Community nursing is not in every NDIS plan, and getting it added takes evidence and the right request. This guide explains where nursing funding sits, what the NDIA needs to see, and how to ask.
Community nursing is funded by the NDIS only where the nursing need is a consequence of your disability, and it has to be requested with evidence. Participants often assume that a GP mentioning nursing is enough; it is not. This guide sets out where the funding sits in a plan, what the NDIA looks for and how to make the request at a planning meeting, a review or mid-plan. MediHealth Connect offers NDIS community nursing, and the points below apply whichever provider you choose.
Community nursing is funded from the Core budget as a disability-related health support. Where support workers perform delegated clinical tasks such as PEG feeding, catheter care or bowel care, those hours are funded at the high intensity rates, also in Core. Nursing consumables such as dressings and continence products are generally claimed from Core too. Nursing for an acute illness unrelated to your disability is a Medicare or hospital matter and will not be funded by the NDIS.
The test is whether the nursing is reasonable and necessary and related to your disability. The evidence that satisfies it is clinical: a letter or report from your GP, specialist or hospital that describes the health need, links it to your disability, states what nursing is required and how often, and explains the risks if it is not provided. A nursing assessment from a community nursing provider strengthens the case considerably, because it turns a diagnosis into a care plan with hours attached. Vague requests for "some nursing support" are usually declined; specific requests for "wound care twice weekly for a sacral pressure injury related to paraplegia" are usually funded.
At a planning meeting or scheduled review, bring the evidence and ask for community nursing as a stated support with an hours estimate. If your needs have changed mid-plan, for example after a hospital admission, you can request a plan variation or an unscheduled review rather than waiting. Your support coordinator, LAC or planner lodges the request; a coordinator will also help you assemble the evidence and word the request in the NDIA's terms.
You can ask for an internal review of the decision, and if that fails, apply to the Administrative Review Tribunal. Most declined requests fail on evidence rather than merit, so the first step is usually to obtain a more specific clinical report and a nursing assessment and ask again.
Once nursing is funded, the hours go further when the nurse trains and supervises support workers to deliver the routine parts of care, when consumables are claimed correctly rather than out of nursing hours, and when the care plan is reviewed so visits match need rather than habit. Ask your provider for a utilisation report if you are unsure how the funding is being used.
Core, as a disability-related health support. Older plans and some older guides describe it under Capacity Building; current NDIS pricing places it in Core.
Core funding is flexible, so in some cases nursing can be purchased from existing Core budget if the support is reasonable and necessary. Check with your plan manager or support coordinator, because doing so reduces what is left for other supports.
A registered nurse from a community nursing provider. MediHealth Connect nurses provide assessments that set out the care required, the hours and the evidence the NDIA expects.
MediHealth Connect provides community nursing across South East Queensland.