Case
Nigel is an NDIS participant who lives permanently in a residential aged care facility.
Nigel needs a new power wheelchair so he can move independently around the facility and when he goes out into the community.
He asks for funding for this NDIS support. The aged care facility is not responsible for providing this support and Nigel needs it due to his disability support needs.
Would we typically fund this?
We may fund additional supports for Nigel if they directly relate to his disability support needs.
He needs to support his request with evidence, which we assess against the NDIS funding criteria to work out if the support is reasonable and necessary.
Residential aged care facilities are expected to give NDIS participants the same supports they give to residents who do not have NDIS funding for disability supports.
Why would we fund this?
If you permanently live in a residential aged care facility, you may be eligible for extra NDIS supports for your disability-specific needs, as well as the supports that all aged care residents would normally receive.
This includes NDIS supports to help you get out into your community for social activities, when you need support beyond what we expect your aged care provider to provide.
You need to give us evidence from a suitably qualified therapist to explain why the level of care you get from the aged care provider doesn’t meet your disability support needs.
The aged care provider should also give us information on the amount of support it provides so we can assess what extra NDIS support may be reasonable and necessary.
To work out if an NDIS support is reasonable and necessary for you, we look at the information you have given us against the NDIS funding criteria.
What else might we fund?
We assess NDIS funding for participants living in residential aged care using the same criteria as we assess participants not living in residential aged care.
This includes funding for disability-specific NDIS supports that other aged care residents would not normally receive, such as:
- assistive technology specific to the participant’s needs
- specialised positive behaviour supports
- social and community participation.
This ensures that participants who have an NDIS plan and live in residential aged care facilities have comparable levels of NDIS support as participants living in the community.
Case example
Rajni is 62 and has an intellectual disability. He also had a stroke that severely affected his left arm and leg.
If he tries to hurry through tasks or is rushed, he has uncontrollable tremors and can become upset and confused.
He becomes particularly distressed and agitated when he has to bath in a shower bed. Rajni requires some level of support for all of his daily care needs.
Rajni’s therapist recommends he receive funding for behavioural support to ensure proper measures are in place to reduce his distress.
The therapist also recommends we make modifications to Rajni’s room so he can shower himself without risk of injury to himself or others.
Rajni’s nominee sends the therapist’s report to us, requesting funds to:
- put behaviour supports in place
- modify his room so he can feed and shower himself.
To work out if the funding for Rajni’s NDIS supports is reasonable and necessary, his planner looks at the information provided against the NDIS funding criteria.
The planner considers whether:
- the supports Rajni needs are related to his disability
- modifications and behaviour supports will be, or are likely to be, effective and beneficial for Rajni with regard to current good practice
- the cost of the modifications and behaviour supports would be value for money when compared with other NDIS supports available to Rajni for day-to-day living
- it’s a NDIS support for Rajni. This means it’s a support NDIS laws say we can fund and isn’t appropriately provided by other general systems of support, like the aged care system.
In Rajni’s case, the planner decides that:
- the supports he needs are related to his disability needs. For example, Rajni’s behavioural impacts and functional impairment of his left arm and leg
- behaviour supports will be, or are likely to be, effective and beneficial in helping to address Rajni’s behavioural support needs. The planner decides that this is an NDIS support for Rajni
- shower modification is not an NDIS support for Rajni. His residential aged care facility is responsible for making any home modifications. This is a support all aged care residents should receive. We already fund this support through cross-billing arrangements with the Department of Health.
- the modification to allow Rajni to feed himself without a care worker is not an NDIS support. This is a support that all aged care residents should receive. We already fund this support through cross-billing arrangements with the Department of Health.
The planner concludes the:
- behaviour supports meet the NDIS funding criteria, so we approve funding
- modifications to the aged care facility do not meet the NDIS funding criteria, so we decline funding for the support. We already fund these supports through cross-billing arrangements with the Department of Health.
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