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Include disability-related health supports or meal preparation supports in the participant’s plan

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Include disability-related health supports or meal preparation supports in the participant’s plan

This Standard Operating Procedure (SOP) will help you to include disability-related health supports or supports for meal preparation in the participant’s plan.

Note: The age range is changing for the NDIS early childhood approach. From July 1 2023, the age will change to include children younger than 9. The change will be rolled out over the next 2 years. Early childhood partners will need to use this resource to plan for children aged 7 or 8.

1. Recent updates

Date What’s changed
July 2023 Updates to support early childhood partners to plan for children aged 7 or 8.
December 2022 Guidance updated to include new core line items. Clearer guidance for staff for how to calculate meal preparation costs.
June 2022 Included content from retired DRHS Practice guides to align with release of 6 new OGs for individual DRHS including Continence supports, Diabetes management supports, Dysphagia supports, Epilepsy supports, Podiatry and foot care supports and Wound and pressure care supports. Updated guidance related to Delegation of Care hours.
February 2022 New guidance included to align with release of Our Guideline — Nutrition supports including meal preparation. New guidance for how to calculate hours to include in the participant’s plan for meal preparation in section 4.2. Name changed to Include disability-related health supports or meal preparation supports in the participant’s plan.

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2. Checklist

Topic Checklist
Pre-requisites You have read and understood:
• Our Guideline — Disability-related health supports
• Our Guideline — Creating your plan
• the Age range change
Actions You have read and understood the relevant guidance:
• Our Guideline — Continence supports
• Our Guideline — Diabetes management supports
• Our Guideline — Dysphagia supports
• Our Guideline — Epilepsy supports
• Our Guideline — Nutrition supports including meal preparation
• Our Guideline — Podiatry and foot care supports
• Our Guideline — Wound and pressure care supports
• Our Guideline — Justice system
• Our Guideline — Changing your plan
• Practice Guide — Respiratory supports
You have read the Technical Advisory Branch (TAB) intranet page and:
• checked if the disability-related health support needs referral to TAB for advice
• received TAB advice, if needed, before you include the health support in the participant’s plan.

| | Actions | | | | 3.1 Calculate disability-related health supports | | | If needed: | | | 3.2 Add disability-related Core health supports in the plan | | | 3.3 Add Capacity Building (Assistance) health supports in the plan | | | 3.4 Add Capital health supports in the plan | | | 3.5 Find state and territory help for electricity and oxygen costs | | Then: | | | | 3.6 Next steps

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Procedure

To calculate disability-related health supports use evidence to guide your decision. Evidence can include assessments or health-related plans and will vary based on the type of disability-related health supports the participant is asking for.

For example:

  • continence assessment
  • nurse developed care plan
  • mealtime management plan
  • hospital discharge plan
  • epilepsy management plan
  • diabetes management plan.

For help making a reasonable and necessary decision, you can ask for support from your Service Delivery Team Leader, Assistant Director or Director. For children younger than 9, you can also ask for support from the Children’s Taskforce. If you need specific subject matter expertise support, request advice from TAB.

  1. Review the evidence available and add the reasonable and necessary supports to the participant plan. If:
    • you decide the supports recommended in the assessments and plans are reasonable and necessary, go to step 2
    • you decide the supports recommended in the assessments and plans are not reasonable and necessary, go to step 4
    • the participant is unable to give you evidence for their disability-related health support needs, go to step 6.
  2. Refer to the assessment and/or health-related plan in your justification for the supports.
  3. Go to 3.1.1 Calculate supports for shadow shifts.
  4. For participants younger than 7:
    • follow guidance in Practice Guide – Early childhood planning about including supports for capacity building in plans and information about Supports not recommended.

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Calculate supports for shadow shifts

Shadow shifts may be required to introduce some participants to new workers before they commence providing support independently, if they have complex support needs including disability-related health support needs. For example:

  • very limited communication
  • behaviour support needs
  • complex supports such as ventilation.

Shadow shifts:

  • let the participant become familiar with new staff
  • help new staff understand the participant’s complex support needs
  • provide the participant with disability-related health supports in a safe way.

Shadow shifts do not replace formal training by an employer to their workforce. Formal training includes shadowing or buddying less experienced staff or new staff with experienced workers or informal carers.

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  1. Does the participant need shadow shifts for disability-related health supports? • Yes, go to step 2. • No, go to 3.1.2 Calculate health consumable supports.
  2. The number of shadow shifts should be based on the number of workers the participant has and the complexity of their needs. For help to determine the number of shadow shifts, you can ask for support from your Service Delivery Team Leader who can seek advice from TAB.
  3. Go to 3.1.2 Calculate health consumable supports.

3.1.2 Calculate health consumable supports

Health consumables include continence, dysphagia, wound care, nutrition and respiratory support.

  1. Determine the reasonable and necessary consumables required across all disability-related health support needs using 5 Related procedures or resources.
  2. If TAB provides advice for health consumable supports, follow any advice for how to enter supports in the plan.
  3. Bundle these in units of $500 or $1500 depending on the support item you select. This will maximise funding flexibility and avoid funding multiple small support items/services. Note: Although we include this funding in units of $500 or $1500, providers will be able to claim against units of $100.
  4. Add funding for delivery, repairs and maintenance of disability-related health consumables and equipment. For specific funding guidance, go to 4. Appendices.
  5. Add disability-related Core supports using 3.2 Add disability-related Core health supports in the plan.
  1. Determine the reasonable and necessary amount of personal care hours the participant needs for assistance with health-related tasks and/or meal preparation using information from: • the participant • the nurse developed care or hospital discharge plan • 4.2 Guide to disability-related Core supports • guidance in 5. Related procedures or resources.

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  1. Determine personal care hours for all types of workers including support workers, allied health professionals and direct care hours from nurses. For example, for a nurse to change a catheter. Note: Nurse direct care hours are separate to delegation of care and supervision hours. To learn more about how to calculate hours for delegation of care, go to 3.1.4 Calculate capacity building health-related supports.

  2. Consider if you can combine support workers hours so the participant gets value for money. For example, the participant may require support with multiple tasks which require 10 -15 minutes each to complete. Examples include support with administering insulin, skin and pressure area checks and application of pressure garments. In this case 1 hour would be enough to cover multiple tasks.

  3. Consider additional time required for nurses, supports workers and other staff to travel to provide daily activities. Refer to Our Guideline – Reasonable and necessary supports and the NDIS Pricing Arrangements and Price Limits.

  4. Add disability-related Core supports using 3.2 Add disability-related Core health supports in the plan.

  1. Does the participant need support which can be delegated from a registered nurse to a support worker to deliver? • Yes, go to step 2 • No, go to step 3. If you are unsure whether the participant needs support which can be delegated from a registered nurse, ask for support from your Service Delivery Team Leader, Assistant Director or Director. If you need specific subject matter expertise support, request advice from TAB.

  2. Can the participant provide you with a report or assessment recommending the supports required? • Yes, go to step 3 • No, use 4.1 Guide to registered nurse hours to calculate the amount of registered nurse support hours to include for a nurse to develop a Delegation of care or nursing care plan.

  3. Determine the reasonable and necessary disability-related capacity building health supports the participant needs. Use information from:

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• the participant • the nurse developed care or hospital discharge plan • 4.3 Guide to disability-related Capacity Building supports • 5. Related procedures or resources.

  1. Check all hours the participant needs across the different health support categories.
  2. Where possible, combine similar disability-related health support hours from different health support categories. This will reduce duplication of hours for therapy supports. For example, if the participant has a speech pathologist request for swallowing difficulties and verbal language consider if the hours can be combined. You will need to make sure there is enough hours to cover both needs.
  3. Add disability-related Capacity Building supports using 3.3 Add Capacity Building (Assistance) health supports in the plan.

To complete this section, use the information you have gathered in 3.1.3 Calculate personal care hours for assistance with health-related tasks and/or meal preparation.

  1. In Planning – Staff Tasks, select the Determine the Funded Supports task.
  2. The Determine the Support Needs form will open. Select Core.

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3. The Core support category form will open.

You can include disability-related health supports in the Consumables or Daily Activities budgets.

  1. Add low cost health assistive technology using the Standard Operating Procedure – Add low cost assistive technology supports in a plan.

  2. If the participant: • needs disability-related health consumables, go to 3.2.1 Add health consumables • needs personal care hours for health-related tasks, go to 3.2.2 Add personal care hours for assistance with health-related tasks or meal preparation. • doesn’t need either of these supports, go to step 6.

  3. Record the Core Comment using 3.2.3 Record the Core Comment.

Add health consumables

  1. Select the Consumables expander button.

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  1. The Support Calculator will open. Select Add Row (plus sign) to add a row if the Select a Product field does not display or to add extra rows.

  2. Search for support item Disability-Related Health Consumables.

  3. Select the most appropriate support item for the participants individual support needs.

  4. This will take you back to the Support Calculator.

  5. Complete the following fields: • Quantity: enter the number of units • How Often: as required • Item Type: leave blank.

Note: The price will change depending on the support item you have selected.

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7. Select Done.

Add personal care hours for assistance with health-related tasks or meal preparation

  1. Select the Daily Activities expander button.

The Support Calculator will open. Select Add Row (plus sign) to add a row if the Select a Product field does not display or to add extra rows.

  1. Add the reasonable and necessary disability-related health supports or meal preparation supports using the calculator. You will use different support items based on the type and level of support the participant needs. • If you have included supports that relate to delegation of care, you need to upload supporting information using Standard Operating Procedure – Manage inbound documents.

Note: Meal preparation supports should not be stated and do not require a quote. This will allow participants to use this support flexibly.

  1. Select Done.

Record the Core Comment

Due to the flexible nature of the Core budget, combine comments for all Core categories into one comment. You record this comment in the Daily Activities Comment field.

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Add Capacity Building (Assistance) health supports in the plan

  1. Select the Comments field for Daily Activities.
  2. Add your comment. Make sure the comment describes supports across all Core categories and for all types of supports, not just health. For example:

Core supports can be used flexibly to help with my daily activities, disability-related needs and pursuing my goals. Core supports include funding for my respiratory consumables and low cost assistive technology.

  • Where funding is included for respiratory consumables, include in your comment: Respiratory consumables must be compatible and fit for purpose with my prescribed respiratory equipment.
  • Where funding is for meal preparation support, you should specify in your comment: Core supports include [amount] for support with preparing meals.

  1. Determine the next step:

    • if the participant requires health supports for capacity building in their plan, go to 3.3 Add Capacity Building (assistance) health supports in the plan
    • if the participant requires Capital health supports, go to 3.4 Add Capital health supports in the plan
    • if there are no other disability-related health supports to add to the participants plan, go to 3.6 Next steps.

  2. In Planning – Staff Tasks, select the Determine the Funded Supports task.

  3. The Determine the Support Needs form will open. Select Capacity Building.

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  1. The Support Category form will open. Select Capacity Building.

  2. The Capacity Building form will open. The Capacity Building support categories where disability-related health supports can be included are:

  • CB Daily Activity: allied health practitioners and all levels of nursing.
  • CB Health and Wellbeing: support from a dietitian.

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Determine the Support Needs

  1. Select the CB Daily Activity expander button.

  2. The Support Calculator will open. Select Add Row (plus sign) to add a row if the Select a Product field does not display or to add extra rows.

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• Add disability-related health nursing supports using 3.3.1 Add nursing supports. • Add disability-related health podiatry supports using 3.3.2 Add podiatry supports. • Add disability-related health speech pathology supports using 3.3.3 Add speech pathology supports.

  1. Record the CB Daily Activity Comment. Write the comment so the participant will understand what the funding is for. For example:

Includes podiatry assessment, care plan and selection or manufacture of customisable or wearable technology.

  1. If you have included supports that relate to delegation of care, upload supporting information to the NDIS Business System. Refer to Standard Operating Procedure – Manage inbound documents.
  2. LonIf the participant has disability-related health dietitian supports, go to 3.3.4 Add dietitian supports.
  3. Determine the next step: • If the participant requires Capital health supports go to 3.4 Add Capital health supports in the plan. • If there are no other disability-related health supports to add to the participant’s plan go to 3.6 Next steps.

Add nursing supports

The plan developer should make sure there are sufficient funds included in the plan to cover a participant’s reasonable and necessary nursing support needs. It is the responsibility of the service provider to assign the most appropriately qualified nurse to provide the disability related health support.

  1. Search for and select the nursing support. • If you do not know the level of nursing at the time of planning, include all nursing hours together using the support item Composite Funding For Delivery Of Health Supports By A Clinical Nurse Consultant. • When the participant provides clear supporting information include like-for-like support items from:

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Composite Funding For Delivery Of Health Supports

  • Composite Funding For Delivery Of Health Supports By An Enrolled Nurse
  • Composite Funding For Delivery Of Health Supports By A Registered Nurse
  • Composite Funding For Delivery Of Health Supports By A Clinical Nurse
  • Composite Funding For Delivery Of Health Supports By A Clinical Nurse Consultant
  • Composite Funding For Delivery Of Health Supports By A Nurse Practitioner.

Completing Fields

  1. Complete the following fields: • Quantity: enter the number of units • How Often: as required • Item Type: leave blank. Nursing supports should not be Stated. This is so the participant can access all levels of nursing support for the duration of their plan.

Add Podiatry Supports

  1. Search for and select podiatry supports using support items below: Assessment, Recommendation, Therapy and/or Training (Incl. AT) - Other Therapy Selection and/or Manufacture of Customised or Wearable Technology.

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2. Complete the following fields:

  • Quantity: Enter the number of units
  • How Often: as required
  • Item Type: leave blank.

3.3.3 Add speech pathology supports

  1. Search for and select support item: Assessment, Recommendation, Therapy And/or Training (Incl. AT) - Other Therapy.

3.3.4 Add dietitian supports

  1. Complete the following fields: • Quantity: enter the number of units • How Often: as required • Item Type: leave blank.

  2. Select the CB Health and wellbeing expander button.

  3. The Support Calculator will open. Select Add Row (plus sign) to add a row if the Select a Product field does not display or to add extra rows.

3. Search for and select Dietician Consultation And Diet Plan Development.

Select a Product

dietician Dietician Consultation And Diet Plan Development 12_026_0128_3_3

Dietician Group Session - Group of 3 12_026_0128_3_3

4. Complete the following fields:

  • Quantity: enter the number of units
  • How Often: as required
  • Item Type: leave blank.

5. Record the CB Health and Wellbeing Comment. Write the comment so the participant will understand what the funding is for. For example:

Funding for a nutrition plan consultation, assessment and report - 4 hours.

3.4 Add Capital health supports in the plan

You only include mid cost or high cost disability-related heath supports in the Capital - Assistive Technology budget. Note: You can include low-cost assistive technology (AT) in the Core Consumables budget. For more information, go to Our Guideline – Assistive technology and Assistive Technology guidance on the Planning resources intranet page.

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Select Capital from the Determine the Support Needs form.

  1. Select Capital from the Determine the Support Needs form.

  2. Select Assistive Technology expander button.

  3. The Support Calculator will open. Select Add Row (plus sign) to add a row if the Select a Product field does not display or to add extra rows.

  4. Search for and include disability-related assistive technology supports. Examples of disability-related health supports are:

    • Air-Filled Garments And Compression Units For Managing Circulation Problems

    • Aspirators – Portable suction machines

    • Cough Assist Machine

    • Respirators - Invasive Ventilation For Continuous Use

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Ventilators - Supplemental Ventilation Support (Including CPAP and BPAP)

  1. Complete the required fields for the support.

  2. Select Done.

  3. Delete any information in the Assistive Technology Comment field that pre-populates.

  4. Record a comment so the participant will understand what the total funding is. For example:

Funding for a cough assist machine.

If TAB advice has been provided, follow any direction for how to state the support in the plan. 9. Go to 3.6 Next steps.

Find state and territory help for electricity and oxygen costs

State and territory help for electricity costs

If the participant asks you for more information about emergency medical essential power in their area please refer to the links below, or the relevant state or territory government website:

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3.5.2 State and territory help for oxygen costs

State and territories are responsible for providing oxygen supply and related equipment. If the participant asks you about help for oxygen costs in their area, use this table to guide them on where they can get information.

Region Where to find information
Western Australia Government of Western Australia Department of Health - Respiratory Health Network — Domiciliary Oxygen
Queensland Home Oxygen — Queensland Health
New South Wales Home Respiratory — EnableNSW
Northern Territory To learn more, encourage participants to contact their local health service or go to:
Northern Territory — General equipment schemes and services
Tasmania Health — Tasmanian Government Discounts & Concessions
Victoria Other services — Health. Vic
South Australia Home Oxygen Therapy — SA Health
Australian Capital Territory Oxygen and Equipment Services — ACT Government

Refer any requests to fund oxygen support related to the participant’s disability and not provided by the state or territory health system to the TAB for advice. Learn more on the TAB intranet page for Disability Related Health Supports.

3.6 Next Steps

  1. Check you have obtained and followed any mandatory TAB advice related to supports you are including in the plan.
  2. Check you have included all reasonable and necessary supports when completing the Determine the Funded Supports task. Refer to relevant planning resources when completing the remaining steps to develop the participant’s plan.

4. Appendices

4.1 Guide to registered nurse hours

Use the tables below to guide you on the amount of registered nurse support to include in the participant’s plan to develop and implement a registered nurse Delegation of Care plan. It does not include the hours required for a nurse to complete specific disability-related health support tasks. For example, changing catheters.

  1. Determine the tasks the registered nurse will need to complete.

  2. Determine the level of support using Our Guideline — Disability-related health support. This will be Low, Intermediate or High. Note: Only use this table when the participant can’t provide you with a nurse developed care plan or hospital discharge plan. If you need help to calculate hours for delegated care tasks or supervision of those tasks, request advice from TAB.

Includes training and assessment in tasks to ensure competency. Training may be suitably undertaken in small groups or inindividually between the Registered Nurse and Support Workers.

Training for delegated disability-related health support tasks Low Level Intermediate level High level
2 skill areas delivered to 2-4 support staff 3 hours per year N/A N/A
3 skill areas delivered to 2-4 support staff N/A Up to 10 hours per year N/A

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tasks Low Level Intermediate level High level
4 skill areas delivered to 2-4 support staff N/A N/A 17 hours per year
4 skill areas delivered to 5+ support staff N/A N/A 34 hours per year
5 skill areas delivered to 2-4 support staff N/A N/A 25 hours per year
5 skill areas delivered to 5+ support staff N/A N/A 50 hours per year
6 skill areas delivered to 2-4 support staff N/A N/A 33 hours per year
6 skill areas delivered to 5+ support staff N/A N/A 66 hours per year
7 skill areas delivered to 2-4 support staff N/A N/A 41 hours per year
7 skill areas delivered to 5+ support staff N/A N/A 82 hours per year
8 skill areas delivered to 2-4 support staff N/A N/A 49 hours per year
8 skill areas delivered to 5+ support staff N/A N/A 98 hours per year

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4.1.2 Guide of hours for assessments, developing care plans and supervision of staff

Task Low Level Intermediate level High level
Health assessment
Preparation, initial assessment, reassessment and reporting on health assessment		 6 hours per year 6 hours per year 12 hours per year
Environmental Assessment 1 hour per year 4 hours per year 4 hours per year
Care plan
Developing new care plans, a variation or an update to a care plan		 4 hours per year 4 hours per year 7.5 hours per year
Supervision of staff delivering tasks delegated by registered nurse
Direct and indirect		 12 hours per year 24 hours per year 52-104 hours per year

These hours have been calculated based on the estimated weekly need for indirect support by a registered nurse:

  • Low: 1 hour per month
  • Intermediate: 2 hours per month
  • High: 1-2 hours per week.

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Use the Our Guideline relevant to the specific DRHS and the 5 related procedures and resources to support your reasonable and necessary decision making for disability-related health Core supports.

The table outlines the broad type of support and the estimated hours for each of the relevant support categories to include in the participant’s plan.

For any personal care hours where tasks are delegated from a Registered Nurse, determine the skill level of the personal care worker using Our Guideline — Disability-related health support.

Type of Support Supports for consideration
Nutrition Consumables: Percutaneous Endoscopic Gastrostomy (PEG) and Home Enteral Nutrition (HEN) equipment and consumables. This includes enteral feeding tube, administration reservoir such as a feed bag or bottle, giving set, syringes, enteral pump. 
* Health consumables can be included in plans using line items — Disability-Related Health Consumables — High Cost, or Disability-Related Health Consumables — Low Cost.
* HEN formula — Up to $23.66 per day can be included at the budget level for full or partial HEN feeds if not covered by the Pharmaceutical Benefits Scheme.

Note: For requests for more than $23.66 per day for HEN formula, contact the Technical Advisory Phone Services (TAPS) for further guidance.

Nutrition - Daily Activities

Personal care hours to:

  • Administer HEN and help with PEG maintenance and care where a participant or their child representative is unable to independently manage due to their functional impairment.

    Note: It is generally expected that supports to manage HEN are a delegated task but there may be rare cases where a nurse is recommended. Requests for more than 3 hours per day for registered nurse direct care for PEG or HEN maintenance need to be referred to the TAPS.

  • Attend individualised training conducted by a nurse to implement the HEN regime under delegation of care — up to 3 hours, 2-3 times a year. The frequency will depend on the participant’s individual circumstances and needs.

    Note: Hours will vary depending on the participant’s other disability related support needs.

Nutrition - Daily Activities

Assistance with meal preparation can be provided either through a disability support worker or prepared meals.

As a guide, costing for meal preparation should be based upon personal care hours for a support worker to plan, shop and prepare meals with the participant. For example:

  • 1 meal a day: up to 3 hours per week
  • 2 meals a day: up to 4 hours per week
  • 3 meals a day: up to 5 hours per week

This should be sufficient time for support workers to help a participant order food, prepare and store enough meals for the week.

If meal preparation is specified in the plan, participants can use this support flexibly to instead have meals prepared and delivered for a period of time. It does not include the cost of food and ingredients. When purchasing ready/prepared meals participants can flexibly use their funding to claim:

  • 100 percent of the invoice if the provider has removed the cost of food
  • 70 percent of the invoice if the provider includes the cost of food in the total cost.

The cost of meal preparation and delivery should usually cost less than a support worker to prepare meals with the participant.

This support no longer requires a quote and should not be stated. This will make sure participants can maintain flexibility in how they access this support as their needs change.

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Supports for Consideration

Note: Some participants will always have their meals prepared and delivered. In these instances, if you know the cost, you can include this instead of the support worker hours. You will need to specify this in the comments of the participant’s plan. If you don’t know the cost, you should use the personal care hours for a support worker above as a guide.

Note: Hours will vary depending on the participant’s other disability related support needs, existing informal supports and participant’s other supports. For example, participants with supported independent living should not require this additional support.

Note: For children younger than 7, consider what is reasonable to expect of families or carers in preparing the child’s meals. Learn more in the Practice Guide - Early childhood planning. If the child’s support needs are significantly beyond what is usually required for children of the same age, you may consider funding for a support worker to help with meal preparation. Make sure any supports above typical parental responsibility are clearly outlined in the justification comments — Core.

You should talk with the Children’s Taskforce or your line manager if you get a request for meal preparation and delivery for a child participant.

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Supports for Consideration

Type of support Support Category
Wound and pressure care Consumables

Consumables for prevention and dressing of wounds such as PH wash, moisturiser and barrier creams, gauze, bandages, dressing packs, dressings, tape to dress wounds. Providers are generally responsible for Personal Protective Equipment related to wound and pressure care for staff.

You should consider the following amounts when including consumable related to wound prevention and management:

  • Wound Prevention kit for participants at risk of pressure injury - $1000 per year.
  • Additional $1000 per year where management of 3-4 simple wounds per year required — (dressings for wound care 2-3 days for each wound for 2-6wks) - $2000 total per year.
  • Additional $2500 per year above the prevention kit funding where management of ongoing chronic wound care required, $3,500 total per year.

Any additional funds will be quotable following assessment by Clinical Nurse Consultants (CNCs).

Pressure care garments and supports (AT) up to $1500 per item, disability-related health equipment and consumables delivery and repairs and maintenance of disability-related health machines can all be included using the low-cost AT line items.

Continence Consumables
Continence supports are typically funded for children 5 years of age or older. In rare situations we may include funding for continence supports for children younger than 5 for disability-related medical conditions. Learn more in Our Guideline – Continence Supports. The guided planning questions in the System provide a drop down option for the selection of continence needs identified as part of the planning conversation for participants 7 years or older. Example guided planning question: ‘Do you currently use any consumable products, for example, continence products or tube feeding for getting your food?’ Select the option best describes the participant’s use. There are 7 responses to choose from:
  • Adult level 1 – high use, higher cost
  • Adult level 2 – high use, moderate cost
  • Adult level 3 – high use only, or moderate use and higher cost
  • Adult level 4 – moderate use, moderate cost
  • Adult level 5 – low to moderate use, low to moderate cost
  • Adult level 6 – low use, low cost
  • Adult level 7 – none necessary. The level selected will change the TSP generated. Review the amount generated in the TSP. Consider if this will be enough to cover the costs of all the participant’s consumable needs. Adjust the TSP if needed using reasonable and necessary | |

Supports for Consideration

Refer to Standard Operating Procedure — Complete the determine the funded supports task for guidance on adjusting the amount generated in the TSP.

Note: For children younger than 7 years of age continence needs are guided by a continence assessment. Use the Assistive Technology, Home Modifications and Consumables Code Guide to help calculate continence consumables for children aged 5-7. Include consumables as per the rate of daily use.

For children younger than 7 who need a membership to a stoma association, add either $50 concession or $60 full rate at the budget level.

Type of support Support Category Supports for consideration
Continence Daily Activities Personal care hours for assistance with continence care as part of the participant’s daily personal care. For example, for maintenance and care of a catheter, go to section 4.1 Guide to registered nurse hours.

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Supports for Consideration

Type of support Support Category Supports for consideration
Epilepsy Daily Activities Personal care hours for a support worker to:
  • Attend training to implement Epilepsy Management Plan or Emergency Medication Management Plan - up to 90 minutes every 2 years.
  • Attend training to implement a ketogenic diet plan — up to 1hr per year initially and then reviewed when there has been a change to the diet plan.
  • Implement a Ketogenic diet plan (shop for and cook). The frequency of support will also need to be decided depending on the participant’s capacity. Support may be required daily or weekly at the start of a plan and decrease in frequency over time.
  • Monitor seizures where the level and risk of seizure are high due to the severity of the participant’s epilepsy — hours will depend on participant’s other disability support needs. Low-cost assistive technology (up to $1500 per item) such as seizure monitor alarm systems, seizure mats for beds and oximeters, to measure a person’s oxygen saturation.

Important note: Any requests for 24/7 or 2:1 support should be referred to TAB for advice. | | Podiatry and foot supports | Consumables | Low-cost AT (non-quotable, up to $1500 per item) such as orthotics and wearable technology |

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Supports for Consideration

Type of support Support Category Supports for consideration
Podiatry and foot supports Daily Activities * Personal care hours - As a general guide 15 minutes per day on top of the participant’s normal daily care routine.
  • Training in the specific needs of the participant - 1 hr per support worker. | | Dysphagia | Consumables | * Low-cost AT: up to $1500 — for example adaptive cutlery, plate guards or sticky mats.
  • thickeners for participant who have a full oral feeding diet: slightly thick fluids $360, mildly thick fluids $700, moderately thick fluids $1400 and extremely thick fluids $2100.
  • thickeners for participants who have a combination of oral and HEN feeding: Up to $23.66 per day for HEN. Seek TAB advice for the amount of funding for thickeners to include in the plan. |

Include consumables in plans in multiples of $500, using support item - Disability-related health consumables — low cost.

Consider all of the participant’s disability related health consumable needs when you include funding in the plan.

Note: Calculations have been determined using Thicken-up Clear ® 900 gram tin Brightsky thickeners (external).

Supports for Consideration

FOI-2 23-24-0538

Type of support Support Category Supports for consideration
Dysphagia Daily Activities Personal care hours:
  • hours to support the implementation of a participant’s mealtime management plan with any recommended swallowing therapy strategies, where informal supports are unable to provide
  • additional hours to attend participant specific training: up to 2 hours per year per support worker
  • consider personal care supports required for other areas, for example, other health-related supports, morning and evening routines, social participation. | | Diabetes | Consumables | The NDIS does not generally fund diabetic consumables as these are available under NDSS. |

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Supports for Consideration

Type of support Support Category Supports for consideration
Diabetes Daily Activities Personal Care hours to support the participant to implement their diabetic management plan. This includes support with the administration of routine, non-complex insulin when the participant is unable to perform the tasks due to their ongoing functional impairment. As a general guide the task to administer insulin will take 15 minutes per administration and the total time required will depend on:
  • the number of insulin injections for example, one to 5 times per day
  • the equipment used by the participant for example, to measure blood glucose levels
  • their functional capacity.

Personal Care hours for a support worker to attend training to implement a disability-related diabetes management plan specific to the needs of the participant. As a general guide 2 hours per year per worker however this could be provided to a group of workers at the same time.

Use the Our Guideline relevant to the specific DRHS and the 5. Related procedures and resources to support your reasonable and necessary decision making for disability-related health Capacity Building supports.

The table outlines the broad type of support and the estimated hours for each of the relevant support categories to include in the participant’s plan.

Type of support Support Category Supports for consideration
Nutrition CB Daily Activity Composite nursing hours for a RN to train a support worker in the individualised needs of the participant in relation to their PEG maintenance and care. To calculate the nursing hours, refer to 3.1.4 Calculate capacity building health-related supports.
Note: PEG general maintenance and care is a standard competency skill expected for disability support workers. The NDIS will not fund training for staff to attain basic competency. It is the responsibility of a provider to employ suitability qualified staff with these basic level competencies.
Nutrition CB Daily Activity Nursing consultation to develop a PEG maintenance care plan, which informs the daily management and care of the PEG and surrounding tissue and the HEN regime by the instructing dietitian. To calculate the nursing hours, refer to 4.1 Guide to registered nurse hours.
Nutrition CB Health and Wellbeing Dietitian hours for standard nutrition plan:
- Initial consultation, assessment and report: 2 hours
- Development of the plan: 1-2 hours

Supports for Consideration

Type of Support Support Category Supports for consideration
• Re-assessment: 2 hours
• Training 2-3 family members or support workers specific to the participant’s individual nutritional needs - 1-2 hours of training once a year (more frequently if the nutritional plan is updated).
Dietitian Dietitian hours for complex nutrition plan — for example, HEN feeding plan:
• Initial consultation and assessment: 2-3 hours
• Report and development of the plan: 2-5 hours
2 hours for fully HEN fed, stable nutritional status and constant feeding regime.
5 hours for a combination of HEN and oral feeding, unstable or declining nutritional status and changes to the feeding regime in terms of formula type and pattern.
• Re-assessment depending upon the above varying factors: 2 hours.

Use line item - Dietitian Consultation And Diet Plan Development

You need to refer requests for more than 20 hours per year for assessment and development of a meal plan to TAPS for advice.

Wound and pressure care | CB Daily Activity | Prevention of pressure injury can be delegated by a nurse (skin integrity checks), occupational therapist or physiotherapist for positioning care.

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Supports for Consideration

Consider composite nursing hours for specific pressure care and wound management assessment and plan:

  • Including initial consultation and assessment — 2hrs

  • Development of the plan — 1-2hrs

  • Ongoing clinical intervention support as identified by assessment — 3-7 hours per week (RN rate) if support is provided by a nurse

  • Training and assessment of the support worker/s to deliver the delegated support based on the participant’s care plan if the support is delegated by the RN. 1 hr per support worker

  • Reassessment — 1hr.

Wound and pressure care | Daily activities

Consider if you need to include hours for the support worker to attend training. We can fund suitable hours for support worker training that is:

  • Provided by the health treatment team.

  • Specific to the implementation of the participant’s management plan.

  • Required to make sure the support worker can perform day-to-day monitoring, maintenance and prevention of pressure injury.

Continence Supports

| Type of support | Support Category | Supports for consideration | |—|—|| | Continence supports | CB Daily Activity | Continence supports are typically funded for children 5 years of age or older. In rare situations we may include funding for continence supports for children younger than 5 for disability-related medical conditions. Learn more in Our Guideline — Continence Supports.

Continence assessment plans and reviews from a continence nurse (CNC level nurse) which includes identification of continence consumable and AT support needs.

  • 5 hours per year for participants with changing needs.
  • 3 hours per year for children between 5 and 7 years of age.
  • 2 hours per year for participants with stable needs.
  • 1 hour for reviews.

Nursing hours for catheter changes for suprapubic and indwelling catheters — estimated at 30mins to 1 hour per change every 4-8 weeks suprapubic and 1-3 months for indwelling catheters. This will be guided by participant experience and continence assessment.

Podiatry and Foot Care

| Type of support | Support Category | Supports for consideration | |—|—|| | Podiatry and foot care | CB Daily Activity | Podiatrist hours including:

  • Podiatry assessment — 2hrs
  • Prepare a podiatry care plan — 1hr
  • Conduct a re-assessment — 1hr up to 3 per year

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Supports for Consideration

Type of Support Support Category Supports for consideration
Provide subsequent plans - 2hr to conduct the assessment, and a further 1hr to prepare the podiatry care plan.
Training support workers in the individual needs of the participant - 1 hr per support worker.
Cutting toenails and other foot care - 20 - 60min per visit, every 6-8 weeks.

Include podiatrist hours using line items: Assessment, Recommendation, Therapy and/or Training (Incl. AT) - Other Therapy Selection and/or Manufacture of Customised or Wearable Technology

Note: Where the complex health and disability care needs of the participant exceed the skill set of a trained support worker, podiatrist hours may be included to implement the podiatry care plan.

| Dysphagia | CB Daily Activity | Delivery of health supports by a speech pathologist including: | | | | assessment mealtime management plan: 3-5 hours per location | | | | development of plan and report: 2 hours | | | | re-assessment of plan, including update of plan: 2 hours | | | | swallowing therapy intervention: usually included as part of the mealtime management plan

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Supports for Consideration

  • training of support workers, including family, carers and informal supports, by the speech pathologist at the therapist rate: 1-2 hours, twice a year in each environmental setting.

Use support item - Assessment, Recommendation, Therapy And/or Training (Incl. AT) - Other Therapy.

Diabetes CB Daily Activity

If the participant needs support from someone who is more skilled than a trained support worker with medication competencies, registered nurse hours may be included. The registered nurse will assess blood glucose levels and administer insulin until evidence about the complex disability support needs are provided. As a general guide the task to administer insulin will take 15 minutes per administration and the total time required will depend on:

  • the number of insulin injections for example, one to 5 times per day
  • the equipment used by the participant for example, to measure blood glucose levels
  • their functional capacity.

Note: You must contact TAB for advice if registered nurse supports are requested for direct management of diabetes when there is evidence that the diabetes is stable.

Use Our Guideline relevant to the specific DRHS and the 5 related procedures and resources to support your reasonable and necessary decision making for disability-related health Capital supports.

The table outlines the broad type of support and the estimated hours for each of the relevant support categories to include in the participant’s plan.

Type of support Support Category Supports for consideration
Wound and pressure care Assistive technology Purchase or lease of pressure supports (AT) over $1500 per item including:
  • Pressure cushions
  • Mattress
  • Air-Filled Garments and Compression Units for Managing Circulation Problems and Lymphoedema
  • Lymphoedema machine if required for maintenance
  • Negative pressure wound therapy — Vacuum assisted closure (VAC). | | General | Assistive Technology | Air conditioning or heating for people who have a disability that affects their ability to regulate their body temperature may be funded as a disability-related health support if considered reasonable and necessary. Refer all requests for air conditioning or heating to TAB for advice.

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• Our Guideline – Disability-related health support • Our Guideline – Continence supports • Our Guideline – Diabetic management supports • Our Guideline – Dysphagia supports • Our Guideline – Epilepsy supports • Our Guideline – Nutrition supports including meal preparation • Our Guideline – Podiatry and foot care supports • Our Guideline – Wound care and pressure supports • Practice Guide - Respiratory Supports • Standard Operating Procedure – Add low cost assistive technology supports in plan • Standard Operating Procedure – Add self-care and community access supports

6. Feedback

If you have any feedback about this Standard Operating Procedure, please complete our Feedback Form.

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7. Version control

Version Amended by Brief Description of Change Status Date
1.0 CW0032 Class 2 approved. APPROVED 2021-06-03
Standard Operating Procedure moved to the new SOP format to be used with Our Guideline Disability Related health supports.
SOP includes information on:
* shadow shifts
* guide to registered nurse hours (only to be used when the participant is unable to provide you with evidence of the disability-related health supports)
* state and territory power and oxygen subsidies
2.0 JSO0082 Class 1 approval APPROVED 2021-11-18
Added guidance for mandatory referrals to TAB to align with DRHS OG.
Updated table for state and territory information about oxygen.
Content updates endorsed by JRO059 from TAB

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Version History

Version Amended by Brief Description of Change Status Date
3.0 CW0032 Class 2 approved APPROVED 2022-02-15
JC0075 Addition of guidance for planners to calculate nutrition support including meal preparation.
AGV957
DCP167 Included information from PG Nutrition supports to support release of OG nutrition supports including meal preparation.
LS0042 Name changed to include disability-related health supports or meal preparation supports in the participant’s plan
4.0 CW0032 Class 2 approval APPROVED 2022-06-16
CMO0032 Included information on individual DRHS topics to support the release of DRHS OGs. Updated Delegation of Care table.
AGV957
DCP167 Further Class 1 approval by JSO082 for additional feedback provided by ECS.
LS0042
5.0 JSO0082 Class 1 approval APPROVED 2022-12-02
Update to amend errors in support categories.
Clearer guidance for how to calculate meal preparation costs.
6.0 CW0032 Class 2 approved. APPROVED 2023-06-21
IIW664 Updated to align with the early childhood age range change. Updates to support early childhood partners to plan for children aged 7 or 8.

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