NDIS Q&A…. Nov 2017

General Information/ Lessons Learnt:- NDIS is Participant centred to bring Choice and Control to their life. * Goals generated by the Participant are incorporated into their Plan * NDIS communicate with the Participant only(unless formal consent on their file for you to link with case) Health goals are not visible to the LAC or Planner if not raised by the Participant. NDIS like to build capacity in people so less dependent on the Scheme in future. LACs and Planners in many cases do not have Health/Disability backgrounds. - our report language and expectations of their insight into anticipated patient needs has to be realistic. Unscheduled reviews can be requested of NDIS by Participant * For omitted items in Plan; underfunded items. * New, separate team established last month in NDIS. * Find out your LHD escalation processes for high priority unmet patient needs.

Some of your Questions If there are insufficient funds allocated to prosthetics, can funds from another category be utilised? Agency vs self managed Reasonable and Necessary: The Act ‘Reasonable’= Fair. Also re: sustainability of the Scheme as it is an Insurance Scheme ‘Necessary’= must have R&N: help to live an ordinary life to achieve their goals.

Overall the information NDIS requires is similar to what Enable has always required to provide funding for prosthetics. We require the specific evidence to be able to determine that a support is reasonable and necessary for improving a person’s social and economic participation against the NDIS Act.

NDIA can at times consider rental of assistive technology but this support would need also need to meet the reasonable and necessary criteria. The general focus is for the person to have access to the right support they require to meet their goals. We would need to discuss the situations that you expect would require hiring

…..clear information that demonstrates the additional outcomes that will be provided by a higher grade or more expensive technology. This can be in the form of research and personal evidence and will need to show the benefit to cost value, in terms of the functional outcomes for participants. Please keep in mind that you will need to demonstrate their ability to maintain and care for the equipment ensuring that an item really is the most suitable for them.

How likely is it that there are no clues of a limb requiring replacement without any repair options? If this is not the likely occurrence then preparing the information on what is expected to be needed will assist. NDIS do have connection and input from Enable on prosthetic prescriptions.