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NDIS

The National Disability Insurance Scheme (NDIS) is the new way of providing individualised support for people with permanent and significant disability, as well as their families and carers.

The no-fault scheme is designed to empower eligible people to make choices about the supports they need, based on a plan that includes support needs, goals and aspirations.

What you need to know about the National Disability Insurance Scheme

https://vimeo.com/217598220
This is an introductory video about the National Disability Insurance Scheme, created in collaboration between Eastern Melbourne and North Western Melbourne PHNs.

The NDIS participant experience, Alycia’s story

https://vimeo.com/217599199
Alycia shares her experience accessing the National Disability Insurance Scheme as a participant. This video may be useful for those applying for the NDIS, their carers and families.

Who can access the NDIS?

All eligible Victorians now have access to the NDIS. To be eligible, you must:

  • meet residency requirements by living in Australia, and be an Australian citizen, OR hold a Permanent Visa, OR hold a Protected Special Category Visa
  • be aged under 65 at the time you apply to access the scheme
  • demonstrate you have a permanent disability that affects your everyday life.

Who can access early intervention support?

Support at the earliest possible stage can alleviate the effect of a person’s impairment on their functional capacity, and potentially reduce their future needs. Early intervention support is available for children and adults.
You may meet the early intervention requirements if you have an impairment or condition that is likely to be permanent, and there is evidence that early intervention supports:

  • will reduce how much help you will need to do things because of your impairment in the future
  • will improve or reduce deterioration of your functional capacity
  • will help your family and carers to keep helping you
  • are most appropriately funded through the NDIS, and not through another service system.

A child under 6 may also meet the early intervention requirements if they have a developmental delay:

  • which results in substantially reduced functional capacity in one or more of the areas of self-care, receptive and expressive language, cognitive development or motor development
  • which requires a combination and sequence of special interdisciplinary or generic care, treatment or other services which are of extended duration, and are individually planned and coordinated
  • which requires supports that are most appropriately funded through the NDIS, and not through another service system.

HealthPathways Melbourne

Visit the NDIS pathway for clinical and referral advice.

Who runs the NDIS?

The National Disability Insurance Agency (NDIA) is the independent Commonwealth agency responsible for managing the NDIS.

It assesses whether a person is eligible to become an NDIS participant and, if so, how much funding they will receive, according to the requirements of the National Disability Insurance Scheme Act 2013. It partners with other organisations to provide necessary supports.

Partners

Early Childhood Early Intervention (ECEI) partners

ECEI partners help children aged 0–6 years who have a developmental delay or disability.

ECEI partners employ coordinators to help children and their families access supports and services tailored to the needs of each child. ECEI coordinators also help families connect to other services such as community health services, playgroups or other local activities.

In Victoria, these partners are:

Local area coordination partners

Local area coordination partners employ local area coordinators (LACs) who help people understand and access the NDIS. They also work with NDIS participants to develop and use their NDIS plan.

For most people aged seven years and older, a LAC will be the main point of contact for the NDIS.

A LAC will connect people with disability to supports, services, activities in their community and other government services. LACs also help communities become more accessible and inclusive for all people with disability.

In Victoria, local area coordination partners are:

  • Brotherhood of St Laurence (North East Melbourne, Hume Merri-bek, Bayside Peninsula, Brimbank Melton, and Western Melbourne service areas)
  • Latrobe Community Health Service (Central Highlands, Ovens Murray, Wimmera South West, Barwon, Inner East Melbourne, Inner Gippsland, Outer Gippsland, Outer East Melbourne, and Southern Melbourne service areas)
  • Intereach (Loddon, Mallee, and Goulbourn service areas).

Visit the NDIS locations page or call 1800 800 110 to find the most up-to-date ECEI and LAC partner address and contact details.

Other frequently asked questions

  • How do people join the NDIS?

    Those already receiving disability support services from their state or territory government will be contacted by the NDIS. In these cases, most will not need to provide evidence of their disability or submit an access request form.

    If you are not currently receiving any disability supports, but wish to join the NDIS, you or your guardian (including carer or nominee), will need to complete a form: phone NDIA on 1800 800 110 and ask for an ‘access request form’.

  • Who can provide evidence (if requested)?

    Depending on the primary disability, your treating health professional should provide evidence about your disability. For example, your GP, paediatrician, occupational therapist, speech pathologist, psychologist or physiotherapist. Your health professional must have been treating you for at least six months.

    It’s important to note that health professionals do not have to refer a patient to a specialist to obtain supporting evidence. A health professional can summarise or attach existing medical reports which describe the diagnosis and/or condition, and the impact of the disability on the person’s daily function.

  • What kind of evidence is required?

    It’s important to summarise the effect of the disability on the person’s day-to-day function in all relevant domains, including mobility, communication, social interaction, learning, self-care and/or their ability to self-manage.

    To avoid requests for additional evidence about a person’s disability, health professionals should include information regarding treatments that have been completed or planned, as well as information about the permanency of the impairment and how it affects the person’s function capacity.

    For practical examples, see p. 3 of the GP and Health Professionals Guide to the NDIS.

  • Where can I go for more support?

    Local area coordinators (LACs) can help you get your evidence together. (It’s important to remember that the person helping you to gather your disability evidence will not be able to tell you if you meet the NDIS requirements: only the NDIA can make this decision.)

For GPs: Billing through Medicare

When GPs provide any details about a patient without an associated consultation, and without the patient present, a Medicare rebate is not payable under subsection 19(5) of the Health Insurance Act 1973.

However, in providing eligibility information, it is reasonable to expect that GPs will perform an examination of some description to assess or confirm the patient’s current medical condition. With this examination, the time taken for GPs to provide details and information for the purposes of the NDIS may be claimed under a Medicare item, if it is part of the consultation.

Consistent with the Medicare Benefits Schedule generally, it is at the GP’s discretion to select the Medicare item number that most appropriately reflects the nature of the consultation.

Quick links

Related resources

Navigating the NDIS in general practice (webinar held on 2 March 2021)

Find out more

Contact us to find out more about the NDIS support we can provide for primary health care providers.

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