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Frequently asked questions

What is an Occupational Therapist?

An Occupational Therapist, or OT as they are often known as, has completed either a four year Bachelor degree, or a two year Masters degree, in Occupational Therapy. Occupational Therapy is a client-centred health profession, with the primary goal of enabling the person to participate in activities of everyday life. Some of the areas an OT can help you with are:

  • Gross Motor Skills
  • Fine Motor Skills
  • Sensory Processing
  • Social Skills
  • Daily Living and Functional Life Skills
  • Sleep
  • Toileting

What is a Speech Pathologist?

A Speech Pathologist, or Speech and Language Pathologist as they are sometimes called, has completed either a four year Bachelor degree, or a two year Masters degree, in Speech Pathology. Speech Pathologists are client-centred health professionals, who focus on assessing, diagnosing and treating communication and swallowing difficulties in children and adults. Some of the areas a Speech Pathologist can help you with are:

  • Speech Delays and Disorders
  • Expressive and Receptive Language
  • Augmentative and Alternative Communication
  • Feeding and Swallowing
  • Language and Speech
  • Social Skills

What is a Social Worker?

A Social Worker has completed either a four year Bachelor degree, or a two year Masters degree, in Social Work. Social Work is a broad and diverse profession, but is consistent in its commitment to human rights and social justice. Social Workers work with individuals, families and groups to assist and improve the individuals wellbeing and identifying and addressing any external issues that may impact on their wellbeing, or may create inequality, injustice and discrimination. Social Workers can help you with the following:

  • Community Linkage and Engagement
  • Operating as a Key Worker
  • Emotional Regulation, Awareness and Identification
  • Social Skills
  • Individual or Family Counselling
  • Capacity Building
  • NDIS Plan Optimisation

What is a Developmental Education?

A Developmental Education, or DE as they are commonly known, has completed a four year Bachelor Degree in Disability and Developmental Education. Developmental Educators use a practical and holistic approach to address issues which may affect the function, independence and social inclusion of people with disabilities across the lifespan. Developmental Educators also often can work on challenging or difficult behaviours through the development of a Positive Behaviour Support Plan. Some of the areas a Developmental Educator can help you with are:

  • Social Skills
  • Behaviour Management Plans
  • Emotional Awareness and Identification
  • Daily Living and Functional Life Skills

What is the NDIS?

The National Disability Insurance Scheme, or NDIS as it is commonly known as, is a national system to support people with disabilities, their families and their carers through the provision of funding to access the necessary services. The NDIS is focused on providing individuals with choice and control over their plan, giving them the flexibility to utilise the services that best suit their needs to help them achieve their goals. The NDIS is overseen and facilitated by the National Disability Insurance Agency, or NDIA.

What is a Support Coordinator?

A Support Coordinator is a person or organisation that helps you to get started on your NDIS journey, helping you to understand your plan and its budgets, and assisting you to connect with supports and services in your community to help you achieve your goals. A Support Coordinator can also assist you during times of crisis and conflict, advocating for you with the NDIS, other providers, and other mainstream services, such as schools.

What is a Plan Manager?

A Plan Manager is a person or organisation that specialises in processing and paying invoices from providers and monitoring your funding throughout your plan. A Plan Manager provides the same flexibility to an individual as if they were Self-Managed, however the individual does not have to keep the records themselves in case of audit. Funding for a Plan Manager can be added into your plan at your next review, and is independent to any funding types.

What is a Local Area Coordinator (LAC)?

A Local Area Coordinator, more commonly known as LAC’s, are a third party organisation who are contracted by the NDIA to assist individuals to link with the NDIS, link individuals with information and support in the community, and to work with the community to make it more accessible and inclusive for people with disabilities.

 

They also assist the NDIS to create a first plan with the individual, once the plan has been finalised assist you to action your plan and begin accessing services and supports, and to review your plan and begin planning your subsequent plan.

 

In South Australia, the LAC’s are:

  • Feros Care
  • Baptcare
  • Mission Australia

 

For more information about the regions the LAC’s work in, please visit the NDIS website https://www.ndis.gov.au/about-us/our-sites/SA.html

What is the difference between the NDIS and NDIA?

The National Disability Insurance Scheme (NDIS) is the funding system that allows individuals the ability to access the supports they need in the way they would like them. The National Disability Insurance Agency (NDIA) is the government agency whose role it is to implement and manage the NDIS and ensure that people with disabilities continue to receive the support that they need.

I have my NDIS Plan, what now?

Once you have received a copy of your plan, you can now begin accessing services. If you already know which providers you would like to use, then you can typically just contact them to arrange services. It is often a good idea however, to sit down and break your funding down and determine how you would like to spend this. You can do this on your own or your providers can assist you with this process. Before commencing services it is often a good idea to ensure you have signed a Service Agreement with you provider as this is essentially your contract between yourself and them.

 

If you do not know which providers you would like to use, the NDIS website has a Registered Provider Finder tool to assist you https://www.ndis.gov.au/document/finding-and-engaging-providers/find-registered-service-providers

What does ‘Reasonable and Necessary’ mean?

‘Reasonable and Necessary’ is an NDIS term that is used to determine whether a support, service or equipment is the responsibility of the NDIS to fund, or whether it is a reasonable cost for the individual or family, or existing mainstream services to fund. The NDIS considers the following when determining if a support is ‘Reasonable and Necessary’:

  • Will the support assist the participant to pursue their goals and aspirations?
  • Will the support help the participant to engage in community, education or employment activities?
  • Is the support value for money?
  • Is the support already provided by a mainstream service or is it the expectation that families or the community provide the support?
  • Be related to the Participant’s disability?
  • Not include day-to-day living costs that are not related to the Participant’s disability support needs?
  • Be likely to be effective and beneficial?

If you can answer all these considerations with a yes then the NDIA may consider the support or item to be ‘Reasonable and Necessary’ and fund it as part of your plan.

How do I access your services?

To access any of our services, you just need to contact our friendly admin team either via phone on (08) 8322 2792 or via email to support@pahs.com.au and in the email just providing your contact details and information about what services you are interested in. Once you have made contact, we will arrange for a no-cost Initial Consult session with a member of our team. It is during this meeting that we will gather any information that we need, identify what services will help you to meet your goals, and assist you to understand your NDIS Plan if you require it.

How do I know what funding type my NDIS Plan is?

NDIS Plans do not always explicitly state ‘Agency Managed’ or ‘Self-Managed’ in your plan, so you need to look at the specific details of each of your support budgets to determine this. It is important to note, that your plan can all be one funding type, or could be a combination of two funding types.

You can identify the funding type for each Support Budget by looking in the ‘How will the supports be paid’ box beneath the support budget name. This box will have one of the following three phrases, these are:

  • NDIS will pay my support provider directly for these supports – this means that this Support Budget is Agency Managed; or
  • NDIS will pay my plan management agency directly for these supports – this means that this Support Budget is Plan Managed; or
  • NDIS will pay me directly for these supports – this means that this Support Budget is Self Managed.

Often times a plan will all be one funding type, but it is not uncommon for a plan to be partly Agency Managed and partly Plan Managed.

What is a Plan Gap?

A Plan Gap is where your previous NDIS Plan has ended, but a new plan has not been finalised yet. There are several circumstances that could result in a plan gap occurring, these include:

  • The NDIA has inadequate information to determine funding for the subsequent plan, i.e. reports have not been lodged or are not detailed enough; or
  • The NDIA has inadequate information to determine your ongoing eligibility to remain a participant of the scheme, i.e. not having details of a formal diagnosis or funded supports are no longer necessary; or
  • The NDIA or the LAC has attempted to make contact with you to arrange a review meeting but have not been able to make contact, and as such your review has now stopped until contact can be made; or
  • The NDIA or the LAC has a significant backlog of plans to review and they are unable to action your review prior to the end of your current plan.

Depending on the cause of the Plan Gap and what actions may be required to resolve the gap, it may last between a few days to several months.

What is a NDIS Plan Review, and when does it happen?

An NDIS Plan Review is your opportunity to identify what did and didn’t work in your plan, and what supports you might like or need in the next plan. As part of the plan review, you will typically need a report from each of your therapists and service providers addressing what was provided, how it was working towards your goals, what progress was made and what recommendations they believe would be beneficial for the next plan. The NDIA or your local LAC will contact you to arrange a time to meet with you to discuss your plan and plan your next plan. Typically, a Plan Review occurs every 12 months at the end of your current plan, however the NDIA and LAC’s reserve the right to review a plan a few weeks prior to the plan ending, or if there is a significant backlog or they are awaiting further information, your planning meeting may be delayed, resulting in a Plan Gap.

What can I do about a Plan Gap?

If your current plan expires and you have not yet had a review meeting, or received your new plan, you may be experiencing a Plan Gap. If this occurs, you first point of contact should be to contact the NDIA by calling 1800 800 110 and identifying the cause of the Plan Gap. During this conversation, the NDIA staff member should be able to identify the cause of the Plan Gap and what actions may be necessary to resolve it.

 

If your Plan Gap lasts for longer than 3 weeks, we ask that you let our team know so that we can try and follow up with the NDIA ourselves in the hope that we may be able to assist in getting the situation resolved. If this is unsuccessful, or your Plan Gap is in excess of one month, we encourage you to contact your local member of parliament.

If your current plan expires and you have not yet had a review meeting, or received your new plan, you may be experiencing a Plan Gap. If this occurs, you first point of contact should be to contact the NDIA by calling 1800 800 110 and identifying the cause of the Plan Gap. During this conversation, the NDIA staff member should be able to identify the cause of the Plan Gap and what actions may be necessary to resolve it.

 

If your Plan Gap lasts for longer than 3 weeks, we ask that you let our team know so that we can try and follow up with the NDIA ourselves in the hope that we may be able to assist in getting the situation resolved. If this is unsuccessful, or your Plan Gap is in excess of one month, we encourage you to contact your local member of parliament.

What do I do if my NDIS Plan is not suitable, is inadequate or the details of my plan are incorrect?

If you believe that details of your plan are incorrect, or that a decision about your plan made by the NDIA was unfair or inadequate, you should contact the NDIA immediately on 1800 800 110 to discuss this.

 

If you believe their response is inadequate, you may be eligible to commence an internal merits review. This process includes an independent representative of the original decision at the NDIA will review the information available and the decision making process and determine if the decision was fair and accurate.

 

For more information about internal reviews or a plan appeal, please contact Brain Injury SA (link) on 08 8217 7600

http://braininjurysa.org.au/support-and-services/ndis-appeals/

What does ‘Psychosocial Disability’ mean?

Psychosocial Disability is a term used to describe a disability that may arise from a mental health issue, but it is important to recognise that not everyone who has a mental health issue will have a psychosocial disability, but for those who do it can be severe and longstanding. People with a disability as a result of their mental health condition may qualify for the NDIS. For more information, please visit the NDIS website

https://www.ndis.gov.au/psychosocial/products.html

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