The Apoio Pulse – Issue 35

This week, we want to dive into the pivotal concept of 'Reasonable and Necessary' and how, as providers, we can educate our participants about its significance.

In a nutshell, 'Reasonable and Necessary' is the criteria used to determine whether a support or service is eligible for NDIS funding. It ensures NDIS resources are allocated effectively, providing participants with the support they genuinely need to achieve their goals.

Let's break it down with both the abbreviated version of the 6 stipulations of 'Reasonable and Necessary' and a few practical examples:

1. Disability Related: Ask, "Is this product or service needed because of my disability?"

2. Goal Related: Consider, "Does it help me pursue my NDIS goals as detailed in my plan?"

3. Promote Participation: Think, "Does it increase participation in family, social activities, or work?"

4. Value for Money: Evaluate if it represents value for money or if more cost-effective alternatives exist.

5. Build Independence: Reflect on how the support encourages or builds independence.

6. Appropriate Funding Body: Ensure that NDIS is the right funding body for this product or service.

Now, let's apply these principles:

Mobility Aids: If a participant needs a wheelchair to move around but requests a gold-plated, diamond-encrusted model, that may not be considered 'Reasonable and Necessary.' However, a sturdy, reliable wheelchair that meets their mobility needs would certainly qualify.

Therapies: Extensive and ongoing therapies are unquestionably 'Reasonable and Necessary' for many participants. On the other hand, paying for a weekly psychology session as therapy when a monthly session would suffice might not meet the criteria.

Home Modifications: Installing a wheelchair ramp to ensure accessibility at home is a classic example of 'Reasonable and Necessary' spending. On the flip side, building a lavish entertainment room might not align with the NDIS goals.

Our role as providers often goes beyond offering support; it involves guiding participants in making informed choices. By educating them on what qualifies as 'Reasonable and Necessary' and these six criteria, we empower them to make responsible and beneficial decisions.

Stay tuned for next week's email, where we'll delve into the consequences of claiming items that don't meet the 'Reasonable and Necessary' criteria. Understanding this aspect is crucial for participants to navigate the NDIS landscape successfully.

We encourage you to share this information with your participants and open the doors for conversations about their goals and needs. After all, knowledge is the key to unlocking the full potential of the NDIS.

If you have any questions or need further clarification, please don't hesitate to reach out. We're here to support you and our participants every step of the way.