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The Answers We've Been Waiting For

Sara explores the latest Agency's latest revelations on Independent Assessments, eligibility reassessments and the growing cost of internal reviews.

By Sara Gingold

Updated 15 Apr 202418 Jan 2021

Many of you will remember that last year’s Senate Estimates were as messy as hell. There were tense exchanges about Independent Assessments (IAs); the Fast Pathways program, which bypassed reasonable and necessary; mounting legal fees, etc. But for anyone who had the misfortune of watching the proceedings, the most frustrating thing, by far, was the number of really juicy questions that were taken on notice. 

Taking a question on notice is basically a fancy way of saying, “I’ll get back to you on that”. For the public servants being questioned, it has the advantage of protecting them from follow-up questions or tense exchanges on TV. In the last Estimates hearing, the NDIA took no less than 88 questions on notice. And guess what? The answers are back! While many of the answers are so useless they are pretty much the bureaucratic version of giving someone the finger, there are nuggets of gold among the many pages of boredom. Here’s what we learned: 


INTERNAL REVIEWS DON’T COME CHEAP

The Agency was asked numerous questions about reviews of a reviewable decision (also known as “internal reviews”) and what plan sizes tend to look like before and after them. The table below details the differences in average plan sizes pre- and post-internal reviews. It shows that average plan sizes increase substantially after internal reviews. At its peak, in early 2020, plan sizes increased by, on average, 54 percent following a plan review.

Table of Before plan review and after plan review comparisons for each quarter in 2019 and 2020

So, what happened in 2020 (other than literally everything that happened in 2020)? At the Estimates hearing, we learned that this was when the NDIA implemented its Fast Pathways program for speeding through the backlog of internal reviews. The program streamlined the approval of particular supports at internal reviews. The only supports ineligible for fast tracking were those on the naughty list, or exceptions list as they called it (you can read more about this list in our previous Senate Estimates article). At the time, it was unclear what the approval process was for supports eligible for the Fast Pathway program, but documents presented at the hearing made it seem like they were automatically approved. 

The NDIA has adamantly denied that any supports were automatically approved. However, in one answer, they provided the Standard Operating Procedure (SOP) for the Fast Pathway program. This SOP is mostly pretty boring, so I wouldn’t recommend adding it to your nightstand, but there is one tell-tale line: if all supports are eligible for the Fast Pathway program, the first instruction for delegates is to . . . 

“. . . advise the participant that you have made the internal review decision to approve all supports”. 

Wow! 

Many participants probably benefited from the Fast Pathway program, but for an Agency obsessed with budget cuts, this might not have been the cheapest strategy. The answers also contained a strong denial that either Martin Hoffman, Minister Stuart Robert or the NDIA board were involved in the Fast Pathways program. 

 

THE INDEPENDENT ASSESSMENTS PILOT WHICH CRASHED 

Many of the questions put to the Agency focused on one of the most controversial issues in the NDIS landscape at the moment—Independent Assessments. At the Estimates hearing, the evaluation of the first pilot was zoned in on, and the NDIA was slammed for the fact that only 145 people in the first pilot filled in the online evaluation survey. The answers to the questions on notice provided even more insight into the evaluation. We learned that of the 145 people who completed the survey, 110 were representatives and only 35 were participants, so it was pretty lopsided. We also discovered that 126 people completed the survey after the assessment and only 19 completed it after the subsequent planning meeting. This demonstrates another key problem with the evaluation: assessments conducted during the pilot program are not supposed to impact planning decisions. This makes sense because they are still testing everything out. However, the planning outcomes dramatically alter people’s feelings towards the whole process. The absence of this piece of the puzzle makes it hard to read too deeply into satisfaction rates, even if they had managed to collect more than 145 responses. 

If you are interested, you can view a list of the survey participants and representatives who were asked to fill in the survey form here. It’s confusing to follow, so we can only assume that it must have made more sense online. 

As for the second pilot, the NDIA says that it will be concluded in early 2021. However, no oh-so crucial information is provided about the planned evaluation methodology. What we do know is that, at the time of answering, they had invited 4,896 people to take part in the pilot, and of these

  • 215 have accepted,
  • 185 have declined
  • and 4,496 have not yet responded (awks!). 

All this makes it hard to see how they will get anything statistically significant by early 2021. 

 

ASSESSING ELIGIBILITY REASSESSMENTS 

We don’t often talk about eligibility reassessments, but they represent a significant source of anxiety for many NDIS participants. The questions on notice finally shine some light on a process that has been largely clouded in mystery. We learned that between October 2019 and September 2020, 3,591 eligibility reassessments were completed. It should be noted that this is not a huge number, though it does not include assessments that were initiated by the Agency but later withdrawn. 

However, the picture is certainly different when the disability cohort is taken into account. As you can see from the table below, participants with autism make up over half of eligibility reassessments. 

The NDIA was also asked about eligibility reassessments during the Melbourne lockdown. 

Between 21 March and 28 October, there were 1,658 eligibility reassessments initiated in Melbourne. Unfortunately, we don’t know how many of these reassessments were actually completed. The way the data is presented in answer to these questions is far from consistent. Regardless, initiating so many reassessments at that time seems quite mean, especially as it would have been difficult for participants to gather counter evidence. 

Senator Steele-John also questioned the Agency about the eligibility reassessment checklist for LACs. Some of you might have seen this document, as it was leaked online late last year. The checklist instructed planners to refer participants for an eligibility reassessment if they had disabilities that were “unlikely” to meet the disability requirements. The disabilities it lists are fibromyalgia, chronic fatigue syndrome, chronic pain, depression, anxiety, PSTD, obesity and osteoarthritis. However, perhaps inconveniently for the NDIA, the NDIS Act itself focuses on the reduction-of-functional capacity rather than the cause of the disability. Therefore, the NDIA really should not be targeting particular disabilities for reassessments. When questioned about this checklist, the Agency insisted that these were just included as “examples of circumstances that may not meet the legislative requirements” (emphasis added)but that every participant’s circumstances “are considered on a case-by-case basis”. 

In my honest (and probably biased) opinion, there is quite a difference between “may not” and “unlikely to”. 

 

THE NEVER-ENDING HEADACHE OF THE NDIA WEBPAGE

The NDIA’s support worker matching webpage—which was a pandemic measure that lists 15 providers who run support worker matching services—was the source of some controversy in the Estimates hearing. The Agency was accused of favouring certain providers, which is outside its mandate. 

Answers to the questions on notice show that the NDIA contacted 5 providers about being included on the page, while the other 10 providers contacted the NDIA about being included. It seems that all providers who were in communication with the Agency were added to the site. This is good for giving all providers an equal footing, but it was an interesting move from quality and safeguards perspectives. Six of the listed providers are unregistered, meaning that the NDIS Quality and Safeguards Commission has limited oversight over their services. The NDIA was also asked how they decided on the order in which to display the providers (which is something that I certainly wondered about). The answer was that they uploaded them chronologically after providers sent them their logos and web addresses.  

That’s enough of the Senate Estimates for the time being, but if you, like me, are one of those people who enjoys reading bureaucratic documents that don’t really seem to lead anywhere, you can find the Agency’s response to questions on notice here. You’ll need to search for questions asked of the NDIA in the 2020–21 Budgets Estimates round. I can’t guarantee that you’ll be there for a good time, but you will be there for a long time.

Authors

Sara Gingold

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