NDIA releases new Functional Capacity Framework

The NDIA has today released a new NDIS Functional Capacity Assessment Framework – the evidence base and principles to inform the introduction of best practice Independent Assessments.

CEO Martin Hoffman said that functional assessments have always been central to the implementation of the NDIS, to help inform NDIS planning and development of support packages, with the Agency focussed on ensuring assessments were free and fair for all Australians with disability.

“The Agency completed an in-depth review of how functional assessments and assessment tools are currently used, to implement a best practice approach,” Mr Hoffman said.

“This paper details that important work that provided the foundation for the new Functional Capacity framework in line with recommendations. Shortly we will also publish a further paper explaining the specific assessment tools we have selected and why.”

Mr Hoffman said Independent Assessments were first recommended by the Productivity Commission, at the Scheme’s inception, and more recently by the NDIS Act Review (Tune Review),and were also announced as part of the Minister’s Plan for the NDIS in November 2019.

The Tune Review recommended a new approach to assessments – specifically for the NDIA to provide an assessment for the purposes of decision-making, using NDIA-approved assessors in a form set by the Agency to address:

• cost as a barrier for people with disability to access the Scheme

• improvements in the quality, consistency and transparency of NDIA decisions.

• ensuring planning decisions are directed towards improving functional capacity in the context of a participants goals and outcomes.

The framework for Functional Assessments was developed from the International Classification of Functioning, Disability and Health, the 2011 Productivity Commission report, which provided a blueprint for the Scheme, and the NDIS Act and Rules and other published information, as well as collaboration with experts in the sector.

University of Sydney’s Dr Ros Madden AM, Honorary Research Fellow and Nick Glozier, Professor of Psychological Medicine were consulted extensively in developing the framework.

“The NDIA has taken on one of the difficult technical and implementation problems in the disability field worldwide,” Dr Madden and Professor Glozier said.

“They have outlined a framework on which to build a fairer and more consistent disability assessment – to enable the rights of people with disability to participate across society. This diagnosis-neutral framework combines both the need to evaluate capacity and the determining role of the environment in helping or hindering participation.

“The framework recognises that assessment must combine quantifiable information obtained using scientific standards with the expert knowledge of people living with disability and the families and professionals who know them.”

Professor Andrew Whitehouse from the Autism CRC and Telethon Kids Institute and Professor of Autism Research at The University of Western Australia is very supportive of the assessment framework.

“The framework is consistent with international best practice. It has great potential to increase the accuracy of assessment, which is a critical foundation in determining the most appropriate supports for each individual,” Professor Whitehouse said.

Professor and Chair of Infant, Child and Adolescent Psychiatry at the University of New South Wales and Head of the Academic Unit of Child Psychiatry, South West Sydney, Valsamma Eapen said functional assessments are critical to the comprehensive assessment and an integral part of planning intervention and supports.

“The new functional capacity assessment framework by NDIS aligned to the International Classification of Functioning will undoubtedly enhance the development of effective programs matching each individual’s functional level and needs, thereby optimising outcomes.” Professor Eapen said

Mr Hoffman said that the introduction of independent assessments has been part of ongoing discussion regarding improvements to the NDIS experience, including consultation with more than 40 peak health and disability bodies from across the sector, with the release of the framework the next important step in transparent communication about the new approach.

‘We know that with change there can be uncertainty – that’s why we have begun talking about these changes well in advance of rolling them out, so that we can continue gathering feedback, answer questions and address any concerns,’ said Mr Hoffman.

“We have heard that while people understand the importance of having free, consistent and fair independent assessments, people, understandably, have questions – that we are here to discuss and answer.”

The Agency wanted to provide clarity around independent assessments, specifically that:

• Wherever possible, participants will have a choice of assessor or organisation who can deliver their Independent assessments, from a panel of assessors engaged by the NDIA.

• Participants will be able to request a copy of their independent assessment results.

• Assessments are conducted separate to the NDIA with assessors drawn from a panel, which is being established through an open and competitive tender process.

• The NDIS panel of assessors will be live and will be changed based on needs and will not be a closed panel of providers

• Participants will still be able to request a review or appeal of access and planning decisions, if they feel a decision made about them is wrong.

“Ultimately, Independent Assessments will improve the quality and consistency of plans which we know has been a challenge during the roll out of the Scheme,’ said Mr Hoffman.

“They will also be a cost-free, simpler and more equitable approach to ensure participants receive the supports and funding they need – part of a wide range of improvements we are making for a simpler, fairer and better NDIS.”

Mr Hoffman said consultations on independent assessments will continue with a further 4,000 people receiving an independent assessment on a voluntary basis before by the end of the year to help further refine Agency practice ahead of wider rollout.

Read about the Functional Assessment Framework

BACKGROUND

Dr Rosamond Madden AM

Dr Rosamond (Ros) Madden AM is a consultant who has worked on disability information, statistics and research since 1992, in leadership roles at the Australian Institute of Health and Welfare (to 2006) and at the University of Sydney (where she now holds an honorary position). Ros has published widely in these fields. She worked internationally with the WHO on the development and application of the International Classification of Functioning, Disability and Health (ICF) for 20+ years, and was a member of the Editorial Committee for the World Report on Disability (2007-2011).

At AIHW she led publications on: the definition and prevalence of disability; disability and ageing; children with disabilities; Indigenous disability; disability, health conditions and environmental factors; national data standards for functioning and disability; and unmet need for disability support services. At the University, she led the collaborative development, with colleagues in Asia and the Pacific region, of a Monitoring Manual and Menu for CBR (community-based rehabilitation).

Ros was made a Member of the Order of Australia in June 2014 for significant service to leadership and reform in the disability sector as an administrator, statistician and academic.

Professsor Nick Glozier

Nick Glozier is a consultant psychiatrist specialising in epidemiology, trials and health services research. He has a research interests in public mental health, function, sleep, the workplace, stress, disability and discrimination in our changing psychosocial and technological environments. In thirteen years since arriving in Australia he has been awarded over $60 million in nationally competitive grants as a Chief Investigator, and is a theme leader in the new ARC Life Course Centre of Excellence.

In the late 1990s Prof Glozier worked at the World Health Organisation and is an author of the WHO’s Disability Classification system, the ICF, sister to the ICD-10 diagnostic system and the WHO Disablement Assessment Schedule (WHODAS -II). He has a number of international projects with collaborators in LIMCs and Europe

His team are commissioned by NGOs, industry, and government to produce policy relevant end user driven research and program evaluations.

Professor Andrew Whitehouse

Andrew Whitehouse is the Angela Wright Bennett Professor of Autism Research at the Telethon Kids Institute and Professor of Autism Research at The University of Western Australia. He is also Chief Research Officer of the Cooperative Research Centre for Living with Autism (Autism CRC) and Adjunct Professor at Curtin University and Edith Cowan University.

At the Telethon Kids Institute he leads a large team that use a wide range of methodologies to investigate the early identification and intervention of children with Autism Spectrum Conditions, including molecular genetics, neuroscience, endocrinology, behavioural experiments and clinical trials. Andrew has published over 150 peer-reviewed journal articles and attracted over $35 million in competitive research grants. He currently presents an internationally syndicated video series called ’60 Second Science”, which has been viewed by over 1 million people. He is an advisor to State and Commonwealth Governments on policies relating to children with Autism Spectrum Conditions, and he chaired the committee that generated Australia’s first national guideline for autism diagnosis.

Professor Valsamma Eapen MBBS, PhD, FRCPsych, FRANZCP

Valsamma Eapen is Professor and Chair of Infant, Child and Adolescent Psychiatry at the University of New South Wales (UNSW) and Head of the Academic Unit of Child Psychiatry, South West Sydney (AUCS).

Professor Eapen has over 25 years clinical and research experience. Her interests centre on issues of early development and neurodevelopmental disorders including Tourette Syndrome and Autism. She has authored around 300 scientific publications. She is a member of several international consortiums including Obsessive Compulsive Foundation Genetics Collaborative, Homozygosity Mapping Collaborative for Autism and Psychiatric Genomics Consortium. She is part of several collaborative grants with over $30 million in funding including from National Health and Medical Research Council (NHMRC), Australian Research Council (ARC), and Co-operative Research Centre for Autism where she is a Program Director. She leads the Clinical Academic Group on “Early Life Determinants of Health (ELDoH)” under the Sydney Partnership for Health Education Research and Enterprise (SPHERE), an NHMRC accredited Advanced Health Research and Translation Centre (AHRTC).

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