DOCUMENT 1
FOI 23/24-0933 Disclosure Log The contents of this document are OFFICIAL
PXC - Cover Page
Agenda item: [insert number and title]
Matter Overview
Context: In the absence of a suitable TSP for children under 7, the ECS Branch developed a method for determining capacity building supports. NDIA staff currently use this internal guidance in decision making however there is limited ability to communicate this to families and stakeholders, including the AAT which impacts on the number and outcome of appeals. NDIA staff including early childhood partners have stated that an external policy would increase the transparency of their work and enable the same information to be used to guide decision making at all decision making points in the NDIS.
Recommendation PXC to support the ECS Branch policy position on determining capacity building supports in early childhood. It is proposed that the agreed policy position will be externally published in OGs and will include the guidance to staff and participants to inform early childhood planning considerations but will not include calculation methods. This will increase transparency in decision making and support decisions to be made using the same guidance.
Engagement to Date Early childhood partners have been using and improving the capacity building guidance in early childhood since the early childhood approach was developed. The internal documents, the Guide, Alternative Method and the Intensive form were presented to the Autism Advisory Group (AAG) as a possible solution to guiding determination of intensive supports for children with Autism (Attachment D). In March 2022, the AAG agreed on the importance of a consistent and transparent approach to determining levels of Capacity Building support in early childhood plans.
Engagement Planned The ECS branch will work with Service Guidance and Practice Branch to prepare OGs for publication. The documents are currently in place and being used for decision making in place of a TSP. The consistent decision making framework (CDMF) through co design will ensure thorough external consultation on any future variations.
Risks and mitigations Risk: There is a risk that including information in OGs that has a foundation in the current inconclusive evidence base may be contested by stakeholders, such as the Autism sector. Mitigation: Publishing OGs about capacity building supports is likely to reduce the number of internal reviews and AAT cases, impacting positively on Participant experience and Scheme sustainability. The policy is based on our best interpretation of the evidence until future research becomes available. The future consistent decision making framework (CDMF) will ensure thorough external consultation on any future variations to the guidance for CB in early childhood.
Participant Impact Externally publishing the current processes used to determine a level of CB support in EC NDIS plans will create more clarity for participants, families and carers. It will prompt more transparent and consistent decision making by NDIA delegates.
Attachments
Attachment A - Guide for calculating early childhood capacity building supports (the Guide)
Attachment B — Intensive capacity building supports in early childhood form (the Intensive form) Attachment C — The alternative method
Attachment D — AAG 1 March 2022
Attachment E — ECEI reset recommendations 3 and 18
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PXC meeting of 18th May 2022 FOI 23/24-0933 Agenda Item: # Disclosure Log
Agenda Item: [insert title]
Paper Type: For Recommendation
SES Sponsor: Christine McClelland
Draft resolution: PXC to support the ECS Branch policy position on determining capacity building supports in early childhood for external publication.
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Purpose
1.1. To seek recommendation for an agreed policy on determining capacity building funding in early childhood for external publication. -
Recommendation
2.1. PXC to recommend publication of the policy on determining capacity building funding in early childhood in OGs, based on current processes. This includes the information provided in the Early Childhood Planning Practice Guide (attachments A, B & C) but excludes any specific dollar amounts or hours. -
Background
3.1. The early childhood planning documents for children younger then 7years of age (attachments A, B & C) have been developed by the Early Childhood Services team of early childhood intervention subject matter experts based on best available evidence. They are internal documents and therefore cannot be applied consistently across all decision making points within the NDIA (initial decision, internal review and Administrative Appeals Tribunal (AAT)). NDIA staff and partners cannot be fully transparent with families and external stakeholders about how they make their decisions regarding capacity building supports in early childhood NDIS plans. 3.2. NDIS plans with an intensive level of capacity building support continue to rise. This is largely driven by providers who develop standardised quotes based on their business models, rather than an individualised assessment of need. Quotes range up to `redacted: s47E(d) - certain operations` (12 months). Often provider quotes do not meet the Reasonable and Necessary criteria and cannot be used to determine a level of support in the plan. 3.3. When considering matters before the (AAT), the Tribunal cannot refer to the NDIA’s internal early childhood planning guidance as it is not an external NDIS policy. This has led to reversing of some decisions and increased funding in plans, along with contributing to mixed messaging for families and providers. Inconsistency in decision making has led to reduced trust in NDIA decisions and increased incidence of reviews. Most importantly, young participants and their families are confused and distressed by the process. 3.4. The Early Childhood Early Intervention (ECEI) Reset recommendations 3 and 18 state that the NDIA has made a commitment to be consistent and transparent about decision making processes for all EC participants, including publishing new guidance about reasonable and necessary support for children with Autism (Attachment E). 3.5. Early childhood NDIS plans include capacity building supports for early childhood intervention. For most children, a level of reasonable and necessary capacity building support ranging from `redacted: s47E(d) - certain operations of agencies` (12 months) will meet their developmental and functional needs. This is calculated using the internal Guide (Attachment A). The Guide has been successfully used to determine the level of capacity building supports in early childhood plans since 2015. 3.6. The Guide provides 5 levels of funding and considers the individualised circumstances of the participant to determine the level of support, such as, number of areas of need and level of functional impact that require support, level of support required for the child and family/carers in natural settings and level of support required for mainstream participation (including transition support to mainstream), consistent with best practice. 3.7. Capacity building supports for children above the Guide level `redacted: s47E(d) - certain operations of agencies` for 12 months) are considered to be at an intensive level. An intensive level of funded support is where very
PXC meeting of 18th May 2022 FOI 23/24-0933
substantial support is required for redacted family to build capability and to increase
independence and participation in daily routines and activities. It typically represents multiple
hours of early intervention across multiple days in the week.
3.8. All requests for an intensive level of capacity building supports in an early childhood plan are
considered against the R&N criteria using the internal Intensive form (Attachment B). It
supports NDIA staff to consider the impact of disability on daily life, level of participation in
mainstream settings, early intervention goals and outcomes for the child and family, and
whether provider recommendations/quotes meet R&N.
3.9. When there is evidence that both the request for intensive supports and the provider quote
meet R&N, the level of support placed in the early childhood plan is based on the provider
quote. In these circumstances, NDIA staff are easily able to communicate with families about
the level of supports placed in the plan because it matches their and/or the provider’s
requests.
3.10. When provider quotes do not meet R&N or are not available, yet there is sufficient evidence
that the participant requires an intensive level of CB support, NDIA staff must find another way
to determine the funding level.
3.11. To meet this need, the ECS Branch developed the alternative method (Attachment C) for
internal use. When developing the alternative method, current research evidence was
considered but there is no consistent evidence to suggest that greater amounts of early
childhood intervention leads to better outcomes, or that there is an optimal amount of
intervention a child should receive (Attachment D).
3.12. The alternative method takes into account the level of support required to enable child and
family capacity building and to support increased mainstream participation. It is based on an
analysis of the range of funded supports that have been placed in early childhood plans that
were at an intensive level since 2015. The alternative method provides consideration of
capacity building support ranging from approximately `redacted: s47E(d) - certain operations of agencies`. (Attachment D,
slides 16 to 24 show examples).
3.13. The alternative method was presented to the Autism Advisory Group as a possible solution
to guide determination of intensive supports for children with Autism. The Autism Advisory
Group have endorsed the use of a consistent and transparent approach to determining levels
of capacity building support in children’s plans (Attachment D).
3.14. The early childhood planning documents as described in this paper are proposed to be
developed into an external policy to support determination of capacity building supports in
early childhood. Just as the TSP for participants over the age of 7 years is not published, we
suggest not to include the calculations or levels of funding themselves until further
consultation and co design is complete as part of the consistent decision making framework.4. Risks
4.1. Despite having access to information on how decisions are made, if a child does not receive
the level of support, they, or their provider requested, some families may remain unsatisfied
and request an internal review. Providers may continue to encourage families to request
unreasonably high levels of capacity building supports or to appeal decisions because their
business models may be impacted. NDIA staff will continue to support families with
information on how to request a review of a decision, as per current process. The availability
of public facing policy will mean the AAT can apply the same guidance in their decision
making as the original decision maker.
4.2. Publishing guidance material on how decisions are made, not including the funding calculation
methods may not fully resolve transparency issues. Future iterations of the policy may move
to include this when additional evidence is available from research currently underway. The
consistent decision making framework co design work will also further strengthen and approve
this policy and the transparency and consistency of the process to determine NDIS funding for
all participants.5. Impacts
PXC meeting of 18th May 2022 FOI 23/24-0933
5.1. Families and other stakeholders will redacted have access to information about how decisions are
made regarding capacity building and intensive supports for children younger than 7 years of
age. It will assist to manage expectations about what is R&N that the NDIS will fund in early
childhood.
5.2. The policy will support all NDIA staff, including EC Partners, planning delegates, Internal
Reviews team and Administrative Appeals Tribunal/Branch to make consistent decisions and
to openly communicate to families about how decisions were made. This is expected to
positivity impact scheme sustainability and participant experience.6. Sustainability Impacts
6.1. A policy will support consistent decision making and will provide clear messaging and
transparency on how decisions are made.
6.2. Positive impact on Scheme sustainability as a result of reduced number of AAT cases in the
future.7. Responsibility and next steps
7.1. The proposed next steps is to publish the policy in a new Operational Guideline for capacity
building supports in early childhood. Service Guidance and Practice Branch are responsible
for the creation of Operational Guidelines and Early Childhood Services Branch are
responsible for policy content.Internal use only
Prepared by: [Action Officer] Approved by: [GM Name]
Division: Loretta Kingston Christine McClelland Luke Napolitano Brown Phone: s22(1)(a)(ii) - irrelevant material s22(1)(a)(ii) - irrelevant materia s22(1)(a)(ii) - irrelevant material
Internal use only
Checklist
| If yes = Who? If N/A = Why? |
Contact (where consultation)/Further Detail |
||
|---|---|---|---|
| Legal consultation | Yes/No/N/A | ||
| Scheme Actuary | Yes/No/N/A | ||
| Consultation | |||
| Change Management Plan |
Yes/No/N/A | ||
| Risk management Plan | Yes/No/N/A | ||
| Identified dependencies | Yes/No/N/A | ||
| Defined Timeframes | Yes/No/N/A | ||
| Consultation with impacted areas |
Yes/No | (list areas and contact) | |
| Communications Plan | Yes/No/N/A | ||
| Participant Impact | Yes/No/N/A | ||
| Alignment with Australia’s Disability Strategy |
Yes/No/NA | If yes, please complete the ‘Alignment with national frameworks’ section |
|
| Alignment with National Agreement on Closing the Gap |
Yes/No/NA | If yes, please complete the ‘Alignment with national frameworks’ section |
Internal use only – Alignment with national frameworks
PXC meeting of 18th May 2022
Please indicate alignment of this work with the relevant redacted Area(s) under Australia’s Disability Strategy 2021-
2031:
| Employment and Financial Security |
Inclusive Homes and Communities |
Safety, Rights and Justice |
Personal and Community Support |
Education and Learning |
Health and Wellbeing |
Community Attitudes |
|---|---|---|---|---|---|---|
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
Please indicate alignment of this work with the relevant Priority Reform area(s) of the National Agreement on Closing the Gap
| Formal partnerships and shared decision making |
Building the community- controlled sector |
Transforming Government organisations |
Shared access to data and information at a regional level |
|---|---|---|---|
| ☐ | ☐ | ☐ | ☐ |
Pages 6 to 61 redacted in full, as per s22(1)(a)(ii) - irrelevant material
Disclosure Log