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Agency Understand self-care and community access supports Insurance

Guidance in this document is not approved for use unless you view it in PACE.

This article provides guidance for a planner delegate to:

understand self-care and community access supports
consider when to include high intensity supports.

National Recent updates the by 2 September 2024

Guidance updated to include links to new articles that will help you understand and determine levels of support for assistance with social and community participation for participants in shared living arrangements.

12 August 2024Guidance updated to: Information of • advise the Plan Conversation Support Tool (PCST) must be used for all new plans and plan reassessment

change article Calculate disability-related health supports and meal preparation supports to Determine disability-related health supports and meal preparation supports.

Freedom the under Before you start You have:

read and understood Our Guideline – Reasonable and Necessary Supports (external)
read and understood Our Guideline – Social and Recreation Support (external)
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read and understood article Support Categories
read and understood article Understand social and community participation funding Agency for participants in a shared living arrangement
read and understood article Develop a social and community participation budget for participants in a shared living arrangement Insurance
read and understood article Understand social and community participation funding

for a participant in a shared living arrangement – Case examples.

Disability

Understand self-care and community access supports When you include self-care or community access supports in a participant’s plan, you’ll need to National make sure you include the appropriate support category.

Self-care

Self-care supports provide assistance with daily personal activities. This could include:

personal care such as, bathing, dressing, toileting and grooming
assistance with eating
mobility including exercise, positioning and moving.To include supports for self-care, you’ll need to use the support category Assistance with Daily Life.

Community Access

Community access supports provide assistance with participation in community, social and Freedom civic activities. the If the participant lives in a shared living arrangement, go to article Understand social and community participation supports for participants in a shared living arrangement for more under information. To see how you can use the Plan Conversation Support Tool (PCST) to develop a social and community participation (SCP) budget for a participant in a shared living arrangement, go to article Understand social and community participation supports for released participants in a shared living arrangement – Case examples.

wasTo include supports for community access, you’ll need to use the support category Assistance with Social, Economic and Community Participation. For a participant in a

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shared living arrangement, go to article Develop a social and community participation budget for participants in a shared living arrangement.

Agency To learn more, go to article Support Categories.

e Consider when to include high intensity support A support is considered a high intensity support if it’s a support provided to a participant who requires assistance from a disability support worker who has one or more high intensity support skills. These skills are specified in the NDIS Commission’s NDIS Practice Standards: Insurance Disability National skills descriptors (external).

Developing a plan with high intensity supports A participant’s plan doesn’t change by including high intensity support. This means you’ll continue to develop the plan as normal. Participants with complex needs may need some or all of their supports provided by a support worker with high intensity skills.

You’ll need to make a decision based on the NDIS funding criteria to determine if the participant’s support needs are standard or high intensity. Support items are explained in the ActNDIS pricing arrangements and price limits (external). Use the PCST to guide your decision making. You must use the PCST for all new plans and plan reassessments and attach to the participant record. Go to article Understand and update the plan conversation support tool.

Information from the participant, their providers, functional assessments, therapy reports, behaviour reports and medical information may help to determine if the participant has higher intensity support needs.

Standard supportParticipants without high intensity support needs would generally require a support worker with standard skills.

High intensity support

Participants with high intensity support needs will generally require a mix of support workers with standard skills and high intensity skills to have their support needs met.

For example, a mixture of standard and high intensity support may be required when a releasedparticipant:

only needs a support worker with high intensity skills for their disability related health was supports (DRHS) that occur at a certain time of day.

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For Internal Use Only In some situations, the participant will always need a support worker with high intensity skills to provide all their supports. Talk to your team leader if you need help to decide what level of Agency worker is needed.

Registered nurse (RN) delegation of care allows an RN to delegate high level care to another suitably trained person.

Participants who meet the criteria for DRHS may need a support worker who is skilled to meet this need. The provision of these supports could be delegated by the RN to a support worker who has the required high intensity support skills. The number of hours needed will depend on the tasks required. When determining the number of hours to fund for DRHS, information from the following sources will help you to make sure the support meets the NDIS funding criteria:

the participant
their providers
functional assessments
therapy reports
behaviour reports
medical information.

Go to Our Guideline – Disability-related health supports and article Determine disability-related health supports and meal preparation supports for further information.

Plan Changes

A plan change should only be considered where necessary. The participant should talk to their provider first to understand their supports and the price control being claimed. The my NDIS contact or support coordinator who implemented the plan may help to:

determine if there’s enough funding in the plan to cover any increased costs
re-arrange their supports to better meet their needs. You should support the participant to seek a plan change if they’re considerably disadvantaged and unable to purchase their supports because of the change in price controls. The prioritisation of the plan change will be considered in line with the current prioritisation process.

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Implementation

Encourage the participant to discuss with their providers how the delivery of their supports can Agency be improved to create the most efficient use of their plan. Providers are encouraged to help the participant to arrange their supports within the available plan budget to deliver efficient service and value. This includes where a support worker with high intensity skills may be appropriate Insurancefor some supports.

The participant’s my NDIS contact, or support coordinator, supports the participant to implement the plan and develop their service agreements. Disability Providers

The price controls are the maximum prices that can be charged for each support. Go to NDIS National Pricing Arrangements and Price Limits (external) for more information on price controls. This theenables the participant to use their plan budget to purchase an appropriate mix of supports, including support workers with high intensity skills if necessary. by

Service bookings and claims will be subject to audit. Providers may be required to provide 1982 proof that the staff member who delivered a support was subject to the high intensity price Actcontrol and had the relevant skills or experience.

If the participant has concerns about their provider and the use of the price controls, they should escalate these to the local provider engagement team. InformationNext steps of For a:

Plan Approval case, you’ll need to use the PCST to calculate the funded supports. Freedom To add or update this support in a draft budget go to article Change the draft budget the • Plan Change or Participant Budget Update case, go to article Action a budget
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Article labels released PACE user role names wasNo change.

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For Internal Use Only No change. AgencyCase names

No change. Ownership Insurance

No change. Version control Disability Amended Version Brief Description of Change Status Date by the 5.0 JS0082 Class 1 Approval APPROVED 2024-08-08 by Class 1 update to include links to new social and community participation articles for participants in shared living arrangement. These have been developed as part of the home and living reform branch project to improve guidance for planners to include funding for participants in shared living.

5.1 REB563 DRAFR 2024-08-26

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