The National Disability Insurance Scheme (NDIS) has undergone significant reforms, particularly with the implementation of the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No.1) Bill, which came into effect on 3 October 2024. These changes aim to ensure that NDIS funding is used for supports that are directly related to a participant’s disability. A key aspect of this reform is the introduction of a detailed list of supports that are not considered NDIS-funded, known as “carve-outs.”​

What Are Carve-Outs?

Carve-outs refer to goods and services that the NDIS will not fund. However, there are exceptions where these items may be funded if they are directly related to a participant’s disability support needs. The NDIS has provided a comprehensive list of these carve-outs, which includes various categories such as:​

• Day-to-Day Living Costs: This category encompasses expenses like rent, utility bills, groceries (unless modified for disability-related needs), and general household maintenance.​
• Health and Medical Services: Services such as general medical consultations, hospital admissions, and prescription medications are typically not funded unless they are directly related to the participant’s disability.​
• Education and Employment: Costs associated with school fees, university tuition, and vocational training are generally not covered, unless they are specifically tailored to the participant’s disability-related needs.​
• Lifestyle and Recreation: Expenses for activities like holidays, entertainment, and personal hobbies are usually excluded unless they serve a therapeutic purpose related to the participant’s disability.​

Notable Exceptions

While the list of carve-outs is extensive, there are notable exceptions where funding may be approved:​

• Modified Household Items: Upgrades to standard household items to include accessibility features may be funded if they are necessary for the participant’s daily living.​
• Specialist Therapies: Therapies that are directly related to the participant’s disability and are not considered mainstream health services may be funded.​
• Disability-Related Health Supports: Supports like continence aids, nutrition management, and podiatry may be funded if they are a regular part of the participant’s daily life and result from their disability.​

Impact on Participants

These changes are designed to ensure that NDIS funds are used effectively and efficiently, focusing on supports that directly address a participant’s disability-related needs. However, some participants and service providers have expressed concerns about the potential limitations these carve-outs may impose. For instance, creative therapies like music therapy, which have been beneficial for many participants, may face funding restrictions unless they can be justified as directly related to the participant’s disability support needs. ​

What Participants Should Do

Participants are encouraged to:​

• Review the Updated Lists: Familiarize themselves with the new lists of NDIS supports and carve-outs to understand what is and isn’t funded.​
• Consult with Planners: Discuss their specific needs with NDIS planners to ensure that necessary supports are included in their plans.​
• Provide Evidence: Supply relevant documentation and evidence to support the necessity of certain supports that may fall under carve-outs.​
• Seek Advocacy Support: Engage with advocacy organizations if they feel their needs are not adequately met under the new guidelines.​

Conclusion

The introduction of carve-outs within the NDIS framework represents a significant shift towards more targeted and efficient use of resources. While these changes aim to prioritize funding for supports that are directly related to a participant’s disability, it’s crucial for participants to stay informed and actively engage with the NDIS to ensure their needs are met. By understanding the new guidelines and advocating for necessary supports, participants can navigate these changes effectively.​

For more detailed information, participants can refer to the NDIS’s official summary of legislation changes and the comprehensive list of supports or contact us here at Navigate Your Way for more details.