Advice Support Tool
Theme: Hearing
Sub-Theme(s): Cochlear and BAHA and OSIA sound processors
NOTE: BAHA vs BCHA vs OSIA vs MED EI vs Cochlear
Bone Anchored Hearing Aids (BAHA) and Bone Conduction Hearing Aids (BCHA) use the same type of sound processors. BAHA is an implanted device, while BCHA is worn on a soft band or sound arc. Many clinicians use BAHA for both systems, which is technically incorrect.
When considering s34.1 there is a difference between BAHA and BHCA sound processors, particularly relating to s34.1 (f). It is important to ensure you have determined if the sound processor is for a BAHA (implant) or BCHA before proceeding. For BCHA requests, use the advice support tool for hearing aids.
s47E(d) - certain operations of agencies
References:
- NDIS Act 2013 Section 34 1. (a) - (f) and 2.
- NDIS Support for Participant Rules 2013
- NDIS and Hearing Supports
- Hearing Supports Fact Sheet
- PG Hearing Supports
Note: All criteria need to be met for the supports to be funded through the NDIS.
| Criteria for reasonable and necessary | Is criteria | Considerations (including evidence used) |
|---|---|---|
| supports | met? | used |
| 34.1(a) Enabling the participant’s goals and objectives (supports will assist the participant to pursue the goals and objectives in their plan) | Yes | Has evidence been provided to demonstrate: s47E(d) - certain operations of agencies |
| No | ||
| 34.1(b) Assist the participant’s social and economic participation (supports will assist the participant to undertake activities to facilitate their social and economic participation) | Yes | Has evidence been provided to demonstrate: s47E(d) - certain operations of agencies |
| No |
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Criteria for reasonable and necessary supports
34.1(c) Value for money
(supports represents value for money, ie the costs of support are reasonable, both in terms of the benefits achieved and the cost of alternative support) Consider NDIS Support for Participant Rules 2013 Part 3.1 (a) – (f); s47E(d) - certain operations of agencies
Are there comparable support options which would achieve the same outcome at a substantially lower cost? What alternative supports were considered? Is there evidence that the support will substantially improve the life stage outcomes and be of long-term benefit to the participant? Is there evidence that funding support is likely to increase independence and reduce funded support costs in the long-term? Is there evidence the support will increase the participant’s independence and reduce the participant’s need for other kinds of supports? S47E(d)-certain operations of agency
Is there evidence the quoted support cost is comparable to expected cost of same kind of supports? s47E(d) - certain operations of agencies
34.1(d) Support is effective or beneficial for the participant
(supports will be, or are likely to be, effective for desired effect and beneficial for the
| Criteria for reasonable and necessary | Is criteria met? | Considerations (including evidence used) |
|---|---|---|
| 34.1(c) Value for money | ☐ Yes → | Has evidence been provided to demonstrate: |
- The participant’s current sound processor/s are outside their 6-year expected service life, or
- Require early replacement or refit?
- Replacement reasons may include:
- Devices have reached the end of expected service life
- Devices are damaged beyond repair
- Device/s are lost or stolen
- Refit reasons may include:
- A significant deterioration in health or a permanent change in physical condition of the ears/ear health (medical evidence required) | | | ☐ No → | |
| Criteria for reasonable and necessary Is criteria Considerations (including evidence supports met? used) | — | — | | participant, having regard to current good practice) | | | Consider NDIS Support for Participant Rules 2013 Part 3.2 and 3.3 | | | What are the expected benefits of the support provision? | | | How will effectiveness of achieved outcome be measured? | | | When will effectiveness of achieved outcome be achieved? | | | Are there other supports required to achieve or maximise the reported support outcomes for participant? | | | 34.1(e) Support coordinates with but does not replace informal support (funding or provision of supports takes account of what it is reasonable to expect families, carers, informal networks and the community to provide) Consider NDIS Support for Participant Rules 2013 Part 3.4 | | | 34.1(f) Support is most appropriately funded by the NDIS (supports are not more appropriately funded or provided through other general service systems or universal service obligations Consider NDIS Support for Participant Rules 2013 Schedule 1. | |
| Criteria for reasonable and necessary supports | Is criteria met? | Considerations (including evidence used) |
|---|---|---|
| For ALL participants (regardless of who funded the sound processor), fitting, mapping and adjustments are funded through the health system not the NDIS. | s47E(d) - certain operations of agencies | |
| redacted: s47E(d) - certain operations of agencies |
NOTE #2: The following participants are automatically eligible for the HSP:
- anyone aged under 26 years
- Aboriginal or Torres Strait Islander and either: o aged 50 years or over, or o take part in the Community Development Program (formerly known as the Remote Jobs and Communities Program and the Community Development Employment Projects Program), or o took part in the Community Development Employment Projects Program from 30 June 2013 and received hearing services from Hearing Australia before you stopped participating |
Criteria for reasonable and necessary supports
| Criteria for reasonable and necessary supports | Is criteria met? | Considerations (including evidence used) |
|---|---|---|
| Support will not cause harm | ||
| (Supports will not be funded if it is likely to cause harm to the participant or pose a risk to others, or the support would be contrary to a law of a jurisdiction) | ||
| Consider NDIS Support for Participant Rules 2013 Part 5.1 and 5.3 | ☐ Yes → | Most likely YES (will not cause harm), but look out for: s47E(d) - certain operations of agencies |
| Support is directly related to the participant’s disability | ||
| (supports will not be funded under the NDIS if they do not relate to the participant’s disability or are day-to-day expenses or income replacement) | ||
| Consider NDIS Support for Participant Rules 2013 Part 5.1 and 5.2 | ☐ Yes → | Do they have hearing loss listed as a disability |
| Support does not duplicate other supports | ||
| (supports do not duplicate other supports delivered under alternative funding through the NDIS such as Information, Linkages and Capacity Building (ILC) funding.) | ||
| Consider NDIS Support for Participant Rules 2013 Part 5.1 | ☐ Yes → | ☐ No → |
| Are all of the above criteria met for all supports? | ☐ Yes → | ☐ No → |
Version Control
| Version # | Status | Date | Modified by | Brief Description of Modification |
|---|---|---|---|---|
| V1.0 | Cleared | 01/09/2023 | LHN531 | Production of initial V1.0 |
| V1.0 | Cleared | 05/09/2023 | JIF775 | Transferred to Key Advisor Advice Resources repository |
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