New guidelines listing what National Disability Insurance Scheme (NDIS) participants can and cannot spend their individual funding on came into effect on Thursday.
The disability support system had operated on the basic principle that people who qualified and were granted NDIS plans were able to spend money allocated to them on supports that were "reasonable and necessary".
released the lists two days before they came into effect and said they would bring "more clarity and more certainty for all participants in how they can use their budgets".
What are the two NDIS lists?
NDIS participants have been sent
— supports that are NDIS supports and those that aren't.
The creation of such lists follows a review of the scheme that called for the development of "a unified system of support" to "deliver better outcomes for people with disability in a more responsive and cost-effective way".
The final report from the review found that the costs of the NDIS were growing much faster than anticipated and were only expected to grow, with projections the scheme would cost $92 billion by 2032-33 if changes were not made.
Items on the 'no' list
The 'no' list makes clear to NDIS participants that they are not to spend money from their plan on tattoos and body piercings or getting their pet cremated or taxidermied.
While those may seem straightforward, deputy CEO of People With Disability Australia (PWDA) Megan Spindler-Smith questioned some other items on the same list.
She said some disabled people were unable to prepare their own meals, and while their NDIS funding may allow for a support worker to assist, "that is a fairly high cost, and we have a shortage of support workers".
"Things like meal delivery or even just getting frozen foods bulk from a supermarket provides safe access to food and the ability to eat and engage in just having a meal in a safe way that doesn't require the availability of a support worker or a potential family member," she said.
Also on the 'no' list is gaming therapy, which a growing number of occupational therapists have begun offering in recent years. This therapy is often aimed at developing skills and social connections in neurodivergent children.
Spindler-Smith said while many people "wouldn't necessarily understand the importance or the value of gaming therapy", it provides participants with an opportunity to engage in socialisation and capacity-building.
She is concerned that without a flexible approach, some people may not engage in therapy.
Megan Spindley-Smith is concerned about some of the changes to the NDIS. Source: Supplied
"What we know is that sort of socialisation, or access to the social community, is so imperatively important as a way to keep people safe, and we know it's a suicide prevention methodology," Spindler-Smith said.
Another support listed as not to be paid for with NDIS funding is animal therapy.
Spindler-Smith said PWDA was seeking clarification as to whether this included equine or horse therapy, which in the past has been an accepted use of NDIS funding.
Equine therapy is not listed on the 'yes' list, and "animal therapy — for example, puppy therapy, goat therapy" is currently on the 'no' list.
Assistance animals will continue to be covered.
Sexual services and holidays
While the inclusion of cuddle therapy and tarot card readers on the 'no' list may have made headlines, Spindler-Smith said these were "definitely not things people were claiming regularly".
Holiday airfares and accommodation were also listed as items that NDIS funds could not be spent on.
Spindler-Smith said she was aware some people may have used NDIS funds on travel and transport costs in the past.
"A lot of the time, these sort of things are actually to cover the cost of the support worker to travel [to accompany a person with a disability who was travelling]," she said.
While sexual services are listed at the very top of the 'no' list, Spindler-Smith said different types of support around sexual relationships and activity should be considered in certain circumstances.
"People are using the term sex work, but actually what we're talking about is different types of sexual supports.
"They could be as specific as supporting a disabled couple, so two people with disability who are in a relationship to be able to engage in sexual activity together."
She said in such a situation, someone working in the sex industry would be the "better qualified" person to provide such support rather than a support worker.
"It could also be about people who have trauma or who have not had positive, consensual sexual experiences that are people with disability being able to engage in opportunities like that in a safe and trauma-informed way.
"There's lots of different things that fit within that, it could even be something as simple as a disability affirming or ergonomic style sex tool or sex toy, that a lot of the time is much more expensive than standard ones," Spindler-Smith said.
Consequences of misspending
Spindler-Smith said it was her understanding that those with existing plans are able to spend their funding on supports that are not listed on the 'yes' list if they are specifically stated in their current plan.
Those who use NDIS funds on a support not accepted under the scheme will have to repay the amount of money spent.
There will be a 12-month transition period in which "if a participant makes a mistake and purchases a non-NDIS support", worth less than $1,500 up to two times, they will not be asked to pay it back.
Spindler-Smith raised concern about whether those who self-manage their plans and pay for services before being refunded upon submitting their claim could end up out of pocket.
"It's unclear whether or not, for people who are self-managed, they may not necessarily have the approval automatically to not have a debt raised because they will have already paid it out, and then they're claiming it back."
In the case of a service provider delivering or claiming for supports on a participant's behalf, the transition period is 30 days.
Some NDIS providers 'selling snake oil': Shorten
NDIS Minister Bill Shorten said the update would help return the scheme to its original purpose and ensure it wasn't paying for supports that should be covered by Australia's other care systems or shouldn't be covered at all.
"This scheme is going to be run properly, transparently, and in the best interest of participants, not some service providers who are selling therapies which we cannot find much in the way of a scientific or evidence basis," Shorten told reporters in Canberra.
"They're selling snake oil. They're selling stuff which, frankly, doesn't work.
"What this does is it gives all Australians confidence that the cowboys and fly-by-nighters can't sell their nonsense and be subsidised to do so."
Spindler-Smith acknowledged that the changes to what is accepted NDIS spending may be being made with "an assumption" that further supports outside of the NDIS will eventually "kick in," and at this stage, such supports were "very much still in consultation mode".
The final report of the NDIS review stated the scheme "should be one part of a big system that supports people with disability", urging governments to commit to "creating a unified ecosystem".
It called for the scheme to provide care for those most in need while diverting others away from the NDIS and towards supports outside of it referred to as "foundational supports".
It has been suggested that some of these supports could be offered within schools and childcare settings but the government is yet to announce any details on these.
With the Australian Associated Press.
