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NDIS eligibility: The funding gap

Does the funding criteria put you at risk of missing out on vital support?

Girl in wheelchair at table with parents, laptop and notebook

The National Disability Insurance Scheme (NDIS) is designed to offer long-term, person-centred care and support to Australians with a significant and ongoing disability.

Through personalised funding packages, the NDIS intends to help people with disability fully participate in society and reach their goals and aspirations. But there are many people with disability likely to miss out on its benefits.

Of the estimated 4.3 million Australians living with disability, NDIS eligibility is an issue. The majority won’t be entitled to NDIS funded packages and many of those who are eligible won’t engage with the scheme, or have the access or support to apply for it.

This article explains some of the gaps in the NDIS and the strategies helping to address them.

Proving NDIS eligibility

To be part of the NDIS, you need to meet a number of eligibility requirements. The Australian Institute of Health and Welfare (AIHW) estimates that 89% of people with disability will not be eligible for the NDIS.

This may be because their disability is deemed not permanent or not significant. Many people with psychosocial disabilities and chronic illnesses struggle to prove their condition is likely to be permanent. Modern approaches to mental health treatment now emphasise recovery, making it difficult for people with serious mental health issues to access support through the scheme.

There are also issues in completing the applications correctly, with many people finding the system confusing. People with cognitive, social and emotional impairments can find it challenging to apply for the scheme and demonstrate appropriate proof of eligibility.

Disadvantaged groups

Even among those people who are eligible for the NDIS, there will be a significant number that can’t access it.

These people often have multiple and complex support needs, such as cultural and language barriers, mental illness, poor education, poverty and drug and alcohol use. They may also be in the criminal justice system, where they’re less likely to be identified as having a disability.

Young people may be unaware of the NDIS, in particular, those living in residential care. Research has shown young people in nursing homes can lack the skills, advocacy and support networks to access the scheme.

There are also people who may not associate themselves with having a disability due to differing cultural or generational perspectives on diversity. Research shows people from Indigenous or other culture and language-diverse backgrounds are less likely to identify as having a disability or use disability services.

Other people may not apply the disability label because of the wrongful stigma and discrimination associated with it. Or they may believe their condition or behaviour is a developmental stage or in the case of older people, a consequence of aging.

The National Disability Insurance Agency (NDIA) has relatively few customer service outlets and relies heavily on online communication channels. This is problematic for people with disability living in rural and regional areas. These areas are generally more digitally excluded, with limited access to the internet.

The future of disability support in Australia

In February 2018, the NDIA commissioned Flinders University to provide an independent evaluation of how the NDIS was faring after two years in operation. In response to the evaluation, the agency has developed a new strategy for disadvantaged groups.

This strategy includes better systems to assist Early Childhood Early Intervention (ECEI) for children under the age of seven with developmental delay or disability, people with complex needs, psychological and social disabilities, Aboriginal and Torres Strait Islander communities, people living in remote communities and people from culturally and linguistically diverse (CALD) communities.

People with a disability who do not meet NDIS access requirements, and have previously received support, have been promised continuation of their current government supports. Unfortunately, there have been funding cuts and discontinuation of other disability programs as a byproduct of the NDIS rollout.

The NDIS is intended to complement, not replace, existing mental health services in each state and territory. It’s vital that properly funded and provided disability services remain available to support people who are ineligible for the NDIS.

Get the disability support you need

If you believe you meet the NDIS funding criteria, you’ll need to provide good evidence of disability to support your application. This evidence must be recent, confirm your primary disability and the impact it has on different areas of your life, and be completed by a treating health professional.

It’s also important that you have the right tools to plan and benefit from this new scheme. First2Care is an NDIS Plan Management App that allows people with disability to plan and participate in the NDIS with ease.

If you’re a person with a disability but are not eligible for the NDIS, it’s important that you still get the support you need. Information and referrals to disability service providers can be made by your Local Area Coordinator (LAC) or Early Childhood partner in your region.

And there are a number of disability advocacy services that offer further support and can promote your needs if you feel uncomfortable or vulnerable.

While the NDIS is an exciting reform, there are still significant problems ensuring people can access the scheme. It’s essential we address the gaps and ensure people in and outside of the NDIS receive the support they need.

Having a good understanding of the application process, funding criteria and potential pitfalls will help you get the best possible outcome for yourself or your loved one.

Over to you ...

Have you or someone you care for experienced difficulties accessing services since the rollout of the NDIS? Do you have any ideas about the NDIS could better support people in marginalised communities?

We’d love to know in the comments below.