1. On 23 March 2023, the respondent approved a plan for the applicant which included a Statement of Participant Supports. On 12 May 2023, the applicant's mother sought an internal review of that decision, with the primary focus of her request at that time being the inclusion of a significant amount of additional Short-Term Accommodation.
2. On 22 June 2023, the respondent issued its internal review decision, which confirmed the original plan approval. It is this decision that is the subject of the present application for review before the Tribunal. The applicant applied to the Tribunal for a review of that decision on 14 June 2023.
3. During the review proceedings, several further plans have been approved for the applicant. A new plan was approved on 17 May 2024, followed by another on 14 February 2025 and yet another plan was approved on 5 August 2025. A further variation to the plan was approved on 18 August 2025, the first day of the hearing, to provide funding for an eight-week transitional period to assist the applicant in engaging a new service provider.

1. The Tribunal's function is to conduct a review on the merits of the decision under review. This requires the Tribunal to stand in the shoes of the original decision maker and determine the correct or preferable decision based on the evidence presented to the Tribunal.
2. Under the National Disability Insurance Scheme Act 2013 (Cth) (the NDIS Act), every participant must have a plan. The plan must include a Statement of Participant Supports (SoPS), which specifies the supports to be funded by the National Disability Insurance Scheme (NDIS). So far as is reasonably practicable, a participant's plan must be individualised and directed by the participant.[1]
3. The CEO of the respondent is required to facilitate the preparation of a participant's plan. Section 33 of the NDIS Act requires the plan to include two key components: the participant's statement of goals and aspirations, and the SoPS, which is prepared with the participant and must be approved by the CEO. The statement of goals and aspirations is made by the participant and, unlike the SoPS, does not require the CEO's approval.
4. The NDIS Act does not define the composite phrase 'reasonable and necessary supports'. Its meaning is determined by reference to the criteria set out in sections 33 and 34 of the NDIS Act.
5. In McGarrigle, Mortimer J (as her Honour then was) observed that the word 'support' must be given a broad construction:[2]

Section 13 expressly indicates that a 'support' might be a service, or it might be an activity. In my opinion, although s 14 (which deals with funding by the Agency of others to assist the participant rather than the Agency assisting the participant directly) is expressed purposively, its subject matter is also 'support' - whether by way of services of activities or any other matter that assists a person with disability in a way that is consistent with the general principles set out in s 4. The word 'support' must be given a broad construction in this context, and there is no need for the purposes of this proceeding to seek to give it any comprehensive meaning. Rather, the point to be made is that it is a practical description of the means by which a person with disability is assisted. It is not intended, in my opinion, to encompass funding, especially because what s 14 contemplates is that the Agency will 'fund' a support. The Agency cannot 'fund' funding.

6. Her Honour also explained that the words 'reasonable' and 'necessary' perform different work, noting their connection to the criteria in s 34(1):

Whether a support is 'reasonable' requires a different assessment to whether a support is 'necessary'. Again, it is not necessary in the context of this proceeding to be definitive about the nature and extent of the meaning of the phrase, or its components. It is enough to observe that using the concept of necessity would appear to tie one aspect of the CEO's assessment to an evaluation of the kinds of factors set out in ss 34(1)(a), (b) and (d). The word 'reasonable' would appear to be directed at factors such as those set out in s 34(1)(c) and (f). That is not to say the meaning of each word is exhausted by the factors set out in s 34(1): rather, it is to illustrate the different work that each concept does as an adjective in the phrase 'reasonable and necessary supports'.

7. The Full Court of the Federal Court of Australia in WRMF**[3]** explained the phrase by reference to its context of public funding:

[T]here is no doubt that the contextual use of the phrase in this Act links it to public funding to be provided to a participant. In that context, the phrase connotes supports which meet a threshold which justifies - by reference to the context, objects and guiding principles of the Act and the facts of the case - the expenditure of public funds for that support, for a particular participant. As we have already explained, the phrase also needs to be understood taking into account what has qualified a person as a participant, and the links between a person's impairment and their full participation in the community, in the same variety of ways as persons without a disability might choose to participate.

8. Section 34(1) of the NDIS Act establishes mandatory criteria that must each be satisfied before a decision maker can be satisfied that a support is reasonable and necessary. Following the commencement of the National Disability Insurance Scheme Amendment (Getting the NDIS back on Track No. 1) Act 2024 (Cth) on 3 October 2024, s 34(1) of the NDIS Act now provides:

1. For the purposes of specifying, in a statement of participant supports, the general supports that will be provided, and the reasonable and necessary supports that will be funded, the CEO must be satisfied of all of the following in relation to the funding or provision of each such support:

(aa) the support is necessary to address needs of the participant arising from an impairment in relation to which the participant meets the disability requirements (see section 24) or the early intervention requirements (see section 25); > > (a) the support will assist the participant to pursue the goals, objectives and aspirations included in the participant's statement of goals and aspirations; > > (b) the support will assist the participant to undertake activities, so as to facilitate the participant's social and economic participation; > > (c) the support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support; > > (d) the support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice; > > (e) the funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide; > > (f) the support is an NDIS support for the participant. > > Note: For the purposes of paragraph (aa): > > (a) the time at which the disability requirements or the early intervention requirements need to be met is the time the CEO decides to approve the statement of participant supports; and > > (b) a participant's disability support needs arising from an impairment in relation to which the participant meets the disability requirements or the early intervention requirements may be affected by a variety of factors, including environmental factors or the impact of another impairment in relation to which the participant does not meet either of those requirements.

9. The National Disability Insurance Scheme rules may prescribe methods or criteria to be applied, or matters to which the CEO is to have regard, in deciding whether or not he or she is satisfied as mentioned in any of paragraphs (1)(aa) to (f).
10. The National Disability Insurance Scheme Amendment (Getting the NDIS back on Track No. 1) Act 2024 (Cth) also introduced a new s 10 which provided for the definition of a 'NDIS Support'. The operation of s 10 of the NDIS Act as it now stands was comprehensively addressed by SM French in FSWN.[4] I respectfully agree with, and gratefully adopt without repeating, that analysis.
11. Section 35 of the NDIS Act provides for the making of rules in connection with the funding or provision of reasonable and necessary supports, including in relation to:

(a) methods or criteria to be applied, or matters to which the CEO is to have regard, in deciding supports that will be funded or provided under the NDIS; and > > (b) supports that will or will not be funded or provided under the NDIS for some or all participants.

12. The National Disability Insurance Scheme (Supports for Participants) Rules 2013 ('Support Rules') prescribe further criteria and matters to which regard must be had when considering the supports to be included in a participant's plan.
13. In WRMF[5] the Full Court observed:[6]

The supports to be provided to a person who qualifies as a participant are intended to accommodate an individual's particular impairments and to assist that particular individual to be a participating member of the Australian community, and to do so on the basis of the values set out in the objects and guiding principles clauses of the Act, as well as the values set out in s 17A of that Act ...

14. Both adjectives qualify the noun 'support', but they do so as a composite phrase.[7]
15. The Full Court of the Federal Court of Australia considered the meaning of 'reasonable and necessary supports in WRMF:

... the phrase connotes supports which meet a threshold which justifies - by reference to the context, objects and guiding principles of the Act and the facts of the case - the expenditure of public funds for that support, for a particular participant.[8]

16. When addressing the Support Rules in McGarrigle, Mortimer J relevantly stated:

The [Support Rules] are an important element of the legislative scheme, introducing the ability to modify the operation of ss 33 and 34 by, for example, excluding certain kinds of supports from inclusion in participant plans. It is through the Rules that the executive is able to implement ... some policy decision-making about the nature and extent of supports to be provided or funding under the NDIS.[9]

17. Section 34(1) of the NDIS Act requires the CEO to be 'satisfied' that each criterion is met before funding a reasonable and necessary support in a Statement of Participant Supports. In conducting this review, the Tribunal must be similarly satisfied. This state of satisfaction is a positive one, which must be attained in relation to each criterion. While no formal onus of proof rests on either party, the applicant bears a practical onus.[10] The applicant must place material before the Tribunal sufficient to persuade it that the support in dispute is reasonable and necessary.[11]

1. A support will only be included in a participant's SOPS if the Tribunal is satisfied that it meets the criteria for a 'reasonable and necessary support'. The NDIS Act sets out a series of criteria in section 34(1), all of which must be met for each requested support. In short, the Tribunal must be satisfied that each support:

(a) the support is necessary to address needs of the participant arising from an impairment in relation to which the participant meets the disability requirements > > (b) will assist the participant to pursue the goals and aspirations included in their plan; > > (c) will assist the participant to undertake activities that facilitate their social and economic participation; > > (d) represents value for money, meaning the costs are reasonable relative to both the benefits achieved and the cost of alternative supports; > > (e) will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice; > > (f) takes into account what it is reasonable to expect families, carers, informal networks, and the community to provide; and > > (g) is an NDIS support.

2. Schedule 1 of the Transitional NDIS Supports Rules prescribes those supports that are NDIS Supports for the purposes of ss 10 and 34(1)(f) of the NDIS Act.
3. The NDIS Act and its associated rules define what is, and what is not, considered an NDIS support. The National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 prescribe certain categories of support that are not NDIS supports. If a requested support falls into one of these excluded categories, it cannot be funded because the criterion in section 34(1)(f) of the NDIS Act will not be met.

1. The Tribunal received written reports from three expert witnesses:

(a) Ms Carly Pickering, an occupational therapist who has treated the applicant since 2020; > > (b) Ms Sessina Figueiredo, the applicant's behaviour support practitioner. > > (c) Ms Laura Kruger, an occupational therapist engaged by the respondent to provide an independent assessment; and

2. All three experts, along with the applicant's mother, Ms R, gave oral evidence at the hearing

1. Ms R gave evidence about the profound and constant impact of her daughter's disabilities on WXDD and the entire family. She described WXDD as a loving and social child who nonetheless requires continuous, one-to-one supervision to keep her safe. She explained that due to WXDD's unpredictable seizure activity, lack of safety awareness, and challenging behaviours, she cannot be left alone at any time.
2. Ms R spoke of the significant physical and emotional toll of providing this level of care. She described herself as severely burnt out and living in 'survival mode'. She explained that her older daughter, Maya, has also suffered significant mental health challenges as a result of the trauma and responsibility associated with her sister's high needs. Ms R gave evidence that without a substantial increase in formal support, she fears she will be unable to sustain her caring role and may have to relinquish care of WXDD.
3. She also explained that her fly-in fly-out work roster, while challenging, provides a greater income and more time at home than a standard full-time job, and is essential to financially support her family as a single parent.

Ms Sessina Figueiredo, Behaviour Support Practitioner

1. Ms Figueiredo reports that the applicant's disabilities 'result in profound functional impairments across all aspects of the applicant's life'[12].
2. Ms Figueiredo identifies the applicant's diagnoses as Dravet syndrome (a severe genetic epilepsy), severe intellectual disability, Autism Spectrum Disorder (Level 3), Attention Deficit Hyperactivity Disorder (ADHD), sensory processing disorder, and ataxia.
3. According to Ms Figueiredo, the applicant's Dravet syndrome causes 'frequent absence seizures... multiple times per day'.[13] Her severe intellectual disability results in a 'cognitive age... below five years old',[14] and she 'cannot manage self-care tasks... without full physical assistance'. Her Level 3 Autism includes 'extreme rigidity around routines' and a 'pathological demand avoidance (PDA) profile,' which causes her to 'resist any and all demands'.[15]
4. Ms Figueiredo concludes that the applicant is 'fully dependent for all her needs over a 24/7 period'[16] and 'relies on a supporter to engage in all activities of daily living'.[17]
5. The report details several high-risk behaviours. Ms Figueiredo states that physical aggression, including biting, pinching, and hitting, is 'likely to occur multiple times per day'.[18] This aggression can be severe, 'leaving bruises, pulling hair, or drawing blood'.[19] Ms Figueiredo notes one incident 'resulted in nerve damage in the support workers hand'.[20]
6. A 'critical risk of harm' is identified during car travel.[21] Ms Figueiredo reports the applicant may 'unbuckle her seatbelt, climb around the vehicle, attempt to open car doors' or 'climb onto the driver's lap while the car is moving'.[22] She refers to a 'historical incident' where the applicant 'tumbled out of the car as the driver went around a corner'.[23]
7. Other significant behaviours identified by Ms Figueiredo include property damage, for example having 'kicked holes in doors... and shattered glass windows',[24] 'leaving her house, running onto or across roads'[25], and 'daily' episodes of 'becoming stuck'[26] where she will 'drop to the floor or refuse to move during transitions'.[27]
8. Ms Figueiredo states the applicant 'always requires 2:1 support at home, when preparing for transitions, in the car, in the community, and at school'.[28] This ratio is recommended to 'ensure her safety and provide consistent engagement'[29] and in her opinion, aligns with 'NDIS criteria for high intensity supports'.[30]
9. In her oral evidence, Ms Figueiredo repeated her opinion that the applicant requires a 2:1 support ratio at all times during community access and transport to manage these behaviours safely. She gave evidence that two trained support workers are necessary to physically manage WXDD if she becomes stuck in a dangerous location, such as a road or car park, and to prevent her from absconding or causing harm to herself or others.

1. Ms Pickering has been WXDD's treating occupational therapist for over five years. Her evidence is best encapsulated by her written response to targeted questions which she adopted when giving oral evidence. Ms Pickering's report describes Dravet Syndrome as a severe, epileptic brain disorder.[31] It is characterised by multiple seizure types, 'accompanied by cognitive decline, as well as motor, and behavioural abnormalities'.[32] Ms Pickering indicated based on academic research that '87.5% to 100% of adults with the condition reside in residential care or receive home-based care'[33] and that the 'majority of participants were found to have moderate to severe intellectual disability'.[34]
2. Regarding the applicant's prognosis, Ms Pickering states that the applicant's 'disability is both permanent and progressive, which limits the functional improvement that can be made'.[35] Ms Pickering expects that the applicant's 'need for continuous 1:1 and 2:1 support across all aspects of her life... is expected to remain unchanged'.[36] Ms Pickering opines the applicant is 'likely to require continuous supervision and support to ensure her ongoing health and safety throughout her life'.[37]
3. The applicant's function is reportedly variable.[38] Her 'daily functioning and skill level are heavily influenced by her seizure management, medication regimen, and cognitive and physical fatigue'.[39] Consequently, she 'requires varying levels of assistance on different days'.[40] However, due to difficulties with executive functioning and motor planning, she 'always requires standby supervision and verbal prompting to ensure her safety and to meet her needs'.[41]
4. The report details 'increasingly more behaviours of concern'.[42] These include 'yelling, laying on the floor refusing to move, unbuckling her seatbelt, attempting to abscond vehicles, and running across the road'.[43] She also 'exhibits aggressive behaviours such as biting, hitting, kicking, hair-pulling, and throwing objects'.[44]
5. The authors contrast the applicant's needs with those of her peers, stating her 'support needs far exceed the support needs of other twelve-year-olds'.[45] While a 'typically developing 12-year-old'[46] would manage simple daily tasks, the applicant 'necessitates 1:1 formal support for all personal and domestic ADLs'.[47] This support is opined to '[go] well beyond typical parenting responsibilities'.[48]
6. Specific examples of her dependency are provided. She requires 'continuous physical support' for showering and washing her hair.[49] For dressing, she requires support 'ranging from verbal prompting with minimal physical assistance to complete physical assistance'.[50] She requires 'full assistance at mealtimes' and receives her medications 'via PEG, administered by informal and/or formal supports'.[51]
7. Ms Pickering notes that the applicant's sleep is significantly disrupted. The report notes she 'experiences insomnia', 'wakes 2-4 times per night seeking a caregiver', and her mother 'consistently co-sleeps with [WXDD]'.[52]
8. In the community, the applicant uses an 'attendant-propelled wheelchair'. The authors state she 'requires 2:1 support at all times while accessing the community' due to her behaviours of concern.[53]
9. The applicant is described as 'not an independent communicator' and is 'heavily reliant on familiar communication partners to anticipate all her needs and wants'.[54] While she uses an iPad with an AAC app and a PODD book, she 'requires support from a familiar communication partner to effectively utilise her AAC'.[55]
10. Ms Pickering opined it is 'imperative that [the applicant] receive 2:1 support for all community outings'.[56] This is because her 'escalating behaviours can pose risks to herself and others'.[57] The report notes a 'long history... of removing her seat belt, moving around unrestrained in the vehicle, hitting out at the driver and passengers'.[58] She also has a history of 'absconding from caregivers' and 'laying down on roads and unsafe spaces'.[59]
11. The authors report the reports of caregivers that 'even with 2:1 supports is has been difficult to keep [WXDD] safely engaged in her community'.[60] For car travel, 'one adult drives while another must sit beside [WXDD] to ensure she remains safely seated and does not attempt to leave the vehicle'.[61]
12. A specific incident from May 2024 is provided to illustrate this need.[62] During an outing to an IGA store with three supports (two support workers and an occupational therapist), the applicant 'became distressed,' 'hoarded approximately 8 packets' of chips, and 'lay on the floor, yelling/kicking, and refusing to leave'.[63] '3:1 Physical assistance was required to safely manage this situation'. Ms Pickering also observes, however, that this is not an isolated incident and that '[t]here are dozens of examples of this over the last few years'.[64]
13. The report concludes that the applicant 'never leaves her home or respite facility if two familiar adults are not available to support her needs in the community'.[65] This has 'resulted in extremely limited social and community participation'.[66]
14. Currently, the applicant receives '18-22 hours of support per week', but 'only 3-7 of those hours involve 2:1 support'.[67] Ms Pickering expressed the opinion that without an increase in 2:1 support, the applicant's 'ability to access and participate in her community will be severely restricted, as her safety and the safety of others cannot be adequately managed'.[68]
15. The report notes the applicant's mother 'is stretched in her capacity to meet [WXDD]'s complex needs' and is 'subsequently experiencing caregiver burnout',[69] opining she 'urgently requires additional assistance'.[70]
16. The authors recommend 'long-term support' and anticipate that '[w]hen [WXDD] transitions into adulthood, supported independent living will likely be the best fit'.[71]
17. Ms Pickering's opinion was that the applicant requires 1:1 formal support for all personal and domestic activities, and 2:1 formal support for all community access. She supported the requests for the activity chair to provide essential postural support and safety during mealtimes, and for the second skin garment to assist with the applicant's posture and gait.[72]

1. Ms Kruger was engaged by the respondent to provide an independent functional assessment. The Tribunal received Ms Kruger's report dated 30 May 2025, which was based on an assessment conducted on 5 May 2025.
2. Ms Kruger observes that the applicant has 'high intensity support needs'[73] and is 'completely dependent on others to facilitate functioning in all domains'.[74] Ms Kruger describes the applicant's 'level of functioning [as] representative of toddler in many respects'[75] and notes her presentation is 'heavily influenced' by her seizures, medication, and fatigue.[76]
3. Ms Kruger administered several formal assessments by proxy via the applicant's mother.[77] On the WHODAS-proxy, the applicant's 'Overall Disability' score was '79/100', which is categorised as 'Severe disability'.[78] Domain scores included 'Cognition: 80/100- Severe disability'', 'Mobility: 81/100 - 'Severe disability'', 'Self-Care: 80/100- Severe disability'', and 'Life Activities: 88/100-'Extreme Disability/ Cannot do''.[79]
4. On the Vineland-3 assessment, the applicant's Adaptive Behaviour Composite score was '47, which is well below the normative mean of 100'. This corresponds to a 'percentile rank for this overall score is (a) Core Supports:

   (i) during the School Term: a package consisting of 1:1 and 2:1 active high-intensity support for all hours where the applicant does not attend school. This includes 24-hour support on Wednesdays, when she does not attend school;

   (ii) during the School Holidays: 24-hour 1:1 active high-intensity support on weekdays, and 24/7 1:1 support on weekends, supplemented with additional 2:1 support for community access for four hours on each of Saturday and Sunday;

   (b) Transitional Supports comprising eight weeks of continuous 24/7 active high-intensity support at a 2:1 ratio to manage her transition to a new service provider;

   (c) Capacity Building Supports: 30 hours per year of dietitian services and two hours per week of house cleaning;

   (d) Assistive Technology including funding for a specialised activity chair and a second skin garment; and

   (e) Consumables, including Funding for PEG-related care items and nutritional powder.

2. I will consider each of these requested supports in turn.

1. The central issue is the level of ongoing support WXDD requires at home and in the community. The applicant seeks what is, in effect, continuous 24/7 active, high-intensity 1:1 support for all hours she is at home, supplemented by 2:1 high-intensity support for all community access and transport.
2. The specific hours sought for the 40-week school term are:

(a) Monday, Tuesday, Thursday, Friday: 18 hours per day of 1:1 active high-intensity support, plus two hours of 2:1 support for community access and transport; > > (f) Wednesday: 24 hours of 1:1 active high-intensity support, plus two hours of 2:1 support for community access and transport; and > > (g) Saturday and Sunday: 20 hours per day of 1:1 active high-intensity support, plus four hours of 2:1 support for community access.

3. For the 12 weeks of school holidays, the applicant seeks:

(a) Monday to Friday: 24 hours of 1:1 active high-intensity support, plus three hours per day of 2:1 support for community access and transport; > > (h) Saturday and Sunday: 20 hours per day of 1:1 active high-intensity support, plus four hours of 2:1 support for community access;

1. The applicant submits this level of support is necessary to manage her complex needs. The request for 1:1 active support, including overnight active support, is submitted to be required based on the applicant's complete dependence on others for all self-care, her constant medical needs, and the significant safety risks from seizures and behaviours, even while sleeping. Her mother, Ms R, gave evidence that WXDD cannot be left unsupervised at any time and that she provides active, vigilant care throughout the night.
2. The request for 2:1 support is for periods of community access and transport. The applicant's position is that two support workers are required to manage her safely in public. One worker provides direct physical and behavioural support to WXDD, while the second is needed to carry essential medical equipment, such as oxygen, and manage the environment, for example by preventing her from absconding into traffic.

1. The respondent submits that the requested core supports should not be approved for four reasons:[97]

(a) the level of support sought is excessive and does not properly account for the care that it is reasonable to expect a family to provide;[98] > > (b) the level of support sought is not related to the applicant's disability needs;[99] > > (c) the support is not a NDIS support, as that term is defined;[100] and > > (d) the support does not represent value for money.[101]

2. More broadly, the respondent argues the request is excessive and fails to take account of the substantial care it is reasonable to expect a family to provide for a 13-year-old child. The respondent submits the request amounts to a complete outsourcing of parental responsibilities and that some support sought is a substitute for parental supervision, rather than a support necessitated by the applicant's disability.

Do the requested core supports meet s 34(1)(e) of the NDIS Act?

1. The respondent's primary objection relies on s 34(1)(e) of the NDIS Act, which requires that the funding of a support must 'take account of what it is reasonable to expect families, carers, informal networks and the community to provide'.
2. Rule 3.4 of the Supports Rules guides this consideration. For a child, it requires the decision maker to consider:

Reasonable family, carer and other support > > In deciding whether funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide, the CEO is to consider the following matters: > > (a) for a participant who is a child:

(i) that it is normal for parents to provide substantial care and support for children; and

(ii) whether, because of the child's disability, the child's care needs are substantially greater than those of other children of a similar age; and

(iii) the extent of any risks to the wellbeing of the participant's family members or carer or carers; and

(iv) whether the funding or provision of the support for a family would improve the child's capacity or future capacity, or would reduce any risk to the child's wellbeing;

...

(c) for all participants - the desirability of supporting and developing the potential contributions of informal supports and networks within their communities.

1. The respondent submits that parents of a 13-year-old are normally expected to provide substantial care, including supervision and transport. While acknowledging the applicant's needs are greater than those of a typical child,[102] the respondent submits that NDIS funding 'remains predicated on an expectation that parents still provide a substantial amount of 1:1 care'.[103] The respondent contends it is reasonable to expect Ms R to provide direct 1:1 care to prepare WXDD for school, transport her, and provide care before bed. This, the respondent argues, is inconsistent with the applicant's request for 24/7 formal support outside school hours.

1:1 active support (including active overnight support)

1. The evidence from all experts, including Ms Kruger who was called by the respondent, was consistent, unanimous, and in my view compelling. Based on that evidence, I am satisfied that WXDD is a person with profound and multiple disabilities who is wholly dependent on others for every aspect of her life. Her occupational therapists, Ms Pickering and Ms Kruger, both gave evidence that she requires complete or maximum assistance for all activities of daily living. Ms Kruger observed that WXDD's functional and cognitive capacity was in many respects equivalent to that of a toddler.
2. The evidence before me demonstrates, and I find, this is not merely a need for passive supervision. I find it requires constant, active supervision and engagement to ensure her safety. Ms R's evidence, supported by the clinical reports, is that WXDD cannot be left alone at any time due to her lack of safety awareness, unpredictable seizures, and challenging behaviours. Her behaviour support practitioner, Ms Figueiredo, described behaviours including physical aggression, property damage, and absconding into dangerous situations.
3. I am satisfied on the evidence that this need for constant, active supervision does not cease when WXDD is asleep. The evidence establishes frequent sleep disturbances and behavioural escalations at night. Further, I am satisfied that the applicant is at an increased risk of Sudden Unexpected Death in Epilepsy (SUDEP) due to her uncontrolled seizure activity. This risk necessitates constant supervision by an awake and vigilant person to provide immediate medical intervention. The respondent's suggestion that an inactive 'sleepover' shift would suffice is, I find, inconsistent with this evidence and fails to address the gravity of this risk.
4. I turn to the respondent's submission under s 34(1)(e). The respondent argues that funding this level of support fails to take account of the 'substantial care and support' it is reasonable to expect parents to provide. I accept this proposition at a high level of generality.
5. However, I am satisfied that the respondent's submission conflates the provision of substantial care and support, which it is ordinarily expected parents provide, with the provision of what is high-intensity and complex disability support. The evidence overwhelmingly demonstrates that the support WXDD requires is significantly beyond the ordinary parental care that could reasonably be expected in relation to a 13-year-old. It requires a regime of essentially constant medical monitoring, complex behaviour management, and complete physical assistance for almost all day-to-day tasks.
6. I accept Ms Pickering's evidence that while Ms R is physically capable of these tasks, the sheer magnitude and intensity of providing this support single-handedly is unsustainable and has led to severe burnout. Ms R described herself as living in 'survival mode' and expressed fears she may have to relinquish care of the applicant. This is a clear risk to the wellbeing of WXDD and her family. There are matters which I must, and do, consider under Rule 3.4(a)(iii).
7. Even with this support, I am satisfied Ms R will still provide significant care and support to the applicant. I am satisfied that active overnight support is reasonable and necessary.
8. I do not accept the respondent's submission that 1:1 active support for all hours that the applicant is not at school, including active overnight support, fails to satisfy the requirements of s 34(1)(e) of the NDIS Act. Rather, I am satisfied on the evidence before me that the funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide having regard to the particular circumstances of the applicant and her family situation.
9. I am satisfied that s 34(1)(e) is met.

Do the requested supports meet s 34(1)(aa) of the NDIS Act?

1. The next basis upon which the respondent opposes the high intensity active support sought is that it fails to satisfy s 34(1)(aa) of the NDIS Act in that it is not related to the applicant's disability needs.
2. The respondent's case in this respect is that the requested supports are necessary not because of the applicant's disability needs but rather because the applicant requires parental supervision whilst Ms R is at work. The evidence before me was that Ms R works on a fly in fly out roster, 7 days on and 7 days off to provide for her family.
3. I reject the respondent's submission that the support required is a 'substitute for parental supervision' or 'childcare' needed only because Ms R works and is therefore a support that is not related to the applicant's disability needs. This submission misunderstands the analysis required by s 34(1)(f).
4. The proper approach is to focus the inquiry on the applicant's needs arising from her disability. I have approached my assessment of what supports are reasonable and necessary for WXDD, without regard to the availability or capacity of her mother to be present, whatever the reason for her absence might be.
5. I accept, as the respondent submits, that many families must balance work commitments around their children's schooling. However, that is not the issue before me. The support sought here is not to manage a logistical childcare arrangement. It is to manage complex and intense disability-related needs. To label this 24/7 regime of medical and behavioural management as 'parental supervision' ignores the evidence and mischaracterises the support provided.
6. A parent of a child with disability is, like any other citizen, entitled to pursue employment. Nothing in the NDIS Act evinces an intention to require a parent to forgo employment so as to personally provide 24/7 high-intensity disability support that, as I have found, falls far outside the scope of what it is reasonable to expect a family to provide. However, as I have noted, the focus must be on the needs of an applicant, not the arrangements of their parents (or parent in this case).
7. Acceptance of the respondent's submission on this point could lead to the result that any high-intensity support provided to a child could be characterised as a 'substitute for parental supervision'.
8. My analysis is not based on Ms R's availability; it is focused squarely on the applicant's complex, intense, and unrelenting needs. As I have said, the evidence establishes that WXDD's need for active, 1:1 skilled support is constant. This need is a direct consequence of her profound disabilities, her medical risks and comorbidities and her associated complex behaviours. This need exists 24 hours a day, 7 days a week.
9. Therefore, I am satisfied that the applicant's need for this support would be identical irrespective of her mother's working arrangements. It would be the same whether Ms R worked her 7-day-on, 7-day-off FIFO roster, worked part-time during school hours, or did not work at all. The support is required to manage WXDD's disability, not to accommodate her mother's employment.
10. I am satisfied that the requested supports meet s 34(1)(aa) of the Act.

Do the requested supports meet s 34(1)(c) of the NDIS Act?

1. The Respondent submits that the level of support requested by the applicant does not represent value for money, as required by s 34(1)(c) of the NDIS Act. This submission is advanced on two grounds: first, in relation to active overnight support, and second, in relation to 2:1 support for community access which I deal with later in these reasons.
2. In determining whether the supports represent value for money, I am required to, and do, take into account paragraph 3.1 of the Supports Rules.
3. The Respondent contends that the request for 1:1 active overnight support is not value for money. It is submitted that an inactive (sleepover) support, where a worker sleeps but can be woken if required, would be sufficient and more cost-effective. The respondent relies on evidence that inactive support was previously provided at Harry's House and that seizure alarms could be used to wake a sleeping support worker.[104]
4. I do not accept this submission. The evidence, which I have accepted, establishes that WXDD has uncontrolled, catastrophic epilepsy (Dravet syndrome) and is at a high risk of Sudden Unexpected Death in Epilepsy (SUDEP). This risk is unpredictable. It necessitates constant supervision by an awake and vigilant person who can provide immediate medical intervention. Active overnight support was supported by each of the expert witnesses in both their written and oral evidence.
5. The Respondent's suggestion that a seizure alarm is a sufficient alternative is not supported by the evidence of risk. A seizure alarm is a reactive measure; it alerts a sleeping person only after a potentially life-threatening event has commenced. Given the gravity of the risk to WXDD, an immediate, proactive medical response is required. A sleeping support worker, even if woken by an alarm, cannot provide the same level of immediate intervention as an awake carer monitoring for the first signs of seizure activity.
6. The Respondent's reliance on a lack of incident reports or the alleged sufficiency of past arrangements is not persuasive. A support must be proportionate to the risk, not just to the average night. The purpose of this support is preventative. Additionally, if anything the absence of past incidents demonstrates the careful attention to which Ms R has approached the task of monitoring the applicant whilst she sleeps.
7. The benefit achieved by active overnight support is the mitigation of a constant, life-threatening risk. The cost of this support is reasonable relative to this profound benefit and to the catastrophic cost of the alternative.
8. A further reason why I am satisfied the requested supports meet s 34(1)(c) is that inactive overnight support only permits up to 2 hours of 'active' support each night. The evidence establishes that the applicant experiences frequent sleep disturbances and has behavioural escalations at night. In addition to these sleep disturbances and behavioural escalations, the evidence satisfies me that the applicant is at an increased risk of Sudden Unexpected Death in Epilepsy (SUDEP) due to her uncontrolled seizure activity. I am satisfied that this risk necessitates constant supervision by an awake and vigilant person, even while the applicant sleeps, to provide immediate medical intervention if required. The respondent's suggestion that an inactive or 'sleepover' shift would suffice is inconsistent with this evidence and fails to adequately address the gravity of this risk. I am satisfied that the shift notes from Harry's House, which record minimal resettlement times on some nights, do not negate the constant and unpredictable risk of a life-threatening seizure that requires an active, awake carer. I am satisfied that active overnight support is reasonable and necessary.
9. Considering the matters referred to in paragraph 3.1(a)-(f), I am satisfied the request for 1:1 active overnight support, as opposed to inactive overnight support, represents value for money.

1. The Respondent submits that aspects of the requested support do not meet the criteria in s 34(1)(f), arguing they are not an 'NDIS support' as defined in s 10 of the Act and the Transitional Rules.
2. This submission is advanced on two grounds. First, that 2:1 transport to school is excluded as a day-to-day living cost. I will deal with this submission below. Second, and more relevantly for present purposes, the respondent relies on Item 14(e) of Schedule 2 of the Transitional Rules, which excludes 'childcare services' as being an NDIS support. Put simply, the respondent appears to contend that when a support worker supervises the applicant while her mother is absent, that the support is, or perhaps becomes, a 'childcare service' and is thereby excluded as an NDIS support.
3. This second submission can be dealt with briefly. It is, or should be, manifestly clear that the provision of 1:1 active, high-intensity support for a 13-year-old with the applicant's profound and complex needs is not 'childcare' on any reasonable construction of that phrase.
4. I do not accept the respondent's submission that support required while Ms R is working constitutes 'childcare' or a 'substitute for parental supervision'. The need for 24/7 active supervision arises directly and solely from WXDD's profound disabilities. To accept the respondent's submission could lead to the result that any high-intensity support for a child could be described as a substitute for parental supervision. In any event, I am satisfied that the applicant's needs exist whether her mother is in the next room or at her remote worksite. The support is required to manage WXDD's disability-related needs, not to accommodate her mother's employment.
5. The support WXDD requires is for constant medical monitoring (including seizure management), complex behaviour management, and complete physical assistance for all daily tasks. This is skilled disability support. It bears no resemblance to the supervisory childcare that a child might require. The support is necessitated entirely by the applicant's disability-related impairments, not by her age or a generic need for supervision. As I have already observed in a different context above, this remains true regardless of whether her mother is present in the home or absent for work.
6. I therefore reject the submission that this support constitutes an excluded 'childcare service' and I am satisfied that the support is an NDIS Support.

Conclusion on active 1:1 high-intensity support

1. I am satisfied that the provision of active 1:1 high-intensity support for all hours the applicant is at home, including overnight, is a reasonable and necessary support. For the above reasons, I am satisfied this support:

(a) is necessary to address the applicant's needs arising from her profound disabilities, including Dravet syndrome, Level 3 Autism, and severe intellectual disability. I am satisfied that the need for constant, active supervision is a direct result of these impairments; > > (b) will assist the applicant to pursue her goal of remaining in the family home; > > (c) will assist the applicant to facilitate her social participation by ensuring she is safe and supported at home; > > (d) represents value for money. The cost of active overnight support is reasonable relative to the benefit of mitigating a constant, life-threatening risk of SUDEP. The 24/7 support is value for money as it sustains the informal care arrangement and prevents carer burnout, which could lead to a far more costly crisis intervention or relinquishment of care; > > (e) is effective and beneficial, based on the unanimous expert evidence that the applicant requires constant, active supervision to manage her medical and behavioural risks; > > (f) takes account of what it is reasonable to expect families to provide. I find that it properly takes into account what is reasonable for her family to provide by funding disability-specific support that goes far beyond the scope of ordinary or typical parental care; and > > (g) is an NDIS support. I reject the respondent's submission that this support is 'childcare'. It is skilled disability support required entirely because of the applicant's impairments, not her age or a generic need for supervision.

Core Supports: 2:1 Community Access and Transport

1. The applicant seeks funding for high-intensity support at a 2:1 ratio for all periods of community access and transport. Specifically, this includes two hours per day on school days (Monday, Tuesday, Thursday, Friday), two hours on Wednesday, and four hours each on Saturday and Sunday.
2. The applicant's position is that two paid support workers are required to manage her safely in public. The evidence is that one worker is needed to provide direct physical and behavioural support to WXDD, while the second worker is required to manage the environment, for example, by preventing her from absconding into traffic and to carry essential medical equipment, such as oxygen. The applicant's mother, Ms R, gave evidence that she is unable to take WXDD out alone for fear of an incident she could not manage by herself.

1. The respondent opposes funding for a second paid support worker for community access and transport, arguing it is not a reasonable and necessary support. The respondent submits that this request fails to take account of what it is reasonable to expect a family to provide, as required by s 34(1)(e) of the Act. It is argued that transporting a 13-year-old child to school and participating in community activities are normal aspects of parental responsibility. The respondent otherwise contends that it is reasonable to expect Ms R to be one of the two adults providing this support.
2. Further, the respondent submits the request does not represent value for money under s 34(1)(c). It is argued that funding a second worker merely to alleviate parental responsibility, or to allow Ms R to 'observe' her daughter is not a reasonable or cost-effective use of NDIS funds. Finally, the respondent argues that transport provided by families is a day-to-day living cost and therefore not an 'NDIS support' under s 34(1)(f).

1. I am satisfied, based on the expert and lay evidence, that WXDD requires the support of two adults to safely access the community and for transport. The evidence of Ms Figueiredo regarding the risk of absconding or dropping to the ground in dangerous locations is compelling and was unshaken. I accept Ms R's evidence that she cannot safely manage her daughter in the community alone.
2. I am satisfied that, the central issue is not whether two adults are required, but whether the second adult should be a funded support worker, as the applicant contends, or an informal support, as the respondent submits.
3. On this specific point, I prefer the submissions of the respondent. As I have explained above, the NDIS Act and the Supports Rules requires that the funding of supports must take account of what it is reasonable to expect families and carers to provide. I accept that participating in community activities with one's child, even a child with high and complex support needs, is a normal part of family life. This includes transporting that child to school and accompanying them on outings, however I recognise that unlike a normal 13-year-old, the applicant is not able to access public transport to make her own way to school. However, I am satisfied that fact is reflected in the acceptance that 1:1 support worker assistance is required for transport and community access.
4. While I accept WXDD requires a second person for safety, I am satisfied that it is reasonable to expect her mother, Ms R, to be that second person when she is participating in the outing with her daughter. The role of the second person, as described in evidence, is to manage the environment, carry medical equipment, and provide back-up support. This is a form of informal support that a parent can reasonably be expected to provide. This finding is distinct from my finding in relation to 24/7 in-home support, which I have found goes far beyond the scope of reasonable parental responsibility.
5. For the same reasons, I am satisfied that funding a second paid worker for these activities does not represent value for money, as required by s 34(1)(c). The cost of funding this second worker is not reasonable relative to the benefits achieved, particularly when that role can be effectively and reasonably fulfilled by an informal support (Ms R) who is already present. I accept the respondent's submission that funding a support worker so that Ms R can 'observe' outings rather than participate in direct care of the applicant, or remain at home to attend to other chores, is not value for money.
6. Therefore, I am not satisfied that 2:1 high intensity support is reasonable and necessary and should be funded. I am not satisfied that funding a second paid worker takes account of what it is reasonable to expect families to provide. Participating in community outings and transporting a child to school are normal parts of family life. While a second person is necessary for safety and that makes community outings more onerous with the applicant, I am satisfied that it is reasonable to expect Ms R be that second person when she is participating in the outing with her daughter.
7. There is otherwise no dispute, and I am satisfied, that funding for 1:1 high-intensity support for all community access and transport is reasonable and necessary. As I have explained, I am otherwise satisfied that the second support person required for safety can and should reasonably be provided by an informal support, such as her mother.

1. The respondent approved a new plan during the hearing which included funding for an eight-week transitional period. While the respondent did not make extensive submissions on this point, its approval of the varied plan indicates an acceptance that some form of intensive transitional support was required to stabilise the applicant's care arrangements following the withdrawal of her previous providers. The specifics of that funding were noted to provide for 2:1 high-intensity support for four hours on weekdays and four hours on weekends, rather than the 24/7 support sought by the applicant.

1. The applicant seeks eight weeks of 24/7 active high-intensity support at a 2:1 ratio to ensure a safe and effective transition to her new support provider, Perth Disability Services. This request follows the sudden cessation of services from her two previous providers, a situation which her mother, Ms R, described as leaving the family in crisis.
2. The applicant submits that this intensive, time-limited support is required to ensure a safe and effective transition to her new support provider, Perth Disability Services. This follows the sudden cessation of services from her two previous providers, which left her family in a crisis. It is argued that the 2:1 ratio is necessary to allow for 'buddy shifts', where new support workers can shadow experienced workers and the applicant's mother to learn her complex behavioural and medical needs. The applicant's position is that this upfront investment in comprehensive training is critical to establishing a stable and skilled care team, thereby reducing the risk of future service breakdowns.
3. Regrettably, the applicant's written closing submissions do not address the transitional supports sought in any detail, particularly in circumstances where some transitional supports were provided during the hearing.

1. The applicant's need for a stable and highly skilled care team is self-evident. The evidence establishes that WXDD has complex medical needs and significant behaviours of concern that require trained and consistent responses. The breakdown of services with two previous providers underscores the importance of a robust transition process to ensure continuity of care.
2. However, a request for 24/7 support at a 2:1 ratio for a period of eight weeks is not, in my view, entirely reasonable or necessary. While 'buddy shifts' are a practical and effective way to train new staff in WXDD's specific and complex needs, it is not necessary for this intensive training to occur for 24 hours a day. The evidence indicates that the most critical and complex routines occur during waking hours, particularly the morning routine and the after-school period. I find that the respondent's provision of funding for a second support worker for four hours per day is a reasonable and proportionate response to the need for this hands-on transitional training.
3. Where I differ from the respondent's approved plan is in the duration of that support. While the plan was varied for an eight-week period, I am satisfied that a four-week period is sufficient to achieve the desired outcome. In my view, this provides ample opportunity for a new team to shadow existing supports during WXDD's most complex routines and to develop the necessary skills and rapport to manage her care. Therefore, I find that funding for a second support worker for four hours per day, for a period of four weeks, is a reasonable and necessary support.

1. The applicant seeks funding for two supports under this heading: 30 hours per year for a dietitian and two hours per week for house cleaning. I will consider each separately.

1. The applicant seeks 30 hours per year for a dietitian. However, other than to refer to a bare assertion that the requested support is reasonable and necessary, the applicant's written closing submissions do not address this support in any detail.[105] However, I infer that the applicant submits that 30 hours are required to manage her complex nutritional needs, which include food avoidance behaviours, a very restricted diet, and reliance on PEG feeding. This is supported by evidence from her treating team at Perth Children's Hospital (PCH).
2. The respondent submits that it is clear the applicant does not currently require funding for 30 hours of dietitian support.[106] The respondent otherwise submits the request for 30 hours is not justified, particularly as the applicant also receives dietetic services through the mainstream health system at PCH.

1. I am not satisfied that funding for an additional dietitian hours is reasonable and necessary.
2. The evidence clearly shows that the applicant has complex nutritional needs. However, the applicant's mother gave evidence that WXDD has not used the 10 hours currently funded in her plan, as she is on a waiting list for a private dietitian. Given that the currently funded NDIS supports have not been utilised, the applicant has not satisfied me that funding for an additional 20 hours would be effective or beneficial or represent value for money at this time.
3. More fundamentally, the Tribunal must be satisfied that a support is most appropriately funded or provided through the NDIS and not through other general systems of service delivery. The applicant's mother confirmed in her evidence that she has had contact with WXDD's dietitian at PCH within the last six months and can access that service as needed.
4. I accept the respondent's submission that these dietitian services can be, and are being, provided by the mainstream health system. Accordingly, I am not satisfied that the requested support is an NDIS support for the purposes of s 34(1)(f) of the NDIS Act. As such, I do not accept that this support is reasonable or necessary as required by s 34(1) of the NDIS Act.

1. The applicant seeks funding for two hours per week for house cleaning. The applicant's mother gave evidence that additional cleaning is required as a direct result of the applicant's disability-related behaviours, such as food smearing and property damage. It is argued that this goes beyond standard household cleaning and that her mother does not have the time or capacity to manage this additional workload given her intensive caring responsibilities.
2. The respondent opposes this funding. It submits this is a day-to-day living cost and there is insufficient evidence to establish the need is a direct result of the applicant's disability.[107] The respondent submits that cleaning is a task that it is reasonable to expect family members to undertake.[108]

1. I am not satisfied that this support is reasonable and necessary as required by s 34(1) of the NDIS Act. The NDIS Act requires that a support must take account of what it is reasonable to expect families to provide.[109] I accept the respondent's submission that, in the circumstances of the present case, household cleaning is a day-to-day living cost and a task ordinarily undertaken by family members and, in particular, the parents of a 13-year-old child.
2. While I accept the applicant's disability-related behaviours may create additional cleaning tasks, there was limited evidence before me to distinguish the cleaning sought from that required for the ordinary running of a household. Furthermore, this decision will result in the applicant receiving a considerable increase in formal support, including 24/7 1:1 active support at home. I am satisfied that this will, in turn, significantly reduce the overall domestic and caring responsibilities currently borne by the applicant's mother. In relation to house cleaning, the applicant's mother gave evidence that additional cleaning is required as a direct result of the applicant's disability-related behaviours, such as food smearing and property damage. It is argued that this goes beyond standard household cleaning and that her mother does not have the time or capacity to manage this additional workload given her intensive caring responsibilities.
3. In these circumstances, the applicant has not satisfied me that funding for two hours of house cleaning per week meets the criteria in s 34(1)(e) of the NDIS Act having regard to Rule 3.4. The applicant has not satisfied me that this support takes account of what it is reasonable to expect families to provide. I find that it is reasonable to expect the additional two hours of cleaning per week which is sought is something that ought be performed by informal supports.

1. The applicant seeks funding for an activity chair and a second skin garment. The applicant relies on the evidence of Ms Pickering and Ms Kruger, who-from a clinical perspective-both recommend these items. It is submitted that the activity chair is needed to provide safe and effective postural support during mealtimes and other tabletop activities at the kitchen bench. Evidence was given that the applicant's current seating is unsafe and unstable.
2. The second skin garment, a custom-made supportive suit, is recommended to assist with her posture, gait, and functional mobility, which are affected by her low muscle tone.

1. The respondent submits that the request for the activity chair does not represent value for money. It notes the evidence that a formal in-home trial, which Ms Pickering described as essential to ensure the chair would fit in the family's tight kitchen space, has not occurred. Without this trial, the respondent argues the Tribunal cannot be satisfied that the specific chair quoted is suitable or beneficial.
2. In relation to the second skin garment, the respondent raises concerns about its effectiveness and benefit. It points to evidence that a previously funded garment was not purchased due to the applicant's significant seizure activity at the time. The respondent questions whether the garment would pose a risk by restricting her movement during a convulsive seizure, contrary to the advice in her seizure management plan.

1. The applicant seeks funding of $4,080.26 for a custom 'Second Skin' supportive garment to assist with her posture, gait, and mobility. Both Ms Pickering and Ms Kruger recommended this item.
2. In its closing submissions, the respondent conceded this point and agreed to fund the garment. Notwithstanding this concession, I must be independently satisfied that the support meets the criteria in section 34.
3. The evidence establishes that the garment is clinically indicated to assist with WXDD's biomechanical posture and functional mobility, which are affected by her low muscle tone and ataxia. The respondent initially raised a concern that the garment could restrict movement during a seizure, contrary to WXDD's seizure management plan. However, Ms Pickering gave evidence that the garment is a neurological splint and can be custom designed with specific webbing styles to ensure it does not compromise respiratory function or pose a danger during a seizure. I accept this evidence.
4. I am satisfied that the Second Skin garment is a reasonable and necessary support. In particular, I am satisfied that the garment:

(a) is necessary to address the applicant's needs arising from her low muscle tone and ataxia, which affect her posture and gait; > > (b) will assist the applicant's mobility and participation goals; > > (c) will assist the applicant to undertake activities by improving functional mobility; > > (d) it represents value for money, noting the respondent's concession and the absence of any specific alternative being identified; > > (e) is likely to be effective and beneficial, based on the clinical recommendations of two occupational therapists. I accept the evidence that the garment can be custom-designed to mitigate risk during a seizure; and > > (f) is an NDIS support as defined.

1. The applicant seeks funding of $11,659 for a specialised Rifton activity chair. The clinical evidence from Ms Pickering and Ms Kruger supports the need for such a chair. Ms Pickering explained that it would provide a stable base to support WXDD's posture, promoting a safe swallow to manage her dysphagia, and would allow her to safely participate in activities at the kitchen bench.
2. The respondent submits that the request does not represent value for money. Ms Pickering's own report, dated January 2024, states that it is 'essential to complete an in-home trial due to the tight kitchen and dining space, ensuring accessibility for WXDD in home environments'. At the hearing, both Ms Pickering and Ms R confirmed this trial has not happened.
3. I agree with the respondent. While the clinical need for a supportive chair is established, section 34(1)(c) of the Act requires me to be satisfied that the support represents value for money. The applicant's own occupational therapist identified an in-home trial as 'essential'[110] to ensure the chair's suitability given the 'tight kitchen and dining space'.[111] Without this trial having been completed, I cannot be satisfied that this particular chair is suitable and, in those circumstances, that it represents value for money.
4. I am not satisfied that the requested activity chair, at a cost of $11,659, represents value for money at this time. Accordingly, I am not satisfied that s 34(1)(c) is satisfied.

1. The applicant seeks funding for PEG care accessories, syringes, extensions, a mic-key button, and PediaSure powder. The respondent submits these items are more appropriately funded through the mainstream health system.

1. The applicant submits that these items are a direct result of her disability-related health needs. She requires a PEG for nutrition, hydration, and medication, and these consumables are essential for its daily management. Her mother gave evidence that she purchases the PediaSure powder privately because the liquid supplement provided by the hospital has a short shelf life and results in considerable wastage.

1. The respondent's position is that these supports are more appropriately funded through the mainstream health system. It relies on correspondence from Perth Children's Hospital which indicates that nutritional feeds and some consumables can be provided through the hospital's Home Enteral Nutrition (HEN) program. The respondent argues that, as these items can be provided by the health system, they are not a responsibility of the NDIS and therefore cannot be funded in the applicant's plan.

1. The evidence supports the respondent's position. Correspondence from PCH indicates that nutritional feeds and some consumables can be provided through the hospital's Home Enteral Nutrition (HEN) program. The applicant's mother confirmed she is able to order extension sets from the hospital. While the applicant's mother gave evidence that she prefers to purchase PediaSure powder privately because the liquid supplement provided by the hospital has a short shelf life and results in considerable wastage, this appears to be a matter of preference and convenience rather than clinical necessity.
2. I am not satisfied these items are an NDIS support as defined and, accordingly, they do not satisfy s 34(1)(f) of the NDIS Act. I am satisfied that these supports are available to the applicant through the mainstream health system via the Perth Children's Hospital Home Enteral Nutrition (HEN) program. The preference for a powdered supplement due to the shorter shelf life of the hospital-supplied liquid is a matter of convenience, not clinical necessity, and does not shift the funding responsibility from the health system to the NDIS.

1. Neither party made submissions as to the duration of the plan. Nonetheless, I consider it appropriate that the applicant's plan be reviewed within 12 months.
2. I have reached that conclusion because this decision directs the inclusion of a comprehensive and significantly increased package of supports, most notably the provision of ongoing 24/7 active 1:1 high-intensity support. This 12-month period will provide a sufficient opportunity for these new and complex support arrangements to be implemented and to stabilise. It will also enable the parties to gather evidence as to the impact and operation of these supports, permitting an objective assessment at the next review as to whether the provision of this high level of support, particularly the active overnight component, remains reasonable and necessary.

1. For the reasons set out above, the decision under review is varied. I direct the respondent to include in the applicant's Statement of Participant Supports funding for:

(a) a second support worker for four hours per day for a transitional period of four weeks, at a high-intensity rate; > > (g) ongoing 24/7 active, 1:1 high-intensity support for all hours the applicant is at home; > > (h) ongoing 1:1 high-intensity support for all community access and transport; and > > (i) assistive Technology in the amount of $4,080.26 for a Second Skin garment.

1. I certify that the preceding one-hundred and seventy three (173) paragraphs are a true copy of the reasons for the decision herein of General Member Robertson

..........................[SGD].........................

18 and 19 August 2025 (final written submissions filed on 16 September 2025 and 14 October 2025)

[1] National Disability Insurance Scheme Act 2013 (Cth) s 31.

[2] McGarrigle v National Disability Insurance Agency [2017] FCA 308, [88], [91] ('McGarrigle').

[3] National Disability Insurance Agency v WRMF [2020] FCAFC 79; (2020) 276 FCR 415 ('WRMF').

[4] FSWN and National Disability Insurance Agency (NDIS) [2025] ARTA 114, [31]-[39]; [43]-[46].

[5] National Disability Insurance Agency v WRMF [2020] FCAFC 79; (2020) 276 FCR 415.

[6] National Disability Insurance Agency v WRMF [2020] FCAFC 79; (2020) 276 FCR 415, [141]-[151].

[7] National Disability Insurance Agency v WRMF [2020] FCAFC 79; (2020) 276 FCR 415, [150].

[8] National Disability Insurance Agency v WRMF [2020] FCAFC 79; (2020) 276 FCR 415, [151].

[9] McGarrigle v National Disability Insurance Agency [2017] FCA 308, [43].

[10] National Disability Insurance Agency v Davis [2022] FCA 1002 [60]; National Disability Insurance Agency v WRMF [2020] FCAFC 79; (2020) 276 FCR 415, [201].

[11] Beezley v Repatriation Commission [2015] FCAFC 165 (2015); 150 ALD 11 [68]; HPSC and National Disability Insurance Agency [2021] AATA 727 [85].

[97] Respondent's written closing submissions dated 14 October 2025, [13].

[98] Respondent's written closing submissions dated 14 October 2025, [14]-[32].

[99] Respondent's written closing submissions dated 14 October 2025, [33]-[36].

[100] Respondent's written closing submissions dated 14 October 2025, [37].

[101] Respondent's written closing submissions dated 14 October 2025, [38]-[46].

[102] Respondent's written closing submissions dated 14 October 2025, [17].

[103] Respondent's written closing submissions dated 14 October 2025, [17].

[104] In this regard, I note that Ms Kruger was specifically asked about these matters in her oral evidence by counsel for the respondent and maintained her view that active overnight support was required: see Transcript of the hearing on 19 August 2025, pp 27-28.

[105] See applicant's written closing submissions dated 16 September 2025, [46] which refers to the applicant's statement of issues, facts and contentions. Paragraph 26 of the applicant's statement of facts, issues and contentions simply claims '[t]he applicant contends that 30 hours of dietitian is a reasonable and necessary support pursuant to s 34 of the NDIS Act.'

[106] Respondent's written closing submissions dated 14 October 2025, [60].

[107] Respondent's written closing submissions dated 14 October 2025, [47]-[53].

[108] Respondent's written closing submissions dated 14 October 2025, [49].

[109] National Disability Insurance Scheme Act 2013 (Cth), s 34(1)(e).

[110] See transcript of the hearing on 19 August 2025, p 50.

[111] See transcript of the hearing on 19 August 2025, p 50.