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Section 25 – Early Intervention

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Disclosure Log - FOI-25/26-0321 | DOCUMENT 3

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Acknowledgement of Country

Before we begin, I would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea, and community. I pay my respects to their Elders, past and present.

I would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples here today.

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Learning outcomes

This session has been designed to help you:

• Develop an understanding of the early intervention requirements for accessing the NDIS
• Increase your knowledge on the resources used to guide our decision making
• Increase your knowledge of common terms used in decision making

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Section 25 – Early Intervention

Early intervention is usually early access to support, to help reduce the functional impacts of a person’s impairment.

• Streamlined requirements:
  • List B
  • List D
  • Developmental Delay
• Hearing loss (aged 0-25 yrs)

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List B & D Conditions

List B = Section 25(1)(a) likely met = Assess from 25(1)(b) onwards

List D + Under 7 = Early Intervention requirements met

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Section 25(1)(a)(i)

the person:

(i) has one or more identified intellectual, cognitive, neurological, sensory or physical impairments that are, or are likely to be, permanent

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Section 25(1)(a)(ii)

the person:

(ii) has one or more identified impairments to which a psychosocial disability is attributable and that are, or are likely to be, permanent

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Impairment

A loss or significant change in at least one of your body’s functions, your body structure or how you think and learn

• Intellectual
• Cognitive
• Neurological
• Sensory
• Physical
• Attributable to a psychiatric condition

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Permanency

An impairment that is permanent or likely to be permanent

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NDIS (Becoming a Participant) Rules

• 6.4 – no known, available and appropriate evidence-based clinical, medical or other treatments that would likely to remedy the impairment
• 6.5 – An impairment may be permanent notwithstanding that the severity of its impact on the functional capacity of the person may fluctuate
• 6.6 – does not require further medical treatment or review in order for its permanency or likely permanency to be demonstrated
• 6.7 – If an impairment is of a degenerative nature, the impairment is, or is likely to be, permanent if medical or other treatment would not, or would be unlikely to, improve the condition.

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Activity – Permanency

From the below examples, which section of the NDIS (Becoming a Participant) Rules 2016 or Our Guidelines is applicable?

• The person is living with a diagnosis of Intellectual Disability
• The person is living with a degenerative neurological impairment
• The person is living with Major Depressive Disorder for 20+ years with fluctuating functional capacity, their psychiatrist has optimally treated them and they have regular psychology intervention for maintenance.

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Test your Knowledge 1 – True or False

A person can meet the permanency criteria but still continue treatment.

True – clarification may be required to determine what the outcome of the treatment will be, however as per Section 6.6 of the NDIS (Becoming a Participant) Rules 2016, the impairment can continue to be treated after permanency has been demonstrated. If the treatment is likely to remedy the impairment then Section 25(1)(a) would not be met in line with Section 6.4 of the NDIS (Becoming a Participant) Rules 2016.

I am assessing an application for a person with a List A impairment. Therefore, they are likely to meet Section 24 and I don’t need to assess Section 25.

False – although the person likely meets the disability criteria with their List A impairment, they still need to be assessed against the early intervention criteria. This is because a person can meet access under both the disability and early intervention criteria.

Section 25(1)(a)(iii)

the person:

• (iii) is a child who has developmental delay

Questions - Section 25(1)(a)(i) and (ii).

Let’s take a break

Section 25(1)(b)

The provision of Early Intervention supports is likely to benefit the person by reducing their future need for supports in relation to disability

Section 25(1)(c)

The provision of Early Intervention supports is likely to benefit the person by:

i. Mitigating or alleviating the impact of the person’s impairment upon the functional capacity, or

ii. Prevent deterioration of such functional capacity, or

iii. Improve such functional capacity, or

iv. Strengthen the sustainability of informal supports

How to apply

Sections 25(1)(b) and 25(1)(c) to access decisions

• Likely trajectory and impact of the person’s impairment over time
• Potential benefits of early intervention
• Factors including;
  • Time elapsed since the diagnosis of the disability
  • Has there been a recent, or impending, significant change in the person’s impairment or disability?

Considerations when assessing Sections 25(1)(b) & 25(1)(c)

The person’s age

• Age-appropriate development
• Different skill sets

Capacity building vs Maintenance supports

Their Disability

• Recent diagnosis?
• How will the recommended supports reduce their need for future supports?

Capacity Building

Supports should be capacity building in nature. If someone is required to do the task for you this is not capacity building and will not reduce the need for future disability related supports.

Other factors

Whilst taking into consideration the time elapsed since the onset of the diagnosis is important, it is also important to look at other factors for longer standing conditions:

• Is the person going through a transition period and needs early intervention supports (i.e. transition out of school)?
• New skills are required at different life stages. Someone diagnosed with autism at eight years old who has accessed early intervention, can still access early intervention at 13 as the skills of a 13 differ to the skills of an eight year old.

You do not need to know the duration or frequency of the required supports.

If Section 25(1)(b) is met, then it is likely that 25(1)(c) will be met as “reducing the person’s need for disability related supports” (25(1)(b)) will generally mean at least one part of Section 25(1)(c) is met.

Test your Knowledge 2

Meets or Doesn’t Meet Section 25(1)(b)

Test your Knowledge 3

Meets or Doesn’t Meet Section 25(1)(b)

Test your Knowledge 4 – True or False

If the evidence on record states the person will require ongoing supports, this always means that 25(1)(b) is not satisfied.

False – This will be dependent on the evidence available. Sometimes ongoing supports will mean short term intensive supports to build capacity, and then longer term maintenance supports. It is important to determine is whether or not the recommended supports are capacity building in nature.

A person living with a degenerative condition can meet early intervention criteria, even though they will always need future supports.

True – Early intervention is not just to reduce the future need for disability related supports, but it is also to prolong the need for future supports. In turn, by prolonging the need you are reducing their future need for supports by delaying the level of supports required.

Key Points

• A person living with a degenerative condition can meet criteria in Sections 25(1)(b) and 25(1)(c) – look at the trajectory of the condition and what putting supports in place now may look like.
• Early intervention may reduce the future need for disability related supports by prolonging the need for future supports.
• The term ongoing supports does not determine this criterion is not met. It may require further investigation. An example of where ongoing supports would meet this criteria is when initial supports are to build capacity and the ongoing supports are maintenance supports and will maintain that new level of functional capacity.

Questions - Section 25(1)(b) and (c).

Section 25(1)(d)

A person meets the early intervention requirements if the CEO is satisfied any early intervention supports that would be likely to benefit the person as mentioned in paragraphs (b) and (c) would be NDIS supports for the person.

NDIS supports list

Supports that are ‘NDIS supports’

There are 37 categories of goods and services that are ‘NDIS supports’. NDIS supports are the services, items and equipment that can be funded by the NDIS.

Supports that are not ‘NDIS supports’

There are 15 categories of goods and services that are not ‘NDIS supports’. These are services, items, and equipment that can’t be funded by the NDIS. Note: Under the laws of the NDIS, we also cannot fund sexual services and sex work, alcohol or drugs.

NDIS supports lists (external)

Section 25(1)(d) – Case Study

• Name: Kelly Oliver* *For training purposes only
• Age: 45 years old
• Diagnosis: Multiple Sclerosis
• Evidence:
  • Provided by the MS Society (Physio, OT and Psychologist)

Note: This is a de-identified case. For the purposes of the case study, the dates of the EOD are recent.

Case Study – Q&A

Q: Does Kelly meet Section 25(1)(d) of the NDIS Act?

A: Yes – the evidence provided demonstrates that Kelly requires allied health therapy which would achieve incremental gains or prevent functional decline. As per the NDIS supports lists, this is the responsibility of the NDIS.

Q: What other services systems would be responsible for providing support to Kelly?

A: Kelly would also benefit from engaging with the Mental Health System for treatment of her depression and employment services for an air conditioner for the office. This is considered “workplace specific supports” that are not the responsibility of the NDIS.

Test your Knowledge 5 – True or False

Hearing aids are the responsibility of the NDIS, therefore all people who require hearing aids automatically meet the criteria in Section 25(1)(d)

False – This is only one criterion and the person must meet the previous criteria before determining if the hearing aids are NDIS supports.

Someone can meet Section 25(1)(d) and at the same time still require support from another service system

True – If some of the person’s supports are the responsibility of the NDIS and others are not then the service systems will work together to provide support to the person.

Test your Knowledge 6 – True or False

People with Psychosocial disabilities can meet the early intervention requirements

True - People living with psychosocial disabilities can meet early intervention requirements.

Treatment and early intervention of the psychiatric condition

= Mental Health system.

Functional and capacity building supports (such as social skills), including those that enable people to undertake activities of daily living

= may be the responsibility of the NDIS

S25(3) has been replaced by s25(1)(d)

Prior to October 3rd 2024

• Apply section 25(3)

From October 3rd 2024

• Apply section 25(1)d – early intervention supports must be an NDIS support

Section 25(3)

Previous legislation:

S25(3): The person does not meet the Early Intervention requirements if the CEO is satisfied that early intervention support for the person is not most appropriately funded or provided through the NDIS, and is more appropriately funded or provided through other general systems of service delivery or support services, or through support services offered as part of a universal service obligation or in accordance with reasonable adjustments required under law dealing with discrimination on the basis of disability.

Responsibility of Other Service Systems

• NDIS
• HEALTH SYSTEM
• EDUCATION

Final notes

• 10% formal training session
• 20% walkthroughs, shadowing, demonstrations
• 70% On-the-job experience. Using guidance materials to action work items independently

Useful resources

• NDIS Act 2013 (external)
• NDIS (Getting the NDIS Back on Track No. 1) Act 2024 (external)
• NDIS (Becoming a Participant) Rules 2016 (external)
• Knowledge Article – Understand early intervention requirements (external)

Questions

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