Advice Support Tool
Theme: Diabetes
Sub-Theme(s):
- Diabetes AT – continuous glucose monitors, insulin pumps.
- Nursing support to manage diabetes.
- HIDSW under a DsOC to manage diabetes.
References: [include any relevant referenced documents] NDIS Act 2013 Section 34.1 (a) - (f) and 2. NDIS Support for Participant Rules 2013 OG_DiabetesManagementSupports
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 → ☐ No → |
The participant may not have specific goals regarding diabetes support, however, consider how the appropriate management of the participant’s diabetes may underpin and assist the participant to pursue their states 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 → ☐ No → |
s47E(d) - certain operations of agencies |
Criteria for reasonable and necessary supports
| Criteria for reasonable and necessary supports | Is criteria met? | Considerations (including evidence used) |
|---|---|---|
| s47E(d) - certain operations of agencies |
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); S47E(d)-certain operations of agency redacted redacted redacted Are there comparable support options which would achieve the same outcome at
- Information to consider when deciding if the support is value for money:
- Diabetes management plan. What other support may be required to follow the diabetes management plan.
- Quote for the requested AT. S47E(d) - certain operations of agencies
- Has the participant trialed the requested AT? What was the outcome?
- Will funding the AT reduce the requirement for formal supports.
Criteria for reasonable and necessary supports
Is criteria met? Considerations (including evidence that the support will 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(@}ertanjoperations/oFagency SS ees used) If the participant has Type 1 diabetes can this support be funded through other services such as the NDSS.NDSS — Where a nurse is being requested to manage a participant’s BGLs things to consider: Can the diabetes management be delegated to HIDSW under a DsOC rather than a nurse. 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? O Yes O No Has the participant trialed the requested AT. What was the HIDSW/Nurse Version 1.0 Page 79 of 442 Page 3 of 7
Criteria for reasonable and necessary supports
Is criteria met?
Considerations (including evidence used)
- When will effectiveness of achieved outcome be achieved?
- Are there other supports required to achieve or maximise the reported support outcomes for participant?
If the participant is unable to self-manage their diabetes even with diabetes AT. Then it would be appropriate for informal or formal supports to manage their diabetes for them. This would ensure the participant’s diabetes is correctly managed, maintaining their health and well-being. Thus, where a participant is unable to self-manage their diabetes it is effective and beneficial to the participant’s livelihood to fund a HIDSW/nurse where required.
In addition to the request for a nurse or HIDSW, supports may be requested for a “second check” for insulin administration. As per Australian Community Industry Alliance, ACIA 044 Diabetic Management in the Community.pdf a second-person check of the insulin dose is considered best practice and the person providing the check can be:
- the participant themselves (if they have the cognitive capacity to do so),
- an informal support i.e., family/friend,
- another support worker who has undertaken training and is deemed competent, or
- a health practitioner e.g. a trained nurse.
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
Where a participant is a child requiring support to manage their diabetes this would remain a parental responsibility. However, once the participant is of an age that one would typically be self-managing their diabetes it would be reasonable to consider funding for AT to allow the child to self-manage their diabetes or providing HIDSW/nurse to assist in the management of the participant’s diabetes.
Version 1.0 Page 4 of 7
Criteria for reasonable and necessary supports
| Is criteria met? | Considerations (including evidence used) |
|---|---|
| Yes | Is the requested support best funded through other government bodies e.g. NDSS. This might include CGM, finger prick consumables, needles etc. |
| Where the participant resides in an Aged Care Facility the Aged Care Quality of Care Principles (2014 legislation - Quality of Care Principles 2014 (legislation.gov.au)) Diabetes management would be best funded through the facility themselves. It is expected that mainstream health retains oversight and management of the participant’s diabetes condition. | |
| For participants with newly diagnosed diabetes, it is expected that in the first instance, mainstream health supports provide appropriate education and training to the participant or informal supports including information on the condition, medications they may be prescribed, how the medication is administered, their blood sugar range goals, emergency management of hyper/hypoglycemia events, etc. Other training specific to the participant is built into the DSoC hours. | |
| A participant may request supports for a Dietitian to assist with mealtime planning; it would be expected that mainstream health supports, or diabetes support provide this support. A DSW may assist with implementation of a plan as part of a participant’s daily support needs, however, the participant can access specialist Dietitian/mealtime planning supports through mainstream health | |
| No | A diabetes management plan should detail all risks related to the management. |
| Has the AT been trialed redacted: s22(1)(a)(ii) - irrelevant |
Criteria for reasonable and necessary supports
| Criteria for reasonable and necessary supports | Is criteria met? | Considerations (including evidence used) |
|---|---|---|
Is the appropriate person undertaking the requested task s47E(d) - certain operations of agencies |
||
| 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 → | Is the participant unable to self-manage their diabetes without AT or direct support (HIDSW/nurse) as a result of their primary reported disability. |
s47E(d) - certain operations of agencies |
||
| 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 → | s47E(d) - certain operations of agencies |
| Are all of the above criteria met for all supports? | ☐ Yes → |
Version Control
| Version # | Status | Date | Modified by | Brief Description of Modification |
|---|---|---|---|---|
| V1.0 | Cleared | 01/09/2023 | AHK808 | 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