NDIS

What’s happened:

As part of the NDIA’s early designs for a new early intervention pathway for children under 9, the Government plans to create and fund a “dedicated, multidisciplinary workforce” of needs assessors to assess children under 9 with developmental delay or disability. Families will not need to pay for these assessments.

Driving the change:

• The authors of the 2023 NDIS Review recommended the NDIA should reform the early intervention pathway for children under the age of 9 to enter the NDIS; and introduce a more “consistent and robust approach to assessing developmental delay”. 
• The Government claims that creating a new workforce of dedicated needs assessors will mean that allied health professional time will be “freed up” so we can spend more time delivering supports, “putting downward pressure on waiting times…over the next 5 years”. 

Anti-provider undercurrents? While acknowledging allied health professionals have a “crucial role in the Scheme”, the Minister, in his press release (linked below): 

• states repeatedly that the aim of the change is to put participants “back in the centre of the scheme”, suggesting they’re not there now; and
• unhelpfully claims allied health professionals write “expensive 80-page reports which are not able to be implemented”. (!)

Reality checks: 

• Nothing is changing right now for participants or allied health providers. The NDIA will need time to:
  • create and (presumably) train a new dedicated workforce of needs assessors; 
  • consult with participants and professionals to identify valid and reliable assessment tools they can use to determine the NDIS support needs of children; and
  • co-design and implement the rest of the early intervention pathway.
• If the announced changes are implemented, families will have less choice and control over who assesses their child.
• The proposal is a sustainability measure. There is no such thing as a free assessment – somebody will pay, e.g.:
  • some families, through Government savings from decisions to revoke or not grant access to the NDIS, or through significantly reduced plan funding; and
  • taxpayers.

What to watch:

• What criteria (experience, qualifications, checks) will be required for someone to become a needs assessor? 
• How will needs assessors balance their NDIA policy objectives with their legal, ethical, and professional obligations to clients, their professions, and to the public?
• Who will train and supervise needs assessors? To whom will they be accountable?
• Which assessment battery/tools will needs assessors use to assess participants, and are they valid and reliable for the children assessed?
• How will the (as yet undesigned) new early intervention pathway interact with the (as yet unfunded and unannounced) Targeted Foundational Supports system, and various mainstream supports systems in different settings and states to support children?

Assessment quality affects the safety and quality of NDIS supports: 

• To deliver safe, evidence-based, and quality NDIS supports to young children, allied health professionals need accurate, complete, and reliable assessment data, communicated in clear, trustworthy reports written by qualified professionals. 
• Reports shouldn’t be 80-pages long. But, to meet NDIS objectives and measure outcomes, they must take into account:
  • a child’s delay or disability;
  • the effects of the child’s delay or disability on their real-world functioning, inclusion, participation, and quality of life; and 
  • the family’s priorities and concerns. 
• Without solid assessment data and reports, allied health professionals will struggle to provide personalised, evidence-based and family-centred care, and to measure outcomes without spending scarce therapy time establishing baselines and evidence-informed therapy goals. 

Bottom line

• Allied health professionals should:
  • continue to advocate for the choice and control of participants and families; 
  • push back against unhelpful anti-provider rhetoric that seeks to pit participants against providers in a zero-sum-game; and
  • be proud of the work we do to deliver high quality, safe supports to children across the country, despite all the uncertainties and risks created by rolling reforms.

Read more: 

Minister for the NDIS Media Release: Putting participants back at the centre of the NDIS