NDIS High Intensity Supports: Daily Activities, Worker Skills and Funding

NDIS high intensity supports involve specialised assistance for participants who need help with certain disability-related daily activities that carry additional health or safety risks. Under the NDIS Practice Standards, eight specific areas are classified as High Intensity Daily Personal Activities, including complex bowel care, enteral feeding, severe dysphagia management and ventilator management.

These supports do not always have to be delivered by a nurse. Appropriately trained and competent disability support workers may undertake particular tasks when suitable clinical guidance, participant-specific support plans and safeguards are in place. Other activities require a registered nurse or another appropriately qualified health professional.

The distinction matters when choosing a provider. A worker’s general disability support experience does not establish competence in a particular high-intensity task. Nor does an NDIS plan or a provider’s registration automatically establish that every specialised activity can be delivered safely.

This guide explains the eight recognised high-intensity activities, the skills and safeguards involved, how high-intensity supports differ from nursing and standard personal assistance, what to check in your NDIS funding, and how to arrange an appropriate support discussion.

Information checked against NDIS and NDIS Quality and Safeguards Commission guidance on 4 November 2026.

What are NDIS High Intensity Supports?

The term “high intensity supports” is commonly used to describe disability support that requires additional knowledge, training and safeguards because of the nature of the participant’s needs.

The formal NDIS Practice Standards category is High Intensity Daily Personal Activities.

These activities are identified in a supplementary module of the NDIS Practice Standards, administered by the NDIS Quality and Safeguards Commission.

The module describes expected outcomes for participants and the safeguards providers must demonstrate when delivering relevant services.

High-intensity support may involve a disability support worker undertaking a task under an appropriate participant-specific support plan and clinical arrangements. It can also involve qualified health practitioners who assess the person’s needs, establish clinical requirements, train workers or provide professional interventions.

These roles are connected, but they should not be treated as interchangeable.

For the authoritative definition, see the Commission’s High Intensity Daily Personal Activities supplementary module.

How is high-intensity support different from everyday personal assistance?

Ordinary assistance with daily personal activities may include helping someone shower, dress, prepare meals or complete an established routine.

These supports can be important and may be required frequently. However, the amount of time spent providing assistance does not automatically make a task a High Intensity Daily Personal Activity.

The distinction is the specific activity, the participant’s needs, the additional risk and the competencies necessary to deliver the support safely.

For example, helping prepare an ordinary meal is different from supporting a person whose severe dysphagia requires a specialist management plan. Similarly, helping someone organise their daily routine is different from undertaking a complex health-related activity that requires specific training and monitoring.

A participant may receive both standard and high-intensity assistance during their day.

It is therefore important to identify the actual task being delivered rather than applying a single “complex care” label to every activity.

For a broader explanation of everyday assistance, see Aligned Assist’s NDIS In-Home Support Guide.

What are the eight High Intensity Daily Personal Activities?

The NDIS Commission identifies eight activity areas within the current supplementary Practice Standards.

High-intensity activity	What it involves	Important support question
1. Complex bowel care	Specialised assistance with a participant’s individual bowel management needs.	Is there a current participant-specific management plan and appropriate worker training?
2. Enteral feeding and management	Support involving nutrition or fluids delivered through an enteral feeding arrangement.	Have workers been trained for this participant’s feeding method and current support plan?
3. Severe dysphagia management	Specialist support for significant swallowing difficulties and associated mealtime risks.	Has an appropriately qualified health practitioner assessed the needs and delivered the required training?
4. Tracheostomy management	Specialised assistance relating to an established tracheostomy and its management requirements.	Are the relevant clinical plan, worker competencies and escalation arrangements in place?
5. Urinary catheter management	Support associated with a participant’s particular urinary catheter needs.	Does the worker have competence in the specific catheter-related task required?
6. Ventilator management	Specialist support for a participant who requires ventilator-related assistance.	Are device-specific training, clinical oversight and emergency arrangements established?
7. Subcutaneous injections	Support involving prescribed medication delivered by subcutaneous injection.	Are appropriate prescriber instructions, individual plans and worker competencies established?
8. Complex wound management	Specialist support connected with managing a participant’s complex wound-care needs.	Which activities require qualified clinical care, and which can safely be delegated to a competent worker?

These are the eight formal activity areas. They should not be expanded simply because another support is medically complex.

For example, seizure management, medication reminders, general mealtime assistance and some other health-related tasks may involve additional skills or safeguards, but they are not separate ninth or tenth categories in this supplementary module.

The actual support required within each of the eight areas can vary considerably between participants.

Can disability support workers deliver high-intensity supports?

Yes, for appropriate tasks and arrangements.

The NDIS Commission specifically explains that inclusion in the High Intensity Daily Personal Activities module does not automatically mean the support must be delivered by a nurse or another health professional.

Competent disability support workers may deliver certain high-intensity supports where the necessary requirements are met.

Those requirements depend on the task and participant. They can involve an individual support plan, training by an appropriately qualified person, demonstrated competence, suitable supervision and clear responses to changes or emergencies.

There are also professional boundaries.

A disability support worker should not independently diagnose a condition, prescribe medication, change clinical treatment or improvise procedures outside their training, lawful role and the participant’s established arrangements.

Some interventions require qualified health practitioners to undertake the activity themselves.

The question is therefore not whether someone is called a “high-intensity support worker”. It is whether that individual worker has the necessary competency to undertake the particular support safely for that participant.

What makes a high-intensity support worker competent?

Experience in disability support is valuable, but high-intensity competence needs to be demonstrated in relation to the support being delivered.

The NDIS Commission’s supplementary module and linked High Intensity Support Skills Descriptors describe the relevant expectations.

Depending on the activity, providers should consider whether a worker:

• understands the participant’s individual support needs and preferences
• has received the training required for the specific task
• can demonstrate the relevant practical competence
• understands the current participant-specific support plan
• knows the boundaries of their role
• can recognise when the situation is outside the agreed plan
• knows when and how to escalate concerns
• understands the relevant incident and emergency arrangements
• has access to appropriate supervision and ongoing support
• receives further training or reassessment of competence when needed

A general training certificate does not, by itself, establish competence for every participant or every high-intensity activity.

Similarly, an NDIS Worker Screening clearance is a safeguarding measure, not a clinical competency qualification.

A participant or Support Coordinator can reasonably ask how a provider establishes competency for the individual task and what happens when a worker needs additional training.

Why does severe dysphagia management have a specific training requirement?

Severe dysphagia management illustrates why the details of the Practice Standards matter.

Dysphagia involves difficulties with swallowing. Severe dysphagia can create significant risks when a person eats, drinks or receives related support.

Under the current High Intensity Daily Personal Activities supplementary module, workers providing severe dysphagia management must receive training specific to the participant’s needs.

That training must be delivered by an appropriately qualified health practitioner with expertise in severe dysphagia management.

For some other high-intensity activity areas, the module permits training by an appropriately qualified health practitioner or a person who meets the expectations of the relevant skills descriptor.

The broader training allowance should not be incorrectly applied to severe dysphagia management.

There is also a distinction between ordinary meal preparation, general mealtime management and the specific severe dysphagia standard. A participant’s actual assessment and risks determine what support arrangements are required.

Why is a participant-specific support plan important?

High-intensity support should not depend on a worker remembering how a similar task was performed for someone else.

The participant’s own needs, clinical circumstances and preferences matter.

Depending on the activity, a relevant support plan may address:

• the participant’s specific support requirements
• how their preferences and communication needs are respected
• the responsibilities of relevant workers and professionals
• which activities are permitted within the arrangement
• the equipment and resources required
• hygiene and infection-prevention responsibilities
• monitoring and documentation needs
• the circumstances requiring professional review
• incident and emergency responses
• escalation and communication arrangements

The plan should be established and reviewed with appropriate qualified professional involvement, as required by the participant’s circumstances and the relevant standards.

The participant must be meaningfully involved in planning their support, with appropriate consent and decision-making arrangements.

The plan also needs to be accessible to the people who are authorised and expected to implement it.

A generic care checklist or an outdated document may not be sufficient when a participant’s needs have changed.

What role do nurses and other qualified health professionals play?

Some participants need both disability support workers and qualified health professionals.

A registered nurse may assess particular health-support requirements, contribute to clinical planning, provide professional treatment, train workers or supervise delegated activities where appropriate.

Other suitably qualified practitioners may also have relevant roles. For example, a professional with specific expertise in swallowing difficulties may be responsible for aspects of dysphagia assessment and management.

Professional scope depends on qualifications, registration where applicable, the activity involved and the participant’s particular circumstances.

The NDIA’s current disability-related health support guidance explains that funding may cover certain nursing services, qualified practitioner input, training and specific support-worker activities when they are eligible NDIS supports.

However, the NDIS does not replace the health system’s responsibility for diagnosis, acute treatment and other mainstream healthcare services.

Aligned Assist’s separate Complex Nursing Care Melbourne page provides information about its published specialist nursing service.

High-intensity daily activities, nursing and complex behaviour support: what is different?

Support concept	Main purpose	Important distinction
Standard Daily Personal Activities	Assistance with ordinary daily routines such as dressing and personal care.	Frequency alone does not make an activity high intensity.
High Intensity Daily Personal Activities	Specialised support within the eight recognised high-intensity areas.	Task-specific worker competence, support plans and safeguards are essential.
Community or complex nursing	Clinical services delivered within the scope of qualified nursing professionals.	Clinical assessment, treatment and nursing interventions are not automatically support-worker responsibilities.
Intensive and complex behaviour support	Specialist behaviour-related assessment, planning or relevant support arrangements.	Separate behaviour support rules and pricing may apply. It is not automatically registration group 0104.

A participant may need more than one of these supports.

For instance, someone could need help with ordinary household activities, a specifically trained worker for one high-intensity task and a registered nurse for a separate clinical responsibility.

Those services should be coordinated appropriately, but their professional responsibilities, funding and claiming requirements must remain clear.

Do high-intensity providers need registration group 0104?

The relevant NDIS provider registration group is 0104 – High Intensity Daily Personal Activities.

The NDIS Commission lists this registration group as requiring a certification audit.

For a registered provider delivering High Intensity Daily Personal Activities, it is important to check that its registration certificate covers the relevant supports and that applicable Practice Standards are met.

The Commission also states that registered providers may deliver only the high-intensity daily activity supports included in their certificate of registration.

A statement that an organisation is an “NDIS registered provider” does not, on its own, establish registration scope for every high-intensity activity.

Registration obligations can also depend on the type of support, plan management and other applicable rules. It would be incorrect to claim that every possible high-intensity support arrangement must be delivered through registration group 0104 in every circumstance.

The practical approach is to check the applicable registration requirements, the provider’s actual certificate scope and the competence of the workers proposed for the participant.

See the Commission’s registration groups and classes of support.

How is high-intensity support funded under the NDIS?

Funding depends on the participant’s plan, the type of assistance required and whether the proposed support meets current NDIS requirements.

There is no single automatically approved “high-intensity care package” available to everyone with a complex health condition.

Depending on the arrangement, relevant supports may involve:

• assistance with daily personal activities
• eligible disability-related health supports
• appropriate nursing services
• training or supervision for support workers
• certain approved equipment or consumables
• other supports specifically included in the participant’s plan

Daily personal assistance may be funded through Core Supports – Assistance with Daily Life.

Other disability-related health supports may have different funding arrangements or support items.

Before engaging a provider, check:

• the relevant NDIS support budget and category
• the participant’s actual funded supports
• whether the funding is flexible or stated
• the funding period and amount available
• how the funding is managed
• whether the proposed activity meets the current support item and claiming requirements
• what qualified professional input or worker training may also need to be arranged

The NDIA determines the supports included in a participant’s plan. A provider cannot approve additional funding simply because it identifies a need or is willing to deliver a service.

You can read the NDIS Core Supports guidance or Aligned Assist’s Understanding NDIS Funding guide for broader plan information.

Why can high-intensity support cost more?

The NDIS has different support items and price limits reflecting the types of services being delivered.

High-intensity support may involve additional worker qualifications, experience or skills, as well as the responsibilities associated with delivering a more complex task.

However, a higher level of participant need does not automatically authorise charging every hour at a high-intensity rate.

The appropriate support item and rate depend on the work actually provided, the participant’s funded arrangements and the current pricing rules.

For example, a person might require high-intensity assistance during a particular task but standard daily personal assistance at other times.

It is important to establish how those activities should be funded and claimed rather than assuming the entire roster carries the same price.

The NDIS pricing schedule effective 24 September 2026 sets out relevant support item descriptions and maximum prices.

Maximum price limits generally apply to NDIA-managed and plan-managed supports where price limits are specified. Self-managed participants have different pricing arrangements, but all funding must still be used in accordance with NDIS rules.

The provider’s actual agreed charge may be below the applicable maximum.

Before accepting a service agreement, ask for:

• the proposed support item and rate
• the reason that item applies to the activity
• which hours or tasks will be charged at which rates
• travel and other permitted additional charges
• cancellation conditions
• the arrangements for clinical assessment or training costs where relevant
• the process for approving changes to charges or support arrangements

Use the current NDIS pricing arrangements rather than relying on a historical rate sheet or assuming a provider’s advertised price is the NDIS maximum.

Which health supports does the NDIS fund, and which belong to the health system?

Disability-related health supports may be funded by the NDIS when they meet the relevant requirements and help a participant manage the impact of their disability in everyday life.

These may include certain support-worker assistance, qualified practitioner services, training and equipment.

However, the mainstream Australian health system remains responsible for other services, including diagnosis, acute treatment, hospital services and medical treatment that falls outside NDIS responsibilities.

The fact that a participant needs ongoing support for a health-related activity does not automatically mean the NDIS funds every related medical expense.

Similarly, an activity being delivered at home does not by itself determine whether it is an NDIS support or a healthcare responsibility.

The clinical and funding boundaries should be clarified with the participant’s treating professionals and my NDIS contact.

Do the October 2026 budget changes affect high-intensity supports?

On 1 October 2026, the NDIA began applying reductions to specified support budgets for Social, Economic and Community Participation and Improved Daily Living Skills, according to the relevant plan approval, reassessment and renewal dates.

The NDIA explicitly identifies high intensity supports and disability-related health supports among groups excluded from those particular reductions.

That is an important protection, but it should not be misunderstood.

It does not mean that every participant automatically receives high-intensity funding, that every service described as “complex” is exempt, or that no individual funding decision can ever change.

The exclusion relates to the specified October 2026 support-budget measures and their rules.

For the latest details, see the NDIA’s support-budget changes announcement.

What if high-intensity support needs change?

A participant’s health-related support needs may change over time.

That might affect the tasks required, the support plan, worker competence, clinical monitoring or the amount of funded assistance needed.

The first consideration is whether the appropriate treating professional needs to review the clinical arrangements or support plan.

If the participant’s ongoing disability-related support needs have changed significantly and the current NDIS plan cannot meet them, the participant may also need to discuss an appropriate plan-change pathway with their my NDIS contact.

That may involve a variation or reassessment, depending on the circumstances and current rules.

For the separate funding-change process, see Aligned Assist’s NDIS Plan Reassessment guide.

What should happen when a high-intensity support worker changes?

Continuity matters particularly when a participant relies on specialist daily assistance.

A replacement worker cannot safely be treated as interchangeable simply because they hold the same general job title.

Before a new worker undertakes a high-intensity activity, the provider should be satisfied that the worker has the required participant-specific knowledge, training and competence.

Handover arrangements may need to cover:

• the participant’s preferences and communication needs
• the relevant current support plan
• the specific task the worker is authorised and competent to undertake
• equipment and routine requirements
• monitoring and documentation responsibilities
• escalation and emergency arrangements
• clinical contacts and the limits of the worker’s role

Providers should also plan for leave, absence or unexpected changes without assuming that any available employee is qualified for a specialised task.

If no appropriately competent worker is available, the service needs an appropriate response rather than unsafe substitution.

High-intensity support after hospital discharge

For some participants, returning home from hospital involves establishing ongoing disability-related supports alongside appropriate clinical follow-up.

A discharge date does not automatically mean a community provider is clinically or operationally ready to commence every required support.

Useful preparation may involve:

• clarifying which tasks belong to the hospital or treating healthcare team
• establishing the participant’s current clinical support requirements
• making sure relevant support plans and instructions are available
• identifying which activities require qualified professionals
• confirming worker training and competence
• checking the actual NDIS funding arrangements
• confirming suitable provider capacity and continuity arrangements

Health services remain responsible for their applicable clinical and discharge obligations.

A provider should confirm suitability and safe delivery arrangements before accepting a specialised support commitment.

Can high-intensity supports be delivered in Supported Independent Living?

High-intensity assistance may be relevant to participants receiving Supported Independent Living (SIL) support.

However, SIL is a distinct home and living support model. It does not mean every activity undertaken in that setting is automatically high intensity.

The participant’s particular needs determine which supports and staff competencies are required.

The NDIA’s current SIL guidance recognises both standard and high-intensity support pricing, subject to the relevant requirements and funding arrangements.

A SIL property vacancy does not establish eligibility for SIL funding or guarantee that a provider can deliver particular high-intensity health-related tasks.

Likewise, the cost of accommodation and the cost of disability support are separate questions.

For an explanation of the home and living model itself, see the SIL Accommodation Guide.

A hypothetical example: getting the support arrangement right

Consider a fictional Melbourne participant who receives ordinary assistance with everyday personal activities and also requires a specific ongoing high-intensity disability-related health support.

A qualified treating professional has already established the clinical requirements for that activity.

The participant wants a support arrangement that respects their preferred routine without introducing unnecessary staff changes.

A prospective provider would need to understand the particular high-intensity task, current support plan, required worker competence, professional oversight and agreed escalation arrangements.

Separately, the participant and their Support Coordinator would need to check that the necessary NDIS supports are funded appropriately.

The provider could not responsibly assume that its existing personal-care roster is automatically suitable for the specialist activity.

This example is hypothetical. It does not describe an Aligned Assist participant or establish a particular clinical recommendation, staffing arrangement or funding outcome.

How to choose a high-intensity support provider

For high-intensity support, a provider’s general reputation or service catalogue is only a starting point.

Participants and referrers should ask practical questions about the exact activity involved.

1. What relevant support can the provider deliver? Is the specific high-intensity activity within its current scope?
2. What registration requirements apply? If the provider is registered, does its certificate cover the relevant activity?
3. Who will provide the support? What participant-specific skills and competence have been established?
4. Who establishes and reviews the clinical requirements? Is an appropriately qualified professional involved where needed?
5. How are workers trained? What evidence demonstrates the required task-specific training and competency?
6. What happens if something changes? Are clinical escalation and emergency arrangements clear?
7. How is continuity handled? What happens when an experienced worker is absent or a replacement is needed?
8. What will the support cost? Which support items, rates and service agreement conditions apply?

It is reasonable to expect clear answers before agreeing to a complex support arrangement.

Participant preferences, communication accessibility, privacy and consent should be part of those discussions, rather than being treated as secondary to clinical and staffing considerations.

What information helps when making a referral?

A useful initial referral should explain enough for a prospective provider to decide whether a detailed suitability discussion is appropriate.

That does not mean sharing a full medical history through an unsecured message.

Initial information may include:

• the participant’s general Melbourne suburb or service location
• the specific high-intensity activity for which support is sought
• the broad frequency or timing required
• whether an established participant-specific support plan exists
• whether appropriate treating professionals are already involved
• the general worker competency requirements, if known
• the participant’s important support preferences
• the relevant NDIS funding and management arrangements, if known
• the proposed commencement window, where relevant
• who is authorised to coordinate further communication

Detailed clinical records, medication information and other sensitive documents should be requested and exchanged only when needed through an appropriate private process.

A professional referral does not itself establish NDIS funding, clinical readiness or provider acceptance.

Discussing High Intensity Supports with Aligned Assist

Aligned Assist is a registered NDIS provider in Melbourne with published services covering Daily Personal Activities, Community Nursing and Complex Nursing Care.

Its service information includes support for participants with high-intensity needs. However, the exact activity, provider registration scope, worker competence, professional arrangements and current capacity must be confirmed before any specialised service can be agreed.

If you are seeking high-intensity disability support in Melbourne, an initial conversation can clarify the assistance required, the participant’s preferences, existing clinical arrangements and the relevant NDIS funding.

Aligned Assist can discuss whether an appropriate service pathway may be available. An enquiry does not guarantee immediate commencement, a particular worker, specialist clinical capability for every procedure or an NDIA funding decision.

• Phone: 1300 927 248
• Email: info@alignedassist.com.au
• Professional referral or EOI: Submit an NDIS referral
• General enquiries: Contact Aligned Assist

Frequently asked questions about NDIS High Intensity Supports

What are high-intensity supports under the NDIS?

High-intensity supports commonly refer to specialised disability-related assistance requiring additional worker skills and safeguards. The formal High Intensity Daily Personal Activities supplementary Practice Standards identify eight specific activity areas, including complex bowel care, enteral feeding, severe dysphagia management and other specialised supports.

What are the eight High Intensity Daily Personal Activities?

They are complex bowel care, enteral feeding and management, severe dysphagia management, tracheostomy management, urinary catheter management, ventilator management, subcutaneous injections and complex wound management.

Does high-intensity support always require a nurse?

No. The NDIS Commission says these supports do not automatically have to be delivered by a nurse or another health professional. Appropriately trained and competent disability support workers may deliver suitable tasks within the required support and clinical arrangements. Other activities require qualified professional involvement.

Can a disability support worker assist with enteral feeding or urinary catheter management?

Potentially, depending on the particular activity, participant-specific plan, relevant clinical requirements, training and demonstrated worker competence. The presence of these activities in the standards does not give every support worker blanket permission to perform them.

How do I check that a high-intensity worker has the right skills?

Ask the provider how competency has been assessed for the specific task and participant, what training has been completed, who provides professional oversight and what happens when circumstances or workers change.

Is high-intensity support the same as complex nursing care?

No. High Intensity Daily Personal Activities are a defined group of specialised supports that may sometimes be delivered by competent disability support workers. Complex nursing care involves clinical services provided within the professional scope of qualified nurses. A participant may need both.

Is intensive behaviour support one of the eight high-intensity daily activities?

No. Intensive and complex behaviour supports can involve separate specialist practice, funding and pricing considerations. They should not automatically be classified as one of the eight High Intensity Daily Personal Activities.

Does every NDIS provider have registration group 0104?

No. Registration group 0104 relates specifically to High Intensity Daily Personal Activities. A registered provider’s relevant certificate scope should be checked rather than assuming that generic NDIS registration covers all eight activity areas.

Can Core Supports fund high-intensity assistance?

Some high-intensity daily personal assistance may be funded through relevant Core Supports arrangements, including Assistance with Daily Life. Other disability-related health supports, professional input or equipment may use different support items or arrangements. The participant’s actual plan and current NDIS rules determine what can be funded.

Does the October 2026 budget change remove high-intensity funding?

The NDIA identifies high intensity supports and disability-related health supports among groups excluded from the specified October 2026 reductions affecting certain support budgets. This does not guarantee that every participant’s overall funding will remain unchanged or that a particular activity will automatically be approved.

Can high-intensity supports be arranged after hospital discharge?

They may be, but clinical readiness, discharge responsibilities, participant-specific plans, funding, competent workers and suitable provider capacity must be established. A proposed discharge date does not guarantee that every community support arrangement is ready.

What happens if my usual high-intensity support worker is unavailable?

The provider should have appropriate continuity and contingency arrangements. A replacement worker must have the required competency for the participant’s particular activity. A provider should not assign an unprepared worker simply because a shift needs covering.