What “high intensity” means
High-intensity daily personal activities are everyday personal supports that carry a clinical risk serious enough that the NDIS regulates who may deliver them and how. They are covered by NDIS Practice Standards Module 1, and delivered under registration group 104 (Assist Personal Activities — High).
A provider that does not hold Module 1 is not permitted to deliver these supports. This is the single most useful fact a family can know when they are calling providers, because it explains why so many say no.
The seven high-intensity supports
Module 1 covers exactly seven supports:
- Complex bowel care — prescribed bowel programs and stoma care, beyond routine toileting assistance.
- Enteral feeding and management — feeding through a PEG, PEJ or NG tube, including medications and site care.
- Tracheostomy management — suctioning, tube and stoma care, and emergency response for a participant with a tracheostomy.
- Urinary catheter management — indwelling, suprapubic and intermittent catheterisation.
- Subcutaneous injections — prescribed injections given under the skin.
- Complex wound management — pressure injuries, chronic wounds and surgical wounds requiring a clinical dressing regime.
- Severe dysphagia management — mealtime support for participants at serious risk of choking or aspiration, delivered against a speech pathologist’s mealtime management plan.
That list is fixed. If a support is on it, a Module 1 provider is required. If it is not on it, it is ordinary personal care.
Who is allowed to deliver them
High-intensity supports are delivered either by registered nurses, or by support workers who hold high-intensity training and work under registered-nurse supervision — depending on the participant’s clinical needs and circumstances.
Both models are legitimate. Both involve a registered nurse. What is never legitimate is an untrained worker delivering a high-intensity support with no clinical oversight.
The registered nurse’s role is not decorative. Under the NDIS Quality and Safeguards Commission’s High Intensity Support Skills Descriptors, the expectation is that workers are trained and assessed as competent against the individual participant’s plan — not merely trained in a general course. A worker who has done a tracheostomy module has not, by that fact alone, been trained to support your family member.
Questions worth asking any provider
- Do you hold Practice Standards Module 1? If they hesitate, they don’t.
- Which of the seven supports do you actually deliver? Registration is not the same as experience.
- Will a registered nurse be involved, and how? “Supervision” should have a concrete answer: who, how often, and who the worker calls at 2am.
- How are the workers trained for my plan specifically? The answer should describe training against the participant’s own clinical plan, before the first shift.
- What happens in an emergency? There should be a written, rehearsed plan specific to the participant.
Where the funding comes from
High-intensity supports are funded from the Core supports budget of an NDIS plan, because they are daily personal activities. They generally require evidence of the clinical need in the plan.
Some of the same clinical care can also be delivered as community nursing (registration group 114), by a registered nurse. Providers who hold both 104 and 114 can move between the two models as the participant’s needs require.
Module 1 and Module 2A are different things
Module 1 covers high-intensity daily personal activities — the seven clinical supports above.
Module 2A covers implementing behaviour support plans. It is the module a provider needs when its workers support a participant who has a behaviour support plan, including where that plan authorises a regulated restrictive practice.
Implementing a behaviour support plan and writing one are different roles with different registrations, and the NDIS separates them on purpose. A provider that delivers the daily support should not also be the one deciding what the behaviour strategies are.