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IPSP FACT SHEET 3:
Documentary evidence to
demonstrate ongoing high support
needs for Inclusion Support Subsidy
Note: This fact sheet contains information that outlines the documentation that must be submitted
as evidence of a child’s disability diagnosis or continuing assessment of disability and/or a child’s
refugee status. This information is required to be submitted or attached to the online application in
the Inclusion Support Portal (IS Portal) when a child care and early learning service submits an
application for the Inclusion Support Subsidy (ISS) element of the Inclusion and Professional Support
Program (IPSP). In addition, services must also ensure documentary evidence is maintained in
support of their ISS claims.
This fact sheet should be read in conjunction with the IPSP Guidelines 2013–2016, which include
information on eligibility, purposes for which the subsidy can be used, and other conditions and
requirements for funding.
1. Introduction
To apply for ISS, a service must provide documentary evidence that demonstrates it is caring for a
child with ongoing high support needs. That is, the child has a diagnosed disability, or is undergoing
continuing assessment of disability, or is from a refugee or humanitarian intervention background.
Most eligible services can apply for the ISS online through the IS Portal. However, some services,
such as Budget Based Funded (BBF) services and some In Home Care (IHC) services, are required to
submit paper-based applications. This fact sheet provides information on what documentation a
service must submit as evidence of a child’s demonstrated ongoing high support needs status.
2. Documentary Evidence
Documentary evidence of the child’s diagnosed disability or continuous assessment of disability
and/or the child’s refugee status must be attached to the application for ISS. Documentary evidence
provided with the application must be current (dated within 12 months of the application being
IPSP Fact Sheet 3 – Documentary evidence to demonstrate ongoing high support needs for Inclusion
Support Subsidy
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submitted) and signed or otherwise validated by the medical practitioner or psychologist.
Documentary evidence will be assessed by the National Inclusion Support Subsidy Provider (NISSP).
If the NISSP has previously assessed evidence that demonstrated a permanent diagnosis of disability,
the service will not be required to submit further documentary evidence for future applications for
this child while enrolled at the service. Documentary evidence provided with the first ISS Application
will be assessed by the NISSP and a note will be made in the case indicating evidence of permanent
disability. When an application is approved, the NISSP will advise whether further documentary
evidence will be required for a renewal application.
Services will, however, need to provide sufficient information in their renewal application to
demonstrate the impact the child’s current needs has on the care environment and the support
required to include the child in the care environment. The NISSP may also request further
documentary evidence, on a case by case basis, if the application does not contain adequate
information to allow it to make an assessment of the service’s need.
As part of the IPSP Compliance Strategy, the Department may ask services for documentary evidence
in support of their ISS claims. Services must be able to provide documentary evidence of the child’s
attendance (eg. sign in/sign out records including the Additional Educator/Carer attendance (eg.
Attendance Record).
3. Documentary Evidence Not Provided by a Medical Practitioner,
Registered Psychologist or Centrelink
Documentary evidence will be accepted from Allied Health Practitioners in all areas, not just in rural,
remote and very remote areas.
In addition, the NISSP will accept documentary evidence that is provided by a registered nurse or
nurse practitioner.
It is expected that documentary evidence from Allied Health Professionals will provide the NISSP
with more detailed information on the child’s needs than some of the other acceptable forms of
documentary evidence. This should minimise the amount of follow up required on ISS Applications.
Services will still be required to demonstrate in the ISS Application how these needs impact on the
ability of the service to include the child in the care environment.
The Department has developed a list of Allied Health Professionals who could provide documentary
evidence. A copy of this list is provided at Attachment A. Please note, this list includes Aboriginal
Health Workers. Consistent with Medicare requirements to provide services, Aboriginal Health
Workers in the Northern Territory must be registered with the Aboriginal Health Workers Board of
the NT. In other states and the ACT, they must have a Certificate III in Aboriginal and Torres Strait
Islander Health from a registered training organisation.
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4. Evidence of a diagnosed disability
A list of what is considered a permanent disability for the purposes of ISS is at Attachment B.
Evidence for diagnosed disability may include:

Centrelink documentation stating a parent’s or guardian’s eligibility for Carers Allowance with
respect to the child

the child’s Health Care Card stating the disability code

the child’s Disability Support Pension, if the child is over 16 years of age

a qualified medical practitioner’s confirmation of a diagnosis

the results of an assessment by a registered psychologist, and

diagnosis provided by allied health professionals, Registered Nurses or Nurse Practitioners.
Evidence for a child undergoing continuous assessment for disability may include:

an appointment letter for an assessment by a medical practitioner;

supporting documentation or diagnostic report signed by a qualified medical practitioner or
registered psychologist; or

a report or supporting documentation signed by an allied health professional, Registered
Nurse or Nurse Practitioner of the continuing assessment of a child for the purpose of
diagnosing disability.
5. Evidence of a child’s refugee status
Evidence for a child from a refugee or humanitarian background may include:

documentary evidence of the child’s refugee status. As visa codes are subject to change, ISAs
and/or services must check with the Department of Immigration and Border Protection for
the current humanitarian-related visa codes; or

the results of an assessment by a qualified medical practitioner or registered psychologist.
6. Documentation and eligibility for ISS
Eligibility for ISS does not mean an automatic entitlement to ISS funding. ISAs are reminded that
meeting documentary evidence requirements is only one component of assessing an application for
ISS. The ISS application must also demonstrate that there is need for an additional educator to
support the inclusion of a child with ongoing high support needs with their typically developing
peers in the care environment. When ISAs are endorsing an ISS Application, they are confirming that
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they are satisfied that there is a demonstrated need for an additional educator, and the provision of
ISS will assist the service to build its capacity to include all children, including children with ongoing
high support needs.
7. Attaching Documentary Evidence to an IS Portal Application
For applications that have been entered on the IS Portal, services can claim for ISS online through
the IS Portal. In completing this application services must attach the required documentary
evidence. Where the NISSP has advised the service that they do not need to obtain new
documentary evidence (because the child has a permanent disability), the service may attach the
evidence provided in a previous ISS application. The following steps outline the process involved.
Step 1 Details regarding each child’s disability must be populated under the Child Details
Tab in the Children Tab. (See Inclusion Support Portal Task Card 3 – Setting and
Children Tab – Version 1 September 2011.)
Step 2 Select the child from the list for whom you are entering the details. It will be
highlighted. Enter the details regarding the child’s Priority Group.
Step 3 Click the  next to Disability Eligibility Basis and select from the drop down box.
Choose either Disability Eligibility Basis or Refugee/Humanitarian; then Undergoing
Assessment, With Diagnosis.
If you do not choose Disability Eligibility Basis or Refugee/Humanitarian
Background here the child will not be eligible and you will not be able to
submit the case.
Step 4 DO NOT ATTACH DOCUMENTS HERE. GO TO ATTACHMENTS TAB (see Inclusion Support
Portal Task Card 5 – Adding Attachments – Ver 1 September 2011)
Click the Primary Attachments Tab. Click the New button. A new screen will open.
Click the glyph .. A new ‘Add Attachment Internet Explorer’ window will open.
Step 5 Browse and navigate to your local drive to locate the required document. Click
Open/Add. The window will close and you will see that the Document Name:* field
has been populated. The Document Type, Size and Date Created will automatically
populate. Add a comment if required for e.g. Comments: doctor’s letter.
Step 6 Repeat 4 to 6 to attach additional documents.
8. Attaching Documentary Evidence to a Paper-based application
Services submitting a paper-based application must attach the documentary evidence to their
application when they provide it to the NISSP for assessment.
(Updated March 2014)
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Attachment A
Allied Health Professionals:
In relation to IPSP, the range of Allied Health Professionals that could be accessed by parents and
carers to provide documentary evidence may include, but is not limited to:
 Psychologists
 Physiotherapists
 Occupational Therapists
 Speech Pathologists
 Audiologists
 Social Worker
 Aboriginal Health Workers
Each of the professions described in the list above have minimum standards required to be able to
claim for services, under Medicare, and must meet specific eligibility requirements as detailed
below.
Psychologists must be registered, without limitation, with the Psychologists Registration Board in
the State or Territory in which they are practising.
Physiotherapists must be registered with the Physiotherapists Registration Board in the State or
Territory in which they are practising.
Occupational Therapists in Queensland, Western Australia, South Australia and the Northern
Territory must be registered with the Occupational Therapists Board in the State or Territory in
which they are practising; in other States and the Australian Capital Territory, they must be a ‘Fulltime Member’ or ‘Part-time Member’ of OT AUSTRALIA, the national body of the Australian
Association of Occupational Therapists.
Speech Pathologists in Queensland must be registered with the Speech Pathologist Board of
Queensland. In all other States, the Australian Capital Territory and the Northern Territory, they
must be a ‘Practicing Member’ of Speech Pathology Australia.
Audiologists must be either a ‘Full Member’ of the Audiological Society of Australia Inc (ASA), who
holds a ‘Certificate of Clinical Practice’ issued by the ASA; or an ‘Ordinary Member – Audiologist’ or
‘Fellow Audiologist’ of the Australian College of Audiology (ACAud).
A Social Worker must be a ‘Member’ of the Australian Association of Social Workers (AASW) and be
certified by AASW as meeting the standards for mental health set out in AASW’s ‘Standards for
Mental Health Social Workers 1999’.
An Aboriginal Health Worker practising in the Northern Territory (NT) must be registered with the
Aboriginal Health Workers Board of the NT; in other States and the Australian Capital Territory they
must have been awarded a Certificate Level III (or higher) in Aboriginal and Torres Strait Islander
IPSP Fact Sheet 3 – Documentary Evidence To Demonstrate Ongoing High Support Needs For
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Health from a Registered Training Organisation that meets training standards set by the Australian
National Training Authority’s Australian Quality Training Framework.
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Attachment B
List of Allied Health Professionals in relation to the IPSP
Documentary Evidence – Determining if a disability is considered permanent
Severe Disabilities
For the purposes of the ISS, if a child care service has provided documentary evidence that the
identified child has been diagnosed with one of the severe disabilities listed below, or has medical
documentation to support that a diagnosis is permanent, the NISSP will consider this to be a
permanent disability, and documentary evidence is only required to be provided with the initial
application to the NISSP. In these circumstances, the NISSP will also accept documentary evidence
that is not current, provided there is sufficient information to support that the disability is
permanent.
Chronic Medical Conditions
A chronic medical condition is a recognised disability, however, it may not result in a permanent
disability. For this reason, the NISSP will assess on a case by case basis whether the chronic medical
condition is considered permanent and, therefore, whether current documentary evidence is
required to be provided with all ISS applications. This assessment will be made based on the
information provided in the original documentary evidence that is provided to the NISSP.
Background
The lists below have been developed using the ‘Guide to Social Security Law, 1.1.R.90 Recognised
disability CA (child)’, last reviewed 9 February 2012. The lists are not exhaustive and may be
amended from time to time.
Please note, inclusion on these lists does not mean that a service including a child diagnosed with
that disability or medical condition is eligible for ISS. The NISSP must assess all applications in
accordance with the ISS Guidelines.
There are 2 categories of recognised disability:


Severe disability, and
Chronic medical conditions.
SEVERE DISABILITY
Severe disabilities are associated with severe, moderate or profound disability that is permanent or
likely to be permanent.
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The following are severe disabilities:

Moderate to severe multiple disability or moderate to severe physical disability where the
child is, or is likely to be, dependent for mobility indoors and outdoors from 3 years of age
onwards, including:
o neurological disability
o cerebral palsy
o lower limb deficiencies, or
o spina bifida

Severe multiple or physical disability requiring constant care and attention where the child is
less than 6 months of age (eg. uncontrolled seizures)

Moderate, severe or profound intellectual disability where IQ is less than 55. This includes a
child with a known syndrome.

Autistic Disorder or Asperger's Disorder

Sensory impairment, including:
o
o
o
Bilateral blindness where:
 visual acuity is less than or equal to 6/60 with corrected vision, or
 visual fields are reduced to a measured arc of less than 10 degrees
A 45 decibels or more hearing loss in the better ear, based on a 4 frequency
pure tone average (using 500, 1,000, 2,000 and 4,000Hz)
Deaf-blindness diagnosed by a specialist multidisciplinary team, including a
professional audiological and ophthalmological evaluation

Epilepsy (uncontrolled while on medication)

Cystic Fibrosis

Down syndrome

Fragile X syndrome

Diabetes Mellitus Type 1 and child is aged under 10 years

Phenylketonuria (PKU)

Osteogenisis Imperfecta (moderate to severe)

Chromosomal or syndromic conditions (not specified elsewhere) where there is moderate or
severe intellectual disability and/or multiple, major and permanent physical abnormalities as
diagnosed by a paediatrician, paediatric sub-specialist or clinical geneticist, including:
o
o
o
o
o
o
o
Cri du chat syndrome
Rett syndrome
Angelman syndrome
Prader-Willi syndrome
Edwards syndrome (Trisomy 18)
Williams syndrome
Patau syndrome (Trisomy 13)
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o Coffin-Lowry syndrome
o Congenital rubella syndrome
o Cornelia de Lange syndrome
o Kabuki Make-up syndrome
o Larsen syndrome
o Opitz G syndrome
o Pallister-Killian syndrome
o Seckel syndrome
o Smith-Magenis syndrome
o CHARGE association
Note: This category may apply to children diagnosed with other non-listed chromosomal or
syndromic conditions who have a moderate or severe level of intellectual disability and/or
multiple, major and permanent physical abnormalities.

Neurometabolic degenerative conditions where there is moderate or severe intellectual and/or
moderate or severe physical disability as diagnosed by a paediatrician, paediatric sub-specialist
or clinical geneticist, including:
o Lysosomal storage disorders, including:
 Metachromatic Leukodystrophy
 Tay Sachs disease
 Krabbe disease
 Pompe's disease
o
Mucopolysaccharidoses, including:
 Hurler syndrome ((MPS) 1)
 Hunter syndrome (MPS 2)
 San Filipo syndrome (MPS 3)
 Morquio syndrome (MPS IVA)
 Maroteaux-Lamy syndrome (MPS VI)
o
Neurometabolic conditions, including:
 Lesch Nyhan syndrome
 Menkes disease
 Zellweger syndrome and related peroxisomal disorders
 some mitochondrial respiratory chain disorders
Note: This category may apply to children diagnosed with other non-listed neurometabolic
degenerative conditions who have a moderate or severe level of intellectual and/or physical
disability.

Neurodegenerative disorders where there is moderate or severe intellectual and/or moderate
or severe physical disability as diagnosed by a paediatrician, paediatric sub-specialist or clinical
geneticist, including:
o Ataxia Telangiectasia
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o Unclassified Leukodystrophies
Note: This category may apply to children diagnosed with other non-listed neurodegenerative
conditions who have a moderate or severe level of intellectual and/or physical disability.

Dermatological conditions, including:
o Epidermolysis Bullosa Dystrophica
o Hypohidrotic ectodermal dysplasia (synonym: anhidrotic ectodermal dysplasia)
o Hay Wells syndrome (synonym: ankylobepharon, ectodermal dysplasia and
clefting (AEC) syndrome)
o Lamellar ichthyosis
o Harlequin ichthyosis
o Sjorgren Larsson syndrome
o Netherton syndrome
o Severe congenital ichthyosiform erythroderma
o Generalised bullous ichthyosis (synonym: bullous ichthyosiform erythroderma;
epidermolytic hyperkeratosis)

Neuromuscular conditions including:
o Duchenne (or Becker) muscular dystrophy
o Autosomal recessive muscular dystrophy
o Spinal muscular atrophy conditions, for example Werdnig-Hoffman
o Friedrich's Ataxia

Psychiatric conditions (when diagnosed by a psychiatrist using the current Diagnostic and
Statistical Manual of Mental Disorders (DSM)) such as:
o Child Disintegrative Disorder
o Major depression of childhood
o Childhood schizophrenia

Other inborn errors of metabolism (not specified elsewhere) that are treated by a medically
prescribed diet to prevent neurological disability and/or severe organ damage (eg. organic
acidaemias, urea cycle defects, galactosaemia, some fatty acid or oxidation defects, etc).
CHRONIC MEDICAL CONDITION
A chronic medical condition is one of a category of recognised disabilities that may not result in
moderate, severe or profound disability that is permanent, but will:

Consistently require medical treatment and supervision for a continuous period of at least 12
months;
 Result in significant restriction to the child's normal activities; and
 Require significant levels of skilled personal care by the parent/carer.
The following are chronic medical conditions:
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
Chronic or end stage organ failure where the child is receiving organ specific treatment and/or
awaiting transplant (eg. kidney failure, heart failure, heart/lung failure, liver failure)
Note: This condition applies to those cases where life will not continue without a transplant of the
failed organ (or organs).

HIV/AIDS where the child is symptomatic in addition to having lymphadenopathy and requires
treatment with a three or more drug antiviral regimen

Immunodeficiency where the child requires regular immunoglobin infusions

Chronic respiratory disease requiring home oxygen including:

o
A condition where the child is dependent for his or her health on an external
apparatus/machine called a ventilator to assist with breathing, either on a continuous or
intermittent basis
o
Long term tracheostomy where the child is cared for at home
Childhood malignancies/cancers (where the child is undergoing chemotherapy, radiotherapy or
palliative care) including:
o
Leukaemia
o
Haemophagocytic Lymphohistiocytosis

Haemophilia with Factor VIII or Factor IX deficiency (less than 10%)

Thalassaemia or Haemoglobinopathy requiring chelation therapy

Chronic Transfusion Dependent Anaemia requiring chelation therapy

Langerhorn Cell Histiocytosis disseminated (multi-organ) disease requiring chemotherapy for
longer than 6 months

Severe congenital Neutropenia (Kostman's variant, dependent on Filgrastin)

Severe atopic dermatitis which involves at least 75% of the body surface and which has required
two or more hospitalisations of at least 5 days duration in the previous calendar year, and/or the
use of immunosuppressive therapy

Significant burn where more than 30% of body surface area is affected, or a lesser burn where
there is significant impairment of function of the hands or feet or assistance is required with
feeding or toileting to a greater degree than is age appropriate for the child

Gastroenterological condition or other medical condition requiring total parenteral nutrition for
an extended period, with medical treatment and medical supervision required for at least 12
months

Final stage of Ulcerative Colitis where the condition is no longer responding to medical
treatment and where a sub-total colectomy and ileo-rectal anastomosis with formation of Jpouch is required

Polyarticular course Juvenile Arthritis requiring regular multi-disciplinary therapy, including
immunosuppressive medication

Diabetes Mellitus Type 1
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