Advice Support Tool

Theme: Continence

Sub-Theme(s):

References: [include any relevant referenced documents]

• NDIS Act 2013 Section 34 1. (a) - (f) and 2.
• NDIS Support for Participant Rules 2013
• SOP_DisabilityRelatedHealthSupports.docx
• Continence Supports | NDIS

Continence Assessment

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

Criteria for reasonable and necessary supports	Is criteria met?	Considerations (including evidence 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 regarding incontinence, however, consider how the management of urinary and faecal incontinence may underpin and assist the participant to pursue their stated goals. s47E(d) - certain operations of agencies
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	Continence management will result in appropriate and socially acceptable strategies in place to ensure that the participant’s urinary and fecal incontinence is appropriately managed, and their dignity preserved. s47E(a) - certain operations of agencies
34.1(c) Value for money (supports represents value for money, ie the costs of support are reasonable, both in	☑️ Yes	Has there been a Continence Assessment by an independent or hospital-based Continence Specialist?

Criteria for reasonable and necessary supports

• 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

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 of supports? S47E(d)-certain operations of agency

Is criteria met?	Considerations (including evidence used)
No → nurse? #=¢s=sq	s47E(d) - certain operations of agencies

Has the assessor considered any likely changes i.e., are the individual needs stable? Participant’s continence consumable needs may change over time #7s@sssinsrstasersien

Have comparable continence consumables been explored and reasons outlined why they could not achieve the same outcome at a substantially lower cost?

s47E(d) - certain operations of agencies

For newly suggested consumables — has a trial been completed? If so, what was the trial result? Or is the request to fund a trial? Seuss|

Criteria for reasonable and necessary supports

Criteria for reasonable and necessary supports	Is criteria met?	Considerations (including evidence used)
Is the suggested consumable required due to the participant’s functional impact?		s47E(d) - certain operations of agencies

Is the suggested consumable required due to the participant’s functional impact?

In some circumstances lower cost consumable alternatives may achieve the same outcome.

If the participant is unable to manage their incontinence independently, they may rely on informal/formal support. The level of Core DA support provided is typically included within the provision of personal care

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? | Yes | s47E(d) - certain operations of agencies Or has a trial been completed? Or is the request to fund a trial of high-cost consumables? |

Criteria for reasonable and necessary supports

Is criteria met?

Considerations (including evidence used)

• How will effectiveness of achieved outcome be measured? redacted

• When will effectiveness of achieved outcome be achieved? redacted

• Are there other supports required to achieve or maximise the reported support outcomes for participant? redacted

• Has the participant been using the suggested consumables for some time? Or has there been a trial completed? redacted

• Are the continence consumables compatible with the environment where they will be used? redacted

• If the participant is unable to manage their incontinence independently, they may require informal/formal supports to assist with toileting, personal care including catheterization/complex bowel care and skin care to manage the risk of integrity issues.

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 redacted
• No redacted

Typically, if a child requires support to manage their incontinence this would remain a parental responsibility.

Criteria for reasonable and necessary supports

Is criteria met?

Considerations (including evidence used)

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.

(supports are not more appropriately funded | ONo — >

Criteria for reasonable and necessary Is criteria Considerations (including evidence supports met? used) 34.1(f) Support is most appropriately &K Yes > | Ifthe participant is an inpatient (hospital) it is deemed the responsibility of the health system to provide continence products during the hospital stay. Discharge planning may request continence consumables be funded for use in the community. Evidence will be provided by the hospital nursing/Continence Specialist.

Is the requested consumable a treatment which is not funded by NDIS? #47E(a)=certain operations of agencies These may be available on the PBS, or the participant may need to purchase them privately.

As per Continence Supports | NDIS, typically if a child has incontinence issues NDIS may fund consumables after age Syo jesse

Free stoma appliances and products are provided by Stoma Appliance Scheme (health) Stoma Appliance Scheme | Australian Government Department of Health and Aged Care

Criteria for reasonable and necessary 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

Are all of the above criteria met for all supports?

Version Control

Version #	Status	Date	Modified by	Brief Description of Modification
V1.0	Cleared	29/08/2023	NIB743	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