MR25/00038 | FOI 24/25-0317 DOCUMENT 7

Advice Support Tool

Theme: Assistive Technology Sub-Theme(s): Communication Devices

References: e NDIS Act 2013 e NDIS Support for Participant Rules 2013 e Assistive Technology Operational Guideline e Assessment and/or recommendation of a communication device s47E(d) - certain operations of agencies

note: s47E(d) - certain operations of agencies

All recommendations for a communication device from a Speech Pathologist need to be considered on an individual basis.

The prescription of communication devices is dependent on a wide range of clinical factors and considerations.

Criteria for reasonable and necessary supports	Is criteria met?
34.1(a) Enabling the participant’s goals and objectives	Yes
	No
(supports will assist the participant to pursue the goals and objectives in their plan)

has the speech pathologist provided an up-to-date overview or functional assessment of the participants communication skills

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(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 N

Part 3.1 (a) — (f);

s47E(d) - certain operations of agencies

O No

Criteria for reasonable and _ | Is criteria Considerations (including evidence used) necessary supports met? s47E(d) - certain operations of agencies as well as background information on their current cognitive, behavioural, physical and sensory skills/requirements. Has the Speech Pathologist explained why the communication device is required ————— | ee = a Has the Speech Pathologist explained how the communication device will support the participant to pursue their plan goals and objectives? s47E(d) - certain operations of agencies Has the Speech Pathologist provided an overview of any S=§“” present AAC that has been used by the participant? 34.1(b) Assist the 0 Yes > | Has the Speech Pathologist explained how the participant’s social and communication device will support the participants economic participation CNo : participation S47E(a) = certain operations of agencies (supports will assist the a ay fr . . participant to undertake 47E(d) - certain operations of agencies activities to facilitate their social and economic participation) 34.1(c) Value for money O Yes > | LOWER COST ALTERNATIVES

17E(d) - certain operations of agencies

Has the Speech Pathologist considered, trialled or

implemented lower cost alternatives

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Criteria for reasonable and necessary supports

| Criteria | |—|| | 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 ?|

Considerations (including evidence used)

\ d) - certain operations of agencies Has the Speech Pathologist documented the functional communication outcomes that the participant achieved on the redacted: s47 AAC? s47E(d) - certain operations of agencie: Has the Speech Pathologist explained why the same outcomes cannot be achieved on a lower cost alternative for the participant =a“
CONSIDERATION OF OPTIONS $47E(d) - certain operations of agencie

Criteria for Reasonable and Necessary Supports

The following table outlines considerations regarding reasonableness and necessity.

Criteria for reasonable and necessary supports
is criteria Considerations (including evidence used)
S47E(d) - certain operations of agencies
Has the Speech Pathologist addressed value for s47E(d) - certain operations of agencies
S47E(d) – certain operations of agencies

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Criteria for Reasonable and Necessary Supports

The following information was extracted from page 46 of an official document.

Considerations (including evidence used)

A list has been prepared detailing all assistive technology currently being used by the participant s47E(d) [- certain operations of agencies](/library/documents/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-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 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?

Is criteria met?

• O Yes
• O No

Outcomes

Has the communication device #7=tsstnsrsseete [ey] been tested or trialled directly with the participant? s47E(d) - certain operations of agencies

The Speech Pathologist provided details regarding trials: s47E(d) - certain operations of agencies.
s47E(d) - certain operations of agencies

Criteria for reasonable and

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

Is criteria Considerations (including evidence used) necessary supports met? If more than one communication device was reported to have been tested/trialled with the participant, has the Speech Pathologist provided s47E(d) - certain operations of agencies to compare the results between different types of hardware and software? 34.1(e) Support coordinates | F Yes ——~ | Has the Speech Pathologist confirmed that the with but does not replace device being requested is a informal support COONo : communication device for the purpose of AAC related to the participants disability and as such is (funding or provision of not a reasonable expectation for informal support supports takes account of networks to provide for the participant?

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The Speech Pathologist confirmed that the device being requested is a communication device intended for Augmentative & Alternative Communications (AAC) purposes related to the participant’s disability and such is most appropriately funded by the National Disability Insurance Scheme (NDIS) and not by another service system.

s47E(d) - certain operations of agencies

is the device being requested intended for the purpose of AAC to support the participants communication goals/needs that are related to their disability?

s47E(d) - certain operations of agencies

n/a to Communication Assistive Technology

Criteria for Reasonable and Necessary Supports

The considerations are as follows:

e Consider NDIS Support for Participant Rules 2013 Part 5.1

Version Control

A table detailing version control information is shown below.

Version #	Status	Date	Modified By	Brief Description of Modification
V1.0	Cleared	07/09/2023	LJE255	Production of initial V1.0
V1.0	Cleared	07/09/2023	JIF775	Transferred to Key Advisor Advice Resources repository

note: Document uncontrolled in hard copy

MR25/00038 | FOI! 24/25-0317

Advice Support Tool

Theme: Respiratory supports Sub-Theme(s): Oxygen and Portable Oxygen Concentrator support considerations

References: [include any relevant referenced documents] NDIS Act 2013 Section 34 1. (a) - (f) and 2. NDIS Support for Participant Rules 2013 PG RespiratorySupports.docx

Note: All criteria need to be met for the supports to be funded through the NDIS.

CRITERIA FOR REASONABLE AND NECESSARY SUPPORTS

Criteria
34.1(a) Enabling the participant’s goals and objectives (supports will assist the participant to pursue the goals and objectives in their plan)
This is individual to each participant and reflective of their individualized goals and objectives.
❌ No
34.1(b) Assist the participant’s social & economic participation *(supports will assist the participant to undertake activities to facilitate their social and economic participation)

  |✅ Yes If funding of a portable oxygen concentrator is requested, consider how the provision of funding this support will assist the participant in social and economic participation.| ❌No To be considered for funding a portable oxygen concentrator the participant must meet the eligibility criteria for home oxygen and be receiving this support state-based scheme.

|
| 34.1(c) Value for money | ✅Yes When assessing the request to ensure the requested device is reflective of |

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(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

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 participants’s independence and reduce their need for other kinds of supports? S47E(d)-certain operations of agency

In the situation such as the examples outlined above consideration to the cost of renting a device opposed to purchasing should be considered and evaluated.

Is there evidence the quoted support cost is comparable to expected cost of same kind of supports? S47E(d)-certain operations of agency

34.1(d) Support is effective or beneficial for the participant

☒ Yes In a participant who is dependent on supplemental oxygen ☐ No

(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

A clear oxygen prescription from the participants respiratory physician is required to support this request. This is discussed further below.

What are the expected benefits of the support provision?

MR25/00038 | FOI 24/25-0317

How will effectiveness of achieved outcome The expected benefits from the support provision include redacted: [s47E(d) - certain operations of agencies](/library/documents/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/). be measured? When will the effectiveness of achieved outcome be achieved?

are there other supports required to achieve or maximise the reported support outcomes the effectiveness of this support should be seen instantaneously once implemented. with regards to other supports options to maximize the support outcomes this is dependent on the participants underlying cause and treatment options available to the participant. as there are many different portable concentrators on the market each with different features, redacted: s47E(d) - certain operations of agencies. this can usually be organized through the supplier/provider.redacted: 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 ☐ No

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.)

in some state-based schemes such as enable funding of a portable oxygen cylinder may be provided on the prescriber’s request if the participant meets the eligibility criteria. adult home oxygen funding criteria (nsw.gov.au). See links for other state based schemes below. provision of a redacted: s47E(d) - certain operations of agencies, and the prescriber should consider if this is appropriate for the participant aligning with their goals and objectives and in the relevant state. The ndis does not typically fund oxygen cylinders.

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Support will not cause harm ■ Yes (Supports will not be funded if it’s likely to cause harm to the participant, or pose a risk to others, or the support would be contrary to law of jurisdiction) Consider NDIS Support for Participant Ruless 2013 Parts 5.1 & 5.3

Presentation of supporting evidence & a current clear prescription from Respiratory Physician is mandatory when funding portable oxygen concentrators. s47E(d) – Certain Operations Of Agencies

and this is an indicator for further evaluation of requested device. It’s essential that provider / supplier of respiratory equipment provides participants informal &/or formal supports training ensuring its safe use. The participant or their representative must be made aware they engage suitably skilled competent providers (with applicable experience in respiratory devices), implement care prescribed treating Practitioner Providers need ensure direct delivery clinical oversight respiratory supports met providing these services. The participant remain engaged with Respiratory Physicians regularly review respiratory needs ensures equipment and prescribed settings continue meet those needs Any change participant respiratory status documented by Treating Practitioners communicated Provider Services including any changes required Equipment Settings Or Supports Needs Copy This Information Provided NDIA Participants Record.

Support directly related To The Participant’S Disability ■ Yes (Supports will not funded under NDIS if They do relate participant disability are day-to-day expenses income replacement.) Consider NDIS Support For Participant Rulesses 2013 Partss 5.1 & 5.2 is the request Portable Oxygen Concentrator Directly Related to participant disability which accessed scheme? s47E(d) - certain operations agencies

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s47E(d) – Certain Operations Of Agencies

Example 1: Participant made access to the scheme for Chronic Pulmonary Obstructive Disease s47E(d) – certain operations of agencies

Example 2: Participant made access to the scheme for Visual Impairment redacted

although the participant oxygen requirement is an ongoing/daily issue or the participant, it is not related to their primary/functional impairment and therefore typically NOT funded by the NDIS.

Sometimes you may need to assess current literature/research when considering if the participants request is disability related. The Lung Foundation Australia is a valuable resource with regards to respiratory conditions. Other lung conditions - Lung Foundation Australia. s47E(d) – certain operations of agencies

Support does not duplicate other supports: ☒ Yes The provision of home oxygen is the responsibility of the participant’s state. ☐ No Home oxygen is provided to the participant by their state-based scheme and NOT funded by the NDIS.

Further information in regard to state- based oxygen schemes can be found via the attached hyperlinks, including information with regards to eligibility, inclusions and the application process.

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This is a helpful resource to provide a Delegate if you receive a request for home 02.

Home oxygen | Queensland Health

Home Respiratory Program - EnableNSW

Mictorian Aids and Equipment Program Home oxygen therapy | SA Health Tasmanian Government Concessions WA Respiratory Health Network i ly - Canberra

The request must be accompanied with medical evidence and current prescription for the requested support. As well as evidence that the participant lhas trialed the device.

are all of the above criteria met forall supports?

☐ Yes ☐ No

Version Control

A table outlining version control information:

Version#	Status	Date	Modified By	Brief Description of Modification
V1.0	Cleared	31/08/2023	CFD218	Production of initial V1.0
V1.0	Cleared	05/09/2023	JIF775	Transteredte Key (Uva AGiiCE Resources repository

note: Document uncontrolled in hard copy

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