FOI 24/25-0753 DOCUMENT 6
AAT Case Management Guide
Disability Related Health Supports
OFFICIAL For Internal Use Only
| Field | Content | Reference Documents |
|---|---|---|
| Title | Disability Related Health Supports | |
| Purpose | This document is part of a suite of guidance documents for case managers to use in formulating their approach to managing individual cases before the Administrative Appeals Tribunal (AAT). | |
| Scope | Disability-related health supports are health supports which directly relate to the functional impact of a participant’s disability on their functional capacity to partake in their day-to-day life, become independent, and pursue their goals. | Disability-related health supports How do we decide what disability-related health supports we fund? | NDIS |
| Escalation to Hearing Oversight Committee (HOC) | If a matter is within the parameters of this document, the AAT Case Management Branch Manager may approve proceeding to hearing. Where there is substantial risk or the matter is outside the parameters of this document, the matter should be referred to HOC. | 6 AAT Case Management Branch |
| Current National Disability Insurance Agency (NDIA) policy on the subject | The AAT process is often seen as stressful and adversarial by the participants and our focus should be on resolving issues as practicably and quickly as possible. The role of the NDIA is to assist the AAT and the participant in reaching the best possible resolution for the participant by agreement. The NDIA will fund all reasonable and necessary supports which meet the NDIS funding criteria. This means that the NDIA will fund all disability related health supports which: |
- directly relate to a participant’s disability;
- help increase a participant’s social and economic participation;
- are effective and beneficial;
- represent good value for money, in comparison to other supports which the NDIA may fund; and
- would not be more appropriately funded by another mainstream service delivery system
Particularly in the context of disability-related health supports, the NDIA is unable to fund supports which | NDIA Dispute Resolution Policy
Appendix B to the Legal Services Directions 2017
Sections 34(1) National Disability Insurance Scheme Act 2013
Dysphagia supports | NDIS
Nutrition supports including meal preparation | NDIS
Diabetes management supports | NDIS
Continence Supports | NDIS
Wound and Pressure Care Supports | NDIS |
1
Page 17 of 44
AAT Case Management Guide
Disability Related Health Supports
OFFICIAL For Internal Use Only
| Field | Content | Reference Documents |
|---|---|---|
| would more appropriately be funded by another mainstream service delivery system. Common examples of what this means the NDIA is able to fund include: ### Dysphagia supports |
- low-cost assistive technology (equipment or devices to help a participant eat and drink)
- thickener products
- help to prepare specific foods
- a support worker
- a speech pathologist, to make and implement a mealtime management plan and train support workers, family and/or carers
Nutrition supports
- a dietician, to create a disability-related meal plan for a participant
- support to help follow that meal plan
- Home Enteral Nutrition (HEN) and Percutaneous Endoscopic Gastrostomy (PEG) equipment
- other products which may help a participant eat safely, and acquire the nutrition they need (such as good thickeners)
- support to manage HEN and PEG strategies
Diabetes management supports
- a nurse or otherwise qualified person to create a disability-related diabetes management plan
- support to follow that management plan
- a support worker, to monitor glucose levels and administer insulin or other medication
- training for support workers
- a nurse or otherwise qualified person to monitor glucose levels and administer insulin or other medication (for participants with unstable diabetes, and/or complex disability support needs)
- assistive technology to help manage diabetes, which a participant is otherwise unable to acquire through the healthcare system
Continence supports | Podiatry and foot care supports | NDIS
Epilepsy Supports | NDIS
Assistive technology | NDIS
What if you need someone with training to provide the support you need? | NDIS |
2
Page 18 of 44
AAT Case Management Guide
Disability Related Health Supports
OFFICIAL For Internal Use Only
| Field | Content | Reference Documents |
|---|---|---|
| - pads and/or nappies - bedding and/or chair protection - liners or shields - anal plugs - collection bags - bottles - strapsor tape - professional training for someone to assist a participant with bodily functions and hygiene - continence assessment(s) - a bed wetting alarm ### Wound and pressure care supports |
-
an enrolled/registered/clinical nurse consultant to develop a wound management plan or pressure care plan
- a support worker, enrolled/registered/clinical nurse to help implement that management plan or care plan
- training for a support worker to help implement that pressure care plan
- wound care items (gauze, bandages, dressing and tape)
- items to prevent wounds (including pressure relief cushions, moisturiser, barrier creams and non-PH washes)
- review and planning of pressure care positioning
- support to manage lymphoedema
### Podiatry supports -
an initial consultation and assessment by a podiatrist, including the development of a podiatry care plan
- regular re-assessment(s) during a care plan
- appointments with a podiatrist to assist with overall foot care and foot health
- a support worker
- assistive technology (orthoses, custom made orthoses, medical grade/custom footwear, as well as maintenance and repair)
### Epilepsy supports -
funding and training for a support worker to follow an epilepsy management plan | |
3
Page 19 of 44