The National Disability Insurance Scheme in Victoria and Tasmania

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What is the NDIS?

The National Disability Insurance Scheme (NDIS) is the new way of providing support for Australians with disability, their families and carers.

The NDIS will provide about 460,000 Australians under the age of 65 living with a permanent and significant disability with the reasonable and necessary supports they need to live an ordinary life.

The NDIS supports people with disability to build skills and capability so they can participate in the community and employment.

What is responsible for delivering the NDIS?

National Disability Insurance Agency

The NDIS is delivered by the National Disability Insurance Agency (NDIA) which is the independent Commonwealth Government agency responsible for implementing the NDIS nationally.

The NDIA makes decisions about whether someone is eligible to become an NDIS participant and, if so, how much funding they will receive. This is based on legislation called the NDIS Act 2013 which sets out what supports and services are considered reasonable and necessary for the NDIS to fund.

Early Childhood Early Intervention (ECEI) Partners

Early Childhood Early Intervention (ECEI) helps children up to six years of age who have a developmental delay or disability.

ECEI Partners employ ECEI Coordinators who help children and their families access supports and services that are tailored to the child’s needs. ECEI Coordinators will also help with connection to other services such as community health services, playgroups or other activities available in the area.

In Victoria, these partners are:

Barwon Child, Youth and Family in the Barwon Service Area;
Latrobe Community Health Service in the Central Highlands, and Wimmera South West Service Areas;
Link Health and Community in the Inner East Melbourne, Inner Gippsland, Outer East Melbourne, Southern Melbourne, and Outer Gippsland Service Areas;
Intereach in the Loddon, Goulburn, and Mallee Service Areas;
Brotherhood of St Laurence in the North East Melbourne, Hume Moreland, Bayside Peninsula, Brimbank Melton, and Western Melbourne Service Areas; and
Merri Community Health Service in the Ovens Murray Service Areas.

In Tasmania, these partners are:

Mission Australia in Tasmania’s south east and north west; and
Baptcare in Tasmania’s north and south west.

Local Area Coordination (LAC) Partners

Local Area Coordination Partners employ Local Area Coordinators (LAC) who help people understand and access the NDIS. They also work with NDIS participants to develop and use their NDIS plan.

For most people aged seven years and older, a LAC will be their main point of contact for the NDIS.

A LAC will connect people with disability to supports, services, activities in their community and other government services. LACs also work in communities to help them become more accessible and inclusive for all people with disability.

In Victoria, these partners are:

Brotherhood of St Laurence in the North East Melbourne, Hume Moreland, Bayside Peninsula, Brimbank Melton, and Western Melbourne Service Areas.
Latrobe Community Health Service in the Central Highlands, Ovens Murray, Wimmera South West, Barwon, Inner East Melbourne, Inner Gippsland, Outer Gippsland, Outer East Melbourne, and Southern Melbourne Service Areas.
Intereach in the Loddon, Mallee, and Goulbourn Service Areas.

In Tasmania, these partners are:

Mission Australia in Tasmania’s south east and north west; and
Baptcare in Tasmania’s north and south west.

Visit the NDIS locations page or call 1800 800 110 to find the most up to date ECEI and LAC Partner address and contact details.

Who can access the NDIS?

To access the NDIS in Victoria, a person must live in an area where the NDIS is available. In addition, they must also:

meet residency requirements by living in Australia and:
- be an Australian citizen OR
- hold a Permanent Visa OR
- hold a Protected Special Category Visa
be aged under 65 at the time they apply to access the Scheme; and
demonstrate they have a permanent disability that affects their everyday life.

If they are already receiving disability support services from their state or territory government, they will be contacted as the NDIS becomes available in their area.

To access the NDIS in Tasmania, a person must live in an area where the NDIS is available. In addition, they must also:

meet residency requirements by living in Australia and:
- be an Australian citizen OR
- hold a Permanent Visa OR
- hold a Protected Special Category Visa
be aged under 65 at the time they apply to access the Scheme; and
demonstrate they have a permanent disability that affects their everyday life.

If they are already receiving disability support services from their state or territory government, they will be contacted as the NDIS becomes available in their area.

Access under Early Intervention Requirements

You may meet the early intervention requirements:

if you have an impairment or condition that is likely to be permanent and there is evidence that getting supports now (early interventions) will help you by:
- reducing how much help you will need to do things because of your impairment in the future an
- improving or reducing deterioration of your functional capacity or
- helping your family and carers to keep helping you and
- those supports are most appropriately funded through the NDIS, and not through another service system.

you are a child aged under 6 years of age with developmental delay which results in:
- substantially reduced functional capacity in one or more of the areas of self-care, receptive and expressive language, cognitive development or motor development and
- results in the need for a combination and sequence of special interdisciplinary or generic care, treatment or other services which are of extended duration, and are individually planned and coordinated; and
those supports are most appropriately funded through the NDIS, and not through another service system.

Access Request Form

To join the NDIS, a person will need to provide evidence of their primary disability.

In a defined support program

If they are already receiving disability support services from their state or territory government, they will be contacted as the NDIS. In these cases, most will not need to provide evidence of their disability or submit an Access Request Form.

Not receiving any disability supports

If they are not currently receiving any disability supports, but wish to join the NDIS, they or their guardian (including carer or nominee), will need to complete an Access Request Form. This Form can be obtained by contacting NDIA on 1800 800 110 and ask for an Access Request Form.

Who can provide this evidence?

Depending on the primary disability, their treating health professional should provide this evidence, e.g. General Practitioner (GP), Paediatrician, Occupational Therapist, Speech Pathologist, Psychologist, Physiotherapist, etc. They must also have been your treating health professional for at least six months.

It’s important to also note that health professionals do not have to refer a patient to a specialist to obtain supporting evidence. A health professional can summarise or attach existing medical reports which describe the diagnosis/ condition and the impact of the disability on the person’s daily function.

What kind of evidence is required?

It is important to summarise the effect of the disability on the person’s day to day function in all relevant domains, including mobility, communication, social interaction, learning, self-care and/or their ability to self-manage.

To avoid requests for additional evidence about a person’s disability, please include information regarding treatments that have been completed or planned, permanency or the impairment and the impact(s) the impairment has on the person’s function capacity.

Some practical examples are found on page three of of the GP and Health Professionals Guide to the NDIS.

Where can I go for more support?

If you need help to get your evidence together, Local Area Coordinators (LAC) are available to assist you. It’s important to remember that the person helping you to gather your disability evidence will not be able to tell you if you meet the NDIS requirements; only the NDIA can make this decision.

Frequently asked questions (FAQ)

Billing through Medicare

When GPs provide any details about a patient without an associated consultation and without the patient present, a Medicare rebate is not payable under subsection 19(5) of the Health Insurance Act 1973.

However, in providing this information, it is reasonable to expect that GPs will perform an examination of some description to assess or confirm the patient’s current medical condition. With this examination, the time taken for GPs to provide details and information for the purposes of the NDIS, may be claimed under a Medicare item if it is part of the consultation.

Consistent with the operation of the Medicare Benefits Schedule generally, it is at the GP’s discretion to select the Medicare item number that most appropriately reflects the nature of the consultation.

Additional Resources

NDIS Guides for Physicians and Paediatricians
NDIS Glossary
NDIS Factsheets and publications
Providing evidence of disability
NDIS General Practice Toolkit
Victorian Department of Health and Human Services – Advice for service providers

Jurisdictional perspective

It is estimated that those requiring disability support may grow from 78,000 people to 105,000 in Victoria and from 4,300 people accessing supports in 2014 to 10,600 in Tasmania by 2019.

Investment in disability supports is estimated to nearly double from $2.6 billion to $5.1 billion in Victoria and from $220 million to $480 million in Tasmania by 2020.

The workforce required to meet the demand is estimated to grow from 19,550 – 23,900 to 34,400 – 42,000 full-time equivalent staff in Victoria and from 1,750 – 2,150 to 3,200 – 3,900 full-time equivalent staff in Tasmania by 2019.

More information about the market growth can be found in the Victorian Market Position Statement (April 2016) and Tasmanian Market Position Statement (July 2016).