Advice Support Tool
Theme: Home Modification
Sub-Theme(s): Bathroom and Toilet Modifications
References: [include any relevant referenced documents]
- NDIS Act 2013 Section 34.1 (a) - (f) and 2.
- NDIS Support for Participant Rules 2013
- NDIS Operational Guideline Home Modification (Oct 2022)
- NDIS Guidance for builders and designers (Sept 2022)
[Example: Complex or minor home modification assessment report] [Example: Our Guideline – Home Modifications] [Example: NDIS Guidance for Builders and Designers] [Example: NDIS Guidance for Home Modification Assessors] [Example: Minor home modification budget levels]
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 → The participant may not have a specific goal outlining a home modification is required, however consider how the requested home modifications may underpin and assist the participant to pursue stated plan goals.
- 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 → Same as per above 34.1.a.
- No →
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);
- Yes → 3.1a
- No → Has the assessor provided robust evidence that minor HMODs, and low-cost AT will not meet the participants needs. For example, transfer bench, shower buddy, shower chair/stool, long-handled aids, grab rails, handheld shower, non-slip floor application, re-swinging of doors, replacement of shower screen with shower rail and curtain. Has the assessor provided robust evidence that capacity building supports have been exhausted. For example, fatigue management strategies, falls prevention strategies,
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Criteria for reasonable and necessary supports
| 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? | transfer practice using low cost AT and task modification. | |
| Is there evidence that the support will substantially improve the life stage outcomes and be of long-term benefit to the participant? | Is the support being recommended to enable participants with safe and accessible amenities for personal care and hygiene? If being recommended for pain management or behaviours of concern, have other options been considered. | |
| Is there evidence that funding support is likely to increase independence and reduce funded support costs in the long-term? | Is there evidence that the participant plans to remain in the home. | |
| 3.1b | ||
| Does the participant have any foreseeable changes in circumstance, functional capacity or degenerative condition that may impact the long-term suitability of the proposed modification For example: the participant has progressive MS and a bathroom modification has been requested however access to the toilet has not been included as it is not a current need. Long term the participant is unlikely to be able to access the toilet and therefore the recommended modification is unlikely to meet 3.1b. | ||
| Is there evidence the support will increase the participant’s independence and reduce the participant’s need for other kinds of supports? | 3.1c | |
| Consider if the provision of the bathroom/toilet modification will avoid or delay the reliance of more costly supports. | ||
| 3.1d | ||
| If evidence is provided that the participant has foreseeable changes in circumstance, functional capacity or degenerative condition has the assessor considered alternative short-term solutions. | ||
| 3.1e | ||
| 2 quotes are required for complex HMOD to determine local area value for money; however, the advisor should consider if there are alternative reasons for higher-than-expected cost i.e., rural location | ||
| S47E(d)-certain operations of agency | ||
| Is there evidence the quoted support cost is comparable to expected cost of same kind of supports? S47E(@)meertain operations or agencies |
| Criteria for reasonable and necessary Is criteria Considerations (including evidence | supports met? used) | resulting in higher costs, limited | providers. | 3.1f | Is there evidence that funding the | support is likely to increase | independence and reduce funded | support costs in the long term sEts““ | ————=E=E=== = ae | Does the participant use mobility | | 34.1(d) Support is effective or beneficial O Yes — > | for the participant | No — > | (supports will be, or are likely to be, effective | | for desired effect and beneficial for the Has the assessor considered all | participant, having regard to current good bathrooms within the home. | | 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 Ol Yes ? | does not replace informal support ONo — > | | (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 O Yes > | Consider who owns the property. | funded by the NDIS |
Criteria for reasonable and necessary supports
| Criteria for reasonable and necessary supports | Is criteria met? | Considerations (including evidence used) |
|---|---|---|
| (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. | ☐ No ——»> | The NDIS is responsible for funding HMOD in private dwellings. |
| If it is an SDA property, the NDIS is not responsible for funding HMOD. | ||
| 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 ——> | Are there any extra features noted that are likely to cause harm. For example has a glass shower screen been recommended for a participant with a high risk falls.
| 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 ——> | Has the modification been recommended to address functional impacts associated with the disability for which the participant has gained access to the scheme? – check Disability tab in CRM or PACE.. Are there any extra features noted that are not disability related features – see NDIS guidance for builders and designers section 7.6 pg. 19 for examples.
| 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 ——> |
| Are all of the above criteria met for all supports? | ☐ Yes ——> |
| Version # | Status | Date | Modified by | Brief Description of Modification |
|---|---|---|---|---|
| V1.0 | Cleared | 01/09/2023 | HBL949 | 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