Operational Guideline – Planning and
Assessment – Supports in the Plan
Legislation
1.
Read sections 4, 13, 31, 33, 34 and 118 of the National Disability Insurance Scheme Act 2013
(NDIS Act), the National Disability Insurance Scheme (Supports for Participants) Rules 2013
(Supports for Participants Rules) and Part 6 of the National Disability Insurance Scheme (Plan
Management) Rules 2013 (Plan Management Rules).
Principles
2.
Reasonable and necessary supports for people with disability should:
a.
Support people with disability to pursue their goals and maximise their independence, and
b.
Support people with disability to live independently and to be included in the community as
fully participating citizens, and
c.
Develop and support the capacity of people with disability to undertake activities that enable
them to participate in the community and in employment.
See s.4(11) of the NDIS Act.
3.
People with disability should be supported to receive supports outside the National Disability
Insurance Scheme (NDIS) and be assisted to coordinate these supports with the supports provided
under the NDIS.
See s.4(14) of the NDIS Act.
4.
The preparation, review and replacement of a participant’s plan should so far as reasonably
practical be individualised; directed by the participant; where relevant consider family, carers and
significant others; consider availability of informal support, access to mainstream and community
supports; and build individual capacity to increase participation and inclusion in community with the
aim of achieving individual aspirations.
5.
Plans should maximise choice and independence of the participant and facilitate tailored and
flexible responses to individual goals and needs.
See s.31 of the NDIS Act.
6.
The statement of participant supports must specify the general supports (if any) that will be
provided to, or in relation to, the participant and the reasonable and necessary supports (if any) that
will be funded through the NDIS. In deciding whether to approve a statement a delegate must:
a.
Have regard to the legislation and rules, participant statement, relevant assessments
b.
Be satisfied that all clauses of s.34 of the NDIS Act on reasonable and necessary supports
are met including that the support is most appropriately funded by the NDIS and offers value
for money, and
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c.
Have regard to the principle that a participant should manage their plan to the extent they wish
and the operation and effectiveness of any previous plans of the participant.
See ss.33, 34 and 35 of the NDIS Act.
Support for participants during the planning process
7.
To support people with disability to exercise choice and control in the pursuit of their goals, a
delegate may provide support and assistance (including financial assistance) during the planning
process, including by assisting a participant to clarify their goals, objectives and aspirations.
See s.6 of the NDIS Act.
The statement must include general and reasonable
and necessary supports
8.
The plan must include a statement of participant supports that specifies the general supports that
will be provided to, or in relation to, a participant and the reasonable and necessary supports that
will be funded.
See s.33(2) of the NDIS Act.
Before including any support the delegate must
apply a test to that support
9.
Before specifying any general support, or reasonable and necessary support, in a participant’s
plan, a delegate must be satisfied of all of the following in relation to each support:
a.
The support will assist the participant to pursue the goals objectives and aspirations included
in the participant’s statement of goals and aspirations, and
b.
The support will assist the participant to undertake activities, so as to facilitate the participant’s
social and economic participation, and
c.
The support represents value for money in that the costs of the support are reasonable,
relative to both the benefits achieved and the cost of alternative support, and
d.
The support will be, or is likely to be, effective and beneficial for the participant, having regard
to current good practice, and
e.
The funding or provision of the support takes account of what it is reasonable to expect
families, carers, informal networks and the community to provide, and
f.
The support is most appropriately funded or provided through the NDIS, and is not more
appropriately funded or provided through other general systems of service delivery or support
services offered by a person, agency or body, or systems of service delivery or support
services offered:
g.
i.
As part of a universal service obligation, or
ii.
In accordance with reasonable adjustments required under a law dealing with
discrimination on the basis of disability, and
The support is not a support mentioned in Part 5 of the Supports for Participants Rules as a
support that will not be funded or provided by the NDIS.
See s.34 of the NDIS Act and Part 5 of the Supports for Participants Rules.
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10. Each of these criteria is considered in further detail below.
Supports that will not be provided or funded under
the NDIS
11. Under the Supports for Participants Rules, a support will not be provided or funded under the NDIS
if a delegate is satisfied that:
a.
It is likely to cause harm to the participant or pose a risk to others
b.
It is not related to the participant’s disability
c.
It duplicates other supports delivered under alternative funding through the NDIS, or
d.
It relates to day-to-day living costs (for example, rent, groceries and utility fees) that are not
attributable to a participant’s disability support needs.
12. Although most day-to-day living costs are not to be funded the Supports for Participants Rules
allow some day-to-day living costs to be funded. Day-to-day living costs can be funded only if they
relate to reasonable and necessary supports and are:
a.
Additional living costs that are incurred by a participant solely and directly as a result of their
disability support needs; e.g. specialised food that relates specifically to a person’s disability
and that is not available to the general population, or
b.
Costs that are ancillary to another support that is funded or provided under the participant’s
plan, and which the participant would not otherwise incur – for example, significant additional
utility costs due to the cost of operating an NDIS-funded piece of assistive technology.
See s.34(1)(g) of the NDIS Act and rs.5.1 and 5.2 of the Supports for Participants Rules.
13. Under the Supports for Participants Rules the following supports will also not be provided or funded
under the NDIS:
a.
b.
A support, the provision of which would be contrary to:
i.
A law of the Commonwealth, or
ii.
A law of the state or territory in which the support would be provided, and
A support that consists of income replacement.
See r.5.3 of the Supports for Participants Rules.
Supports must assist goals, objectives, aspirations
and activities
14. Before a support is added to a plan the delegate must be satisfied that it will:
a.
Assist the participant to pursue the goals objectives and aspirations included in the
participant’s statement of goals and aspirations, and
b.
The support will assist the participant to undertake activities, so as to facilitate the participant’s
social and economic participation.
See ss.34(1)(a) and 34(1)(b) of the NDIS Act.
15. There are no provisions in the NDIS Rules that apply to these two paragraphs of s.34 of the NDIS
Act.
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See s.4(8) of the NDIS Act.
Value for money
16. Before a support is added to a plan the delegate must be satisfied that it represents value for
money in that the costs of the support are reasonable, relative to both the benefits achieved and
the cost of alternative support.
See s.34(1)(c) of the NDIS Act.
17. In deciding whether the support represents value for money, the Supports for Participants Rules
require delegates to consider each of the following:
a.
Whether there are comparable supports which would achieve the same outcome at a
substantially lower cost, and
b.
Whether there is evidence that the support will substantially improve the life stage outcomes
for, and be of long term benefit to, the participant, and
c.
Whether funding or provision of the support is likely to reduce the cost of the funding of
supports for the participant in the long term (for example, some early intervention supports
may be value for money given their potential to avoid or delay reliance on more costly
supports), and
d.
For supports that involve the provision of equipment or modifications:
i.
The comparative cost of purchasing or leasing the equipment or modifications, and
ii.
Whether there are any expected changes in technology or the participant’s
circumstances in the short term that would make it inappropriate to fund the equipment
or modifications, and
e.
Whether the cost of the support is comparable to the cost of supports of the same kind that
are provided in the area in which the participant resides, and
f.
Whether the support will increase the participant’s independence and reduce the participant’s
need for other kinds of supports (for example, some home modifications may reduce a
participant’s need for home care).
See r.3.1 of the Supports for Participants Rules.
18. In TKCW and National Disability Insurance Agency [2014] AATA 501 (TKCW), the Administrative
Appeals Tribunal (AAT) applied the value for money requirement noting that funding a support
whose effectiveness and benefits are largely unknown could undermine the financial sustainability
of the NDIS, especially where a reliable means of measuring any benefits of the support is lacking.
In deciding not to fund a therapy known as The Listening Program (TLP) for a child with Autism
Spectrum Disorder, the AAT considered that TLP did not represent value for money because they
could not be confident of the benefits likely to be achieved.
See TKCW and National Disability Insurance Agency [2014] AATA 501.
Effective and beneficial for the participant
19. Before a support is added to a plan the delegate must be satisfied that the support will be, or is
likely to be, effective and beneficial for a participant, having regard to current good practice.
See s.34(1)(d) of the NDIS Act.
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20. In deciding whether the support will be, or is likely to be, effective and beneficial for a participant the
delegate is to consider the available evidence of the effectiveness of the support for other people in
like circumstances. That evidence may include:
a.
Published and refereed literature and any consensus of expert opinion
b.
The lived experience of the participant or their carers, or
c.
Anything the NDIA has learnt through delivery of the NDIS.
21. The Supports for Participant Rules also require the delegate to take into account, and if necessary
seek, expert opinion.
See rs.3.2 and 3.3 of the Supports for Participants Rules.
22. In TKCW the AAT considered the meaning of "current good practice" in s.34(l)(d) of the NDIS Act
and considered that it means a practice which, even if not widely used, is recognised by sufficient
numbers of practitioners as being based on sound evidence. In weighing up the evidence about
whether TLP was likely to be effective and beneficial, the AAT noted that:
“One of the objects of the NDIS Act is "to promote the provision of high quality and
innovative supports that enable people with disability to maximise independent lifestyles
and full inclusion in the community": s.3(g). There may be some tension between this
object and s.34(1)(d) which requires that the CEO of the NDIA (and so the Tribunal), be
satisfied that a support "will be, or is likely to be, effective and beneficial for the
participant, having regard to current good practice" but, whatever innovative supports s
3(g) has in mind, they must be "of high quality". The most that we can say at this early
point in the life of the NDIS is that we are bound to be satisfied of all of the criteria in s
34(1), and innovation, of itself, cannot displace those criteria.”
See TKCW and National Disability Insurance Agency [2014] AATA 501.
Reasonable family, carer and other support
23. Before a support is added to a plan the delegate must be satisfied that the funding or provision of
the support takes account of what it is reasonable to expect families, carers, informal networks and
the community to provide.
See s.34(1)(e) of the NDIS Act.
24. In deciding whether funding or provision of the support takes account of what it is reasonable to
expect families, carers, informal networks and the community to provide, the delegate is to consider
the following matters:
a.
b.
For a participant who is a child:
i.
That it is normal for parents to provide substantial care and support for children
ii.
Whether, because of the child’s disability, the child’s care needs are substantially greater
than those of other children of a similar age
iii.
The extent of any risks to the wellbeing of the participant’s family members or carer or
carers, and
iv.
Whether the funding or provision of the support for a family would improve the child’s
capacity or future capacity, or would reduce any risk to the child’s wellbeing.
For other participants:
i.
The extent of any risks to the wellbeing of the participant arising from the participant’s
reliance on the support of family members, carers, informal networks and the community
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ii.
iii.
c.
The suitability of family members, carers, informal networks and the community to
provide the supports that the participant requires, including such factors as:
A.
The age and capacity of the participant’s family members and carers, including
the extent to which family and community supports are available to sustain them
in their caring role
B.
The intensity and type of support that is required and whether it is age and
gender appropriate for a particular family member or carer to be providing that
care, and
C.
The extent of any risks to the long term wellbeing of any of the family members or
carers (for example, a child should not be expected to provide care for their
parents, siblings or other relatives or be required to limit their educational
opportunities).
The extent to which informal supports contribute to or reduce a participant’s level of
independence and other outcomes, and
For all participants—the desirability of supporting and developing the potential contributions of
informal supports and networks within their communities.
See r.3.4 of the Supports for Participants Rules
25. In TKCW the AAT considered whether the NDIS should fund the provision of childcare for the
participant’s brother while the participant was at therapy sessions with a parent. In finding the NDIS
should not fund this care, the AAT stated:
“One of the principles in s 4 of the NDIS Act is that the role of families, carers and other
significant persons in the lives of persons with disability is to be acknowledged and
respected. Section 34(1)(e) also recognises that it may be reasonable to expect
families, carers, informal networks and the community to provide support.
In our view this is not a support that should be funded through the NDIS. The need for
childcare for TKCW's brother is being met at present by the helper provided by Disability
South Australia. We understand that this arrangement may not continue indefinitely but
there is nothing to suggest that it will not continue at least for the life of TKCW's present
plan. It is hard to see why it should be considered a reasonable and necessary support
at this time and we are not satisfied that it is.
We accept that using some of the hours allocated to household help, and organising the
helper's hours around TKCW's therapist appointments, is not entirely convenient for
TKCW's mother. However, the hours are relatively few, and we think it is reasonable for
the family to make what is a relatively minor adjustment. As such, funding this support
through the NDIS would not meet s 34(1)(e) of the NDIS Act.”
See TKCW and National Disability Insurance Agency [2014] AATA 501.
The support is most appropriately provided or
funded through the NDIS
26. Before a support is added to a plan the delegate must be satisfied that the support is most
appropriately funded or provided through the NDIS, and is not more appropriately funded or
provided through other general systems of service delivery or support services offered by a person,
agency or body, or systems of service delivery or support services offered:
a.
As part of a universal service obligation, or
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b.
In accordance with reasonable adjustments required under a law dealing with discrimination
on the basis of disability.
See s.34(1)(f) of the NDIS Act.
27. In deciding whether the support is most appropriately provided or funded through the NDIS the
delegate must consider each of the matters set out in Schedule 1 of the Supports for Participants
Rules. The matters to have regard to are set out under the following headings in Schedule 1 of the
Supports for Participants Rules:
i.
Health (excluding mental health)
ii.
Mental health
iii.
Early childhood development
iv.
Child protection and family support
v.
School education
vi.
Higher education and vocational education and training
vii.
Employment
viii. Housing and community infrastructure
ix.
Transport, and
x.
Justice.
See rs.3.5 and 3.6 of the Supports for Participants Rules.
28. In Young and National Disability Insurance Agency [2014] AATA 401 the AAT considered whether
a portable oxygen concentrator and insulin pump were most appropriately funded by the NDIS or
the health system. The AAT held that:
a.
the different method of delivering oxygen and insulin did not change the fact that their
essential character was clinical treatment, and
b.
the applicant (Mr Young) was able to undertake activities of daily living and participate in the
community although he experienced embarrassment and inconvenience.
29. Regarding the test of whether a support is most appropriately funded or provided through the NDIS,
the AAT stated:
“Whether or not funding is available through other general systems is not the test of
whether it is most appropriately funded or provided through the NDIS. The fact that the
health system does not fund entirely, or even at all, what is essentially clinical treatment,
or some other form of support that is more appropriately funded through the health
system, does not make it the responsibility of the NDIS.
30. The fact that insulin needs and the oxygen supplies were funded or subsidised under the health
system and that insulin pumps were fundable under private health insurance were held to support
the conclusion that the supports are the responsibility of, and more appropriately funded through,
the health system.
See Young and National Disability Insurance Agency [2014] AATA 401.
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Participants with existing supports
31. When considering the criteria in s.34 of the NDIS Act in relation to each support, delegates also
need to consider the context for participants who have existing supports and how they will transition
to any new supports funded by the NDIS.
32. A participant who is currently receiving supports under a Commonwealth, state or territory disability
support program may not wish to vary their current supports. In this situation, delegates should note
that a participant has indicated this preference. These existing supports may form the basis of the
statement of participant supports but a delegate would still need to be satisfied of all of the matters
in s.34 of the NDIS Act.
33. If existing supports do form the basis of a statement of participant supports, delegates should
consider whether the support needs of a participant are likely to change over time and whether a
different composition of supports may be more appropriate under the NDIS. Delegates should
consider and discuss with participants the possibility of transitioning to new supports, or a new
composition of supports, at an appropriate time (potentially over the course of several NDIS plans if
necessary).
34. In discussing the transition from existing supports, delegates should seek to minimise any
disruption to the participant and the supports the participant receives, for example, by timing any
changes at natural transition points such as a life transition or at the end of a plan. Delegates
should be mindful of the importance that supports can play in a participant’s life and the challenges
of varying current support arrangements. Delegates should consider how to build a participants’
capacity to source supports from another service system when this may be more appropriate in the
context of developing or reviewing a plan.
35. Where the NDIS is funding supports that are intended to be part of the transition for a participant
towards alternative supports or greater independence, this should be made clear to the participant
and documented in the participant’s plan. The plan should state clearly which supports are intended
to be transitional including through the use of plan review dates and time-limited support items.
The Intergovernmental Agreement for the NDIS
Launch (IGA) and the principle of “no disadvantage”
36. Governments have made a commitment – through the Intergovernmental Agreement for the NDIS
Launch (IGA) – that people receiving supports before becoming participants in the NDIS should not
be disadvantaged by the transition to the NDIS. The commitment is that people should be able to
achieve at least the same outcomes in the NDIS, compared to those expected from their previous
support.
37. The Agency is not a party to the IGA and the commitment to “no disadvantage” is not in the NDIS
Act or other legislation. However, the Agency must, in performing its functions under the NDIS Act,
use its best endeavours to act in accordance with the IGA or any other relevant intergovernmental
agreement.
See s.118(2)(a) of the NDIS Act.
38. In accordance with this obligation, the Agency’s policy is to use its best endeavours to give effect to
the principle of “no disadvantage” and the commitment of governments that people should be able
to achieve the same outcomes under the NDIS.
39. This does not mean a participant will always have the same level of funding or quantum of
support. A delegate must ensure that the approach to planning and funding reasonable and
necessary supports is consistent with the NDIS Act and Supports for Participant Rules.
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40. For example, if a support would be more appropriately funded or provided by another system of
service delivery in accordance with s.34(1)(f) (such as pharmaceuticals), the fact that a participant
received that support previously through a state or territory program does not mean the support
must be funded under the NDIS. If the support does not meet the requirement in s.34(1)(f), it must
not be included in a statement approved under s.33(2) of the NDIS Act. For further information,
please refer to the Operational Guidelines dealing with specific types of supports, for example, the
Operational Guideline - Planning and Assessment - Supports in the Plan - Interface with Health.
41. Where the NDIS does not fund a support that a participant previously received under another
program, the delegate should seek to identify alternative supports or refer the participant to other
systems with a view to ensuring the participant is able to achieve substantially the same outcomes
under the NDIS.
Flexibility in describing supports
42. Delegates have a high degree of flexibility around how they describe the supports in the plan. The
supports can be described by specifically identifying them in the plan or the plan can describe them
generally. For example, by a general reference to the purpose of the support.
See s.33(3) of the NDIS Act.
43. Delegates may choose to describe a support generally in cases where it is intended to give a
participant a high degree of flexibility over the implementation of the support. Delegates may
choose to put a specific description of a support in the plan where that is intended to have less
flexibility. For example, a support that is described in the plan with detail of how it is to be
purchased or implemented.
44. When deciding whether to describe a support generally or specifically, the Plan Management Rules
require the delegate to have regard to each of the following:
a.
The cost of the support, and
b.
Any expected return or saving in costs from providing the support, and
c.
Any risks associated with the supply of the support such as the need for the support to
conform to state or territory laws, and
d.
Whether achievement of other goals in the plan or the effectiveness of other supports is
contingent on a particular support being procured or used, and
e.
Whether a participant’s disability requires a specialist, evidence-informed support provided by
a qualified person or a particular delivery mode, and
f.
Whether the participant accessed the NDIS by satisfying the early intervention requirements.
See rs.6.1 to 6.4 of the Plan Management Rules and
Operational Guideline – Planning and Assessment – Risks and Safeguards.
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The plan must identify supports that are more costeffectively provided by the NDIA
45. If a delegate considers that it is more cost-effective for the support to be provided directly by the
NDIA (for example, using bulk purchasing of goods), the plan must specify that the support will be
provided by the NDIA.
See r.6.5 of the Plan Management Rules.
The plan must identify supports to be provided by a
particular provider
46. If a delegate is considering a support and:
a.
The NDIA has entered into a funding arrangement with a provider to provide that support, and
b.
The delegate considers that the support is most efficiently and effectively provided to the
participant by that provider, then
c.
The plan is to specify that the support will be provided by that provider.
See r.6.6 of the Plan Management Rules.
The plan must identify where supports are to be
provided by a particular qualified person or delivery
mode
47. If :
a.
The delegate considers that a participant’s disability requires:
i.
Specialist, evidence-informed support provided by a qualified person, or
ii.
A support to be provided in a certain delivery mode, and
b.
The delegate considers that the support is most efficiently and effectively provided to the
participant by a particular person or through a particular delivery mode, then
c.
The plan is to specify that the support will be provided by that qualified person or that delivery
mode.
See r.6.7 of the Plan Management Rules.
The plan must identify supports previously provided
by the Commonwealth, a state or a territory
48. If the support was previously provided to the participant by the Commonwealth, or by a state or a
territory, and there is a funding agreement that relates to the support that is in force, the plan must
specify that the support will be provided in accordance with the funding agreement and not by the
NDIA.
See r.6.8 of the Plan Management Rules.
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The plan must be tested against the Reference
Package and where relevant the Lifetime Cost
Estimator
49. In finalising the plan and the supports to be provided, the NDIA’s policy is that a delegate is
required to check the plan against the relevant Reference Packages and Lifetime Cost Estimator.
These tools serve as NDIA decision support tools in relation to:
a.
Whether a participant’s annual plan funding is comparable with the expected funding level for
the participant (based on key characteristics), and
b.
The NDIA’s annual and lifetime costs.
50. The tools indicate the level of delegation to apply for approval of expenditure associated with the
plan.
51. Where the recommended funded support is outside the boundaries of the expected level of
support, a further consideration will need to be given by a more senior delegate.
52. The senior delegate will ask the delegate to explain the logic of the variance against the expected
level of funding and ensure that the decision to fund at that level is in keeping with the NDIS Act
and documented thoroughly.
General supports
53. This Operational Guideline applies to both the provision of general supports and the funding of
reasonable and necessary supports. The following paragraphs are to assist delegates in relation to
general supports.
54. The term ‘general support’ is defined in the NDIS Act to mean a service provided by the NDIA to a
person, or an activity engaged in by the NDIA in relation to a person, that is in the nature of a
coordination, strategic or referral service or activity. It includes a locally provided coordination,
strategic or referral service or activity.
See s.13(2) of the NDIS Act.
55. If a participant would like assistance to identify suitable general supports and community resources,
allocation of a Local Area Coordinator (LAC) may be appropriate as a general support in the plan.
In this way, the support a LAC can provide a participant is very similar to the support they provide
non-participants.
See Operational Guideline – Gateway – Local Area Coordinators
56. A key general support for participants will be referral to other sources of supports. In arranging a
referral, NDIA officers or LACs should ensure the referral reflects the participant’s choice and obtain
informed consent to provide information about the participant to the provider. NDIA officers or LACs
should describe the information that will be exchanged, and how and when the support will be
implemented.
57. The referral should only contain information related to the provision of the support requested. If
there is a risk to the service provider, the delegate or LAC is to ensure that the service provider is
appropriately informed without breaching the participant’s privacy.
58. NDIA officers or LACs should check that the referral has been accepted and the support
implemented.
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59. Where the participant is not able to access these supports due to waitlists or unavailability of
services in their local community, NDIA officers or LACs will work with the participant to access
alternative supports.
See s.34 of the NDIS Act.
General considerations for delegates
60. In administering the NDIS and in approving each plan, the delegate must have regard to objects
and principles of the NDIS Act including the need to ensure the financial sustainability of the NDIS
and the principles relating to plans.
61. The delegate should utilise available evidence concerning the effectiveness of the support, and if
necessary, seek expert opinion.
62. A checklist has been developed to assess the reasonable and necessary supports that may be
funded as part of a participant’s plan under the NDIS. In applying the checklist, it is important to
consider each support in the context of the participant’s plan as a whole including any general
supports that will be provided. It may also be necessary to carefully consider whether an individual
support meets each of the requirements in the decision tree, for example, whether further
information may be required to ensure that a support represents value for money, will be effective
and beneficial to a participant or whether it is most appropriately funded or provided through the
NDIS. The checklist must be completed by a delegate and attached to the NDIA information system
record for each participant’s plan.
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Appendix A
Decision support tool for reasonable and necessary supports
Planner’s name:
Participant’s name:
Date:
NDIS Number:
Is criteria met?
Considerations (including
evidence used)
Enabling the participant’s goals and
objectives
 Yes
(supports will assist the participant to
pursue the goals and objectives in their
plan)
 No
In reaching this conclusion, I
have had regard to [insert
information considered, i.e. the
participant’s statement of goals
and aspirations and/or other
sources].
1. Criteria for general supports and
reasonable and necessary supports
(s.34)
Note: A delegate must be satisfied of each of the criteria in
the table below for a support to be provided or funded
under the NDIS
The reason for this conclusion is
that [insert reason why you are
satisfied or not satisfied that this
criterion is met].
s.34(1)(a) of the NDIS Act
Assist the participant’s independence,
social and economic participation
 Yes
(supports will assist the participant to
undertake activities to facilitate their social
and economic participation )
 No
s.34(1)(b) of the NDIS Act
In reaching this conclusion, I
have had regard to [insert
information considered, i.e. the
participant’s statement of goals
and aspirations and/or other
sources].
The reason for this conclusion is
that [insert reason why you are
satisfied or not satisfied that this
criterion is met].
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1. Criteria for general supports and
reasonable and necessary supports
(s.34)
Is criteria met?
Considerations (including
evidence used)
 Yes
In reaching this conclusion, I
have had regard to [insert
information considered, i.e. the
participant’s statement of goals
and aspirations and/or other
sources].
Note: A delegate must be satisfied of each of the criteria in
the table below for a support to be provided or funded
under the NDIS
Value for money
(supports represents value for money, i.e.
the costs of support are reasonable, both in
terms of the benefits achieved and the cost
of alternative support)
 No
The reason for this conclusion is
that [insert reason why you are
satisfied or not satisfied that this
criterion is met].
s.34(1)(c) of the NDIS Act, r.3.1 of the Supports for
Participants Rules
Effective or beneficial for the participant
 Yes
(supports will be, or are likely to be,
effective and beneficial for the participant,
having regard to current good practice)
 No
The reason for this conclusion is
that [insert reason why you are
satisfied or not satisfied that this
criterion is met].
s.34(1)(d) of the NDIS Act, rs.3.2 and 3.3 of the
Supports for Participants Rules
Coordinates with but does not replace
informal support
 Yes
(funding or provision of supports takes
account of what it is reasonable to expect
families, carers, informal networks and the
community to provide)
 No
s.34(1)(e) of the NDIS Act, r.3.4 of the Supports for
Participants Rules
In reaching this conclusion, I
have had regard to [insert
information considered, i.e. the
participant’s statement of goals
and aspirations and/or other
sources].
In reaching this conclusion, I
have had regard to [insert
information considered, i.e. the
participant’s statement of goals
and aspirations and/or other
sources].
The reason for this conclusion is
that [insert reason why you are
satisfied or not satisfied that this
criterion is met].
Operational Guideline – Planning and Assessment – Supports in the Plan (v 2.1)
Publication date: 1 September 2014
Page 14 of 18
Is criteria met?
Considerations (including
evidence used)
Most appropriately funded by the NDIS
 Yes
(supports are not more appropriately
funded or provided through other general
service systems or universal service
obligations)
 No
In reaching this conclusion, I
have had regard to [insert
information considered, i.e. the
participant’s statement of goals
and aspirations and/or other
sources].
1. Criteria for general supports and
reasonable and necessary supports
(s.34)
Note: A delegate must be satisfied of each of the criteria in
the table below for a support to be provided or funded
under the NDIS
The reason for this conclusion is
that [insert reason why you are
satisfied or not satisfied that this
criterion is met].
s.34(1)(f) of the NDIS Act, Schedule 1 of the
Supports for Participants Rules
See also table 2 below
Is criteria met?
Considerations (including
evidence used)
Is the support likely to cause harm to
the participant or pose a risk to others?
 Yes
(a supports will not be funded or provided
under the NDIS if the support is likely to
cause harm to the participant or pose a risk
to others)
 No
If the answer is ‘Yes’, the support
should not be included in the
statement of participant supports
2. Additional general criteria (s.35(1)(a)
and Supports for Participant Rules)
Note: A delegate must also consider each of the general
criteria in the table below for a support to be provided or
funded under the NDIS
r.5.1 (a) of the Supports for Participants Rules
Is the support related to the
participant’s disability?
 Yes
(a support will not be funded or provided
under the NDIS if the support does not
relate to the participant’s disability)
 No
If the answer is ‘No’, the support
should not be included in the
statement of participant supports
r.5.1(b) of the Supports for Participants Rules
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Publication date: 1 September 2014
Page 15 of 18
2. Additional general criteria (s.35(1)(a)
and Supports for Participant Rules)
Is criteria met?
Considerations (including
evidence used)
 Yes
If the answer is ‘Yes’, the support
should not be included in the
statement of participant supports
Note: A delegate must also consider each of the general
criteria in the table below for a support to be provided or
funded under the NDIS
Is the support duplicating other
supported delivered under alternative
funding through the NDIS?
 No
(supports do not duplicate other supports
however they are provided)
r.5.1(c) of the Supports for Participants Rules
Does the support relate to day-to-day
living costs that are not attributable to a
participant’s disability support needs?
(eg. rent, groceries and utility fees)
 Yes
 No
If the answer is ‘Yes’, the support
should not be included in the
statement of participant supports,
unless it falls into the exception in
s.5.2 of the Supports for
Participants Rules described in
the table below
r.5.1(d) of the Supports for Participants Rules
Note the exception in r.5.2 and refer to Operational
Guideline – Planning and Assessment – Supports in
the Plan – Interface with Housing and Community
Infrastructure
Operational Guideline – Planning and Assessment – Supports in the Plan (v 2.1)
Publication date: 1 September 2014
Page 16 of 18
Is criteria met?
Considerations (including
evidence used)
Is the support an additional living cost
that is:
 Yes
a) related to a reasonable and
necessary support, and
 No
If the answer is ‘Yes’, the support
may be included in the statement
of participant supports
3. Exception for day-to-day living costs
(r.5.2)
Note: For a support that relates to day-to-day living costs a
delegate must consider the matters below to identify
whether the support is an exception to the general rule
that a support will not be provided or funded under the
NDIS if it relates to day-to-day living costs that are not
attributable to a participant’s disability support needs
b) incurred by the participant solely
and directly as a result of their
disability support needs?
r.5.2(a) of the Supports for Participants Rules
Does the support relate to day-to-day
living costs:
 Yes
a) related to a reasonable and
necessary support, and
 No
If the answer is ‘Yes’, the support
may be included in the statement
of participant supports
b) costs that are ancillary to
another support that is funded or
provided under the participant’s
plan, and which the participant
would not otherwise incur?
r.5.2(b) of the Supports for Participants Rules
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4. Supports that will not be funded or
provided under the NDIS (r.5.3)
Is criteria met?
Considerations (including
evidence used)
 Yes
If the answer is ‘Yes’, the support
must not be included in the
statement of participant supports
Note: The following supports will not be funded or
provided under the NDIS and therefore must not be
included in a statement of participant supports.
Would the provision of the support
contravene a law of the Commonwealth,
State or Territory?
 No
r.5.3(a) of the Supports for Participants Rules
Would the support consist of income
replacement?
 Yes
 No
If the answer is ‘Yes’, the support
must not be included in the
statement of participant supports
r.5.3(b) of the Supports for Participants Rules
5. Other issues – Plan administration
requirements (s.33)
Is criteria met?
Have you specified the general supports
(if any) that will be provided under the
plan?
 Yes
Considerations (including
evidence used)
 No
s.33(2)(a) of the NDIS Act
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