Understand Self-Care And Community Access Supports

For Internal Use Only

The contents of this document are OFFICIAL.

Agency\nUnderstand self-care and community access\nsupports\nInsurance\n Guidance in this document is not approved for use unless you view it in PACE.

This article provides guidance for all NDIA staff and partners to:\n \u25CF understand self-care and community access supports\n \u25CF understand when to include high intensity supports\n \u25CF understand when to include intensive and complex behaviour support.

Recent updates\nby\n

3 October 2024\nGuidance updated to include new section for understanding intensive and complex behaviour Act\nsupport.

2 September 2024\n Guidance updated to include links to new articles that will help you understand and determine Informationlevels of support for assistance with social and community participation for participants in\nliving arrangements.

12 August 2024Guidance updated to:\n \u25CF advise the Plan Conversation Support Tool (PCST) must be used for all new plans and plan reassessment\n \n \u25CF change article Calculate disability-related health supports and meal preparation\n supports to Determine disability-related health supports and meal preparation\n supports.\nreleased\nwassBefore you start\n You have read and understood:\n\n \u25CF Our Guideline – Reasonable and Necessary Supports (external)\n \u25CF Our Guideline – Social and Recreation Support (external)

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• article Support Categories
• article Understand social and community participation supports for participants in a Agency shared living arrangement
• article Develop a social and community participation budget for participants in a shared living arrangement Insurance
• article Understand social and community participation supports for a participant in a

shared living arrangement – Case examples.

You have also referred to the NDIS Pricing Arrangements and Price Limits (external).

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 the make sure you include the appropriate support category.

Self-care

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

• 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 support category Assistance with Daily Life.

Community access

Community access supports provide assistance with participation in community, social and the civic activities.

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

To include supports for community access, you’ll need to use support category Assistance with Social, Economic and Community Participation. For a participant in a shared livingarrangement, go to article Develop a social and community participation budget for participants document in a shared living arrangement. To learn more, go to article Support Categories.

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Understand when to include high intensity support

AgencyA participant may need high intensity support if they need 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: skills descriptors (external).

Insurance

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 to include standard or high intensity supports using OurGuideline – Reasonable and necessary supports (external). Information from the participant, his providers, functional assessments, therapy reports, behaviour reports and medical information may help to understand if the participant has higher intensity support needs.

You must use the PCST for all new plans and plan reassessments and attach to the participant record. Include standard and high intensity support using article Understand and update the plan conversation support tool.

Standard support

Participants without high intensity support needs would generally need a support worker with standard skills.

High intensity support

Participants with high intensity support needs will generally need a mix of support workers with standard skills and high intensity skills to have their support needs met.For example, the participant may need a mixture of standard and high intensity support if they only need a support worker with high intensity skills for certain times of the day. Such as supporting with their disability related health supports (DRHS) at a certain time of the day.

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 worker is needed.For more information about standard and high intensity supports, go to the NDIS pricing arrangements and price limits (external).

Registered nurse (RN) delegation of care

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

Knowledge Article

For Internal Use Only 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 Agency who has the high intensity support skills needed. The number of hours will depend on the tasks they need to complete. When determining the number of hours to fund for DRHS, information from the following sources will help you to make sure the support meets OurGuideline – Reasonable and necessary supports (external):

• the participant
• their providers
• functional assessments
• therapy reports • behaviour reports
• medical information. The Go to Our Guideline – Disability-related health supports (external) and article Determine disability-related health supports and meal preparation supports for more information. Plan Changes Act Only complete a plan change 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:
• understand 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. Implementation Encourage the participant to discuss with their providers how the delivery of their supports canbe improved to create the most efficient use of their plan. Providers are encouraged to help the released participant to arrange their supports within the available plan budget to deliver efficient service wasand value. This includes where a support worker with high intensity skills may be appropriate for some supports. The participant’s my NDIS contact, or support coordinator, supports the participant toimplement the plan and develop their service agreements. This document is uncontrolled when printed OFFICIAL Page 907 of 910

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Providers

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

Insurance Service bookings and claims will be subject to audit. Providers may need to provide proof that the staff member who delivered a support was subject to the high intensity price control and have the relevant skills or experience.

Disability 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.

National Understand when to include intensive and complex behaviour support by

A participant may need intensive and complex behaviour support if they:

• display frequent behaviours of concern that has a significant effect on their or others wellbeing and safety
• need intensive support and frequent daily implementation of intensive proactive strategies, skill development, and response strategies. This may include the use of restrictive practices to reduce the risk of harm to themselves or others
• may or are likely to, experience other issues that further exacerbate or increase the complexity of their behaviour support needs.

Freedom Learn more about behaviour support in article Understand behaviour support.

Develop a plan with intensive and complex behaviour support You’ll need to make a decision to include intensive and complex behaviour support using Our under Guideline – Reasonable and necessary supports (external). Information from the participant, his providers, functional assessments, therapy reports, behaviour reports and medical information may help to understand if the participant needs intensive and complex behaviour support.

Intensive and complex behaviour support can be included and claimed as part of:

• assistance with daily life
• assistance with social, economic and community participation
• Supported Independent Living (SIL).

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For Internal Use Only You must use the PCST for all new plans and plan reassessments and attach to the participant record. Include intensive and complex behaviour support using article Understand Agency and update the plan conversation support tool.

Who can provide intensive and complex behaviour supportTo provide intensive and complex behaviour support to a participant, a provider must:

• be implementing behaviour support with the participant and in accordance with their interim or comprehensive behaviour support plan, and

• be registered with the NDIS Quality and Safeguards Commission and assessed for Module 2A (Implementing Behaviour Support Plans), or • have submitted a registration amendment application or new registration application to the NDIS Quality and Safegards Commission. This includes a completed audit assessment against Module 2A by 30 June 2025. Learn about the responsibilities and registration requirements for providers in fact sheetBehaviour support and restrictive practices (external). Note: Plan managers should only approve claims for implementing intensive and complex behaviour supports from registered NDIS providers who meet these requirements. Next steps

1. Use the plan conversation support tool (PCST) to include self-care and community access supports. Go to article Understand and update the plan conversation support tool. You can use the PCST when completing a budget update but you must use the PCST for all new plans and plan reassessments. Article labels PACE user role names Add:dc_users_plannernonpartneredarea released dc_users_technicaladvisors was dc_users_reviewofficer dc_users_nationalreassessmentdelegate documentdc_users_localareacoordinator This V7.0 2024-09-30Understand self-care and community access supports 192248066 Page 6 of 7 This document is uncontrolled when printed OFFICIAL Page 909 of 910

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For Internal Use Only dc_users_homeandlivingdelegate dc_users_externalreviewofficer Agency dc_users_earlychildhoodpartner

Topics Insurance No change. Case names Disability No change. ownership National No change. the by Version control 1982 Amended Version Brief Description of Change Status Date Act by Update to align with new support items added to the Pricing Arrangements and Price Limits (PAPL). This includes new items for intensive and complex behaviours to allow providers to claim for supporting participants with behaviours of concern at a rate that is equivalent to the High Intensity Supports price limits and the associated criteria.

6.1 MGC723 DRAFT 2024-09-26 Information Freedom under released 6.2 UFEX8 Peer review DRAFT 2024-09-26 6.3 MGC723 Action peer review DRAFT 2024-09-26 document 6.4 AT0022 EL 2 review DRAFT 2024-09-27 was 6.5 MGC723 Transfer BIL feedback DRAFT 2024-09-30 7.0 JC0088 Class 2 Approved APPROVED 2024-09-30 V7.0 2024-09-30Understand self-care and community access supports 192248066 Page 7 of 7 This document is uncontrolled when printed OFFICIAL Page 910 of 910