated, restrictive practice
worsening behaviour which creates a risk to self or others.

Children

children who are living out of the family home or urgently need accommodation outside their home. To learn more, go to Guide – How to support children and young people to

remain in their family home

participant not attending school full time
parent or guardian unable to sustain care, overwhelmed by caring requirements or caring for multiple children who are NDIS participants
Child Protection involvement. Engage with government
voluntary or involuntary involvement in other government service systems. In particular health, child protection, guardianship orders, mental health and justice
difficulty engaging with the NDIS.

Justice Interface

We provide support to eligible people with a disability who are involved in the justice system. Involvement in the justice system may mean the participant:

is currently incarcerated for a period of more than 12 months, either while sentenced or on remand
is currently incarcerated, or has experienced 2 or more periods in a correctional facility in the past 12 months
is considered a high-risk offender under relevant State or Territory legislation
is incarcerated and found unfit to plea, or is currently held on an indefinite order
has transitioned from a custodial setting within the last 12 months and continues to have justice involvement. The participant must have met one of the above criteria for this to

apply.

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Justice involvement refers to any formal interaction with the justice system, including but not limited to:

police engagement, for example, arrests, interviews, or charges
breaches of parole or community corrections orders
court appearances or legal proceedings
custodial remand or incarceration
active supervision by justice authorities. This includes, but is not limited to, extended supervision, justice, or parole orders.

Markets

Markets means the service delivery markets and their capacity to support people:

limited or no service delivery available in remote areas
thin or exhausted markets in regional areas
disengagement of providers. Supports and care
limited or no informal supports to help with decision making or engage in planning. For example, the participant may have limited or no advocates, guardians, nominees, family

members, carers or friends

difficulty engaging or maintaining support coordination
formal guardianship required
transitional supports for returning to the community. For example, leaving rehabilitation or hospital, incarceration
stressed care arrangements. An immediate unmet need for targeted support or a crisis because of a sudden, unexpected change in the participant’s situation
multiple family members with disability living in the one home.

Vulnerable

increased risk of significant harm from abuse or neglect
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limited or no expressive communication.

Complete the CSN Referral Form

Complete and submit the Referral to the complex support needs (CSN) branch. Make sure you complete all sections of the referral form. Provide details and supporting

evidence in the free text fields. This could be any documents and case numbers.

You’ll get an email confirming your submission. If you have any questions or issues submitting the form, please email s47E(d) - certain operations of agencies @ndis.gov.au.

Referral escalations

An escalated or urgent circumstance referral is categorised as Extreme under the Escalation Prioritisation Matrix. An escalation request can be made via email to s47E(d) - certain operations of agencies @ndis.gov.au.

Next steps

CSN Branch will review the referral to determine if it can be accepted. The outcomes of the referral are either:

Accepted – CSN will update the case and will proceed with assessment.
Not Accepted – the CSN will update the case and reassign it to you. You must close the enquiry case. You’ll also get an email advising the referral was Not

Accepted.

When the assessment is complete, you’ll get an email confirming the outcome. The suitability assessment will be uploaded to the participant record and linked to the referral

enquiry case.The suitability outcomes are:

Suitable – CSN will update the case and assign it to a holding inbox until the participant can be allocated to a CSN planner. You’ll get an email to let you know

the outcome. You should continue to support the participant.

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e Not Suitable — CSN will update the case and reassign to you. You’ll get an email

to let you know the outcome.

When the participant is allocated, and the my NDIS contact is updated to a CSN planner, you’ll get an email confirming the update and whether you need to provide a

handover.

Reviewing a Suitability Decision

If you’re not satisfied with the CSN Suitability Assessment Outcome and would like to discuss

the decision, please send an email to S7&(@)seenainoperationsor agencies Cndis gov.au. You need to

include the participant’s name and NDIS number.

A CSN Operations team leader will contact you to discuss the outcome within 2 business days.

Article labels

PACE user role names

No change.

Topics

No change.

Case names

No change.

Ownership

No change.

Version control

Amended

Version by Brief Description of Change Status

13.0 Class 2 update APPROVED | 2025-11-17

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Updated to remove content from archived article Guide – Complex support needs (CSN) pathway

Class 1 Update

13.1                s47F - personal privacy     Update Short term respite to short  DRAFT      2026-06-02

term accommodation

13.2                s47F - personal privacy     Peer review                 DRAFT      2026-06-03

13.3                s47F - personal privacy      Action peer review            DRAFT      2026-06-03

14.0                s47F - personal privacy      Class 1 approval             APPROVED  2025-06-04

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FOI 26/27-0110 DOCUMENT 4

OFFICIAL: SENSITIVE

The contents of this document are OFFICIAL: SENSITIVE.

Changing your plan

Quick summary: we may need to change your plan for many reasons. If your situation changes, your disability support needs may change. You might need more supports, fewer supports, or different supports. There are different ways we can change your plan. In certain situations, we might be able to vary your current plan. If we need to make major changes we’ll do a plan reassessment, and you’ll get a new plan.

We’ll check in with you during your plan to see if you need any changes to your plan. We’ll talk with you about your situation and look at any information you have given us to work out if we need to change your plan. If a change is needed, we’ll then decide what type of change we need to do. You can ask us for a change to your plan at any time, or we could decide to do this. If you want us to review a decision we have already made about your plan, talk to us first. A plan change isn’t used to review any of our decisions.

We’ll work with you to make any changes to your plan. We’ll talk with you about your situation to work out what we need to change. We’ll then either update your plan or create a new plan. We still need to follow the laws for the NDIS that apply when making a change to your plan. For example, any changes to the reasonable and necessary supports in your plan must meet the NDIS funding criteria.

Note:

When we say ‘your plan’ we mean your NDIS plan.
As part of the recent changes to the NDIS laws we are moving towards a new framework for planning. Rules need to be developed for this new framework. We’re working on how and when we’ll introduce these changes.

Until then, all current plans will be known as ‘old framework’ plans, and we will continue to develop these until all participants have transitioned to the new framework. The information in this Our Guideline is about our ‘old framework’ plans, which includes the recent changes to the NDIS laws.

If you’re aged between 9 and 65 years and are looking for information about community connections, go to Our Guideline – Community Connections.
If your child is younger than 9 and you’re looking for information about early connections, go to Our Guideline – Early Connections.

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What’s in this guidance?

This guidance covers:

What do we mean by changing your plan?
How can I ask for a change to my plan?
What happens after I request a change to my plan?
When do we decide to change your plan?
How do we make a change to your plan?
How can I prepare for my plan change?
When would we decide not to change your plan?
What happens after I have had a change to my plan? You may also be interested in:
Reviewing our decisions
Creating your plan
Reasonable and necessary supports
Your plan
What principles do we follow to create your plan? What do we mean by changing your plan?

Your NDIS plan has information about you and your goals and aspirations. We call this the ‘participant’s statement of goals and aspirations’.1

Your plan also has information about:

any general supports provided
your reasonable and necessary supports that meet the NDIS funding criteria
how your NDIS funds and the other parts of your plan will be managed. We call this the ‘statement of participant supports.’2 To learn more go to Our Guideline – Creating your plan.

Every plan must include a reassessment date.3 We need to look at your plan with you by this date and decide if we need to make any changes. You can ask us to change your plan at any time. We can also decide to change your plan at any time if we think we need to. You don’t have to wait until the reassessment date to ask about changing your plan. We’ll work with you to change your plan if we need to.

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In certain situations, we can change your plan by updating part of your current plan. We call this a plan variation.4 Or we can decide to approve a new plan after a plan reassessment.5 Both the decision to vary your plan and the decision to approve a new plan are reviewable decisions.6

If you’re not happy with a decision we’ve made about your plan, you can ask for an internal review of our decision.7 A plan change is not the right pathway to seek a review of a decision we have made.

Learn more about the difference between plan variations, plan reassessments and internal reviews.

What is a plan variation?

A plan variation is where we make changes to your current plan. We can make changes to your current plan without doing a plan reassessment. There are certain situations when we can do this and the laws for the NDIS tell us what these situations are.8 The NDIS rules can also say how we should vary your plan. If we decide to make changes to your plan, we’ll prepare the varied plan with you.9

We can vary your plan if you ask us to, or if we think a plan variation is required.10 When you ask for a variation, we call it a ‘participant-initiated plan variation’. When we decide to vary your plan, we call this a ‘CEO-initiated plan variation’. The varied plan we approve may be different to what you ask for.11 We’ll talk to you about this when we’re varying your plan. If the plan variation is about funding in your plan, the varied plan must still meet the NDIS funding criteria.12

We’ll vary your plan to:

fix a small or technical error13
vary your total funding amount (limitations apply)14
vary your funding component amount(s) and funding periods15
change the reassessment date of your plan16
update how the funds or other aspects of your plan are managed 17
update who must provide a support or how a support must be provided18
add crisis or emergency supports because of a significant change to your NDIS support needs.19

Fix a small or technical error

If there is a minor or technical error in your plan, we can usually update your plan to correct it.20 For example, a small mistake in your plan might be a spelling mistake we need to fix. Or we may need to add in a word that was missed.

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A technical error is where there has been a mistake in how we have processed something. For example, if we have classified or calculated a support the wrong way, we can fix it so it’s right.

We’ll fix any small or technical errors as fast as we can. We’ll let you know if we have fixed an error in your plan.

If there’s an error in your participant’s statement of goals and aspirations, we’ll contact you before we make any changes or corrections.

Vary your total funding amount

Your plan will have a total funding amount. We’ll call this a ‘total budget amount’ in your plan. We can vary the total funding amount in your plan in certain situations.21 These include:

where you need crisis or emergency funding because of a significant change to your support needs22
the CEO (delegate) receives requested information after the plan comes into effect (for example, on an item of assistive technology)23
a change to your reassessment date,24 or
a minor variation which means the total funding amount in your plan has increased.25 New and reassessed plans approved on or after 9 October 2024 will have funding component amounts and funding periods.

Vary your funding component amount(s) and funding periods

Funding component amount(s) is funding for a specific support or group of reasonable and necessary supports funded in your plan.26

Your funding period is the time that a part of your funding becomes available and how long it needs to last. You can spend up to the amount of funding that is available in that time. Funding periods can be for the total funding amount of your plan or each funding component amount in your plan.27

The laws for the NDIS state what we can change in your plan without making a whole new one. If your plan has funding component amount(s) and funding periods,28 we can change:

how we group your NDIS supports. This may change some funding component amounts, but not the total funding amount in your plan.
changes to funding periods, if these are already in your plan. This may change the time we provide funding for, or the amount in some funding periods. If we vary your funding periods, it won’t change the total amount of funding in your plan.
your general supports, if you have any.29

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We don’t add funding component amounts and funding periods to plans through a plan variation if you don’t already have them in your plan. We’ll include them in new plans and plan approval decisions made through a plan reassessment.

Learn more about funding component amount(s) and funding periods in Our Guideline – Creating your plan.

Change the reassessment date of your plan

How far in advance we set a plan reassessment date isn’t the same for everyone. Your reassessment date will be specific to you and your situation. In some situations, we can change your reassessment date to a later date or an earlier date if we need to.30 We’ll talk with you and work with you if we need to make these types of changes.

For example, if your plan is working for you, we may change the reassessment date to a later date. We call this a plan continuation.

We need to make sure we reassess your plan at least every 5 years. This means we can’t change the reassessment date if this would extend your plan longer than 5 years from when it started.31 We won’t change your reassessment date if there are concerns about how your plan is working for you. Or, you haven’t been using the funds in your plan. In this situation we’ll check-in with you.

If we change the reassessment date in your plan, we may need to vary the statement of participant supports in your plan. We’ll work with you to do this.32

Case example

Fatima is a 27-year-old participant who lives with a mild intellectual disability. She speaks Arabic and uses an interpreter.

At Fatima’s last check-in, she and her planner discussed that her current plan was working well for her. At the time, Fatima requested that her current NDIS supports continue for the next 12 months. We didn’t make any changes during her check-in as her plan was near its reassessment date.

When developing Fatima’s next plan, her planner suggests they continue her current plan for 3 years. Fatima’s planner can see that she has found providers she is working well with, and she is working towards her goals. Her current supports have been working well over the past 12 months and are likely to continue to meet her support needs.

At the plan meeting, Fatima and her planner discuss continuing her plan. Fatima would like to continue with her current supports. Fatima’s planner approves a variation to her reassessment date. Fatima’s plan will continue with the same supports for the next 3 years. Fatima’s planner also tells her that if her situation changes, she can contact the NDIS.

Update how the funds or other aspects of your plan are managed

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We can update your plan to change how the funds or other aspects of your plan are managed.33 You can ask us to do this, or we may decide to do this. When we decide to change how the funds or other aspects of your plan are managed, this is called a CEO initiated plan variation. When we make a decision about how your plan funds are managed, we’ll consider if you34, your child representative35, your plan nominee36, or registered plan manager37 are unlikely to spend your funding only on NDIS supports and in line with your plan38

If we think this is the case, we may not approve your request to change your fund management type.

There are some situations that mean we would have to manage your plan for you. This is when you or your plan nominee:

have been convicted of an offence that is punishable by imprisonment of 2 years or more39
have been convicted of an offence that involves fraud or dishonesty.40 We’ll also think about if there’s an unreasonable risk to you if you, your nominee, child representative or registered plan manager manages your funding.41 Learn more about how we decide who manages your funding in Our Guideline – Creating your plan.

If we change how your funds are managed, this may change how we group the funding components in your plan. For example, if you self-manage one part of your plan, and Agency manage another part, we’ll split these into separate components. Learn more in our Guide to self-management.

When self-managing plan funding, we understand that most people try to do the right thing but sometimes make mistakes. We want to help you do the right thing. This means if you do make a mistake, such as spending your NDIS funds on something that’s not an NDIS support, we’ll work with you to resolve the issue. We’ll also look at supports and strategies we can include in your plan to help you manage your funding in the way you want. Find out more about spending in accordance with your plan.

If we think there’s an unreasonable risk to you if you, your nominee, child representative or registered plan manager manages your funding, we may need to do a CEO-initiated plan variation. We might also do this if you don’t spend your funding in line with your plan or on NDIS supports. Learn more about what we mean by an unreasonable risk to you in Our Guideline – Creating your plan.

Update who must provide a support or how a support must be provided

If your current plan specifies that an NDIS support must be provided in a certain way or by a specific provider your plan can be updated. We do this to update who must provide a support

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or how a support must be delivered.42 Learn more about how we include NDIS supports in your plan in Our Guideline – Creating your plan.

For example, your plan might say that a specific provider must provide your NDIS supports. If that provider closes down, then we can vary your plan to update who the new specific provider is.

Add crisis or emergency supports because of a significant change to your NDIS support needs

If a significant and unexpected change happens in your life, we may be able to vary your plan to add crisis or emergency supports.43 To do this, there are certain criteria that must be met.

We’ll do this when your needs for NDIS supports have changed and you need an urgent change to your NDIS plan.44 Sometimes we won’t need to vary your plan if you have a crisis or emergency because we don’t need to change your NDIS supports. When we’re thinking about varying your plan to include crisis or emergency supports, we must look at if there has been a significant change to your:

functional capacity. When we say functional capacity, we mean the things you can and can’t do because of your disability45
informal supports. This means a change in family, friends and unpaid carers who were providing you with support but suddenly they can’t46
living situation.47 For example, following a natural disaster you may need extra supports to live in temporary housing that doesn’t meet your disability support needs.

We must also make sure that the crisis or emergency support is for either:

a specific period of time.48 For example, this could be for one-month if a family member who supports you every day suddenly goes to hospital. We could fund a support worker until the family member can support you again.
a once-off support.49 For example, if a sudden change in your mobility means you urgently need a wheelchair.

We may need to respond quickly in the event that you need crisis or emergency supports. In this case, we may need to do a plan variation. This is to make sure your disability support needs are met until we can do a plan reassessment.

We must also think about if we should be funding the support. Some supports are funded by other state, Commonwealth or territory programs.50 For example, if a storm damages your home, they may offer you a natural disaster payment and crisis accommodation funding. In this case, we won’t vary your plan to include crisis or emergency supports.

When we add these emergency supports to your plan, we’ll let you know how you can use them and for how long. Generally, these NDIS supports won’t be for the whole length of your

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plan. We’ll check in with you regularly over this time. Near the end of this specific time period, we’ll check in to see if your plan can continue without these emergency supports. If it can’t, we may need to do a plan reassessment.

If we’re not sure your disability-related support needs will be met, we might decide to vary your plan. We may add funds for a specific period of time and bring your reassessment date forward. This is so we can provide the immediate support you need and see if your disability related support needs are met. Towards the end of this specific time period, we’ll do a reassessment to see what your ongoing disability-related support needs are.

We might decide not to vary your plan if there are supports in your plan that you can use flexibly.

Case example

Leigh is 20 years old and lives at home with his dad, Geoff. Geoff is Leigh’s only informal support and helps him with all of his personal care needs. Leigh also has support workers to help him get around his house and the community.

Recently, Geoff had an accident and suffered a broken leg. Geoff needs rehabilitation and won’t be able to help Leigh like he usually does. Geoff is expected to recover well and receive medical clearance to provide care to Leigh again in 10 weeks’ time.

Because of Geoff’s accident, Leigh needs urgent personal care support as he is unable to manage this independently. This is a significant change for Leigh because Geoff usually supports him with all of his personal care needs. He needs an increase in his support worker hours for personal care and support with his mobility. He calls his local area coordinator and asks for a change to his plan to get more NDIS supports to cover this.

Leigh’s planner thinks about all the information and can see that his current plan won’t cover his urgent support needs. Leigh’s change in support needs is only for a short time so his planner decides to vary his current plan.

Leigh’s planner approves 10 weeks of personal care support to cover this specific period of time. We don’t need to reassess Leigh’s plan because we can include crisis or emergency funding in a plan variation.

Leigh’s local area coordinator checks in with him to see if he needs more help or linkages to supports in the community.

Understand section 45(5) amendments

Plans approved on or after 9 October 2024 now include total funding amounts, funding components and funding periods. You must stay within the funding amounts set out in your plan, including any funding component amounts and funding periods.

Staying within your plan funding helps you manage your supports and makes sure your plan lasts for the full length of time so you can continue to pay for the supports you need. Usually,

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we are not allowed to pay for supports outside of your plan if you use up your funding before the end of your funding period.

Under the laws for the NDIS, there are some very limited circumstances when we may pay for supports outside of your plan. This might happen if there’s a serious risk to your life, health or safety, if you couldn’t ask for a plan change because of your disability, or if your plan funding was misused due to fraud. We’ll generally only consider paying for essential supports you rely on every day, like personal care, disability-related health supports or behaviour supports.

Learn more about what if you spend your funding before the end of the funding period in Our Guideline – Your Plan.

We receive information or reports after your plan has started that we requested during planning

We can vary your plan if it relates to the information or report we requested.51

For example, when we created your plan, we asked for an occupational therapist assessment and report. This told us about your assistive technology needs to support your mobility goal. If we receive this report after we have already approved your plan, we may decide to vary your plan to include any assistive technology that is recommended in the report which meet all the NDIS funding criteria.

We need to adjust your plan due to a change to the reassessment date

If we extend your plan reassessment date, the NDIS supports in your plan will not change. As the funding will now be for a longer time, we’ll adjust the funds in your plan to account for the longer timeframe.52

For example, if your plan is meeting your needs, we might change the reassessment date, so your plan goes for longer. If we do this, we’ll adjust the funding for NDIS supports to cover the extra time.

If we bring your reassessment date forward, the NDIS supports in your plan won’t change. However, as the funding is now for a shorter time, we’ll adjust the funds to account for the shorter plan timeframe.53

We make a minor variation to your plan which increases your funding

Sometimes we’ll make a minor variation to your plan which increases your funding by adding another reasonable and necessary support.54 We can do this if the support is:

only needed for a specific amount of time. For example, one-month
a once-off support.55 For example, a wheelchair.

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We must also make sure that the support is not the same or doesn’t give you the same support outcomes as another support already included in your plan.56 It must also be one or more of the following. The support is:

for replacing, repairing or maintaining assistive technology in your previous or current plan.57
urgently needed to support your economic participation for a period of time.58 For example, if you have an opportunity to start a job before there is time to do a plan reassessment. In this case, we may add specific employment supports that you need so you don’t miss out on the opportunity.
urgently needed to help you build your skills or support a life change.59 For example, if your child is starting school a year earlier than planned. Now they may need more support to help build their skills to manage this life change.

We may decide to increase the amount of funding for a reasonable and necessary support in your current plan.60 We can only do this if the support is:

a home modification, design or construction61
vehicle modification62
assistive technology.63 We can vary the funding for one of these supports if:
you can’t buy that support with the funding in your current plan.64 For example, you have funding in your plan for vehicle modifications based on an approved quote. When you contact the provider the cost of materials has increased. In this case, you’ll need more funding to cover the cost of the same vehicle modifications.
the way the supports were agreed to be provided has changed.65 For example, you are living in a remote area and a single physiotherapist travels there regularly. They had agreed to fit your assistive technology on one of their regular trips. The provider shuts down and there are no other physiotherapists in the area who can fit your assistive technology. You now have to pay extra for another physiotherapist to travel and fit your assistive technology. In this case, you’ll need more funding to cover the cost of the same supports.
there is extra unexpected information needed such as quotes, assessments, services or materials.66 For example, you’re having home modifications completed. After work started, termites and rot were discovered in the floor. The floor must be repaired for the home modifications to be completed. So, you’ll need more funding to cover the costs of the same home modifications.

To learn more go to Home modifications explained.

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We may need to respond quickly in the event that you need urgent supports before your plan reassessment date. In this case, we may need to do a plan variation. This is to make sure your disability support needs are met until we can do a plan reassessment.

Case example

Elijah is 5 years old and has cerebral palsy. Elijah requires an ankle foot orthotic (AFO) to improve his walking pattern and stability.

He has had a growth spurt and his current AFO is now too small and needs to be changed.

Elijah’s mum Rose is his child representative. Rose asks their early childhood partner to help them make this change to Elijah’s plan.

It is clear to Elijah’s planner that Elijah still requires the use of an AFO. We said this was a reasonable and necessary support in his current plan.

Elijah’s planner decides to vary his plan and approves funding for a new AFO. Elijah doesn’t need any other changes to his plan.

What is a plan reassessment?

A plan reassessment is when we replace your current plan with a new one. You may need a plan reassessment to make sure you have an NDIS plan that meets your support needs and helps you pursue your goals.

When can your plan be reassessed?

We can do a plan reassessment at any time.67 Under the laws for the NDIS, the reasons we may reassess your plan are:

you ask us for a plan reassessment68 and we agree with your plan reassessment request69
we think your current plan is not meeting your support needs70
your plan reaches its reassessment date.71 When you ask us to do a reassessment, we have to think about all the information you tell us and any evidence you give us. Once we have looked at this information, we may decide not to reassess your plan. We won’t reassess your plan if it doesn’t meet the criteria in section When can we reassess your plan or we don’t have enough evidence to change your plan.72

When we do a plan reassessment, we create a new plan.73 We can also decide not to reassess your plan and vary your current one.74 We may decide to vary your current plan instead if this meets your need for NDIS supports. Whether we choose to vary your current plan or create a new one will depend on your situation.

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When can we reassess your plan?

When we decide if we can reassess your plan we think about if there has been a significant change in your situation. We can only reassess your plan where the evidence you give us shows your change in situation has led to a significant change to your need for NDIS supports.

Learn more about what evidence you need to give us before we create or change your plan.

The types of changes in your situation that we’ll look at to decide if we do a plan reassessment are:

if your functional capacity has changed.75 When we say functional capacity, we mean the things you can and can’t do because of your disability
if your informal supports have changed.76 This means a change in family, friends and unpaid carers who were providing you with support. For example, a family member’s situation changes, and they can no longer support you on an ongoing basis
if your living situation has changed77
if life is changing in a significant way. For example, you are starting or leaving school, tertiary education or employment78
if there’s been a change to your right to compensation for personal injury. For example, you’re eligible to get an amount of money for personal injury under an insurance claim following a car accident79
anything you, your plan nominee or child representative tell us that we think is relevant or that we think we should look at.80

Some other reasons we may need to reassess your plan are:

we need to include funding periods, funding components or the total funding in your plan for the first time. This is because of the updated laws for the NDIS
if it’s been 5 years since your last plan reassessment.81 We’ll also think about when your next plan reassessment is due.82 For example, if your next plan reassessment date is in one month we’ll wait until then. If it’s in 6 months, we may reassess your plan earlier.

When we think about doing a plan reassessment, we’ll look at any documents or information you give us. To reassess your plan the evidence you give us needs to show your change in situation and significant change to your need for NDIS supports. For example, you can give us a report from your allied health professional.

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We’ll also think about your individual situation and anything you tell us.83 We may use this information, or other information that we think is relevant, to decide if we need to do a plan reassessment.84

To learn more, go to What happens if we need more information?

What is an example of a significant change in support need?

Mara has multiple sclerosis and until recently her NDIS plan was working well to meet her support needs. In the past few months, Mara has found it more difficult to get dressed for work in the morning. She can no longer do this without assistance. She met with her health professional, and they assessed that Mara’s fine motor skills have declined, and this is likely to be permanent.

Mara has requested a change to her plan so she can access a support worker to help her get ready for work in the morning. Mara’s decline in motor skills is a change in Mara’s functional capacity which has significantly changed her need for NDIS supports. The change is also likely to be permanent so to make sure Mara has access to the NDIS supports she needs, we decide to reassess her plan.

Mara is also able to provide us with evidence about her change in situation and NDIS support needs. Mara gives us a report from her health professional so her planner can make a decision to reassess her plan. It also helps us to include the right NDIS supports in Mara’s new plan.

What is an example that isn’t a significant change in support need?

Liam is 32 years old and lives in a one bedroom flat. He is an attendant propelled wheelchair user and uses assistive technology for his job as a children’s writer. Stuart is Liam’s support worker and helps Liam with his personal care and going out to work meetings.

Liam has recently bought a new 2-bedroom house which has space for his office. He will be moving in 3-months. He got in touch to let us know his living arrangements will be changing and he may need a new plan or a change to his current one.

A planner calls Liam to discuss the home move. The new 2-bedroom house is already accessible for Liam’s wheelchair. Stuart is also going to continue to be Liam’s support worker in his new home providing the same amount of support. Liam and Stuart think that 3 months will be enough time to prepare for the move.

Liam’s planner decides that he doesn’t need a change to his plan. This is because even though Liam’s living arrangements will change it hasn’t caused a significant change in Liam’s need for NDIS supports.

We can update Liam’s personal details to make sure we can contact him about his NDIS plan when he moves to his new home.

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Liam can let us know at any time if his situation changes and ask for a change to his plan in the future.

How can I ask for a change to my plan?

A change to your plan could be a plan variation or a plan reassessment.

There are 3 ways you can ask us for a change in your plan:

complete change of details or change of situation form
call us
visit one of our offices. You may decide to ask for a change to your plan if, for example:
there has been a change in your situation that is significantly impacting your need for NDIS supports
you want to change how the funding is managed
you urgently need a change in supports. You need to give us any new information to help us decide if we’ll do a plan change. The type of information or evidence we need can depend on the reason you’re asking for a plan change. This may include any assessments, reports, or other information. These are important to help us understand how your situation has changed and make a decision on whether your plan needs to be changed.

Learn more about what evidence you need to give us before we create or change your plan?

You can give us any new evidence about your support needs when you get it. If you’re not sure what to give us, you can talk to us, your my NDIS contact, support coordinator or recovery coach. You can also give us new evidence during your check-in.

For example, you might ask for a change in your plan because your disability needs have changed. You may have trouble doing things you used to be able to do. We’ll need an assessment or report from an appropriately qualified professional about how your support needs have significantly changed. This may be your doctor, a specialist, or an allied health professional like an occupational therapist.

If you only want to change how the funding is managed in your plan, we might be able to do a plan variation. We may not need new information if everything else is the same, for example, you probably won’t need assessments or reports. We may ask you some questions about this change to make sure there aren’t any risks to you.

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There may be some situations where you won’t be able to self-manage or use a registered plan manager for your NDIS funding.85 Learn more about your options for managing your funding Our Guideline – Creating your plan.

Can someone else ask to change my plan?

Your plan nominee or child representative can ask us to make a change to your plan on your behalf.

You can also give consent for someone else to ask us to do a change to your plan on your behalf. For example, this could be an advocate, family member or friend.

If you want to give consent for this, there are 3 ways you can do it:

fill in the Consent for a third party to act on your behalf form
send us a letter or email
contact us and we’ll make a written note. Learn more about consent.

Before you decide to give consent for someone else to ask for a change to your plan, you should think about if they have a conflict of interest. You should think about:

if you’ve given the person consent to make a plan change request
how long you have given them consent for. To learn more go to conflict of interest.

You can’t ask for a change to your plan if your plan is suspended.86 Learn more about plan suspensions and when can’t you use your plan in Our Guideline – Your planhttps://ourguidelines.ndis.gov.au/your-plan-menu/your-plan/when-cant-you-use-your plan.

How can I change my goals?

You can change your statement of goals and aspirations at any time, you just need to let us know.87 We’ll update your plan with your new statement of goals and aspirations. We’ll give you a copy of your varied plan within 7 days of getting your changed statement.88 This change results in a variation to your statement of goals and aspirations rather than a new plan.89 We can only change your statement of goals and aspirations if you ask, we can’t decide to change them for you.

We don’t make any other changes to your plan if you only ask us to change your participant statement of goals and aspirations. The NDIS supports funded in your plan, how your funding is managed, and when we must reassess your plan, all stay the same.90

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Learn more about setting goals and the information about you in Our Guideline – Your planhttps://ourguidelines.ndis.gov.au/your-plan-menu/your-plan/when-cant-you-use-your plan.

What happens after I request a change to my plan?

When we receive your request to change your plan, we’ll look at the information you have given us to make our decision.

Request for a plan variation

If you request a plan variation, we can decide to:

vary your plan91
not vary your plan92
let you know we need more time to make our decision.93 We must make our decision about your request for a plan variation request within 21 days of receiving your request.94 We’ll send you a letter telling you about our decision and our reasons behind it.95

There may be times we’ll tell you we need more time to make our decision. When we do, then we must either vary the plan or decide to not vary the plan as soon as reasonably practicable.96 What is reasonable will depend on whether we have requested any information or reports.97 We may ask you to provide more information to help us make our decision.98 Or we may ask you to get an assessment or examination or both, and provide us with a report or reports.99

If we request more time to make our decision, we’ll decide whether to vary your plan within:

28 days; or
50 days if we are addressing complex needs.100 If you don’t agree with our decision to vary your plan, or not vary your plan, you can ask us to review this decision.101 Learn more about internal reviews in Our Guideline – Reviewing our decisions.

Request for a plan reassessment

If you request a plan reassessment, we can decide to:

vary your plan102
reassess your plan103
not reassess your plan.104

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Just like plan variations, we must make our decision about your request for a plan reassessment within 21 days of receiving your request.105

We’ll send you a letter telling you about our decision. If we decide to vary your plan, or not reassess your plan, we’ll provide you with reasons for our decision.106 If you don’t agree with our decision to vary your plan, or not reassess your plan, you can ask us to review this decision.107

If we don’t decide within 21 days, we are taken to have decided not to reassess your plan.108 We’ll review this decision automatically.109 We call this an automatic internal review. We’ll let you know in writing if we do an automatic internal review.110 You don’t need to do anything.

Learn more about internal reviews in Our Guideline – Reviewing our decisions.

If we decide to reassess your plan, we must complete the reassessment111 and either:

vary your plan (as a result of the reassessment)112 or
prepare and approve a new plan.113 When do we decide to change your plan?

We may decide to do a CEO-initiated plan change if your plan needs a variation114. For example, to make changes to how your funding is managed if you, your child representative, your plan nominee or registered plan manager have not:

spent funding on NDIS supports
spent funding in line with your plan.115 We understand that people can make mistakes when they or their plan manager are managing their NDIS funding. This is why before we change your plan management type, we’ll think about supports and strategies you could use that reduce the risks to you. This is so that you can use your preferred plan management type. To find out more about when we may do a CEO-initiated plan variation to change your fund management type, go to Our Guideline – Creating your plan.

We may also decide to do a CEO-initiated plan change if your plan needs a reassessment116 For example, due to a significant change in your situation or if there is an issue with how your funding is being used.

Spending in line with your plan means only spending your funding on the NDIS supports included in your plan. To spend in line with your plan, you need to:

spend your funding in the way we describe. This includes any stated supports, where we describe the supports you can buy more specifically
make sure your funding will last for the whole length of your plan

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make sure your funding will last for the length of each funding period, if your plan includes funding periods and funding component amounts.

There are rules that help us decide if you’ll spend your NDIS funds only on NDIS supports and in line with your plan. For more information, go to What supports can you buy with your NDIS funding?

When you buy supports in line with your plan, you need to make sure they’re:

NDIS supports or
an agreed replacement support that relates to your disability. For information on what is an NDIS support, what is not an NDIS support, and what can be considered a replacement support, go to What does the NDIS fund?

If we decide to change your plan, we’ll let you know we’re doing this and what type of plan change we’re doing.117

We must also reassess your plan before the reassessment date in your plan.118 We’ll write to you around 3 months before your plan reassessment date to let you know it’s coming up. We’ll confirm the check-in details in the letter. After the reassessment we may decide to approve a new plan119 or vary your current plan,120 depending on your situation. We’ll prepare the variation of your plan, or your new plan, with you.121

If you don’t agree with our decision to vary your plan, or approve a new plan, you can ask us to review this decision.122 Learn more about internal reviews in Our Guideline – Reviewing our decisions.

If we can’t reassess your plan before your reassessment date, your current plan will continue beyond the reassessment date. We’ll write to you to let you know if this is going to happen.

Sometimes a plan will say that in certain situations we must reassess the plan.123 For example, your plan might say we need to reassess it once you leave school.

We must reassess your plan at least every 5 years. However, this doesn’t mean we’ll only reassess your plan every 5 years. This will depend on your individual situation. We’ll talk to you about this to work out when your plan reassessment will be, based on what best suits your needs.

During your plan, we’ll check in to see how you’re going. We’ll talk with you about how the NDIS supports in your plan are meeting your disability support needs.

We’ll check in with you:

at regular times, for example each year
if we think your plan might not be working for you.

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Learn more about check-ins in Our Guideline – Your planhttps://ourguidelines.ndis.gov.au/your-plan-menu/your-plan/when-cant-you-use-your plan.

If the check-in shows your plan is meeting your disability support needs, we won’t do a plan change and your current plan will continue. If we find you have a significant change to your NDIS support needs, we will discuss changing your plan.

We may decide to do a plan change if we know your plan isn’t working for you. For example, you may not have the right NDIS supports you need, or you may not be using your NDIS supports. This information might come from:

you or someone else in your life
your local area coordinator, early childhood partner, or support coordinator
our system that shows how you’re using the funding in your plan. If we think you need a change to your plan, we’ll get in touch to explain why a plan change is needed. We’ll also make sure you understand what this means for you and what happens next.

We’ll prepare your plan with you, and we might not need to ask you all the usual planning questions. Your goals can stay the same if you don’t want to change them.124

If we decide to change your plan, we must provide you with a copy of your:

varied plan within 7 days of being approved125
new plan within 7 days after your plan is approved.126 There may be times where you only want to change your statement of goals and aspirations. When you do, we’ll provide you with a copy of your varied plan within 7 days of receiving your changed statement.127

Learn more about how long this takes in our Participant Service Charter.

How do we make a change to your plan?

We’ll work with you to change your plan. We’ll think about the type of change your plan needs to meet your disability support needs. We’ll let you know what type of plan change we’re doing, a plan reassessment or plan variation, and what that means.

We’ll do a plan change either in person or over the phone. It depends on what suits you best. You can ask a family member, friend, advocate, or other support person to be involved in your plan change.

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Everyone’s plan changes are different. When we’re working with you to change your plan, we may look at different things. This will depend on what type of change we’re doing and the sort of changes we’re making.

Until we have finished updating our computer systems, new and reassessed plans completed in our new computer system will go for one year.

Sometimes when we’re doing a plan reassessment or plan variation we may also check to see if you’re still eligible for the NDIS. We call this process an eligibility reassessment. This is a normal part of the plan reassessment and variation process. Learn more about when you’re no longer eligible for the NDIS.

What happens during a plan variation?

When we do a plan variation, we’ll work with you to understand how your situation has changed. We may be able to make changes to your plan without doing a full plan reassessment. We think about the information you have provided and work with you to make any necessary changes to your current plan.

All NDIS supports in your varied plan must meet the NDIS funding criteria. This includes the NDIS supports that were already in your plan.

When we vary your plan, we’ll let you know the date when the variation to your plan starts. This can only be on or after the day we decide to vary your plan.128

What happens during a plan reassessment?

When we do a plan reassessment, we must complete the reassessment and decide to either:

make changes to vary your plan without doing a full reassessment129
prepare and approve a new plan.130 If we vary your plan, it will only include a total funding amount, funding component amounts and funding periods if they’re already in your plan.

If we prepare and approve a new plan because of a reassessment, your new plan will include:

a total funding amount
funding component amount(s) and
funding periods.131 This is because of changes to the laws for the NDIS.

When we do a plan reassessment, we think about all your information including your goals, situation, and disability support needs. We reassess all the supports you require to meet

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your disability support needs. You may not need some of your supports anymore, while others may increase or change.

We’ll usually look at how you’ve been using your NDIS supports and how well your previous plans worked for you.132 We also look at if you have spent your funding on NDIS supports in line with your plan.133 This will help us decide if the NDIS supports are still working for you.

If you haven’t used all the funding by your plan reassessment date, it doesn’t mean we’ll reduce the funding in your next plan. There may be very good reasons why you weren’t able to use the funding.

We might talk about any problems you have using your funding and support you may need to get help with this. If you consistently don’t use your NDIS funding, we think about whether the supports really do meet the NDIS funding criteria. For example, they may not be effective and beneficial for you if you’re not actually using them.

Your needs and situation will most likely change over time. This means your NDIS funding may change over time. For example, your disability support needs might increase, and we might consider funding more NDIS supports.

Or we might fund NDIS supports to help you build your skills in a particular area. Once you have built those skills, you won’t need that funding anymore. So, we probably won’t include that funding in your next plan. NDIS supports to build your skills may have met the NDIS funding criteria before, but they might not in the future.

All NDIS supports in your new plan must meet all NDIS funding criteria.

What happens if we need more information?

To help us decide whether we can change your plan, we may ask you for more information or to provide an assessment. This information will help us work out your disability support needs. It’s important you give us this information as without it, we may need to decline your plan change request.

We’ll ask for different types of information for different types of supports. We might ask you for:

a new assessment and report,134 if your last assessment was a long time ago and doesn’t tell us about your current support needs. For example, an occupational therapist may write a letter to explain why you need a specific type of wheelchair
more information about the types of supports you need and how often you need it, from a suitably qualified person. This could be your doctor or psychologist
information from a provider about how you have progressed towards your goals.

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The most important information we gather about what NDIS supports to include in your plan comes from you. We collect this information during check-ins. You can also give us this information anytime there’s a change in your situation.

We must give you a reasonable opportunity to give us the information.135 We’ll review the information you give us to make sure the NDIS supports meet the NDIS funding criteria for you. The sooner you can give us the information, the sooner we can change and approve your plan.

In some situations, we may need to approve your plan before you get an assessment or give us information. If this happens, we may then do a CEO-initiated plan change after we receive the reports. This could be a plan variation or a plan reassessment.136

For example, we might approve your plan, so you have funding for urgent self-care supports. We could then do a CEO-initiated plan change afterwards, once you have the assessments and reports for other supports, such as assistive technology.

How can I prepare for my plan change?

We have some guides you can use to help you prepare for your plan change. You can find the Changing your plan factsheet on our website. You can also check out our pages on Supports you can access and Would we fund it.

Before your plan change, you need to gather any assessments, reports, and other information to help us change your plan. You might have this information yourself, or you might need to get it from a support coordinator or provider.

If you have a support coordinator or specialist support coordinator, we’ll need a report from them. The report should tell us how your NDIS supports are meeting your needs and helping you pursue your goals.

For children younger than 9, we have an Early childhood provider report form. Providers should complete this form to tell us about the supports the child has received. The form tells us the information we need, such as:

what services were provided and who provided them
a progress update, including what stage the child has got to
future recommendations. When would we decide not to change your plan?

There may be several reasons we decide not to change your plan if you ask us to do a plan reassessment or plan variation.

When would we decide not to do a plan reassessment?

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If you ask us to do a plan reassessment, we need to think about whether your current plan can meet your support needs. We also think about the reason you are asking for a plan reassessment. Reasons we would decide to not do a plan reassessment137 include:

if you don’t have any new information or evidence of a significant change to your support needs
if your request is only about wanting more funding, or NDIS supports that other participants have
if informal, community or mainstream supports can meet your needs
if your plan is suspended
if your plan reassessment date is soon, we may decide to wait until then.138 If you don’t have any new information or evidence

We generally won’t change your funding if there’s no new information about how your support needs have changed. For example, we generally won’t do a plan change if:

you changed your mind about the NDIS supports you want after we’ve approved your plan
there’s no evidence, or not enough evidence to show there has been a change to your situation
there’s no evidence, or not enough evidence there has been a significant change to your need for NDIS supports. This means, you can still do the same things you could do when we approved your plan.

Remember, you can give us new information or evidence anytime there is a change in your situation. Learn more about what evidence you need to give us before we create or change your plan.

If your request is only about wanting more funding, or NDIS supports that other participants have

We can’t change your funding just because you want more NDIS supports, or the same supports as other participants. This may include:

more funding because you’ve used all the funding in your plan, even though your situation hasn’t changed
extra NDIS supports because another participant has these supports
NDIS supports added to your plan without enough evidence showing why you need them
funding for NDIS supports that don’t relate to your disability support needs.139

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If informal, community or mainstream supports can meet your needs

We can’t change your funding if friends, family or other services can meet your needs. For example, if you ask for things:

that are not NDIS supports140
that we’d reasonably expect family or friends to do for you. For example, short-term care if the family members who usually support you are sick.141

If your plan is suspended

We can’t do a plan change if your plan has been suspended.142 This usually happens after:

you’ve been overseas for more than 6 weeks. However, there are some situations we can extend the 6-week period of your plan.
you don’t claim compensation you’re entitled to after we ask you to, for example, after you’ve had an injury.

To learn more about plan suspensions and when you can’t you use your plan in Our Guideline – Your planhttps://ourguidelines.ndis.gov.au/your-plan-menu/your-plan/when-cant you-use-your-plan.

If your plan reassessment date is soon, we may decide to wait until then

When deciding to reassess your plan we must think about when we’d next be required to reassess it. This will depend on the reassessment date in your current plan.143

We do this because it’s not practical for us to reassess your plan if your plan reassessment date is soon. For example, if your reassessment is in less than one month it’s likely that a planning meeting has already been organised. However, if your reassessment date is 6 months away it may be better to do one sooner.

When might we decide not to do a plan variation?

NDIS laws tell us when we can do a plan variation.144

We’ll decide not to vary your plan if the request doesn’t meet the things the rules say about plan variations, or the following reasons.

For example:

your plan is suspended or ceased145
you have flexible funding left in your plan that can be used
it is to avoid or replace an existing review or appeal pathway
we don’t have enough evidence to support a variation

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you’ve used all the funds in your plan quicker than specified in your plan, without evidence showing why this was needed
you’re requesting to self-manage or use a registered plan manager, but we think it’s an unreasonable risk to you.146 Learn more in Our Guideline – Creating your plan.

We’ll also decide not to vary your plan if we think we should do a plan reassessment instead. The reasons we may decide that your plan needs a reassessment instead of a variation are:

we have varied your plan several times and your plan isn’t meeting your needs, so we need to do a reassessment
we can’t vary your plan without looking at the other supports in it
your situation has changed significantly, and you need a reassessment
you’re wanting more funding to help with a new or changed goal, and the request is not minor
your informal, community or mainstream supports can’t meet your needs. How can we support you?

If we decide not to change your plan, we can link you with other services who may be able to help you. Talk to us, your my NDIS contact, support coordinator or recovery coach about how they can help you get other supports you may need.

If you don’t agree with our decision not to change your plan, you can ask us for an internal review of that decision. This means another one of our staff, who wasn’t involved in the original decision, will look at whether we made the right decision.

Learn more about reviewing our decisions go to Our Guideline – Reviewing our decisions.

What if you’re waiting for an internal review decision?

If your situation and support needs change while you’re waiting for an internal review, contact us. Depending on the changes to your situation and support needs, we may decide to do a CEO-initiated plan change.147 You can also ask for a participant-requested plan change.148

If we decide to change your plan while we’re completing the internal review, our decision will form part of that internal review.149 This will happen automatically, and you don’t need to do anything. Learn more about internal reviews in Our Guideline – Reviewing our decisions.

What if you’re waiting for an external review decision?

If you’re a participant and your situation or disability support needs change during the external review process, contact your case manager. Your case manager is our staff member who helps us at the Tribunal. Your case manager will explain the options available

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to you. We may also need to let the Tribunal know what we think we should do if it might affect your external review.

You can still use the NDIS supports in your plan while the Tribunal considers your external review.

Learn more about external reviews in Our Guideline — Reviewing our decisions.

What happens after | have had a change to my plan?

After we decide to change your plan, you’ll get a copy of it. We’ll also give you a letter with the reasons for the decision we made. If we vary your plan, you’ll get a copy of your plan within 7 days of the day the variation to your plan starts.°° If we approved a new plan, you’ll get a copy within 7 days of your plan being approved. ’*“

Your local area coordinator, early childhood partner or support coordinator can help you start using your plan. For example, they can explain the NDIS supports in your plan, help you connect with supports outside the NDIS, and help you find service providers.

Learn more in Our Guideline — Your planhttps://ourguidelines.ndis.gov.au/your-plan menu/your-plan/when-cant-you-use-your-plan.

What if I’m not happy with my plan?

If you’re not happy with your new plan, you should talk to us, your my NDIS contact. They may be able to explain the decision, clarify how you can use the funding, or help you fix any problems. If you’d like more details about the supports that make up your plan’s total funding amount, we can send this to you. You can contact us and ask for a funding breakdown. This could be when you get your varied plan or when we meet with you to approve your new plan.

If you don’t agree with your new plan or varied plan, you can ask us to review our decision. We call this process an internal review.’®? This means another one of our staff, who wasn’t involved in the original decision, will look at whether we made the right decision.

It’s up to you to decide whether you want an internal review. We don’t decide this for you.

You need to ask for an internal review of our decision within 3 months of receiving our decision. We can’t do an internal review if you ask us after 3 months has passed. If you ask us after 3 months, we’ll let you know what other options you have. To earn more about reviewing our decisions go to Our Guideline — Reviewing our decisions.

Version Control

Version Amended Brief Description of Change Status

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7.0           s47F - personal privacy BM review and approval           APPROVED  2025-02-28

Updated resource based on new rules

44 National Disability Insurance

Scheme (Management of Funding) Rules 2024 and draft rules National

Disability Insurance Scheme (Variation

and Reassessment of Participants’ Plans) Rules 2024 47a and 48. Check all footnotes for accuracy with the NDIS act and updated where needed.

8.0           s47F - personal privacy BM review and approval           APPROVED  2025-04-07

Update to remove the term ‘impairment’ and return to pre-legislation change language where we say we fund supports which relate to the participant’s disability.

9.0           s47F - personal privacy BM review and Class 2 approval      APPROVED  2025-12-11

Update to:

align with National Disability

Insurance Scheme (Variation

and Reassessment of

Participants’ Plans) Rules 2025

include examples on what is considered a significant change in support need and strengthen requirement to have evidence, consent from the participant and COI if request from a provider
incorporate BM endorsed language to understand s45(5) amendments.

Reference list

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1 NDIS Act.s33(1)

2 NDIA Act s 33(2) 3 NDIS Act s 33(2)(c). 4 NDIS Act ss 47; 47A. 5 NDIS Act s 48. 6 NDIS Act s 99. 7 NDIS Act s 100. 8 NDIS Act s 47; NDIS Act s 47A. 9 NDIS Act s 47A(1). 10 NDIS Act s 47A(2). 11 NDIS Act s 47A(9). 12 NDIS Act s 47A(3). 13 NDIS Act s 47A(1)(a)(ii). 14 NDIS Act s 47A(1A). 15 NDIS Act s 47A(1A). 16 NDIS Act s 47A(1A)(d)(iii). 17 NDIS Act s 47A(1A)(b). 18 NDIS Act s 47A(1A)(c). 19 NDIS Act s 47A(1A)(d)(i). 20 NDIS Act s 47A(1)(a)(ii). 21 NDIS Act s 47A(1A)(d). 22 NDIS Act s 47A(1AB)((j)(i);NDIS Act s 47A(1A)(d)(i). 23 NDIS Act s 47A(1A)(d)(ii). 24 NDIS Act s 47A(1A)(d)(iii). 25 NDIS Act s 47A(1A)(d)(iv). 26 NDIS Act s 33(2A)(b)(c). 27 NDIS Act s 33(2A)(d). 28 NDIS Act s 47A. 29 NDIS Act s 47A(1A)(ag). 30 NDIS Act s 47(1A)(a). 31 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.2. 32 NDIS Act s 47A(1A)(d)(iii). 33 NDIS Act s 47(1A)(b). 34 NDIS Act s 44(1)(c). 35 NDIS (Management of Funding and Plan Management) Rules r 6.5. 36 NDIS Act s 44(2A). 37 NDIS Act s 44(2). 38 NDIS Act ss 44(1)(c), 44(2A)(c), 74(3C)(b). 39 NDIS Act s 44(1AA)(i); NDIS Act s 44(2AA)(i). 40 NDIS Act s 44(1AA)(ii); NDIS Act s 44(2AA)(ii). 41 NDIS (Management of Funding and Plan Management) Rules r 6.2. 42 NDIS Act s 33(3);NDIS Act s 47A 43 NDIS Act s 47A(1A)(d)(i). 44 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.3(a,c). 45 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.3(b)(i). 46 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.3(b)(ii). 47 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.3(b)(iii). 48 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.3)(d)(i). 49 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.3)(d)(ii). 50 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.3(e). 51 NDIS Act s 47A(1A)(d)(ii). 52 NDIS Act s 47A(1A)(d)(iii). 53 NDIS Act s 47A(1A)(d)(iii). 54 NDIS Act s 47A(1A)(d)(iv); NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.4(a). 55 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.5(a)(i)-(ii).

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56 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.5(c). 57 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.5(b)(i). 58 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.5(b)(ii). 59 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.5(b)(iii). 60 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.6(a). 61 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.6(a)(i). 62 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.6(a)(ii). 63 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.6(a)(iii). 64 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.7(a). 65 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.6(b). 66 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.7(c). 67 NDIS Act s 48(1). 68 NDIS Act s 48(2). 69 NDIS Act s 48(3) 70 NDIS Act s 48(2). 71 NDIS Act s 49(a). 72 NDIS Act s 48(3)(c) 73 NDIS Act s 48(7)(a) 74 NDIS Act s 4(7)(b)(i-ii) 75 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 6.3(a)(i) 76 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 6.3(a)(ii). 77 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 6.3(a)(iii). 78 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 6.3(a)(iv). 79 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 6.3(b). 80 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 6.3(d)-(e). 81NDIS (Variation and Reassessment of Participants’ Plans) Rules r 5.2. 82NDIS (Variation and Reassessment of Participants’ Plans) Rules r 6.3(c). 83NDIS (Variation and Reassessment of Participants’ Plans) Rules r 6.3(d). 84NDIS (Variation and Reassessment of Participants’ Plans) Rules r 6.3(e). 85 NDIS Act s 44(1)(c); NDIS (Management of Funding and Plan Management) Rules r 6.3. 86 NDIS Act s 41(2)(c). 87 NDIS Act s 47(1). 88 NDIS Act s 47(3). 89 NDIS Act s 47(2). 90 NDIS Act s47(2). 91 NDIS Act s 47A(4)(a). 92 NDIS Act s 47A(4)(b). 93 NDIS Act s 47A(4)(d). 94 NDIS Act s 47A(4). 95 NDIS Act s 100(1). 96 NDIS Act s 47A(8)(b). 97 NDIS Act ss 47A(8),50. 98 NDIS Act s 50(2)(a). 99 NDIS Act s 50(2)(b).

100 Participant Service Charter

101 NDIS Act s 99(1) Items 6, 6A, 6B. 102 NDIS Act s 48(3)(a). 103 NDIS Act s 48(3)(b). 104 NDIS Act s 48(3)(a). 105 NDIS Act s 48(3). 106 NDIS Act ss 99(1), Items 6 and 6C; 100(1). 107 NDIS Act ss.99(1) Item 6C; 100(2) 108 NDIS Act s 48(4). 109 NDIS Act s 100(1A)(a)(ii). 110 NDIS Act ss.48(4),100(1A)(a)(ii).

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111 NDIS Act s 48(7)(a). 112 NDIS Act s 48(7)(b)(i). 113 NDIS Act s 48(7)(b)(ii). 114 NDIS Act s 47A. 115 NDIS Act s 44(c). 116 NDIS Act s 48. 117 NDIS Act s 48(6). 118 NDIS Act s 49. 119 NDIS Act s 49(1)(b)(ii). 120 NDIS Act s 49(1)(b)(i). 121 NDIS Act ss 47A,33(2) 122 NDIS Act s 99(1)item 6,6A, 6B,6C 123 NDIS Act s 49A 124 NDIS Act s49 125 NDIS Act s 47A(11). 126 NDIS Act s 38. 127 NDIS Act ss 47(3), 47A(11). 128 NDIS Act s 47A(10). 129 NDIS Act s 48(7)(b)(i). 130 NDIS Act s 48(7)(b)(ii). 131 NDIS Act s 33(2). 132 NDIS Act s 33(5)(f). 133 NDIS Act s 33(5)(g). 134 NDIS Act s 50(2)(b)(i). 135 NDIS Act s 50(3). 136 NDIS Act s 50(3) Note. 137 NDIS Act s 48(3)(c). 138 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 6.3(c). 139 NDIS Act s 34(1)(aa). 140 NDIS Act ss 10(4),(9). 141 NDIS Act s 34(1)(e). 142 NDIS Act s 41(2)(c). 143 NDIS (Variation and Reassessment of Participants’ Plans) Rules r 6.3(c). 144 NDIS ss 47, 47A. 145 NDIS Act s41(2)(c) 146 NDIS (Management of Funding and Plan Management) Rules r 6.2. 147 NDIS Act s 48(2). 148 NDIS Act s 48(2). 149 NDIS s 101. 150 NDIS Act s 47A(11). 151 NDIS Act s 38. 152 NDIS Act s100.

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FOI 26/27-0110 DOCUMENT 5

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The contents of this document are OFFICIAL: SENSITIVE.

Including Specific Types of Supports in Plans

Overview

What is the purpose of this operational guideline? This Operational Guideline is intended to be used in conjunction with Our Guideline – Creating your plan and provides additional guidance in relation to the preparation and review of a participant’s plan when specific types of supports are under consideration.

In particular, this Operational Guideline provides additional guidance in relation to making a decision to approve a plan that includes one or more of these specific types of supports.

What is the relevant legislation?

Sections 3, 4, 5, 6, 9, 10, 17A, 31 – 50, 51, 74, 99, 100 and 209(2A) of the

National Disability Insurance Scheme Act 2013 (NDIS Act)

National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Supports for Participants Rules).
National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024.

Overview Once a person becomes a participant in the National Disability Insurance Scheme (NDIS), they develop a personal goal-based plan with the National Disability Insurance Agency (NDIA).

A participant’s plan must include the participant’s statement of goals and aspirations, and a statement of participant supports. See What is an NDIS plan? in Our Guideline – Creating your plan.

The statement of participant supports specifies, amongst other matters, the general supports (if any) that will be provided, and the reasonable and necessary supports (if any) that will be funded under the NDIS (section 33(2)).

When deciding to include any support in a participant’s plan, the NDIA must have regard to a range of matters set out in the NDIS Act, including the participant’s statement of goals and aspirations.

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Specifically, before including any support in a participant’s plan, the NDIA must:

be satisfied that each support meets each of the criteria outlined in section 34(1)(aa)-(f) of the NDIS Act and the Supports for Participants Rules. See Does

the support meet the reasonable and necessary criteria? in Our Guideline –

Reasonable and necessary supports

have regard to the specific principles relating to plans
have regard to the other considerations which may apply when including supports in a participant’s plan, and
depending on the specific type of support being considered, refer to the additional guidance available for specific support types:
Assistive technology
Home modifications
Work and study supports
Vehicle modifications and driving supports
Prosthetic limbs
Personal care supports
Social and recreation support
Sustaining informal supports
Transport
Specialist Disability Accommodation (SDA). See also Our Guideline – Creating your plan.

Prosthetic limbs Prosthetic (artificial) limbs are devices that provide a portion of functions normally provided by natural arms and legs. They are often used when there is absence of part or all of a limb. For example, due to an accident or birth defect, and help to improve function and quality of life.

Prosthetic limbs consist of a custom-made socket which fits the residual limb and a terminal device made up of different components that assist in performing functional tasks and providing compatible cosmesis.

Prosthetic limbs vary considerably in their sophistication by virtue of their complexity, cost, and specialisation and due to the varying levels of function they provide. For example, a

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prosthetic limb may be a simple device that is functionally efficient, or an enhanced limb that is configured to have an appearance and functional performance that is similar to that of a natural limb.

The NDIA must be satisfied, amongst other matters, that the funding of a prosthetic limb represents value for money in that the costs of the support are reasonable relative to both the benefits achieved and costs of alternative support (section 34(1)(c)).

In considering whether a proposed prosthetic limb represents value for money, the NDIA will consider whether:

the total labour and associated costs, including the number of hours and hourly rate of the prosthetist, represents value for money in the participant’s local market;

and

the cost of componentry proposed represents value for money when compared to the cost of similar prosthetic components that would meet the participant’s

functional needs and goals.

The NDIS will generally fund definitive limbs only where they are specified (prescribed) by health professionals who are designated and accredited (where applicable) by the artificial limb service in the state or territory where the participant resides.

For upper and lower limbs, the specifications should propose the minimum level or grade of socket materials, componentry and coverings required that relate to:

the participant’s weight
the participant’s goals and aspirations
the ability to use, put on and remove the limb
the ability to care for the limb
the medical needs, that is, residual limb shape, fixed deformity to be accommodated, skin integrity and alignment-relevant co-morbidities.

In addition, the necessity for a particular level of componentry should relate to factors that include:

the participant’s expected or known functional level (based on standard measures such as the K classification)
functional needs related to the environment of use. For example, typical floor surfaces and gradients, the use of stairs, the amount of time walking, typical

terrain if used outside, expected impacts

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the impact of actual or expected vocational demands on limb type. Generally, the NDIS will fund:
entry level or standard grade prostheses for participants up to K2 classification and will consider higher prosthesis for people up to K3 and K4 classification
repairs, maintenance, minor and major adjustments to prosthetic limbs (or prosthetic limbs funded by other systems prior to the participant joining the NDIS)
ancillary costs related to prosthetic limbs such as residual limb socks and sheaths (typically 6 per year)
limbs external to osseointegrated implants; and
upper limb myoelectric prostheses where the participant is either a bi-lateral amputee or has contralateral overuse syndrome which prevents the use of body

powered prosthetics and where there is demonstrated commitment and success

using a training device.

Generally, the NDIS won’t fund:

repairs due to damage resulting from use of a limb outside of recommended use and care guidelines;
more than one prosthetic limb (i.e. a spare prosthetic limb), unless reasonable and necessary to do so having regard to any vocational demands or other relevant

considerations (for a second limb for recreational use, recreational supports); and

for K4 level, microprocessor joint and computerised components unless reasonable and necessary to do so having regard to the functional benefits

expected to be achieved and whether such benefits can be achieved in other

ways.

Limbs will be replaced at typical replacement intervals unless more frequent replacement is warranted. Typical replacement periods are 3 years for most adults and, as needed, due to growth for children under 18 years of age (typically no more than bi-annually).

The NDIA may consider whether more frequent replacement is warranted on the basis of the participant’s needs.

Personal care supports

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Personal care supports relate to assistance with daily personal activities including assistance with, or supervision of, personal tasks of daily life. For example:

personal hygiene, including showering, bathing, oral hygiene, dressing and grooming;
toileting, bladder and bowel management and menstrual care;
eating and drinking;
attending appointments;
use of aids and appliances, hearing and communication devices;
mobility and transferring. For example, moving in and out of bed and on or off the toilet; or
application of splints, basic first aid due to injuries sustained as a result of a participant’s disability.

Personal care supports may be required across a variety of settings. For example, a participant living alone in their own home, living with family or other people, when undertaking social, recreational, education or employment activities or during holidays away from home.

When personal care supports are being considered, the NDIA will have regard to the degree to which these supports:

maximise the independence and functional skills of the participant;
are appropriate to the participant’s age and circumstances; and
whether alternative arrangements or supports could meet a participant’s needs in a less intrusive manner. For example, aids and equipment may enable a

participant to complete tasks for themselves or the provision of training may

increase the participant’s independence in the tasks.

Before including any personal care support in a participant’s plan, the NDIA must, amongst other matters, be satisfied that the support will assist the participant to pursue their goals. objectives and aspirations (section 34(1)(a)).

Personal care supports are likely to be supports which assist a participant to pursue a number of different goals, rather than being related to a specific goal.

Personal care supports for children are not intended to replace the usual care and supervision provided, or paid for, by a parent. However, the NDIS may fund personal care supports for children with complex needs where the level of support needed is beyond the level usually required for children of the same age.

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A participant’s request that intimate personal care not be provided by family members or friends should always be respected and taken into account when determining the level of assistance that should be funded.

Supports to provide assistance with daily personal activities should generally be limited to a maximum of 6 hours per day. This level of support is based on:

bathing, dressing, toileting and grooming up to 2 hours per day – including bowel management, skin care, bladder management, menstrual care;
assistance with eating up to 2 hours per day which may include assistance with medication;
mobility including exercise, positioning, moving up to 1 hour per day; and
where toileting assistance alone is required, up to 1 hour a day. In some circumstances, the NDIA may decide to fund higher levels of personal care support. In considering whether a higher level of support is needed, the NDIA will give consideration to:
whether the participant has high care needs. For example, unstable seizure activity or respiratory support;
the weight (and other physical aspects) of the participant;
the medical condition of the participant, including any medication required;
whether the need for a higher level of support is of a temporary nature. For example, due to waiting for a suitable home modification, such as a bathroom

modification to be completed;

whether two people are required for transfers;
whether there are behavioural concerns which require more intensive assistance with personal care activities and there are no other options, for example

behavioural support intervention; and

whether additional time-limited funding is likely to reduce a participant’s longer term support costs by building their capacity to independently perform personal

care activities.

The NDIA will also consider whether assistive technology, home modifications or other supports can be used to reduce the level of assistance with daily personal activities.

Sustaining informal supports

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The NDIA recognises informal support provided by family, friends and the community is vitally important to people with disabilities. Informal supports mean the family and friends who provide unpaid, active, disability-related support. The things informal supports do for and with participants is vital to participant wellbeing. The NDIA understands how important it is for informal supports to be able to keep supporting participants.

The NDIA considers how illness, ageing and other caring responsibilities can put the wellbeing of those providing informal supports at risk, and impacts their ability to continue providing care. Sustaining informal supports is an important part of meeting a participant’s needs.

The NDIA aims to increase the social and economic participation of people with disabilities within the context of their families and existing support networks. The NDIA will use the planning process to build an understanding of a participant’s overall support needs. Information about the informal supports provided will be identified and recorded. The NDIA will consider how this informal support can be sustained and also take into account what level of support it is reasonable to expect others to provide.

6.1 Can family members be paid to deliver NDIS supports?

NDIS supports are the supports funded in a participant’s plan which meet all the NDIS funding criteria. They don’t replace the informal supports reasonably provided by family and friends.

The NDIS generally does not pay family members to provide NDIS supports.

This is because evidence says funding a family member to replace paid supports can impact relationships, health and wellbeing of participants and their families.

This may:

limit a participant’s choice and control in the delivery of their supports
stop family members who provide paid supports from taking a break
create a conflict of interest. That’s why the NDIS won’t pay family members to deliver NDIS supports unless there are exceptional circumstances.

In considering whether to fund a family member to deliver NDIS supports, the NDIA will think about if:

there’s a risk of harm or neglect to the participant
there are cultural or religious reasons for funding family members to provide support

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there are significant risks to the participant’s privacy or dignity that can only be managed by paying a family member to provide these supports
all other options to find a suitable provider for supports including personal care and community access have been exhausted.

The NDIA will work with the participant and their family to identify suitable support providers. The individual circumstances for each participant will be considered, including any wishes they’ve expressed.

If the funding for supports under a participant’s plan is managed by the NDIA, a family member can only be paid to provide NDIS supports if they are a registered provider.

If the NDIA approves a family member to be paid to deliver NDIS supports, that person stops being considered an informal support.

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However, the NDIS may fund day-to-day living costs that are incurred by a participant solely and directly as a result of their disability support needs (rule 5.2(a) of the Supports for Participants Rules).

These additional living costs (i.e. those incurred by a participant solely and directly as a result of their disability support needs) may be funded under the NDIS if they are NDIS supports that meet the NDIS funding criteria.

Before including any transport support in a participant’s plan, the NDIA must also be satisfied that the support will assist the participant to pursue their goals, objectives and aspirations.

In addition, the NDIA must take into account what is reasonable for families, carers, informal networks and the community to provide. In relation to transport, this consideration may be different for participants who are children as compared to participants who are adults.

When considering whether a proposed transport support represents value for money, the NDIA will compare the costs of transport to the overall costs of alternative supports which may provide a similar level of independence or reduce a participant’s future needs for supports. For example, vehicle modifications and driving supports.

The NDIA may also consider what options may be available for the participant in their local community, or whether funding other supports has the potential to build a participant’s capacity to engage in local community activities.

Transport should only be funded where it has been determined to be reasonable and necessary, where it is an additional cost incurred solely and directly as a result of a participant’s disability support needs and, where ancillary to another funded support, it is a cost which the participant would not otherwise incur.

It does not follow, merely because transport is ancillary to a funded support, that it should be funded. The circumstances in which transport may be funded are strictly limited. Transport must:

relate to an NDIS support that has been determined to be reasonable and necessary; and
be an additional cost and incurred solely and directly as a result of disability support needs; and
where transport is ancillary to another funded support, it must be a cost which the participant would not otherwise incur (see JQJT and NDIA [2016] AATA 478 at [35]).

The NDIS won’t be responsible for:

ensuring that public transport options are accessible to a person with disability, including through the funding of concessions to people with disability to use public transport;

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compliance of transport providers and operators with laws dealing with discrimination on the basis of disability, including the Disability Standards for Accessible Public Transport 2002;
transport infrastructure, including road and footpath infrastructure, where this is a part of a universal service obligation or reasonable adjustment (including managing disability parking and related initiatives); or
support to compensate for the lack of a public transport system. See also Supports that are not NDIS supports?

7.1 Transport and considerations relating to children

Parents of NDIS participants aged under 18 years have a responsibility to meet their child’s daily transportation requirements. However, some children may require additional assistance, for example children who cannot use public transport or their parent’s vehicle, even if modified, due to their disability.

The NDIS will generally not fund day-to day-living costs associated with caring for children, including transport costs, as parents are expected to meet a child’s everyday transport requirements (see JQJT and NDIA [2016] AATA 478 at [35]).

When considering whether transport meets the NDIS funding criteria for a child, the NDIA must take into account what is reasonable for families, carers, informal networks and the community to provide (section 34(1)(e)).

What is reasonable for a family to provide in respect of a particular support should be considered in light of the support they have to provide the child generally because of his or her disability (see JQJT and NDIA [2016] AATA 478 [39]).

When considering whether funding for transport for a participant who is a child takes account of what it is reasonable to expect families, carers, informal networks and the community to provide, the NDIA will consider:

that it is normal for parents to provide substantial care and support for children;
whether, because of the child’s disability, the child’s care needs are substantially greater than those of other children of a similar age;
the extent of any risks to the wellbeing of the participant’s family members or carer or carers; and
whether the funding or provision of the support would improve the child’s capacity or future capacity or would reduce any risk to the child’s wellbeing (rule 3.4(a) of the Supports for Participants Rules).

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The NDIS will be responsible for supports that a student requires that are associated with the functional impact of the student’s disability on their daily living activities, such as transport to and from school (rule 7.13 of the Supports for Participants Rules).

When considering if specialist transport to and from school for a participant who is a child meets the NDIS funding criteria, the NDIA will consider:

if any other transport option is available and appropriate; and
whether providing the supports would substitute for parental responsibility. 7.2 Transport and considerations relating to adults

A participant will generally be able to access funding through the NDIS for transport assistance if the participant cannot use public transport without substantial difficulty due to their disability.

The funding the NDIS provides will take into account any relevant taxi subsidy schemes available to the participant and does not cover transport assistance for carers or family members to transport the participant for everyday commitments.

There are generally three levels of funding support for transport. The levels are used to provide a transport budget for participants. In exceptional circumstances, participants may receive higher funding if the participant has either general or funded supports in their plan that enable their participation in employment.

Level 1

the NDIS may provide $1,784 per year for participants who are not working, studying or attending day programs but are seeking to enhance their community access.

Level 2

the NDIS may provide $2,676 per year for participants who are currently working or studying part-time (up to 15 hours per week), participating in day programs and for other social, recreational, or leisure activities.

Level 3

the NDIS may provide $3,456 per year for participants who are currently working, looking for work, or studying, at least 15 hours per week, and are unable to use public transport because of their disability.

When considering whether funding for transport for a participant who is an adult takes account of what it is reasonable to expect families, carers, informal networks and the community to provide, the NDIA will consider:

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e the extent of any risks to the wellbeing of the participant arising from the participant’s reliance on the support of family members, carers, informal networks and the community; and

e the suitability of family members, carers, informal networks and the community to provide the supports that the participant requires, include such factors as:

the age and capacity of the participant’s family members and carers, including the extent to which family and community supports are available to sustain them in their caring role;
the intensity and type of support that is required and whether it is age and gender appropriate for a particular family member or carer to be providing that care; and
the extent of any risks to the long-term wellbeing of any of the family members or carers (for example, a child should not be expected to provide care for their parents, siblings or other relatives or be required to limit their educational opportunities); and

e the extent to which informal supports contribute to or reduce a participant’s level of independence and other outcomes;

e for all participants — the desirability of supporting and developing the potential contributions of informal supports and networks within their communities.

Version control

Version Amended by Brief Description of Change Status

2.0 fees |Updates to align to 2024 APPROVED | 2024-11-19

legislation. Replaced broken and outdated links.

3.0 ‘Teese §=6| Class 1 Approval APPROVED | 2025-12-10

Updated to explain that the NDIA will not consider funding a family member or other informal support to deliver NDIS supports unless there are specific exceptional circumstances.

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Reasonable and Necessary Supports

Quick summary: there are new laws about what we can and can’t fund under the NDIS. All NDIS supports need to meet each of the reasonable and necessary criteria before we can fund them in your plan. For example, supports need to relate to your disability support needs, be value for money, and effective and beneficial. We also need to make sure each support is an NDIS support. This means it’s a service, item, or equipment that can be funded by the NDIS. Examples of NDIS supports include support with personal daily living tasks and accessing the community, therapeutic supports, and personal mobility equipment.

Note:

When we say ‘your plan’ we mean your NDIS plan.
When we say ‘disability support needs’, we mean supports you need because of your disability.
If you’re aged between 9 and 65 years and are looking for information about community connections, go to Our Guideline – Community Connections.
If your child is younger than 9 and you’re looking for information about early connections, go to Our Guideline – Early Connections.
As part of the recent changes to the NDIS laws we are moving towards a new framework for planning. Rules need to be developed for this new framework. We’re working on how and when we’ll introduce these changes.

Until then, the information in this Our Guideline is about our ‘old framework’ for planning, which include the legislative changes that become operational when the law commences. All current plans will be known as ‘old framework’ plans, and we will continue to develop these until all participants have transitioned to the new framework.

What’s on this page?

This page covers:

What are reasonable and necessary supports?
How do we make decisions about what is reasonable and necessary?

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How do we include the reasonable and necessary supports in your plan?
What if you don’t agree with our decision? You may also be interested in:
Mainstream supports
Creating your plan
Changing your plan
Reviewing our decisions
Would we fund it? What are reasonable and necessary supports?

The National Disability Insurance Scheme (NDIS) was set up as a world first approach to disability support. It puts people with disability at the centre of decision-making, through the principles of reasonable and necessary supports and individual choice and control.

We provide funding for reasonable and necessary supports to people with a permanent and significant disability or developmental delay.

Reasonable and necessary supports are the supports we fund in your plan to meet your disability needs. All NDIS supports we fund in your plan need to meet the criteria set out in law for the NDIS of what we can and can’t fund.1 For information on what is an NDIS support and what is not, go to NDIS support.

NDIS supports should complement, not replace, other supports available to you. That’s why we consider:

the things you’re able to do for yourself
support you have from others in your network, including family members, relatives, friends, local community services and mainstream government services.

Once we’ve considered your situation, we need to follow the rules determined under the law for the NDIS in our planning decisions.2

This guideline explains how we decide what reasonable and necessary supports must consider, which we’ll explain in detail.

When creating your plan, we also follow these principles.

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We also have Would we fund it guides. They have examples of how we decide if we fund different types of supports.

How do we make decisions about what is reasonable and necessary?

When we create your plan with you, we’ll discuss your disability support needs.3 We want to help you pursue your goals, increase your independence, and help you work, study and join social activities.

The NDIS will only fund a support if it meets all the reasonable and necessary criteria. We also won’t fund a support if the law says we can’t fund it. We explain the reasonable and necessary criteria in more detail further down.

What supports can you get outside the NDIS?

Before we decide what reasonable and necessary supports to fund in your plan, we’ll first discuss what other supports may be available outside the NDIS. This is an important information-gathering step. For example, there may be mainstream, community and informal supports that suit you.

There are many supports you can get outside the NDIS. Other government and community services provide supports to all Australians, including people with disability. And your friends, family, and other people you know can often be your best supports.

To find out more about supports you can get outside the NDIS, go to Creating your plan.

It’s important we gather this information and help you access these services before we consider what reasonable and necessary supports we can fund. That way, we can help make sure you’re able to access mainstream, community, and informal supports wherever possible.

For more information, go to Mainstream and community supports.

What types of supports may be included in your plan?

Your plan may include ‘general supports’ and ‘reasonable and necessary supports’.4

General supports

General supports are the coordination, strategic or referral services and activities we provide or arrange to be provided, for you.5 They’re how we help you develop your plan and connect with support and activities in your community. This includes the support you get from your early childhood coordinator or local area coordinator to connect to mainstream, community,

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and informal supports. You don’t need to pay for your general supports from your plan as the NDIS pays for them directly

Reasonable and necessary supports

Reasonable and necessary supports are the NDIS supports we fund or provide in your plan to meet your disability support needs.6 NDIS supports are the services, items, and equipment we can fund or provide under the NDIS.7 For information on what supports are considered NDIS supports, go to NDIS supports.

The laws for the NDIS tell us what we can fund in your plan.8 All NDIS supports we fund in a plan need to meet all the criteria set out in these laws. We call these the NDIS funding criteria.

We’ll check your support types and amounts of support will complement each other to help you fulfil an ordinary life.9 Any funded supports must be an NDIS support10 that is right for you.
It must not be a type of support the law says we can’t fund or provide.11 Each NDIS support must be reasonable and necessary individually, but the supports must also be reasonable and necessary when considered as a package of supports.

Does the support meet the reasonable and necessary criteria?

We can only include NDIS supports in your plan if they meet all the reasonable and necessary criteria.12

This means that before we can include an NDIS support in your plan, we need to be satisfied it meets all the following criteria:

The support is related to your disability13.
The support will help you to pursue your goals in your plan.14
The support will help you to undertake activities, to facilitate your social and economic participation.15 This means the support will help you join in social outings, recreation, work and study by reducing the disability-related barriers that prevent you from participating.
The support represents value for money. This means we need to consider the costs and benefits of the support, as well as the costs and benefits of alternative supports.16
The support will be, or is likely to be, effective and beneficial for you, having regard to current good practice.17 This means we consider if there is evidence the support

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works for someone with similar disability support needs. We won’t need an expert report for every support, as we can often rely on other information or evidence. For example, we may have information already about whether the support is widely accepted to suit someone with your disability support needs.18 We also consider your lived experience.

The funding of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide.19 This means we need to consider what support is reasonable for your family, friends and community to provide.
The support is an NDIS support for you.20 The law for the NDIS sets out things that we need to consider when we apply the reasonable and necessary criteria.21

For example, funding a vehicle modification may reduce your need for other supports. By funding a vehicle modification in your plan, we’ll look at whether you need less support to access the community.

If the vehicle modification will reduce your support needs, we might reduce the amount of support we fund for you to access the community. This is because the same amount of support might not be reasonable and necessary when the whole package of supports is considered.

Is the support related to your disability?

We’ll only fund a support if it relates to your disability.22 This means there must be a direct link between your disability support needs and the NDIS supports we fund.

We consider if the support addresses your disability support needs. Your disability support needs are those that come from, or are caused by, your disability.

For example, we don’t fund things like flights to go on a holiday or a gym membership to get fit.

This is because you’re unlikely to need these supports because of your disability support needs. They are things that all people, with or without disability, might want or need.

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Example

Alan uses a wheelchair and needs some changes to their house. They need to be able to independently use their bathroom and kitchen. They also want to set up an outdoor entertainment area for when their friends visit.

We may be able to fund home modifications so Alan can access areas of their home, including their bathroom and kitchen. They need the home modification because they can’t access those areas due to their disability.

Alan will need to pay for the outdoor entertainment area, as it’s not related to their disability.

Does the support help you pursue your goals?

We need to be satisfied that the support will help you pursue the goals, objectives and aspirations in your plan.23 This helps us determine if the support is necessary.24

While we only fund supports that help you pursue your goals, objectives and aspirations, we understand that different people express themselves in different ways.

Reasonable and necessary supports should help you pursue your goals,25 but you don’t need a specific goal for every support in your plan. When we decide if a support will help you pursue your goals, we consider your whole situation.

We look at how a support will address your disability support needs, and the disability specific barriers that prevent you from pursuing your goals.

A support that addresses your disability support needs is most likely to help you pursue your goals, objectives and aspirations in your plan.

This means that if your goal is to ‘live independently’, we may fund home modifications that address your disability support needs. However, we won’t fund supports that aren’t NDIS supports, including day-to day-living costs like rent or utilities. These costs aren’t incurred solely and directly because of your disability support needs, so they don’t meet other funding criteria.26

Also, choosing a different goal ‘to have a more accessible home’ won’t change the supports we could fund in your plan.

Achieving goals usually takes many different kinds of supports. NDIS supports will most likely be just one kind of support that helps you work toward your goals.

Learn more about setting your goals in Creating Your Plan and the Setting Goals fact sheet.

Example

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Morgan is ready to look for work and they have a goal in their plan to get a job. They’ve built up their skills and know the type of work they want to do. Disability Employment Services are helping Morgan find work, so we can’t fund this support for Morgan.

However, because of their disability, Morgan will need personal care supports to help them get ready for work in the morning. We will consider:

how Morgan’s disability support needs relate to their goals
if funding NDIS supports that address these disability support needs will help Morgan pursue their goals.

Morgan’s planner determines the personal care supports meet this criteria. The supports that address their personal care needs will help Morgan to pursue their employment goals.

Morgan’s planner then needs to look at if the support meets the other NDIS funding criteria. In this case Morgan does get personal care in their plan. Morgan doesn’t have a job yet but will need personal care support to help them get ready to look for work. Morgan will also be able to use these supports when they get a job.

We don’t fund all the supports that relate to Morgan’s employment goals. We only fund the supports we consider are reasonable and necessary – that is, when they meet all the NDIS funding criteria.

Does the support help you do activities that will help your social and economic participation?

We need to be satisfied that the support will help you to do activities, which make it easier for you to participate socially and economically.27

Social participation means doing things you enjoy, like going out with friends, playing sport or going out into the community. It also means doing the things you need to do, like going to school or medical appointments.

Economic participation usually means being involved in things that help you work towards getting and keeping a job. This might be things like volunteering, study, learning new skills or trying work experience. Research tells us that work can lead to health benefits and improve our quality of life. Learn more about the Health Benefits of Good Work.

Social and economic participation are important to most people. They’re critical to living an ordinary life.

To work out if a support meets this criteria, we look at the purpose of the support and how it will help you.

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We fund reasonable and necessary supports that reduce the barriers that prevent you from doing activities. This will help you increase your social and economic participation.

Some supports help economic and social participation directly. There are lots of supports we can fund to directly help with social and economic participation. Learn more about Social and recreation supports and Work and study supports.

Other supports help you do activities like self-care, which indirectly help your economic and social participation.

Example

Sue is going to university next year. She has a vision impairment and has been working with her Guide Dog Mobility Instructor to decide if a Dog Guide is right for her. A Dog Guide can help her leave her home safely and independently, and travel to and from university.

A Dog Guide could also help her go out with friends and join in other community activities. As long as it meets the other funding criteria, we could fund a Dog Guide for Sue. It will help her with activities of daily living.

In Sue’s case, a Dog Guide will also increase her social and economic participation. Having a Dog Guide will help her get to her university independently where she studies and also has lots of friends.

Is the support value for money?

All supports we fund under the NDIS need to be value for money. This means the cost of the support is reasonable when we consider the benefits of the support and the cost of other supports.

Making sure your supports are value for money is one of the ways we keep the NDIS financially sustainable. This means we make careful decisions about funding so that we make sure the NDIS exists for future generations. It’s also one of our principles.28

When we decide if the support is value for money, we consider:

if other supports would achieve the same result at a substantially lower cost.29 This means there should be a real or material difference in cost
if there’s evidence that the support will substantially improve your life stage outcomes and benefit you in the long term30
if the support will likely reduce the cost of other supports over time31
how the cost compares to other supports of the same kind in your area32

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if the support will make you more independent and mean you won’t need as many supports in the future. For example, in some situations home modifications may reduce the need for support in your home.

When we consider the likely cost of supports, we consider the cost over the long term. We consider if the support will help you achieve milestones at different ages or stages of your life and have long term benefits.

For example, some supports like home modifications may be expensive now, compared to other supports. But getting these supports now may mean you need much less support in a few years, or later in life. Or it may delay the need for other more costly supports.33

When determining if the cost of the support is value for money, we consider:

the prices for NDIS supports in the NDIS Pricing Arrangements and Price Limits
quotes for specific or high risk supports. It’s important we consider the cost of the support. This will be the level of funding we include in your plan, if we decide the support is reasonable and necessary.

When we fund equipment or modifications, we also need to consider:34

how the cost of buying the equipment or modifications compares to the cost of renting them
if it’s appropriate to fund the equipment or modifications you want, based on your situation and any expected changes in technology.

Learn more about how we consider value for money when we fund assistive technology, home modifications and vehicle modifications.

Example

Elias needs a shower commode.

He got an assessment and sent us a quote for one that will suit his needs. As part of the process to work out if this meets the reasonable and necessary criteria, his planner considers other similar shower commodes.

There’s another commode that’s $5,000 cheaper than the one Elias has asked for. It won’t meet Elias’ needs, as it doesn’t provide enough support for his back. That means, it won’t achieve the same result as the one Elias has asked for.

Elias’s planner finds a commode that’s $1,000 cheaper. The planner contacts Elias’s occupational therapist who confirms this commode will meet Elias’ needs.

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Elias’ planner decides to fund the commode that’s $1,000 cheaper. This has the same features and will have the same benefits for Elias at a substantially lower cost.

Is the support effective and beneficial?

We need to be satisfied that the support will be, or is likely to be, effective and beneficial, when we consider current good practice.

We need to work out if the support is likely to be both:

effective – it will do what you need it to do35
beneficial – the support will help you do things you can’t otherwise do and meets your support needs.36

It can also be effective and beneficial if it will help you maintain your current level of functioning. That is, it will help you keep doing the things you can currently do. And it’ll help you maintain your work, study and social life as much as you can.37

When we decide if a support is effective and beneficial, we look at what is current good practice. This means we look at if there is evidence that the support works for someone with similar disability support needs to you. We won’t need an expert opinion or report for every support, because we can often rely on other evidence.

For example:

We may have information already about whether the support is widely accepted to suit someone with your disability support needs.38 For example, we could rely on academic research and other literature. This could include university studies on therapies that have been published and referred in academic journals, evidence based practice resources, or clinical practice guidelines.
If you or other participants have used the support before, we can consider your experience and the experience of your family members and carers.39

We may consider things we’ve learnt from other participants in the NDIS with similar support needs to you.40 We know you’re the expert in your own life, and we use your own experience as much as we can.

For example, we’ll talk to you about any supports that have helped you do things you can’t otherwise do. Or some supports may have helped maintain your ability to be as independent as possible.

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If it’s a new support such as new assistive technology, we might fund a trial. This is so we can learn from your experience of using the support to check if it’s likely to do what you need it to.

Your evidence can be particularly useful when it’s consistent with other evidence, or if we don’t have expert evidence.

We’ll look at the opinions held by the majority of experts and what they generally agree on.41 Sometimes we’ll have to seek expert opinion or report to make a decision.42

Example

Vivek is 12 and has a goal to improve his communication skills. He and his family want him to improve his social skills with the kids in his class.

When he was younger, Vivek’s family tried speech therapy, and believe it really helped him improve his communication. His family told his planner about how it helped Vivek learn how to respond to different social settings.

Vivek’s speech therapist also believes it could work well for him now and help him interact with his classmates.

When deciding if the therapy is effective and beneficial, Vivek’s planner will consider:

how speech therapy has helped Vivek in the past, including first-hand information from Vivek, his family members, and carers
the reports or assessments from his speech therapist on the effectiveness and benefits of speech therapy for Vivek
other information or expert evidence about the effectiveness and benefits of speech therapy, including for children of the same age, with the same disability and functional capacity.

Based on this information and evidence, Vivek’s planner decides the speech therapy is effective and beneficial. If it meets the other funding criteria, we will be able to fund speech therapy in Vivek’s plan.

Is the support something we would reasonably expect your informal supports, like family or friends, to provide?

We need to be satisfied that funding the support takes into account what is reasonable to expect families, carers, informal networks and the community to provide.43

To make sure we understand how disability supports might work for you, we consider:

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the things you’re able to do for yourself
any support you have from others in your network – including family members, relatives, friends and local community services.

When we fund supports under the NDIS, we need to consider if it’s reasonable to expect your informal supports to provide that support. We can’t fund supports that an ordinary person would think is reasonable to expect friends, family or the community to provide for you.44

Informal supports are the help and support you get from friends, family and the community. They are called ‘informal’ because you don’t pay for them, and they’re not part of a formal agreement. They’re the usual things friends and family do for us, and with us.

Most of us get some kind of help and support from friends and family. In our society, we expect that friends, family and our community will support each other and help each other out when they need it.

A good example is families who have young children. In our community, we expect families will provide most of the support a young child needs.45 They will care for the child, make sure they’re safe and drive them around places.

Grandparents, uncles and aunties often have a role to play in supporting young children as well. Neighbours and friends might also help care for the child.

As a child gets older, our society’s expectations of the role of the family and community in caring for the child changes. For example, we expect schools to provide a child’s learning needs.

We also usually expect the role of family in providing personal care for a child would reduce as they get older and develop new skills and independence. But families are usually still responsible for things like food, emotional support, decision-making and providing a safe home.

It’s a similar idea for adults. Our society expects that adults – like family, friends and neighbours – will provide some support to each other. This might be things like taking a friend with you to the football game or providing emotional support if someone is upset.

NDIS supports won’t ever replace the support people like your friends and family provide to you. This support is given freely because people care and is often quite different to supports bought with NDIS funding.

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You have a special bond with your friends and family that’s different from your relationship with paid carers. And there are potential risks and problems for you if your friends and families become your paid carers.

We also must consider the benefits you may get from your informal supports. For example, your family and friends may be better at helping you meet other people, or helping to build your social skills, than paid supports.

We consider if we can help these relationships so that you get the support you need.46 For example, we may be able to fund training for your informal supports, so they can help you build your skills.

We also think about the capacity of your informal supports to continue caring for you, for example if they’re ageing or sick.

There are different things the law for the NDIS says we need to consider for adults and children.

If you’re under 18, we consider what support is reasonable to expect parents to provide at your age. It’s normal for parents to provide substantial care and support for children.47 We consider that it’s usual for parents to provide almost all the care and support that young children need.

For example, it’s reasonable to expect parents or other family members to provide transport to and from their child’s after-school activities. Of course, the amount of care and support for a child without a disability would typically reduce as they get older.

For children under 18, we consider:

if your needs are substantially greater because of your disability, compared to other children the same age.48 This means you need much more disability support
any risks to the wellbeing of people providing informal support to you49
if including funding for the support will help build your skills and capacity in the future or reduce any risks to you.50

For example, we consider any health, safety or other impacts resulting from what’s involved in meeting your disability support needs.

If you’re over 18, we consider:

if there are any risks to you or your informal supports if you rely on them to provide the support you need51

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how much your informal supports would help improve or reduce your independence and other outcomes.52

We also consider the suitability of informal supports to provide the supports you need,53 including:

how old your carers are and their capacity to provide the support54
if other family members and the community can help your informal supports in their caring role55
the intensity and type of support you need, and if it’s appropriate for your informal supports to provide this, based on their age and gender56
any long-term risks to the wellbeing of your informal supports.57 When we consider the risks for people over 18, we consider if the supports are sustainable for your informal supports. We consider the health, safety and other impacts on family and carers in the long term.

For example, we wouldn’t expect a child to have their schooling affected because they need to provide care. We also wouldn’t expect an elderly parent to be responsible for physical activities, if it may result in injury.58

We generally don’t fund family members to provide supports funded under the NDIS. There are very limited situations where we can consider this.

Learn more about Sustaining informal supports.

Example 1

Simon is getting his first plan. For the last 15 years, Simon and his wife Jan’s preference was that Jan provide all the physical support he needs at home, such as toileting, showering and dressing.

But as Jan is getting older, it’s not safe for her to do this. It’s becoming risky for both Jan and Simon to keep providing this support informally.

Jan and Simon think it might be best for someone else to provide the personal care support that Simon needs. Their children have moved out of home, and it’s not reasonable to expect them to help Simon with personal care.

Based on this information and other evidence, Simon’s planner decides that the personal care support meets this criteria. It takes into account what is reasonable for his family and

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others to provide. If the personal care support meets the other funding criteria, we may fund the personal care support for Simon.

Simon and Jan still prefer Jan to do the other support Simon needs though, such as helping Simon eat his meals. At this time, we wouldn’t fund a support worker in Simon’s plan to help him eat his meals. It’s reasonable to expect Jan to help Simon with this, because it’s what they want to do and it’s not a safety risk for Jan or Simon.

Example 2

Qing is 14 and wants to join a local chess club. Like most 14-year-olds in this situation, she needs someone to drop her off and pick her up from the mid-week and weekend gatherings.

But unlike most 14-year-olds, she needs someone to help her get dressed before she can go to the chess club. Her parents have been doing this, but as Qing is getting older, she no longer wants her family to help her get dressed.

It’s reasonable to expect her family or other informal supports to drop Qing to and from the match and training sessions. So, we wouldn’t fund transport in Qing’s plan.

But at age 14, it’s not reasonable to expect her family to help her get dressed.

Based on this information and other evidence, Qing’s planner finds that the personal care support considers what is reasonable for family and others to provide. If it meets the other funding criteria, we may fund personal care support in her plan.

Is the support an NDIS support for you?

A support will only be an NDIS support for you if either:

the Rules say that the support is a NDIS support for everyone, or
the Rules say that the support is only for a specific group of people, and you are part of that group.59

NDIS supports are the services, items, and equipment that can be funded under the NDIS.

Remember, we can only fund a support if it is:

an NDIS support for you
necessary for your disability.60 Go to NDIS supports to find more information on what is and isn’t an NDIS support.

Example

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Max has a spinal cord injury and uses a manual wheelchair to move around. His home has a carport at the front. The path from the carport to the front door is too narrow for his wheelchair and the uneven ground makes it unsafe for him to use his wheelchair on his own.

In Max’s planning meeting, he requests the installation of a pathway from the carport to the front door to enable safe access to his home.

Max’s planner checks that the home modifications are an NDIS support.

Because Max needs a pathway to access his house safely, the planner decides that the home modifications are an NDIS support.

What types of supports can’t be funded or provided under the NDIS?

Under the law for the NDIS, there are things we can’t fund or provide.61 We can’t fund goods and services that are not NDIS supports.62 For example, we can’t fund or provide supports that:

consist of sexual services and sex work, alcohol, or drugs63
are not legal64
are income replacement65
are likely to cause harm to you, or pose a risk to other people66
relate to a ‘day-to-day living cost’, like groceries, rent or utilities67
duplicate other supports provided by the NDIS under alternative funding68
include tickets to events or the cost of going on a holiday.69 For more information on what we can’t fund, go to NDIS supports.

What else do you need to know about deciding if supports meet the NDIS funding criteria?

From our experience, we learned there are some common misunderstandings about how we work out what supports meet the NDIS funding criteria.

Why don’t we always fund what your health professionals recommend?

Although we take expert opinions into account, we can’t and don’t always fund everything your health professional might recommend. This is because every support we fund needs to meet all the NDIS funding criteria.

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For example, your therapist might recommend a piece of equipment on the basis that it will be ‘effective and beneficial’ for you. But if there is something cheaper that will achieve the same outcome, we won’t be able to fund what the therapist recommended.

This is because it may not be value for money. We may be able to fund the cheaper option instead if it meets all the NDIS funding criteria.

Why don’t we fund the same supports as your last plan?

We might fund different supports in your next plan. This is because we will fund supports in your plan based on how we use the NDIS funding criteria at that point in time.

Your needs and situation will most likely change over time. This means it’s likely your NDIS supports and needs for those supports will change over time.

For example, we may have funded supports to help you build your skills in a particular area. Once you have built those skills, you won’t need funding for that anymore. So, we probably won’t include that funding for those supports in your next plan.

Supports to build your skills may have met the NDIS funding criteria before, but the same supports might not meet the criteria in the future.

Or your disability support needs might increase or decrease over time. This may mean we consider funding more or less supports as a result.

What else do we consider when deciding what to include in your plan?

As far as possible, we have to act according to principles set out in the law for the NDIS.70 These principles guide us when we make decisions about what we can fund.

These principles don’t override or replace the NDIS funding criteria under the law for the NDIS. They can help us apply the funding criteria, by giving us more guidance when we decide what supports to approve in your plan.

The principles include the following:

You have the same right as other Australians to realise your potential for physical, social, emotional, and intellectual development.71
You should be supported to take part in and contribute to social and economic life.72
You should be supported to make choices about planning and how your supports will be delivered. This includes taking reasonable risks, so you can pursue your goals.73
You have the same right as other Australians to decide your own best interests. You have the right to be an equal partner in decisions that affect your life.74

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Your privacy and dignity should be respected.75
We must make sure the NDIS is financially sustainable.76 The principles also tell us that the reasonable and necessary supports we fund should:77
support you to pursue your goals and maximise your independence
support you to live independently and to be included in the community as a fully participating citizen
develop and support your capacity to do things that help you participate in the community and employment.

Just because a support helps you do these things doesn’t mean we’ll fund it in your plan. All supports we fund need to meet all the NDIS funding criteria.

We consider these principles set out in the law for the NDIS, along with the principles we follow to create your plan.

How do we think about an ordinary life when deciding what supports to include in your plan?

To help guide us in our decision-making about reasonable and necessary supports, we took advice from the NDIS Independent Advisory Council (The Council).

The Council represents people with disability and carers, bringing their own lived experience and expertise of disability. They give us advice on how the NDIS should work.

The Council advised us that all Australians, including people with disability, should have an ‘ordinary life’. They also told us we should think about the idea of an ordinary life when we apply our principles and use the NDIS funding criteria.

An ordinary life is a life where you have the same opportunities as people without a disability. An ordinary life is one that is typical or usual for everyone in modern day Australia. It’s a life where you can pursue your potential and participate in society on an equal basis with others.

An ordinary life will be different for different people. We are all different and come from different cultures and backgrounds. We each have our own values, experiences, beliefs, and goals.

But there are some common things that can improve the quality of our lives and help us participate equally. These are the things, such as the following, that make up an ordinary life:

Positive relationships with families and informal support networks.

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Individual autonomy. This means being free and independent, and having the same opportunities as people without disability.
Active involvement in decision-making including the ability to make meaningful decisions, and exercise choice and control.
Using your strengths in ways that provide a challenge and enjoyment.
A sense of belonging to our families, friendship networks, communities, workplaces and society.
Active involvement and contribution to society and your community. An ‘ordinary life’ in the context of the NDIS involves supporting you to:
have and maintain good relationships
belong and participate in your community
be involved in making choices about your own life. One way we can help you have an ordinary life is to support you to access mainstream, community, or informal supports wherever possible. These are the usual supports that everyone in the community uses.

When we fund reasonable and necessary supports under the NDIS, we need to make sure they meet the NDIS funding criteria.

When we apply the NDIS funding criteria and make decisions about reasonable and necessary supports, we’re guided by the principles in the law for the NDIS. We also consider how the supports will best help you to live an ordinary life.

What other services or systems are responsible for providing supports?

We have to be satisfied that the support is considered an NDIS support which means the support is something that can be funded or provided through the NDIS. Some supports are not considered an NDIS support because they’re more appropriately funded or provided through:

other service systems or supports offered by a person, agency or body (like a State or

Territory Statutory Scheme)

services or supports offered as part of a universal service obligation (like the health or education system)

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services or supports offered in line with reasonable adjustments required under discrimination laws (like your employer, or the health or education system).78

We won’t fund the support if the support should be provided by someone else, even if the other service system doesn’t actually provide it. We don’t make up for other organisations and systems that don’t provide the supports they should.

The list of goods and services that are not NDIS supports includes supports that are considered the responsibility of service systems such as:

Health
Mental health
Child protection and family support
Early childhood development
School education
Higher education and vocational education and training
Employment
Housing and community infrastructure
Transport
Justice. For more information, go to Mainstream and community supports.

How does the NDIS work with other government services?

We call supports provided by other government services, including those provided as part of a universal service obligation, ‘mainstream supports’. When we talk about mainstream supports, we mean supports available to everyone in your state or territory, or across Australia, regardless of if you have a disability.

This includes services provided by state and federal governments, related to health care, education and mental health services.

You have the same right as all Australians to access these services. There are certain things that mainstream services have to do to make their services accessible for people with disability. Using mainstream supports can also help you be part of your community, or to work or study.

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When we fund NDIS supports, we won’t fund supports that are not considered NDIS supports because the support is more appropriately funded or provided by a mainstream service or system, such as the education system or health system.79 Under the law for the NDIS, we can’t fund supports that should be provided by a mainstream service.

The Australian federal, state and territory governments agreed on responsibilities for funding different types of supports. The law for the NDIS has an outline of funding responsibilities and were developed with the agreement of each State and Territory.80

Learn more about who is responsible for the supports you need.

What is reasonable adjustment and why is it important?

People with a disability can sometimes face barriers that make it harder to do the same things as people who don’t have a disability. For example, it might be harder to find and keep a job. Or it might be harder to get in and around places, or to get the same services as other people.

It’s against the law to discriminate against people with a disability in many areas.81 This includes in employment, when providing goods and services, and when accessing public places.

This means organisations or people who are responsible for providing these services have to make what are called ‘reasonable adjustments’. They have to make sure people with a disability have equal access to the services they provide, as far as is reasonable.

They have to do reasonable things that will make their services equally available to everyone, whether or not you have a disability.

Reasonable adjustments do not mean they have to provide everything you need because of your disability. It means they have to do what’s reasonable to make sure you have equal access to employment, public spaces or services. This takes into account what they can afford to do and what is reasonable to expect them to provide in the circumstances.

When we decide what supports to include in your plan, we need to consider what should be provided through reasonable adjustments. Under the law for the NDIS, we can’t fund a support if it should be provided by someone else through reasonable adjustments.

What about in-kind supports?

We agreed that state and territory governments will keep providing some supports for a period of time. We call these ‘in-kind supports’.

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If we fund in-kind supports like specialist school transport or personal care in schools, you will need to use state or territory government providers for these supports. These supports are most efficiently and effectively provided by state and territory government providers.82 Learn more about Work and study supports.

For most other in-kind supports, you can choose your provider if you don’t want to use your in-kind provider anymore. We can let you choose another provider if we consider that the support isn’t most effectively and efficiently provided by the in-kind provider.

We usually let you choose another provider if:

another provider can give you the same support or level of support as the in-kind provider
the supports with the new provider still meet the NDIS funding criteria, including that they’re value for money compared to the in-kind support
there are no serious risks with changing providers. Learn more about in-kind supports.

How do we include the reasonable and necessary supports in your plan?

Once we’ve identified the supports, and decided they meet the NDIS funding criteria, we can include the description and funding for the NDIS support in your plan.

If the support doesn’t meet the NDIS funding criteria, we can’t include the support in your plan. We may consider if a differently described support meets the NDIS funding criteria instead.

When we approve your plan, we’ll also make sure all your supports are reasonable and necessary when considered as a package of supports.83

Sometimes you might not need any supports under the NDIS. For example, your informal supports may meet all your disability support needs. If so, we’ll approve a plan with no funded supports.

Learn more about how we create and approve your plan.

Learn more about using the funding in your plan.

Learn more about changing your plan.

What happens if we don’t include the supports you want?

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If we decide a support doesn’t meet the NDIS funding criteria, we can’t include the support in your plan. Also, if the amount of support you want doesn’t meet the criteria, we can’t include that amount in your plan.

But, we’re committed to our principles and helping you live an ordinary life. Even if we can’t fund a particular support, we may still be able to help.

If the support doesn’t meet the NDIS funding criteria, we can consider if a different support meets the NDIS funding criteria. We might be able to consider describing the support differently or funding a different type of support.

Or we may be able to connect you to mainstream or community supports that can help. Mainstream and community supports are available to everyone. They can be a good way to connect with your local community, learn new skills and gain independence.

There are lots of ways we might be able to help, so talk to us if you’re in this situation. We can do this at any time. We may be able to help before we approve your plan.

We’ll give you the reasons for our decision to approve your plan in writing.84 You can contact us if you’d like more detail about the reasons for our decision.

What happens if I want to replace a support for something else?

We fund NDIS supports in your plan. NDIS laws set out what we can and can’t fund.85

Sometimes, we may agree that you can spend your funding on supports that are not NDIS supports. We call this a ‘replacement support’. Go to Your plan for more information. For more information about replacement supports, go to NDIS supports.

What if you don’t agree with our decision?

If we decide the supports you requested don’t meet our NDIS funding criteria, we can’t include them in your plan.

If you’d like more details about the supports that make up your plan’s total funding amount, we can send this to you. You can contact us and ask for a Budget Breakdown.

We’ll give you written reasons why we made the decision. You can contact us if you’d like more detail about the reasons for our decision.

If you don’t agree with a decision we make about what supports to include in your plan, you can ask for an internal review of our decision.86

You’ll need to ask for an internal review within 3 months of getting your plan.87

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Learn more about reviewing our decisions.

Version Control Table

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New Operational Guideline

This guideline is about how the NDIA makes decisions about funding for reasonable and necessary supports. This guideline replaces parts of the Operational Guideline — Planning and the Practice Guide — Reasonable and

Necessary Supports.

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‘ATF - personal privacy -

4.0 Updated to align with 1 July APPROVED | 2022-06-28

legislation amendments.

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community connections plan.

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Updated to incorporate multiple updates required with new legislation for the NDIS Amendment (Getting the NDIS Back on Track No.1) Bill 2024.

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e remove the term ‘impairment’ and return to pre-legislation change language where we say we fund supports which relate to a participant’s disability support need

e add relevant footnotes.

Reference List

’NDIS Act s 34(1)(aa).

2 NDIS Act and delegated legislation made under the NDIS Act, especially NDIS (Supports for Participants) Rules and NDIS (Plan Management) Rules.

3 NDIS Act s 34 (1)(aa); NDIS (Supports for Participants) Rules r 5.1(b).

4 NDIS Act ss 33(2)(a), 33(2)(b), 33(5)(c), 34.

®> NDIS Act ss 13, 33(2)(a).

® NDIS Act s 34 (1).

™NDIS Acts 10.

8 NDIS Act and delegated legislation made under the NDIS Act, especially NDIS (Supports for Participants) Rules and NDIS (Plan Management) Rules.

° NDIS (Supports for Participants) Rules r 2.4; NDIS Act s 33(5)(c).

10 NDIS Act s 34(1)(f).

11 NDIS Act ss 33(5)(d), 35(1)(b); NDIS (Supports for Participants) Rules pt 5.

12 NDIS Act ss 33(5)(c), 34(1).

13 NDIS Act s 34(1)(aa); NDIS (Supports for Participants) Rules r 5.1(b).

14 NDIS Act s 34(1)(a).

15 NDIS Act s 34(1)(b).

16 NDIS Act s 34(1)(c).

’T NDIS Act s 34(1)(d).

18 NDIS (Supports for Participants) Rules r 3.2(a).

19 NDIS Act s 34(1)(e).

20 NDIS Act s 34(1)(f).

21 NDIS (Supports for Participants) Rules pts 3, 4.

22 NDIS (Supports for Participants) Rules r 5.1(b), NDIS Act s 34(1)(aa).

23 NDIS Act s 34(1)(a).

24 McGarrigle v National Disability Insurance Agency (2017) 252 FCR 121 at [91]. 25 NDIS Act s 34(1)(a).

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26 NDIS (Supports for Participants) Rules r 5.1(d). 27 NDIS Act s 34(1)(b). 28 NDIS Act ss 3(3)(b), 4(17). 29 NDIS (Supports for Participants) Rules r 3.1(a). 30 NDIS (Supports for Participants) Rules r 3.1(b). 31 NDIS (Supports for Participants) Rules r 3.1(c). 32 NDIS (Supports for Participants) Rules r 3.1(e). 33 NDIS (Supports for Participants) Rules r 3.1(c). 34 NDIS (Supports for Participants) Rules r 3.1(d). 35 McCutcheon and NDIA [2015] AATA 624 at [34]. 36 McCutcheon and NDIA [2015] AATA 624 at [34]. 37 McCutcheon and NDIA [2015] AATA 624. 38 NDIS (Supports for Participants) Rules r 3.2(a). 39 NDIS (Supports for Participants) Rules r 3.2(b). 40 NDIS (Supports for Participants) Rules r 3.2(c). 41 NDIS (Supports for Participants) Rules r 3.3. 42 NDIS (Supports for Participants) Rules r 3.3. 43 NDIS Act s 34(1)(e). 44 NDIS Act s 34(1)(e). 45 NDIS (Supports for Participants) Rules r 3.4(a)(i). 46 NDIS (Supports for Participants) Rules r 3.4(c). 47 NDIS (Supports for Participants) Rules r 3.4(a)(i). 48 NDIS (Supports for Participants) Rules r 3.4(a)(ii); JQJT and National Disability Insurance Agency [2016] AATA 478 at [39]. 49 NDIS (Supports for Participants) Rules r 3.4(a)(iii). 50 NDIS (Supports for Participants) Rules r 3.4(a)(iv). 51 NDIS (Supports for Participants) Rules rr 3.4(b)(i), (ii). 52 NDIS (Supports for Participants) Rules r 3.4(b)(iii). 53 NDIS (Supports for Participants) Rules r 3.4(b)(ii). 54 NDIS (Supports for Participants) Rules r 3.4(b)(ii). 55 NDIS (Supports for Participants) Rules r 3.4(b)(ii)(A). 56 NDIS (Supports for Participants) Rules r 3.4(b)(ii)(B). 57 NDIS (Supports for Participants) Rules r 3.4(b)(ii)(C). 58 NDIS (Supports for Participants) Rules r 3.4(b)(ii)(C). 59 NDIS Act s 34(1)(f). 60 NDIS (Supports for Participants) Rules r 5.1(b), NDIS Act s 34(1)(aa). 61 NDIS (Supports for Participants) Rules r 5. 62 NDIS Act s 10. 63 NDIS Act s 10. 64 NDIS Act s 10. 65 NDIS Act s 10. 66 NDIS Act s 10. 67 NDIS Act s 10. 68 NDIS Act ss 33(5)(d), 35(1)(a); NDIS (Supports for Participants) Rules r 5.1(c). 69 NDIS Act s 10. 70 NDIS Act ss 4, 31. 71 NDIS Act s 4(1). 72 NDIS Act s 4(2). 73 NDIS Act s 4(4). 74 NDIS Act s 4(8).

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75 NDIS Act s 4(10). 76 NDIS Act s 4(17). 77 NDIS Act s 4(11). 78 NDIS Act s 34(1)(f). 79 S10(b1) -(3). 80 NDIS (Supports for Participants) Rules rr 3.5-3.7, Schedule 1; NDIS Act ss 209(4), (8) item 1. 81 Disability Discrimination Act 1992 (Cth); Discrimination Act 1991 (ACT); Anti-Discrimination Act 1977 (NSW); Anti-Discrimination Act 1996 (NT); Anti-Discrimination Act 1991 (Qld); Equal Opportunity Act 1984 (SA); Anti Discrimination Act 1998 (Tas); Equal Opportunity Act 2010 (Vic); Equal Opportunity Act 1984 (WA). 82 NDIS (Plan Management) Rules r 6.6. 83 NDIS Act s 33(5)(c). 84 NDIS Act s100(1). 85 NDIS Act s 10. 86 NDIS Act s 100. 87 NDIS Act s 100(2).

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FOI 26/27-0110 DOCUMENT 7

Social and recreation support

Quick summary: social and recreation activities are an important part of life for many people. You may be able to enjoy these activities independently, or with support from friends, family and the community. If you need extra help to participate in social and recreation activities because of your disability, we may be able to fund this. You’ll still need to pay for the general costs of your social and recreation activities. This means you’ll pay for things like membership, basic equipment or entrance fees. These are costs that everyone has to pay for.

Note: when we say ‘your plan’ we mean your NDIS plan. If you’re looking for information about community connections, go to Our Guideline – Community connections.

If you’re looking for information about your child’s early connections, go to Our Guideline – Early connections.

What’s on this page?

This page covers:

What do we mean by social and recreation support?
How do we decide if social and recreation supports meet the NDIS funding criteria?
How do you get social and recreation supports in your plan?
What happens once you have social and recreation support in your plan? You might also be interested in:
Work and study supports
Transport
Personal care supports
Assistive technology

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What do we mean by social and recreation support?

The National Disability Insurance Scheme (NDIS) aims to support people with a disability to achieve independence, social and economic participation. Social and recreation supports play a key role in this.

Social and recreation activities are part of everyday life. These are activities everybody does for fun and can help with your health and wellbeing. They can also help you meet new people and improve your skills. When we talk about NDIS supports for social and recreation activity, we mean the extra help you need to take part in these activities because of your disability.

Social and recreation activities can include things like:

visiting your friends and family
active hobbies, like bike riding, skiing or kayaking
playing sport, like tennis, surfing or basketball
going out, for example to the movies or a concert
going places for fun, like shopping or visiting a museum
relaxing, like meditation or yoga
learning new skills, like dance, art classes or quilting. You’ll need to pay for the costs of the activity that everyone would pay for, such as membership or entrance costs.1 We may then be able to fund the NDIS support you need to take part in the activity because of your disability.

You may need short-term support to help you get started with your social and recreation activity. This short-term support may build your skills so you can participate independently. Or it could connect you with someone else who can regularly help you to participate. You might also need ongoing support to participate in social and recreation activities. If you need ongoing NDIS support, we may fund this as well.2

For example, you might need extra help to go to a pottery class because of your disability. You would need to pay for the cost of the class.3 We might fund a support worker to help you operate the pottery wheel if you need help because of your disability. Or, to support you to attend a class if you can’t go on your own because of your disability.4

You may already have funding for core NDIS supports in your plan. You can use this for the help you need to participate in social and recreation activities because of your disability.

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Check with us if you aren’t sure how to use the funding in your plan for social and recreation NDIS supports.

We may fund social and recreation NDIS supports if you need them because of your disability support needs. Some examples may include:

specialised equipment or modification to equipment to help you to join in social and recreation activities5
help to build your skills to take part in social and recreation activities6
a support worker to help you participate in activities, like help changing into sports clothes or setting you up to join the activity7
help to travel to a recreation event when you can’t use public transport, and it’s not reasonable for family or friends to take you.8

Learn more about supports that are NDIS supports.

These are some examples of things we don’t fund:

the basic cost of the activities that everyone would be expected to pay for, like entry fees, registration and membership fees9
standard equipment you need to take part in a social or recreation activity, like a standard tennis racket or soccer shoes10
participation in activities at professional or elite level11
support for a young child to attend or participate in social or recreation activities where parents would normally be expected to stay and support their child.12

When we fund support for social and recreation activities, we’ll fund them so you can participate at an entry level. If you want to participate in professional or elite level competitions, you’ll have to pay for the extra costs of competing at that level.13 For example, at State or National Championship level, or in competitions for prize money.

Learn more about supports that are not NDIS supports.

How do we decide if social and recreation supports meet the NDIS funding criteria?

There are many different supports available to help you join in with social and recreation activities. We’ll work with you to find the best way to get the NDIS supports you need because of your disability. We also know your support needs might change over time.

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All supports we fund must meet the NDIS funding criteria. This includes that it’s an NDIS support for you.

The questions below will help you think about whether we’ll consider funding social and recreation NDIS supports for you.

Is the social or recreation support:

an NDIS support for you?
directly related to your disability support needs?
helping you pursue your goals?
value for money?
effective and beneficial for you?
legal and safe?
something we expect family, friends or the community to provide? Is the social and recreation support an NDIS support for you?

Social and recreation support will be an NDIS support for you if either:

the Rules say that the support is an NDIS support for everyone, or
the Rules say that the support is only for a specific group of people and you are part of that group.14

NDIS supports are the services, items and equipment that can be funded under the NDIS. Supports that should be funded by organisations or services outside of the NDIS aren’t NDIS supports.

Many local clubs and community organisations provide social and recreation activities you can join in with. If one of these services provides the type of help you need, you might not need NDIS funded supports.

Your my NDIS contact or support coordinator can help you connect to other organisations in the community. They can help you find information on what’s available or help you develop the skills and confidence to connect with those services.

Example

Jo loves heavy metal and wants to go see some live music but needs some support to do this. Jo’s local area coordinator suggests a community group that connects people with a disability to volunteers so that they can go and see bands together. Jo is connected with a

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volunteer who also loves heavy metal. The volunteer is the same age and lives close by. Now Jo and the volunteer are catching up every fortnight to see a band and they both enjoy the live gigs. Jo and the volunteer continue to learn just how Jo wants to be supported and they are planning some other activities together.

Reasonable adjustments

Community organisations, shops and sporting clubs must also take steps to remove barriers you may face because of your disability. This is to make sure you receive the same services as everyone else. We call this a ‘reasonable adjustment’.15

Reasonable adjustments could be things like:

physical access such as ramps and wide doorways16
giving you the same opportunity to participate. For example, making changes to standard golfing competition rules to allow you to use a motorised buggy
adapting to suit your communication needs, like using a flash instead of a noise to signal the start of a game or race.

Example

Adeem is a teenager who uses a wheelchair and loves robotics. Adeem is very keen to meet others who have the same interests. Adeem and his mum learn from their local area coordinator about a robotics group running at the local library every Tuesday after school. Adeem, his mum and local area coordinator talk about whether Adeem will need any extra NDIS supports to attend the group.

The library already has a ramp and accessible space. This is part of their reasonable adjustment to make sure all community members can access the library. Adeem will need extra NDIS support to get in and out of his wheelchair to test the robots on the floor. Adeem doesn’t want his mum to stay with him during the robotics group. As a teenager, building independence can be very important. We could fund a support worker to help Adeem get up and down as needed during the robotics group.

For more information on reasonable adjustments check out the Australian Human Rights Commission website. You can also ask your my NDIS contact or support coordinator.

Is the social and recreation support related to your disability support needs?

We can only fund social and recreation supports if they’re directly related to your disability support needs.17 This means that you need the extra NDIS support to take part in the activity because of the effects of your disability.

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We don’t fund registration fees or standard equipment for social and recreation activities. You’ll need to pay these costs yourself.18

Does the social and recreation support help you pursue your goals?

When we fund social and recreation supports, we need to know these NDIS supports will help you pursue the goals in your plan.19

For example, you might have a goal to make new friends and start a new hobby. The NDIS support we fund will need to help you pursue that goal.

Learn more about setting goals.

Is the social and recreation support value for money?

Your social and recreation supports must be value for money compared with the benefits for you, and compared with other supports that would achieve the same outcome.20 We’ll think about whether:

there are NDIS supports that might achieve the same outcome that are less costly.21 For example, you might be able to share NDIS supports, rather than needing individual supports
your social and recreation supports will increase your independence, or reduce your support needs in future22
the assistive technology or modified equipment you need could be hired or leased instead of purchased.23

Is the social and recreation support effective and beneficial for you?

We need to check the social and recreation supports we fund will be effective and beneficial for you.24 We’ll look at whether the NDIS supports will help you to participate in a social and recreation activity. This might be something you haven’t been able to do or has been difficult to participate in because of your disability. We also look at how effective the support has been for other people with the same type of needs as you.

Is the social and recreation support legal and safe to use?

We need to make sure the social and recreation support is safe and legal. We can’t fund social and recreation supports if they’re likely to cause harm to you or others.25

For example, before we fund adapted sporting equipment for you, we may ask an occupational therapist to check the equipment is safe to use and won’t hurt you or others.

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Do we expect your family, friends or the community to provide the social and recreation support?

When we fund social and recreation supports, we think about the different supports family, friends and the community would provide at different ages and stages in your life.

For example, we would expect parents to help their children get to and from social and recreation activities.26 But we don’t expect parents to provide help for adults getting to and from social and recreation activities. This is because parents aren’t usually expected to provide this level of help for their adult children.

What about children?

We’ll consider if children need extra support because of their disability compared to other children the same age, and what is reasonable for family, friends and the community to provide.

We consider whether:27

because of their disability, a child’s support needs are much more than the needs of other children of the same age. This means the family needs to provide a lot more care than would normally be provided for a child of that age
the NDIS support will help build the child’s capacity
the NDIS support will reduce any risks to a child’s wellbeing
the NDIS support will reduce any risks to family members or friends. Generally, we won’t fund travel supports for children to get to and from social and recreation activities.28 This is because families or guardians have a role in meeting their child’s daily travel needs.29

Example

Debbie is 14 years old and loves dancing. Debbie has just started lessons at a new dance school but is finding it hard to understand the teacher’s instructions. Debbie’s dance lessons start at 7pm each Tuesday night. At age 14, we would generally expect Debbie’s parents to provide transport for her. This is because parents would usually transport their child to nighttime dance lessons.

We wouldn’t expect Debbie’s family to support their 14-year-old daughter during the dance lesson. This is because parents don’t usually provide support for their teenage children during the class. Instead, we might fund a support worker to help Debbie follow the teacher’s instructions and explain her needs to the dance teacher.

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What if you’re an adult?

We know that getting support from your family, friends and the community can be important for you and your wellbeing. At times you may prefer to be independent and enjoy social and recreation activities without calling on friends or family to help you.

If you’re an adult, we look at whether it’s reasonable for your family, friends or the community to provide the extra help you need.

We’ll think about:

how much extra help you need and what type
whether the activity is the kind of thing an adult would usually do without extra help from family or friends
if your family, friends or the community provide the extra help, would it pose a risk to your wellbeing or to theirs
whether support from your family, friends or the community would help you become less or more independent
whether it’s suitable for your family, friends or the community to provide this support. For example, they may not have the capacity to provide the support at the level you need.

Often, friends and family can and want to help. Their involvement can be an important part of enjoying social and recreation activities. Paid NDIS supports can’t, and are not intended to, replace the support that’s reasonable for family, friends and other community networks to provide.

Example

Nadine enjoyed yoga as a teenager and used to attend with her sister. Since Nadine began experiencing psychosocial disability, she has wanted to stay at home and not go back to the yoga centre. This is due to feelings of anxiety and isolation, which result from her disability. She’s lacked the confidence to go almost anywhere on her own. Nadine’s sister tried to encourage her back to yoga but wasn’t able to attend the centre with her.

We fund a support worker to support Nadine to return to yoga classes. The support worker helped her become familiar again with the yoga centre and the instructors, find the right clothes to wear, and attend classes. After a few weeks of NDIS support to get to know others at yoga, Nadine connected with a person who also attended on their own. Nadine was able to attend yoga without her sister or the support worker and now goes twice a week with her new yoga buddy.

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How do you get social and recreation supports in your plan?

To get social and recreation NDIS supports in your plan, you need to give us evidence that helps us understand the disability-related supports you need. Talk to your my NDIS contact or support coordinator to work out what evidence we need. Learn more about the evidence we need before we create or change your plan.

You can give us any new information or evidence about your support needs when you get it or any time we talk with you.

We’ll need to understand the support you need for your disability and the barriers you’re facing to participate in a social and recreation activity. We’ll look at the information we have about your support needs and decide on what NDIS supports to include in your plan. This may include reports from an allied health professional or psychologist which detail the support you need to take part in social and recreation activities.

Social and recreation support always needs to meet the NDIS funding criteria before we can include it in your plan. We’ll think about who is best to provide the social and recreation support and, if needed, help you find a service or organisation.

You should think about how you may be able to use your NDIS supports flexibly for different social and recreation activities. You may already have funding in your plan that you can use for social and recreation supports.

You can talk to your support coordinator or your my NDIS contact about this at any time.

What happens once you have social and recreation support in your plan?

Once we’ve approved your plan, you can start using your NDIS supports for social and recreation activities. Talk to your support coordinator or my NDIS contact for more information.

We fund most social and recreation supports in your Core budget. If we fund assistive technology for your social and recreation supports, you’ll find this funding in your Capital budget. Learn more about using your budget.

If your needs change and you don’t have enough funding in your plan, you should talk to us. You might be able to use your Core budget flexibly or you might need a change to your plan. Learn more about changing your plan.

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What if you don’t agree with our decision?

If we decide social and recreation supports don’t meet our NDIS funding criteria, we can’t include them in your plan.

We’ll give you written reasons why we made the decision. You can contact us if you’d like more detail about the reasons for our decision.

If you don’t agree with a decision we make about social and recreation supports, you can ask for an internal review of our decision.30

You’ll need to ask for an internal review within 3 months of getting your plan.31

Learn more about reviewing our decisions.

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Version control

Version Amended by Brief Description of Change

(login ID)

5.0 20 - perme hey Class 1 approval APPROVED | 2023-12-20

Update to remove reference to community connections plan.

Markup version for online team

6.0 — Class 1 approval APPROVED | 2024-11-21

Updates to align with 2024 legislation

7.0 P| Class 1 approval APPROVED | 2025-04-07

Update to remove the term ‘impairment and return to pre legislation change language where we say we fund supports Which relate to the participant’s disability.

Reference List

’ NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 2 item 4(h), (q) (r).

2 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 1 item 27.

3 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 2 item 4(r).

4 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 1 item 27(a).

5 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 1 item 7.

® NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 1 item 27(b).

7 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 1 item 27(a).

8 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 1 item 6(a).

° NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 2 item 4(h), (q), (r). 10 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 2 item 4(g), (h), (p), (r).

11 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 2 item 4(i).

12 NDIS Act s34(1)(e); NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 2 item 6(g).

13 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 2 item 4(().

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14 NDIS Act s34(1)(f). 15 Discrimination Act 1992 (Ch), ss 5 and 6. 16 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 2 item 19(c). 17 NDIS Act s34(1)(aa); NDIS (Supports for Participants) Rules rule 5.1(b). 18 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 2 item 4(h), (q), (r). 19 NDIS Act s34(1)(a). 20 NDIS Act s34(1)(c). 21 NDIS (Supports for Participants) Rules r 3.1(a). 22 NDIS (Supports for Participants) Rules r 3.1(c), (f). 23 NDIS (Supports for Participants) Rules r 3.1(d). 24 NDIS Act s34(1)(d). 25 NDIS (Supports for Participants) Rules r 5.1(a). 26 NDIS Act s34(1)(e); NDIS (Supports for Participants) Rules r 3.4(a); NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 2 item 6(g). 27 NDIS Act s34(1)(e) NDIS (Supports for Participants) Rules r 3.4(a). 28 NDIS (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 sch 2 item 6(g). 29 OG - Including Specific Types of Supports in Plans Operational Guideline – Section 12. 30 NDIS Act s 100. 31 NDIS Act s 100(2).

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