DisabilityCare eligibility

Recently there has been uncertainty in the media about the eligibility of people with Down syndrome to access DisabilityCare, the new name for the National Disability Insurance Scheme.

Eligibility for DisabilityCare has very deliberately been designed around need rather than a diagnosis, so therefore every person applying for funding will be required to demonstrate their level of need.

However, the news regarding eligibility for people with Down syndrome is good.

Firstly – all people with intellectual disability are eligible to apply for support through the NDIS, the level of which will be determined by their individual needs. This means that all people with Down syndrome are covered given that everyone with the syndrome has some level of intellectual disability. It is also important to remember that Down syndrome is a named disability in the Better Start program, which is likely to be rolled into the NDIS at some time in the future. Inclusion in Better Start highlights Government acceptance that children with Down syndrome benefit from early intervention.

Secondly, to be eligible for NDIS funding, a person’s disability must be permanent or likely to be permanent. Down syndrome is a lifelong disability and so this criterion is easily met.

Thirdly, a person with Down syndrome is highly likely to

  • Need support to undertake activities of daily living
  • Need support to participate in the community and employment and
  • Have support needs that will persist for all of their lives.

It is currently unclear what the actual eligibility process will be but it is possible that each individual with Down syndrome may need to provide a (standardised) assessment of intellectual disability. From this point, their individual support needs – which will vary greatly – will be assessed and met through the NDIS.

The only eligibility exception at this point in time is people over 65 who have Down syndrome. People with Down syndrome who receive support from DisabilityCare Australia before they are 65 will be able to choose whether they continue to receive this support or move to the Aged Care system. However, at the time of the launch people with Down syndrome who are over 65 will not be given this choice. Down Syndrome Australia would be interested in hearing from people with Down syndrome or their families if this age cut-off were likely to negatively affect the support available to them.

It is important to remember however that it will take a number of years for the NDIS to be rolled out in full across the country, and that transition arrangements will need to be put in place for those who already receive support through their State disability system. What those transition arrangements will be should become clearer over time.

For more information, please visit the NDIS website.

You will find the latest fact sheets on the NDIS here.


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