High Intensity support is one of the most sensitive areas within the NDIS, as it bridges daily life with significant clinical risks. In this space, safety, dignity, and trust are not optional; they are essential.
For participants and families, the term can sound intimidating, raising natural concerns about what it involves, how safe it is, and who is trained to provide it.
NDIS High Intensity support is deeply personal work. When delivered with the right skill, compassion, and professionalism, it can reduce fear, ease family stress, and empower people to live safely and confidently every day.
Continue reading this article for a clear guide that helps you feel more confident as you navigate your NDIS options.
What is NDIS High Intensity Support?
NDIS High Intensity Support refers to complex daily personal activities that carry higher health risks and require specialised skills, advanced training, and strict safety procedures.
These supports sit under the NDIS Practice Standards Module 1: High Intensity Daily Personal Activities and aim to ensure that people with complex needs receive safe, skilled, and consistent care.
These supports are not simply “tasks”. They involve areas of life that are deeply personal, such as breathing, feeding, skin integrity, medication, and emergency response.
For participants, High Intensity support often means relief. For families, they mean peace of mind. And for workers, they require training, clinical oversight, and competency that go beyond general personal care.
High Intensity supports may include bowel care, enteral feeding, ventilator or tracheostomy support, seizure management, subcutaneous injections, or complex wound care.
These tasks are considered “high risk” because incorrect assistance can lead to medical complications or emergencies.
Types of NDIS High Intensity Supports (Updated List)
High Intensity supports cover a wide range of clinical or high-risk personal activities. In practice, these tasks look different for every participant, but the NDIS groups them into categories so support workers receive appropriate training.
Here are some types of NDIS High Intensity Supports;
Complex Bowel Care
Complex bowel care is required when someone cannot manage bowel routines independently or safely.
This includes manual evacuation, digital stimulation, specialised enemas, and working conditions such as chronic constipation, impaction, or autonomic dysreflexia.
Why it’s High Intensity:
Even minor errors can lead to severe pain, infection, blood pressure emergencies, or hospitalisation. Workers must understand warning signs, clinical triggers, and safe techniques.
Enteral Feeding (PEG, PEJ, NG Tubes)
Enteral feeding provides nutrition, hydration, and medication through a tube directly into the stomach or small intestine.
Workers assist with pump setup, flushing tubes, administering formulas or medications, and monitoring for blockages or alarms.
Why it’s High Intensity:
Tube dislodgement, aspiration, or incorrect administration can be dangerous. Workers must confidently follow feeding plans and respond quickly when something isn’t right.
Tracheostomy Care
A tracheostomy is a surgical opening in the neck that supports breathing. Workers help with suctioning, humidification, tube changes, emergency responses, and monitoring airway stability.
Why it’s High Intensity:
A blocked airway becomes life-threatening within minutes. Workers require advanced skills, the ability to remain calm under pressure, and strict hygiene practices.
Ventilator Management
Some participants rely on mechanical ventilators for breathing support. Workers check ventilator settings, respond to alarms, replace filters, manage tubing, and set up backup systems.
Why it’s High Intensity:
Ventilator failure is a critical emergency. Workers must recognise signs of respiratory distress and follow emergency protocols precisely.
Subcutaneous Injections
These injections deliver medications, such as insulin, just under the skin. Workers help prepare doses (where permitted), administer injections, monitor reactions, and follow medication plans.
Why it’s High Intensity:
Incorrect dosing or poor injection technique can cause dangerous side effects, including hypoglycaemia or allergic responses. Workers must be precise and trained.
Complex Wound Care
This includes supporting participants with chronic ulcers, pressure injuries, post-surgical wounds, or wounds requiring specialised dressings.
Workers follow wound-care plans, monitor signs of infection, and maintain strict hygiene.
Why it’s High Intensity:
Improper wound care increases the risk of infection and may lead to hospitalisation. Workers must understand pressure-relief, tissue health, and early warning signs.
Seizure Management & Emergency Medication
Participants with epilepsy or seizure-related conditions often require close monitoring, safe positioning, distress support, and sometimes administration of emergency medication (if the worker is authorised).
Workers also document seizure activity and recovery progression.
Why it’s High Intensity:
Seizures can escalate quickly or cause injury. Emergency medication must be given safely, at the correct time, and in accordance with strict protocols.
Catheter Care (Indwelling and Suprapubic)
Workers assist with drainage bags, hygiene, infection monitoring, managing blockages, and supporting participants who use suprapubic or indwelling catheters.
Why it’s High Intensity:
Catheter issues can lead to severe pain, urinary retention, infections, or medical emergencies. Workers must know early warning signs and escalation pathways.
Mealtime Management for Dysphagia (Swallowing Support)
This involves supporting participants who experience swallowing difficulties. Workers provide texture-modified meals, follow swallowing plans, use safe-feeding techniques, and monitor for choking risks.
Why it’s High Intensity:
Incorrect food texture or unsafe feeding can cause aspiration, choking, or pneumonia. Safe mealtime support requires training and clinical guidance.
Behaviour Support for High-Risk Behaviours
Workers follow behaviour support plans for participants whose behaviours may cause harm to themselves or others.
This includes safety monitoring, de-escalation strategies, communication techniques, and consistent implementation of Positive Behaviour Support (PBS) recommendations.
Why it’s High Intensity:
Inconsistent support increases risk. Workers must be trained in safe engagement, emotional regulation, and evidence-based behaviour strategies.
Levels of NDIS High Intensity Support
The NDIS classifies high-intensity supports into levels to match the task’s complexity to the worker’s required skills.
Level 1: Lower Risk, Predictable High-Intensity Tasks
Level 1 supports involve tasks that are still clinically sensitive but follow clear, stable routines with a lower risk of sudden health emergencies.
Examples include:
- Basic wound care under a clinician’s clear instructions
- Stable seizure support with known patterns
- Catheter and continence support following predictable routines
- Mealtime support with low-risk swallowing needs
Why it matters:
Although Level 1 tasks are simpler, they still require workers to understand safety steps, follow clinical plans, and recognise early signs that something isn’t right.
Workers at this level need foundational high-intensity training and supervision.
Who it suits:
Participants whose needs do not fluctuate dramatically and who have clear, stable care instructions.
Level 2: Moderate Complexity, Higher Skill Requirements
Level 2 supports involve tasks that require greater clinical awareness, more technical skill, and a deeper understanding of risk.
These tasks often involve equipment, emergency protocols, or close monitoring.
Examples include:
- PEG or enteral feeding (including pump setup and monitoring)
- Complex bowel care (manual evacuation, digital stimulation)
- Subcutaneous injections (e.g., insulin)
- Moderate dysphagia and texture-modified meal support
- Behaviour support where participant risks require advanced knowledge
Why it matters:
Level 2 tasks are more sensitive. They involve equipment, medication, or procedures that must be performed accurately.
Workers need hands-on training, competency assessments, yearly refreshers, and the ability to notice subtle clinical changes.
Who it suits:
Participants with needs that may have higher health consequences if not performed correctly, but who do not require constant emergency readiness.
Level 3: High Complexity, High Clinical Risk
Level 3 is the most intensive category. It involves supports where health can change quickly, emergencies are possible, and workers need advanced, specialised training.
Examples include:
- Ventilator support (checking settings, responding to alarms)
- Tracheostomy care, including suctioning and emergency tube changes
- High-risk seizure support with emergency medication
- Advanced wound care for chronic, infected, or complex wounds
Why it matters:
These tasks carry significant clinical risk. A small error can have life-threatening consequences, and workers must be able to respond calmly and correctly, often within moments.
Level 3 workers require extensive training, ongoing supervision, and strong clinical judgment.
Who it suits:
Participants whose safety depends on continuous monitoring, quick response times, and workers who can manage critical medical needs.
Why Understanding Levels Matters
High-intensity support isn’t “one-size-fits-all”. The levels acknowledge that every person’s needs are different and that safety comes from tailored, skilled support.
- Participants receive support that truly matches their needs
- Workers have the proper training for the tasks they perform
- Providers follow the correct risk and safety guidelines
- Families feel reassured knowing care is delivered safely
NDIS High Intensity Support Training & Skills Requirements
Not every provider can deliver high-intensity supports. To do so, a provider must meet strict requirements under the NDIS Practice Standards (Module 1).
Core Skills a High Intensity Support Worker Must Have
High Intensity support work requires specialised knowledge, practical skill, and a strong commitment to participant safety.
Below are the core skills every High Intensity support worker must have:
- Ability to follow participant-specific care plans developed by qualified health practitioners.
- Knowledge of risks, early warning signs, and escalation pathways for each high-intensity task.
- Competency in safe use of specialised equipment (PEG pumps, ventilators, suction devices, etc.).
- Understanding of infection control and hygiene standards for high-risk procedures.
- Skills to recognise deterioration in a participant’s health and respond appropriately.
- Ability to deliver care in a safe, calm, participant-centred manner.
- Understanding of the NDIS Practice Standards for High-Intensity Daily Personal Activities (HIDPA).
- Ability to maintain accurate documentation and incident reporting.
These skills ensure participants receive safe, high-quality support and give families confidence that skilled, well-trained professionals are delivering care.
Responsibilities of a High Intensity Support Worker
High Intensity support workers carry significant responsibility, ensuring every aspect of care is delivered safely, correctly, and in line with NDIS expectations. Their key responsibilities include:
- Provide support exactly as outlined in the participant’s individual plan and clinical instructions.
- Participate in training delivered by a qualified practitioner specific to each participant’s needs.
- Maintain up-to-date skills and complete refresher training (recommended annually, or sooner if inactive).
- Follow strict safety protocols for tasks like bowel care, enteral feeding, dysphagia, tracheostomy, ventilator support, injections, and wound care.
- Ensure care is delivered with respect, choice, control, and participant engagement.
- Work collaboratively with families, allied health practitioners, and the participant’s support network.
- Support consistent, reliable care as consistent workers improve participant wellbeing.
- Demonstrate competency during audits as required under NDIS Practice Standards.
These responsibilities ensure participants receive safe, high-quality support and uphold the standards expected of NDIS High Intensity workers.
Training Expectations
- Must complete participant-specific High Intensity skills training.
- Must be assessed as competent, not just attend training.
- Must complete refreshers when plans change or when they haven’t delivered the support for 3 months.
- Must be trained by someone who is clinically competent to teach that specific High Intensity task.
This ensures participants receive safe, skilled, and consistent care, not guesswork or “trial-and-error care”.
NDIS High Intensity Support Rates (2025 Updated)
According to the NDIS Pricing Arrangements and Price Limits 2024-25 v1.3 (effective 1 October 2024), high-intensity supports fall under “High Intensity Daily Personal Activities” and are billed at higher hourly limits due to the additional:
- Clinical complexity
- Higher skill level required
- Increased risk
- Specialised training required
- Tighter safety and compliance needs
Latest High Intensity Support Rates (2024-25)
These rates apply nationally unless specified. All rates below come directly from the official pricing table for High Intensity Assistance with Self-Care Activities.
High Intensity Assistance With Self-Care Activities (National Price Limits)
| Support Item | Time of Week | National Price Limit (Per Hour) |
| Assistance With Self-Care Activities – High Intensity | Weekday Daytime | $73.09 |
| Assistance With Self-Care Activities – High Intensity | Weekday Evening | $80.53 |
| Assistance With Self-Care Activities – High Intensity | Weekday Night | $82.02 |
| Assistance With Self-Care Activities – High Intensity | Saturday | $102.86 |
| Assistance With Self-Care Activities – High Intensity | Sunday | $132.62 |
| Assistance With Self-Care Activities – High Intensity | Public Holiday | $162.38 |
Remote and very remote regions have higher limits. Pricing is automatically indexed annually (usually each July).
Why the High Intensity Support Rate is Higher
NDIS sets higher limits for High Intensity Support due to:
- Higher clinical risk
- Greater responsibility for worker safety and participant wellbeing
- Additional training and competency assessment
- Complex health-related support tasks
Risk Management and Compliance in High Intensity Supports
The recent NDIS document makes it clear that high-intensity supports fall under Special NDIS Pricing Arrangements, which require additional provider responsibilities and higher standards of safety, oversight, and worker competency.
This is because High Intensity Daily Personal Activities involve tasks listed in Module 1 of the NDIS Practice Standards and therefore must be delivered only by providers who meet stricter governance, clinical, and safety obligations.
Why High-Intensity Supports Require Strong Risk Management
High-intensity supports are considered high-risk because they often involve:
- Complex medical procedures
- Behaviour support involving high-risk behaviours
- Disability-related health supports
- Life-preserving clinical responses
NDIS rules require providers to have strong systems beyond standard personal care, because these supports may involve life-threatening conditions if mishandled.
Here are a few examples:
- Tracheostomy/airway management
- PEG tube care
- Seizure response
- Diabetes-related emergencies
- Respiratory care
These fall under Disability-Related Health Supports categories such as dysphagia, respiratory supports, continence, diabetes, epilepsy, and wound care.
Supporting Participants and Families in High-Intensity Care
High-intensity care is never just a set of clinical tasks; it’s deeply human. Behind every care plan is a person with routines, fears, preferences, and dreams.
And behind many participants are families who carry love, responsibility, exhaustion, and the constant fear of “What if something goes wrong?”
At Affective Care, we understand that the emotional experience of high-intensity care matters just as much as the technical skill.
That’s why our approach supports not just the participant but also the people around them.
A Holistic and Emotionally-Centred Approach
We work closely with:
- Families
- Allied health teams
- Hospitals
- Support coordinators
- Plan managers
This collaboration ensures that support is safe, consistent, and emotionally grounded.
Our role goes beyond delivering tasks; we create an environment where every person involved feels informed, valued, and reassured.
How to Access NDIS High Intensity Support (Step-by-Step Guide)
Accessing high-intensity supports can feel overwhelming, especially when you or a loved one is managing complex daily care needs.
The good news is that the NDIS has a clear pathway, and with the proper preparation, you can secure the support that keeps you safe, empowered, and well cared for.
Here’s a detailed step-by-step guide to help you navigate the process with confidence.
Step 1: Identify Your High-Risk Daily Personal Needs
Begin by speaking with the professionals who know your health and daily living situation best. This may include your GP, allied health team, specialist, or support coordinator.
Together, you’ll explore areas where you need skilled, high-risk, or complex support, such as:
- Feeding and mealtime support
- Catheter or bowel management
- Wound care
- Ventilator or tracheostomy care
- Seizure management
- Behaviours of concern
- Pressure care
- Medication administration
This step helps clarify your needs in medical and functional terms, ensuring your NDIS request is precise and evidence-based.
Step 2: Gather Assessments, Reports & Evidence
Strong, clear evidence is the foundation of successful NDIS planning, especially for High Intensity supports. Your supporting documents may include:
- Clinical reports explaining your diagnosis, risks, and required care
- Risk assessments that outline what may happen without the right support
- Mealtime assessments (particularly if choking, swallowing, or feeding risks exist)
- Wound care or pressure area management plans
- Behaviour support plans
- Capacity building assessments (OT, psychology, physiotherapy, speech therapy)
- Letters from your treating clinicians that outline the frequency, complexity, and necessity of the support
The more detailed and recent your evidence is, the smoother your NDIS planning process becomes.
Step 3: Discuss Your High Intensity Needs in the NDIS Planning Meeting
During your planning meeting, your LAC or planner will look closely at:
- Your functional limitations
- The level of risk involved in your daily tasks
- How often do you require the support
- The skill level required (e.g., trained support worker, nurse)
- How the support will help you live safely, independently, and in line with your goals
Be open and honest; the goal is to ensure your plan reflects your real, day-to-day lived experience.
Step 4: Ensure the Correct Supports are Included in Your NDIS Plan
If approved, your plan may include one or a combination of the following categories:
- High Intensity Daily Personal Activities (for complex care delivered by trained support workers)
- Nursing Supports (if your care requires clinical intervention)
- Behaviour Support Services (specialist intervention for behaviours of concern)
- Core Supports are funded at a level suitable for high-risk tasks
This section of your plan ensures you have the proper funding for safe and consistent support.
Step 5: Choose a Qualified High Intensity Provider (Module 1 Registered)
A provider with the correct NDIS registration, training processes, and risk management systems must deliver High Intensity supports.
Affective Care is fully qualified to provide all High Intensity supports, including:
- Complex bowel care
- Enteral feeding
- Catheter care
- Airway management
- Diabetes management
- Wound care
- Complex behaviour support
Our approach blends clinical excellence with emotional intelligence, ensuring every participant feels supported, respected, and understood.
Step 6: Begin Services with a Detailed Safety & Care Plan
Before services begin, a high-quality provider will work with you to develop:
- A personalised High Intensity support plan
- A risk management plan tailored to your specific needs
- Clear emergency and escalation protocols
- Communication guidelines for staff and family
- Clinical handover and training for all support workers involved
What Families and Participants Can Expect From Affective Care
High Intensity support can feel overwhelming, so it’s important for families and participants to know exactly what to expect from a quality provider. At Affective Care, you can rely on:
Clear and Compassionate Communication
We prioritise open communication, so families never feel confused or left in the dark. We explain what’s happening, why it matters, and how we’re keeping everyone safe.
Empathy, Choice, and Respect
Participants are encouraged to express their preferences, routines, and comfort levels. Their voice shapes every part of the care journey.
Emotionally-Centred Practice
While evidence-based care guides our clinical decisions, each person’s emotional well-being guides our approach.
Building Confidence and Independence
Wherever possible, we support participants to build skills, confidence, and autonomy in ways that feel meaningful to them.
Trauma-Informed Support
We recognise that many people receiving High Intensity care have experienced stress, fear, or medical trauma. Our team responds gently, calmly, and without judgement.
Reassurance During Overwhelming Moments
Whether it’s a new routine, a sudden change, or a difficult day, our support workers are trained to provide calm, grounding reassurance.
Replacing Uncertainty with Trust
For many families, the greatest challenge isn’t the care itself, it’s the uncertainty that surrounds it. Our commitment is to replace that uncertainty with:
- Consistency
- Transparency
- Trust
- A genuine sense of safety
When people feel seen, heard, and supported, High Intensity care becomes more than a clinical service. It becomes a partnership built on compassion, understanding, and heart.
Empowering You Through High Intensity Care
High Intensity care is more than a set of clinical tasks. It is the foundation of safety, dignity, and possibility for many people living with disability.
When delivered with both technical excellence and emotional intelligence, it restores the freedom to breathe safely, eat safely, participate safely, and live each day with confidence.
At Affective Care, we bring together professional training, rigorous safety standards, and a heart-centred approach that honours the whole person.
Whether you’re navigating High Intensity supports for the first time or looking for a provider who truly understands the emotional weight of complex care, we are here to walk with you.
Your safety matters. Your dignity matters. And you deserve support that sees you as a person, not a list of tasks.
