Understanding SDA, High Intensity Supports and Complex Care

How They Work Together – and How They're Different

If you live with a complex or nuanced disability—or support someone who does—you know that daily life rarely fits neatly into boxes. The NDIS uses terms like Specialist Disability Accommodation (SDA), high intensity support, and complex care, but it’s not always clear how these pieces fit together in real life.

Let’s start by making one important distinction:

• SDA is housing. It refers to specially designed homes for people with extreme functional impairment or very high support needs.
• High intensity and complex care are support services. These are separate from housing and can be delivered to any NDIS participant, whether they live in an SDA home, a private rental, social housing, or their family home.

In this article, we’ll unpack what each of these terms means, how they relate, and when they intersect—so you can better understand your options and make informed choices that respect your needs, health, and independence.

What is SDA?

Specialist Disability Accommodation (SDA) refers to the physical housing—specially designed homes for people with extreme functional impairment or very high support needs. These are purpose-built environments that allow residents to live more independently and receive the level of support they need safely and consistently.

SDA homes include accessible features, assistive technologies, and layouts that accommodate one-on-one or shared supports. They’re not about the support workers—they’re about the structure itself.

At Vertika, we focus on delivering SDA homes built for real people, with careful attention to design, accessibility, and long-term comfort.

What is High Intensity Support?

High Intensity Daily Personal Activities are supports delivered to people who need assistance with complex health or behaviour needs that require workers with specific skills or training.

This may include:

• PEG (enteral) feeding
• Catheter and stoma care
• Tracheostomy care
• Subcutaneous injections
• Seizure and epilepsy management
• Diabetes support including insulin
• Ventilation support
• Complex wound care

These supports are funded under the Core Supports budget of your NDIS plan, not under SDA. An example of an NDIS provider who offers high intensity support care in Sydney is Best Care Services.

What is Complex Care?

Complex Care often includes high intensity supports but isn’t limited to them. It refers to participants who have multiple or interrelated support needs, such as physical health conditions alongside psychosocial disabilities, or behaviours of concern that require behaviour support planning.

People with complex care needs often require:

• Close clinical oversight
• Coordinated multi-disciplinary teams
• Consistency in care routines to reduce risk

An example of an NDIS provider who offers NDIS complex care in Sydney is United For Care.

When Do SDA and High Intensity/Complex Care Overlap?

Many participants with high intensity or complex care needs may also qualify for SDA—but not always. Here’s the difference:

• You might require high intensity supports in any home, not just an SDA.
• You may be eligible for SDA even if you don’t need high intensity support, if your physical disability requires a specially designed living space.
• Eligibility for SDA depends on your housing needs, not just your care needs.

To qualify for SDA, you must show that:

• Your functional impairment is extreme
• Standard housing can’t meet your long-term needs
• SDA would reduce long-term costs to the NDIS and improve your quality of life

Evidence usually comes from allied health professionals like occupational therapists, behaviour support practitioners, or clinical specialists.

The Right Home Makes Care Easier

When high support needs exist, the environment matters. A home designed with ceiling hoists, extra circulation space, reinforced walls for safety, or automated doors and lighting doesn’t just improve daily life—it makes the delivery of care safer and more sustainable for everyone involved.

At Vertika, we understand that safe, well-designed housing can reduce the intensity and frequency of certain supports, while preserving dignity and privacy for residents.

How can we help you?

Understanding how SDA, high intensity support, and complex care fit together can help you make more informed decisions about the right housing and care. They’re not interchangeable terms—but when considered together, they shape a full picture of support that meets a person’s needs with clarity, respect and precision.

If you’re unsure whether SDA is the right fit—or how to navigate the assessments required—speak with your support coordinator, OT, or your current provider. The right advice now can make a long-term difference.

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