Advice Support Tool

Theme: Disability Related Health Supports

Sub-Theme(s): Dysphagia

References: [include any relevant referenced documents]

• NDIS Act 2013 Section 34.1 (a) - (f) and 2.
• NDIS Support for Participant Rules 2013

AT Nutrition and Dysphagia Template or reports from Speech Pathologist Include disability-related health supports or meal preparation supports in the participant’s plan.

Our Guideline — Dysphagia supports.

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

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 dysphagia support, however, consider how the management of disability related health issues 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 → The Speech Pathology supports themselves may not specifically be utilized to assist economic and social participation s47E(d) - certain operations of agencies

Additionally, the Speech Pathologist may need to s47E(d) - certain operations of agencies

Criteria for reasonable and necessary supports

S47E(d)-certain operations of agency | ☐ Yes → | Is there a Speech Pathologist report? This may be from a hospital-based or independent Speech Pathologist. s47E(d) - certain operations of agencies

As the participant’s diagnoses may result in lifelong disability related health support needs, the need for Speech Pathology supports may also be lifelong however, typically the level of need may increase and decrease over time — do not assume that because a level of Speech Pathology support was included in one plan that it should be duplicated in the next.

The Speech Pathology report should outline if the individual needs are stable, deteriorating or if new temporary issues have arisen redacted

As per COAG - NDIS-Principles-to-Determine-Responsibilities-NDIS-and-Other-Service (1).pdf Health remains responsible for all health related needs that are not directly linked to the disability including palliative care.

Consideration to the participants age should occur and responsibility of informal supports in supporting the participant in their dysphagia needs. | | 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? Is there evidence the quoted support cost is comparable to expected cost of same kind of supports? S47E(d)-certain operations of agency

| Criteria for reasonable and necessary Is criteria Considerations (including evidence supports met? used) | — | — | — | | Low cost dysphagia support AT such as, plate guards, specialized cutlery and cups may reduce the need for hand-on supports for participants with dysphagia. | 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? When will effectiveness of achieved outcome be achieved? Are there other supports required to achieve or maximise the reported support outcomes for participant? | ☐ Yes → There will be some dysphagia support tasks that only a Speech Pathologist can complete. However, some tasks can be completed by a trained disability support worker. This can be completed under an RN DSOC. The High Intensity Support Skills Descriptors - December 2022 (ndiscommission.gov.au) provides supplementary guidance that clearly outlines the skills and knowledge that HI DSW should possess when delivering complex DRHS supports. The NDIS funds training of support workers to ensure the particular dysphagia needs of the participant are met e.g. a support worker will be competent in Mealtime Management, suctioning needs related to dysphagia or training to ensure that the particular needs of the participant are considered such as positioning when eating for example. Oversight and assessment for dysphagia supports should be completed annually to ensure effectiveness of the supports remain at their best. | ☐ No → Consideration is given to what is a reasonable level of support for a

Criteria for reasonable and necessary supports

(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

Is criteria met?

• No → parent to provide their child, especially if they have been trained by the hospital in completing clinical tasks.

Considerations (including evidence used)

• If the participant is an inpatient (hospital) it is deemed the responsibility of the health system to provide suitable speech pathology assessment and dysphagia supports, s47E(d) - certain operations of agencies
  • Instrumental assessment, such as video fluoroscopy study remain the responsibility of acute health.
• Has the Speech Pathology report outlined any potential risks?

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

Is criteria met?

• Yes →
• No →

Considerations (including evidence used)

• Are the supports that have been recommended s47E(d) - certain operations of agencies
  • E.g. Vision impairment, or lower limb amputation will likely not be a disability related need for NDIS funded dysphagia supports.

Criteria for reasonable and necessary supports

| Are all of the above criteria met for all supports? | | |

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