Access - Decision Tree for Disability and Early Intervention

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Operational Guideline – Access – Decision
Tree for Disability Requirements and Early
Intervention Requirements
Planner’s name:
Person’s name:
Date:
Person ID:
Criteria to meet disability requirements
(s.24)
Is requirement met? Consideration: indicate evidence
used and record in Siebel
comments field
A person will meet the disability requirements, which are part of the access criteria to become a
participant of the NDIS, if they meet Criterion 1 and 2 and 3 and 4 and 5:
Note: A delegate must also be satisfied that a person meets the applicable age and residency requirements.
Criterion 1 (Section 24(1)(a))
 Does the person have a disability that
is attributable to one or more
intellectual, cognitive, neurological,
sensory or physical impairments or to
one or more impairments attributable to
a psychiatric condition?
☐Yes at least one
condition on List B
☐Yes
☐No
and
In reaching this conclusion, I
have had regard to [insert
evidence considered, i.e. planner
observation, self-report from
person, diagnostic information
and/or other sources].
The reason for this conclusion is
that [insert reason why you are
satisfied or not satisfied that this
criterion is met, including an
evaluation of the conflicting
evidence if necessary].
Operational Guideline
Access - Decision Tree for Disability and Early Intervention Requirements (v 2.2)
Publication date: 6 February 2015
Page 1 of 10
Criteria to meet disability requirements
(s.24)
Is requirement met? Consideration: indicate evidence
used and record in Siebel
comments field
Criterion 2 (Section 24(1)(b))
☐Yes at least one
 Are the person’s impairment(s)
permanent (or likely to be permanent)?
That is, is it the case that:
o there is no known, available and
appropriate evidence based
clinical, medical or other
treatments that would be likely to
remedy the impairment(s); and
o the impairment(s) do not require
further medical treatment or review
in order to demonstrate
permanency (or likely permanency)
condition on List B
☐Yes
☐No
In reaching this conclusion, I
have had regard to [insert
evidence considered, i.e. planner
observation, self-report from
person, diagnostic information
and/or other sources].
The reason for this conclusion is
that [insert reason why you are
satisfied or not satisfied that this
criterion is met, including an
evaluation of the conflicting
evidence if necessary].
Note: An impairment may be permanent
notwithstanding that the severity of its impact
on functional capacity may fluctuate or there
are prospects that the person’s functional
capacity, including psychosocial functioning,
may improve.
and
Criterion 3 (Section 24(1)(d))
☐Yes
 Do the impairment(s) affect the
person’s capacity for social and
economic participation?
☐No
and
In reaching this conclusion, I
have had regard to [insert
evidence considered, i.e. planner
observation, self-report from
person, diagnostic information
and/or other sources].
The reason for this conclusion is
that [insert reason why you are
satisfied or not satisfied that this
criterion is met, including an
evaluation of the conflicting
evidence if necessary].
Operational Guideline
Access - Decision Tree for Disability and Early Intervention Requirements (v 2.2)
Publication date: 6 February 2015
Page 2 of 10
Criteria to meet disability requirements
(s.24)
Is requirement met? Consideration: indicate evidence
used and record in Siebel
comments field
Criterion 4 (Section 24(1)(e))
☐Yes
 Is the person likely to require support
under the NDIS for their lifetime?
☐No
Note: An impairment that varies in intensity
(for example because the impairment is of a
chronic episodic nature) may be permanent,
and the person is likely to require support
under the NDIS for their lifetime despite the
variation.
Note: This requires consideration of the
person’s likely need for both general supports
and reasonable and necessary funded
supports.
In reaching this conclusion, I
have had regard to [insert
evidence considered, i.e. planner
observation, self-report from
person, diagnostic information
and/or other sources].
The reason for this conclusion is
that [insert reason why you are
satisfied or not satisfied that this
criterion is met, including an
evaluation of the conflicting
evidence if necessary].
and
Operational Guideline
Access - Decision Tree for Disability and Early Intervention Requirements (v 2.2)
Publication date: 6 February 2015
Page 3 of 10
Criteria to meet disability requirements
(s.24)
Is requirement met? Consideration: indicate evidence
used and record in Siebel
comments field
Criterion 5 (Section 24(1)(c))
☐Yes
 Do the impairment(s) results in
substantially reduced functional
capacity to undertake, or psychosocial
functioning in undertaking, activities in
one or more of the areas of
communication, social interaction,
learning, mobility, self-care or selfmanagement? That is, is it the case
that:
o the person is unable to participate
effectively or completely in the
activity, or to perform task or actions
required to undertake or participate
effectively or completely in the
activity without assistive technology,
equipment (other than commonly
used items such as glasses) or
home modifications; or
o the person usually requires
assistance on most days (including
physical assistance, guidance,
supervision or prompting) from other
people to participate in the activity or
to perform task or actions required
to undertake or participate in the
activity; or
o the person is unable to participate in
the activity or to perform task or
actions required to undertake or
participate in the activity, even with
assistive technology, equipment,
home modifications or assistance
from another person.
☐No
In reaching this conclusion, I
have had regard to [insert
evidence considered, i.e. planner
observation, self-report from
person, diagnostic information
and/or other sources].
The reason for this conclusion is
that [insert reason why you are
satisfied or not satisfied that this
criterion is met, including an
evaluation of the conflicting
evidence if necessary].
Operational Guideline
Access - Decision Tree for Disability and Early Intervention Requirements (v 2.2)
Publication date: 6 February 2015
Page 4 of 10
Criteria to meet disability requirements
(s.24)
Is requirement met? Consideration: indicate evidence
used and record in Siebel
comments field
Were all of Criterion 1, 2, 3, 4 and 5
met?
☐Yes
☐No
If the person meets Criterion 2 but not 1, 3, 4 or 5 then consider the early intervention
requirements below.
Children under 7 years of age may be considered against the early intervention requirements
before the disability requirements.
Note: Where a child is diagnosed with a condition on List A at Appendix A of the Operational
Guideline – Access – Disability Requirements, they may generally be regarded as meeting the
disability requirements.
Operational Guideline
Access - Decision Tree for Disability and Early Intervention Requirements (v 2.2)
Publication date: 6 February 2015
Page 5 of 10
Criteria to meet early intervention
requirements (s.25)
Is requirement met?
Consideration: indicate
evidence used and record in
Siebel comments field
A person will meet the early intervention requirements, which are part of the access criteria to become
a participant of the NDIS, if they meet Criterion 6 and 7 and 8 and 9:
Note: A delegate must also be satisfied that a person meets the applicable age and residency requirements.
Criterion 6 (Section 25(1)(a)(i), (ii) and
(iii))
 Does the person have:
o one or more identified intellectual,
cognitive, neurological, physical
or sensory impairments that are
permanent or likely to be
permanent? or
o one or more identified
impairments attributable to a
psychiatric condition that are
permanent or likely to be
permanent? or
o Is the person a child who has
developmental delay?
☐Yes at least one
condition on List B
☐Yes
☐No
In reaching this conclusion, I
have had regard to [insert
evidence considered, i.e.
planner observation, selfreport from person,
diagnostic information and/or
other sources].
The reason for this
conclusion is that [insert
reason why you are satisfied
or not satisfied that this
criterion is met, including an
evaluation of the conflicting
evidence if necessary].
Note: A person is generally taken to have a
permanent impairment if:
 there is no known, available and
appropriate evidence based clinical or
medical or other treatments that would be
likely to remedy the impairment; and
 it does not require further medical
treatment or review in order to
demonstrate permanency (or likely
permanency);
Note: An impairment may be permanent
notwithstanding that the severity of its impact
on the functional capacity of the person may
fluctuate or there are prospects that the
person’s functional capacity may improve.
Operational Guideline
Access - Decision Tree for Disability and Early Intervention Requirements (v 2.2)
Publication date: 6 February 2015
Page 6 of 10
Criteria to meet early intervention
requirements (s.25)
Is requirement met?
Consideration: indicate
evidence used and record in
Siebel comments field
See rs 6.4 to 6.7 of the Becoming a Participant Rules.
and
Criterion 7 (Section 25(1)(b))
 Are you satisfied that the provision of
early intervention supports is likely to
benefit the person by reducing the
person’s future needs for supports in
relation to disability?
☐Yes
☐No
In reaching this conclusion, I
have had regard to [insert
evidence considered, i.e.
planner observation, selfreport from person,
diagnostic information and/or
other sources].
The reason for this
conclusion is that [insert
reason why you are satisfied
or not satisfied that this
criterion is met, including an
evaluation of the conflicting
evidence if necessary].
Note: Delegates should consider:
 the likely trajectory and impact of the
person’s impairment over time, and
 the potential benefits of early intervention
supports on the impact of the impairment
on the person’s functional capacity and in
reducing their future needs for support,
and
 evidence from a range of sources.
and
Criterion 8 (Section 25(1)(c))
 Are you satisfied that the provision of
early intervention supports is likely to
benefit this person by:
o mitigating or alleviating the impact
of the person’s impairment upon
the functional capacity of the
person to undertake
communication, social interaction,
learning, mobility, self-care or
self-management or
o preventing the deterioration of
such functional capacity; or
o improving such functional
capacity; or
☐Yes
☐No
In reaching this conclusion, I
have had regard to [insert
evidence considered, i.e.
planner observation, selfreport from person,
diagnostic information and/or
other sources].
The reason for this
conclusion is that [insert
reason why you are satisfied
or not satisfied that this
criterion is met, including an
evaluation of the conflicting
Operational Guideline
Access - Decision Tree for Disability and Early Intervention Requirements (v 2.2)
Publication date: 6 February 2015
Page 7 of 10
Criteria to meet early intervention
requirements (s.25)
o
Is requirement met?
strengthening the sustainability of
informal supports available to the
person, including through building
the capacity of the person’s carer;
Consideration: indicate
evidence used and record in
Siebel comments field
evidence if necessary].
Note: In certain circumstances, a person with
a degenerative condition could meet the early
intervention requirements and therefore
become a participant.
and
Criterion 9 (Section 25(3))

Are you satisfied that early
intervention supports are most
appropriately funded or provided
through the NDIS and are not most
appropriately funded or provided
through:
o other general systems of service
delivery or support services
offered by a person, agency or
body, or
o through systems of service
delivery or support services
offered as part of a universal
service obligation; or in
accordance with reasonable
adjustments under a law dealing
with discrimination on the basis of
disability?
☐Yes
☐No
In reaching this conclusion, I
have had regard to [insert
evidence considered, i.e.
planner observation, selfreport from person,
diagnostic information and/or
other sources].
The reason for this
conclusion is that [insert
reason why you are satisfied
or not satisfied that this
criterion is met, including an
evaluation of the conflicting
evidence if necessary].
Note: In determining whether early
intervention supports would be more
appropriately funded or provided through a
different service system delegates should
consider paragraphs 7.8 to 7.10 of the
National Disability Insurance Scheme
Operational Guideline
Access - Decision Tree for Disability and Early Intervention Requirements (v 2.2)
Publication date: 6 February 2015
Page 8 of 10
Criteria to meet early intervention
requirements (s.25)
Is requirement met?
Consideration: indicate
evidence used and record in
Siebel comments field
(Supports for Participants) Rules 2013
(Supports for Participants Rules) outlined
below:
See r.7.5 of the Supports for Participants Rules.
The NDIS will be responsible for:
 Personalised supports, specific to a
child’s disability (or developmental delay),
which are additional to the needs of
children of a similar age and beyond the
reasonable adjustment requirements of
early childhood development service
providers.
 Early interventions for children with
disability (or developmental delay) which
are:
o specifically targeted at enhancing a
child’s functioning to undertake
activities of daily living, but not
supports which are specifically for the
purpose of accessing a universal
health service; and
o likely to reduce the child’s future
support needs, which would
otherwise require support from the
NDIS in later years, including through
a combination and sequence of
supports.
See rs 7.8 to 7.9 of the Supports for Participants Rules.
The NDIS will not be responsible for:
 supports, which are clinical in nature
provided in the health system, including
acute, ambulatory or continuing care; or
 new-born follow-up provided in the health
system, including child and maternal
health services.
See rs 7.10(b) and (c) of the Supports for Participants
Rules.
Operational Guideline
Access - Decision Tree for Disability and Early Intervention Requirements (v 2.2)
Publication date: 6 February 2015
Page 9 of 10
Criteria to meet early intervention
requirements (s.25)
Is requirement met?
Were all of Criterion 6 and 7 and 8 and
9 met?
☐Yes
Consideration: indicate
evidence used and record in
Siebel comments field
☐No
Operational Guideline
Access - Decision Tree for Disability and Early Intervention Requirements (v 2.2)
Publication date: 6 February 2015
Page 10 of 10
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