All NDIS supports need to meet all the reasonable and necessary criteria.
This means that before we can include an NDIS support in your plan, we need to be satisfied it meets all the following criteria:
- The support will assist you to pursue your goals in your plan.
- The support will assist you to undertake activities, to facilitate your social and economic participation. This means the support will help you to undertake activities, by reducing the disability-related barriers that prevent you from participating in things such as social outings, recreation, work and study.
- The support represents value for money in that the costs of the support are reasonable relative to both the benefits achieved and the cost of alternative supports. This means we need to consider the costs and benefits of the support, as well as the costs and benefits of alternative supports.
- The support will be, or is likely to be, effective and beneficial for you, having regard to current good practice. This means we consider if there is evidence the support works for someone with similar disability support needs. We won’t need an expert report for every support, as we can often rely on other information or evidence. For example, we may have information already about whether the support is widely accepted to suit someone with your disability support needs. We also consider your lived experience.
- The funding of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide. This means we need to consider what support is reasonable for your family, friends and community to provide.
- The support is most appropriately funded or provided through the NDIS, and is not more appropriately funded or provided through:
- other general systems of service delivery, or support services offered by a person, agency or body (for example, a State or Territory Statutory Scheme)
- systems of service delivery or support services offered as part of a universal service obligation (for example, the health or education system)
- systems of service delivery or support services offered in accordance with reasonable adjustments required under discrimination laws (for example, your employer, or the health or education system).
The law for the NDIS sets out things that we need to consider when we apply the reasonable and necessary criteria.
We must be satisfied that each support is reasonable and necessary individually, but we must also be satisfied that the supports are reasonable and necessary as a package of supports.
For example, a home modification may reduce your need for other supports. If we plan to fund a home modification, we will need to take that home modification into account when considering what other supports are reasonable and necessary, such as the amount of care you need at home.
If the home modification will reduce your care needs, we may need to reduce the amount of care we fund, as a higher amount may not be reasonable and necessary when the whole package of supports is considered.