This is a plain guide to complex care and high intensity support under the NDIS in Perth: what the terms mean, what gets funded, what evidence you need, how to choose a provider, and what to do when nobody will take the referral. It is written for families and for support coordinators, by a registered provider that does this work in Perth’s northern suburbs every day. If you would rather just talk to someone, our line is answered 24 hours a day on (08) 9515 8000.
What “complex care” actually means
Complex care is not a category in the NDIS price guide. You will not find it in a plan. It is the phrase providers and hospitals use for participants whose disability, health needs and daily life interact in ways that a standard support arrangement cannot hold safely.
In practice a participant is described as complex when several of these are true at once: they need support around the clock, or awake overnight; they need clinical tasks performed as part of ordinary daily life; more than one health professional is involved and their instructions have to be reconciled; there are behaviours of concern with a behaviour support plan; a hospital admission is a regular event rather than a rare one; and the consequences of getting the support wrong are serious rather than inconvenient.
The practical difference is not the tasks. It is that complex care cannot be delivered by a roster of whoever is available. It needs a small consistent team, trained on one person’s plan, with clinical oversight behind them and a way to reach a decision-maker at 3am.
High intensity supports: the formal version
Where “complex care” is informal language, High Intensity Daily Personal Activities is a real NDIS registration group, number 0104, and it has rules. It covers daily supports that carry a higher clinical risk, and a provider must be registered for it and audited against the NDIS Practice Standards to deliver them.
The supports usually included are:
- Enteral feeding — PEG, PEJ and nasogastric tubes
- Tracheostomy care and suctioning
- Ventilation, including non-invasive ventilation
- Complex bowel care
- Subcutaneous injections
- Urinary catheter management
- Complex wound and pressure injury care
- Dysphagia support and mealtime management
- Seizure management, including emergency medication under a written plan
- Diabetes management
The NDIS publishes High Intensity Support Skills Descriptors setting out what a worker must be able to do before they deliver each of these. A properly run provider trains each worker on the specific participant’s plan, has a registered nurse assess them as competent before they work alone, and reassesses periodically. If a provider cannot describe that process to you in concrete terms, that tells you something.
Worth knowing: high intensity supports attract higher price limits than standard personal care, but only where the support genuinely meets the descriptors and the provider is registered. A plan that funds the support at standard rates will not stretch, which is why the evidence at planning matters so much.
What gets funded, and where it sits in a plan
Most complex care is funded from Core Supports, which is the most flexible part of a plan. The pieces usually break down like this:
- Assistance with Daily Life — the bulk of personal care and daily support, including the high intensity price limits where they apply, and including active overnight support where someone must be awake
- Community Nursing Care — registered nurse time for assessment, care planning, clinical tasks, delegation to support workers and competency sign-off
- Social and Community Participation — getting out of the house, at whatever support ratio is safe
- Short-Term Accommodation — respite, commonly up to 28 days a year
- Supported Independent Living — 24/7 or near-24/7 support in a shared or individual home, quoted against a roster of care rather than simply drawn down
Alongside those, Capital funding covers equipment and home modifications, and Capacity Building covers support coordination, behaviour support practitioner hours and allied health. For a complex participant, support coordination is not optional; the number of moving parts makes it the difference between a plan that works and a plan that exists on paper.
Getting the evidence right
The commonest reason a complex plan comes back underfunded is evidence that describes the disability without describing the support it requires. “Requires assistance with transfers” funds far less than “requires two workers for all transfers using a ceiling hoist, six times daily, per the OT assessment dated March 2026, following two falls in the previous plan period.”
What a strong evidence pack contains: current medical reports; an OT functional assessment covering personal care, transfers, equipment and the home; physiotherapy input where mobility is involved; speech pathology where there is dysphagia; a nursing care plan for every clinical task with the delegation arrangement written down; a current behaviour support plan where relevant; hospital discharge summaries; incident records showing frequency; and a carer statement describing an actual 24 hours. Our NDIS planning checklist works through this in detail.
Choosing a provider
Anyone can say they do complex care. These are the questions that separate providers who can from providers who would like to.
- Which registration groups do you actually hold? Ask specifically about High Intensity Daily Personal Activities (0104) and Community Nursing Care (0114). Check them yourself on the NDIS provider finder.
- Who provides clinical oversight, and how do workers get signed off? You want a name, a process and a review interval, not “our workers are all trained”.
- How many different workers will we see in a month? Consistency is the single biggest predictor of whether complex care goes well.
- Who answers the phone at 3am, and what can they actually do? An answering service that takes a message is not an after-hours service.
- What happens after an incident? Debrief, notification, reporting, and a plan review — or filing it and moving on.
- What will you say no to? A provider who says yes to everything has not read the referral.
- Can you start before discharge? If a hospital admission is in the picture, the answer needs to be yes.
When nobody will take the referral
Support coordinators in Perth regularly hit this: the participant needs high intensity supports plus behaviour support, or 24-hour care in a home that is hard to staff, or a discharge date is three days away. Providers decline, slowly, one at a time.
Three things help. Refer to providers who hold the right registration groups rather than to whoever has capacity, because an unregistered provider cannot legally deliver the clinical part. Send the full picture in the first email, including the difficult bits — providers who discover the complexity on day three withdraw on day four. And ask for a decision on the first call rather than a “we’ll get back to you”, so you can move on quickly if the answer is no.
Hospital to home
A large share of complex referrals start in a hospital bed, with someone medically ready to leave and nowhere safe to go. The NDIA runs a dedicated hospital discharge pathway: once the hospital notifies them, with consent, they aim to make contact within four days and assign a hospital liaison officer, then create or vary the plan so providers can be engaged before discharge. Our Hospital to Home guide covers the process step by step, with the phone number for each major Perth hospital.
The thing families are rarely told: you can start talking to providers while the plan is still being sorted out. The provider’s written support proposal is often the evidence the liaison officer needs.
Complex care in Perth’s northern suburbs
Complex Care Continuum is based at Girrawheen and supports participants across the City of Wanneroo, City of Stirling, City of Joondalup and City of Swan — Balga, Mirrabooka, Marangaroo, Koondoola, Alexander Heights, Nollamara, Warwick, Landsdale, Ballajura, Dianella, Joondalup, Wanneroo and the suburbs around them. Being local matters more than it sounds: it is why a worker can get there in twenty minutes, and why the team stays the same.
We are registered for High Intensity Daily Personal Activities and Community Nursing Care, and our referral line is answered 24 hours a day. Complex Care Continuum has supported Western Australians for three years, first as a department within a larger organisation and now as an independent, WA-owned provider, with more than forty years of combined complex care experience across our management team.
Where to go next
- Complex care and 24-hour support — what we deliver and how it is set up
- High intensity daily personal activities — the clinical supports in detail
- Community nursing — registered nurse support at home
- Hospital to home — discharge support and the referral form
- NDIS planning checklist — evidence to take into a plan review
Talk to us
Call (08) 9515 8000 at any hour, or email info@complexcarecontinuum.com.au. If we are not the right provider for someone, we will tell you on the first call.
General information about the NDIS, current at August 2026. Funding decisions rest with the NDIA and depend on individual circumstances.