Navigating the NDIS

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Navigating the NDIS

The Department of Health reported that as of 31 December 2019, 5,297 permanent residents of aged care facilities were under the age of 65.

Since the commencement of the National Disability Insurance Scheme (NDIS) on 1 July 2013, 4,018 participants under the age of 65 living in residential aged care have an approved NDIS plan with a further 1,346 participants aged over 65 years with an approved plan.

Anchor Excellence has expanded our services to support aged care Boards, Executives and Managers to navigate the regulatory interface between the Aged Care Act and the NDIS Act. Operationally, the two separate legislative regimes interweave when an aged care provider is providing support and services to a consumer who is also an NDIS participant.  The overlapping nexus of requirements of both Acts are complex with aged care providers feeling overwhelmed. 

What is the NDIS?

The National Disability Insurance Scheme (NDIS) is a national approach based on insurance principles that provides individualised support and services for people with a disability, their families and carers to achieve their goals and aspirations. 

The NDIS is overseen by an independent statutory agency of the National Disability Insurance Agency (NDIA). The NDIA role is to implement the NDIS.

Aged care and the NDIS 

The NDIA is working in partnership with the Department of Health and the Department of Social Services to transition eligible people under the age of 65 living in residential aged care into the NDIS.

Quarterly, the Department of Health provides the NDIA with a list of all permanent residents under the age of 65 who live in an aged care facility across Australia. Based on the information provided, the NDIA contacts the residential aged care facilities to arrange a face-to-face meeting with the consumer and their nominated representative (family member, friend or guardian) to discuss the NDIS and eligibility for access. 

Eligibility for NDIS                        

To be eligible for the NDIS the person applying must:

• have a permanent and significant disability or a development delay
• be an Australian citizen or hold a permanent visa or a Protected Special Category visa
• be under 65 years of age on the day you apply to access the NDIS.

It’s not mandated that people under the aged of 65 years in receipt of aged care support and services access the NDIS.

Support for aged care receipts not eligible for NDIS 

Not all people in receipt of aged care support and services will be eligible for the NDIS. People who are not eligible or over the aged of 65 years will continue to receive support and services from the aged care system. 

Preparing for a meeting with an NDIS Planner

Once eligibility has been met, a planning meeting is scheduled between an NDIS Planner and the newly registered NDIS participant. At the meeting, the NDIS participant can invite a family member, friend or guardian. During the meeting, the participant will be asked about their goals and what support and services exist and what further support and services are required to achieve these goals. 

The discussion will shape the participant’s NDIS plan. Once the plan has been approved, the NDIS will fund support and services to achieve the participant’s goals.

What support and services will NDIS fund?

People in residential aged care needs are met through a combination of support and services funded by the Aged Care Act and once they become an NDIS participant, the NDIS Act. Additional support and services assessed as meeting the reasonable and necessary criteria under Section 34 of the NDIS Act will be funded.

Residential aged care fees and charges 

While the person remains a permanent resident of an aged care service, they are required to pay fees to contribute to their accommodation costs, living expenses and care services that are not funded by the NDIS. NDIS will contribute to some aged care fees and charges. 

Aged care and NDIS registration 

If you are an aged care provider providing:

–       support and services for an NDIS participant 

–       delivering behaviour supports to an NDIS participant

–       the use of restrictive practices to an NDIS participant

you are required to register under the NDIS Quality and Safeguards Commission by 30 November 2020. Registration is to ensure obligations are met for quality and safety of care and services and that they are equitable to the specific care and health support needs of an NDIS participant.

Further information and support 

Using the Anchor Excellence Governance Framework, we will work in partnership with you to strengthen your capacity to align and deliver a sustainable operating model meeting the overlapping regulations under the Aged Care Act and the NDIS Act. 

Article written by:

Ingrid Fairlie
Aged Services, Disability and Compliance
Remediation Specialist

Britt O’Keefe
Disability Specialist

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