Escalation Pathways
The NDIS website outlines their commitment to supporting the timely discharge of NDIS participants in hospital, including expected decision making timeframes. Escalation should occur as soon as these timeframes have been exceeded, or when the NDIS has made a decision that does not align with the person’s needs for discharge, so this decision can be reviewed.
The first point of escalation should always be via your Health Liaison Officer (HLO). Your HLO can also assist in determining what additional evidence is required to support an ideal funding outcome.
Most hospital networks have NDIS navigators or similar roles to support with NDIS processes, who often act as the nominated representative for contact with the HLO. Your NDIS navigator may also be able to assist with further escalation to the health interface branch if needed.
Top Tips and Tricks
- Disability Liaison Officers (DLO) play a useful role in health service accessibility for people with a disability, however do not typically play a role in discharge planning and escalations.
- Multiple and Complex Needs Initiative (MACNI) may offer gap funding while awaiting outcomes and have their own escalation pathways with the NDIA.
- DFFH housing crisis line for those facing homelessness or escaping family violence.
- Marathon NDIS crisis service when NDIS supports break down.
Case Study
Despite the need to live alone, Daniel was funded for specialist disability accommodation (SDA) in a 3 resident house.
Daniel’s care team located an appropriate 1 resident apartment, and then provided updated evidence to the NDIA via their HLO in order to request an increase to his funding.
The new evidence was reviewed by the Home and Living panel, who changed Daniel’s funding to SDA, 1 resident villa/duplex/townhouse. Despite this seeming like good news, the hospital team realised that the funding was still not sufficient for the housing option they’d identified for Daniel.
The HLO recommended they provide evidence of their housing search to the NDIA, and as a result, Daniel’s funding was updated to allow him to move into a 1 resident apartment.
View the PDF version of the Escalation Pathways resource: