“No, a Kia Sportage Can’t Be Funded in Your Plan”: Conversations on Assistive Technology Purchases

With the recent announcement of the 2023 Federal Budget, it’s official: NDIS funding is tightening up.

In fact, plans are being made to reduce NDIS costs to the tune of $15.3 BILLION over the next four years. We’re talking eye-watering sums.

Now, that isn’t to say NDIS participants will start to lose out on critical care and support, but the government is becoming more concerned about making absolutely certain NDIS funding is spent only as intended, on items and services that are evidence-based, reasonable and necessary.

“No doubt there are many participants and families of participants out there right now wondering how all of this is going to impact their NDIS Plan,” says WA-based Local Plan Management Representative for Capital Guardians Di Gulberti.

“I’m already having lots of conversations regarding the purchase of Assistive Technologies for NDIS participants and there’s a lot of confusion out there.”

To be clear, the intentions, aspirations and guidelines of the NDIS are not changing, but they will be increasingly enforced to the letter.

Cost, Risk and Relevance All Taken into Account in AT Funding

NDIS Plans are designed by an NDIS Planner to help each individual participant meet their specific goals and fund what the participant cannot do because of their disability.

Every Plan is different, so if AT funding is needed, then it should be detailed in the Plan.

Low Cost (under $1,500), Low Risk AT

“Low cost” and “low risk” AT funding for most things will be included in the Core Supports budget and apply to purchases that cost no more than $1,500 (sometimes, the Core Supports will stipulate funds for even less than that).

Low-cost and low-risk is likely to include “off the shelf” AT items such as everyday products that address functional impairments like a non-slip bathmat, long-handled equipment and small devices to assist with dressing, eating and drinking, or even an adjustable toilet seat raiser.

There can be quite a bit of flexibility with AT purchases under Core Supports, where they are linked to goals and the reasonable and necessary checks are satisfied.

“Just because a recommendation from a therapist and a quote for a purchase has been produced, doesn’t mean the AT can be automatically funded or is included in a participant’s Plan,” says Di.

“The therapist recommendation is typically needed when a plan is created, or can be used for a plan review, not as a tool to justify AT that’s not mentioned in a plan.”

If an item is seen as an everyday living expense, regardless of disability, then it normally won’t be funded.

High Risk or High Cost AT

High-cost or higher risk AT funding will be covered under the Capital Supports budget. These items are always named, and there is no discretion possible. Some items require a quote approval from the NDIA Planner, others are called Stated Items, where a very detailed description of what can be purchased is listed.

High-cost and high-risk items are likely to include things that require a higher level of assessment to be included in a participant’s Plan, such as:

• Mobility scooters – High cost, high risk
• Beds – High cost, high risk
• Mattresses – Medium cost, high risk
• Weighted blankets – Low cost, but still considered high risk

Previously Allowable, Common Requests Being Rejected

“During the COVID-19 lockdowns, the NDIS was allowing the purchase of more items under AT than was strictly allowable under the guidelines,” says Di.

Some commonly requested purchases that had previously been allowed are now being rejected, including things like:

• Tablet devices and iPads – In most cases, these are an everyday living expense and therefore not a justifiable AT expense. If these items are needed, specifically relating to the participant’s disability, for example: communication, then it would need to have NDIS approval prior to purchasing
• Nutritional supplements – Generally any supplements need to be specified by the participant’s Plan in order to be funded

“For any purchases a participant or their nominee strongly feels should be included, confirmation and approval needs to be sought from their NDIS Planner or Local Area Coordinator.”

Niche Requests That Get Rejected

Even when a participant or their nominee understands how AT funding works, we still see cases where questions are asked regarding niche or exceptional circumstances.

There are two key examples of these requests:

• “Can I make a personal contribution towards a low-risk item over the $1,500 threshold?” – In this circumstance, the participant assumes they should be able to acquire a high cost item and have it partially subsidised by their NDIS Plan, because it’s considered low risk. This is not the case and the NDIS will either fund the entirety of the purchase or none of it.
• “Can I use my fund to repair or replace due to damage caused by an NDIS-funded item?” – In this case, the participant believes that, because accidental damage was caused by something the NDIS had funded, then the NDIS would also fund the repair/replacement. Not so, and should be instead handled through private insurance.

“Care workers and participants should all work to make sure they have appropriate private insurance coverage for their needs.

“The NDIS simply will not cover accidents or damage incurred to personal effects, a house, cars or individuals even if they occur during an activity or by an item that is in part or wholly funded by the NDIS,” explains Di.

Outlandish AT Funding Requests We’ve Received

An individual’s NDIS Plan is designed to include funding for supports that are specific to that person’s needs. Those supports will therefore be evidence-based, reasonable and necessary.

The below is a list of examples of some of the more incredible requests that clearly don’t meet those criteria.

• A Kia Sportage – Motor vehicles aren’t considered a disability related support because it’s a day-to-day living cost people can either afford, or they can’t. While the NDIS may provide funding for vehicle modifications, they’ll never fund the purchase of a car regardless of whether it’s new, used, a Kia or a Porsche.
• A Miele washing machine – Common household appliances are also day-to-day living expenses that aren’t related to a disability, and so this is also ‘out’ as far as the NDIS is concerned, regardless of make or model.
• A Dyson Airwrap hairdryer – See above!
• A Shetland pony – Pets aren’t likely to meet funding criteria, even if you can also claim them as some form of transport. Even when included as part of specialist therapy, the cost of animals isn’t considered value for money compared to the costs of other supports. To a request to fund a pony, the NDIS will almost certainly say “neigh”.
• A Nintendo Switch – Smart devices and computers are generally considered day-to-day living costs unrelated to a disability, so it’s unlikely a gaming platform will ever clear the bar when it comes to NDIS funding. However, some tablet devices may receive funding if the participant is able to supply written evidence to show it’s solely and directly needed for their disability needs. These items also need NDIS approval and to be written into the plan.
• A shamanic healer – All therapies must be evidence-based in order to qualify for funding. Until the day comes that ancestral spirits are able to demonstrate they’ve completed a recognised medical degree and can consistently influence the physical realm, the NDIS is unlikely to cover any kind of magic or white witchcraft in a Plan.
• An Apple iPhone 14 Pro – Like tablets and computers, smartphones like the Apple iPhone are seen as an everyday living expense and so are rarely funded through the NDIS.
• A gift from Aphrodite’s Pleasure – We all have needs, but that’s exactly why these kind of ‘toys’ would not be considered for AT funding. Instead, this is an everyday living expense unless it’s specifically listed in the individual’s Plan as it relates to their disability-specific needs. See a case study on sex-related requests here.
• A trampoline – Like any other gift you might buy your kids, there’s nothing disability-specific about play equipment, so the trampoline gets bounced faster than a bad cheque.

Have you got more questions about what is and isn’t likely to be funded? Check out our FAQs on what’s reasonable and necessary to find out more.

Exercising Choice and Control

Another core principle of the NDIS is that it enables participants to exercise choice and control. But, as committed as the NDIA is to the fundamentals of the NDIS allowing participants to use their funding how they want to in meeting their goals, the freedom of choice regarding what those items are is limited and must be detailed in the Plan by the NDIS Planner.

AT guidelines at a glance:

• AT included in a Plan’s Core Supports budget can ONLY be low-risk and low-cost (under $1,500)
• Items that cost over $1,500 can’t be split into parts in order to appear less than $1,500 – this would be considered fraudulent
• Medium or high risk items can not be purchased without having the NDIS Planner fund the items in the Capital Supports budget part of a Plan
• Low versus high risk AT items is defined by the NDIS, with further guidelines to found here

Gaining a firm understanding of the Plan and what AT items are included is the main way to avoid confusion and disappointment when it comes to receiving the correct supports for a participant’s needs.