What Is High Intensity Support Under the NDIS? Eligibility, Funding, and What to Expect

High intensity support is a critical, and often misunderstood, category within the NDIS. For support coordinators working with participants who have complex medical, physical, or behavioural support needs, understanding what qualifies as high intensity, how it is funded, and what it looks like in practice is essential to building the right support around the right person.

This post breaks down the NDIS definition of high intensity support, explains how it differs from standard support, outlines the role of the Authorised Program Officer (APO), and provides practical guidance on getting high intensity support included in an NDIS plan.

Whether you are a support coordinator navigating a complex referral or a family member trying to understand what options are available, this guide is designed to give you clear, accurate information in plain English.

What the NDIS defines as high intensity support

Under the NDIS, high intensity support refers to daily personal activities that carry a higher level of health risk and require workers with specialised skills and training. The NDIS Quality and Safeguards Commission sets out these requirements through the NDIS Practice Standards, specifically under the High Intensity Daily Personal Activities supplementary module.

The NDIS Commission identifies the following categories of High Intensity Daily Personal Activities:

Complex bowel care
Enteral feeding and management (such as PEG feeding or nasogastric tube management)
Severe dysphagia management
Tracheostomy management
Urinary catheter management
Ventilator management
Subcutaneous injections
Complex wound management
Epilepsy and seizure management

These are disability supports delivered by trained workers under clinical direction. They are not medical or nursing procedures, but they do require a level of skill and knowledge that goes well beyond standard support work.

A participant may also require high intensity support due to the nature of their disability where behaviours of concern are present, or where physical complexity means that 2:1 or higher support ratios are needed for safe service delivery.

How high intensity differs from standard support

The key difference between standard and high intensity support is the level of training and qualification required of the support worker.

Standard disability support workers deliver a broad range of daily living and community participation supports. High intensity support workers, by contrast, must complete additional training specific to each participant's needs. This training is delivered by an appropriately qualified health practitioner and covers the specific High Intensity Daily Personal Activities the worker will be supporting.

For example, a worker supporting a participant with a tracheostomy must receive training that covers that participant's specific tracheostomy management plan, including suctioning, emergency responses, and escalation protocols. This training is not a generic course. It is tailored to the individual participant.

This difference in training is reflected in the NDIS Pricing Arrangements and Price Limits. High intensity support attracts a higher hourly rate than standard support, recognising the additional skill, responsibility, and risk involved. The higher rate exists because high intensity workers carry greater accountability and must maintain competency in specialised procedures.

Providers delivering High Intensity Daily Personal Activities must also be registered with the NDIS Commission and audited against the relevant supplementary module of the NDIS Practice Standards. Only the specific high intensity activities listed on a provider's certificate of registration can be delivered by that provider.

What high intensity support looks like in practice

In practice, high intensity support is highly individualised. Every participant's support needs are different, and the way high intensity support is delivered reflects that. Some common examples include:

Enteral feeding support

A support worker trained in PEG feeding assists a participant with their daily feeding schedule, monitors for complications, and follows the management plan developed by the participant's treating health practitioner.

Tracheostomy management

A worker provides daily tracheostomy suctioning and monitoring, with clear protocols for emergency situations and escalation to medical services.

Seizure management

Epilepsy and seizure management is recognised as a High Intensity Daily Personal Activity. Participants who experience seizures require support workers with specific training in seizure response, positioning, medication administration where applicable, and when to escalate to emergency services. This training is tailored to the individual participant's seizure management plan.

Support during behaviours of concern

Participants whose behaviour support plans identify the need for skilled responses during episodes of behaviours of concern may require workers trained in de-escalation, positive behaviour strategies, and safe practices. In some cases, 2:1 support ratios are necessary to maintain safety for both the participant and workers.

Each of these scenarios requires a documented support plan, participant-specific worker training, and regular review by qualified health practitioners. The emphasis is always on the participant being involved in the development of their own support plan.

The role of the Authorised Program Officer

The Authorised Program Officer (APO) plays a key oversight role in the use of restrictive practices within NDIS service delivery. In Victoria, the APO is responsible for reviewing and authorising the use of restrictive practices, monitoring compliance with behaviour support plans, and working toward the reduction and elimination of restrictive practices over time.

For participants receiving high intensity support where restrictive practices are in use, the APO provides an additional layer of governance. The APO reviews whether restrictive practices are being used in accordance with the participant's behaviour support plan, whether less restrictive alternatives have been considered, and whether the use of restrictive practices is being reported and monitored appropriately.

The APO role is Victoria-specific, established under the Disability Act 2006 (Vic) and administered by the Department of Families, Fairness and Housing. Other states and territories have their own authorisation structures for restrictive practices. The APO's oversight is particularly relevant for participants who receive Implementing Intensive and Complex Behaviour Supports, where the intersection of high intensity daily personal activities and behaviour support requires careful governance.

Understanding the APO's role is important for support coordinators because it directly affects how support is delivered, documented, and reviewed for participants with complex support needs.

How to get high intensity support in an NDIS plan

High intensity support is funded through the Core Supports budget in an NDIS plan, typically under the Assistance with Daily Life category. However, having high intensity support included at the appropriate level requires clear evidence and planning.

Here are the practical steps:

Gather evidence from treating professionals. Reports from occupational therapists, speech pathologists, physiotherapists, or medical specialists that detail the participant's specific high intensity support needs are essential. These reports should describe the type of support required, the level of risk, and the training or qualifications workers will need.
Document current support arrangements. If a participant is already receiving support, documenting how their current plan does or does not meet their high intensity support needs provides important context for the NDIA.
Request a plan review or reassessment. If a participant's current plan does not include adequate funding for high intensity support, a plan review can be requested. The evidence gathered from treating professionals will form the basis of this request.
Work with the support coordinator. Support coordinators play a central role in connecting the evidence, the participant's goals, and the funding request. A well-prepared plan review that clearly articulates why high intensity support is needed, what it involves, and what outcomes it supports gives the NDIA the information they need to make an informed decision.

It is worth noting that NDIS funding decisions are made by NDIA delegates based on individual circumstances. No provider or support coordinator can guarantee what the NDIS will fund for a specific participant. What they can do is ensure the right evidence is in place and the request is clearly articulated.

Availability in Melbourne, Bendigo, and Geelong

High intensity support requires providers who are registered, audited, and staffed with appropriately trained workers. Across Victoria, availability can vary depending on the specific High Intensity Daily Personal Activities a participant requires and the provider's certificate of registration.

In Melbourne, Bendigo, and Geelong, participants and support coordinators should look for providers whose registration covers the specific high intensity activities relevant to the participant's needs. Asking a provider what is listed on their certificate of registration, how they train their workers, and how they maintain competency over time are all reasonable and important questions.

Where to from here

If you are a support coordinator working with a participant who may benefit from high intensity support, or a family member trying to understand what this category of support involves, the information in this post is a starting point.

For more detail on how high intensity support is delivered in practice, visit the Myxa high intensity support page. You can also explore core support services or learn more about working with Myxa as a support coordinator.

If you would like to discuss a specific situation, get in touch with the Myxa team.