The NDIS will fund specific disability-related health supports for participants who need help to manage a range of needs, including those associated with continence, diabetes, dysphagia, epilepsy, nutrition, podiatry, respiratory care, and wound and pressure care.

Disability-related health supports can be delivered by suitably qualified and competent workers, which may include nurses and/or allied health practitioners.

The health system will continue to be responsible for the diagnosis, early intervention and clinical treatment of health conditions, ongoing and chronic health conditions not related to a participant’s disability, time limited (non-ongoing) and palliative conditions, rehabilitation, convalescent care and acute/post-acute care (e.g. hospital and Hospital in the Home).

What is a reasonable and necessary support?

The NDIS funds a range of supports and services. In order to be considered reasonable and necessary, a support or service:

• must be related to a participant’s disability; 
• must not include day-to-day living costs not related to a participant’s disability support needs;
• should represent value for money;
• must be likely to be effective and work for the participant; 
• should take into account support given to a participant by other government services, family, carers, networks and the community;
• is most appropriately funded by the NDIS.

A participant’s reasonable and necessary supports take into account any informal supports already available (informal arrangements that are part of family life or natural connections with friends and community services) as well as other formal supports, such as health. 

These supports will help participants to:

• • pursue their goals, objectives and aspirations;
  • increase their independence;
  • increase community and workplace participation, and 
  • develop their capacity to actively take part in the community.

The NDIS will fund specific disability-related health supports where the supports are a regular part of the participant’s daily life, and the need for the support results from the participant’s disability. 

The typical types of support available can be grouped into eight ‘support type’ categories. 

The following list of fundable supports is not exhaustive and supports may be delivered in a range of ways. 

1. Continence supports

• An NDIS-funded suitably qualified and competent worker to undertake insertion, removal or change of indwelling urethral catheter, suprapubic catheter and/or clean intermittent catheter. 
• Training of an NDIS-funded suitably qualified and competent worker to provide catheter maintenance and care. 
• Provision of daily catheter maintenance and care by an NDIS-funded suitably qualified and competent worker. 
• All continence consumables (for example catheter, bags, pads, bottles, straps.)
• Training of an NDIS-funded suitably qualified and competent worker to provide assistance to manage bowel care where needed.
• An NDIS-funded suitably qualified and competent worker to provide stoma management and care.

2. Diabetic management supports

• Development of a specific diabetes management plan where the participant’s disability complicates the management and care of their diabetes. This would build on the clinical plan developed by the General Practitioner.
• Implementation of a diabetic management plan and daily maintenance and care by an NDIS-funded suitably qualified and competent worker.
• Training of an NDIS-funded suitably qualified and competent worker to implement a diabetic management plan.

3. Dysphagia supports

• Development and periodic review of a meal time management plan by an NDIS-funded suitably qualified and competent clinician.
• Implementation of a meal time management plan by an NDIS-funded suitably qualified and competent worker.
• Development, implementation and periodic review of an oral eating and drinking care plan (OEDCP) by an NDIS-funded suitably qualified and competent clinician.
• Implementation of an OEDCP by an NDIS-funded suitably qualified and competent worker.
• Training of an NDIS-funded suitably qualified and competent worker to implement the meal time management plan and OEDCP.
• Swallowing therapy associated with dysphagia provided by an NDIS-funded suitably qualified and competent worker.
• Consumables such as thickeners to enable a participant to swallow more easily and reduce their risk of aspiration/choking, if not available through the Pharmaceutical Benefits Scheme (PBS).

4. Epilepsy supports

• Training of an NDIS-funded suitably qualified and competent worker to implement the participant’s Epilepsy Management Plan (EMP) and/or Emergency Medication Management Plan (EMMP).
• Epilepsy seizure monitoring by an NDIS-funded suitably qualified and competent worker including the application of assistive technology.

5. Nutrition supports

• Dietetic consultations and the development and periodic review of a nutritional meal plan by an NDIS-funded suitably qualified and competent clinician.
• Implementation of a nutritional meal plan by an NDIS-funded suitably qualified and competent worker.
• Training of an NDIS-funded suitably qualified and competent worker to implement the nutritional meal plan.
• Percutaneous Endoscopic Gastrostomy (PEG) Stoma Changes (to assist feeding) by a suitably qualified and competent clinician.
• Provision of PEG maintenance and care by a suitably qualified and competent worker.
• Training of an NDIS-funded suitably qualified and competent worker to provide PEG maintenance and care.
• Home Enteral Nutrition (HEN) and (PEG) and equipment and consumables excluding food.
• HEN formula/nutritional supplements (to meet participant’s nutritional needs) if cost is in excess of PBS funding.

6. Podiatry supports

• Assessment, development, implementation and periodic review of a podiatry care plan by an NDIS-funded suitably qualified and competent clinician.
• Training of an NDIS-funded suitably qualified and competent worker to implement the podiatry care plan and perform any required daily maintenance and care related to the plan.

7. Respiratory supports

• Development and periodic review of a care plan for the daily maintenance of tracheostomy (insertion, removal and change) by an NDIS-funded suitably qualified and competent clinician.
• Implementation of daily maintenance of tracheostomy (insertion, removal and change) by an NDIS-funded suitably qualified and competent worker.
• Training of an NDIS-funded suitably qualified and competent worker to provide tracheostomy maintenance and care.
• Provision of tracheostomy equipment and consumables.
• Provision of a Constant Positive Airway Pressure machine (CPAP) machine and consumables.
• Provision of a Bi-level Positive Airway Pressure (BIPAP) machine and consumables.
• Provision of a ventilator, air humidifier, portable suction machine and/or cough assist machine and consumables.
• Assistance with the use of all respiratory medical equipment as well as the training of a suitably qualified and competent worker to use the equipment.

Any requests to the NDIS are being considered on a case-by-case basis in discussion with local health services.

8. Wound and pressure care supports

• Development of a care plan by a suitably qualified and competent clinician. 
• Wound care and pressure care (including pressure injury management) by an NDIS-funded suitably qualified and competent worker.
• Training of support workers/families in prevention of pressure areas and wounds.
• Wound care and pressure care consumables (e.g. dressings, gauze, bandages, tape, lymphoedema garments and pressure wraps).
• Provision of Assistive Technology as required due to a participant’s disability, to prevent pressure areas/wounds occurring.
• Lymphoedema machines as well as assistance with the use of the equipment and the training of an NDIS-funded suitably qualified and competent worker to use the machine.

The disability-related health supports funded by the NDIS can be can be grouped into three main categories:

1. Consumables 

• Consumables consist of supports that are meant to be consumed through eating, drinking or using. Examples of consumable disability-related health supports are items such as thickeners, wound care dressings, and catheter bags.
• Consumables for disability-related health supports can immediately be paid for out of any unspent funds from existing core supports category in an NDIS plan, without the need for a plan review. Funding for these supports will be included at the next scheduled plan review if reasonable and necessary.
• In most instances, there is no need to ask for an unscheduled review to purchase disability-related health supports consumables. However if you do not have enough unspent funds in your core supports, you will need to request a plan review through the NDIS contact centre, your Local Area Coordinator or NDIA planner.

2. Assistance

• • Assistance consists of supports provided by another human being.
  • Assistance is when a suitably qualified and competent worker, nurse or allied health professional is required to assist in the provision of a support that the participant is unable to administer themselves. For example, when a participant requires a suitably qualified and competent worker to operate a ventilator.

• If a support worker, nurse or allied health professional is needed, their services can be paid for out of any unspent funds from existing core supports budget in an NDIS plan, without the need for a plan review. 

• • When it is time for your next plan review, you can then discuss your need for these supports and they will be included in your plan if they are reasonable and necessary.

• If you are using your plan flexibly prior to a plan review and still have unspent funds, you need to initially pay for a registered nurse through your core support budget until your next plan review. After your plan review, these assistance supports will be funded through the capacity building budget in your plan.

• In most instances, there’s no need to ask for an unscheduled plan review. However if you don’t have enough unspent funds in your core supports category, you will need a plan review.

3. Assistive Technology 

• Assistive Technology (AT) is ‘any device or system that allows individuals to perform tasks they would otherwise be unable to do or increases the ease and safety with which tasks can be performed’. Examples of AT includes equipment such as a ventilator, and epilepsy monitoring devices such as seizure monitoring alarm systems. 
• The NDIA has made changes to deliver better AT experiences and outcomes for participants and providers, including improvements to the planning process and quoting requirements.
• For AT purchases over $1500, you will need to have a plan review to add funding to your capital supports budget in your NDIS plan.
• For further information on Assistive Technology, visit the NDIS website.

Does the NDIS fund self-care supports?

A NDIS participant’s disability may prevent them from being able to self-manage certain health conditions that a person without disability would be expected to do themselves. 

In these circumstances, the NDIS will fund self-care supports. The NDIS will also fund self-care supports where it is necessary for the support to be delivered by a clinician.

Please talk to an Amaranth staff member or your Support Coordinator if you feel that our Nursing Supports could benefit you in any way. 

Your Support Coordinator can assist you to find the right Nursing supports and pricing for your needs.