MR25/00038 | FOI 24/25-0317 DOCUMENT 20

Advice Support Tool

Theme: Hearing

Sub-Theme(s): Hearing Aids (including Bone Conduction Hearing Aids)

A NOTE: BAHA vs BCHA Bone Anchored Hearing Aids (BAHA) and Bone Conduction Hearing Aids (BCHA) use the same type of sound processors. BAHA is an implanted device, while BCHA is worn on a soft band or sound arc. Many clinicians use BAHA for both systems, which is technically incorrect. When considering §34.1 there is a difference between BAHA and BHCA sound processors, particularly relating to §34.1 (f). It is important to ensure you have determined if the sound processor is for a BAHA (implant) or BCHA before proceeding. For BAHA requests, use the advice support tool for sound processors.

References: NDIS Act 2013 Section 34.1.(a) - (f) and 2.

NDIS Support for Participant Rules 2013 NDIS and Hearing Supports Hearing Supports Fact Sheet PG Hearing Supports

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’s needs cannot be achieved with a lower level of technology, or
• The participant’s needs cannot be served by their current hearing aids (if within their expected service life of five years), used in combination with a remote microphone to assist in overcoming background noise? | Q No →
  
  The EVIDENCE should include:
• Including objective speech evidence of multiple technology levels starting at the standard level and working UP through the more advance levels of technology
• and any evidence of user experience using measurement

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Criteria for reasonable and necessary supports	Is criteria met?
Considerations (including evidence used)
tools such as the Speech, Spatial and Qualities of Hearing Scale (SSQ).
NOTE: The Hearing Devices and Hearing Technology Assessment Template provides information on the
required evidence.
t=tis=snpssimssmnes
Has evidence been provided to demonstrate the recommended hearing aids will further assist the participant’s social and economic participation t=(@)=eertain operations otagencies

34.1(b) Assist the Participant’s Social and Economic Participation

|- Yes | No —> |(Supports will assist the participant to undertake activities to facilitate their social and economic participation ) | EVIDENCE refer to 34.1 (a) |

34.1(c) Value For Money

|- Yes | No —> Has evidence been provided to demonstrate: The participant’s current hearing aids are outside their 5-year expected service life, or Require early replacement (with same level of technology) or refit (different level of technology)? Replacement reasons may include:

• Devices have reached the end of expected service life • Devices are damaged beyond repair (DBR letter from manufacturer – not clinician - required as evidence) • Device/s are lost or stolen (Stat Dec required) e Refit reasons may include: are there comparable support options which would achieve the same outcome at a substantially lower cost? What alternative supports were considered? Version 1.0 Page 2 of 7 Page 141 of 442

Criteria for reasonable and necessary Is criteria Considerations (including evidence supports met? used) 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 ¥ a Steniicant Geter arelen likely to increase independence and reduce in health, St funded support costs in the long-term? oS | SSS Is there evidence the support will increase SSSI the participant’s independence and reduce | the participant’s need for other kinds of <— Supports? e If hearing aids are beyond their S47E(@)-certain operations of agency ra aa a a — 7 ps ticre ovate —— SARC NEL S ——— a | technology with or without a remote microphone will Is there evidence the quoted support cost is not achieve similar == comparable to expected cost of same kind outcomes for this of Supports? 547E(d) - certain operations of agencies participant at a SSE = significantly lower cost? EVIDENCE for considering lower cost alternatives outlined above for 34.1 (a) Version 1.0 Page 3 of 7

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criteria for reasonable and necessary Is criteria Considerations (including evidence Supports met? used)

34.1(d) Support is effective or beneficial O yes > |

Has evidence been provided to demonstrate: for the participant

• The recommended hearing aids will be more effective or beneficial over the participant’s current o no —> •The ecninnermed Hearn ais hearing aids (if within their expected service life of five years), or •the recommended hearing aids will be more effective or beneficial over a lower level of technology? evidencE as outlined above for 34.1 (a).

34.1(e) Support coordinates with but does not replace informal support O Yes → redacted

O No

(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.

34.1(f) Support is most appropriately funded by the NDIS O Yes | Has evidence been provided to

demonstrate: o4 o no -» • the participant is NOT independently eligible for the Hearing Service Program (HSP). Version 1.0

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| Criteria for reasonable and necessary supports | | Is criteria met? | | Considerations (including evidence used) | | Audiology hours for HSP participants are the responsibility of the HSP, not the NDIS.

s47E(d) - certain operations of agencies

note NOTE #2: The following participants are automatically eligible for the HSP: ® anyone aged under 26 years e Aboriginal or Torres Strait Islander and either: o aged 50 years or over, or o took partin the Community Development Program (formerly known as the Remote Jobs and Communities Program and the Community Development Employment Projects Program), or o took part in the Community Development Employment Projects Program from 30 June 2013 and received hearing services from Hearing Australia before you stopped participating

note NOTE #3: In-kind vouchers were provided to participants up to July 2020. If the participant has a current in-kind voucher, then the client will need to cancel this voucher before the NDIS will take responsibility for funding hearing aids for the participant. All in-kind vouchers that had an initial expiry date past 01/07/2021 were extended a further {Wo years. s47E(@)=ceain operations oragencies

Considerations (including evidence used)

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

Criteria for reasonable and necessary Is criteria supports met?

Support will not cause harm Ol Yes ? (Supports will not be funded if it is likely to

cause harm to the participant or pose arisk | 4 No

Most likely NO (the support will not cause harm), but look out for e information that mentions a

If YES (any of the above possibilities are mentioned) ee

(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 is directly related to the O Yes > | Does the have hearing loss listed as

participant’s disability a disability?

(supports will not be funded under the NDIS O1No —+>

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

Support does not duplicate other 0 Yes > | While hearing supports are not

supports typically duplicated (YES), it is ONo 5 possible

NO (Supports are duplicated) if: e if the participant was fitted with hearing aids within the last five years through a previously available ‘in-kind’ voucher

Version 1.0

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Criteria Assessment

The table below outlines the assessment against established criteria.

table:

Criteria for reasonable and necessary supports
Is criteria met?
—
□Yes →
□No →
Considerations (including evidence used)
s47E(d) - certain operations of agencies

A summary of version control is provided below.

Version Control

Version #	Status	Date	Modified By	Brief Description of Modification
V1.0	Cleared	01/09/2023	LHN531	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