What makes a support 'high intensity'
High Intensity Daily Personal Activities — usually shortened to HIDPA — is an NDIS registration group. It covers personal supports where a mistake could cause serious harm, and where the worker therefore needs specific training, assessed competency, and clinical oversight behind them.
The supports usually included are:
- Complex bowel care
- Enteral (PEG or tube) feeding
- Severe dysphagia and mealtime management
- Tracheostomy care
- Ventilation support
- Urinary catheter care
- Subcutaneous injections
- Complex wound care
- Epilepsy and seizure management
Who is allowed to deliver them
This is where the real answer surprises people. A high intensity support does not have to be delivered by a nurse. It can be delivered by a support worker — provided that worker has been trained for that specific support, assessed as competent to deliver it for that specific person, and is working with clinical oversight in place.
That combination is the safeguard. The same task, on two different people, can require different technique, different equipment and different warning signs, which is why competency is assessed person by person rather than as a general tick. The NDIS Quality and Safeguards Commission publishes High Intensity Support Skills Descriptors setting out what competence looks like for each of these supports, and registered providers are audited against the High Intensity Daily Personal Activities module.
What good oversight actually looks like
Any provider can say the words 'nurse oversight'. It is fair to ask what sits behind them. Questions that get you a real answer:
- Which registered nurse is responsible for oversight of my supports, and how often do they review them?
- How were the workers on my roster trained, and who assessed their competency for my specific support?
- What happens when a regular worker is away — is the replacement competency-assessed for me too?
- Who writes and updates my care plan, and how do workers know when it changes?
- What is the process if something goes wrong or a worker is unsure at 9pm on a Sunday?
Restrictive practices and Module 2a
Some participants with complex needs require regulated restrictive practices — a defined set of practices that limit a person's rights or freedom of movement, which are tightly controlled under NDIS rules. A provider can only implement them if they are registered under the relevant module, commonly referred to as Module 2a, and only ever in line with an approved Behaviour Support Plan and NDIS Commission requirements.
This matters practically: a provider without that registration cannot lawfully implement those practices, which can make them unsuitable regardless of how good they are otherwise. If restrictive practices are part of your plan, ask about registration early. Our guide to behaviour support plans explains how they are built and reviewed.
How high intensity supports are funded
High intensity daily personal activities are generally funded from the Core Supports budget, at rates that reflect the additional training and oversight required. Because they sit in Core, funding is often flexible between support types — but the amount available still depends on how your plan is written.
If your needs have changed and your current funding no longer reflects the level of support required, evidence from a nurse or allied health professional setting out the clinical need is usually what the NDIS will look for at your next plan review.
Where Care Alliance fits
Care Alliance is an NDIS-registered provider approved to deliver High Intensity Daily Personal Activities, and a registered Module 2a provider. Every staff member delivering high intensity supports completes structured clinical eLearning and competency training overseen by our nursing team, and Registered Nurses maintain oversight of those supports. Our multidisciplinary team includes Registered Nurses, Enrolled Nurses, Assistants in Nursing, psychologists and behaviour support practitioners.
If you are comparing providers for complex care, our guide to choosing an NDIS provider lists the questions worth putting to us and to anyone else on your shortlist.
Common questions
What does HIDPA stand for?
High Intensity Daily Personal Activities. It is the NDIS registration group covering personal supports that carry higher clinical risk — such as PEG feeding, complex bowel care, tracheostomy care or seizure management — and which must be delivered by appropriately trained workers under clinical oversight.
Does a nurse have to deliver my high intensity support?
Not necessarily. A trained support worker can deliver many high intensity supports, as long as they have been trained for that support, assessed as competent for you specifically, and a registered nurse maintains oversight. Some supports and some situations do require a nurse directly — a nursing assessment is what determines which applies.
How do I know if a provider is properly registered for these supports?
Check the NDIS Quality and Safeguards Commission's public register, which lists each provider's registration groups and any conditions on their registration. It is a matter of public record, and any provider should be comfortable with you looking.
Can high intensity supports be delivered in Supported Independent Living?
Yes, and they frequently are. SIL is the funded roster of support in your home; high intensity supports describe the clinical nature of some of the tasks within it. The two work together, with nursing oversight sitting behind the support team.
This guide is general information about the NDIS, not advice about your individual situation, and scheme rules change over time. For decisions about your plan, check the current guidance at ndis.gov.au or talk to your support coordinator, planner — or call us on 1300 206 309.