Note: this article is about recent changes to the NDIS for participants 7 years and older. There is a separate process being considered for Early Childhood Early Intervention (ECEI) participants aged 0-6 years.
Consistency! Equity! Holistic whole-of-person approach! A focus on function rather than diagnosis and less financial burden on individuals – it sounds good, right?!
The NDIA’s new Functional Capacity Framework and Independent Assessment approach will impact people with Down syndrome, both applying for and already receiving NDIS supports. While it sounds good in theory, there are some significant concerns within the community right now.
The Framework (released on 7th September) outlines why and how the NDIA are introducing Independent Assessments.
This new approach to assessments aims to address current issues around inconsistency in NDIS decisions. As you’re no doubt aware, currently two people with relatively similar functional capacity and contexts could receive entirely different outcomes in terms of NDIS supports. The NDIA is essentially saying a key cause of this is inconsistent data (for a variety of reasons), and that their new approach with Independent Assessments will address this. In the Framework they are quick to point out that there is no single perfect one-size-fits-all assessment, but that this approach will be an improvement on what is currently in place. The Agency will select a ‘suite of assessments’ that will provide a ‘best fit’ approach which Independent Assessors will carry out. The assessments chosen will be scientifically rigorous – reliable and consistent. The data collected will then go back to the Agency to contribute to Planners’ decisions regarding what is reasonable and necessary within a plan.
In theory, the new approach should improve how the Agency makes decisions by providing a way to measure functional impact consistently, regardless of the type of disability, or number of disabilities a person has. It is based on a fusion of the 2013 NDIS Act and the World Health Organisation-International Classification of Functioning (ICF) and in theory aims to take into consideration not just the impacts of a person’s impairment(s) but also environmental factors like attitudes and institutional barriers to accessibility.
While this all sounds good, on the ground it looks like short assessments (1-4 hours) by an NDIA approved professional who has never met you or your loved one before. While in theory the process aims to take into account physical, social and environmental factors impacting on individuals, the reality of this – particularly for individuals with complex needs or from marginalised population groups – is questionable. How assessors will respond to individuals who do not agree with the assessment or are non-verbal has not been outlined, and the likelihood of the assessors being entirely unbiased, given they are contracted by the NDIA (and one would assume, will be invested in maintaining ongoing contracts) is questionable. It is also unclear whether the NDIA will accept other supplementary evidence alongside these independent assessments, for example from the therapists you see on a regular basis.
The evaluation report from the pilot of the assessments has not been made public which is somewhat ironic, given this new Framework touts increased transparency as one of its potential outcomes. Also on this point, the professionals conducting these assessments cannot share or discuss their findings with participants. Participants can only access their results/reports from the Independent Assessments by putting in a request to their LAC or NDIA planner.
The changes do provide some good news around equity of access. Currently individuals applying to the scheme not only have to provide evidence of their diagnosis but also seek out numerous medical reports various health professionals outlining the functional impact of their disability. The Tune review recommended that the NDIS Act be amended to provide prospective participants with assessments such as these, however it specifically said that these are not appropriate for current participants. In other words – the Agency should provide assessments at no cost and by independent assessors for people applying to the scheme, but these same requirements should not be placed on people already accessing the scheme. While it can be useful to people applying to the NDIS to have support to gather evidence of the functional impact of their disability, once they are in the scheme, that’s another question. It brings into question the idea that once people have met Access, they’ve met access for life. Suddenly, it feels a lot like people will be having to prove their eligibility at every step of the way, including Plan Reviews.
What this new approach does not do, is put the power in the hands of the person with disability. Choice and control? Not really. We’re still talking a medical-model of external “expert” coming in measuring someone’s “capability”. And that this will be done by a stranger, in a brief assessment, with an impact on future supports.
Currently there is no Easy Read version of Functional Capacity Framework, but the Agency note on the webpage that one will be out soon
Down Syndrome Australia are involved in high level, ongoing communication with the NDIA, including consultation regarding Independent Assessments.
Please connect with our team at DSQ to share thoughts or concerns so we can channel the experiences of our members right to the top.
For more information see: