1. What is the purpose of this operational guideline?
This Operational Guideline is to be used in conjunction with the Operational Guideline on Planning and provides additional guidance in relation to the preparation and review of a participant’s plan when Specialist Disability Accommodation (SDA) is under consideration.
In particular, this Operational Guideline provides guidance in relation to making a decision to approve a statement of participant supports which includes SDA, and where a plan includes SDA, how the National Disability Insurance Agency (NDIA) will describe the SDA type and location.
2. What is the relevant legislation?
Currently, there is no SDA specific legislation.
Therefore, decisions which involve including SDA in plans are made applying the same legislation which applies for all plan decisions.
For decisions involving SDA, the following legislation is particularly relevant:
- Sections 33, 34 , 36, 42, 43 and 44 of the National Disability Insurance Scheme Act 2013 (External website) (NDIS Act);
- Rules 3.1 to 3.7 and 5.1 to 5.3 of the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (External website) (Supports for Participants Rules); and
- Rules 6.1 to 6.8 of the National Disability Insurance Scheme (Plan Management) Rules 2013 (External website) (Plan Management Rules).
SDA refers to accommodation for participants who require specialist housing solutions to assist with the delivery of their supports and which cater for their significant functional impairment or very high support needs. SDA does not refer to the support services themselves, but the homes in which these services are delivered.
SDA may include special designs for participants with very high support needs, or may have a location or feature which makes it feasible to provide complex or costly supports.
SDA is intended to be a specialist solution for participants with a very high need for constant or immediately available supports, and/or those participants with extreme or complete functional impairment in a core area (self-care, mobility or self-management) where key activity limitations remain even following the use of assistive technologies, home modifications or capacity building supports.
Once a person becomes a participant in the National Disability Insurance Scheme (NDIS), they develop a personal goal-based plan with the NDIA.
The statement of participant supports specifies, amongst other matters, the general supports (if any) that will be provided, and the reasonable and necessary supports (if any) that will be funded under the NDIS (section 33(2)).
SDA is one type of reasonable and necessary support that may be funded for a participant under the NDIS. For other support types, please refer to the Operational Guideline on including specific types of supports in plans.
The decision to approve a statement of participant supports should consider the inclusion of SDA as a support in the context of the other supports to be funded or provided for a participant and the overall plan cost, not just the cost of SDA.
When deciding to include any support in a participant’s plan, the NDIA must have regard to a range of matters set out in the NDIS Act, including the participant’s statement of goals and aspirations.
Specifically, before including any support in a participant’s plan, the NDIA must:
- be satisfied that each support meets each of the criteria outlined in section 34(1)(a)-(f) (External website) of the NDIS Act and the Supports for Participants Rules (see deciding to include supports in a participant’s plan);
- have regard to the specific principles relating to plans;
- have regard to the other considerations which may apply when including supports in a participant’s plan; and
- depending on the specific type of support being considered, refer to the additional guidance available for specific support types, including the additional guidance in this operational guideline relating to SDA (see deciding to include SDA in a participant’s plan).
4. Performing a SDA support needs assessment
A support needs assessment is undertaken for all participants as part of the process of developing a participant’s plan. The information collated from the various sources of information available will inform the supports a participant needs to attain their goals (see performing a support needs assessment).
The information in this section contains additional considerations relevant to performing a support needs assessment when the inclusion of SDA is under consideration.
4.1 Reviewing existing information
In preparation for the planning and assessment conversation, the NDIA will review existing information.
When the inclusion of SDA in a participant’s plan is under consideration, the NDIA will also review the following information where available:
- information regarding the participant’s accommodation history, including whether the participant has been living in SDA or SDA-like accommodation. For example, for a participant who is living in a hospital and is unable to be discharged to appropriate accommodation because of their disability, information relating to the accommodation in hospital and the circumstances of the discharge;
- for a participant on a state or territory waiting list where inclusion on the list requires an assessment, any information that is part of that assessment; and
- for a participant who is a child residing in residential aged care, information relating to the accommodation and assessment, including ACAS or ACAT.
4.2 The planning and assessment conversation
The purpose of the planning and assessment conversation is to explore a participant’s support needs and identify specific supports which would assist the participant to achieve their goals and aspirations.
When the inclusion of SDA in a participant’s plan is under consideration, in preparation for the planning and assessment conversation the NDIA will also consider:
- the principal of no-disadvantage; and
- the considerations relevant for participants transitioning with existing supports.
4.3 Requesting further information or reports to inform the inclusion of the SDA in a participant’s plan
The NDIA may request further information for the purposes of preparing or reviewing a participant’s plan.
When the inclusion of SDA in a participant’s plan is under consideration, the NDIA may consider specifically requesting:
- evidence-based or informed assessments examining:
i. functional capacity or impairment as a result of disability and establishing extreme or complete functional impairment; or
ii. whether a housing response may be required, for example an Occupational Therapy Housing assessment;
- information regarding the participant’s support needs and support model, including their need for responsive services nearby or immediately responsive services;
- assessments of whether a participant can expect to benefit from capacity building activities; and
- behavioural assessments, in particular, where behaviors of concern are indicated that may impact an SDA decision. For example, functional behavioural assessments (HCR-20, START, or DASA) and associated positive behavioural support or risk management plans.
4.4 Assessing risks and safeguards
- The NDIA must assess risks and safeguards in relation to the participant when deciding whether or not to approve a statement of participant supports (rule 5.1(d) of the Supports for Participants Rules).
- When the inclusion of SDA in a participant’s plan is under consideration, the additional matters the NDIA will discuss with a participant in relation to risks and safeguards are:
- whether the participant is at risk, or poses a risk to others, and if so whether that risk could be mitigated by the provision of SDA, or by SDA of a specific type or location, having regard to the participant’s response to risk and the interaction of the participant with the environment;
- the proposedsupport model, the other residents in the household and any specific risks or vulnerabilities of the participant or others in the household; and
- whether additional supports, such as support co-ordination or similar supports are required to manage any identified risks and provide necessary safeguards.
Additional safeguards the NDIA can put in place through the participant’s plan include:
- setting a shorter period before the participant’s plan is reviewed;
- setting out arrangements for regular contact between the NDIA and the participant; and
- considering whether additional supports, such as support co-ordination or similar supports are required to manage risk and provide necessary safeguards.