Advice Support Tool

Theme: Core supports

Sub-Theme(s): s47E(d) - certain operations of agencies

References:* NDIS Act 2013 Section 34 1. (a) - (f) and 2.* NDIS Support for Participant Rules 2013

• Functional Capacity Assessment report
• Behaviour Support Plan
• Other allied health reports

Our Guideline –* Including Specific Types of Supports in Plans Operational Guideline - Personal care supports | NDIS* Social and recreation support | NDIS* Work and study supports | NDIS* Including Specific Types of Supports in Plans Operational Guideline - Sustaining informal supports | NDIS

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 |Refer to NDIS Plan for goals, objectives and aspirations.

The participant may or may not have a specific goal outlining the level of core support they require. However their goals may be to function as independently as possible and engage in social, economic and community participation.|No |

Criteria for reasonable and necessary supports

Criteria for reasonable and necessary supports

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); 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?

Criteria for reasonable and necessary supports

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 agency

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 | Yes | The person to person support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice:|

Criteria for reasonable and necessary supports

redacted

consider: (a) Published and refereed literature and any consensus of expert opinion (b) The lived experience of the participant or their carers

• What supports are currently in place, how has the participant been using their plan? s47E(d) - certain operations of agencies s47E(d) - certain operations of agencies

Criteria for reasonable and necessary

supports

• Independent assessment | The funding or provision of person to person support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide: Part 3.4 of the NDIS Supports for Participants Rules, 2013 Reasonable family, carer and other support, consider: |

Criteria for reasonable and necessary supports

Is criteria met?

Considerations (including evidence used)

Consider NDIS Support for Participant Rules 2013 Part 3.4

(a) for a participant that is a child: (I) It is normal for parents to provide substantial care for children (ii) Whether because of disability the child’s care needs are substantially greater than those of other children a similar age;

• Consider the functional impairment, the caring arrangement, and the child’s age and stage of development: redacted

(iii) Any risks to wellbeing of the participant’s family members/carers

• Consider family member’s wellbeing, redacted

Criteria for reasonable and necessary supports

Considerations (including evidence used)

(iv) Whether the support for a family would improve the child’s capacity or reduce risks to their wellbeing

Would the support improve the child’s capacity or reduce risk to family member?

s47E(d) - certain operations of agencies

(b) for other participants:

(I) the extent of any risks to wellbeing to the participant arising from reliance on informal supports

Is there a risk to the informal support

Loy 8

Risk to wellbeing of family members if paying informal supports due to reliance.

(ii) suitability of family members, carers to provide supports, considering factors such as age and capacity of family members; intensity

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Criteria for reasonable and necessary supports

Is criteria met? and type of support required and whether it is age/gender appropriate for a particular carer to provide that care; and risk to long term wellbeing of family member. s47E(d) - certain operations of agencies

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)

• Yes | Schedule 1 Part 7 Considerations relating to whether supports are most appropriately funded through the NDIS: note the Rules provide broad detail on what NDIS would typically be responsible for and what other service systems would be responsible for.

Consider NDIS Support for Participant Rules 2013 Schedule 1

• Part 7.4 and 7.5 Health
• Part 7.6 and 7.7 Mental Health

| Criteria for reasonable and necessary | supports | | — | | Is criteria | met? | | Considerations (including evidence used) | 3. Part 7.8, 7.9, 7.10 Early Childhood Development 4. Part 7.11 and 7.12 Child Protection & Family Support 5. Part 7.13 and 7.14 School Education 6. Part 7.17 and 7.18 Employment 7. Part 7.19 and 7.20 Housing 8. Part 7.21 and 7.22 Transport 9. Part 7.23, 7.24 and 7.25 Justice Relevant Agency Guidance: Justice System, s47E(d) - certain operations of agencies; Psychosocial Disability; Mainstream and Community Interfaces/s47E(d) - certain operations of agencies redacted OG Transport; s47E(d) - certain operations of agencies

| Criteria for reasonable and necessary Is criteria Considerations (including evidence used) | supports met? | Support will not cause harm Yes | Part5 of the NDIS Supports for Participants | (Supports will not be funded if it is likely to Bikes, 2019 = Genet itera fer Supports | cause harm to the participant or pose a risk COXNO) ——~5.1A support will not be provided or funded | to others, or the support would be contrary to under the NDIS if: | ala ofa jonsdicion) (a) _ itis likely to cause harm to the participant | Consider NDIS Support for Participant Rules or pose a risk to others; or | 2013 Part 5.1 and 5.3 | e Relevant Agency Guidance: Safeguarding | the participant’s interests, SOP: Participant | Critical Incident;

| Support is directly related to the Yes ~ /!s the support requested related to the | participant’s disability disability for which the participant met access? | (supports will not be funded under the NDIS_ | O1 No <=

Criteria for reasonable and necessary supports

Consider NDIS Support for Participant Rules 2013 Part 5.1 and 5.2

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

Support does not relate to day-to-day living costs (for example, rent, groceries and utility fees) that are not attributable to a participant’s disability support needs.

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Criteria for reasonable and necessary supports

Are all of the above criteria met for all supports?

Is criteria met? | Considerations (including evidence used)

• | - Yes | All of the above criteria must be met for the provision of continuous person to person support to be considered reasonable and necessary. No

Version Control

Note: Document uncontrolled in hard copy