Case
Brenda’s disability means she needs help with some core mobility tasks, such as safely standing from a seated position. She works with her therapist to explore support options that help make this task easier. Based on her therapist’s recommendation, she asks us to fund an electric lift chair.
Would we fund this?
Yes, we would typically fund buying or hiring a lift chair or specialised recliner chair if Brenda can’t stand independently. They are generally effective and beneficial and have been shown to help people sit and stand independently. This means they are likely to meet our funding criteria.
Brenda will need to provide written evidence from her therapist or clinician that this equipment is effective and beneficial for her disability support needs.
Why would we fund this?
Recliner chairs are common household furniture. A lot of people buy them and they are found in many homes in Australia. Household furniture that most people have in their homes is unlikely to be a disability-related support. Therefore we are unlikely to fund it.
If, however, Brenda needs this furniture because of her disability support needs, we may consider it reasonable and necessary for her. This most commonly relates to specialist furniture designed specifically for disability or aged-care support.
To work out whether a support is reasonable and necessary for Brenda, we look at the information she gives us against the NDIS funding criteria. She would have to show written evidence that she needs the furniture to support her disability. This could be a report, letter or email from a registered therapist.
It would need to show us the lift chair:
- is needed directly as a result of Brenda’s disability
- can be properly installed, and then safely operated by Brenda
- will be effective and beneficial in increasing her independence when moving between sitting and standing.
It also needs to show the lift chair is value for money. This may include giving us evidence from a therapist or clinician that shows either:
- a comparable support, such as a more standard chair, would not properly meet Brenda’s disability support needs
- the lift chair would likely reduce the long-term cost of other supports, for example home care support hours.
To work out whether the lift chair Brenda asks for is value for money, we also look at such things as the ongoing maintenance and repair when compared with other supports that would achieve the same outcome.
For example, it may be more cost effective to rent the lift chair if she only needs the chair for a few months. The planner will decide how much funding Brenda will need for maintenance and repairs based of the expected cost and how often the lift chair will need maintenance or repairs.
In most cases, the funding for a lift chair also includes the cost of delivery and installation.
The planner will think about these costs when assessing whether the lift chair is value for money.
What else do we think about?
We won’t fund extra items that don’t relate to Brenda’s disability. She may, however, choose to pay extra from her own money if she would like to have:
- a particular brand, model or design of an item with the same specifications
- add-on special features not related to her disability needs, such as leather arm supports.
If the lift chair Brenda asks for has higher functionality than the base model, we will work out whether the higher-priced item still meets our funding criteria.
We will think about whether she needs the higher functionality as a direct result of her disability and whether it is value for money.
Brenda then gets written advice from her therapist to help her buy the right lift chair.
Case example
Dimitri is 32 and lives alone. He has muscular dystrophy and due to ongoing deterioration in his muscle strength, he is falling more often when he tries to stand up out of the chairs in the house living area.
Dimitri’s therapist recommends he buy a sit-to-stand recliner chair to help him transition (sit to stand) safely. Dimitri asks us to fund his sit-to-stand recliner chair. He gives us his therapist’s written evidence for the recommended specialised electric recliner chair.
To work out whether the funding for the sit-to-stand recliner chair is reasonable and necessary, his planner looks at this information against the NDIS funding criteria.
The planner thinks about a range of things.
- Is the sit-to-stand recliner chair a disability-related support, or a day-to-day living cost not related to, or caused by, Dimitri’s disability? We would not fund something that is not for Dimitri’s disability needs. To work this out the planner considers whether Dimitri needs the chair because of his disability support needs. That is, whether his muscular dystrophy is the reason he can’t transfer safely out of his lounge chair. Or does he need the chair for a non disability-related reason? For example, he can’t transfer safely because his current chair is old or broken.
- What are the benefits of the requested specialised sit-to-stand recliner chair? Will it achieve the desired outcome of preventing or minimising Dimitri’s disability-related falls?
- How does the cost of the sit-to-stand chair compare with other specialist recliner chairs available? The planner would look at the typical chair type that other participants have used successfully as a benchmark to show if there are more cost-effective options with equivalent performance and function.
- What other services or comparable supports are available that may have wider or longer term benefits. This might include Dimitri’s therapist developing a strengthening program to increase his ability to stand independently.
In Dimitri’s case the planner decides:
- there is evidence to show Dimitri’s falls are directly related to his disability and the recliner is a good option to meet his needs
- the therapist report gives enough evidence to show the sit-to stand chair will be, or is likely to be, effective and beneficial for Dimitri, having regard to current good practice.
The planner also decides the sit-to-stand chair is value for money. Its cost is comparable with what participants have paid for similar sit-to-stand chairs. The planner decides that options such as general furniture items or a strengthening program are unlikely to adequately meet Dimitri’s disability support needs and improve his safety.
The price doesn’t include extra accessories not related to Dimitri’s disability support needs.
The planner assesses funding for the specialised sit-to-stand recliner chair as reasonable and necessary and this is approved in Dimitri’s plan.
Dimitri then gets written advice from his therapist to help him choose the right sit-to-stand recliner chair. Dimitri contacts different providers to get the best price for his chair and buys it with the funding in his plan. His therapist and the supplier help set it up and show him how to safely use it.