If you or your family member has been approved as an NDIS participant, you’ll receive funding you can use for supports that help you with your disability. The purpose of NDIS participation is to provide you choice and control in determining the types of supports you need, which means you’ll get to make decisions about how much money you need and how to spend it. The first step in exercising that choice is understanding the NDIS support categories.
The support categories determine how much money you have for different types of supports and services for your disability. All of the supports you purchase must be ‘reasonable and necessary,’ which means they need to be related to your disability and not to your ordinary costs of living. This means you can’t use NDIS funds to pay for things that everyone needs, such as groceries and rent; you can only use them for services and items related to your disability.
Your NDIS budget won’t include funding in every support category. Instead, when you design your NDIS plan, you’ll work with your planning manager to decide which support categories you need in your funding and how much money each category needs. Every NDIS participant is different, so you’ll create a plan that’s specific to your needs, enabling you to access the supports that will help you live the life you want.
As you’re creating your NDIS plan, you’ll also consider supports that you have through family, friends, and your community. Although these types of supports may not need funding from your NDIS budget, they’re important for helping you in your daily life, so they’ll be considered in your plan.
In addition, you’ll write goals in each category as part of your NDIS plans. Your goals aren’t directly related to funding, so you might not receive support funding for every goal you want to pursue. However, your plan will include funding to help you overcome any disability-related obstacles to your goals.
As needs change, your NDIS plan and support funding will change as well. You might no longer need funding in a specific category, or you might need to add a new category based on your changing situation. Some of the categories are flexible to allow you to use money in a different category if your needs change or your spending is different from what you planned in your budget. Other categories are more strict, and money allocated to those categories can only be used for those purposes.
Within each category, there are many specific services and items. Many of those services are listed in the NDIS Pricing Arrangement, which places a limit on the maximum amount that NDIS will pay for that service. Other services don’t have a pricing limit. The pricing arrangement (formerly known as the NDIS price guide) is updated annually in July. The current prices reflect the market value for the service, and there are different limits depending on when and where the service is performed.
The NDIS program is designed to provide participants with as much choice and control as possible over what supports they receive and how they receive them, so you do have some choices regarding the NDIS pricing arrangements. For example, you can work with your provider to negotiate a lower price for a particular service than the price listed in the guide. You can also choose any provider you want for your support services. However, NDIS-approved can’t charge more than the price limit for a service.
If you are self-managing your plan, you have the option to choose unregistered providers who aren’t approved by NDIS. These providers can charge any rate they want for a service, which could be more or less than the price limit. If you decide to purchase supports from a provider who charges a higher rate than the NDIS pricing arrangement maximum, you may not be able to claim reimbursement for more than the pricing arrangement rate, and you would have to pay the rest out of pocket.
NDIS Support Purposes
Each NDIS category falls under one of three overarching purposes: Core Support, Capacity Building, and Capital Support. These three different types of support work together to provide individualised support to each participant as their needs and strengths change over time.
Although NDIS support is lifelong, it’s also goal-focused, which means it’s designed to help you increase your abilities and meet your goals while living with a disability. Capacity building is a core focus of NDIS participation, and significant support is dedicated toward helping you meet the goals you set for yourself. This can sometimes cause a change in the types and amount of support funding that you need.
For example, suppose you have difficulty cleaning your house yourself due to a disability that affects mobility and your ability to grasp items with your hands. You could use Core Support funding in the Assistance with Daily Life category to pay for housecleaning services. But you could also budget Capacity Support funds in the Improved Daily Living category to hire a therapist to help you create house organisational systems that enable you to do some of your cleaning yourself. In addition, you could use Capital Support funds in the Assistive Technology category to purchase tools that would help you pick up and put away items without needing to grasp them with your hands.
These two supports would increase your ability to clean your home yourself if you wanted to, which would mean you might need to use less money for house cleaning services. This example demonstrates how the three support purposes work together to build your capacity and help you enjoy a full, independent life.
NDIS Budget Flexibility
It’s important to note, however, that the goal of capacity-building is not to decrease your need for support – only to increase your capacity for independence and your ability to enjoy the life you want. Therefore, some of the NDIS categories, especially in the Core Support domain, are deliberately designed to be flexible. This means you can sometimes use funds in a different category than the one they were originally budgeted for, enabling you to use money for the supports that are most important to you as your goals, abilities, and needs change over time.
The categories in the Core Support domain are very flexible, and you can use money for a different category than it was originally budgeted for with few stipulations. The only exception is the Transport category. People who are eligible for funding in the Transport category are provided a specific amount for the transportation needed, and that money cannot be used in other categories.
Funding in the Capacity Supports domain is less flexible. For these supports, money that’s budgeted for a category must be spent on services in that category. However, you can decide what services and supports will best help you meet your goal within that category. Many of the categories in this domain are intentionally broad. For example, money that’s budgeted for “Increased social & community participation” could be used for a wide variety of services, from taking a community art class to accessing therapeutic support to improve social skills. As your needs and interests change, you can spend the same money on different supports within this category.
Funding in your Capital Support domain is the least flexible. This includes two categories, one for home modifications and one for assistive technology. These funds must be budgeted for specific items, and they usually need to be recommended by a therapist or other health professional. These funds can only be spent on the items they are budgeted for.
NDIS Support Categories
Each of the overarching purposes is divided into funding categories. Your budget will include funding in the categories in which you need support in order to live the life you want with your disability.
Core Support includes supports you need on a regular basis to enjoy a high quality of life.
- The Assistance with daily living category provides funding for daily life activities such as self-care and meal preparation.
- The Consumables category provides funding for consumable items you need for your disability, such as hygiene items.
- The Assistance with social & community participation category provides funding that enables you to participate fully in your community, such as a support worker who attends a community activity with you.
- Transport provides funding for transportation to activities or services.
Capacity Support includes supports that increase your skills and knowledge so you are better able to enjoy life with your disability.
- The Support coordination category provides funding to help you increase your ability to coordinate your own NDIS supports. This budget is intended to help you gain skills such as learning how to identify what you want in a provider and addressing any issues with your supports.
- The Improved living arrangements category provides funding to help you find and retain appropriate housing, such as help looking for an apartment or help with budgeting for rent.
- The Increased social & community participation category provides funding to increase your skills and abilities to participate in your community. It can include activities like joining a sports team or attending classes for a hobby you enjoy.
- The Finding & keeping a job category provides funding for activities such as improving your job-related skills, looking for a job, and filling out job applications.
- The Improved relationships category provides funding for activities that increase your capacity to build positive relationships, such as behavioural therapy or social skills groups.
- The Improved health & wellbeing category provides funding to improve your health, such as nutritional support or exercise support related to your disability.
- The Improved learning category provides funding to help you access higher learning with your disability, and it can be used for supports like help with applying to colleges or managing studying.
- The Improved life choices category provides funding to help you grow your capacity to manage your NDIS plan, including budgeting and financial skills.
- The Improved daily living category provides funding to help you improve your ability to accomplish self-care tasks independently. It could include occupational therapy or physiological therapy.
Capital Support includes a budget for one-time purchases of supports that will improve your independence and quality of life.
- The Assistive technology category provides funding for you to purchase technology that will help you with your disability. This could include mobility aids such as a wheelchair or prosthetics; or it could include personal care equipment such as a shower chair. It can also include technology such as hearing aids, communication devices, or vision equipment.
- The Home modifications category provides funding to make structural changes to your home to improve your ability to function independently. It could also include adding features such as railing or ramps to improve your safety in your home.