Stage 2: individualised living option supports

Like all NDIS funded supports, individualised living option supports must meet the reasonable and necessary criteria.

We’ll work out what individualised living option supports are reasonable and necessary. We’ll also consider any information we already have, to help us make a decision.

We’ll make sure an individualised living option is right for you, and the individualised living option supports described in your Service Proposal suit your needs and circumstances. We’ll also check the cost estimate is value for money.

To work out what individualised living option supports meet our reasonable and necessary criteria we think about the questions below.

We can only fund individualised living option supports if they’re related to your disability. They need to help you do things you can’t do because of your disability.

We’ll look at your Service Proposal to check that the individualised living option supports detailed relate to your disability support needs.

For example, due to your disability, you might need help with doing some of the things tenants need to do when they rent a house. We may be able to fund someone to help you keep up your responsibilities as a tenant if you need help because of your disability.

We don’t fund things everyone needs whether or not they have a disability, such as your food, rent or furniture.

An individualised living option must help you pursue the goals in your plan. To fund an individualised living option support, there must be a goal in you plan the individualised living option would help you pursue.

This might be something like to feel confident and safe in your own home.

An individualised living option could also help you pursue goals to build your skills or do more things yourself, such as paying your bills or managing the household chores.

Remember, it is important to understand:

setting more and bigger goals doesn’t mean we’ll fund more and bigger funded supports
setting a goal about an explicit type or amount of support you might want doesn’t mean we have an obligation to fund that support or in that amount.

Find out more about setting goals .

Your individualised living option must be likely to be effective and beneficial for you. This means it’ll do what it’s meant to do, and it will help you.

Your individualised living option support should help you have a place you can call home. You should be able to express who you are and make choices about your daily life activities.

Your Service Proposal will provide important information to help us work out if your individualised living option support is likely to be effective and beneficial for you. We’ll see if your supports provide the flexibility you need and if the mix of support will work in the long term.

For example, we need to check things like:

Does your Service Proposal clearly describe how your primary support will be provided?
This helps us understand what supports you’ll get, when you’ll get them, and who you’ll get them from. From this, we can better understand if the supports match what you need and want. It also helps us work out whether there are any risks to you or others and whether the supports are value for money.
Are there one or more supplementary supports that provide flexibility and will sustain your primary support?
This helps us work out if your individualised living option supports are likely to be effective and beneficial. We’ll see if your supports provide the flexibility you need and if your primary support is sustainable.
Is there evidence you’ve been involved with and agree to the Service Proposal?
Your Service Proposal isn’t likely to be considered effective and beneficial if you haven’t been involved in designing it or you don’t agree with it.
How will your individualised living option supports fit with other home and living supports, or supports you use for things like recreation, work or study?

Your individualised living option support is more likely to be effective and beneficial if it works with other supports you use such as transport, assistive technology and capacity building supports. We’ll check this and make sure they’ll work together.

Usually, support to help you with work, study or daytime activities, is funded separately from your individualised living option. These supports are very important for helping you live the life you want. It’s important they’re described in your Service Proposal so you can be sure all your supports will work together.

It’s also a good idea to include other housing related supports in your Service Proposal. For example, you might need home modifications so your home suits your needs, or specialist disability accommodation if you meet the criteria. Again, this will help make sure all your supports work together.

Individualised living option supports are for the support you get from other people. Individualised living option supports don’t cover the house or accommodation itself. Specialist disability accommodation relates to the house, accommodation building or physical dwelling, not the funding for supports.

The individualised living option support is not likely to be considered effective and beneficial if there are risks to your safety or the safety of others.

Your individualised living option support must be value for money. This means that the cost of the supports must be reasonable, because of how much you benefit from them. We also compare this to the cost of other supports that would give you the same benefit. We need to consider if:

there are other supports that might achieve the same outcome that are less costly
your individualised living option support will increase your independence, or reduce your support needs in future.

For example, we may be able to fund modifications to your house, so you don’t need ongoing funded supports to help with certain tasks.

There are three levels of individualised living option support. We work out which level of support best suits your needs based on your individual circumstances and our reasonable and necessary criteria.

Individualised living option Support Level 1

We may consider this level of support where:

Primary support involves you sharing your home with a person who provides companionship, a role model and some direct support.
Direct support may involve physical assistance with personal care and prompting with household tasks, along with help to manage emotions and behaviours.
Supplementary Support involves things like drop-in, on call support, regular time with family or formalised assistance from a neighbour.
Monitoring and limited re-design due to a stable and mature arrangement.

Individualised living option support level 1 is funded up to $105,000 per year.

Individualised living option Support Level 2

We may consider this level of support where:

Primary support involves you sharing your home with a person who provides companionship, a role model and more direct support.
Direct support involves physical assistance with personal care and prompting or supervision with household tasks. It also may involve help to manage episodic behaviours of concern, including strategies and supports to address them.
Supplementary Supports involve things like drop-in, on call support, regular time with family or formalised assistance from a neighbour.
Monitoring and potential for redesign of the living arrangement.

Individualised living option support level 2 is funded up to $150,000 per year. This is generally the maximum amount for host arrangements.

Individualised living option Support Level 3

We may consider this level of support where:

Primary support involves support being provided over more sustained periods of time, and offering a more personal relationship than usual rostered supports.
Direct support will involve physical assistance and personal care alongside direct supervision with household tasks. Direct support could include help to manage significant behaviours of concern, a significant physical disability, or disability-related health supports.
The supplementary supports can include those mentioned in the first and second levels, but may require continual assistance and intervention.
Significant monitoring is needed and there is a high potential for re-design, as the arrangement requires high levels of flexibility between the primary and supplementary supports.

Individualised living option support level 3 is funded up to $230,000 per year.

These levels are a guide only. We decide your actual level of support based on your individual situation.

If you need support to take part in activities outside your home, such as work or study, playing sport or going out, we'll include it in another part of your plan.

More or less support may be included in your plan, once all reasonable and necessary criteria has been taken into account. Learn more about what if you need more support.

We know that getting support from your family, friends and the community can be important for you and your wellbeing. An individualised living option support is designed to complement and not replace unpaid informal supports.

We don’t fund supports in your individualised living option that would be reasonable to expect your family, friends or the community to provide. These are the kind of things we all do for each other and it would be reasonable to expect friends or family would do for you.

We’ll think about:

how much support you need and what type
whether the activity you need support for is the kind of thing an adult would usually do without support from family or friends
if your family, friends or the community provide the support, whether it would pose a risk to your wellbeing or to theirs
whether support from your family, friends or the community would help you to become more independent, or less independent
whether it’s suitable for your family, friends or the community to provide this support. For example, they may not have the capacity to provide support at the level you require.

Where friends or family do provide informal support for you, you can include these supports in your individualised living option to help recognise and formalise the important role they play. Including unpaid informal supports in your ILindividualised living option is a proven way to reduce the overall cost of the individualised living option supports.

We only fund supports that are most appropriately funded by the NDIS. We don’t fund supports that are more appropriately provided by another service system or organisation.

For example, an individualised living option doesn’t include funding for medical treatment if you get sick, because this is the role of the health system. A doctor’s visit is funded through Medicare, not through the NDIS.

Your local area coordinator or support coordinator can help you connect to other organisations in the community. They can help you find information on what’s available, or help you develop the skills and confidence to connect with those services.

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