Joint Standing Committee on the National Disability Insurance Scheme

Inquiry into Independent Assessments (IAs)

This is a personal submission from a secondary carer and father of a physically and intellectually disabled existing NDIS participant.

This submission was finalised on the 31st of March 2021, so is based on the original consultation papers and the NDIS media releases dated the 11th and 26th of March 2021.

Several aspects of the media releases amount to promising indications that the NDIA is addressing some of the concerns raised by NDIA participants and disability advocacy/support groups. However, the proposed rollout of IAs continues to pose a significant risk to disabled Australians’ capacity to live rewarding lives.

Despite improvements to the proposed IA framework announced in the media releases, the inevitable sudden surge in the demand for relevant health professionals upon the implementation of IAs is very likely to limit the genuine choice available to existing and prospective participants for the assessments. Moreover it is equally as likely to divert available health professionals from providing ongoing services to disabled Australians, whether they are NDIS participants or not.

The clarification in the media release of the 11th of March of the duration of IAs is welcome. So too the clarification that …”people will be able to choose their assessor from the panel” … but the inclusion of “where possible“ needs further clarification before the legislation is finalised.

As laudable as is the federal government’s initiative, on behalf of Australian taxpayers, to ensure the NDIS is fair, consistent and sustainable, the addition of a new layer of costs to deploy IAs is inconsistent with the financial sustainability of the scheme. In order to provide the number of appropriately qualified health professionals to run the IA programme, increasing reliance on for-profit maximisation providers of disability services will divert funds better spent on the actual provision of services.

Efficiencies in the delivery of services to disabled Australians, including more extensive deployment of digital technologies clearly has the potential to play a major role in the ongoing financial sustainability of the NDIS. However, excessive standardisation of assessment protocols poses a significant risk that complex and/or fluctuating functional impairments will not receive sufficient weight in the IA process. More generally, the one size fits all concept of assessment of such a diverse range of disabilities - physical and/or intellectual - and functional capacities inevitably will cause an unacceptably large number of worthy and legitimate prospective NDIS participants to fall through the cracks of the process.

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The Tune Review’s recommendation that “truly independent functional capacity assessments” form part of the eligibility criteria for accessing the NDIS is frequently cited in NDIS information papers and ministerial statements in support of the introduction of IAs. While it is true that Tune does indeed make such a recommendation, section 4.34 of Tune also recommends the following:

  The NDIS Act should be amended to support the use of functional capacity assessments as proposed above. However, there are a number of key protections that need to be embedded as this approach rolls out, including:

        a. participants having the right to choose which NDIA-approved provider in their area undertakes the functional capacity assessment

        b. participants having the right to challenge the results of the functional capacity assessment, including the ability to undertake a second assessment or seek some form of arbitration if, for whatever reason, they are unsatisfied with the assessment

        c. the NDIA-approved providers being subject to uniform accreditation requirements that are designed and implemented jointly by the NDIA and appropriate disability representative organisations
       d. the NDIA providing clear and accessible publicly available information, including on the NDIS website, on the functional capacity assessments being used by the NDIA and the available panel of providers.

The final protection recommended by Tune (subsection e) cogently highlights the need for transparency and accountability in the operation of the NDIS more broadly. In particular, it is essential that the structural framework of the NDIS outlaws reversion to the time honoured ‘commercially sensitive’ reason for withholding the information required to assess disputed IAs. The burgeoning reliance on for profit maximisation disability service providers further tilts an already severely unbalanced distribution of power between some of Australia’s most vulnerable citizens and the providers of the services they need to live fulfilling lives.

As the balance of power tilts ever further in favour of for-profit maximisation providers, the need for a robust network of effective not for profit disability advocacy and support organisations to hold the NDIS and the profit maximisation providers to account has never been more crucial than it is now.

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