AAT Case Management Guide: Capacity Building Supports

FOI 24/25-0753

DOCUMENT 2

OFFICIAL For Internal Use Only

Field	Content	Reference Documents
Title	Capacity Building Supports
Purpose	This document is part of a suite of guidance documents for case managers to use in formulating their approach to managing individual cases before the Administrative Appeals Tribunal (AAT).
Scope	Capacity building (CB) supports refer to a range of supports which help a participant build their skills and increase their independence. Capacity building supports are grouped under the following support categories: - Support coordination - CB Home Living - CB Social Community and Civic Participation - CB Employment - CB Relationships - CB Health and Wellbeing - CB Lifelong Learning - CB Choice and Control - CB Daily Activity	What are the support budgets in your plan? \| NDIS Support budgets in your plan \| NDIS
Escalation to Hearing Oversight Committee (HOC)	If a matter is within the parameters of this document, the AAT Case Management Branch Manager may approve proceeding to hearing. Where there is substantial risk or the matter is outside the parameters of this document, the matter should be referred to HOC.
Current National Disability Insurance Agency (NDIA) policy on the subject	The AAT process is often seen as stressful and adversarial by the participants and our focus should be on resolving issues as practicably and quickly as possible. The role of the NDIA is to assist the AAT and the participant in reaching the best possible resolution for the participant by agreement. The NDIA will fund capacity building supports which: - relate to a participant’s disability; and - meet the NDIS funding criteria; and - are most appropriately funded by the NDIS. Capacity building supports meet the NDIAs criteria if:	NDIA Dispute Resolution Policy Appendix B to the Legal Services Directions 2017 Section 34(1) of the National Disability Insurance Scheme Act 2013 Rule 5.1 of the National Disability Insurance Scheme (Supports for

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AAT Case Management Guide: Capacity Building Supports

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Field	Content	Reference Documents
	- they will assist a participant to pursue their goals, objectives, and aspirations; and - they will assist a participant to take part in their social and work life; and - they are effective and beneficial; and - represent good value for money, compared to other supports that may achieve the same outcome or reduce a participant’s need for future supports; and - they take account of what is reasonable for families, carers, informal networks, and the community to provide; and - are legal and safe to provide. Where capacity building supports are to be funded as early intervention supports, the NDIA must also be satisfied that they are likely to reduce a participant’s need for future disability supports.	Participants) Rules 2013 Schedule 1 of the National Disability Insurance Scheme (Supports for Participants) Rules 2013 How we work out if a support meets the funding criteria \| NDIS
NDIA Posture in relation to this subject	The NDIA must closely consider a participant’s individual circumstances — in particular, their functional capacity as well the effectiveness of the supports and their value for money. The NDIA must also consider the role of mainstream service delivery systems in meeting a participant’s support needs. The capacity building supports considered reasonable and necessary to provide will differ from one participant to another. For example: - For participants younger than 9 years of age, the focus of the NDIA is about giving participants the best possible start in life, with an emphasis on their development, theirs and their family’s wellbeing, and their ability to take part in the community. Capacity building supports which aid a participant in these areas are more likely to be considered reasonable and necessary. This includes Support Coordination, CB Social Community and Civic Participation, CB Relationships, CB Health and Wellbeing and CB Daily Activity. - When a participant reaches 9 years of age, the NDIA recognises that they are likely participating in education. The education system shares in the community’s responsibility to help a participant build their	Operational Guideline — Reasonable and necessary supports Operational Guideline — Early childhood approach Operational Guideline — Mainstream and community supports overview Operational Guideline — Mainstream and community supports interface Employment \| NDIS Rule 5.1 of the National Disability Insurance Scheme (Supports for Participants) Rules 2013

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AAT Case Management Guide: Capacity Building Supports

OFFICIAL For Internal Use Only

Field	Content	Reference Documents
	skills and increase their independence through school-based therapy delivered in schools. In this context, the NDIA is unlikely to fund capacity building supports that represent a duplication of the supports provided by the education system. This includes supports such as CB Social Community and Civic Participation, CB Relationships, CB Health and Wellbeing and CB Daily Activity. - From the age of 14 years, the NDIA recognises that a participant may have concluded their schooling career and that their goals, aspirations, and objectives are more likely to tend towards furthering their education, seeking employment, and building relationships. Capacity building supports which target these areas are more likely to be reasonable and necessary; this includes supports like CB Employment, CB Lifelong Learning, CB Relationships, CB Health and Wellbeing and CB Daily Activity. - For adult participants, the NDIA is most likely to fund capacity building supports which will help a participant build their skills to progress their career and live independently. These supports include Support Coordination, CB Choice and Control, CB Employment, CB Home Living, CB Health and Wellbeing and CB Daily Activity.
Evidence recommended to inform NDIA position in a specific matter before the Administrative Appeals Tribunal (AAT)	The NDIA will refer to clinical evidence that capacity building supports will be and may have been in the past, effective, and beneficial for the participant’s functional capacity. This evidence would ordinarily be provided by an occupational therapist, psychologist, or physiotherapist. Clinical evidence is to also address the link between capacity building supports and a participant’s individual goals and specify how the capacity building supports will be utilised to assist the participant in achieving those goals. The NDIA will also rely on available evidence to consider whether capacity building supports represent good value for money when compared to	Types of disability evidence \| NDIS Rules 3.1— 3.4 of the National Disability Insurance Scheme (Supports for Participants) Rules 2013 Persons Giving Expert and Opinion Evidence Guideline \| Administrative Appeals Tribunal

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AAT Case Management Guide: Capacity Building Supports

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Field	Content	Reference Documents
	alternative support options which may have a similar outcome at a cheaper cost.
Other considerations	The NDIA is unable to fund capacity building supports which constitute a day-to-day living cost, or which acts as income stream replacement. Note: Capacity building support funding cannot be moved between Capacity Building support categories. The nature of capacity building supports leads to them no longer being reasonable and necessary over time. The provision and funding of these types of support therefore may fluctuate depending on the effect on the participant’s needs. Additionally, if capacity building supports have successfully aided a participant in building their independence, the participants need for other supports is expected to decrease as time progresses.	Rules 5.1 and 5.3(b) of the National Disability Insurance Scheme (Supports for Participants) Rules 2013 Operational Guideline — Reasonable and necessary supports Support budgets in your plan \| NDIS
Previous matters that may advise the NDIA position
Document admin	Quality, Strategy and Training	5 July 2023
Approved	Matthew Swainson, Chief Counsel

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FOI 24/25-0753

DOCUMENT 3

Case Management Guide: Capacity Building

OFFICIAL For Internal Use Only

Field	Category	Reference Documents
Title	Capacity Building
Purpose	This document is part of a suite of guidance documents for Case Managers to use in formulating their approach to managing individual matters before the Administrative Review Tribunal (ART). This Guide applies nationally to the conduct of all matters within the ART Case Management Branch.
Scope	Capacity building (CB) supports refer to a range of supports which help a participant build their skills and increase their independence. Capacity building supports are grouped under the following support categories: - Support coordination - CB Home Living - CB Social Community and Civic Participation - CB Employment - CB Relationships - CB Health and Wellbeing - CB Lifelong Learning - CB Choice and Control - CB Daily Activity	What are the support budgets in your plan? \| NDIS Support budgets in your plan \| NDIS
NDIA policy on this subject	The ART process is often seen as stressful and adversarial by participants and prospective participants of the Scheme. The NDIA will adopt a participant-focused approach to resolving disputes before the ART, and will work directly with participants and prospective participants to provide better and earlier outcomes, where possible. The role of the NDIA is to assist the ART in reaching the correct and preferable decision, including by assisting participants and prospective participants in reaching the best possible resolution by agreement. The NDIA will fund capacity building supports which: - relate to a participant’s disability; and - meet the NDIS funding criteria; and - are most appropriately funded by the NDIS.	NDIA Dispute Resolution Policy Appendix B to the Legal Services Directions 2017 Section 34(1) of the National Disability Insurance Scheme Act 2013 Rule 5.1 of the National Disability Insurance Scheme (Supports for Participants) Rules 2013 Schedule 1 of the National Disability Insurance Scheme

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Case Management Guide: Capacity Building

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Field	Category	Reference Documents
	Capacity building supports meet the NDIS criteria if: - they will assist a participant to pursue their goals, objectives, and aspirations; and - they will assist a participant to take part in their social and work life; and - they are effective and beneficial; and - represent good value for money, compared to other supports that may achieve the same outcome or reduce a participant’s need for future supports; and - they take account of what is reasonable for families, carers, informal networks, and the community to provide; and - are legal and safe to provide. Where capacity building supports are to be funded as early intervention supports, the NDIA must also be satisfied that they are likely to reduce a participant’s need for future disability supports.	(Supports for Participants) Rules 2013 How we work out if a support meets the funding criteria \| NDIS
NDIA posture in relation to this subject	The NDIA must closely consider a participant’s individual circumstances — in particular, their functional capacity as well the effectiveness of the supports and their value for money. The NDIA must also consider the role of mainstream service delivery systems in meeting a participant’s support needs. The capacity building supports considered reasonable and necessary to provide will differ from one participant to another. For example: - For participants younger than 9 years of age, the focus of the NDIA is about giving participants the best possible start in life, with an emphasis on their development, theirs and their family’s wellbeing, and their ability to take part in the community. Capacity building supports which aid a participant in these areas are more likely to be considered reasonable and necessary. This includes Support Coordination, CB Social Community and Civic Participation, CB Relationships, CB Health and Wellbeing and CB Daily Activity.	Operational Guideline — Reasonable and necessary supports Operational Guideline — Early childhood approach Operational Guideline — Mainstream and community supports overview Operational Guideline — Mainstream and community supports interface Employment \| NDIS Rule 5.1 of the National Disability Insurance Scheme (Supports for Participants) Rules 2013

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Case Management Guide: Capacity Building

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Field	Category	Reference Documents
	- When a participant reaches 9 years of age, the NDIA recognises that they are likely participating in education. The education system shares in the community’s responsibility to help a participant build their skills and increase their independence through school-based therapy delivered in schools. In this context, the NDIA is unlikely to fund capacity building supports that represent a duplication of the supports provided by the education system. This includes supports such as CB Social Community and Civic Participation, CB Relationships, CB Health and Wellbeing and CB Daily Activity. - From the age of 14 years, the NDIA recognises that a participant may have concluded their schooling career and that their goals, aspirations, and objectives are more likely to tend towards furthering their education, seeking employment, and building relationships. Capacity building supports which target these areas are more likely to be reasonable and necessary; this includes supports like CB Employment, CB Lifelong Learning, CB Relationships, CB Health and Wellbeing and CB Daily Activity. - For adult participants, the NDIA is most likely to fund capacity building supports which will help a participant build their skills to progress their career and live independently. These supports include Support Coordination, CB Choice and Control, CB Employment, CB Home Living, CB Health and Wellbeing and CB Daily Activity.
Evidence recommended to inform NDIA position in a matter before the ART	The NDIA will refer to clinical evidence that capacity building supports will be and may have been in the past, effective, and beneficial for the participant’s functional capacity. This evidence would ordinarily be provided by an occupational therapist, psychologist, or physiotherapist.	Types of disability evidence \| NDIS Rules 3.1 — 3.4 of the National Disability Insurance Scheme

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Case Management Guide: Capacity Building

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Field	Category	Reference Documents
	Clinical evidence is to also address the link between capacity building supports and a participant’s individual goals and specify how the capacity building supports will be utilised to assist the participant in achieving those goals. The NDIA will also rely on available evidence to consider whether capacity building supports represent good value for money when compared to alternative support options which may have a similar outcome at a cheaper cost.	(Supports for Participants) Rules 2013 `redacted: s22`
Other considerations	The NDIA is unable to fund capacity building supports which constitute a day-to-day living cost, or which acts as income stream replacement. Note: Capacity building support funding cannot be moved between Capacity Building support categories. The nature of capacity building supports leads to them no longer being reasonable and necessary over time. The provision and funding of these types of support therefore may fluctuate depending on the effect on the participant’s needs. Additionally, if capacity building supports have successfully aided a participant in building their independence, the participants need for other supports is expected to decrease as time progresses.	Rules 5.1 and 5.3(b) of the National Disability Insurance Scheme (Supports for Participants) Rules 2013 Operational Guideline — Reasonable and necessary supports Support budgets in your plan \| NDIS
Previous matters that may inform the NDIA position

Document Control	Responsible Person	Date
Document author	Continuous Improvement	`redacted`
Document approver	Director, Continuous Improvement	`redacted`

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