Auditor-General for Australia
Australian National Audit Office
3 April 2020
Senator Hollie Hughes Chair Email: autism.sen@aph.gov.au
Dear Senator
The Australian National Audit Office (ANAO) published the following performance audit report that you may find relevant to the Select Committee on Autism inquiry into and report on the services, support and life outcomes for autistic people in Australia and the associated need for a National Autism Strategy.
- Report No. 24 of 2015-16, Early Intervention Services for Children with Disability.
Information about what the audit assessed, concluded and recommended is attached. The audit reports are available online at www.anao.gov.au.
Should the Committee require further information in relation to this matter, my office would be pleased to provide you with a briefing at a time convenient to you or appear as a witness at a hearing.
To arrange a briefing, please contact our External Relations area at redacted.
Yours sincerely
Grant Hehir
GPO Box 707, Canberra ACT 2601 38 Sydney Avenue, Forrest ACT 2603
Report No. 24 of 2015-16, Early Intervention Services for Children with Disability assessed the effectiveness of the Department of Social Services’ administration of Early Intervention Services for Children with Disability. To form a conclusion against this objective, the Australian National Audit Office (ANAO) examined the Department’s:
a) arrangements for the registration of eligible children and service providers, and access to and utilisation of funded services; b) approach to managing entry requirements, forecasting demand, and monitoring utilisation and expenditure; c) management of the transition of eligible children to the NDIS in trial sites; and d) systems for supporting program administration and the assessment of program performance.
The audit concluded that:
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DSS’ administration of the EISCD is effective in some areas, but overall could be improved. To facilitate access to the program, the Department established a national registration process for eligible children and service providers. Service delivery is supported by program guidelines, but data is not collected on whether service delivery is consistent with the guidelines. Access to, and the utilisation of services, has remained reliant on the proximity to DSS registered service providers, with claims and expenditure for eligible children living in regional and remote areas being disproportionately low when compared to claims by children living in urban areas. This is despite additional funding being made available to children in these areas to assist with the cost of accessing services.
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Critical to the ongoing financial sustainability of a demand-driven program is the capacity to manage entry requirements. A combination of administrative and diagnostic requirements determines EISCD access. The administrative requirements are clearly defined, but the HCWA diagnostic entry requirements have varied over time, broadening the eligibility criteria for the program. DSS has not accurately forecast demand for services funded through the two components of the program, resulting in annual budget overruns of between $1.5 million and $18 million for HCWA and under-expenditure of between $3.9 million and $19.3 million for Better Start.
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DSS’ approach to transitioning children from the EISCD to the NDIS demonstrated limited strategic planning. The need to assist families with timely, clear and consistent information and support prior to the commencement of the NDIS trial should have been identified as part of DSS’ planning for the transition of children from the EISCD to the NDIS. Advice to families about choosing when to transition to the NDIS encouraged families to retain EISCD entitlements to maximise expenditure prior to transitioning. Some families took up the option to delay their transition and increased their annual expenditure to maximise EISCD benefits prior to transitioning. Subsequently, DSS retracted their initial advice, and placed a time limit on families transiting. Families were confused by the conflicting advice and their options. To support families DSS could have made greater use of the national network of registration service providers, in particular those that operate in the jurisdictions with NDIS trial sites. The agreements were varied with these providers to include direct assistance to families transitioning to the NDIS 13 months after the NDIS trial commenced in South Australia and one month after the Australian Capital Territory trial commenced. As at February 2016, agreements in only two jurisdictions had been varied, even though NDIS trial sites operate in each state and territory.
- An information technology system has been developed by DSS to support the administration of the program, including the processing of claims for services, the purchase of resources and the reporting of program utilisation. DSS uses data captured in the system to report on the number of children registered to receive support, service utilisation and expenditure. Nevertheless, reporting in relation to the program has focused on the utilisation of DSS administered services only, rather than the impact of the related activities funded through the package of services available to EISCD children and their families. There would be benefit in DSS working with the Department of Health and the Department of Education and Training to collect data about outcomes and report on the impact of the combination of available intervention services.
The ANAO recommended:
- To better understand the barriers to accessing services funded through the EISCD and to improve access to services for children living outside of urban areas, the ANAO recommends that DSS consult with service providers and EISCD families about access issues and provides advice to the responsible Minister about how to improve access to services.
- To assist the Australian Government in the development of policy frameworks and to make informed decisions regarding the future delivery of the EISCD within financial allocations, the ANAO recommends that DSS provide a comprehensive analysis of EISCD forecast utilisation and expenditure to Government.
- To assist families to transition to the NDIS, the ANAO recommends that DSS work with the registration providers, state and territory governments and the NDIA to develop clear, timely and consistent advice for families as the NDIS is implemented nationally.
- Consistent with the requirements of the Public Governance, Performance and Accountability Act 2013 to report against program outcomes and to assist the Australian Government with making informed decisions about the EISCD, the ANAO recommends that DSS collate and report on the impact of the package of intervention services available to EISCD children and their families.