The Commonwealth and the States have reached an agreement about which disability-related Health Supports will be funded in an NDIS Plan.
Diabetic Management reports
Wound and Pressure Care Supports
Of course, this change has been accompanied by a new Price Guide. This Price Guide and the accompanying Support Catalogue contain the items, codes and prices. They can be found here.
HOW WILL THESE ITEMS BE CLAIMED?
The Disability-related Health support items are in various parts of the support catalogue.
DAILY PERSONAL ACTIVITIES AND HIGH INTENSITY: provision of disability-related health supports by disability support workers
ECEI AND THERAPEUTIC SUPPORTS: Assessment, planning and the provision of disability-related health supports by therapists
NURSING SUPPORT ITEMS: Assessment, planning and the provision of disability-related health supports by a nurse
CONSUMABLES: consumables related to disability-related health supports low cost /high-cost items (there are new line items for this)
ASSISTIVE TECHNOLOGY: assistive technology related to disability-related health supports (there are new line items)
TEMPORARY ACCESS TO THE CORE BUDGET FOR DISABILITY HEALTH-RELATED ITEMS
We understand that there is temporary access to the Core budget for some of the ECEI / Therapy / Nursing disability-related health supports.
Here is how that will work (with thanks to the NDIA).
Claiming for disability-related therapy and nursing health supports
To expedite the ability for participants to access disability-related therapy and nursing health supports using NDIS funding, temporary payment arrangements for these supports are in place.
Traditionally, therapy and nursing supports have been purchased through a participant’s capacity building budget. However, participants will have temporary access to claim disability-related therapy and nursing health supports from their core budget – assistance with daily living
Line items and codes for disability-related therapy and nursing health supports have been developed under core support for this purpose.
The transitional arrangements allow participants to access disability-related health supports from their existing budget immediately (from 1 October 2019), without the need for a plan review.
This is a transitional arrangement only. The ability to claim for disability-related health supports from a participant’s core support budget will cease when participant plan reviews are completed.
At this time, these supports will revert to only being claimable through a participant’s capacity building budget. The NDIA will provide notification when this arrangement is due to end.
Under the transitional arrangements, providers can claim payment for disability-related therapy and nursing health supports as follows:
Providers must be registered in one or more of the following registration groups according to the supports they will deliver:
0114 – Nursing
0118 – Early Intervention Supports for Early Childhood
0128 – Therapeutic Services
To claim nursing and/or therapy supports, providers should first confirm with the participant that they have funding in their core support budget to pay for the support.
If yes, a provider should create a service booking at the category level and, once the support is delivered, claim payment for this item through the participant’s core support budget.
If the participant does not have a budget available in core supports, they are unable to purchase these supports and require a plan review.
HOW CAN WE MAKE SURE THAT OUR CLIENTS HAVE THIS FUNDING ADDED TO THEIR PLANS?
We assume that there will be some need for evidence at Plan Review time to support a Participant to request support for these items.
Our general recommendation is always to use language that is easy to understand, clearly link the need with function and be explicit about how the health issue is connected to the disability.
As with most of these things we anticipate jockeying between the Health systems and NDIS but we encouraged by the addition of the Nursing items and the list of health conditions that the Agency has agreed to fund.
FOR MORE INFORMATION
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