Not So Independent Assessments

Update July 2021: The NDIA no longer plans to move ahead with independent assessments. Read more

Last week when the government released their response to the December 2019 review of the NDIS Act undertaken by David Tune (commonly referred to as the Tune Review) one of the key reforms the response highlighted was the rollout of independent assessments. The new approach will see the NDIA engaging ‘independent assessors’ to undertake functional capacity assessments to support NDIS access, planning and review. These assessments replace those that would usually be done by the allied health (or other) professionals of the participant’s choice.

The first stage of the pilot (November 2019 – April 2019) was reported by the NDIA at first appeared to be largely positive outcomes: 

• 70% of people invited to participate volunteered to

• Of those, 5% of assessments were for Scheme access, 55% were for developing a first plan and 40% were for a scheduled review

• The satisfaction rate (“satisfied” or “very satisfied”) was 91%

However, we later learnt that only 145 people filled out the survey, and only 35 of them were NDIS participants.

The Government is citing the continued rollout of independent assessments as part of its commitment to meeting recommendation 7 of the Tune Review, that stated:

The NDIS Act is amended to:

a) allow evidence provided to the NDIA about a prospective participant or participant to be used for multiple purposes under the NDIS Act, including access, planning and plan review processes

b) provide discretionary powers for the NDIA to require a prospective participant or participant to undergo an assessment for the purposes of decision-making under the NDIS Act, using NDIA-approved providers in a form set by the NDIA.

But the model the Tune Review recommended is quite different to what the NDIA has been proposing. For one thing, the Review stated it was important participants have the right to challenge the results of an assessment and request a new one. Moreover, on page 67 of the Tune Review it explicitly states:

NDIA should not implement a closed or deliberatively limited panel of providers to undertake functional capacity assessments.

The NDIA has since announced that only 8 providers will be approved to deliver independent assessments. To summarise - the Tune Review specifically recommended the NDIA not take this approach and they have instead decided not just to do it, but to announce it to the media as if it were the Tune Review’s idea.

The Government is already facing a serious backlash from disability groups about this approach (an online petition has already garnered over 50,000 signatures). So what is it all about? What can we expect from these assessments?

WHO WILL BE REQUIRED TO HAVE AN INDEPENDENT ASSESSMENT?

In the tender document released in June to engage these independent assessors, the NDIA revealed that initially, all prospective participants will be required to use an independent assessor to support access requests. The important silver lining here could be greater equity of access to the NDIS, as nobody will have to pay out of pocket for the initial assessments to prove eligibility, as they currently do. 

However, it’s not just access requests – from mid 2021, independent assessments will also be required as part of the plan review process.

Update: The NDIA’s Discussion Paper on the future of planning from November 2020, proposed that participants be required to undergo a new assessment if their plan budget is up for review. The Agency is proposing this happens at least every 5 years.

WHO ARE THE ASSESSORS?

Update: the winners of the IA tender have since been announced, read everything that was wrong with the announcement here.

Independent assessors will be engaged by the NDIA through a tender process. The assessors may also be contracted as ECEI Partners or LACs but would only be allowed to provide assessments in regions where they are not the LAC or ECEI Partner.

This raises a question - if the assessors are hired through an NDIA tender, are they really independent? Presumably they will want to win the tender again, maybe they will be not so independent after all.

HOW LONG WILL ASSESSMENTS TAKE?

The original tender stated that assessors are required to undertake “a 20 minute (minimum) interaction or observation session” with the person before writing their report. This is a far cry from the “1-4 hours” advertised on the NDIS web page for participants about independent assessments and few professionals would recognise such a quick assessment as good practice.

While 20 minutes is the minimum observation time, the tender estimates the average time from start to finish (observation, assessment and report writing) is just 2.5 to 3 hours. The NDIA seems to have since backtracked away from the 20 minutes claim.

WHAT IS THE ASSESSMENT BASED ON AND WHAT IS IT FOR?

Assessors must use nominated Functional Capacity Assessment tools as directed by the NDIA to complete their Assessment Report. This report does not include any recommendations about support needs. Advocate and provider CEO, Dougie Herd pointed out earlier this week:

WHO GETS TO SEE THE ASSESSMENT?

The tender notes that “Assessors must not provide Participants or Prospective Participants with copies of the Assessment Reports or discuss results or outcomes with Participants or Prospective Participants in any way.” Instead, the NDIA will provide a copy either through the portal or on request. There is no mention of when this sharing would occur, which raises serious questions about the ethics of a Planner having information on a person’s capacity that they themselves do not have.  

These assessments are designed to influence the supports a person receives. It’s not enough for the NDIA to say people can request their assessments – at a bare minimum, the person should always have as much time to read, understand and potentially dispute their assessments as the Planner does. 

BUT ISN’T IT 2020? WHAT HAPPENED TO THE SOCIAL MODEL OF DISABILITY?

All this focus on assessing people’s capacity, as if it is a fixed, observable fact is not something that belongs in a contemporary NDIS. People deserve better than to have their potential assessed by a stranger in a couple of hours and they certainly deserve better than to have that assessment kept from them.  

We understand that the NDIS need good information to make planning decisions but what this approach may bring in objectivity, it lacks in accuracy, transparency and empathy. If we truly want to achieve our goals as a sector, we need to address the systemic barriers that reinforce the idea that people with disability are lacking in potential and autonomy - not build new ones.