Principles the NDIA Follows Creating Plans
The National Disability Insurance Scheme (NDIS) is established under the National Disability Insurance Scheme Act 2013 (NDIS Act). The NDIA (National Disability Insurance Agency) uses the NDIS Act and supporting rules to make decisions about eligibility and plans, including what supports can be included and funded.
Recent law changes are shifting the NDIS toward a new planning framework, with rules still being developed. Until those rules are finalised and operational, existing plans are treated as “old framework” plans and will continue to develop under the current approach while participants transition over time.
This means participants may see references to both the current planning approach and upcoming changes. The principles and criteria explained below relate to the NDIA’s current guidance for planning and funding decisions.
What Supports Can Be Funded
Under current NDIS law settings and guidance, the NDIA can only fund “NDIS Supports” (services, items, and equipment that the NDIS is allowed to fund). The NDIA’s broader approach is that NDIS supports should complement, not replace, other supports available to a person, including informal supports (family, friends, community connections) and mainstream or other government services.
In practice, this means planning decisions often consider:
What the person can do for themselves;
What informal supports are reasonably available; and
What mainstream/community systems should provide (health, education, etc.), alongside what the NDIS can fund
Reasonable and Necessary Criteria
A support must meet the “reasonable and necessary” criteria to be funded. These criteria are set out in the NDIS Act (including section 34) and reflected on the NDIS website.
Based on the information provided and the NDIS Act framework, the NDIA’s criteria include that the support must:
Relate to the person’s disability support needs
Help the person pursue goals in their plan
Support participation in work, social, or community life
Represent value for money (including reasonable costs compared with benefits and alternatives)
Be effective and beneficial, having regard to current good practice and evidence
Take account of informal supports and what is reasonable for others to provide
Be an “NDIS support” the scheme can fund
The NDIA also provides public guidance tools to help participants understand common funding decisions, including the “Would we fund it” guide.
The NDIA places emphasis on spending in line with the NDIS plan. This generally means using funding as described in the plan, ensuring budgets last the length of the plan (and any funding periods, if relevant), and purchasing supports that are NDIS supports (or an agreed replacement support) that relate to disability needs and align with the plan.
Supports Not Funded
The NDIA states there are things the NDIS cannot fund or provide under the NDIS law. Examples listed in NDIA resources include supports that are not NDIS supports, unlawful, income replacement, likely to cause harm or post risks, or everyday living costs such as groceries, rent, or utilities. The NDIA also lists specific exclusions such as alcohol and illicit drugs.
It is also a core principle of the scheme design and the NDSI does not duplicate supports that are the responsibility of other systems.
Financial Sustainability & Scheme Integrity
The NDIA describes the NDIS as an insurance-based scheme and states that managing financial sustainability is a core function. This means planning decisions also consider the need to distribute supports fairly within the scheme’s budget and to protect the scheme from misuse and fraud (including checks that funding is used appropriately and that information provided is accurate).
The 7 Principles
The NDIA outlines seven principles used to create plans, which is stated as supporting both participants’ disability support needs and the scheme’s financial sustainability.
1. Fair for everyone, both today and future generations
When developing a plan, individual circumstances and disability support needs are carefully considered by the NDIA, while also ensuring decisions are consistent and fair. This means people with similar needs and situations should receive similar levels of support.
Funding is provided for reasonable and necessary supports for those with a permanent and significant disability or developmental delay, in line with the criteria set out in the NDIS legislation. The entire plan is approved as a whole, with supports assessed together to ensure they are appropriate, lawful, and work effectively alongside one another.
The NDIA may then increase or decrease the funding in your plan based on a few factors:
Information you share with the NDIA
Any reports or other information they have
Apply the NDIS funding criteria
These factors help keep the system fair for everyone and ensure the NDIS remains financially stable for future generations to come.
2. Fair funding to pursue your goals
Goals play an incredibly important role in your NDIS plan. The supports funded must help maximise independence and assist in overcoming disability-related barriers that may be preventing progress toward those goals. However, no every cost connected to a goal will be funded, as helping you pursue your goals is only one part of the reasonable and necessary criteria. Some goals may sit outside what the NDIS can fund.
It’s also important to understand that setting more goals, or larger goals, does not automatically result in more funding. For example, if a goal is to live independently in a house with a swimming pool, funding may be provided for disability-related home modification, such as making a bathroom accessible, but not for features unrelated to disability needs, such as a pool.
Similarly, have a goal such as getting a gym membership does not mean it will be funded, as this is considered an everyday expense that people with or without disability may choose to pay for themselves.
Stating a specific type or cost of support does not guarantee that exact item will be funded either. If a lower-cost option can meet the same need and achieve the same outcome (provided it is supported by appropriate professional evidence) it is more likely to be approved. Alternatives may also be considered to ensure the support represents value for money while still addressing disability-related needs.
3. Evidence-based best practice
NDIS supports are funded when they are, or are likely to be, effective and beneficial (based on current good practice). This involves considering whether there is reliable evidence that the support works for people with similar disability-related needs.
Greater weight is given to recognised and credible sources, such as (but not limited to) published research, peer-reviewed literature, and expert consensus. If there is no evidence showing that a support is reasonable and necessary, it will not be funded.
These principles are most useful when they are translated into practical planning preparation. That usually involves matching each requested support to:
The disability support need it addresses
The goal it supports
Evidence of functional impact and benefit
Value-for-money considerations and alternatives
It also involves clearly separating what should be funded by the NDIS from what should be provided through mainstream systems or paid as everyday living costs.
The NDIA’s planning principles are designed to guide consistent, evidence-informed decisions about what supports can be included in a plan, while balancing individual needs with fairness and financial sustainability. Understanding how these principles link to the reasonable and necessary criteria can help participants prepare clearer support requests, gather more relevant evidence, and make more confident decisions about what to ask for or what to source through other systems (mainstream or community like health and education).
Get the support you need with Purple Leopard Plan Management
At Purple Leopard, we’re here to help participants to navigate the complexities of the NDIS. Contact us today to learn how we can support you in getting the most out of your NDIS plan.
For more information on the NDIS guidance, participants can review the NIDS information on supports funded by the NDIS, reasonable and necessary supports, and the NDIA’s updates on the new planning framework at: ndis.gov.au
Or Call the NDIS
For Participants: 1800 800 110
For Providers: 1300 311 675