Show Notes
From 1 October, new NDIS funding changes will affect how some participants can access funding for social, community and civic participation. The detail OTs have been waiting for around the safeguard for participants with high support needs has now been released.
The guidance provides a pathway for some participants whose funding reset leaves them without enough funding to maintain their 24-hour disability supports. But the eligibility criteria create a significant gap: needing 24-hour support is not necessarily enough. The participant must already receive 24-hour funded NDIS supports.
Who qualifies as a high support needs participant?
To access the new safeguard pathway, participants must meet specific criteria relating to their existing plan funding and support arrangements.
The guidance describes a high support needs participant as someone with a relevant total budget of at least $215,000 before the funding reset, who receives 24-hour funded NDIS supports for needs arising directly from their disability and receives those funded supports at a shared ratio of at least 1:3.
The wording around funded NDIS supports is particularly significant because it determines who can access the safeguard when their funding is reduced.
Required support and funded support are not the same thing
A participant may require support 24 hours a day without currently receiving 24 hours of formal NDIS-funded support.
Consider someone who cannot safely be left alone but lives with family. Support workers may assist with personal care in the morning, the participant may attend a day program and family may provide support during evenings and overnight.
Their disability-related need for support exists across the full 24 hours. The difference is that some of those hours are currently being provided by parents, partners or other informal supports rather than funded through the NDIS.
Under the new criteria, this distinction will determine whether the participant has access to the safeguard. The bad news? The above mentioned participants will not.
What happens if they don’t meet the criteria?
If community participation funding is reduced, participants relying partly on informal supports will find themselves in a difficult position.
They won't meet the High Support Needs criteria because they do not currently receive 24-hour funded NDIS supports, even though they cannot safely be left without support.
The funding reduction itself also does not necessarily represent a significant and ongoing change in functional capacity, support needs or circumstances that would provide another straightforward pathway to an unscheduled plan reassessment.
This leaves an important question about what happens when formal community supports are reduced and family is already providing the support required during the remaining hours. There are no clear answers to this.
For eligible participants, what does the safeguard actually provide?
The guidance provides an example of a participant whose social and community participation budget reduces from $150,000 to $75,000, leaving insufficient funding to maintain their previous 24-hour support arrangements.
Through the safeguard pathway, additional funding may be added to daily living supports to address the resulting support gap at home.
However, this does not necessarily restore the participant’s previous level of community participation. Instead, funding may be redirected towards the support required while the participant remains at home.
The safeguard therefore addresses a potential gap in 24-hour support, but it does not necessarily replace the community participation opportunities lost through the funding reduction.
The variation process could create another support gap
Timing creates a separate practical issue for participants who do qualify for the safeguard.
Participants have 90 days to request the variation. The Agency then has 21 days to determine whether the participant meets the High Support Needs defi
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