NDIS eligibility

Children aged 0-6 years

The NDIS Early Childhood Approach (ECA) approach is designed to support children younger than seven years with a disability or developmental delay.

Early childhood partners are community based organisations the NDIS funds to deliver the ECA. Different regions across NSW are allocated an Early Childhood Partner. Parents, carers and guardians can contact their local partner.

Raising Childrenhas excellent resources for families, carers and professionals that explain the NDIS and early intervention through the ECA including how to access support.

A child does not need a diagnosis to receive support through the ECA. The type of supports they receive will depend on their individual circumstances. Families may receive any or all of the following supports:

• information about ECA
• emotional support
• referral to mainstream services such as public health and education services
• short-term capacity building supports for parents, carers and guardians
• help to access the NDIS.

Some children who access NDIS ECA supports will still access supports provided by NSW Health.

Children who can access the Early Childhood Approach will have:

• Disability: Children who have an impairment that is likely to be permanent are considered to have a disability. The impairment could be intellectual, cognitive, neurological, sensory or physical. The NDIS website has more information about eligibility.
• Developmental delay: These are children under the age of 6 who are likely to meet the developmental delay criteria. They are considered to have a substantial reduction in functional capacity. This means that the everyday activities the child does or can do is at a significantly lower competency level or is substantially different when compared with children of the same age. The support required for the child to do the activity would also be significantly greater compared to children of the same age.
• Developmental concern: Children with developmental concerns have delays in their development that don't fully meet the definition of developmental delay. These delays may impact the everyday activities the child can do when compared with children of the same age. However, it may not be clear if the child needs support from a team of professionals or for more than 12 months. These children receive early connections from the early childhood partner and do not receive NDIS funded discipline specific therapies.

Children aged 7 and over

A child over the age of seven with a permanent disability will be eligible for the NDIS if they meet the disability requirements, as well as the standard age and residence requirements. The child may meet the NDIS disability requirements if:

• they have a disability that is caused by an impairment that is likely to be permanent
• the permanent impairment substantially reduces their functional capacity to undertake one or more of the following activities: moving around, communicating, socialising, learning, or undertaking self-care or self-management tasks
• their impairments affect their ability to study or take part in social life
• they are likely to require supports from the NDIS over their lifetime.

The NDIS has advice for families and professionals on how to provide evidence for a child's disability.

NDIS and NSW Health responsibilities

The NDIS does not replace mainstream public health services. The health system is responsible for the diagnosis and clinical treatment of health conditions, including ongoing and chronic health conditions not related to a person's disability. NSW Health continues to provide emergency and routine clinical services such as surgery, dental care, allied health and child and family health services for all NSW residents.

The NDIS

The NDIS may fund early intervention and other supports that improve a child's functional capacity or prevent deterioration of functioning. This may include services delivered or supervised by clinically trained or qualified health practitioners.

Also, the NDIS may fund support for children, families and carers required as a direct result of the child's disability. These supports may help families and carers to maintain their caring role, community participation, and can include therapeutic and behavioural supports, additional respite, aids and equipment.

The NDIS may fund disability-related health supports. The need for these supports must directly relate to the child's functional impairment, where the support need is ongoing and is most appropriately funded or provided by the NDIS. Disability-related health supports can be delivered by a suitably competent worker, which may include nurses and/or allied health practitioners.

NSW Health staff may support families with information about NDIS funded service providers but are not responsible for assessing the skills and experience of providers when transferring care to NDIS funded providers.

NSW Health

Children who are accessing the NDIS can still access health services provided by NSW Health, private health providers or Commonwealth funded health services such as general practitioners (GPs) and Primary Health Networks. This includes children who are receiving support under the Early Childhood Approach.

NSW Health can support children, their families and carers access information about the NDIS and to apply for the NDIS. NSW Health can also provide advice about other disability support services available related to the child's disability and family's circumstances.

NSW Health provides time-limited and goal-oriented services and therapies for children where the predominant purpose is treatment directly related to the child's health condition or after a recent medical or surgical event. NSW Health continues to provide health assessments for children in out-of-home care.

NSW Health has an important role in the diagnosis of disability and developmental delay and providing clinical treatment for health conditions. Children accessing the NDIS can receive interventions provided by NSW Health. NSW Health will consider if a child has NDIS funding and any supports they receive when planning and providing services.

NSW Health can support children with disability who are eligible for Medicare but do not meet the residency criteria for the NDIS such as New Zealand citizens or asylum seekers.