Volume 22, Number 4 - December 2019

The NDIS and diabetes

By
Pollyemma Antees

B Health science (Nutrtion and Dietetics), Grad Cert in Diabetes Education and Management. APD CDE

Senior Dietitian and Diabetes Educator

North West Nutrition

A Dietitian for over 16 years working in rural NSW. Interest in food security and link with chronic disease. Became a CDE to provide clients with best practice advice in regards to treatment and management of diabetes. Love to garden and write cookbooks on healthy eating for less.

Introduction

The National Disability Insurance Scheme (NDIS) coordinates individualised support for people with permanent and significant disability, and their families and carers.

From October 1st, 2019 additional disability-related health supports are available to purchase using NDIS funding, including diabetes management supports.1

To be eligible for NDIS support and funding, clients need to:

  • Be aged between 0 and 65 years. Those 65 years and over can apply for My Aged Care services.2
  • Live in Australia and have Australian residency as an Australian Citizen or have a Permanent or Special Category Visa
  • Require or use special equipment because of a permanent and significant disability
  • Require some support now to reduce future needs

There are many people living with diabetes who also have a disability.

This could be because of hearing loss, vision impairment, amputation, or permanent limitations.

Studies have shown that people with a disability are two to three times more likely to develop diabetes.3

This increased risk can be caused by multiple factors such as limited mobility, increased appetite, limited food preparation skills, depression and anti-psychotic medication.3

NDIS will fund support for a disability, but not the condition of diabetes. However, if the disability limits your client’s ability to manage their diabetes, then the NDIS may fund support for living with diabetes as well.

The plan

When a client is developing the plan that is part of the NDIS application, it is important that they list their life goals and objectives.

Here are a few examples:

  • Increase ability to live independently
  • Increase movement and improve health and wellbeing
  • Be more confident to attend social outings
  • Participate in the workforce and manage a budget
  • Improve quality of life now and management of the condition to reduce problems in the future

If your client already has a plan with government funding, they should have the same level of service or a higher level when they change to the NDIS.

Your clients

It is also important for your client to be organised. For example, they need to:

  1. Contact NDIS and complete an Access Request Form, available at www.ndis.gov.au or call 1800 800 110
  2. Schedule an extra-long appointment with their GP so they can sit down and complete the assessment process together
  3. Provide the GP with a list of goals and the resources they require. This will help them understand your client’s needs and match support to what is needed
  4. Collect letters of support from their Allied Health team on how the assisted technologies and services will help them achieve their goals, offering value for money
  5. Collect quotes on cost of services and technologies.  Some NDIS line items require quotes.
  6. Connect with their Local Area Coordinator to develop a plan.

Resources to support your client’s diabetes management

  • Assisted Technologies
    • Use a General Assistive Technology Assessment Template, available on the NDIS website
    • Vision impairment – a blood glucose meter with talking capabilities.
    • CareSens N Voice by Pharmaco  – requires ability to prick finger. Free via your Credentialled Diabetes Educator
    • Freeestyle Libre with Freestyle Link app on a mobile requires a smartphone to convert text to speech
    • Continuous Glucose Monitoring (CGM) device is also available via NDSS if you have a concession card, type 1 diabetes and meet the requirements.  Both Dexcom and Medtronic have smart phone apps which have text to voice options and alarms when Blood Glucose Levels (BGLs) are out of target range.

 

  • If unable to inject insulin or unable to read a pen, a nurse could be funded to dial insulin and inject.  The NDIS item is 15_036_0114_1_3and comes under Improved Daily Living

 

  • If unable to monitor BGLs due to limited limb mobility, the NDIS may provide access to a Freestyle Libre flash glucose monitor. The reader can be attached to a wall so that BGLs can be monitored without hands.

 

  • Support of a dietitian to help with nutritional education to improve nutritional intake and quality of life.  The NDIS item is 12_025_0128_3_3and comes under Improved Health and Wellbeing

 

  • As Credentialled Diabetes Educators are funded by the states’ Health Departments as treatment for diabetes, this service is unable to be funded through the Federal Government’s NDIS. However, your services as a CDE can be funded under staff training in relation to insulin delivery and blood glucose monitoring. The NDIS item varies depending on the CDE qualifications. For nurses it depends on level of qualifications and falls under the group of Community Nursing Care.   For Allied Health it relates to their profession.

 

  • Clients can organise to have prepared meals delivered to their door if they have difficulty preparing meals due to disability. The NDIS line item is 01_022_0120_1_1and comes under Core Supports, assistance with daily life activities

 

  • Diabetes organisations as part of NDSS requirements are required to provide health professionals education and support programs to assist them to support people with diabetes to understand and self-manage their life with diabetes. Contact 1300 136 588 for more information.

 

If your client’s plan is rejected or they are not satisfied with the outcome, they can request an internal review in the first three months.

If they are still not satisfied with the outcome they can have their plan reviewed by the Australian Appeals Tribunal.

References

1.

National Disability Insurance Scheme [Internet]. Canberra, ACT: National Disability Insurance Agency; 2019 [updated 9 November 2019 cited 2019 Dec 4]; Available from https://www.ndis.gov.au/understanding/supports-funded-ndis/disability-related-health-supports

2.

National Disability Insurance Scheme [Internet]. Canberra, ACT: National Disability Insurance Agency; 2019 [updated 9 November 2019 cited 2019 Dec 4]; Available from https://www.ndis.gov.au/applying-access-ndis/am-i-eligible

3.

Brown M, Taggart L, Karatzias T, Truesdale M, Walley R, Northway R, Macrae S, Carey M, Davies M. Improving diabetes care for people with intellectual disabilities: a qualitative study exploring the perceptions and experiences of professionals in diabetes and intellectual disability services. Journal of Intellectual Disability Research. 2017 May;61(5):435-449. doi: 10.1111/jir.12369. Epub 2017 Feb 28. https://www.ncbi.nlm.nih.gov/pubmed/28247543

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