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Calculate disability-related health supports and meal preparation supports

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Calculate disability-related health supports and meal preparation supports

This article provides guidance for a planner to:

  • calculate disability-related health supports
  • understand Guide to registered nurse hours.

Recent updates

October 2023 Current guidance.

Before you start

You have read and understood relevant guidance from:

  • Our Guideline – Disability-related health supports (external)
  • Our Guideline – Continence (external)
  • Our Guideline – Diabetes management supports (external)
  • Our Guideline – Dysphagia supports (external)
  • Our Guideline – Epilepsy supports (external)
  • Our Guideline – Nutrition supports including meal preparation (external)
  • Our Guideline – Podiatry and foot care supports (external)
  • Our Guideline – Wound and pressure care supports (external)
  • Our Guideline – Creating your plan (external)
  • Our Guideline – Justice system (external)
  • Our Guideline – Plan reviews (external)
  • article Guide – Respiratory supports.

You have also read and understood articles:

  • Add or update disability-related health supports and meal preparation supports

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  • Add or update disability-related health supports Appendix A – Guide to core supports
  • Add or update disability-related health supports Appendix B – Guide to capacity building supports
  • Add or update disability-related health supports Appendix C – Guide to capital supports.

You have:

  • checked if the disability-related health support needs advice from the Technical Advisory Branch (TAB) or Childrens Taskforce
  • received technical advice, if needed, before you include the disability-related health support in the participant’s plan.

Refer to TAB intranet page Requesting Advice.

To calculate disability-related health supports (DRHS) use evidence to guide your decision. Evidence can include assessments or health-related plans and will vary based on the type of DRHS the participant is asking for.

For example:

  • continence assessment
  • nurse developed care plan
  • mealtime management plan
  • hospital discharge summary
  • epilepsy management plan
  • diabetes management plan
  • respiratory care plan
  • manual handling plan
  • wound care plan.

For help making a reasonable and necessary decision, talk to your team leader or technical lead. If the support is complex and your team leader or technical lead needs you to get advice, they need to endorse your non-mandatory technical advice case. For children younger than 9,

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you can also ask for support from the Children’s Taskforce. Refer to article Create a technical advice case.

  1. Review any available evidence. If:

    • you decide supports recommended in the assessments meet the NDIS funding criteria, go to step 2
    • you decide supports recommended don’t meet the NDIS funding criteria or the participant doesn’t give you evidence for their disability-related health support needs, go to step 3.

  2. Refer to the assessment or allied health-related plan (AHP) in your justification for the supports. Add supports using article Add or update disability-related health supports and meal preparation supports.

  3. Determine the DRHS to include in their plan using:

    • section ‘Guide to registered nurse hours’, to understand recommended hours to develop and implement a registered nurse Delegation of Care plan.
    • resources listed in the ‘Before you start’ section of this article.

  4. Go to section ‘Calculate supports for shadow shifts’.

Calculate supports for shadow shifts

If a participant has complex support needs including DRHS, they may need shadow shifts to introduce new workers before they provide support independently. For example: - very limited communication - behaviour support needs - complex supports such as ventilation needs and equipment.

Shadow shifts: - allow the participant to become familiar with new staff - help new staff understand the participant’s complex support needs - provide the participant with DRHS in a safe way.

Shadow shifts don’t replace formal training. An employer is expected to provide formal training to their workforce. Formal training includes shadowing or buddying less experienced staff or new staff with experienced workers or informal carers.

  1. Does the participant need shadow shifts for DRHS?

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  • If yes, go to step 2.
  • If no, go to step 3.

Step 2

The number of shadow shifts should be based the complexity of the participant’s needs and how many workers they have. For help working out the number of shadow shifts, you can create a technical advice case. Refer to article Create a technical advice case.

Step 3

If the participant needs disability-related:

  • Consumables, go to section ‘Calculate consumable DRHS’.
  • Personal care or meal preparation, go to section ‘Calculate personal care hours and meal preparation for DRHS’.
  • Nurse or allied health support, go to section ‘Calculate capacity building DRHS’.

Calculate consumable DRHS

Health consumables include continence, dysphagia, wound care, nutrition, and respiratory support.

  1. Determine what consumable DRHS meet the NDIS funding criteria using article Add or update disability-related health supports Appendix A – Guide to core supports. Note: If you have completed a technical advice case from TAB, follow any directions about how to record the support in the plan.
  2. Add funding for delivery, repairs and maintenance of disability-related health consumables and equipment, if required. Refer to article Add or update funding for assistive technology (AT) maintenance, repairs, rentals and trials in a plan approval case.
  3. Add disability-related Core Supports using article Add or update disability-related health supports and meal preparation supports.

Calculate personal care hours and meal preparation for DRHS

  1. Determine what personal care or meal preparation for disability-related health supports meet the NDIS funding criteria using information from:
  1. Determine the amount of support the participant needs for:

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  • personal care hours from different types of workers, including support workers and allied health professionals
  • direct care hours from a nurse. For example, for a nurse to change a catheter.

Note: Nurse direct care hours are separate to delegation of care and supervision hours. To learn more about how to calculate hours for delegation of care, go to section ‘Guide to registered nurse hours’.

  1. See if you can combine support workers hours so the participant gets value for money. For example, the participant may require support with multiple tasks which require 10 - 15 minutes each to complete. Examples include support administering insulin, skin and pressure area checks and application of pressure garments. In this case 1 hour would be enough to cover multiple tasks.

  2. Think about additional time the participant’s support workers may need to travel to provide assistance with daily activities. This may include nurses, supports workers and other staff. Refer to Our Guideline – Reasonable and necessary supports (external) and the NDIS pricing arrangements and price limits (external).

  3. Add disability-related Core Supports using article Add or update disability-related health supports and meal preparation supports.

Calculate capacity building DRHS

  1. Does the participant need support which can be delegated from a registered nurse to a support worker to deliver?
  • Yes, go to step 2
  • No, go to step 3.

If you aren’t sure whether the participant needs support which can be delegated from a registered nurse, talk to your team leader or technical lead. If you need advice, you can create a technical advice case. Refer to article Create a technical advice case.

  1. Can the participant provide you with a report or assessment recommending the supports needed?
  • Yes, go to step 3
  • No, use go to section ‘Guide to registered nurse hours’ to calculate the amount of registered nurse support hours for a nurse to develop a Delegation of care or nursing care plan.
  1. Determine the disability-related capacity building health supports the participant needs. Use the NDIS funding criteria and information from:

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  • the participant
  • the nurse developed care or hospital discharge plan
  • guidance in the ‘Before you start’ section, including article Add or update disability-related health supports Appendix B – Guide to capacity building supports.
  1. Check all of the support hours the participant needs across the different health support categories.
  2. Where possible, combine similar disability-related health support hours from different health support categories to reduce duplication of hours for therapy supports. For example, if the participant asks for support from a speech pathologist for swallowing difficulties and verbal language think about if the hours can be combined. Make sure there are enough hours to cover both needs.
  3. Add disability-related Capacity Building supports using article Add or update disability-related health supports and meal preparation supports.

Guide to registered nurse hours

Use the lists below to guide you on the amount of registered nurse support to include in the participant’s plan. This support is to develop and implement a registered nurse Delegation of Care plan. It does not include the hours for a nurse to complete specific DRHS tasks. For example, changing catheters.

  1. Determine the tasks the registered nurse will need to complete.
  2. Determine the level of support using Our Guideline – Disability-related health supports (external).

Note: Only use these lists when the participant can’t give you a nurse developed care plan or hospital discharge plan.

If you need help calculating hours for delegated care tasks or supervision of those tasks, you can create a technical advice case. Refer to article Create a technical advice case.

Include training and assessment in tasks to make sure supports are competent in the participant’s individual support needs. A Registered Nurse can train Support Workers in small groups or individually if suitable. Providers are responsible for making sure workers have current skills and knowledge, and that the training of workers is documented and regularly audited.

  • Up to 2 high intensity supports delivered to 2-4 support staff: 3 hours per year.

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  • Up to 2 high intensity supports delivered to 5+ support staff: 6 hours per year.
  • 3 high intensity supports delivered to 2-4 support staff: 10 hours per year.
  • 3 high intensity supports delivered to 5+ support staff: 20 hours per year.
  • 4 high intensity supports delivered to 2-4 support staff: 17 hours per year.
  • 4 high intensity supports delivered to 5+ support staff: 34 hours per year.
  • 5 high intensity supports delivered to 2-4 support staff: 25 hours per year.
  • 5 high intensity supports delivered to 5+ support staff: 50 hours per year.
  • 6 high intensity supports delivered to 2-4 support staff: 33 hours per year.
  • 6 high intensity supports delivered to 5+ support staff: 66 hours per year.
  • 7 high intensity supports delivered to 2-4 support staff: 41 hours per year.
  • 7 high intensity supports delivered to 5+ support staff: 82 hours per year.
  • 8 high intensity supports delivered to 2-4 support staff: 49 hours per year.
  • 8 high intensity supports delivered to 5+ support staff: 98 hours per year.

Guide of hours for assessments, developing care plans and supervision of staff

Health assessment

Preparation, initial assessment, reassessment and reporting on health assessment.

  • Up to 2 high intensity supports: 6 hours per year
  • 3 high intensity supports: 6 hours per year
  • 4 or more high intensity supports: 12 hours per year

Environmental Assessment

  • Up to 2 high intensity supports: 1 hour per year
  • 3 high intensity supports: 4 hours per year
  • 4 or more high intensity supports: 4 hours per year

Care plan

Developing new care plans, a variation or an update to a care plan

  • Up to 2 high intensity supports: 4 hours per year
  • 3 high intensity supports: 4 hours per year
  • 4 or more high intensity supports: 7.5 hours per year

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Supervision of staff delivering tasks delegated by registered nurse, direct and indirect

These hours have been calculated based on the estimated weekly need for indirect support by a registered nurse:

  • Up to 2 high intensity supports: 1 hour per month, 12 hours per year
  • 3 high intensity supports: 2 hours per month, 24 hours per year
  • 4 or more high intensity supports: 1-2 hours per week, 52-104 hours per year.

Next steps

  1. Add disability-related health supports to the participant plan, refer to article Add or update disability-related health supports and meal preparation supports.

Article topics and case names – internal use only

User roles

  • Add: dc_users_plannerdelegate

Topics

This article relates to the following topics:

  • Add: t_continence
  • Add: t_diabetes
  • Add: t_disabilityrelatedhealthsupports
  • Add: t_dysphagia
  • Add: t_epilepsy
  • Add: t_nutrition
  • Add: t_podiatryandfootcare
  • Add: t_respiratorysupports
  • Add: t_therapysupports
  • Add: t_woundandpressurecare

Case names

You can use this guidance for the:

  • Add: dc_case_technicaladvice

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Version control

Version Amended by Brief Description of Change Status Date
0.1 MGC723 New KA created to separate guidance for calculating DRHS from KA — Add disability-related health supports or meal preparation supports to this article.

Guidance for registered nurse hours also moved from KA - Add disability-related health supports Appendix B – Guide to registered nurse hours into this article.

Changes applied following consultation with TAB during amendments of SOP. Including update to guidance for training for delegated disability-related health support tasks to cover all skill areas and support staff. | DRAFT | 2023-09-14 | | 0.2 | BTM847 | Peer review | DRAFT | 2023-09-22 | | 0.3 | MGC723 | Action peer review | DRAFT | 2023-09-22 | | 0.4 | CTM829 | EL1 review | DRAFT | 2023-09-22 | | 0.5 | JS0082 | Class 1 review to progress to BiL for endorsement | DRAFT | 2023-09-25 | | 0.6 | MGC723 | Action EL2 review | DRAFT | 2023-09-26 | | 0.7 | MGC723 | Collate BIL feedback | DRAFT | 2023-10-05 | | 1.0 | JS0082 | Class 1 Approval | APPROVED | 2023-10-09 |

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