Attendant care and support services guideline

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Attendant care and support services guideline (PDF, 381KB)

MyGuide6: everyday support services (PDF, 182KB)

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  • Defined terms are shown throughout in bold underlined text when they first appear.

    Aged care is residential care, home care and flexible care as defined under the Aged Care Act 1997.

    Attendant care and support services are services to help a participant with everyday tasks.

    ACSN assessment is an assessment of a participant’s attendant care and support needs done by the NIISQ Agency in consultation with a participant, and any other person which the NIISQ Agency considers appropriate – the assessment must also be informed by advice provided by a NIISQ-approved ACSN adviser.

    Environmental risks include risks which arise in the participant’s home, community, as well as risks which arise due to the participant’s location.

    MyPlan means a support plan prepared by the NIISQ Agency and approved under the National Injury Insurance Scheme Act (Queensland) Act 2016.

    NIISQ-approved ACSN adviser is a person who meets all of the following:

    • is appropriately qualified, including registration in Australia as an occupational therapist registered nurse, or a specialist rehabilitation physician
    • has experience in providing professional advice on attendant care and support services for people with complex support needs
    • is approved by the NIISQ Agency to provide advice about the participant’s treatment, care and support needs for attendant care and support services
    • is regulated by the national regulation as administered by the Australian Health Practitioner Regulation Agency.

    Respite services are services that directly benefit a participant by supporting the participant’s informal support (for example a parent or grandparent) to engage in short breaks from their caring responsibilities.

    Public sector health service means any service provided by, or under any of the following:

    Specialist disability accommodation is a housing support available to some participants in the National Disability Insurance Scheme who have extreme functional impairment or very high needs and who require a specialist dwelling.

    Transport includes where the participant travels using:

    • own vehicle
    • disability specific transport services
    • taxi services
    • rideshare services
    • a vehicle provided by an attendant care and support service provider
    • air travel.

  • The NIISQ Agency will assess a participant’s needs for (or relating to) attendant care and support services and will fund support to assist with everyday tasks in accordance with the National Injury Insurance Scheme (Queensland) Act 2016, the National Injury Insurance Scheme (Queensland) Regulation 2016, this guideline, and other relevant guidelines.

    There is a plain language version of this guideline which is shorter and uses simpler words. To access it, view MyGuide 6 – Everyday support services.

    This guideline should be read in conjunction with the:

  • The National Injury Insurance Scheme (Queensland) Act 2016 and the National Injury Insurance Scheme (Queensland) Regulation 2016 describe how the NIISQ Agency decides whether a treatment, care and support need is necessary and reasonable, and can be funded.

    The NIISQ Agency has published a guideline which explains how it decides whether a support is necessary and reasonable, and is for a treatment, care and support need (see: Necessary and reasonable guideline).

    When the NIISQ Agency is assessing a participant’s need for an attendant care and support service including whether the service is necessary and reasonable, it will give particular attention to:

    • whether attendant care and support services will help the participant achieve any goals identified by the participant or stated in their MyPlan
    • whether attendant care and support services assist the participant with everyday tasks
    • whether the attendant care and support services assist the participant to increase their independence, and facilitate participation in the community
    • whether the attendant care and support services are consistent with current clinical practice and industry best practice
    • whether the attendant care and support services will promote the safety of the participant, family members and attendant care workers
    • whether the attendant care and support service reduces or removes any risk of harm to the participant or others
    • whether the attendant care and support services provided by a provider are appropriate to the participant, including consideration of the participant’s location, age, culture, ethnicity and whether the provider is acceptable to the participant
    • whether other treatment, care and support may reduce the level of attendant care and support services required by the participant (for example, home modifications)
    • whether the attendant care and support services balances participant safety dignity of risk
    • whether the attendant care and support services are the least restrictive option for meeting the participant’s needs.

    The NIISQ Agency will assess a participant’s need for attendant care and support services using advice provided by a NIISQ-approved ACSN adviser.

    This assessment will inform the NIISQ Agency’s decisions regarding any necessary and reasonable attendant care and support services and is based on all available and relevant information.

    The NIISQ Agency may require other information or reports not referred to in this guideline but are determined by a NIISQ Agency delegate to be relevant to a decision to fund attendant care and support services.

  • In accordance with the National Injury Insurance Scheme (Queensland) Regulation 2016, the NIISQ Agency is required to obtain advice from a person that is specifically approved by the NIISQ Agency to provide advice about a participant’s needs for attendant care and support services.

    Only NIISQ-approved ACSN advisers can provide advice to the NIISQ Agency about a participant’s treatment, care and support needs for attendant care and support services.

    A NIISQ-approved ACSN adviser provides advice on the type, frequency, and duration of attendant care and support services for a participant.

  • To understand a participant’s needs for attendant care and support services, the NIISQ Agency will require a NIISQ-approved ACSN adviser to complete an ACSN assessment.

    The ACSN assessment will include:

    • consideration of the participant’s individual needs for attendant care, in the context of other treatment and services provided, including assistive technology, home modifications, and other supports (for example, whether providing home services to the participant enables the participant’s parent to meet their accepted injury-related needs)
    • consideration of the environment in which attendant care services and supports will be provided
    • consideration of any goals identified by the participant, in addition to their abilities and limitations to perform everyday tasks.

    The advice provided by the NIISQ-approved ACSN adviser is to be based on:

    • direct and indirect observations
    • all material available and relevant to the assessment of the participant’s needs for attendant care and support services
    • completed, to the greatest extent possible, in close consultation with the participant.

    The advice provided by the NIISQ-approved ACSN adviser will also be consistent with this guideline.

    Advice from a NIISQ-approved ACSN adviser must include clinical and practical justification as to why the supports are necessary and reasonable including the outcomes to be achieved.

    The NIISQ Agency and/or the NIISQ-approved ACSN adviser may require other information to assess or provide advice on a participant’s needs for attendant care and support services, including:

    • information about needs which relate to injuries, conditions, or disability which are not directly attributable to the participant’s accepted injury
    • any environmental risks, including strategies to mitigate these risks, or alternatives to provide support to the participant
    • information about shared household responsibilities.

    Identifying a participant’s treatment, care and support needs is done in collaboration with the participant, their family and/or other informal supports, and providers.

    Attendant care and support services must be provided by registered providers

    The National Injury Insurance Scheme (Queensland) Act 2016 requires attendant care and support services to be provided by a registered provider, otherwise they are excluded treatment, care and support. Excluded treatment, care and support is not required to be funded under the NIISQ.

    The NIISQ Agency may not require the following providers to be registered providers to support a participant under the NIISQ:

    • home services, including domestic assistance services and home and garden maintenance services (see: Home services), where the provider is a registered business with appropriate insurance in place
    • attendant care and support services when a participant is interstate or absent from Australia, and the NIISQ Agency has specifically approved the provider to provide the service, taking into consideration the appropriateness of the provider, and any other matter which the NIISQ Agency considers relevant (see: Participants travelling overseas guideline)
    • some transport-related support services (for example, taxi and rideshare services, when these services have been approved by the NIISQ Agency before the service is provided (see: Transport-related expenses).
    Why attendant care and support services must be provided by registered providers

    When a provider is registered to provide attendant care and support services to participants in the NIISQ, the provider has demonstrated to the NIISQ Agency that it is likely to have the skill, experience and capability to provide the support. This reduces the risk of harm, abuse, and exploitation to participants. Registered providers are still assessed against the necessary and reasonable criteria, and registration itself does not mean that a provider is appropriate in every circumstance.

    The requirement for attendant care and support services to be provided by a registered provider does not apply if the services are being provided to a participant within a hospital, by hospital staff (which includes both inpatient and outpatient services). This includes hospitals that are a part of a public sector health service, as well as hospitals which are not (for example, private hospitals).

    Support from attendant care and support service providers is provided to NIISQ participants based on active support principles. Active support provides the right level of assistance to enable the participant to do daily activities themselves, to the greatest extent possible.

    Funding care and support provided by family members or friends of a participant

    Excluded treatment, care and support includes support provided gratuitously (without charge) by a participant’s family member or friend.

    Support may be provided to a participant which assists family members who do provide care and support to a participant, with the goal of maintaining and supporting these family members (for more information see: Helping a family member support you (also called respite services).

  • There are several types of attendant care and support services that are commonly funded under the NIISQ, including attendant care services, high-intensity supports, home services, respite services and support, and programs which support social and community participation.

    Attendant care and support services should be provided based on active support principles (see: Attendant care and support services must be supported by advice from NIISQ-approved providers).

    Attendant care and support (also called personal care supports)

    Attendant care services are services to assist a participant to complete everyday tasks and include support for tasks relating to activities of daily living, including:

    • personal hygiene, including showering, bathing, oral hygiene, dressing and grooming
    • toileting, bladder and bowel management and menstrual care
    • eating and drinking
    • meal preparation
    • use of aids and appliances, hearing and communication devices
    • mobility and transferring, for example moving in and out of bed
    • application of splints and basic first aid due to injuries sustained as a result of a participant’s disability.
    Attendant care and support in the community (also called community supports)

    Attendant care and support may also be provided while a participant is in the community and includes:

    • support to attend medical and therapy appointments
    • support to participate in social and recreational activities.
    Family support

    The NIISQ Agency will support a participant who has caregiving roles, or other responsibilities where their accepted injury has impacted their capacity to undertake activities associated with their roles and responsibilities.

    The aim of family support funded under the NIISQ is to support the participant in their role as a caregiver. Family support does not replace a participant’s normal parental or caregiver role or responsibility.

    Support while an inpatient at a hospital

    Community access

    While services provided by hospitals as part of a public sector health service are excluded treatment, care and support under the NIISQ, the NIISQ Agency may fund services to allow the participant to access the community while they are an inpatient where the NIISQ Agency has received evidence of the following:

    • endorsement from the participant’s treating practitioner(s)
    • that the community access facilitates the participant’s wellbeing while an inpatient
    • that the community access aligns with any goals identified by the participant.

    When the NIISQ Agency has decided to fund services to support a participant to access the community while they are an inpatient at a hospital or other place that is part of a public sector health service, the provider of those attendant care and support services must otherwise comply with this guideline, including registration requirements.

    Attendant care and support providers and public sector health services

    A participant’s existing attendant care and support service provider may provide support within a hospital, provided there is an agreement between the participant, the attendant care and support service provider, and the hospital itself. This requirement for agreement reflects the fact that many hospitals and health services will have their own policies and procedures regarding external providers working within their campuses or properties.

    The level of care provided by the participant’s existing attendant care and support service provider will not exceed the participant’s assessed level of care.

    High-intensity supports

    High-intensity supports refers to personal care services that require professional skills, training and expertise. Like attendant care services, high-intensity supports may be delivered while the participant is at home or away from home and in the community.

    The NIISQ Agency may fund high-intensity supports for a participant who has complex medical needs. High-intensity supports may be provided by a person who has significant experience and understanding of health needs and who may be:

    • suitably trained attendant care workers
    • assistant in nursing
    • enrolled nurse
    • endorsed enrolled nurse
    • registered nurse
    • clinical nurse or nurse practitioner.

    The appropriate provider of high-intensity supports depends on a participant’s individual circumstances, and must be consistent with the NIISQ Agency’s policies which apply to providers. High-intensity supports may be appropriate where a participant requires the following in relation to their accepted injury:

    • catheter changes
    • complex bowel care such as an enema
    • complex wound management and pressure care
    • ventilation management
    • tracheostomy changes
    • percutaneous endoscopic gastrostomy (PEG) changes
    • pain management
    • oversight of personal care programs for those with significant or complex medical needs.
    Provider training

    The NIISQ Agency may fund provider-focused training where a particular worker needs to develop specific skills over and above the general level of capability expected, to meet an individual participant’s support needs.

    Wherever possible, attendant care and support workers who have received specialised training funded under the NIISQ should transfer their learnings and experience to subsequent workers.

    Home services

    Home services include domestic assistance services, home maintenance services and garden maintenance services.

    Domestic assistance services

    The NIISQ Agency may fund domestic assistance services that are services to support a participant with everyday tasks which relate to the operation and maintenance of their household and include:

    • meal preparation
    • meal delivery
    • cleaning
    • dishwashing
    • clothes washing and ironing
    • shopping.

    Home and garden maintenance services

    The NIISQ Agency may fund home and garden maintenance including everyday tasks within a participant’s home, garden or yard, which are required to keep a participant’s residence in a safe and habitable condition and include:

    • changing light bulbs
    • replacing tap washers
    • checking and changing smoke alarm batteries
    • lawn mowing
    • pool cleaning
    • light pruning and rubbish removal to ensure safe access for a participant to their home.

    Home and garden maintenance services exclude services or works that are ordinarily undertaken by a skilled tradesperson (for example, carpentry services for deck or façade repairs, painting services, electrical and plumbing services, roofing repair services).

    Lawn mowing, light pruning and rubbish removal is limited to work ordinarily required for an average residence.

    Helping a family member support you (also called respite services)

    The NIISQ Agency may support a participant by funding services to provide a family member (who is the participant’s informal support) with short breaks from their caring responsibilities using respite services.

    Respite services may be provided in a number of different forms, however a common characteristic is that they provide a positive effect to people in a participant’s life who provide informal support, which allows them to engage in other activities.

    Respite services not funded under the NIISQ

    The supports available under the NIISQ do not include carer subsidies which remain the responsibility of the Australian Government and which a participant’s informal supports may remain entitled to, including (but not limited to):

    • carer payments
    • carer allowances
    • carer supplements.

    Specific matters which the NIISQ Agency will consider when deciding respite services

     When suitable for a participant, it is expected that respite services will:

    • sustain the usual living arrangements of the participant
    • maintain or enhance the relationship between the participant and their family
    • protect the participant and their family member from the risk of relinquishment.

    Respite services are services that directly benefit a participant by supporting the participant’s informal support. When deciding respite services, the NIISQ Agency will generally consider the following matters which may affect a participant’s family member actual or risk of:

    • increased family member loneliness
    • declining health and wellbeing of family member or participant
    • social isolation of family member
    • psychological stress of family member
    • financial stress of family member
    • declining confidence in their ability to be a good support for the participant
    • declining physical health of the family member
    • poor access to support from other family members and friends.
    Family member’s circumstances are relevant to determining level of funded respite services

    There are other factors specific to the family member’s and participant’s circumstances which will be relevant to a decision to fund respite services, including the level of care of support services. These factors include:

    • number of people who the family member has responsibility for
    • how long a family member has had caring responsibilities for the participant
    • complexity of disability including whether the participant has psychosocial disability, intellectual disability, drug or alcohol dependency, and disabilities including autism spectrum disorder and developmental disorders which are not related to a participant’s accepted injury
    • whether the family member is caring for a child or grandchild (caring for children or grandchildren presents higher risk of negative outcomes compared with caring for parent, partner, sibling, relative or friend)
    • the level of daily assistance required by the participant and provided by a family member
    • family member’s employment status.

    Respite services may be provided in a participant’s home or outside their home, but must be designed to facilitate and sustain the participant and the usual care arrangements, and may include:

    • support provided in the participant’s own home
    • support provided in a community setting similar to a ‘group home’ structure
    • recreational or holiday-type programs where the primary purpose is to provide respite.

    The respite services funded under the NIISQ may be short (part day) or longer (multiple days) depending on the participant and family member’s circumstances.

    Other attendant care and support services which create a period of rest for the participant’s informal supports may be used, including domestic assistance to maintain and enhance household management.

    Attendant care and support services for a participant who is a child

    Treatment, care and support that falls within the ordinary costs of raising a child is excluded treatment, care and support, and is not required to be funded by the NIISQ Agency.

    However, the NIISQ Agency recognises that parents and caregivers to a participant who is a child may require extra support to meet the needs of the participant within the context of their home life.

    The NIISQ Agency may consider limited funding of home services for a child participant where this support enables the child’s parent or guardian to support a participant’s needs which relate to their accepted injury.

    Whether this is suitable will be assessed as part of the participant’s support needs assessment (see: Assessment of needs for attendant care and support services) and will generally be for a time-limited period.

    Programs which support social and community participation

    The NIISQ Agency may fund the costs for, and associated with, a participant’s participation including:

    • specialised day programs (including programs designed by an occupational therapist for a particular participant)
    • community access programs
    • community-based group supports.

    Activity costs for programs that support social and community participation

    While activity costs are generally not funded, in circumstances where the NIISQ Agency has decided that the costs of participation exceed an affordable level, and where the participant may be at risk of social isolation without the support, the NIISQ Agency may fund the cost of activities when they are a component of a program listed above.

  • Aged care is a combination of programs and services which may cover:

    • assistance with everyday tasks and activities such as cleaning, laundry, shopping, meal preparation and social participation
    • respite services (sometimes referred to as respite)
    • equipment and home modifications such as handrails, widened hallways, accessibly-designed bathrooms, bedrooms, eating areas, indoor and outdoor living areas
    • personal care services, including assistance with dressing, eating and using the toilet
    • health care including nursing and allied health care
    • accommodation.

    Aged care can be provided in a person’s home, or in the community and in residential settings. There are three main types of services:

    • Commonwealth Home Support Programme (CHSP) (which is provided under the aged care legislation)
    • home care packages
    • residential care.

    In some circumstances a participant in the NIISQ may require residential aged care, however not all programs and services delivered in residential aged care meet the definition of treatment, care and support needs and so the NIISQ Agency may only fund particular components of the residential care fees.

    Younger people in residential aged care

    The NIISQ Agency takes a general position that residential aged care is inappropriate for younger participants.

    In line with the Younger People in Residential Aged Care Strategy 2020-2025, the NIISQ Agency will work with younger people with complex needs to identify suitable alternatives to residential aged care, which may include funding specialist support co-ordination to ensure supports available under other systems (including specialist disability accommodation payments under the National Disability Insurance Scheme) are available to the participant.

    The NIISQ Agency may explore temporary transitional arrangements with a younger participant, including transitional accommodation, to divert younger people from residential aged care and into longer term accommodation which is more suitable for them (see: Home modifications guideline).

    Residential aged care provided as part of a public sector health service

    In Queensland, some residential aged care is provided as part of a public sector health service. Services provided as part of a public sector health service in Queensland are excluded treatment, care and support and are not required to be funded under the NIISQ.

    The following table identifies public residential aged care service facilities that are provided as part of a public sector health service and are not required to be funded under the NIISQ.

    If a participant lives at one of these facilities, the NIISQ Agency expects that they would be exempt from any fees, aside from the basic daily fee (described below) which would likely remain the responsibility of the resident participant.

    Table of residential aged care facilities provided as part of a public sector health service

    Based on Queensland Hospital Admitted Patient Data Collection (QHAPDC) 2021-2022 V1.0

     

    Residential aged care facilities Public sector health service
    Gannet House Metro North Health
    Cooinda House Metro North Health
    Dr EAF McDonald Nursing home Darling Downs Health
    Eventide Charters Towers Townsville Hospital and Health Service
    Eventide Home Rockhampton Central Queensland Hospital and Health Service
    Forest View Residential Care Facility Darling Downs Health
    Glenbrook Residential Aged Care Facility Sunshine Coast Hospital and Health Service Karingal Nursing Home
    Milton House Darling Downs Health
    Mt Lofty Nursing Home Darling Downs Health
    North Rockhampton Nursing Centre Central Queensland Hospital and Health Service Parklands Residential Aged Care Facility
    Redland Residential Care Facility Metro South Health
    The Oaks Residential Aged Care Facility Darling Downs Health
    Waroona Multipurpose Centre South West Hospital and Health Service
    Westhaven Nursing Home South West Hospital and Health Service
    NIISQ funding for residential aged care costs

    Residential aged care may be appropriate for a small number of participants who are older, and who require residential aged care services to meet their needs which relate predominately to the natural process of ageing, or where residential aged care is the only option which supports a participant with the management of their accepted injury, or a combination.

    Where residential aged care services are required by a participant as a direct result of their accepted injury, the NIISQ Agency may fund some necessary and reasonable residential aged care costs for the participant.

    The NIISQ Agency will consider the following when deciding whether to fund necessary and reasonable residential aged care costs:

    • whether aged care services were provided to the person before they became a participant in the NIISQ (for example, whether the participant was receiving services under the CHSP or receiving support under a home care package funded by the Australian Government Department of Health and Aged Care)
    • the likelihood that the participant would require residential aged care services in the absence of their accepted injury including the participant’s age, cultural factors, and general health prior to sustaining their accepted injury
    • all alternatives to residential aged care have been explored and determined to be not suitable
    • a participant must also have their eligibility confirmed by the Australian Government – this process is not administered by the NIISQ Agency.

    Where the NIISQ Agency has decided that residential aged care costs are necessary and reasonable for a participant, it may fund or contribute to some of the fees, subsidies and supplements. There is no fixed guidance on the contribution by the NIISQ Agency, as the level of any contribution is dependent on the outcome of an assessment done by an Aged Care Assessment Team through the Australian Government Department of Health and Aged Care.

    NIISQ Agency requirements for residential aged care providers

    The NIISQ Agency requires specific information where a participant is in residential aged care, and where the NIISQ Agency may fund some residential aged care costs. This includes:

    • residential aged care fees letter (i.e. the AN-ACC letter which is sent to a residential aged care facility)
    • previous six months of residential aged care invoices for the participant (where available).

  • The NIISQ Agency may assist a participant with certain transport expenses (including taxi, rideshare and kilometres travelled) and transport-related expenses (for example, car parking costs and tolls).

    The NIISQ Agency will ordinarily fund these expenses where:

    • a participant travels for necessary and reasonable treatment, care and support (for example, medical appointments, therapy appointments, community therapy programs relating to their accepted injury) and
    • the participant requires support as a result of their accepted injury to travel.

    In accordance with the Ambulance transportation guideline, the NIISQ Agency will fund ambulance transportation for participants residing outside of Queensland for:

    • non-emergency pre-hospital patient care and transport
    • specialised transport services
    • inter-hospital transfers
    • Patient Transport Service
    • dispatch and co-ordination of non-urgent patient transport services.
    Requirements for reimbursement of transport expenses

    The NIISQ Agency may reimburse transport expenses for participants who travel in their own car, when the travel has been pre-approved.

    Where a participant is required to travel for necessary and reasonable treatment, care and support, and the only option for the participant to safely travel is by using:

    • disability specific transport services
    • taxi services
    • rideshare services
    • a vehicle provided by an attendant care and support service provider.

    The NIISQ Agency will fund the most appropriate service to enable the participant to travel to receive the treatment, care and support.

    Participants will need to provide evidence of expenditure to be reimbursed (for example, receipts). Reimbursement for transport expenses should be:

    • consistent with reasonable market rates
    • paid where the travel has been taken using the shortest and most direct route
    • be discussed with a NIISQ support planner, and requests for reimbursements should be submitted using the Application for reimbursement of approved transport expenses along with supporting evidence.

    Where a participant is required to travel by air for necessary and reasonable treatment, care and support which is not available locally, the NIISQ Agency may pay the return airfare at the level required by the participant as a result of their accepted injury.

    Travelling with an attendant care worker

    The NIISQ Agency may fund an attendant care worker to accompany a participant either in the participant’s vehicle, or other transport where the participant requires the assistance of the worker. These attendant care workers may also assist the participant by building their capacity to use public transport.

    Transport with an attendant care worker using a vehicle provided by the attendant care and support service provider will be funded to the approved number of kilometres.

    Support related to general transport

    The NIISQ Agency recognises that being able to move around the community safely, conveniently and without high cost is essential for a participant with serious personal injuries and disability.

    Where a participant’s capacity for travel has been affected by their accepted injury, the NIISQ Agency will work with the participant to identify strategies to build the participant’s capacity to travel, to the extent possible, including considering any appropriate vehicle modifications (see: Motor vehicle modifications guideline).

    Where a participant requires transport for purposes other than receiving treatment, care and support funded under the NIISQ, but is experiencing difficulty navigating other systems as a result of their accepted injury, the NIISQ Agency may fund appropriately-qualified providers to assist the participant to access programs and services outside NIISQ including:

    Funding transportation which is not necessary and reasonable treatment, care and support

    The NIISQ Agency may still decide to fund or contribute to a participant’s transport costs in circumstances where it has decided that the expenses are not necessary and reasonable, treatment, care and support.

    This includes where the NIISQ Agency has assessed a need for supported community access, and transportation is required for the participant to participate in social, community and/or recreational activities. The factors which the NIISQ Agency may consider include whether:

    • other transport options have been investigated and determined to be unsuitable
    • the transport costs arise solely and directly as a result of a participant’s accepted injury
    • it is fair and reasonable to contribute to a participant’s transportation expenses
    • funding, or contributing to a participant’s transportation expenses supports a participant to achieve any goals identified by the participant
    • funding the transport supports and enhances a participant’s capacity to engage in community activities
    • (if the participant is a child) the transport falls or does not fall within what the general community would expect a parent to provide for a child’s everyday transport requirements (taking into consideration the support that a parent has to provide because of their child’s disability).

  • Attendant care and support services may be provided to a participant while they are away from home, and where the NIISQ agency has assessed the participant to require the particular care and support provided by the attendant care and support service while away from home. For circumstances where a participant intends to travel overseas, see the Participants travelling overseas guideline.

    The NIISQ Agency should be notified as soon as reasonably possible, to ensure that the participant is supported while they are away from home (ideally, at least one month before the intended travel date). Where possible, the NIISQ Agency will assist with sourcing an appropriate attendant care and support provider in the participant’s intended location.

    This could include where travel is required to receive treatment, care and support funded under the NIISQ, or where the participant is travelling for work, for cultural, for a holiday or for other reasons.

    The NIISQ Agency will work with a participant to identify a suitable provider who provides services at the participant’s destination. Where this is not possible, the NIISQ Agency may fund costs associated with the participant’s existing provider.

    The NIISQ Agency may require additional information to assess a participant’s needs for attendant care and support services while a participant is away from home where there are:

  • Transport

    Attendant care and support services funded under the NIISQ are intended to complement, not replace, some transport and transport-related supports available through the Queensland and Australian Government.

    These supports include travel concession schemes, and assistance available through Services Australia and the National Disability Insurance Scheme.

    Responsibilities for transport may also sit with other authorities, including:

    • ensuring that public transport options are accessible to a person with disability, including through the funding of concessions to people with disability to use public transport
    • compliance of transport providers and operators with laws dealing with discrimination on the basis of disability, including the Disability Standards for Accessible Public Transport 2002 and Disability Discrimination Act 1992
    • transport infrastructure, including road and footpath infrastructure, where this is a part of a universal service obligation or reasonable adjustment (including managing disability parking and related initiatives)
    • support to compensate for the lack of a public transport system.

    Services provided by a public hospital

    Services provided by a hospital as part of a public sector health service in Queensland are excluded treatment, care and support and are funded by the NIISQ through a Queensland Health payment.

    Assistance for everyday tasks

    The level of attendant care and support services funded under the NIISQ must also reflect community expectations. A central principle for all decisions made by the NIISQ agency to fund attendant care and support services, is that the attendant care and support services must assist a participant with everyday tasks, and the assistance is required because of the participant’s accepted injury.

    Services which assist participants with everyday tasks cover tasks which are difficult for the participant to do without assistance, at home, or in the community.

  • The following costs are generally not considered necessary and reasonable treatment, care and support:

    • attendant care and support services provided by a friend or a family member
    • attendant care and support services provided to a person other than the participant
    • general transportation costs (for example, bus, train, hire car and plane tickets) for travel which is not related to necessary and reasonable, treatment, care and support
    • holiday and general activity costs while a participant is away from home (including hotel accommodation, meals and tourist attraction entrance fees) which are not related to necessary and reasonable treatment, care and support
    • transportation and travel-related expenses that are the responsibility of other service systems
    • transport expenses incurred before a person is a participant in the NIISQ, and where the travel is for someone other than the participant
    • services which support a business operated by a participant including performing tasks or labour ordinarily required in the context of that business
    • extensive or excessive landscaping for larger properties, including rural properties, which is beyond work required to ensure safe and convenient access to a participant’s house, and outdoor family or recreational areas
    • services, materials, and other associated costs associated with skilled building or repair works including:
      • carpentry services
      • painting services
      • electrical and plumbing services
      • roofing repair services
    • general accommodation costs (distinguished from costs associated with a participant in residential aged care).

Last updated: July 2024