Can I Buy It?

This is the question that has plan managers support coordinators, participants, their teams and even the agency all tangled up most of the time.

With a focus on scheme sustainability it is becoming increasingly clear that purchasing decisions can no longer be justified by a tick and flick of a self management questionnaire. The agency wants to see participants understanding the relationship between a purchase and functional ability, and that a participant is truly identifying value for the scheme and their disability before buying a service or item. This is particularly important when purchasing an every day item.

What is an everyday item?

This is something anyone might buy. Mobile phones, TVs, kitchen appliances, tablets, laptops and headphones are some of the items participants want to spend their funds on. 

Your decision making increasingly comes with a buyer beware warning. Unless you can demonstrate it relates to disability and how it will improve your life you may be required to pay money back for the item. Generally, the stance of the agency is that these items are not related to disability. Why? Because we all have them. The NDIS is designed to support people with a disability. And the NDIS is not an income replacement scheme. Nor should it be.

But it depends.

There are more than 500,000 participants in the scheme and as a result more than 500,000 individual needs, goals and functional impairments. What might be reasonable and necessary for you will not be for the next person.

The true intention of the NDIS is choice and control, which means you to choose how to spend your funds wisely – but with caveats. It also means you are ultimately responsible for the decisions you make.

And this is where it starts to get murky.

How can I minimise my risk?

First we always recommend you think about why you really want or actually need the item.

For example, the NDIS website Our Guidelines shows that a planner will nearly always refuse a tablet, because we all use one.

In deciding if something is actually relevant to your disability, you need to consider that the NDIS will not fund things that:

• are not legal
• are income replacement
• are likely to cause harm to you, or pose a risk to other people
• are not related to your disability
• relate to a ‘day-to-day living cost’, such as groceries, rent or utilities, that are not attributable to your disability support needs. These are costs that are not caused by or as a result of your disability support needs.
• duplicate other supports provided by the NDIS under alternative funding.
• Are not value for money – eg a bells and whistles laptop won’t be OK if you’re buying something to help you maintain Allied Health appointments.
• Can be afforded in your plan. If purchasing something means you won’t have funds for other supports, it’s likely you won’t get a new plan.

It’s important to really consider this before you submit for an everyday item from your plan. So if you are purchasing a tablet, and really feel that you wouldn’t need one without your disability get a letter of support and demonstrate the functional necessity. Because the last thing we want to see is you having to pay back funds later.

We will send you a questionnaire and guide you through a process that will support this process.

Co-Payments

When purchasing an item that you feel is relevant to your disability we also encourage you to consider a co-payment. This means you are demonstrating that while part of the item can support functional improvements, there is a part that is also an every day item. This can be useful in a participant audit, because it demonstrates again a decision making process that is sound.

Can my plan manager refuse a purchase?

A plan manager is currently not responsible for your plan spending decisions. But we may ask for additional information to support the purchase. We are increasingly seeing “please explain” letters that ask us to demonstrate how we are supporting a participant around responsible use of funds. While we look forward to clarity, we are concerned that this activity is outside the scope and payment for our role and designed to become gatekeeping.

However, as a registered provider we are obliged to tell you about the risks of your spending decisions. In addition, we provide you with links to relevant NDIS information to help you make a decision. We will not refuse a purchase but we will request further documentation to support your purchase i.e., approval from your planner or supporting documentation from an allied health professional. For example, food is not allowed unless clearly funded in the planning stage of a plan. Similarly, if you go to Kmart and buy plates, cups, saucepans and cutlery, we won’t reimburse you. This is because there is no reason for this to be related to disability. If you insist we will ask for evidence and approval from the NDIS.

The Takeaway

In essence, as a plan management business we have a strong desire to support choice and control. With so much lived experience in our team, we understand the value some items may have to your life when purchased using NDIS funds.

However, we also have a responsibility to ensure the scheme is sustainable. That means that while the decision is yours, we can refer a request to purchase to the agency if we are unsure. This is a good thing, because it means we are all working to support your goals (and plan managers are not disability experts).

Instead of saying an outright no, we will give you tools and support to explore different solutions. That is true capacity building!

If you would like support to purchase an item or are looking for a new plan manager, please reach out here and get in touch. We’d love to support you!