The Lifetime Support Scheme (LSS) Rules

The Lifetime Support Authority of South Australia

Table of Contents


Preamble


Part 1 – Introduction

  1. Philosophy
  2. Interpretation
  3. Use of ‘motor vehicle’ in the Rules
  4. Interaction with other legislative requirements
  5. Suspension of participation
  6. Use of interpreters in interactions with Participants or Decision Makers
  7. Sending documents to or from the LSA
  8. Documentation and other supporting material
  9. Medical documentation
  10. Approved providers
  11. Legal representation for Disputes
  12. Participant/ Decision Maker/ Applicant access to documents – Disputes
  13. Corrections of obvious errors in determinations/ Certificates
  14. Privacy and confidentiality/ release of information
  15. Commencement date

Go to Part 1


Part 2 – Eligibility for Participation in the Scheme

  1. Preliminary
  2. Application for participation
  3. Injury criteria
  4. Making an application
  5. Timing of FIM™ or WeeFIM® assessments – application to Scheme
  6. The LSA’s determination
  7. Interim participation timeframes
  8. Timing of assessments – Interim Participant
  9. Request for lifetime participation
  10. No request for lifetime participation
  11. Timing of FIM™ or WeeFIM® assessments – lifetime participation

Go to Part 2


Part 3 – Rules for Disputes about Eligibility for Participation

  1. Preliminary
  2. Lodging a dispute application
  3. Further information or documentation required
  4. Parties to a Dispute
  5. Disputes about non-medical matters
  6. Determination issued by the Review Officer
  7. Disputes about eligibility
  8. Expert Review Panel

Go to Part 3


Part 4 – Necessary and Reasonable Treatment, Care and Support Decision Making in the Scheme

  1. Background
  2. Treatment, care and support
  3. ‘Necessary and reasonable’ criteria
  4. Treatment, care and support service funding exclusions

Go to Part 4


Part 5 – Treatment, Care and Support Needs Assessments

  1. Preliminary
  2. Procedures for assessing Treatment, care and support needs
  3. LSA to require assessment
  4. Discharge Plan
  5. MyPlan

Go to Part 5


Part 6 – Treatment and Rehabilitation

  1. Preliminary
  2. Treatment and Rehabilitation services funded by the LSA
  3. Hearing Impairment
  4. Vision Impairment
  5. Treatment and Rehabilitation funding exclusions

Go to Part 6


Part 7 – Support, Attendant Care and Domestic Services

  1. Preliminary
  2. Support Services
  3. Attendant care services
  4. Domestic Services
  5. Support, attendant care and Domestic Services for Participants who are children
  6. Support and attendant care services for Participants who have caring responsibilities
  7. Alternatives to support and attendant care service provision
  8. Care training for Family members
  9. Support and attendant care services when the Participant is away from home
  10. Respite services
  11. Support, attendant care and Domestic Service funding exclusions

Go to Part 7


Part 8 – Accommodation

  1. Transitional accommodation
  2. Specialist Disability Accommodation
  3. Respite accommodation
  4. Accommodation exclusions

Go to Part 8


Part 9 – Assistive Technology

  1. Preliminary
  2. Assistive Technology prescription
  3. Assistive Technology requirements
  4. Assistive Technology funding exclusions
  5. Participant contribution to Assistive Technology
  6. Ownership of LSA funded Assistive Technology
  7. Modifications to existing household or leisure items
  8. Maintenance and repair of Assistive Technology
  9. Order of readily available Assistive Technology on discharge
  10. Continence products
  11. Beds/ mattresses
  12. Information and communication technology
  13. Environmental control technology
  14. Pressure care Assistive Technology
  15. Positioning and seated mobility Assistive Technology
  16. Orthoses, footwear and walking aids
  17. Respiratory Assistive Technology
  18. Assistive Technology for exercise and fitness
  19. Assistive Technology for recreation or leisure purposes
  20. Funding exclusions

Go to Part 9


Part 10 – Home Modifications

  1. Background
  2. Preliminary
  3. Consent for Home Modifications
  4. Ensuring the home can be modified
  5. Assessment of the need for Home Modifications
  6. Necessary and reasonable Home Modifications
  7. Minor modifications to home
  8. Modifications to a Rental Property
  9. Modifications to a home owned by the Participant or their Family
  10. Relocation if the home is not suitable for modification
  11. Assistance when relocating to or building a new home
  12. Service Providers for Home Modifications
  13. Home Modification to a secondary home that is lived in concurrently
  14. Subsequent Home Modification
  15. Repairs and maintenance on Home Modifications
  16. Room temperature control Assistive Technology
  17. Home Modifications funding exclusions
  18. Room temperature control Assistive Technology funding exclusions

Go to Part 10


Part 11 – Motor Vehicle Modifications

  1. Background
  2. Preliminary
  3. Motor Vehicle Modifications funded by the LSA
  4. Frequency of funding modifications to a motor vehicle
  5. Funding exclusions

Go to Part 11


Part 12 – Prosthetic and Orthotic Devices and Services

  1. Background
  2. Preliminary
  3. Prosthetic and Orthotic services funded by the LSA

Go to Part 12


Part 13 – Education Support Services

  1. Background
  2. Preliminary
  3. Approval of funded education support services
  4. Educational support service exclusions to funding

Go to Part 13


Part 14 – Vocational Support Services

  1. Preliminary
  2. Vocational support services
  3. Excluded vocational support (pre-vocational, vocational training and retraining)

Go to Part 14


Part 15 – Temporary International Travel and Participants Living in International Locations

  1. Preliminary
  2. Notice
  3. Temporary International Travel: Considerations for payment for TCS services
  4. Permanent residence: considerations for payment of TCS services for Participants residing in an international location

Go to Part 15


Part 16 – Self-Directed Support and Reimbursement Arrangements

  1. Preliminary
  2. Self-Directed Support
  3. Eligibility
  4. Unreasonable risk
  5. The Self-Directed Support Agreement
  6. Reimbursement Arrangements

Go to Part 16


Part 17 – Buying into the Scheme

  1. Preliminary
  2. Request to buy in
  3. How the LSA calculates cost to buy in
  4. What the buy in amount includes
  5. The LSA’s notification of the amount required to buy in
  6. Buy in as a Lifetime Participant
  7. Buy in funds reimbursement

Go to Part 17


Part 18 – Rules for Review of Participant’s Treatment, Care and Support Needs

  1. Preliminary
  2. Reassessment
  3. Process
  4. Certificate issued by Assessor
  5. Application to Expert Review Panel
  6. Expert Review Panel

Go to Part 18


Part 19 – Ambulance Services

  1. Necessary and reasonable ambulance services
  2. Method of assessment and criteria

Go to Part 19


Part 20 – Dental Treatment

  1. Necessary and reasonable dental treatment
  2. Method of assessment and criteria
  3. Dentures
  4. Exclusions

Go to Part 20


Part 21 – Medical Treatment including Pharmaceutical Products

  1. Necessary and reasonable medical treatment
  2. Method of assessment and criteria
  3. Necessary and reasonable pharmaceuticals
  4. Assisted fertility treatment
  5. Method of assessment and criteria
  6. Exclusions

Go to Part 21


Part 22 – Workplace and Education Facility Modifications

  1. Preliminary
  2. Modifications to a workplace or education facility
  3. Method of assessment and criteria
  4. Repairs and maintenance to workplace or education facility modifications
  5. Exclusions

Go to Part 22

Page last updated: 16 September 2022