On October 3, 2024, the NDIA introduced the exclusion list as part of the federal government's legislation changes under the "Getting the NDIS Back on Track" initiative. This update aims to provide greater clarity and flexibility on what NDIS funds can and cannot be used for, reducing confusion for participants and ensuring that funds are allocated appropriately to supports that are directly related to disability needs.
Key Updates to the Exclusion List
The new exclusion list specifies clearer definitions of what constitutes "reasonable and necessary" supports under the NDIS. Here are some important updates:
Supports that are not 'NDIS supports'
The NDIS cannot be used to support the provision of: sexual services, alcohol, drugs that contravene a Commonwealth, State or Territory law.
Day-to-day living costs such as. Accommodation, groceries, lifestyle, beauty related services, motor vehicle and travel for holidays, expenses for pets and reproductive health.
Not evidence-based services. Alternative therapies, wellness, energy, and healing practices.
See the full list here. easy read here.
The NDIS would typically not fund a requested support if:
it is likely to cause harm to you or others
it is not related to your disability
it provides the same benefit as another support already funded by the NDIS in your plan; or
it relates to a day-to-day living cost (for example, rent, groceries or utility costs like your water bill) that are not directly related to your disability support needs (NDIS Supports for Participants Rule 5.1(d)).
it is being used as income replacement (NDIS Supports for Participants Rules 5.3(b)).
Replacement Support:
In some cases, participants can request to substitute an excluded item with something else that provides better value or outcomes.
The NDIS defines a replacement support as a support that must:
replace an NDIS support or supports in your plan
help you the same or more than the NDIS support or supports it’s replacing
cost the same or less than the NDIS support or supports it’s replacing.
A replacement support must be for your disability support needs.
A replacement support is not an extra support. It replaces an existing NDIS support or supports in your plan. This means your total budget amount will not change if we approve a replacement support.
Updates to what is Included
Support for Cultural Activities: New provisions now allow First Nations participants to access supports for cultural participation as part of their disability-related needs.
Assistive Technology and Household Modifications: The NDIA now allows for internal and external building modifications if they are needed to address disability-related damage or wear from assistive technology.
Personal Care Items: Specific personal care items, such as menstrual products required for disability-related reasons, have been added as eligible for funding under assistive products.
Driver Training with Adaptations: The list also includes driver training with specialised instructors, especially for participants using adapted vehicles or equipment.
Examples of When It Is Reasonable to Claim Excluded Items
Modified Household Goods: If a participant requires a specialized, disability-friendly appliance (such as a wheelchair-accessible washing machine), this could still be considered reasonable under the new rules, even if standard versions of the same item are excluded.
Therapeutic Activities: Participation in activities like adaptive sports or art therapy, when clearly linked to a participant’s goals in their plan, may be covered, especially if they contribute to physical or social development.
Examples of When It Isn’t Reasonable to Claim Excluded Items
Standard Recreation Costs: General entertainment, such as movie tickets or gym memberships, remain excluded unless directly tied to a therapeutic or disability-specific goal.
General Medical Costs: Routine health care, dental work, or medication costs that fall under the healthcare system remain ineligible for NDIS funding.
Transition Period
To help adjust to these changes, a 12-month transition period has been introduced. During this time, participants who mistakenly claim excluded items under $1,500 will not face penalties, but repeated or fraudulent claims will result in further action
by the NDIS.
Claims and Authorisation
During the transition period when claiming for items and services on the exclusion list, there may be times where claims can only be processed with explicit authorisation from a Planner. This may mean the support must be specifically included in your NDIS plan or approved in writing by the Planner.
These updates aim to make it easier for participants to manage their plans with clearer guidelines and flexibility in certain areas where replacements may offer better support. If you have any questions or concerns about how these changes affect your plan, don’t hesitate to reach out for assistance.