Understanding NDIS High Intensity Supports: Eligibility, Delivery, and Charging

These are important questions for participants, families, and providers alike. Understanding when a participant has been approved for high intensity supports and when they have not is crucial to ensuring they receive the appropriate care while effectively managing their NDIS budget.

First, it’s important to differentiate between these two types of supports under the NDIS:

• Standard Supports: These cover everyday care needs and general disability assistance.

• High Intensity Supports: These are for participants with complex health needs that require specialised training and provider registration.

If a participant's disability-related health supports fall under High Intensity Daily Personal Activities, the NDIA will provide additional funding. These supports include:

• Complex bowel care

• Enteral feeding and management

• Severe dysphagia management

• Tracheostomy care

• Urinary catheter management

• Ventilator management

• Subcutaneous injections (e.g., diabetes management)

• Complex wound management

To qualify for high intensity support, a participant’s health condition must align with the above list. Many participants may also have multiple co-occurring medical conditions requiring additional care considerations.

The NDIA allocates sufficient funding for support workers to assist participants requiring high intensity supports.

Funding decisions are based on:

• The participant’s specific needs

• Identified risks

• The nature and extent of required support

It is common for NDIS plans to include a combination of standard and high intensity supports, depending on individual circumstances.

If a participant believes they meet the requirements and need higher intensity support but haven’t been given funded for this, we suggest they submit a case to the NDIA, providing evidence to support their case.

To deliver High Intensity Daily Personal Activities a provider does not need to be NDIS registered. If a provider is registered, they can only offer high intensity support services that are explicitly stated in their certificate of registration.

If a provider isn’t registered, they still need to demonstrate their ability to provide support in line with the high intensity support skills descriptor, mapped out by the NDIS Quality and Safeguards Commission.

Support workers delivering high intensity supports must receive appropriate training from a qualified health practitioner or someone who meets the expectations outlined in the High Intensity Support Skills Descriptors. These descriptors define the required skills and knowledge for competent workers who are not formally qualified health or allied health practitioners.

Several factors determine whether a provider can charge the higher rate of $73.09 per hour for high intensity supports:

1. Provider Registration: Providers do not need to be NDIS registered to provide “High Intensity Daily Personal Activities”. For those that are registered, they can only provide the high intensity daily activity supports that are set out in their certificate of registration.

2. Participant Eligibility: The participant must have a qualifying health condition recognised under the NDIS Practice Standards and Quality Indicators. Simply having a medical condition does not automatically qualify a participant for high intensity supports.

3. NDIS Plan Allocation: High intensity supports must be detailed in the participant’s NDIS plan, with funding allocated to cover the higher rate.

If a provider charges at the high intensity rate without justification, they may be required to repay the NDIA. There have been multiple cases where providers incorrectly charged participants at the higher rate without their knowledge. In such cases, once reported, the NDIA has sought tens of thousands of dollars in repayments.

Understanding high intensity supports is essential for participants, families, and providers to ensure appropriate care, compliance, and financial accountability. It must be remembered that a provider cannot charge for high intensity support because a participant has a health condition, for example epilepsy. This condition must co-occur with a condition listed by the NDIS Practice Standards and Quality Indicators meeting the “High Intensity Daily Personal Activities” criteria.

By staying informed, providers can deliver high-quality support while adhering to NDIA regulations, and participants can ensure they receive the funding and care they require.

NDIS Practice Standards: High intensity support skills descriptors