DISCLOSURE LOG
FOI 25/26-0529
DOCUMENT 1
Guide - Psychosocial disability
Appendix C - Supports - Guide for
decision makers
SGP KP Publishing
Exported on 2025-11-24 23:27:17
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Table of Contents
1
Recent updates .................................................................................................................... 4
2
Before you start .................................................................................................................... 5
3
Appendix C – Supports – Guide for decision makers ...................................................... 6
Table of Contents – 2
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This article provides guidance for a
planner delegate, internal review delegate, national
reassessment delegate, local area coordinator, early childhood partner, technical
advisors, liaison officers (HLO/JLO), or a
planner (non-partnered area) to understand:
• planning for participants living with psychosocial disability.
Recent updates – 3
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1 Recent updates
December 2023
Updated work and study options in the learning, work and volunteering section.
Recent updates – 4
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2 Before you start
You have read and understood:
•
Our Guideline – Reasonable and necessary supports (external)
•
Our Guideline – Mainstream and community supports (external)
• articl
e Guide – Complex support needs (CSN) pathway.
Before you start – 5
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3 Appendix C – Supports – Guide for decision makers
This list contains important considerations when working with participants with psychosocial
disability and their informal, mainstream and community supports.
Support by a recovery coach
Support by a psychosocial recovery coach (recovery coach) is funded by the National Disability
Insurance Scheme (NDIS). The recovery coach will work with the participant to:
• build capacity and resilience
• manage the complex behaviours involved in psychosocial disability issues
• improve social and economic participation
• identify, plan, design and coordinate supports
• plan and maintain engagement through periods of increased support needs.
Note: Some participants may already have a support coordinator and may choose to continue
working with their support coordinator, rather than changing to a recovery coach.
However, intensive case management is funded and provided by the mental health system,
where a significant component of case management is related to stabilising the impacts of
psychosocial disability.
Co-existing conditions, secondary disability and dual diagnosis
If a participant experiences co-existing conditions (for example, a secondary disability alongside
a diagnosed psychiatric condition), we are responsible for:
• additional, ongoing functional supports associated with the comorbidity to the extent
that the comorbidity impacts on the participant’s overall functional capacity.
Other types of supports are generally funded by mainstream services. For example, clinical
treatment of conditions or symptoms such as:
• ambulatory care
• hospital/acute inpatient care
• rehabilitation
• hospital diversion services
• time-limited follow-up treatment or support, relating to hospital or hospital discharge
• all medical services such as treatment by a GP, mental health professional, psychiatrist
or psychologist
• treatment related specifically to substance abuse.
Medication support
We will generally fund assistance with maintaining a participant’s medication regime where they
experience difficulties due to the functional impact of their disability. This support must align with
their goals and enhance the participant’s functional capacity.
For example, support to:
Appendix C – Supports – Guide for decision makers – 6
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• assist the participant to develop a structured routine that integrates medication support
and encourages the participant to self-manage their medication.
• develop strategies for self-care.
Supports that are generally funded by other mainstream services include:
• clinical treatment. This is where medication support is solely for the purpose of assisting
or requiring a participant to take medication and does not form part of other daily living
supports. This is the responsibility of health and mental health systems (for example a
mental health nurse to administer/supervise the taking of medication in the home).
• clinical monitoring or assessment of side effects related to medications.
• ‘hospital in the home’ services.
• medication supervision, including the administration and monitoring of medication in
compliance with treatment or other legal orders.
• medications or pharmaceuticals, including medications and other items including both
those listed and not listed on the Pharmaceuticals Benefits Scheme (PBS).
Transport
We generally fund supports such as:
• support to attend appointments that the participant is unable to access independently
due to their disability (where no other transport option is appropriate and not
substituting for parental responsibility).
• transport training to build capacity and travel-related skills if the participant’s goal is to
use transport independently. For example, learning to understand timetables, read
maps or use ticket systems, or if the participant cannot leave the house due to
symptoms of their mental health condition. Another example is if social interaction is
impacted by specific behaviours, and these functional impacts may be addressed
through transport training
We don’t fund:
• accessible public transport systems.
• public transport concessions.
Social participation
We generally fund supports like:
• support to attend individual or group activities of the participant’s choice.
• non-labour costs associated with providing transport to participants accessing
community participation supports.
• support to build capacity to participate independently in activities in the future.
We don’t generally fund treatment of underlying symptoms (such as panic attacks) that prevent
a participant from leaving the house and accessing the community.
Assistance with daily life
We generally fund supports like:
Appendix C – Supports – Guide for decision makers – 7
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• supports to assist with activities of daily living, such as self-care tasks, grooming and
hygiene.
• meal planning and meal preparation, such as developing skills related to cooking,
shopping and budgeting.
• personal domestic and household assistance.
We don’t fund day-to-day living costs, for example, rent, groceries or utility fees.
Home and living
We generally fund home and living supports, this may include:
• supported independent living (SIL)
• short term accommodation or respite (STA)
• medium term accommodation (MTA)
• individualised living options (ILO)
Learn more about home and living supports i
n Our Guideline - Home and living supports
(external).
We don’t fund day-to-day living costs, for example, rent, groceries or utility fees.
Therapeutic support
Therapeutic support is non-clinical and provided as a standalone service, aimed at managing or
reducing a specific functional impact of a participant’s mental health condition or impairment.
We generally fund therapeutic support to:
• build a social skill, for example, to build self-confidence and communication skills to
increase community participation.
• increase independence and build independent living skills, such as cooking, cleaning or
budgeting to achieve the goal of living independently.
• develop an individualised exercise plan that the participant can implement
independently following program development (with reviews as required).
Behavioural skill building and behavioural support from counselling must be time-limited,
outcomes focussed and part of a strategy to support a participant’s goals and functional
capacity. For example, individual counselling to build behavioural skills with the goal of using
public transport.
We don’t generally fund:
• ongoing mental health treatment including therapy and medication to manage
symptoms.
• mental health crisis services, including mental health crisis assessment services.
• neurofeedback or brain mapping.
• therapy or therapeutic support where the support is integrally connected to a package
of clinical support provided by the health or mental health system (such as services
accessible under, or encompassed by, a Mental Health Treatment Plan, Mental Health
Care Plan, Better Access to Mental Health Care initiatives)
• individual counselling for treatment of a condition or impairments.
• hospital avoidance services.
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• early interventions related to mental health, including clinical support for child and
adolescent developmental needs.
• counselling for treatment. For example, to treat social anxiety or paranoia symptoms
that arise when a participant uses public transport.
Sustaining informal supports and training for carers
We generally fund ongoing psychosocial recovery supports that focus on a participant’s
functional ability.
For example, family or carer supports to help the participant increase their involvement in the
community and in social and economic life. This could be training for family or carers on how to
implement therapy recommendations or behavioural strategies.
We don’t fund general family support services, such as counselling, support and educational
programs for family and carers that are not directly related to the participant’s disability.
Coordination of Supports
We generally fund:
• capacity building support to help the participant to access and maintain participation in
mainstream and community activities, including recreation, education, training and
employment, housing and primary health care.
• the coordination of NDIS funded supports and supports offered by the mental health
system.
For more information on mainstream and community supports, re
fer to Our Guidelines –
Mainstream and community supports (external).
We don’t fund intensive case coordination. This is provided by the mental health system where
a significant component of case coordination is related to stabilising the impacts of psychosocial
disability.
Learning, work and/or volunteering
We generally fund:
• skill development. For example, organisational skills or essential foundation skills in
work settings .
• supports to access mainstream employment (for example, Disability Employment
Services (DES) providers or other employment services to secure employment, lik
e Job
Access (external) and further education services
• supports for young participants of working age to help them get ready for work when
they leave school. For example, to support a participant to try different types of work,
and learn new work tasks and how to behave at work. Or help connect to the right job
and employer.
For more information on school leaver employment support and other work and study supports,
go to articl
e Understand work and study supports. .
We don’t fund:
• early interventions related to mental health, including clinical support for child and
adolescent developmental needs.
Appendix C – Supports – Guide for decision makers – 9
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• support for learning in educational facilities. This is the responsibility of the Education
system.
• workplace adjustments or equipment that may be required for increased functional
capacity at work
. Employment Assistance Fund (EAF) – Job Access (external) provides
work related modifications and services to eligible people with disability and mental
health conditions (above reasonable adjustment, which is the responsibility of the
employer).
For more information about work and study supports, refer to articl
e Understand work and study
supports an
d Our Guideline – Work and study (external)
Accommodation
We generally fund:
• support for accessing accommodation, assistance with obtaining and/or maintaining
accommodation, where these supports enhance functional capacity or are required due
to the impact of the participant’s impairment on their functional capacity.
• support for budgeting expenses and assistance with financial management.
• coordination to establish a detailed plan of housing options.
We don’t fund:
• any clinical residential care or residential services where the primary purpose is for
inpatient treatment or clinical rehabilitation, or where the service model primarily
employs clinical staff.
• rent or other costs directly associated with housing or tenancy.
• public housing provided by State and Territory Housing Authorities.
• homelessness support and programs.
Assistive Technology (AT)
We generally fund:
• devices (for example, wall planners) that can assist with enhancing cognitive skills
(organisation, concentration and planning) due to a functional impact.
We generally don’t fund:
• additional items that are not related to the participant’s functional impairment or
required to meet the participant’s goals.
• aids or AT required as a result of medication side effects.
Learn more about assistive technology supports i
n Our Guideline – Assistive technology
(external).
Managing life stages
We generally fund:
• life or transition planning to assist in major life stages. This could be moving house,
leaving school, wanting to start or find a job, wanting to begin tertiary study like
university or TAFE
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• mentoring, peer support, individual skill development.
• referral and support to access mainstream and informal supports during times of crisis.
We don’t provide funding where the majority of the coordination and transition supports relate to
those funded by the health or mental health system or other parties (such as treatment for the
impact of drug or alcohol conditions).
Please ref
er to Guide – Psychosocial disability Appendix A – Discharge planning.
Appendix C – Supports – Guide for decision makers – 11
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DOCUMENT 2
Support Categories
SGP KP Publishing
Exported on 2025-11-25 00:48:00
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Table of Contents
1
Recent updates .................................................................................................................... 4
2
Our Guidelines ..................................................................................................................... 5
3
Published Guides ................................................................................................................. 6
4
How support categories have changed from SAP CRM to PACE ................................... 7
4.1
Understand frequency type in continued plans .................................................................. 7
5
Core support categories ...................................................................................................... 8
5.1
Assistance with daily life ..................................................................................................... 8
5.2
Assistance with social, economic and community participation ......................................... 8
5.3
Consumables ...................................................................................................................... 9
5.4
Transport (not recurring) ..................................................................................................... 9
6
Home and living ................................................................................................................. 10
6.1
Individualised Living Options (ILO) ................................................................................... 10
6.2
Medium Term Accommodation (MTA) ............................................................................. 10
6.3
Supported Independent Living (SIL) ................................................................................. 11
6.4
YPIRAC – Cross billing ..................................................................................................... 11
7
Capital support categories ................................................................................................ 13
7.1
Assistive Technology (not maintenance, repair and rental) ............................................. 13
7.2
Assistive Technology – maintenance, repair and rental ................................................... 13
7.3
Home modifications .......................................................................................................... 14
7.4
Specialist Disability Accommodation (SDA) ..................................................................... 14
8
Capacity building support categories .............................................................................. 15
8.1
Behaviour support ............................................................................................................ 15
8.2
Choice and control ............................................................................................................ 15
8.3
Finding and keeping a job ................................................................................................ 16
8.4
Health and wellbeing ........................................................................................................ 16
8.5
Improved daily living skills ................................................................................................ 16
8.6
Improved living arrangements .......................................................................................... 17
8.7
Increased Social and Community participation ................................................................ 17
8.8
Lifelong learning ............................................................................................................... 18
8.9
Relationships .................................................................................................................... 18
8.10
Support coordination and psychosocial recovery coaches ........................................... 18
9
Recurring support categories ........................................................................................... 20
9.1
Recurring transport ........................................................................................................... 20
Table of Contents – 2
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This article provides guidance for all NDIA staff and partners to understand NDIS support
categories.
Recent updates – 3
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1 Recent updates
3 April 2025 Link to Guide – Behaviour support has been removed, as it's now replaced with guidance in Our
Guideline – Behaviour support.
17 March 2025 Article updated with:
• 2 links updated with new article names
• new link Guide – Behaviour support added to the table in the Behaviour Support
section.
Recent updates – 4
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2 Our Guidelines
Our Guidelines (external) are based on the NDIS Legislation and Rules. They explain what you
need to consider and how we make decisions based on the legislation. You should use Our
Guidelines to help your reasonable and necessary decision making when you review the
participant's NDIS funded supports.
Our Guidelines – 5
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3 Published Guides
•
Guide – Aboriginal and Torres Strait Islander supports
•
Guide – Assisting communication
•
Guide – Assisting communication – Accessible formats
•
Guide – Assisting communication – Considerations when arranging interpreting
services
•
Guide – Assisting communication – Disability-related interpreting and translation
supports
•
Guide – Assisting communication – Non-disability related interpreting and translation
supports
•
Guide – How to support children and young people to remain in their family home
•
Guide – Children living in statutory out-of-home care
•
Guide – Complex support needs (CSN) pathway
•
Guide – Conversation style guide
•
Guide – Conversation style guide appendix A – During the conversation
•
Guide – Conversation style guide appendix B – Navigate different types of conversation
•
Guide – Hearing supports
•
Guide – Hearing supports appendix A – Funding responsibilities
•
Guide – Hearing supports appendix B – Capacity building supports
•
Guide – Hearing supports appendix C – Capital supports
•
Guide – Hearing supports appendix D – Core supports
•
Guide – In-kind
•
Guide – Motor Neurone Disease
•
Guide – Psychosocial disability
•
Guide – Psychosocial disability Case examples
•
Guide – Psychosocial disability Appendix A – Discharge planning
•
Guide – Psychosocial disability Appendix B – Definitions
•
Guide – Psychosocial disability Appendix C – Supports – Guide for decision makers
•
Guide – Respiratory supports
•
Guide – Safeguarding the participant's interests
•
Guide – Safeguarding the participant's interests – Context and background
•
Guide – Therapy supports
•
Guide – Therapy supports Appendix A
•
Guide – Therapy supports Appendix B
•
Guide – Transition to adulthood checklist for participants living outside the family home.
Published Guides – 6
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4 How support categories have changed from SAP
CRM to PACE
In PACE, we add funds at the support category level. The reason for this change is to allow the
participant more choice and control to buy the supports that they need.
This means when the participant's plan is approved in PACE, the funding will be set out
differently.
Some of the participant's funding may be included in new support categories. For example,
home and living and recurring transport supports have their own support category.
We're not changing the supports we'll fund, the names of support items or the way participants
claim from these support categories.
4.1 Understand frequency type in continued plans
It's important to understand what happens to NDIS supports when a plan is continued. A plan
continuation is where a participant's plan is continued for up to 12 months. This can happen if
the participant has stable support needs and a plan that is working for them, or if we haven't
created a new plan by their reassessment date. To learn more, go to articles
Understand and
talk about a plan continuation in SAP CRM an
d Understand and talk about a plan continuation
in PACE.
An NDIS support funded with
Once-off as the
Frequency type is intended to be purchased
once, for example Assistive Technology. Once-off NDIS supports will not be provided again if a
plan is continued unless they've not been spent yet. When they've not been spent, the date the
participant can claim the funds will extend with the continued plan.
An NDIS support funded with
Regular as the
Frequency type is intended to continue for the
duration of the participant's plan, for example Assistance with Daily Living. Regular NDIS
supports will be repeated if a plan is continued, adjusted in line with annual indexation. This is to
make sure the participant can continue to access funds for their usual NDIS supports.
How support categories have changed from SAP CRM to PACE – 7
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5 Core support categories
5.1 Assistance with daily life
NDIS supports to assist or supervise you with your personal tasks during day-to-day life that
allow you to live as independently as possible. These supports can be provided individually in a
range of environments, including your own home.
PACE support category
Assistance with Daily Life
name
SAP CRM support
Assistance with Daily Life
category name
Fund management
Self-managed, Agency-managed or Plan-managed
options
Budget type options
Flexible or Stated
Frequency type
Regular
Knowledge Articles
Understand self-care and community access supports
Understand disability-related health supports – core supports
Understand and add onsite shared support in specialist disability
accommodation
Understand interim supports when there are expected changes to
a home and living situation
5.2 Assistance with social, economic and community
participation
NDIS supports that assist with or supervise you to engage in community, social, recreational, or
economic activities. These supports can be provided in a range of environments, such as in the
community or a centre.
PACE support category name
Assistance with Social, Economic and Community
Participation
SAP CRM support category
Assistance with Social, Economic and Community
name
Participation
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Flexible or Stated
Frequency type
Regular
Knowledge Articles
Understand self-care and community access supports
Understand work and study supports
Understand supports in employment (core) funding
Apply the home and living decision in PACE
Core support categories – 8
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5.3 Consumables
NDIS supports to assist with purchasing disability-related everyday items. By everyday items,
we mean the things you would use. For example, continence products like catheter bags, pads,
bottles and straps and enteral nutrition products are included in this category.
PACE support category name
Consumables
SAP CRM support category
Consumables
name
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Flexible or Stated
Frequency type
Regular
Knowledge Articles
Determine hearing support funding
Understand disability-related health supports – core
supports
5.4 Transport (not recurring)
NDIS supports to allow you to pay a provider to transport you to an activity that is not itself a
support, or to a support that is delivered by another provider. This enables you to travel to and
from appointments, your place of work, or to another activity in the community.
PACE support category name
Transport
SAP CRM support category name
Transport
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Flexible or Stated
Frequency type
Regular
Knowledge Articles
Understand transport supports
Core support categories – 9
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6 Home and living
We've moved home and living supports from the SAP CRM assistance with daily life support
category. The PACE Home and Living support category includes:
• Individualised Living Options (ILO)
• Medium Term Accommodation (MTA)
• Supported Independent Living (SIL).
Home and living supports are stated supports but can be flexible with other home and living
supports. However, they are not flexible with other core supports such as consumables or
assistance with daily life. This means the participant may have both stated home and living
supports and flexible core supports in their plan.
For example, the participant has SIL funding in their plan and the funding is allocated to the
home and living category. However, they also need support to access the community. This
community access support will need to be added to the flexible core budget, not the home and
living support category.
6.1 Individualised Living Options (ILO)
An ILO lets you choose the home you live in and set up supports in the way that best suits you.
It can include things like personal care, help to build your skills, or support with household tasks
like shopping or cooking. Family, friends, and other networks can complement your paid
supports.
PACE support category
Home and Living
name
SAP CRM support
Assistance with Daily Life
category name
Fund management
Self-managed, Agency-managed or Plan-managed
options
Budget type options
Stated
Frequency type
Regular
Knowledge Articles
Add Individualised Living Options (ILO) Stage 1 Exploration and
Design funding
Add Individualised Living Options (ILO) Stage 2 Supports funding
Understand interim supports when there are expected changes to
a home and living situation
Apply the home and living decision in PACE
6.2 Medium Term Accommodation (MTA)
MTA gives you somewhere to live if you can't move into your long-term home because your
disability supports aren't ready. To be eligible, you must have a home you'll move into, and you
need somewhere else to live in the medium-term. We usually fund medium-term
accommodation for up to 90 days.
Home and living – 10
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PACE support category
Home and Living
name
SAP CRM support
Assistance with Daily Life
category name
Fund management
Self-managed, Agency-managed or Plan-managed
options
Budget type options
Stated
Frequency type
Regular
Knowledge Articles
Add medium term accommodation (MTA) funding
Understand interim supports when there are expected changes to
a home and living situation
Apply the home and living decision in PACE
6.3 Supported Independent Living (SIL)
SIL is to help you live in your home. It includes help or supervision with daily tasks, like personal
care or cooking meals. It helps you live as independently as possible, while building your skills.
SIL is for people with higher support needs, who need some level of help at home all the time.
PACE support category
Home and Living
name
SAP CRM support
Assistance with Daily Life
category name
Fund management
Self-managed, Agency-managed or Plan-managed
options
Budget type options
Stated
Frequency type
Regular
Knowledge Articles
Add supported independent living (SIL) funding
Understand interim supports when there are expected changes to
a home and living situation
Apply the home and living decision in PACE
6.4 YPIRAC – Cross billing
In PACE, we've created a new support category for Younger People in Residential Aged Care
(YPIRAC). Cross-billing payments are an agreement we have with the Department of Health
and Aged Care to pay some of the fees and charges for younger people in residential aged
care. Cross-billing is a stated support in the participant's plan and must be agency-managed.
Only a YPIRAC planner delegate can add the funding to the participant's plan.
PACE support category name YPIRAC – Cross Billing
Home and living – 11
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SAP CRM support category
Assistance with Daily Life
name
Fund management options
Agency-managed
Budget type options
Stated
Frequency type
Once-off
Knowledge Articles
Add funding for Younger People in Residential Aged Care
(YPIRAC)
Home and living – 12
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7 Capital support categories
7.1 Assistive Technology (not maintenance, repair and rental)
Assistive technology (AT) support is the equipment you might need to help you with everyday
tasks. AT may be equipment or items to support a person with a disability reach their potential
at home, in the community and the workplace.
PACE support category
Assistive Technology
name
SAP CRM support category Assistive Technology
name
Fund management options Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Understand high-cost assistive technology (AT) funding
Calculate vehicle depreciation
Complete checks for vehicle modifications
Determine hearing support funding
Understand disability-related health supports – capital supports
7.2 Assistive Technology – maintenance, repair and rental
We've moved assistive technology, maintenance, repair and rental from the SAP CRM assistive
technology support category to its own support category in PACE.
These supports are to repair and maintain assistive technology. This also includes short-term
rental and trial of your assistive technology supports.
If the participant's plan has moved from SAP CRM to PACE, you need to:
• talk with the participant to understand what supports need to stay in the assistive
technology budget. For example, a customised wheelchair. If required, explain changes
to their assistive technology supports
• check the assistive technology – maintenance, repair and rental supports in the
participant's previous SAP CRM plan
• move the funded amount from the SAP CRM assistive technology budget to the PACE
support category
Assistive Technology – Maintenance, Repair and Rental
supports.
Explain to the participant the changes to their assistive technology supports.
PACE support category
Assistive Technology – maintenance, repair and rental
name
Capital support categories – 13
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SAP CRM support category Assistive Technology
name
Fund management options Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Understand assistive technology (AT) maintenance, repairs,
rentals and trials funding
7.3 Home modifications
NDIS supports to make changes to the structure, layout or fittings of your home, so you can
safely access it and move around comfortably.
PACE support category name
Home modifications
SAP CRM support category name
Home modifications
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off
Knowledge Articles
Add complex home modifications funding
Add minor home modification funding
Add home modification capacity building support
7.4 Specialist Disability Accommodation (SDA)
Specialist Disability Accommodation (SDA) has been moved from SAP CRM home
modifications support category to its own PACE support category called
Specialist Disability
Accommodation (SDA).
SDA is a range of housing for people with very high support needs or who need to live in a
specially designed house.
PACE support category name
Specialist Disability Accommodation (SDA)
SAP CRM support category name Home modifications (SDA items)
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Add specialist disability accommodation (SDA) funding
Capital support categories – 14
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8 Capacity building support categories
8.1 Behaviour support
NDIS supports to help you develop behavioural management strategies to reduce behaviours of
concern. This includes specialist behavioural intervention supports to help improve your quality
of life.
We've moved behaviour support from the SAP CRM improving relationships support category to
its own support category in PACE.
If the participant's plan has moved from SAP CRM to PACE, you need to:
•
check the participant's previous SAP CRM plan
•
move
behaviour support from the SAP CRM
improving relationships budget to the
PACE support category
behaviour support
•
confirm what supports the participant needs to stay in the PACE
behaviour support
budget. For example, support for social skill development
•
explain to the participant changes to their behaviour supports.
PACE support category name
Behaviour Support
SAP CRM support category name
Improving Relationships
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Understand behaviour support
8.2 Choice and control
NDIS supports to help you manage your plan funding and pay for services using a registered
plan manager.
PACE support category name
Choice and control
SAP CRM support category name
Choice and control
Fund management options
Plan-managed
Budget type options
Stated
Frequency type
Regular
Knowledge Articles
Make fund management decision
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8.3 Finding and keeping a job
NDIS supports to help build employment skills to successfully find and keep a job. This includes
employment supports for participants of all ages who have an employment goal and supports
for young people to develop a pathway from school to work. This may also include employment-
related assessments and counselling to support participants to select and successfully engage
in employment that suits their abilities and interests.
PACE support category name
Finding and Keeping a Job
SAP CRM support category name
Finding and Keeping a Job
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Understand work and study supports
Understand capacity building employment supports
8.4 Health and wellbeing
NDIS supports that are directly related to the impact of your disability. This may include
swallowing assessments and mealtime care plans. This doesn't include gym memberships.
PACE support category name Health and Wellbeing
SAP CRM support category
Health and Wellbeing
name
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Understand disability-related health supports – capacity
building supports
8.5 Improved daily living skills
NDIS supports which include assessment, training, or therapy (including Early Childhood
Intervention) to assist the development of, or to increase, your skills and capacity for
independence and community participation. These services can be delivered in groups or
individually.
We may fund therapy supports which aim to increase functional capacity and independence
where it's reasonable and necessary based on the participant's individual circumstances. This
includes in areas such as communication and personal care. This may include, but is not limited
to, psychology, occupational therapy, speech therapy and physiotherapy.
Therapy supports must be evidence based and delivered by an allied health professional who is
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registered with an appropriate governing body. This may include psychologists, occupational
therapists, speech pathologists and physiotherapists.
For example, a participant may see a psychologist to help them feel more confident in social
situations. This will help them work towards their goal of engaging with a community group.
These supports are funded under the Capacity building budget type in a participant's plan.
PACE support category name Improved Daily Living Skills
SAP CRM support category
Improved Daily Living Skills
name
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Guide – Therapy supports
Guide – Hearing supports
Understand disability-related health supports – capacity
building supports
8.6 Improved living arrangements
NDIS supports to help you find and maintain an appropriate place to live.
PACE support category name
Improved Living Arrangements
SAP CRM support category name
Improved Living Arrangements
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Add home modification capacity building support
8.7 Increased Social and Community participation
NDIS supports to allow you to take part in skills-based learning to develop independence in
accessing the community.
PACE support category Increased Social and Community Participation
name
SAP CRM support
Increased Social and Community Participation
category name
Fund management
Self-managed, Agency-managed or Plan-managed
options
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Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Understand social and community participation supports for
participants in a shared living arrangement
Add capacity building supports (coming soon)
8.8 Lifelong learning
NDIS supports to assist you to move from school to further education. Examples include
training, advice and help to move from school to university or TAFE.
PACE support category name
Lifelong Learning
SAP CRM support category name
Lifelong Learning
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Understand work and study supports
Understand capacity building employment supports
8.9 Relationships
NDIS supports to help you develop positive social skills and interact with others in the
community.
PACE support category name
Relationships
SAP CRM support category name
Improving Relationships
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Add capacity building supports (coming soon)
8.10 Support coordination and psychosocial recovery coaches
We've renamed the support coordination support category to support coordination and
psychosocial recovery coaches.
NDIS supports to help you understand your plan and connect with NDIS providers, community
and mainstream and other government supports. These supports help you to build confidence
and coordinate your supports.
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PACE support category
Support coordination and psychosocial recovery coaches
name
SAP CRM support category Support coordination
name
Fund management options
Self-managed, Agency-managed or Plan-managed
Budget type options
Stated
Frequency type
Once-off, Regular
Knowledge Articles
Understand support coordination and psychosocial recovery
coach funding
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9 Recurring support categories
9.1 Recurring transport
In PACE, we've included a new support category for
Recurring Transport.
NDIS supports paid by us on a regular basis to your nominated bank account for transport
supports.
PACE support category name
Recurring Transport
SAP CRM support category name
New Category
Fund management options
Self-managed
Budget type options
Stated
Frequency type
Recurring
Knowledge Articles
Understand transport supports
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DOCUMENT 3
Understand behaviour support
SGP KP Publishing
Exported on 2025-11-24 23:38:42
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SGP KP Publishing – Understand behaviour support
Table of Contents
1
Recent updates .................................................................................................................... 4
2
Before you start .................................................................................................................... 5
3
Understand behaviour support .......................................................................................... 6
4
Understand when to include behaviour support .............................................................. 7
4.1
What to think about when including behaviour support ...................................................... 7
4.2
Behaviour support in supported independent living (SIL) .................................................. 7
5
Understand when to include intensive and complex behaviour support ...................... 9
5.1
What to think about when including intensive and complex behaviour support ................. 9
5.2
Who can provide intensive and complex behaviour support .............................................. 9
6
Fund management ............................................................................................................. 11
7
Next steps ........................................................................................................................... 12
Table of Contents – 2
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This article provides guidance for all NDIA staff and partners to:
• understand behaviour support
• understand when to include behaviour support
• understand when to include intensive and complex behaviour support.
Recent updates – 3
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1 Recent updates
19 May 2025 Guidance updated to add new Participant Budget Update (PBU) pathway links and link to new
article Action a budget update with funding periods.
3 April 2025 Guidance updated to:
• remove link to article Understand behaviours of concern and restrictive practices in a
technical advice case
• remove links to article Guide – Behaviour support
• add links to article Our Guideline – Behaviour support
• add section Behaviour support in supported independent living (SIL)
• add section Fund management.
Recent updates – 4
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2 Before you start
You have read and understood:
•
Our Guideline – Reasonable and necessary supports (external)
•
Our Guideline – Creating your plan (external)
•
Our Guideline – Behaviour support (external)
•
articl
e Complete a streaming case (Streaming and Restreaming). If a participant is
streamed as General or Supported and needs behaviour support, you may need to
restream them to Intensive or Super Intensive
•
articl
e Support Categories.
Before you start – 5
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3 Understand behaviour support
Behaviour support includes:
•
specialist behavioural support
•
an interim behaviour support plan
•
a functional behavioural assessment
•
a comprehensive behaviour support plan
•
training for formal and informal supports in behaviour management strategies
•
monitoring and reporting
•
ongoing review of effectiveness of the behaviour support plan
•
individual social skills development.
A behaviour support practitioner works with the participant, their family, supports and carers to
complete a functional behavioural assessment. They'll also develop the behaviour support plan.
If a participant needs behaviour support, their plan duration should be 12 months. This is
because of the need to monitor and review outcomes and their situation. If you need to change
the plan duration, go to articl
e Change plan duration.
Us
e Our Guideline – Reasonable and necessary supports (external) and article
Our Guideline -
Behaviour support (external) to support your decision-making for behaviour support.
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4 Understand when to include behaviour support
To determine if behaviour support should be included in a participant's plan, you must have
read and understoo
d Our Guideline - Behaviour support (external).
When you include behaviour support in a participant's plan, you'll need to make sure they
receive the appropriate support in their plan to address any behavioural complexities in their
current life situation. Think about a participant's individual situation and supporting information
to understand the support they need in their plan. This may include extra supports to build
capacity and implement strategies in the participant's behaviour support plan.
To help develop a draft budget, use the Plan Conversation Support Tool (PCST). You must use
the PCST for all new plans and plan reassessments and attach to the participant record. Go to
articl
e Understand and update the plan conversation support tool.
4.1 What to think about when including behaviour support
You need to think about:
• reports or information from family, providers or supports that indicate they are
concerned about the participant's behaviour
• recommendations from providers or allied health professionals like occupational
therapists or psychologists, including strategies already used and any further
interventions that have been identified as necessary
• behaviours of concern that could require single or minimal interventions
• any lack of services willing to engage with the participant due to presenting behaviours
and risk to staff, participants or the community
• any changes in the participant's situation that will result in withdrawal of service support
and need for immediate intervention
• multiple complexities that may require multiple interventions
• behaviours of concern where there's use of regulated restrictive practice. Refer t
o Our
Guideline – Behaviour support (external)
• behaviours of concern involving various stakeholders. For example, multiple issues for
intensive intervention requiring comprehensive assessment, planning, support and
training for the participant and carers
• participants who may have 1:1 or 1:2 support in the community more than 30% of the
day due to their behaviour. This includes high level supports at home
• participants who need extra support to implement newly developed strategies in the
community or in newly engaged activities or services
• participants who are anticipated to experience a significant transition during the plan
period. For example, they may move into supported independent living (SIL) or from
school to day program.
4.2 Behaviour support in supported independent living (SIL)
A participant with behaviours of concern may live in supported independent living (SIL).
Behaviour support needs to take a whole of house approach if:
Understand when to include behaviour support – 7
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•
the participant lives with other people with disabilities
•
there are regular incidents such as assaults, self-harm or property damage
•
high-level staffing ratios are needed to manage risk to staff and residents
•
restrictive practices are used which impact all residents, such as a locked fridge or
removing people to a safe area during an incident.
Behaviour support for a whole of house approach may include:
•
a shared living environmental assessment, also known as ecological assessment
•
a behaviour support systems review
•
program development
•
staff training.
The cost of the environmental assessment should be shared between all the people living in the
home. For example, if there's one shared living environmental assessment completed by one
provider to understand the household situation.
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5 Understand when to include intensive and complex
behaviour support
A participant may need intensive and complex behaviour support if they:
•
display frequent behaviours of concern that have a significant effect on their or others
wellbeing and safety
•
need intensive support and frequent daily implementation of intensive proactive
strategies, skill development and response strategies. This may include the use of
restrictive practices to reduce the risk of harm to themselves or others
•
may or are likely to, experience other issues that worsen or increase the complexity of
their behaviour support needs.
5.1 What to think about when including intensive and complex
behaviour support
You'll need to make a decision to include intensive and complex behaviour support usin
g Our
guideline – Reasonable and necessary supports (external). To help you understand if the
participant needs intensive and complex behaviour support, you can use information from the
participant, their providers, functional assessments, therapy reports, behaviour reports and
medical information.
Intensive and complex behaviour support can be included and claimed as part of:
•
assistance with daily life
•
assistance with social, economic and community participation
•
Supported Independent Living (SIL).
You must use the PCST for all new plans and plan reassessments and attach to the participant
record. Include intensive and complex behaviour support using articl
e Understand and update
the plan conversation support tool.
5.2 Who can provide intensive and complex behaviour support
To provide intensive and complex behaviour support to a participant, a provider must:
•
be implementing behaviour support with the participant and in accordance with their
interim or comprehensive behaviour support plan, and
•
be registered with the NDIS Quality and Safeguards Commission and assessed for
Module 2A (Implementing Behaviour Support Plans), or
•
have submitted a registration amendment application or new registration application to
the NDIS Quality and Safeguards Commission. This includes a completed audit
assessment against Module 2A by 30 June 2025.
Learn about the responsibilities and registration requirements for providers i
n Behaviour support
and restrictive practices fact sheet (external). Note: plan managers should only approve claims
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for implementing intensive and complex behaviour supports from registered NDIS providers
who meet these requirements.
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6 Fund management
We recommend that behaviour support is Agency-managed to support the use of registered
NDIS providers. However, the participant may choose to self-manage their supports or use a
registered plan manager. Whichever way they choose to manage their behaviour support, they
must use registered providers.
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7 Next steps
1. Add a provider relationship for behaviour supports. If the participant hasn't chosen a
provider, add the relationship as soon as the provider is confirmed. This is mandatory
so the provider can access funds for payment. For guidance, go to articl
e Add or update
a provider relationship.
Note: when a participant transitions from SAP CRM to PACE with an active behaviour
support service booking, PACE will create a my provider relationship with the behaviour
support category, as well as a general my provider relationship. This could take up to 5
minutes after the plan is approved. You must check the relationships have been created
correctly.
Talk with the participant to check if they want to use the same provider and if they want
to share any plan information with them. For more information, read section
Understand what happens with existing provider relationships when a participant
transitions to PACE in articl
e Understand provider relationships.
2. Use the Plan Conversation Support Tool (PCST) to include behaviour support. Go to
articl
e Understand and update the plan conversation support tool. You can use the
PCST when completing a budget update but you must use the PCST for all new plans
and plan reassessments.
3. For a:
o
Plan Approval case, you'll need to use the
Plan Conversation Support Tool
to calculate the funded supports. To add or update this support in a draft
budget go to articl
e Change the draft budget
o
Plan Change or
Participant Budget Update case where the plan was
approved before 9 October 2024, go to articl
e Action a budget update
o
Plan Change or
Participant Budget Update case where the plan was
approved on or after 9 October 2024, go to articl
e Action a budget update with
funding periods.
Next steps – 12
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Creating your plan
Quick summary: we’ll work with you to create your NDIS plan. We’ll speak with you to help
us decide what NDIS supports to fund in your plan. We’ll also talk to you about what
informal, community and mainstream supports you have access to and include them in your
plan. Your plan will have a total funding amount. We will call this a 'total budget amount' in
your plan. We’ll work with you to decide how your NDIS funding will be managed, and when
we’ll create your plan.
This guideline is about what we think about when we create your plan including the laws and
rules we need to follow.
Note:
• When we say 'your plan', we mean your NDIS plan.
• 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 includes the legislation changes we are introducing from now. 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 is an NDIS plan?
•
How do we create your plan?
•
How do we decide what NDIS supports to include in your plan?
•
How do we include the NDIS funding in your plan?
•
What are your options for managing your funding?
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•
How do we decide who manages your funding?
•
How long will your plan go for?
•
When will we approve your plan?
•
What happens once you have your plan?
You may also be interested in:
•
Applying to the NDIS
•
What principles do we follow to create your plan?
•
Your plan
•
Changing your plan
•
Reviewing our decisions
•
Guide to self-management
•
NDIS Guide to Plan Management
What is an NDIS plan?
Once you’re an NDIS participant, we’ll work with you to create your NDIS plan. You can find
out more about how to become a participant in
Applying to the NDIS.
Your NDIS plan sets out your goals and the supports that may help you pursue those goals
and live as independently as possible. We call this the ‘participant’s statement of goals and
aspiration
s’.1 We create your plan based on your disability support need
s.2 Your plan will be
just for you.
Your plan will include:
• your NDIS number
• your my NDIS contact
• your NDIS plan start date
• your NDIS plan reassessment date
• your total budget amount
• your NDIS supports
• funding component amounts
• funding periods
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• information about you
• your goals, or things you want to work towards
• how you can use your NDIS funding
• who will manage your NDIS funding
• your supports outside of the NDIS, for example, informal supports such as family and
friends, as well as mainstream and community supports
• what to do if something changes.
How do we create your plan?
We create your plan based on your individual disability support needs
.3 We’ll use the
information you give us about your lived experience and how your disability impacts your
day-to-day life. We will:
• get to know you and discuss your situation
• ask you about your goals, or things you want to work towards
• think about what supports your family, friends, community and other government
services can provide
• think about an
y NDIS supports you may need
• review any information gathered by your local area coordinator or early childhood
partner if they supported you to apply to the NDIS
• ask for further information about your support needs if we need to
• meet with you to approve your plan
• send your plan to you.
You can ask other people to help you if you want to. For example, you can have friends,
family or an advocate join any conversation we have with you. They can also help you make
your own decisions about your plan.
If you need someone else to make decisions for you about your NDIS plan, we can help you
set this up. This may be:
•
a plan nominee if you’re an adult
•
a public guardian or trustee if you’re an adult with a guardianship arrangement
•
a child representative if you’re under 18 years old.
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We’ll start making your plan within
21 days after you become an NDIS participant.
What information do we look at?
We want to get a good understanding of your disability support needs. We know you’re the
expert in your own life, and we use your lived experience as much as we can.
To learn about your life and the supports you need, we’ll look at:
• your goals and aspirations
• where you live and your living arrangements
• how you move around your home and your community
• who supports you now, like your family, friends, or service providers
• support available from community and other government services to help you learn
new skills and become more independent
• what self-care support you need
• if you use or need
equipment, technology or devices, also known as assistive
technology
• wha
t social and recreation activities you’d like to do now or in the future
• if you need help to build friendships or connect with your family
• if you’d like to
work or study now or in the future
• what support you need to build your skills and do more things yourself.
We also look at:
• the information you gave us when you applied to the NDIS
• any support you may get through
community connections
• any reports from your doctors or allied health professionals
• other information you give us, for example from other government agencies, or
disability service providers
• other relevant information we have about your support needs, such as functional
assessments, like the PEDI-CAT or WHODAS
• any other information you give us, including about your lived experience.
We use the information you give us as evidence to help us decide what NDIS supports to
include in your plan. We use this evidence to create your plan with you. Sometimes we may
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ask for more evidence to consider funding an NDIS support. We may not be able to fund an
NDIS support if we don’t have enough evidence to support including it.
We look at different types of evidence for different types of supports. We may need a report
or assessment from your doctor or health professional who specialises in helping you
manage your disability.
Reports and assessments may tell us why you need the support and how the support relates
to your disability
.4 For example, an occupational therapist may send us a letter about why
you need a specific type of wheelchair.
We’ll keep your personal information safe and secure.
Learn more about what
evidence you need to give us before we create or change your plan.
How do you set the goals in your NDIS plan?
We need to know your goals and aspirations so we know how we can help you.
Your goals are your own and tell us about the things you’d like to do. You can have as many
or as few goals as you want.
Your goals can be big or small, short term or long term, simple or complex. They can be
about anything you want to work towards.
You may express your goals broadly, or you may have specific goals. For example, one of
your goals might be to ’live independently’, and another might be ‘to have an accessible
bathroom’.
You, your plan nominee or child representative set your goals and tell us what information
you want to include about your life.
If you want, your family and friends who support you can also give us information about their
life.
You can tell us about your goals at any time, even after we’ve approved your plan. If you tell
us your goals, we’ll record them and send you a new copy of your plan with your updated
goals
.5
They are your goals, and we’ll write them down in your own words. We can’t change your
goals or choose them for you. But we can help you choose what words to use if you want us
to.
Who can help you set your goals?
You can ask other people for help to set your goals if you want to. For example, your friends,
family, or my NDIS contact can help you.
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We’ll talk with you about what your goals will mean for your NDIS plan. For example, we
could talk about:
• what your goals will look like for you
• how you can work towards your goals
• when you’d like to work on your goals
• what NDIS supports you need to work towards your goals. But just because you have
a goal doesn’t mean we have to fund supports for it
• where you might get supports to work towards your goals, for example community or
mainstream services
• what NDIS supports we might be able to fund to help you work towards your goals
• what supports you need to overcome any challenges in working towards your goals
• how you could develop skills and talents you haven’t focused on before
• if you’d like to include smaller goals as part of a big goal
• if you’d like to add a few steps to work towards your goals.
For example, you might choose a goal, ‘I want to find a part time job where I can use my
computer skills.’ You might also want to choose to add steps to work towards this goal, like
building your skills in looking for a job.
Learn more abou
t setting your goals.
Will we always fund supports for your goals?
NDIS laws determine what we can and can’t fund. Things we fund are called NDIS supports.
NDIS supports are the services, items and equipment that can be funded by the NDIS. You
can use the funding in your plan to buy NDIS supports if they are related to your disability
and a
re in line with your plan.6
The NDIS supports we fund should help you pursue your goa
ls,7 but you don’t need a
specific goal for every support in your plan. When we decide if an NDIS support will help you
pursue your goals, we think about your whole situation. There are some things to remember
when setting goals:
• setting more and bigger goals doesn’t mean we’ll provide more NDIS supports or
more funding
• setting a goal doesn’t mean we have an obligation to fund NDIS supports that help
you pursue that goal
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• setting a goal about an explicit type or amount of support you might want doesn’t
mean we have to fund that support or in that amount.
This is because helping you pursue your goals is only one of the
NDIS funding criteria. So
not all supports that help you pursue your goals will be reasonable and necessary supports
we can fund in your plan.
For example, you might be ready to look for work and have a goal to find a job.
Disability
Employment Services help people with a disability look for jobs. This is not an NDIS support
that we can fund
.8
But we can help you connect with a Disability Employment Service. We can also think about
what NDIS supports we could fund to help build your job skills. Learn more abou
t work and
study supports.
Learn more abou
t how we consider your goals when we decide what NDIS supports to
include in your plan.
How do we think about risks when we create your plan?
You have the right to decide what you do each day and to make your own life choices. For
all of us, our choices come with some risks. We all make our own choices about how much
risk we want to take in our lives. You should also be able to choose how much risk you want
to take when you make your life choice
s.9
We’ll work with you to understand areas of risk in your life and things that may increase risk
of harm to you. This includes being aware of your individual situation, the transitions in your
life and recognising your own experience.
We’ll help you think about supports that help you live your life the way you want to
.10 We
balance your right to take reasonable risks in pursuing your goals, with your safety and the
safety of other peop
le.11
There might be risks to your personal safety, your personal finances, or your NDIS funding
.12
For example:
• there might be risks to your family or friends’ health if they keep supporting you when
they get older
• there could be risks if you’re socially isolated or if you rely only on providers for
support
• there could be risks of physical injury to you or the people who support you.
Some of these risks might affect:
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• the NDIS supports in your plan
•
who manages your NDIS funding
• how we include the funding in your plan.
We’ll support you to make your own choices wherever possible. But we can’t fund NDIS
supports that are likely to risk harming you or someone else
.13
When we create your plan, we’ll talk with you about how we can help you reduce risks.
There are a few things we could do to reduce risk and make sure your plan meets your
needs.
For example, we could:
• check in with you regularly about how your plan is meeting your disability support
needs and if you need any changes
• connect you with mainstream services related to health or education
• fund NDIS supports to help you build your support network. For example, to help you
make friends or build relationships in your community
• include NDIS supports to help build your skills so you can manage the funding in your
plan
• include shorter funding periods in your plan. Learn more abou
t how we decide how
long your funding periods go for
• consider how we apply funding component amounts in your plan
• help you understand if any providers are using restrictive practices. Providers using
restrictive practices need to be registered with the
NDIS Quality and Safeguards
Commission and follow the requirements of registration for this support
• let you know how you can make a
complaint about your service providers
• tell you how to ask for a review of a decision we have made.
Sometimes, there might be an unreasonable risk to you when you or someone else manage
your funding. Learn more about
how we decide if there is an unreasonable risk to you.
What can you expect from us when we create your plan?
We’ll create a plan that wil
l:14
• be personalised and guided by you
• respect the role of family, carers and other people who are important to you
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• look at the support your friends and family provide, and the support services available
to everyone in the community
• respect your right to have control over your life and make your own choices
• help you participate in the community, and help you study or find and keep a job, if
you want to
• focus on choice and flexibility when it comes to your goals, needs and your supports
• build the capacity of families, carers, and your community to support you, where
appropriate
• support you to manage any risks that may have been identified in discussions with
you.
We’ll start making your plan within
21 days after you become an NDIS participant
.15
You can ask us to change your plan at any time. You’ll need to give us supporting
information about why you’d like us to change your plan when you ask for this.
Learn more about what you can expect from us and what we consider when we create your
plan in ou
r Participant Service Charter.
You can also read abou
t the principles we follow to create your plan.
How do we decide what NDIS supports to include in your
plan?
We fund NDIS supports that relate to your disability. NDIS supports are the services, items
and equipment we fund under the NDIS
.16
These NDIS supports may help you pursue your goa
ls,17 but you don’t need a specific goal
for every support in your plan.
Your NDIS supports funded in your plan need to meet all
NDIS funding criteria. For example,
a support will only be a reasonable and necessary support for you if:
• it’s related to your disabil
ity18
• it’s an NDIS suppo
rt.19
Learn more about how we decide what supports to include in your plan
in Our Guideline –
Reasonable and necessary supports.
What are informal, community and mainstream supports?
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When we create your plan, we help you connect with supports and activities in your area.
For example, we can help you connect with:
•
informal supports like your friends, family, or other people you know in your
community. They can sometimes be your best supports. They know you and can
often help in ways other supports can’t
•
community supports that are open to everyone in the community, like sporting
clubs, activity groups or libraries. They offer a wide range of services that may help
with your disability support needs. They are often a great way to get involved in your
local community, meet new people, and learn new skills
•
mainstream supports which are other government services such as employment,
education, health, and family support services. They are available to everyone,
including people without disability. There are many ways they can help you. For
example, they can help you learn new skills or how to live as independently as
possible.
How do we include your NDIS supports in your plan?
We include your NDIS supports in funding component amounts in your plan. When we
create your plan, we’ll include funding for a specific support or groups of reasonable and
necessary supports in your plan. Your plan could include one funding component or more
than one funding component.
We’ll describe each NDIS support in the funding component. Learn more abou
t funding
components.
Currently, plans show your supports as funding components grouped under 4 different
support budgets:
•
Core supports
These NDIS supports help you with everyday activities, like helping you to take part in
activities in the community. Core supports are usually flexible. If your Core supports
are flexible, you will have lots of choice over the Core supports you buy under your
plan.
If your Core supports are stated, you can only use the funding to buy the approved
NDIS supports in the Core supports budget. It can’t be used to pay for anything else.
If you have different plan management types for different supports within the Core
supports budget, this may also reduce the flexibility of how you can use your NDIS
funding.
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•
Capacity building supports
These NDIS supports help you build your skills and increase your independence. This
should reduce the need for the same level of support in the future. We’ll discuss your
progress and outcomes from these supports at each plan reassessment.
Capacity building supports are stated. This means you can only use this funding to
buy the NDIS supports described in the capacity building budget.
•
Capital supports
These NDIS supports include high-cost assistive technology, equipment, vehicle
modifications, home modifications and specialist disability accommodation.
Your capital supports are stated. This means you can only use this funding to buy the
NDIS supports described in the capital supports budget.
•
Recurring supports
Your funding for recurring supports will be paid regularly to your nominated bank
account. This funding is not included anywhere else in your budget.
Learn more about the
support budgets and support categories in your plan.
We are moving to a new way of showing your budget in your plan to give you more flexibility
in how you manage your individual supports. Your next plan may not show your capacity
building, capital and recurring supports in the same way. Your NDIS supports will be
included in your plan as individual funding components instead of being grouped as a
support budget, like capacity building or capital. Your plan will still show if the supports are
flexible or stated.
Learn more about flexible and stated NDIS supports in
How do we describe the supports in
your plan?
How do we include the NDIS funding in your plan?
Some of the changes to the NDIS laws are how we include the funding in your plan. Your
next plan will include
:20
• a total funding amount
• funding component amounts
• funding periods.
What is your total funding amount?
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Your total funding amount is the total amount for all reasonable and necessary supports in
your plan. We’ll call this a 'total budget amount' in your plan.
We develop the total plan funding amount by using the information you gave us and the
NDIS funding criteria.
For each reasonable and necessary support, we look at:
• if you share this support with anyone
• how much of this support you need, including hours, items or equipment
• how often you need this support, including days, weeks, months or years.
We use price limits to help participants and disability support providers to understand how
price controls for supports and services work in the NDIS. You can find more information in
the
NDIS Pricing Arrangements and Price Limits guide on the NDIS website.
We then work out the funding for each support and combine these amounts to arrive at your
plan’s total funding amount.
We display your total funding amount at the beginning of your plan and in your plan approval
letter.
What are funding component amounts?
A funding component amount is the total amount of funding for a specific support, or a group
of reasonable and necessary supports in your plan. This will show the total amount of
funding you have for these supports over the full length of your plan. You can only use this
funding for the NDIS supports included in each funding component.
Your plan could include one funding component or more than one funding component.
A funding component can be for a group of supports. For example, you may have a funding
component for core supports. This can include support categories for assistance with daily
life, assistance with social, economic and community participation, consumables and
transport. You may also have a funding component for another group of supports, like
behaviour supports, assistive technology, or specialist disability accommodation (SDA).
You may also have a funding component for a specific support in your plan. For example,
funding for assistive technology that must be spent on a power wheelchair.
There are things we need to consider when we decide to include a funding component for a
specific support in your plan
.21 These are:
• the type of support
• the cost of the support. This includes thinking about quotes for the support
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• how the support will be provided, including who will be providing the support
• early intervention. This means thinking about if the support will meet your needs
under early intervention
• risk to you
• who will be managing the funding for the supports
• if you haven’t spent your funding on NDIS supports and in line with your plan in
previous plans.
What are funding periods?
Your funding will also be divided into funding periods. A funding period is the time that 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. If you don’t spend all your funds in a funding
period, they will roll over into your next funding period within the same plan.
Any unspent funds won’t roll over to your next plan, as this is a new plan that we need to
make sure meets your disability support needs.
Funding periods can be for either the total budget amount of your plan or for each funding
component amount in your plan.
Funding periods can go for different lengths of time. For example, your plan might have
funding periods of 1, 3, 6 or 12 months. You might have one funding component amount with
3-month funding periods, and one funding component amount with shorter 1-month funding
periods.
Most plans will have more than one funding period. If your plan goes for longer than 12
months, you will always have more than one funding period in your plan. Each funding
period will start immediately after the previous one, so you won’t be left without funding.
Your plan will show:
• if funding periods apply to your whole plan or to funding component amounts
• the dates each funding period starts and ends
• how much funding you can use during each funding period.
There are some things we must think about when deciding how long your funding periods
should be. Learn more abou
t how we decide how long your funding periods go for.
Example
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Sal has recently become an NDIS participant and has received their first plan. Their plan
goes for 5 years and includes two funding component amounts.
1. Their first funding component amount includes $160,000 for Core supports. Sal can
use this funding to pay for NDIS supports to help them in their daily life, and to
participate in the community.
Their funding period is 3 months, so they’ll receive $8,000 every 3 months to use on these
Core supports.
In the first funding period of Sal’s plan, they spend $5,000 on NDIS supports. This means
that $3,000 will roll over to the next funding period, when they will now have $11,000 they
can buy NDIS supports with.
2. The second funding component amount in Sal’s plan is $1,500 for assistive
technology, because they need a shower chair. This is the only support Sal needs for
assistive technology, so we create a funding component amount for this specific
support. We expect Sal to spend most of this funding in one go when they buy the
shower chair. So, we include the $1,500 for assistive technology in the first funding
period of their plan. This funding period is for 3 months. Sal won’t need funding for
assistive technology included in the other funding periods of their plan.
Any unspent funds in the last funding period of a plan won’t roll over to the next plan. We’ll
need to make a new plan to make sure it meets your disability support needs.
Learn more about how to use your funding in
Our Guideline – Your plan.
How do we decide how long your funding periods go for?
Before setting funding periods, we have to think about
:22
• the total funding amount in your plan
• the type and cost of supports in your plan
• how long you’d like your funding periods to go for.
We also think about
if:23
• you’re unlikely to spend your funding on NDIS supports and
in line with your plan
• you are at risk of experiencing fraud or financial exploitation
•
you are at risk of experiencing physical, mental or financial harm because of the
length of your funding periods
• you, your plan nominee or child representative a
re currently insolvent under
administration
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• you’ve overspent your funding in previous plans
• a payment for a support is more than the amount you have in your plan for the funding
period
• you’ve asked several times for a change to your plan but haven’t given us information
about a change in your support needs
• you haven’t spent your funding on NDIS supports and in line with your plan in
previous plans.
For most supports, funding periods will generally go for 3 months. They may be able to go
for longer if all of these apply to you:
• you tell us you’d like longer funding periods
• there’s a special reason you need longer funding periods. For example, if you have a
degenerative condition where your support needs are uncertain
• you’ve previou
sly spent your funding on NDIS supports and in line with your plan
• we don’t think there is a risk to you
• you’re likely to spend your funding on NDIS supports and in line with your plan.
Some regular supports in your plan will generally have 1-month funding periods. This
includes:
• supported independent living (SIL) and individualised living options (ILO)
• funding for a registered plan manager
• specialist disability accommodation (SDA)
• cross billing payments for residential aged care subsidies and supplements
• home and living or core funding for assistance with daily living that is more than
$200,000 per year.
You can tell us if you’d like shorter funding periods. For example, you might want 1-month
funding periods to help you manage your funding.
Funding periods may also go for 1 month
if:24
•
you, your plan nominee or child representative are currently insolvent under
administration
• you’ve overspent your funding in previous plans
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• you haven’t spent your funding on NDIS supports and in line with your plan in
previous plans
• you’ve asked several times for a change to your plan but haven’t given us information
about a change in your support needs.
When will you get your funding?
Funding will generally be spread evenly across the funding periods of your plan. This is to
make sure you have funding to pay for supports over the whole length of your plan. For
example, if you have 3-month funding periods and your plan goes for 12 months, you will
generally get 25% of your funding at the start of each funding period.
Sometimes, you may get different funding amounts for regular supports in each funding
period. For example, if you have funding for in-home care every day, we think about the
number of days in each funding period, including weekends and public holidays.
For some supports with 3-month funding periods, you’ll get all the funding in the first funding
period of your plan or in the funding period that falls before you need to buy these supports.
If you don’t buy the supports you need in one funding period, your funding will roll over to the
next funding period. Supports that work in this way include:
• assistive technology
• vehicle modifications
• home modifications
• repair and maintenance of assistive technology
• therapy supports related to assistive technology, vehicle modifications and home
modifications. For example, funding for an allied health professional to assess what
assistive technology you need before you buy it
• medium term accommodation.
If you have supports for enteral feeding products, you’ll get 12 months of funding for these in
the first funding period of each year of your plan.
We may also provide more funding in the first funding period of your plan for other supports,
including:
• behaviour support. For example, if you need funding to work with your behaviour
support practitioner to develop a behaviour support plan
• if you have changing support needs
• if you have a change of situation, like being discharged from hospital
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• if you need intensive capacity building supports for a time
• to cover set-up costs for your first plan
• to bulk buy consumables, like continence products.
What are your options for managing your funding?
You have
three options for how you can manage the funding in your plan.25
•
Self-managed: you, your plan nominee or child representative, manage the funding
and pay your providers.
• A
registered plan manager: they
manage the funding and pay your providers.
•
Agency-managed: we manage the funding and pay your providers.
You can also choose a mix of these options. For example, you might like to manage some of
the funding yourself, and we’ll manage the rest.
There are different benefits for each plan management option.
Self-management gives you the most flexibility. You manage every decision when it comes
to spending your funds on NDIS supports and in line with your plan
.26
Using a registered plan manager provides you with support and assistance to manage your
funding.
Having your funding Agency-managed means you’ll have fewer things to do when it comes
to managing your funding.
Whether your funding is managed by you, us, or a registered plan manager, managing NDIS
funding mean
s:27
• buying the NDIS supports as described in your plan, including paying GST related to
those supports. This means paying for NDIS supports in your plan:
o in line with the funding period
s28
o within the total funding amount and funding component amoun
ts29
• receiving and managing your NDIS funding, including paying for NDIS supports on
time
• keeping track of what you buy with your funding, including keeping receipts and
invoices.
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:
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• 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
• make sure your funding will last for the length of each funding period if your plan
includes funding periods and funding component amounts.
When you buy supports in line with your plan, you need to make sure they a
re NDIS
supports or an agreed replacement support that relates to your disability.
We’re committed to helping you have more choice and control when it comes to managing
your funding if that’s what you want.
We’ll talk to you about what you want and what suits you when it comes to managing your
funding.
We’ll talk more about the different plan management options in the next sections.
Your plan will say who manages your NDIS funding
.30
Learn more abou
t ways to manage the funding in your plan.
What does it mean to self-manage your funding?
We’re committed to helping you manage your own funding if that’s what you want to do,
unless there a
re reasons why you must not manage your funding. Managing your own
funding can give you more choice and control over how you use the funding in your plan.
Self-managing your funding means you can choose what NDIS supports you buy in line with
your plan. This means paying for NDIS supports in your plan
:31
• in line with your funding period or funding periods, and
• within the total funding amount and funding component amounts.
You can decide who provides these NDIS supports and how they are delivered. You can
also negotiate costs above or below the
NDIS Pricing Arrangements and Price Limits. This
can help you arrange your NDIS supports in a way that gives you the best value. But you
always need to make sure you have enough funding in your plan to last for the funding
period.
You’ll also be responsible for receiving your funding, arranging your NDIS supports and
paying your providers on time. You’ll need to keep records of invoices and receipts for 5
years. You’ll also need to meet your obligation as an employer if you choose to
employ staff
directly or use a contractor.
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You might want to self-manage a part of your funding. This can be a good way to develop
your skills. It may help you self-manage more of your funding in the future if you want to.
How can you learn how to self-manage your funding?
You might want to learn or improve your skills to help you manage your NDIS funding. For
example, you might want to build your skills to:
• budget and keep records of your purchases
• choose your NDIS supports and get the most out of your plan
• claim your NDIS funding, pay providers, and make service agreements.
If you need support to build your skills to manage your funding, we might be able to fund
support. If it meets the
NDIS funding criteria we can include funding in your plan for capacity
building and training in self-management. Talk to your my NDIS contact about this.
You might choose to use the funding on training with another organisation. As you build your
capacity in self-managing, you’re likely to need less of this support in the future.
We can also answer questions about self-management and help you problem-solve when
you start out.
We’ll talk to you about whether there are an
y mainstream and community supports which
could help you. These are the supports you get outside the NDIS, and are available to
everyone, whether or not they have a disability. Supports outside of the NDIS can help you
build your skills to manage your own finances and learn about self-management.
You might speak with your informal supports, and other participants who self-manage to
learn more about self-management. Community supports can help connect you to important
and practical information about self-management. You’ll need to decide if information from
outside the NDIS is reliable and if you want to use it.
We know you might be nervous about self-managing funds. We understand making mistakes
can be an important part of learning to self-manage, and sometimes things can go wrong. If
you have any issues, you can alwa
ys contact us and we’ll work with you to fix them.
You can read ou
r guide to self-management, and learn more about
self-managing on the
NDIS website.
Self-management and NDIS registered providers
If you self-manage your funding or use a registered plan manager, you can generally use
any provider. But you must use a
registered NDIS provider if they provide:
•
specialist disability accommodation
•
behaviour support
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• supports where the use of restrictive practices occurs or is likely to occur.
Sometimes we might also say in your plan which provider you need to use.
A registered provider meets the
NDIS quality and safety standards. Workers with registered
providers also undergo an
NDIS worker screening check to make sure a worker is safe for
you to use.
You can contact the
NDIS Quality and Safeguards Commission to check for registered
providers. They can also help if you’re worried about a provider’s compliance with their legal
obligations. If you choose a provider that isn’t registered, you’ll need to make sure they have
the right qualifications, training, and safety checks. You can ask providers, employees or
contractors providing you with supports to do an NDIS worker screening check.
When can’t you self-manage your funding?
You, your plan nominee or child representative can’t self-manage your funding if:
• you, your nominee or child representative are curren
tly bankrupt or insolvent under
administration32
• you or your nominee have been convicted of an offence punishable by 2 or more
years in priso
n33
• you or your nominee have been convicted of an offence involving fraud or
dishone
sty.34
Or if we think that:
• you, your plan nominee or child representative are unlikely to spend your funding only
on NDIS supports and in line with your pla
n35
• there’s an
unreasonable risk to you if you, your nominee or child representative self-
manage your funding
.36
Are you bankrupt or insolvent?
You can’t manage your NDIS funding if you’re currently insolvent under administration
.37
Your plan nominee or child representative also can’t manage your funding if they’re insolvent
under administration
.38
Insolvent generally means you can’t pay your debts when they are due.
Your NDIS funding can’t be self-managed if you, your plan nominee or child representative:
• are curren
tly bankrupt – contact the
Australian Financial Security Authority if you’re
not sure
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• have property under the control of people you owe money to
.39 For example, your
bank or the Australian Financial Security Authority
• have a
personal insolvency agreement to repay money you owe, and you haven’t
followed the agreemen
t40
• have a
debt agreement to repay money you o
we.41
This also applies if you, or your plan nominee or child representative are insolvent under
administration in another country
.42
You might be able to self-manage your funding if you’re no longer insolvent under
administration. But we’ll consider if there might be an unreasonable risk if you manage your
funding.
Your plan nominee might be a company or body corporate, like a service provider or
advocacy organisation. If so, they can’t be insolvent either.
A company or organisation can’t manage your funding if they are unde
r voluntary
administration, liquidation, or receivership.
What if you’ve been convicted of an offence punishable by 2 or more years in prison
or involving fraud or dishonesty?
We need to think about if you or your plan nominee have had any criminal convictions. You
can’t self-manage if you or your nominee have been convicted of an offence tha
t:43
• led to a prison sentence of 2 years or more
• involves fraud or dishonesty.
What if you have a plan nominee or child representative?
If it’s part of their nominee arrangement, a plan nominee or child representative, may be able
to manage your plan funding.
Your plan nominee may also be able to request who will manage your plan funding. They
can do this if their nominee arrangement allows them to make decisions about parts of the
preparation, management or changes to your plan.
Your plan nominee needs to work with you to understand what you want. They need to make
decisions that help your personal and social wellbeing
.44 We’ll think abou
t any risks to you if
a plan nominee or child representative manage your plan funding. We’ll also look a
t supports
and strategies we can include in your plan to reduce these risks.
We can’t let your plan nominee or child representative manage your plan funding if they’re
currently bankrupt or insolvent under administration
.45
Or if we think:
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• they’re unlikely to spend your funding on only NDIS supports and in line with your
p
lan46
• it presents an unreasonable risk to yo
u47
• any business or other interests might affect how they manage your money.
We also can’t let your plan nominee manage your funding if
• they’ve been convicted of an offence punishable by 2 or more years in priso
n48
• they’ve been convicted of an offence involving fraud or dishones
ty.49
We consider risk in the same way as if you want to self-manage your plan funding.
Learn more abou
t unreasonable risks and
spending funding on NDIS supports and in line
with your plan.
Learn more abou
t nominees o
r child representatives.
What does it mean when a registered plan manager manages your
funding?
You can choose a registered plan management provider to support you to manage your
funding. They can buy NDIS supports on your behalf from the funding you provide them from
your plan.
A plan manager can help you:
• increase your financial and plan management skills
• pay providers
• increase your choice of providers
• get NDIS plan budget reports and help you monitor your budget.
If you use a registered plan manager to manage your funding, we’ll always include funding in
your plan to cover plan-management costs.
Your registered plan manager can’t claim more than the
NDIS Pricing Arrangements and
Price Limits.
Having a registered plan manager can reduce risks involved with managing funding in your
plan. But there may still be risks to you that we need to consider.
You’ll still need to make sure any provider you choose provides NDIS supports that are safe
and meet your needs.
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We respect your right to take reasonable risks in having a registered plan manager to
manage your NDIS funding. We’ll talk to you about what might help reduce any risks with
having a plan manager manage your funding. We’ll also talk about what helped reduce risks
in your previous plan
.50 If there are no suitable
supports or strategies available to manage
the risk of harm to you, the risk may be unreasonable.
Before we agree to a registered plan manager managing your funding, we need to think
about if:
• it would be an unreasonable risk to yo
u51
• they're unlikely to spend your funding on supports that are only NDIS suppo
rts52
• they're unlikely to spend funding in line with your plan
.53
When we think about if there is an
unreasonable risk to you, we’ll think about if you are at
risk of physical, mental or financial harm. We look at unreasonable risk and the strategies
available to reduce risk, in the same way as we do for self-managing funding.
We also think about whether a provider has delivered supports to you in a way that has
caused you physical, mental or financial harm. Or, if someone might pressure you to do
something.
We look at if your plan manager ha
s spent your funding on NDIS supports and in line with
your plan in the same way as we do for self-managing funding.
We can help you change your registered plan manager if you need to.
What does it mean when your funding is Agency-managed?
You can choose for your funding to be Agency-managed. This means we’ll pay registered
providers directly, from funding in your plan, for services on your behalf.
We may also decide to make part, or all, of your funding Agency-managed when we approve
your plan
.54 We’ll do this if you don’t choose how you want to manage your funding.
Or if you
can’t, or don’t want to, self-manage or use a registered plan manager for any parts of your
funding. When we decide if your funding should be Agency-managed, we think about your
goals, your NDIS supports and the providers you want to use. For example, if your funding is
Agency-managed you’ll need to use
registered NDIS providers.55 If you prefer to use
providers that aren’t NDIS registered, we’ll discuss your options with you. You might agree to
use registered NDIS providers or consider self-managing or using a registered plan
manager.
If your funding is Agency-managed, your providers can’t claim more than the
NDIS Pricing
Arrangements and Price Limits.
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When your funding is Agency-managed, we don’t generally need to think about whether
management of your plan presents
unreasonable risk.
If you already have a plan and we decide to make part, or all, of your funding Agency-
managed, we’ll work with you to make sure you have the NDIS supports you need.
How do we decide who manages your funding?
We’ll ask you who you want to manage your funding. We’ll discuss strategies to help you do
this the way you want to. We’ll let you know what your plan management options will mean
for you.
You can also ask your friends or family for advice.
You can ask to self-manage your plan or use a registered plan manage
r.56
If you don’t let us know how you want your plan to be managed, we will manage it for you
.57
If you’re under 18, you
r child representative can choose how to manage your plan funding
.58
We’ll agree to your request, unless
:59
• you want to self-manage the funding but that would be an
unreasonable risk to you60
• you already have a
plan nominee, in which case we’ll talk to your nominee about your
plan management options
• your plan nominee or child representative want to self-manage your funding but that
would be an unreasonable risk to yo
u61
• you want to self-manage the funding but you, or your plan nominee or child
representative, a
re bankrupt or insolvent under administration62
• you want a registered plan manager to manage your funding but that would be an
unreasonable risk to yo
u63
• you, your plan manager, nominee or child representative are unlikely to spend your
funding on only NDIS supports and in line with your pla
n64
• you or your nominee have been convicted of an offence punishable by 2 or more
years in priso
n65
• you or your nominee have been convicted of an offence involving fraud or
dishone
sty66
• it’s for in-kind supports, or cross-billing payments for younger people in residential
aged care.
If there are risks with how you want your funding to be managed, we’ll:
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• find out more about the risks. For example, we’ll look at records of spending in
previous plans and any other information or documents you or someone else gives us
• look at the risks in more detail. For example, how often they take place and why
• think about supports and strategies we can include in your plan to
reduce the risks
• record our decision and, if we don’t agree to your request, let you know our reasons.
If you’re not happy with the decision we make about managing your plan, you can ask for a
review of our decision
.67
Learn more abou
t requesting a review of decisions we make.
How do we decide if you will spend your funding on NDIS supports and in
line with your plan?
When we decide how your funding should be managed, we also consider if you, your plan
manager, plan nominee or child representative have
:68
• spent funding on NDIS supports
• spent funding in line with your plan.
If you haven’t done this and you self-manage your plan, we’ll look at
:69
• if it was a once off or not. For example, you may have spent your funding on one
support that wasn’t an NDIS support
• why you haven’t spent your funding on NDIS supports and in line with your plan
• if someone else was involved in the decision to use your funding in this way.
If your plan was managed by a registered plan manager, they were responsible for making
sure your funding was used on NDIS supports and in line with your plan.
We’ll also look at if you, your plan manager, plan nominee or child representative
:70
• have given us the information and documents that we need, and have a reasonable
excuse if you or they can’t
• have been involved in fraud, mismanagement or the misuse of funds or other assets
• have been legally or financially exploited or pressured to do something. For example,
someone spending your funding on supports you don’t want or need. We’ll think about
how often this has happened and why
• have the capacity to make decisions or manage your finances, including when you or
they have support from others
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• anything you or someone else tells us, or that we think we should look at.
We’ll also think about if you had the information and support you needed to spend in line with
your plan. For example, if you speak a language other than English, live in a remote area or
don’t have regular access to internet.
When we look at how you, your plan manager, plan nominee or child representative are
likely to spend, or have spent, your funding, we don’t look at
:71
• the type of impairments you have, but we do look at how your impairments may affect
how you manage your funding
• the total amount of funding in your plan
• not using all your funds in a previous plan
• a period of bankruptcy that has now ended.
The funding in your plan must be spent on the NDIS supports described in your plan. We’ll
explain the types of supports included under each funding component amount in your plan,
so you know how to use your NDIS funding.
Sometimes things can go wrong, or you find something’s not right. This can include things
like not getting the support you agreed to or providers claiming more than you agreed to.
We understand most people try to do the right thing but sometimes make mistakes. We want
to help you to do the right thing when you claim from your plan.
If you think you’ve spent your funding on supports that aren’t in your plan or aren’t NDIS
supports, or you’ve made a mistake with your self-managed claim
s, contact us. We can help
you fix any mistakes and understand how to claim for next time. We’ll also look a
t supports
and strategies we can include in your plan to help you self-manage your funding.
We are also here to support your plan manager with any questions they have or claims they
make.
If you spend funding on supports that aren’t in your plan or aren’t NDIS supports, you may
owe us a debt
.72 This means you’ll need to pay back to us the amount of money spent on
supports that weren’t in your plan.
How do we decide if there is an unreasonable risk to you?
You have the same right as all Australians to take reasonable risks in managing your money.
We respect your right to take reasonable risks if you self-manage your funding or have a
plan manager to manage your funding. But it’s also important to understand any risks this
might create for you.
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In most cases, risks will be small or can be managed. We’ll work with you to address risks
and support your request to self-manage your plan, or have a plan manager to manage your
plan, as much as possible. But you can’t self-manage your funding or have a plan manager if
we think this would create an unreasonable risk to you
.73
Your registered plan manager, plan nominee or child representative also can’t manage your
funding if that would be an unreasonable risk to you
.74
An unreasonable risk is where it is likely that you will experience physical, mental or financial
harm if you, your plan manager, plan nominee or child representative manage your plan.
When we look at risks to you when you, your plan manager, plan nominee or child
representative manage your funding, we look a
t:75
• if there are supports or strategies we can include in your plan, or that were included in
a previous plan, to reduce risks
• informal, community and mainstream supports that you, your plan nominee or child
representative have, or had, in place
• the types of NDIS supports in your plan. For example, we’ll think about how your
supports are delivered and who is delivering them
• if you are at risk of physical, mental or financial harm or exploitation. Or if someone
might pressure you to do something
• your capacity to make decisions or manage your finances, including when you have
support from others
• your plan nominee or child representative’s capacity to make decisions or manage
your finances, including when they have support from others
• if a court or tribunal has ordered someone else to manage part or all of your property
or finances
• if a court or tribunal has ordered someone else to manage part or all of your plan
nominee or child representative’s property or finances
• anything you, your plan manager, plan nominee or child representative tell us that we
think is relevant, or that we think we should look at.
When we look at risks, we don’t look at
:76
• the type of impairments you have, but we do look at how your impairments may affect
how you manage your funding
• the amount of funding in your plan
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• if you haven’t used all your funds in a previous plan.
When we are thinking about unreasonable risk to you, we look at your whole situation, not
just one thing by itself. We also look at the supports and strategies we can use to reduce
risk, or that we have used in a previous plan. For example, if you only have a little
experience managing your finances, but strong informal supports like a family member who
can support you with budgeting.
We’ll only decide there is unreasonable risk to you if there are no suitable supports or
strategies available to reduce the risk of harm to you.
Learn more about the
supports and strategies we can use to reduce risk.
How do we decide if there is possible physical, mental or financial harm
to you?
When thinking about risks to you, we’ll look at if there is evidence of possible physical,
mental or financial harm to you. Evidence of possible harm won’t always mean there is an
unreasonable risk to you if you want to self-manage your funding or have a plan manager to
manage your funding. We’ll also think about:
• how big the risk of harm is to you
• if the risk of harm will affect how the funding in your plan is managed.
We know it can be difficult to talk about this information. We’ll only talk about it to make sure
we can identify any possible risks. We can then work out together if we can put
supports and
strategies in place to reduce the risks.
Examples of physical harm might include if there is evidence of:
• you being injured from a reckless or intentional act, caused by you or another person,
like a fracture, contusion, wound, burn or concussion
• you being physically assaulted by a carer, support person, family member or member
of the community, which causes serious harm or injury
• serious unexplained injury to you while receiving NDIS supports
• you having a history of habitual or continued substance abuse within the last 12
months.
Examples of mental harm might include if there is evidence of a family member, carer, or
support person:
• denying you food as ‘punishment’
• threatening to harm you
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• abandoning you by denying support permanently
• consistently not letting you go out and do activities
• secluding or restraining you.
Mental harm might also include an allegation of you being subject to offensive, abusive, or
demeaning language by a family member, carer, plan manager, or support person. This may
also create an unreasonable risk to you.
Examples of financial harm might include if there is evidence of:
• you being financially exploite
d77
• frequent changes in nominee or child representative
• you, your nominee or child representative having a gambling addiction
• you, your nominee or child representative being the victim of coercion, such as being
coerced to sign for a loan or power of attorney
• you, your nominee or child representative being insolvent under administration in the
past 5 years
• deliberate misuse of, or fraud, in relation to plan funds, by you, your plan manager,
nominee or child representative
• you, your nominee or child representative having been involved with the criminal
justice system in relation to funds management or fraud.
Learn more about how we identify, think about and manage risks in ou
r Participant
Safeguarding Policy.
What supports or strategies can we use to reduce risks?
We’ll talk to you about how we can support you to manage any risks to your funding, whether
you are self-managing or using a registered plan manager. Before we make a plan
management decision, we’ll think about:
• supports and strategies that can reduce the risk to you
• supports and strategies that have reduced the risk to you in a previous plan
.78
This includes informa
l, mainstream and community supports.79 In many cases this means
you, your plan nominee, plan manager or child representative, will still be able to manage
part or all of your funding. We just need to make sure the risk to you is no
t an unreasonable
risk.
We’ll consider the specific risk to you and look at suitable ways to help you manage the risk.
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If you want to self-manage your funding, we can give general advice and information, which
might be enough to manage any risks to you. This includes information on things like
employing your own staff and working with providers. If you’re new to self-management, we
can work with you to try and solve any problems you have. We might be able to fund a
support coordinator or a registered plan manager to help you get started. Or include funding
for training in self-management.
Other strategies we can consider to reduce risks to you include:
• giving you a plan with a shorter length of time or shorter funding period
s80
• having regular check-ins with you
• stating how a support in your plan needs to be purchased. For example, there might
be only a few providers who can safely provide a specialised support.
When we think about risks, we also think about the types of supports you want to manage. If
there is an unreasonable risk to you if you, your plan nominee or child representative self-
manage some supports, you might be able to manage other supports in your plan. You might
also be able to manage some of your funding now and manage more in the future if you’re
ready.
For example, you may want to self-manage your funding but haven’t done it before. You may
be unsure how to set up your budget and pay your providers. It might be a good idea to start
small. We could support you to link to a peer support network to get information from other
self-managers about how they manage their payments. For example, you might be able to
start with self-managing the funding component amount for core supports such as social and
community participation.
At regu
lar check-ins you can let us know if you need any help to self-manage your funding,
or if you want to manage more of your funding. Once you’re familiar with the process of
paying providers and keeping records, you might be ready to self-manage other parts of your
funding.
If we can reduce the risk to you with supports and strategies, we’ll put funding in your plan
for additional supports, if needed. We’ll also record what we have done and why.
If we can’t reduce the risk to you with supports and strategies, we may decide that:
• part or all of your plan should be managed by a
registered plan manager
• part or all of your plan should be Agency-managed.
We’ll tell you why we have made this decision and talk about what we can do to support your
plan management choice in the future.
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If we decide to make part, or all, of your funding Agency-managed, you can only use
registered NDIS providers for your supports. We’ll work with you to make sure you have the
NDIS supports you need.
How long will your plan go for?
Everyone has different goals, living situations, and circumstances. So, we’ll work with you to
decide how long it will be before we create your next plan. This will be based on your
individual situation.
We think about how long you want your plan to go for. We’ll try to make the plan length what
you want, where we can.
If you don’t tell us what plan length you want and your living and support needs are stable,
your plan will usually go for:
• 5 years if you’re aged 9 and over
• 2 years if you’re younger than 9.
5 years is the longest time a plan can go for before we do a plan reassessment. Or 2 years
for a child younger than 9.
If your needs are likely to change soon, your plan will be shorter.
Participants younger than 9
These plans will go for one year if:
• participants have early intervention supports, and we expect they’ll work for them.
This means that they won’t generally need NDIS supports long term, after early
intervention supports have finished
• participants have developmental delay and need a formal diagnosis
• participants have intensive capacity building supports. This is so we can look at how
the intensive supports are working
• participants have a positive behaviour support plan with restrictive practices.
Participants aged 9 and over
Your plan will go for 2 years if:
• you have early intervention supports and we expect they’ll work for you. This means
you won’t generally need NDIS supports after early intervention supports have
finished
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• you have a degenerative condition, like multiple sclerosis or muscular dystrophy, or a
terminal illness and disability. This is because we expect your needs to change. This
doesn’t include younger people in residential aged care.
Your plan will go for one year if:
• you have a positive behaviour support plan with restrictive practices.
Your plan length may be different if:
• you have a
Compensation Reduction Amount (CRA) or a
State and Territory Statutory
Scheme (SATSS) plan. In these cases, your plan length will be based on the review
date of your CRA or SATSS
• you’re under 65 and in residential aged care (YPIRAC) and have a goal to move out
of aged care. In this case, we would provide you with a temporary plan to support
your transition out of aged care and to support cross billing.
All participants
Your plan length may be different if:
• you’re going to be discharged from hospital. In this case, we would provide you with a
temporary plan to support your transition out of hospital
• you have a life milestone coming up, like starting or finishing school or moving out of
home.
If you’re not happy with how long your plan goes for, you can ask us to vary your plan. We
call this a plan variation. Learn more about
plan variations.
Your plan will say when we must do a plan reassessment, if we haven’t reassessed your
plan before th
is.81 We call this the ‘NDIS plan reassessment date’.
Learn more abou
t plan reassessments.
When will we approve your plan?
We’ll approve your NDIS plan as soon as we reasonably can, based on your situation
.82 We
may take longer to approve your plan if we need you to give us more information or get an
assessment.
For children younger than 9, we aim to approve your plan within
90 days after you
become a participant.
If you’re 9 or older, we aim to approve your first plan within
56 days after you become a
participant.
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What happens once you have your plan?
Once we approve your plan, you’ll get a copy within
7 days.83 We’ll ask how you’d like to
receive your plan.
You can also find it on the
my NDIS portal and
my NDIS app as soon as we approve it.
If you have a nominee or child representative, they’ll get a copy too, if they’re authorised to
get it. You can also ask us to share it with other people. We can only share your plan where
you ask us to. Learn more about
your privacy and information.
Once you have a plan, you can start using it to buy your NDIS supports. Your plan officially
‘starts’ on the day we approve it
.84 Your my NDIS contact, support coordinator or recovery
coach can help you start using your plan.
We can only pay for your NDIS supports after your plan starts. We pay for NDIS supports in
line with your plan
.85
During your plan, we’ll check in with you to see how you’re going, and how your plan is
working for you. We may check in with you:
• at least annually, or more often depending on your circumstances
• if we think your plan might not be working for you. For example, if you’re using too
much or too little of your NDIS supports
• if you would like help to use your NDIS supports in your plan.
Your plan ends when we approve a new one, or you
leave the NDIS.86 Your plan doesn’t
expire or stop, even if we haven’t created a new plan by the plan reassessment date. You
are never left without a plan, unless you leave the NDIS.
Learn more about what happens once you have your plan in
Our Guideline – Your Plan.
Can you change your plan?
Once we approve your plan, you can request a change to your plan at any time. We can also
change your plan if we need to
.87
If you want to change the information about you and your goals, we can change your plan to
include this at any time
.88 This new plan will have the new statement about you and your
goa
ls.89 It will have the same supports.
For other changes to your plan, you’ll need to give us information explaining why you think
your plan needs to change.
Please contact your my NDIS contact or support coordinator if you’d like to request a change
to your plan. We also have
a form you can complete.
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Learn more in
Our Guideline – Changing your plan.
What if you don’t agree with your plan?
If you’re not happy with your plan, you should talk to 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
budget amount, we can send this to you. You can contact us and ask for a Budget
breakdown.
We’ll give you written reasons on why we made the decision.
Contact us if you’d like to
discuss the reasons for our decision.
If you don’t agree with our decision to approve your plan, you can ask for an internal review.
Your my NDIS contact, support coordinator or recovery coach can help you ask for an
internal review. We also have
a form you can complete.
Having an internal review means someone who wasn’t involved in creating your plan will
review our decision to approve your plan. They’ll consider if we made the right decision
under NDIS laws. An internal review is different to a change or plan reassessment after a
check-in or when your situation changes.
Once you get your plan, you have 3 months to ask for an internal re
view.90
Learn more abou
t reviewing our decisions.
Reference list
1 NDIS Act.s 33(1).
2 NDIS Act s 34(1)(aa); NDIS (Supports for Participants) Rules r 5.1(b).
3 NDIS Act s 34(1)(aa); NDIS (Supports for Participants) Rules r 5.1(b).
4 NDIS Act s 34(1)(aa); NDIS (Supports for Participants) Rules r 5.1(b).
5 NDIS Act s 33(8).
6 NDIS Act s 46.
7 NDIS Act s 34(1)(a).
8 NDIS Act s 10.
9 NDIS Act s 4(4).
10 NDIS Act s 4(4).
11 NDIS Act s 118(1)(a)(v).
12 NDIS Act s 44 (1)(b)(i).
13 NDIS Act s 44; NDIS (Supports for Participants) Rules r 5.1(a).
14 NDIS Act s 31.
15 NDIS Act s 32(2).
16 NDIS Act s 10.
17 NDIS Act s 34(1)(a).
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18 NDIS Act s 34 (1)(aa); NDIS (Supports for Participants) Rules r 5.1(b).
19 NDIS Act s 34(1)(f).
20 NDIS Act s 33.
21 NDIS (Old Framework Plans) Determination 2024 s 5(2).
22 NDIS (Old Framework Plans) Determination 2024 s 7(2).
23 NDIS (Old Framework Plans) Determination 2024 s 7(2).
24 NDIS (Old Framework Plans) Determination 2024 s 7(2).
25 NDIS Act s 42(2).
26 NDIS Act s 46.
27 NDIS Act s 42(1).
28 NDIS Act s 46.
29 NDIS Act s 46.
30 NDIS Act ss 33(2)(d), 42(2).
31 NDIS Act ss 33, 46.
32 NDIS Act ss 44(1)(a), 44(2A)(a), 74(4)(a).
33 NDIS Act ss 44(1)(aa)(i), 44(2A)(aa)(i).
34 NDIS Act ss 44(1)(aa)(ii), 44(2A)(aa)(ii).
35 NDIS Act ss 44(1)(c), 44(2A)(c), 74(4)(b)(iii).
36 NDIS Act ss 44(1)(b)(i), 44(2A)(b), 74(4)(b)(i).
37 NDIS Act s 43(3)(c).
38 NDIS Act ss 43(6)(d), 74(4)(a).
39 Bankruptcy Act 1966 (Cth) s 50, pt X div 2.
40 Bankruptcy Act 1966 (Cth) pt X.
41 Bankruptcy Act 1966 (Cth) pt IX.
42 Corporations Act 2001 s 9.
43 NDIS Act s 44(1)(aa)(i-ii), 44(2A)(aa)(i-ii).
44 NDIS Act s 80(1); NDIS (Nominees) Rules rr 5.3-5.6.
45 NDIS Act ss 44(2A)(a), 74(4)(a).
46 NDIS Act ss 44(5), 74(4)(b)(iii).
47 NDIS Act s 44(3), 74(4)(b)(i).
48 NDIS Act s 44(2A)(aa)(i).
49 NDIS Act s 44(2A)(aa)(ii).
50 NDIS (Management of Funding and Plan Management) Rules r 6.3(a)-(b).
51 NDIS Act ss 44(2), 44(3)-(4).
52 NDIS Act ss 44(2AA), 44(5).
53 NDIS Act ss 44(2AA), 44(5).
54 NDIS Act s 43(3)-(4).
55 NDIS Act s 33(6).
56 NDIS Act s 43(1)(a)(b).
57 NDIS Act s 43(8).
58 NDIS Act s 74(2).
59 NDIS Act ss 43(2), 44.
60 NDIS Act s 44(1)(b)(i).
61 NDIS Act ss 44(2A)(b), 74(b)(i).
62 NDIS Act ss 44(1)(a), 44(2A)(a), 74(4)(a).
63 NDIS Act s 44(2).
64 NDIS Act ss 44(1)(c), 44(2AA), 44(2A)(c), 74(3C)(b).
65 NDIS Act s 44(1)(aa)(i), 44(2A)(aa)(i).
66 NDIS Act s 44(1)(aa)(ii), 44(2A)(aa)(ii).
67 NDIS Act s 100.
68 NDIS Act ss 46.
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69 NDIS Act s 44(5); NDIS (Management of Funding Rules) r 5.2(a).
70 NDIS (Management of Funding) Rules rr 5.2(b)-(g).
71 NDIS (Management of Funding) Rules rr 5.3(a)-(d).
72 NDIS Act s 182(3).
73 NDIS Act s 43(3)(d).
74 NDIS Act ss 43(4A)(b), 43(6)(e), 74(4)(b)(i).
75 NDIS (Management of Funding and Plan Management) Rules rr 6.2(a)-(h), 6.3(a)-(e), 6.4(a)-(h), 6.5(a)-(h).
76 NDIS (Management of Funding and Plan Management) Rules rr 6.6(a)-(c).
77 NDIS (Management of Funding and Plan Management) Rules rr 6.2(d), 6.3(c), 6.4(d), 6.5(d).
78 NDIS (Management of Funding and Plan Management) Rules rr 6.2(a)-(b), 6.3(a)-(b), 6.4(a)-(b), 6.5(a)-(b).
79 NDIS (Management of Funding and Plan Management) Rules rr 6.2(a)-(b), 6.3(a)-(b), 6.4(a)-(b), 6.5(a)-(b).
80 NDIS Act s 33(2A)-(2B).
81 NDIS Act s 33(2)(c).
82 NDIS Act s 33(4).
83 NDIS Act s 38.
84 NDIS Act s 37(1).
85 NDIS Act s 33.
86 NDIS Act s 37(3).
87 NDIS Act s 47(A).
88 NDIS Act s 47(1).
89 NDIS Act s 47(2).
90 NDIS Act s 100(2).
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Creating your plan
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