The National Disability Insurance Scheme or NDIS is a program implemented by the National Disability Insurance Agency(NDIA), an independent Commonwealth statutory agency. The insurance scheme provides individualised support and services to Australians with a disability, their families and carers. NDIS aims to promote independence, community involvement, education and awareness, employment, health and well-being.
The NDIS will offer all Australians under the age of 65 who have a permanent and significant disability with all the necessary and reasonable support to continue living an independent and ordinary life. To become an NDIS participant, one must be:
- Aged less than 65 upon application
- Have a permanent disability that affects the person’s ability to perform daily living activities
- An Australian citizen, currently living in Australia with a permanent visa or under a Protected Special Category Visa
With the exception of Western Australia, the insurance scheme is progressively being rolled out throughout the country and is set to be fully implemented by 2019. Western Australia has opted only to a two-year trial of the NDIS program.
Implications of NDIS to the Aged Care Sector
NDIS is not a health scheme and will not replace the framework structure of the health and aged care sectors. The responsibility for the NDIS falls under the Minister of Social Services and not under the Minister of Health. However, the boundary between health and aged care and disability services based on the NDIS guidelines is arbitrary.
Eligibility and Access
Healthcare providers play a significant role in explaining the framework structure of the NDIS, how to become a participant, how it works or how to transition the current healthcare package of care recipients under the national program. They are also responsible for ensuring appropriate referrals is made for the benefit of the care recipient, as well as to set realistic expectations for the family members.
There is a need to educate the public on the eligibility and access since there is a broad perception that NDIS is available for anyone with a disability from ANY cause. Healthcare providers must be knowledgeable with the eligibility criteria for the NDIS. They must also know how to properly make referrals so that participants will be able to maximise their benefits.
For example, a physical therapy session is eligible for NDIS funding if its purpose is to maintain the person’s functionality and independence. However, the required physical therapy session will fall under health or aged care if its aim is to improve the current health status of the individual. Therefore, the individualised support and services must be related to the functional impact of a person’s disability.
To set the boundaries, the following are examples of support and services that are considered necessary and reasonable based on the NDIS plan:
- Activities of daily living
- Transportation support
- Labour support market for employment
- Therapeutic and behavioural support
- Allied health and other therapy required as a result of the person’s impairment,
i.e. physiotherapy, speech therapy and occupational therapy - Help in household tasks
- Home and vehicle modifications
- Assist in setting up and training in aids or equipment, such as hearing aids, wheelchairs, adjustable beds, prosthetic and artificial limbs and other devices that encourage independent living
The health and aged care systems are responsible for clinical and medical therapy including assessment, diagnosis, and treatment of medical conditions; medications; sub-acute care, post-acute care; and all dental care treatments.
NDIS and Aged Care
To clearly explain how the NDIS will impact the aged care, here are the following scenarios:
Question: “I am turning 66 this year. What will happen to my supports when the NDIS is implemented?”
Answer: Under the Continuity of Support guidelines, people who are aged over 65 years and are currently receiving disability services before being assessed by the NDIA, will still continue to receive support. Disability programs and services are all different, and the Australian government is working to ensure continuity of support based on individual needs.
However, for those who are beyond 65 years old and who do not receive disability assistance, or who are diagnosed with disability after the age of 65, will get the necessary assistance under the Commonwealth aged care system.
Question: “What happens to my disability assistance when I turn 65 after I become an NDIS participant?”
Answer: If you turn 65 after becoming an NDIS participant, you will be given an option to either continue getting support under the NDIS program or receive assistance through the Commonwealth aged care system.
Effective coordination and interaction between NDIS and the health and aged care sector are necessary to ensure a smooth transition and continuous, quality care and services.
Question: “What will happen to my support if I choose to continue as an NDIS participant?”
Answer: Your disability assistance will continue the way they did before you turn 65 years old.
NDIS participants will continue to require medical treatment from the healthcare sector while being enrolled with non-medical support provided by the NDIS. People have uncertainties about the coordination of health or aged care and disability services. Most of the concerns include:
- Falling between the service provision gaps
- Subpar quality of care and service
- Who will fund the services
The NDIS and health or aged care sector must, therefore, work closely to plan and coordinate streamlined care for individuals that require both health and disability services and at the same time ensure a smooth transition from one sector to another.
Opportunities for Learning
The NDIS is still new and it continues to evolve to better suit the needs of its participants. The roll out of NDIS serves as the learning curve to realise opportunities for individualised service planning, funding, referrals and implementations to measure the care recipients’ needs and outcomes better.
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