Practice Guide – Assistance Animals | External submission

Practice Guide – Assistance

Animals

Guidance for Planners, LAC’s and Delegates

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Practice Guide – Assistance Animals ………………………………………………………………………….. 1 Introduction …………………………………………………………………………………………………………… 3 Current position of the National Disability Insurance Agency…………………………………….. 3 Aims and Outcomes ………………………………………………………………………………………………. 4 Work instructions …………………………………………………………………………………………………… 5

The Assistance Animal Assessment Framework …………………………………………………….. 5

Who is responsible for the coordination and Implementation of the Exploring Assistance Animals Tasks? …………………………………………………………………………………………………. 6 Funded Supports which may be required ………………………………………………………………. 6 Workflow ………………………………………………………………………………………………………………. 7 Appendix 1 - Assistance Animal Tasks……………………………………………………………………. 14 Supporting material ……………………………………………………………………………………………… 19 Feedback ……………………………………………………………………………………………………………. 19 Version change control …………………………………………………………………………………………. 19

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Introduction

The purpose of this Practice Guide is to inform plan developers (planners, LACs) and/or Delegates of the process to be followed when determining the suitability of a participant to be provided with funding for an Assistance Animal. This includes the completion of various assessment tasks which are required to inform the reasonable and necessary (R&N) decision making process. Assistance Animals (dog guides) have assisted people with severe vision impairment to successfully navigate through their communities for decades. More recently, Assistance Animals have been used by people to manage a range of other types of needs, such as mobility impairments or general support in the home. When considering R&N supports to include in a participant’s plan, the National Disability Insurance Agency (NDIA) is required to determine if “the support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice” (NDIS Act 2013, s34.1 (d)). In March 2016 the NDIA commissioned La Trobe University to review the evidence for the effectiveness of Assistance Animals. Guide dogs for people with vision impairment were not included as part of this review as long standing evidence of their effectiveness is readily available. The review of the literature found that all studies to date were on dogs, and in most cases Assistance Animals have a positive effect on wellbeing and provide their owners with companionship and emotional support. Other benefits noted were greater independence, quality of life, self-esteem, and community participation. Interviews with users of Assistance Animals confirmed the findings of the literature with benefits stated to include companionship and assistance with specific impairment related tasks. Users also described a range of economic benefits associated with participation in education, employment and a reduced need of medical or personal care. There were also found to be disadvantages to owning an Assistance Animal, including the demands of caring for a living creature, and any undesirable behaviours in the animal that undermine the working arrangement between animal and handler/family. Current position of the National Disability Insurance Agency The provision of R&N funding for an Assistance Animal needs to be in the context of:

a) Dog guides for people with vision impairment are deemed to have long standing evidence of effectiveness.

c) Use of an Assistance Animal to restrain a person, whether for behavioural or other reasons, is not considered a R&N support and further, outside of an approved behavioural support plan, would be considered ‘likely to cause harm to the participant’ based on the NDIS Rules, irrespective of the state/territory exemptions for Assistance Animals.

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Assistance Animal

maintenance costs (including food, grooming, flea and worm treatments, medication, vaccinations and veterinary costs).

Aims and Outcomes

Aim

Outcome

Improved understanding of those supports generally funded by the NDIS and those which are more appropriately funded by other parties.

e More consistent decision making in relation to inclusion of funded supports for Assistance Animals in plans across NDIA regions.

Improve participant satisfaction with their overall quality of life, the NDIA and service provision.

e Participants are supported to address immediate unmet needs through building the capacity of informal networks, mainstream, community and funded supports.

e Improved outcomes for participants.

Evidence based best practice models

e Ensuring supports are evidence based, effective and beneficial having regard to current best practice for Assistance Animals.

Awareness of strategies to increased market growth to provide further opportunities for a range of providers to enter the market.

e Market stimulation — identification of market gaps, market success and failures.

e Increased competition and availability of service providers — improved value for money.

Support the Scheme’s financial sustainability.

e Supports are related to the participant’s disability and represent value for money - Scheme liability.

e Cost containment/reduction in plans — return on Scheme investment.

Identification and data capture of service delivery gaps.

e Improved data capture to improve service delivery and promote innovation across the network.

Risk mitigation strategies.

e Development of service delivery models that are not likely to cause harm to the participant or others.

e Enhancement of positive risk — identification of capacity building supports to facilitate increased independence, social and economic participation.

Building positive relationships with providers

e Identification of ‘best fit’ providers to match individual participant needs and assist the participant to pursue goals and objectives in their plan.

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Work instructions

The Assistance Animal Assessment Framework

The Assistance Animal Assessment Framework is made up of a number of tasks which allows Delegates to determine the suitability of a participant to be provided with funding for an Assistance Animal based on subjective and objective evidence. The framework consists of 5 essential tasks: Task 1 – Allied Health Professionals report Provision of information by the Allied Health Professional recommending the Assistance Animal including confirmation from a Medical Practitioner that the participant and the informal supports living in the property with the Assistance Animal are not allergic or at risk of health impacts due to the Assistance Animal. Task 2 – Participant and/or their informal supports report Provision of information from the participant and their informal supports about their capacity to manage, and care for, an Assistance Animal in their lives including how they will support the welfare of the Assistance Animal, their expectations of it, any previous experience with an Assistance Animal or companion animal including outcomes of those experiences and how they expect it will reduce the functional impairments due to the participant’s disability. Task 3 – Suitability assessment from a registered Assistance Animal training organisation Independent assessment of a participant’s suitability to receive an Assistance Animal from a registered Assistance Animal provider. This includes an assessment of the person responsible for the Assistance Animal should this not be the participant eg.in the case of a young child.

Task 4 – Regional Site/ NDIA Delegate Guidance

Guidance for Delegates making the R&N decision. Task 5 – Review by the Technical Advisory Team Consultation with the Technical Advisory Team (TAT) for specific cases including provision of an Assistance Animal where there are behaviours of concern.

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Who is responsible for the coordination and Implementation of the Exploring Assistance Animals Tasks?

To determine the suitability of a participant to be provided with funding for an Assistance Animal, the following people may be involved with the coordination and implementation:

e The participant and/or their informal support network — where participants or their informal

supports have the capacity to and indicate a desire to coordinate any or all of tasks 1- 3

assistance from a Support Coordinator or LAC may not be required to assist with the

tasks associated with exploring the suitability of funding an Assistance Animal.

e Local Area Coordinators (LACs) — where the participant is supported by an LAC, the LAC

may provide assistance with the coordination and implementation of one or more of the

tasks.

e Support Coordinators — where the participant receives funding for a Support Coordinator,

the Support Coordinator may provide assistance with the coordination and

implementation of one or more of the tasks.

Funded Supports which may be required

Funding for individual assessments and Support Coordination may be required when determining a participant’s suitability for an Assistance Animal including ongoing costs (see

below). Funding will be informed by the \AiMOAR IARI iii ISGEES and applied R&N

decision making.

Support Type

Description

Coordination of Supports

(07_002_0106 8 3)

To assist the participant with the coordination and collation of required supporting documentation/evidence as described in Task 1 — Allied Health Professionals Report, Task 2 — Participant and/or their informal supports Report and Task 3 — Suitability assessment from a registered Assistance Animal training organisation, to be submitted to the regional site/Delegate for funding consideration.

Individual assessment, therapy and/or training (includes assistive technology)

(15.048 0128 1 3)

Allied Health Professionals assessment and provision of a report providing justification for the Assistance Animal and information about the participant and their informal supports capacity to manage the Assistance Animal, as described in the requirements of Task 1 — Allied Health Professionals Report.

Assistance dog (including guide dog)

(05_ 900101023 0130 1 2)

Costs for supply of an approved Assistance Animal (including dog guide) includes the supply, matching, dog/participant training and initial equipment.

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Support Type Description

Assistance dog (including Ongoing costs of for an approved Assistance guide dog) ongoing costs Animal should be provided to reflect the higher costs of

(01. 509001024 0130 1.1) an Assistance Animal over those of an equivalent

companion animal/pet (including food, grooming, flea and worm treatments, medication, vaccinations, and veterinary costs).

Workflow

This workflow is to be implemented in each NDIA region for all Plans:

Where the participant identifies a goal related to their need for an Assistance Animal you must include this in their NDIS plan.

. In circumstances where the participant has autism, an Intellectual Disability (ID),

challenging behaviours or a difficult social situation for e.g. shared custody, shared care etc., you are required to submit the request for an Assistance Animal to the TAT for advice in the first instance.

When developing the participant’s plan, ensure there is sufficient funding for completion of required individual assessments and Support Coordination where

applicable. Funding for these supports will be included as part of the [iil and

applied R&N decision making principles.

. The participant, LAC or Support Coordinator are required to complete the ‘Supporting

Evidence for Assistance Animals’ document. Refer to Task 1 — Allied Health

Professionals Report, Task 2 — Participant and/or their informal supports Report

and Task 3 — Suitability assessment from a registered Assistance Animal training organisation for reporting requirements when completing the Assistance Animal

tasks.

Once the Exploring Assistance Animals tasks have been completed and collated by the either the participant, LAC or Support Coordinator, this documentation is forwarded to the regional site/ Delegate for R&N funding consideration.

The regional site/ Delegate completes Task 4 — Regional Site/ NDIA Delegate

Guidance

The regional site/ Delegate submits ALL supporting documentation from tasks 1-4 to

the TAT for R&N decision making advice.

The regional site/ Delegate completes the TAT Pe for R&N decision making advice.

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Where the TAT advise funding for Assistance Animal supply is R&N, the regional site/ Delegate includes funding for an Assistance Animal supply (‘capital’ budget) and maintenance costs (‘consumables’ budget) to the participant’s plan, and proceeds with the plan approval process. Refer to s47E(d) - certain operations of agencies to include supports within a participant’s plan. NOTE: Funding for the supply of an Assistance Animal must be stated as an Agency managed support. s47E(d) - certain operations of agencies

NOTE: Funding for Assistance Animal maintenance costs may be included as a self managed support, in recognition of providers for these supports (e.g. dog food and vets) not being registered with the NDIA.

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Task 1 – Allied Health Professionals Report

A report from the recommending Allied Health Professionals providing justification for the Assistance Animal and information about the participant and their informal supports’ capacity to manage the Assistance Animal including:

Functional limitations of the participant to be mitigated by the Assistance Animal including the expected impact upon the current and future support needs of the participant
Other options which have been considered as alternatives to an Assistance Animal including Assistive Technology (AT), capacity building, linkages with community supports and increased social participation
Details of any behavioural issues which may impact on, or potentially cause harm to, the Assistance Animal and how these will be managed
How the outcomes of provision of an Assistance Animal will exceed those reasonably expected from the presence of a companion animal
How the provision of an Assistance Animal will impact on the need for informal or funded supports and how these will reduce the participant’s need for this direct care
Who the responsible person/people will be both at home and in other environments including the community, school, work etc.
Who will take legal responsibility if something happens involving the Assistance Animal
Welfare of the Assistance Animal including feeding, exercise etc.
Expectation of the impact of the Assistance Animal
Minimum of 3 tasks which are measurable and related to the participant’s goals that the Assistance Animal is intended to perform to mitigate the participant’s disability. Refer to Appendix 1 - Assistance Animal Tasks.
If the Assistance Animal is intended for use with a child with Autism Spectrum Disorder (ASD), how this is part of an behavioural support plan
Evidence of outcomes of a trial with an Assistance Animal or relevant contact with another animal.

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Task 2 – Participant and/or their informal supports Report A report from the participant and/or their informal supports providing the following details:

Previous experience with animals, in particular an Assistance Animal
Details of any animals currently in the home (including the breed) and expectation of how the Assistance Animal will interact with these
Welfare issues including accommodation, property fencing, etc.
Who the responsible person/people will be at both home and in other environments including the community, school, work etc.
Details of who will take legal responsibility if something happens involving the Assistance

Animal

The participant or the responsible person/s expectations in regards to their role including impact on their time, work and family commitments, ongoing training needs and support to care for the Assistance Animal
The participant or the responsible person/s expectation of the impact of the Assistance Animal on the participant and the household
Details of any behavioural issues the participant displays which may impact on the Assistance Animal and how these will be managed
The tasks (minimum of 3) the Assistance Animal is intended to perform to mitigate the participant’s functional limitations. Refer to Appendix 1 - Assistance Animal Tasks.
How the provision of an Assistance Animal is expected to impact on the participant’s current need for informal or funded supports and how these will reduce the participant’s need for this direct care
Other options which have been considered as an alternative to an Assistance Animal
Evidence of outcomes of a trial with an Assistance Animal or relevant contact with another animal

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Task 3 – Suitability assessment from a registered Assistance Animal training organisation Evidence of completion of an assessment for suitability of an Assistance Animal with a registered Assistance Animal training organisation. Registered Assistance Animal training organisations have rigorous assessment processes (usually aligned to international Assistance Animal standards) to determine the suitability of the recipient of an Assistance Animal and the compatibility of them and their lives with an Assistance Animal. These assessments contribute to the reports above, in particular in relation to:

the minimum of 3 disability mitigating tasks the Assistance Animal will perform
the suitability of the participant to provide for the Assistance Animals welfare
the management of the participant’s potential risk behaviours
the anticipated associated supports that the participant may/will require for ongoing care and management of the Assistance Animal.

The assessment process requires the completion of questionnaires, visits to the home, workshops (e.g. Assistance Dogs Australia requires the parents of prospective child clients to attend a series of 3 workshops) and interviews with the provider. The provider will also need to clarify the ownership and replacement processes of the Assistance Animal.

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Task 4 – Regional Site/ NDIA Delegate Guidance

Guidance for regional sites/ Delegates about information provided by participant/informal support to assist with the determination of whether an Assistance Animal is a R&N support:

Proposed benefits of the Assistance Animal, how and whether these are significantly different to those provided by a companion animal. There must be a minimum of 3 tasks (see example list of tasks in Appendix 1) that the Assistance Animal will provide which mitigate the impact of the participant’s functional limitations. Note: independent orientation and mobility guidance (through a dog guide) is deemed to meet this requirement. Note: The benefits of companionship, developing self-esteem and confidence, assisting the owner to develop a routine and accept responsibilities have been shown to be achieved by the provision of a companion animal.
Lived experience of the participant. There must be evidence of specific benefits provided by a past or existing Assistance Animal.
Quantum of supports in the NDIS plan. There must be evidence that the supports in the NDIS plan are insufficient for the participant to achieve their goals without the provision of an Assistance Animal.
Alternative supports. Consider if there are any other alternatives which could facilitate the achievement of the participant’s goals e.g. therapeutic supports or AT.
How the proposed Assistance Animal contributes to the participant’s capacity building and may affect other goals e.g. replacing social contact and thereby reducing a participant’s increased social participation. If the Assistance Animal is intended to be an interim measure to support a goal of independence, other capacity building supports should be considered.
The participant’s behaviour and the relative safety of the Assistance Animal. In most cases where a participant, or any other resident of the property, has any behaviours of concern, an Assistance Animal is unlikely to be appropriate. Note: this is for the safety of the animal and the safety of the participant should the animal react in its own defence.

Special consideration is required for the following:

a. Children

Written confirmation of who the responsible adult is
If family intend the Assistance Animal to attend school, there needs to be written confirmation from the school that an Assistance Animal is approved to attend classes

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Where the Assistance Animal will attend school, confirmation is required as to who is the responsible adult. It is not R&N for NDIS to fund a support worker to supervise the Assistance Animal and the child participant
Must be part of an capacity building program
Confirmation is required that the Assistance Animal is not at risk due to the participant’s behaviours of concern

b. Assistance Animals for participants with participants with ASD

Confirmation that the Assistance Animal will not be used for tethering (unless it has been considered as part of a behavioural support plan).

c. Assistance Animals for participants intending to take them at work

Confirmation that the employer will allow this
Where the Assistance Animal will attend work, confirmation is required as to who is the responsible adult as it is not R&N for NDIS to fund a support worker to supervise the Assistance Animal and the participant Assistance Animals will not be funded as reasonable and necessary by the NDIS where:
there is no expectation, evidence or intent that the Assistance Animal will result in outcomes different to those reasonably expected from a companion animal
the environment is not suitable e.g. appropriate fencing, other family companion animals which may not be safe with a new Assistance Animal
the welfare of the Assistance Animal cannot be assured
it is expected that the Assistance Animal will be tethered to a child and there is no behavioural support plan under the supervision of a behavioural management expert in place to reduce the need for such restrictive practice in the future
there is known risk to the Assistance Animal due to the participant’s or other people’s behaviours of concern
For children under 5 years, where there is no responsible adult to supervise at all times
an Assistance Animal provider has not confirmed the participant’s suitability for an

Assistance Animal

Task 5 – Review by the Technical Advisory Team (TAT) All finalised submissions for Assistance Animals should be reviewed by the TAT for R&N decision making guidance. This involves providing the TAT with supporting documentation and evidence of completion of all 4 essential tasks. To request advice from the TAT, please refer to s47E(d) - certain operations of agencies

It is expected over time that regional advisors will develop their skills in this area and referrals to the central TAT will not be required.

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Appendix 1 - Assistance Animal Tasks

Author: is47F - personal privacy j IAADP

Category Task

Retrieve based tasks

Bring portable phone to any room in house

Bring in groceries - up to ten canvas bags

Unload suitable grocery items from canvas sacks

Fetch a beverage from a refrigerator or cupboard

Fetch food bowi(s)

Pick up dropped items like coins, keys etc., in any location

Bring clothes, shoes, or slippers laid out to assist with dressing

e Unload towels, other items from dryer

e Retrieve purse from hall, desk, dresser or back of van

e Assist to tidy house or yard - pickup, carry, deposit designated items

e Fetch basket with medication and/or beverage from cupboard

e Seek & find teamwork - direct the dog with hand signals, vocal cues to: retrieve an unfamiliar object out of partner’s reach, locate TV remote control, select one of several VCR tapes atop TV cabinet, other surfaces

e Remove VCR tape from machine after eject button pushed

e Use target stick to retrieve an indicated item off shelves in

stores retrieve one pair of shoes from a dozen in closet

Use laser pointer to target an item to be retrieved

Drag Cane from its customary location to another room

Pick up and return cane if falls off back of wheelchair

Pickup or fetch Canadian crutches from customary location

Drag walker back to partner

e Fetch wheelchair when out of reach

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Category Task

Carrying based e Move bucket from one location to another, indoors & outdoors

tasks (non e Lug a basket of items around the house

retrieval) e Transport items downstairs or upstairs to a specific location

e Carry item(s) from the partner to a care-giver or family member in another room

e Send the dog to obtain food or other item from a care-giver and return with it

e Dog carries a prearranged object to care-giver as a signal help is needed

e Carry items following a partner using a walker, other mobility aids

e Pay for purchases at high counters

e Transfer merchandise in bag from a clerk to a wheelchair user’s lap

e Carry mail or newspaper into the house

Deposit based tasks

Put trash, junk mail into a wastebasket or garbage can

Deposit empty soda pop can or plastic bottle into recycling bin

Assist partner to load clothing into top loading washing machine

Dirty food bowl [dog’s] - put into kitchen sink

e Put silverware, non-breakable dishes, plastic glasses in sink

e Deliver items to “closet” [use a floor marker to indicate drop location]

e Deposit dog toys into designated container

e Put prescription bag, mail, other items on counter top

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Category Task

Tug based tasks |e

Open cupboard doors with attached strap

Open drawers via strap

Open refrigerator door with a strap or suction cup device Open interior doors via a strap with device to turn knob Answer doorbell and open front door with strap attached to lever handle

Open or close sliding glass door with a strap or other tug devices

Shut restroom door that opens outward via a leash tied to doorknob

Close stall door that opens outward in restroom by delivering end of the leash to partner

Shut interior home, office doors that open outward

Shut motel room exterior door that opens inward

Assist to remove shoes, slippers, sandals

Tug socks off without biting down on foot

Remove slacks, sweater, coat

Drag heavy coat, other items to closet

Drag laundry basket through house with a strap

Drag bedding to the washing machine

Wrestle duffle bag or other objects from the van into the house Pull a drapery cord to open or close drapes

Assist to close motel room drapes by tugging on edge near bottom of drape, backing up

Operate rope device that lifts blanket and sheet or re-covers disabled person when he or she becomes too hot or cold Alternatively, take edge of a blanket and move backwards, tugging to remove it or assist someone to pull the blanket up to their chin if cold

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Category Task

Nose nudge e Cupboard door or drawers - nudge shut based tasks e Dryer door - hard nudge

e Stove drawer - push it shut

e Dishwasher door - put muzzle under open door, flip to shut

e Refrigerator & freezer door - close with nudge

e Call …{000] on K-9 rescue phone - push the button

e Operate button or push plate on electric commercial doors

e Turn on light switches

e Push floor pedal device to turn on lamp

e Turn on metal based lamps with touch-lamp device installed nudge base

e Assist wheelchair user to regain sitting position if slumped over

e Help put paralysed arm back onto the armrest of wheelchair

e Return paralysed foot to the foot board of a wheelchair if it is dislodged

Pawing based e Cupboard door - shut it with one paw

tasks (some dogs |. Dryer door - shut it with one paw

sero aaa Refrigerator & freezer door - one forepaw or both

Call …{000]on K-9 rescue phone - hit button with one paw Operate light switch on wall - jump up, paw the switch Depress floor pedal device to turn on appliance(s) or lamp Jump up to paw elevator button [steady dog if he tries it on slippery tile floor] e Operate push plate on electric commercial doors e Close heavy front door, other doors - jump up, use both

forepaws

Bracing based e Transfer assistance from wheelchair to bed, toilet, bathtub or

tasks (no van seat - hold Stand Stay position, then brace on command,

harness) enabling partner to keep their balance during transfer

e Assist to walk step by step, brace between each step, from wheelchair to nearby seat

e Position self and brace to help partner catch balance after partner rises from a couch or other seats in a home or public setting

e Prevent fall by bracing on command if the partner needs help recovering balance

e Steady partner getting in or out of the bathtub

e Assist partner to turn over in bed; have appropriate backup plan

e Pull up partner with a strap [tug of war style] from floor to feet on command, then brace till partner catches balance

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Category Task

Harness based e Only appropriate for large sturdy adult dogs with sound joints,

tasks - Mobility proper training)

Assistance e Assist moving wheelchair on flat [partner holds onto harness pull strap] avoiding obstacles

e Work cooperatively with partner to get the wheelchair up a curb cut or mild incline; handler does as much of the work as possible, never asking the dog to attempt an incline unaided

e Haul open heavy door, holding it ajar using six foot lead attached to back of harness, other end of lead attached to door handle or to a suction cup device on a glass door

e Tow ambulatory partner up inclines [harness with rigid handle or pull strap may be used]

e Brace on command to prevent ambulatory partner from stumbling [rigid handle]

e Help ambulatory partner to climb stairs, pulling then bracing on each step [rigid handle or harness with pull strap may be used to assist partner to mount a step or catch balance]

e Pull partner out of aisle seat on plane, then brace until partner catches balance [harness with a rigid handle and a pull strap, or pull strap only]

e Brace, counter balance work too, assisting ambulatory partner to walk; the partner pushes down on the rigid handle as if it were a cane, after giving warning command, when needed

e Help ambulatory partner to walk short distance, brace between each step [rigid handle]

e Transport textbooks, business supplies or other items up to ..-[23kg] in a wagon or collapsible cart, weight limit depends on dog’s size, physical fitness, type of cart, kind of terrain

e Backpacking - customary weight limit is 15% of the dog’s total body weight; 10% if a dog performing another task, such as wheelchair pulling in addition to backpacking; total weight includes harness (average …[1.3-1.8kg].). Load must be evenly distributed to prevent chafing

Other kinds of e Bark for help on command

assistance in e Find the care-giver on command, lead back to location of

aie disabled partner

e Put forepaws in lap of wheelchair user, hold that upright position so wheelchair user can access medication or cell phone or other items in the backpack

e Wake up partner if smoke alarm goes off, assist to nearest exit

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Supporting material

NDIS Act 2013

NDIS Rules 2013, 2014 and 2016

NDIS Operational Guidelines

s47E(d) - certain operations of agencies

Assistance Dog Tasks by Joan Froling Copyrighted April 16, 2001

Feedback

If you have any feedback about this Practice Guide please email

$47E(d) - certain operations of agencies

In your email remember to include the title of the product you are referring to and to describe your suggestion or issue concisely.

Version change control

Version | Amended | Brief Description of Change: Status Date

No by

0.01 Creation of Practice Guidance — DRAFT 2017-04-04

Assistance Animals

0.02 Reviewed and feedback provided. DRAFT 2017-04-29

0.03 Reviewed and updated DRAFT 2017-09-01

Confirmed line items with i@ and reviewed flow of document

0.04 Class 2 Approval with minor DRAFT 2017-09-03 amendments — to be sent for Class 1 approval.

1.00 Class 1 approval with minor APPROVED | 2017-09-05

amendments to be actioned

1.02 Amendments made based on DRAFT 2017-09-11 feedback

2.00 Class 3 approval on changes APPROVED | 2017-09-12

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Practice Guide – Assistance

Animals

Guidance for Planners, LACs and Delegates Not to be used for Vision Assistance Dogs (Dog Guides)

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Introduction …………………………………………………………………………………………………………… 3 Current position of the National Disability Insurance Agency…………………………………….. 3 The Assistance Animal Assessment Framework ………………………………………………………… 4 Task 1 – Allied Health Professionals report ……………………………………………………………. 4 Task 2 – Participant and/or their informal supports report ………………………………………… 4 Task 3 – Suitability assessment from a registered Assistance Animal training organisation ………………………………………………………………………………………………………. 4 Task 4 – Regional Site/ NDIA Delegate Guidance …………………………………………………… 4 Task 5 – Review by the Technical Advisory Team ………………………………………………….. 4 Coordination and implementation of the Exploring Assistance Animals Tasks? …………… 5 Funded Supports which may be required ………………………………………………………………. 5 Workflow – Assistance Animals ……………………………………………………………………………….. 6 Plan Management ………………………………………………………………………………………………. 6 Purchase of Assistance Animal prior to NDIS approval ……………………………………………. 7 Exploring Assistance Animals Tasks ………………………………………………………………………… 7 Task 1 – Allied Health Professionals Report …………………………………………………………… 7 Task 2 – Participant and/or their informal supports Report ……………………………………….. 8 Task 3 – Suitability assessment from a registered Assistance Animal training organisation ………………………………………………………………………………………………………. 9 Task 4 – Regional Site/ NDIA Delegate Guidance …………………………………………………. 10 Task 5 – Review by the Technical Advisory Team (TAT) ……………………………………….. 11 Appendix 1 - Assistance Animal Tasks……………………………………………………………………. 12 Supporting material ……………………………………………………………………………………………… 16 Feedback ……………………………………………………………………………………………………………. 16 Version change control …………………………………………………………………………………………. 16

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Introduction

The purpose of this Practice Guide is to inform planners, Local Area Coordinators, Early Childhood Early Intervention Partners (collectively called plan developers) and/or Delegates of the process to be followed when determining the suitability of a participant to be provided with funding for an Assistance Animal. This includes the completion of various assessment tasks which are required to inform the reasonable and necessary decision making process. This guidance is not to be used for Vision Assistance Dogs (Dog Guides). In March 2016, the NDIA commissioned La Trobe University to review the evidence for the effectiveness of Assistance Animals. Dog guides for people with vision impairment were not included as part of this review as long standing evidence of their effectiveness is readily available. The research found that all studies to date were on dogs, and in most cases Assistance Animals had a positive effect on wellbeing and provided their owners with companionship and emotional support. Other benefits noted were greater independence, quality of life, self-esteem, and social participation including community, education and employment. It was also found that owning an Assistance Animal had disadvantages, including the demands of caring for a living creature, and any undesirable behaviours in the animal that undermine the working arrangement between animal and handler/family. Assistance Animals are used by people to manage a range of support needs due to for example: mobility impairments, epilepsy, to support the management of behaviours of concern (BoC) as well as for general support in the home. When considering reasonable and necessary supports to include in a participant’s plan, the National Disability Insurance Agency (NDIA) is required to determine if “the support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice” (NDIS Act 2013, s34.1 (d)). Current position of the National Disability Insurance Agency The provision of reasonable and necessary funding for an Assistance Animal needs to be in the context of:

a) Dog guides for people with vision impairment are deemed to have long standing evidence of effectiveness.

b) Other Assistance Animals need to be considered based on the lived experience, goals and identified benefits for each individual participant, over and above the benefits of having a companion animal or pet. Considerations need to include previous use of a trained Assistance Animal and prior experience with alternatives. The funding of assistance animals for the management of a health condition (e.g. diabetes) does not meet the reasonable and necessary criteria as this support is not related to the participant’s disability, rather it is related to a health condition (NDIS Rules 2013 Part 5.21 (b) – General Criteria for supports, and supports that will be funded or provided).

c) Use of an Assistance Animal to restrain a person, whether for behavioural or other reasons, is not generally considered a reasonable and necessary support and outside of an approved behavioural support plan, would be considered ‘likely to cause harm to the participant based on the NDIS Rules.

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d) Maintenance costs for an approved Assistance Animal should be funded to reflect the higher costs of an Assistance Animal over those of an equivalent companion animal/pet. s47E(d) - certain operations of agencies Assistance Animal maintenance costs (including food, grooming, flea and worm treatments, medication, vaccinations and veterinary costs).

The Assistance Animal Assessment Framework

The Assistance Animal Assessment Framework is made up of a number of tasks which allows Delegates to determine the suitability of a participant to be provided with funding for an Assistance Animal based on subjective and objective evidence. The framework consists of five Exploring Assistance Animals Tasks: Task 1 – Allied Health Professionals report Provision of information by the Allied Health Professional recommending the Assistance Animal including confirmation from a Medical Practitioner that the participant and the informal supports living in the property with the Assistance Animal are not allergic or at risk of health impacts due to the Assistance Animal. Task 2 – Participant and/or their informal supports report Provision of information from the participant and their informal supports about their capacity to manage, and care for an Assistance Animal in their lives. The report needs to include how they will support the welfare of the Assistance Animal, their expectations of it, and any previous experience with an Assistance Animal or companion animal. Previous experience may include the outcomes of those experiences and how they expect it will reduce the functional impairments due to the participant’s disability. Task 3 – Suitability assessment from a registered Assistance Animal training organisation Independent assessment of a participant’s suitability to receive an Assistance Animal from a registered Assistance Animal provider. This includes an assessment of the person responsible for the Assistance Animal should this not be the participant e.g.in the case of a young child.

Task 4 – Regional Site/ NDIA Delegate Guidance

Guidance for Delegates making the reasonable and necessary decision. Task 5 – Review by the Technical Advisory Team Consultation with the Technical Advisory Team (TAT) is mandatory for all requests related to Assistance Animals.

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Coordination and implementation of the Exploring Assistance Animals

Tasks?

To determine the suitability of a participant to be provided with funding for an Assistance Animal, the following people may be involved with the coordination and implementation:

e The participant and/or their informal support network — where participants or their

informal supports have the capacity and indicate a desire to coordinate any or all of tasks

1- 3, a Support Coordinator or LAC may not be required to assist with the tasks

associated with exploring the suitability of funding an Assistance Animal.

e Local Area Coordinators (LACs) — where the participant is supported by an LAC, the

LAC may provide assistance with the coordination and implementation of one or more of

the tasks.

e Support Coordinators — where the participant receives funding for a Support

Coordinator, the Support Coordinator may provide assistance with the coordination and

implementation of one or more of the tasks.

Funded Supports which may be required

Funding for individual assessments and Support Coordination may be required when determining a participant’s suitability for an Assistance Animal (see below). Funding will be

informed by the jgeebplGl Re SRS TSS ETS and reasonable and necessary decision

making.

Support Type

Description

Support Coordination

(07_002_0106_8 3)

Individual assessment, therapy and/or training (includes assistive technology)

(15.048 0128 1 3)

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Workflow – Assistance Animals

This workflow is to be implemented for all plans where the participant has requested funding for an Assistance Animal. You are required to submit an advice request to the TAT and receive their response before including any line items relating to the requested Assistance Animal (other than those in the table above) in a participant’s NDIS plan. Note: this guidance does not apply to participant requests for Vision Assistance Dogs (Dog Guides).

Where the participant identifies a goal related to their need for an Assistance Animal you must include this goal in their NDIS plan.
When developing the participant’s plan, ensure there is sufficient funding for completion of the required individual assessments and Support Coordination (where applicable). Funding for these supports will be included as part of the s47E(d) - certain operations of agencies using reasonable and necessary decision making principles. The plan can be approved pending further information being received in relation to the request for an Assistance Animal.
After the plan is approved, the participant, plan developer or Support Coordinator are required to arrange the completion of the five Exploring Assistance Animals Tasks. They will then return all supporting information to the regional site/ Delegate for reasonable and necessary funding consideration. Task 1 – Allied Health Professionals Report, Task 2 – Participant and/or their informal supports Report and Task 3 – Suitability assessment from a registered Assistance Animal training organisation.
The regional site/ Delegate completes Task 4 – Regional Site/ NDIA Delegate Guidance
The regional site/ Delegate submits ALL supporting documentation from tasks 1-4 to the s47E(d) - cer for reasonable and necessary decision making advice.
Where the TAT advises that funding for the supply of an Assistance Animal is reasonable and necessary, the advice will include details of the line items and amount of funding to include in the plan. Refer to s47E(d) - certain operations of agenci and s47E(d) - certain operations of agencies for information on how to add funding to the plan.

Plan Management

In most cases, funding related to the supply of an Assistance Animal will be agency managed due to the risks related to the supply of an Assistance Animal by an unregistered provider. If a participant requests to self-manage their Assistance Animal and you do not identify any risks related to this method of plan management, please refer to the TAT for further advice and guidance. Funding for maintenance costs related to an Assistance Animal approved by TAT, may be included as a self-managed support, as providers of these supports (e.g. pet food and vets) may not be NDIS registered providers. Practice Guide – Assistance AnPagemals v3.0025APPROVEDof 35 2018-06-25 Page 6 of 16

Purchase of Assistance Animal prior to NDIS approval Where the participant has progressed purchase and/or training of an Assistance Animal prior to NDIS approval, supporting evidence as per the Exploring Assistance Animals Tasks below will need to be submitted to TAT for advice.

Exploring Assistance Animals Tasks

Task 1 – Allied Health Professionals Report

A report from an Allied Health Professional providing justification for the Assistance Animal and information about the participant and informal supports’ capacity to manage the Assistance Animal including:

Functional limitations of the participant to be mitigated by the Assistance Animal including the expected impact upon the current and future support needs of the participant
Other options which have been considered as alternatives to an Assistance Animal including Assistive Technology (AT), capacity building, linkages with community supports and increased social participation
Details of any behavioural issues which may impact on, or potentially cause harm to, the Assistance Animal and how these will be managed
How the outcomes of the provision of an Assistance Animal will exceed those reasonably expected from the presence of a companion animal
How the provision of an Assistance Animal will impact on the need for informal or funded supports and how these will reduce the participant’s need for this direct care
Who the responsible person/people will be, both at home, and in other environments including the community, school, work etc.
Who will take legal responsibility if something happens involving the Assistance Animal
Welfare of the Assistance Animal including feeding, exercise etc.
Expectation of the impact of the Assistance Animal
Minimum of 3 tasks which are measurable and related to the participant’s goals that the Assistance Animal is intended to perform to reduce the functional impact of the participant’s disability. Refer to Appendix 1 - Assistance Animal Tasks.
If the Assistance Animal is intended for use with a child with Autism Spectrum Disorder (ASD), how this forms part of a behavioural support plan
Evidence of outcomes of a trial with an Assistance Animal or relevant contact with another animal.

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Task 2 – Participant and/or their informal supports Report A report from the participant and/or their informal supports providing the following details:

Previous experience with animals, in particular an Assistance Animal
Details of any animals currently in the home (including the breed) and expectation of how the Assistance Animal will interact with these
Welfare issues including accommodation, property fencing, etc.
Who the responsible person/people will be, both at home, and in other environments including the community, school, work etc.
Details of who will take legal responsibility if something happens involving the Assistance

Animal

The participant or the responsible person/s expectations regarding their role, including impact on their time, work and family commitments, ongoing training needs and support to care for the Assistance Animal
The participant or the responsible person/s expectation of the impact of the Assistance Animal on the participant and the household
Details of any behavioural issues the participant displays which may impact on the Assistance Animal and how these will be managed
The tasks (minimum of 3) the Assistance Animal is intended to perform to reduce the participant’s functional limitations. Refer to Appendix 1 - Assistance Animal Tasks.
How the provision of an Assistance Animal is expected to impact the participant’s current need for informal or funded supports and how these will reduce the participant’s need for this direct care
Other options which have been considered as an alternative to an Assistance Animal
Evidence of outcomes of a trial with an Assistance Animal or relevant contact with another animal.

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the minimum of 3 disability mitigating tasks the Assistance Animal will perform
the suitability of the participant to provide for the Assistance Animals welfare
the management of the participant’s potential risk behaviours
the anticipated associated supports that the participant may/will require for ongoing care and management of the Assistance Animal.

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Task 4 – Regional Site/ NDIA Delegate Guidance

Guidance for regional sites/ Delegates regarding considerations to assist with the determination of whether an Assistance Animal is a reasonable and necessary support:

Proposed benefits of the Assistance Animal, how and whether these are significantly different to those provided by a companion animal. There must be a minimum of 3 tasks (see example list of tasks in Appendix 1) that the Assistance Animal will provide which mitigate the impact of the participant’s functional limitations. Note: The benefits of companionship, developing self-esteem and confidence, assisting the owner to develop a routine and accept responsibilities have been shown to be achieved by the provision of a companion animal.
Does the participant have (or previously had) an Assistance Animal, if so provide details of the specific benefits the Assistance Animal provided.
Mainstream, informal and NDIS funded supports must be insufficient for the participant to achieve the goals identified in their NDIS plan without the provision of an Assistance Animal. Evidence to support this needs to be provided.
Alternative supports. Consider if there are any other alternatives which could facilitate the achievement of the participant’s goals, e.g. therapeutic supports or AT.
Consider how the proposed Assistance Animal contributes to the participant’s capacity building and may affect other goals, e.g. replacing social contact and thereby reducing a participant’s increased social participation. If the Assistance Animal is intended to be an interim measure to support a goal of independence, other capacity building supports should be considered.
The participant’s behaviour and the relative safety of the Assistance Animal. In most cases where a participant, or any other resident of the property, has any behaviours of concern, an Assistance Animal is unlikely to be appropriate. Note: this is for the safety of the animal and the safety of the participant should the animal react in its own defence.

Special consideration is required for the following:

a. Children

Written confirmation of who the responsible adult is
If family intend the Assistance Animal to attend school, there needs to be written confirmation from the school that an Assistance Animal is approved to attend classes
Where the Assistance Animal will attend school, confirmation is required as to who is the responsible adult. It is not reasonable and necessary for NDIS to fund a support worker to supervise the Assistance Animal and the child participant
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Confirmation is required that the Assistance Animal is not at risk due to the participant’s behaviours of concern

b. Restrictive Practice

Confirmation that the Assistance Animal will not be used for tethering i.e. restricting a participant’s movement, (unless it has been considered as part of a current behavioural support plan and a copy is attached to the participant’s record).

c. Assistance Animals for participants intending to take them to work

Confirmation that the employer will allow this
Where the Assistance Animal will attend work, confirmation is required as to who is the responsible adult, as it is not reasonable and necessary for NDIS to fund a support worker to supervise the Assistance Animal and the participant Assistance Animals will not be funded as reasonable and necessary by the NDIS where:
there is no expectation, evidence or intent that the Assistance Animal will result in outcomes different to those reasonably expected from a companion animal
the environment is not suitable, e.g. inappropriate fencing, other family companion animals which may not be safe with a new Assistance Animal
the welfare of the Assistance Animal cannot be assured
it is expected that the Assistance Animal will be tethered to a child and there is no behavioural support plan under the supervision of a behavioural management expert in place to reduce the need for restrictive practices in the future
there is known risk to the Assistance Animal due to the participant’s, or other people’s behaviours of concern
for children under 5 years, where there is no responsible adult to supervise at all times
an Assistance Animal provider has not confirmed the participant’s suitability for an

Assistance Animal

Task 5 – Review by the Technical Advisory Team (TAT) All finalised submissions for Assistance Animals should be reviewed by the TAT for reasonably and necessary decision making guidance. This involves providing the TAT with supporting documentation and evidence of completion of all 4 essential tasks. To request advice from the TAT, please refer tos47E(d) - certain operations of agencies

It is expected over time that regional advisors will develop their skills in this area and referrals to the central TAT will not be required.

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Appendix 1 - Assistance Animal Tasks

Note: do not apply for vision assistance Dog Guides Author: s47F - personal privacy IAADP

Category Task

Retrieve based e Bring portable phone to any room in house tasks e Bring in groceries - up to ten canvas bags

e Unload suitable grocery items from canvas sacks

e Fetch a beverage from a refrigerator or cupboard

e Fetch food bowl(s)

e Pick up dropped items like coins, keys etc., in any location

e Bring clothes, shoes, or slippers laid out to assist with dressing

e Unload towels, other items from dryer

e Retrieve purse from hall, desk, dresser or back of van

e Assist to tidy house or yard - pickup, carry, deposit designated items

e Fetch basket with medication and/or beverage from cupboard

e Remove VCR tape from machine after eject button pushed

e Use target stick to retrieve an indicated item off shelves in stores

e Retrieve one pair of shoes from a dozen in closet

e Use laser pointer to target an item to be retrieved

e Drag Cane from its customary location to another room

e Pick up and return cane if falls off back of wheelchair

e Pickup or fetch Canadian crutches from customary location

e Drag walker back to partner

e Fetch wheelchair when out of reach

Carrying based e Move bucket from one location to another, indoors & outdoors tasks (non- e Lug a basket of items around the house retrieval) e Transport items downstairs or upstairs to a specific location e Carry item(s) from the partner to a care-giver or family member in another room e Send the dog to obtain food or other item from a care-giver and return with it e Dog carries a prearranged object to care-giver as a signal help is needed

e Carry items following a partner using a walker, other mobility aids

e Pay for purchases at high counters

e Transfer merchandise in bag from a clerk to a wheelchair user’s lap e Carry mail or newspaper into the house

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Category Task

Deposit based ° tasks ‘i

Put trash, junk mail into a wastebasket or garbage can

Deposit empty soda pop can or plastic bottle into recycling bin Assist partner to load clothing into top loading washing machine Dirty food bowl [dog’s] - put into kitchen sink

Put silverware, non-breakable dishes, plastic glasses in sink

Deliver items to “closet” [use a floor marker to indicate drop location] Deposit dog toys into designated container

Put prescription bag, mail, other items on counter top

Tug based tasks °

Open cupboard doors with attached strap

Open drawers via strap

Open refrigerator door with a strap or suction cup device

Open interior doors via a strap with device to turn knob

Answer doorbell and open front door with strap attached to lever handle

Open or close sliding glass door with a strap or other tug devices Shut restroom door that opens outward via a leash tied to doorknob Close stall door that opens outward in restroom by delivering end of the leash to partner

Shut interior home, office doors that open outward

Shut motel room exterior door that opens inward

Assist to remove shoes, slippers, sandals

Tug socks off without biting down on foot

Remove slacks, sweater, coat

Drag heavy coat, other items to closet

Drag laundry basket through house with a strap

Drag bedding to the washing machine

Wrestle duffle bag or other objects from the van into the house

Pull a drapery cord to open or close drapes

Assist to close motel room drapes by tugging on edge near bottom of drape, backing up

Operate rope device that lifts blanket and sheet or re-covers disabled person* when he or she becomes too hot or cold

Alternatively, take edge of a blanket and move backwards, tugging to remove it or assist someone to pull the blanket up to their chin if cold

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Category Task

Nose nudge based | e

Cupboard door or drawers - nudge shut

tasks e Dryer door - hard nudge e Stove drawer - push it shut e Dishwasher door - put muzzle under open door, flip to shut e Refrigerator & freezer door - close with nudge e Call …[000] on K-9 rescue phone - push the button e Operate button or push plate on electric commercial doors e Turn on light switches e Push floor pedal device to turn on lamp e Turn on metal based lamps with touch-lamp device installed - nudge base e Assist wheelchair user to regain sitting position if slumped over e Help put paralysed arm back onto the armrest of wheelchair e Return paralysed foot to the foot board of a wheelchair if it is dislodged Pawing based e Cupboard door - shut it with one paw

tasks (some dogs |,

prefer it to nose nudge)

Dryer door - shut it with one paw

Refrigerator & freezer door - one forepaw or both

Call [000jJon K-9 rescue phone - hit button with one paw

Operate light switch on wall - jump up, paw the switch

Depress floor pedal device to turn on appliance(s) or lamp

Jump up to paw elevator button [steady dog if he tries it on slippery tile floor]

Operate push plate on electric commercial doors

Close heavy front door, other doors - jump up, use both forepaws

Bracing based r) tasks (no harness)

Transfer assistance from wheelchair to bed, toilet, bathtub or van seat - hold Stand Stay position, then brace on command, enabling partner to keep their balance during transfer

Assist to walk step by step, brace between each step, from wheelchair to nearby seat

Position self and brace to help partner catch balance after partner rises from a couch or other seats in a home or public setting Prevent fall by bracing on command if the partner needs help recovering balance

Steady partner getting in or out of the bathtub

Assist partner to turn over in bed; have appropriate backup plan Pull up partner with a strap [tug of war style] from floor to feet on command, then brace till partner catches balance

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Category Task

Harness based e Only appropriate for large sturdy adult dogs with sound joints, proper

Assistance

e Assist moving wheelchair on flat [partner holds onto harness pull strap] avoiding obstacles