Advice Support Tool
Theme: Prosthetics
Sub-Theme(s): Upper Limb Prosthesis
References: [include any relevant referenced documents]
NDIS Act 2013 Section 34 (a) - (f) and 2. NDIS Support for Participant Rules 2013
DOCUMENT 51
Including Specific Types of Supports in Plans Operational Guideline - Prosthetic limbs | NDIS
OG - Social and Recreation Support v3.0 APPROVED - EXTERNAL 2022-06-28 (2).pdf OG Assistive technology 20230216 PDF 298KB (3).pdf
How do we fund assistive technology? | NDIS
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)
34.1(a) Enabling the participant’s goals —>
(supports will assist the participant to pursue | No — > the goals and objectives in their plan)
34.1(b) Assist the participant’s social and economic participation the support will enable the participant?
(supports will assist the participant to undertake activities to facilitate their social and economic participation)
34.1(c) Value for money O Yes ? - Has the provider considered any likely changes such as the impact of growth or a degenerative condition?
(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 agency
| Criteria for reasonable and necessary supports | Is criteria met? | Considerations (including evidence used) | | 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? | Is there evidence the quoted support cost is comparable to expected cost of same kind of Supports? S47E(d) - certain operations of agencies | | Myoelectric considerations:
- Past prosthetic history
- If the participant does not use a prosthesis, how are they currently managing their activities What non-prosthetic low-cost AT/tools/equipment has been utilised previously? S47E(d) - certain operations of agencies | | - Has the provider considered the lowest cost option that may meet all the PCT needs S47E(d) - certain operations of agencies | | Warranty S47E(d) - certain operations of agencies |
| Criteria for reasonable and necessary supports | Is criteria met? | Considerations (including evidence used) |
|---|---|---|
| Consumables | ||
| 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 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? | ☐ Yes → |
- Trial evidence s47E(d) - certain operations of agencies | | | 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 | ☐ Yes → N/A | |
Criteria for reasonable and necessary supports
| Criteria for reasonable and necessary supports | Is criteria met? | Considerations (including evidence used) |
|---|---|---|
| 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. | ☐ Yes → | redacted: s47E(d) - certain operations of agencies |
| 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 → | Is there evidence that the recommended prosthesis is in line with the participant’s individual needs? |
| 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 → | N/A |
| Support does not duplicate other supports | ||
| (supports do not duplicate other supports delivered under alternative funding through | ☐ Yes → | redacted: s47E(d) - certain operations of agencies |
| Criteria for reasonable and necessary Is criteria | Considerations (including evidence used) |
|---|---|
| supports met? | |
| the NDIS such as Information, Linkages and Capacity Building (ILC) funding.) | |
| Consider NDIS Support for Participant Rules 2013 Part 5.1 | |
| Are all of the above criteria met for all supports? | Yes → |
| No → |
s47E(d) - certain operations of agencies
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s47E(d) - certain operations of agencies
Version 1.0 Page 7 of 9 Page 318 of 442
s47E(d) - certain operations of agencies
Version 1.0 Page 8 of 9 Page 319 of 442
Version Control
| Version # | Status | Date | Modified by | Brief Description of Modification |
|---|---|---|---|---|
| V1.0 | Cleared | 01/09/2023 | SGO256 | Production of initial V1.0 |
| V1.0 | Cleared | 05/09/2023 | JIF775 | Transferred to Key Advisor Advice Resources repository |
Note: Document uncontrolled in hard copy