How to get funding for SIL with Cerebral Palsy

Supported Independent Living (SIL) Eligibility

The NDIS have eligibility criteria that must be met the funding for any support to be included in your NDIS plan. This includes SIL.

You are required to demonstrate eligibility for SIL prior to receiving funding for your in-home support needs.

SIL is typically funded for those who require support for 24 hours per day, 7 days per week, including overnight support. While this is not legislated, of this 24 hour per day support, there is a consensus that to access SIL, you require direct support for 8 or more hours. The supports you require must relate directly to your diagnosis of cerebral palsy and any other conditions recognised by the NDIS.

If your need for support is not at this level, SIL might not be the right model of care for you.

Is Supported Independent Living (SIL) Reasonable and Necessary?

Eligibility for SIL must meet the NDIS reasonable and necessary criteria. The reasonable and necessary criteria involve definitions and rules set by the NDIS which they must consider when approving or declining funded supports.

The NDIS will consider the following when approving or declining SIL:

1. Goals

SIL will assist you to pursue and achieve the goals in your plan.

2. Social & Economic Participation

SIL will assist you to undertake activities to facilitate your social and economic participation.

3. Value for Money

The SIL model of care requested represents value for money. This means the cost of the recommended SIL supports are considered reasonable relative to both the benefits achieved and the cost of alternative supports.

4. Effective and Beneficial

SIL will be effective and beneficial for you. This means it will meet your needs related to your diagnosis of cerebral palsy. Your lived experience in previous SIL settings or short-term accommodation (STA) will help in justifying this requirement.

5. Reasonable Expectations for your Family and Informal Supports

Funding of SIL takes account of what it is reasonable to expect families, carers, informal networks and the community to provide. They consider your existing supports available, and what must be provided by a SIL provider, in order for your needs to be met. As cerebral palsy can come with a range of physical barriers and co-occurring conditions, you can justify how expecting family members to cater to your support needs over the long term is considered unreasonable.

6. Related to NDIS & Your Disability

SIL is most appropriately funded or provided through the NDIS, instead of another funding body available. This means the need for SIL relates directly to your disability and your in-home support needs.

The NDIS also consider what other supports you need in your home, and how these supports will all work together to ensure SIL is the most appropriate support.

For an easy-to-understand breakdown of reasonable and necessary from MyCareSpace, click below:

What do the NDIS consider when approving funding for Supported Independent Living (SIL)?

The NDIS consider a range of factors when determining if SIL is reasonable and necessary to fund for you. Considerations include:

• your current situation, goals and aspirations
• where you live now and future home and living goals
• your independent living skills and potential to build on these
• supports you need to achieve your home and living goals
• information about your day-to-day support needs
• any alternative home and living options

This is outlined in the SIL Operational Guidelines provided by the NDIS.

The NDIS will review any reports from allied health professionals or providers which are submitted to them as part of your application for SIL. 

The most sought after assessemnt is a Functional Capacity Assessment, completed by an Occupational Therapist (OT). Following the assessment, the OT will prepare a Functional Capacity Assessment Report that also includes recommendations specific to SIL.

There is no set template provided by the NDIS for the Occupational Therapist to complete. Each provider has their own template and assessment process. For this reason, it may also be called a Support Needs Assessment or Housing Assessment.

What is a Functional Capacity Assessment?

A Functional Capacity Assessment is an in-depth assessment completed by an OT with you in your home. The assessment addresses every aspect of your day to day life. The report is completed following the assessment which outlines your daily life and difficulties experienced related to your disability.

The report includes recommendations for NDIS supports and services you require to address any challenges and goals you wish to achieve.

How does a Functional Capacity Assessment for SIL differ to a standard Functional Capacity Assessment?

A good assessment completed by an OT for SIL should include specific details and recommendations regarding your support needs across all of your daily activities and routines. Across every activity you engage in, the report should provide detail on:

• The ratio of support required (how many people are involved in your care)
• The intensity of support required (the type of care quality necessary based on your needs)
• The best context for this support to succeed (the model of care best suited to you - who you live with, where you live etc.)

The report should include details on what supports you require across the day and overnight. The report must refer to your informal supports (family and friends), and how they are unable to meet all of your daily living needs, which means that SIL is necessary for you.

The report should reference SIL eigibility, which includes the reasonable and necessary criteria, as discussed above.

When working with an OT for a SIL assessment, it is important feel assured that they are skilled in this area and are confident in recommending SIL for you. If they determine SIL may not be the best support model for you, they should discuss this with you during or following the assessment, particularly if they anticipate the NDIS will be unlikely to approve SIL funding. 

Remember, ultimately the decision to approve and decline SIL is the role of the NDIS. The role of the OT is to present recommendations and evidence, with reference to relevant legislation, so that the NDIS can make a decision about funded supports.

How can I get a Functional Capacity Assessment for SIL?

To find Occupational Therapist's who are experienced in completing Functional Capacity Assessment for SIL for people with cerebral palsy, reach out to our Connections Team.

This FREE service can connect you with an OT in your area.

Request a SIL Assessment for Cerebral Palsy

Submitting evidence to the NDIS for SIL

Once your Functional Capacity Assessment has been completed and you have your report which includes recommendations for SIL, you may consider what other evidence is required to submit to the NDIS.

The more justification you provide that illustrates your support needs and need for SIL, the more evidence the NDIS has available to consider when approving SIL in your NDIS Plan.

Other information prepared by family members, carers or yourself may be helpful in communicating your needs, and how insufficient access to support may impact your health, well-being and quality of life. This is often described as an Impact Statement, which you can learn more about here.

The final step is to prepare and submit a Home and Living Request.

Submitting a Home and Living Request for SIL

To request SIL funding, you are required to submit a Home and Living Request. This involves  preparing a supporting evidence form which you can find here.

The form can be completed and submitted in one of the following ways:

• within 100 days of your NDIS plan end date, for consideration during a scheduled plan reassessment.
• with a Change of Details or Change of Situation Form
• with a Request for a Review of a Decision Form

The form will help participants to select the correct option based on their current needs. 

If you have a Support Coordinator, they can assist you in completing and submitting the form to by one of the following methods:

• Via email to: enquiries@ndis.gov.au
• Via mail to: NDIA, GPO Box 700, Canberra ACT 2601
• In person at your local NDIS or partner office. 

Ensure the submission also include the Home and Living Form, as well as any reports prepared by yourself, carers or health professionals. This includes the OT Functional Capacity Assessment with Recommendations for SIL.

The NDIS will review all documents provided to make a decision whether to fund SIL. You will typically be informed of their decision via email. If SIL is approved, this will likely result in the generation of a new NDIS plan. If SIL is declined, you will be offered the opportunity to have this decision reviewed.

How do I find a SIL provider in my area?

When SIL is approved in your plan, you will be provided with a sum of funding for SIL in your Core Support budget.

You are not automatically allocated to a provider, and have choice and control over which provider you engage with for SIL.

Need help finding a SIL provider? Get in touch with the MyCareSpace Connections Team for assistance nagivating the NDIS and find a SIL provider in your area.

Find A SIL Provider