The Australian Government’s proposed reforms to the NDIS explained

The Australian Government has released details about a series of changes it is planning to make to the NDIS and is inviting feedback from participants and their families. 

We explain below how these proposed changes will affect current and future participants, specifically how they access the NDIS and how their plans and funding will be determined. 

We will also highlight how Amaze is working to challenge the proposal, and what you can do to help us. 

 

Why is the Government changing the NDIS? 

The Government states it wants to make sure there is more consistency in how participants’ ‘functional capacity’ is assessed, and how this affects participants’ budgets. The Government plans to use the measure of a person’s functional capacity to determine whether they get access to the NDIS, and what their budget should be.  

The NDIA define ‘functional capacity’ as “an individual’s ability to be involved in life situations and to execute tasks or actions, with and without assistance”. 

Currently, a person with disability who wants to access the NDIS will prove their functional capacity by providing reports that their own therapist (including occupational therapists, psychologists, paediatricians, speech therapists, and physiotherapists) who will use a series of tools and measurements.  The NDIA planners use these reports and meetings with the person with a disability to develop a plan and build a budget. According to the NDIA, this approach is resulting in some people receiving more or less funding than they need because of inconsistency in the way the functional assessment is done. The NDIA describe this as creating ‘inequity’.  

The Government is now proposing a standardised approach to assessing functional capacity. If it goes ahead as planned, this standardised approach will be mandatory for all participants and for any individual seeking to access the NDIS and will be a regular part of the NDIS experience. 

The NDIA is calling this approach ‘independent assessments’. We believe what is planned are not truly independent because the NDIA will choose and approve who does these assessments. Every participant who currently receives NDIS funding will be required to undertake an ‘independent assessment’ paid for by the NDIA. 

If the Government is successful in its plans to introduce these changes, they are intended to begin rolling out from July 2021. 

 

What are the changes? 

There are several major changes being proposed, which can be split into two different groups: 

1. Changes to how participants access the NDIS and how their plans and budgets are determined; and  
2. Changes to the early childhood and early intervention services (formerly the ECEI pathway). 

 In this article we will look at the first point and will discuss changes to early childhood services in a separate article.  

 

What are the key changes to how people access the NDIS? 

1. Access lists will be replaced with independent assessments 

The NDIA currently relies on access lists (List A and List B) to determine which diagnoses have immediate access to the NDIS. The Government plans to replace the lists with an independent assessment to measure a person’s functional capacity. 

The independent assessment will involve a series of tools that clinicians currently use and will give an insight into each person’s functional capacity. 

Independent assessments have undergone a limited first pilot and are currently being piloted among a larger group of participants on a voluntary basis. The results of the first pilot were published by the NDIA, but key details about the relationship between the assessment and plan budgets have not been released. 

Amaze’s position: 

• Amaze welcomes the abolition of Lists A & B in the access process. 
• Amaze approves of the proposed tools to be used for the assessment and that the National Guidelines for Assessment & Diagnosis of Autism (Autism CRC) will guide the assessment process for autistic people. 
• Amaze does not support that participants must use an NDIA approved panel of assessors instead of assessments being undertaken by health professionals and therapists who know the participant. 
• Amaze does not support the NDIA view that a fulsome and accurate assessment can be done for autistic people in three hours. 
• Amaze is concerned that the tools being used for independent assessments will be applied to determine a participant’s access to the NDIS and their subsequent plan budget. While the tools in themselves are robust, their use in this context is untested and unproven. 

 

2. Reassessments will become part of the Scheme 

The new focus on functional capacity leaves room for participants’ capacity to change, either through improvements in their independence and attainment of goals, or potentially through a decline in their functional capacity. 

The proposed changes would see participants undergo regular independent assessments, at least every five years and at major life stage changes, for example graduating high school. 

If in one of these regular assessments it is determined that someone’s functional capacity has improved to the point where they are no longer reliant on the NDIS, it is possible that that person will be referred to undergo an eligibility reassessment, which could mean that their participation in the NDIS might be reviewed. 

While the NDIA already has the power to review the eligibility of existing participants, having the independent assessment as the trigger for this will be a new feature. 

Amaze’s position: 

• Amaze does not support that the NDIA can call for a participant to undertake another independent assessment at its whim. 

 

3. Results of an Independent assessments can only be challenged in limited circumstances 

Participants can currently challenge decisions made by the NDIA about access through the Administrative Appeals Tribunal (AAT). This will not change. 

However, the independent assessment will not be reviewable. This means that participants will not be able to use AAT to challenge the outcomes of the assessment unless the independent assessment conducted was inconsistent with formal guidelines.  

Independent assessments may only be repeated if the original process was flawed and was not aligned with the guidelines. If a participant is unhappy with the outcome of their mandatory assessment, they will not be able to repeat the process. 

Amaze’s position:  

• Amaze is concerned about this lack of accountability for the assessors and does not allow participants any recourse.  

 

4. There will be limited exemptions for participants to not have to undertake an independent assessment 

There will be only two circumstances where someone may be granted an exemption from having an independent assessment. These are: 

1. When there is determined to be a risk to the safety of the participant or assessor, or 
2. When the assessment is likely to be inaccessible or invalid. 

The risk and safety circumstance covers situations where the assessment is likely to do more harm than benefit to the participant, or if the assessment process is likely to put the assessor at risk. 

The NDIA delegate may also grant an exemption when there are concerns about the validity of information, for example when a support person cannot be found to allow the full assessment to be completed. 

Amaze’s position: 

• Amaze supports a clear approach to applying exemptions to independent assessments. We believe the focus must be on ensuring that, if implemented, the assessment process protects the health and safety of the participant as the first priority, including in circumstances when an independent assessment is likely to cause harm to the person’s mental health and wellbeing. 

 

5. The link between independent assessments and planning will be critical 

The current approach to planning will be replaced by a new process where the results of the independent assessment will be used to develop a draft plan and budget. 

Once the draft plan and budget have been developed, they will be shared with the participant and then used as the basis of the first planning conversation, which will include a discussion about the participant’s goals and the community and mainstream supports available in their area. 

Amaze’s position: 

• Amaze is concerned that the independent assessment is the ONLY or principal information the NDIA will use to develop a participant’s plan and budget. 
• Amaze is not clear on how other evidence of the participant’s disability and their needs will be considered in setting a plan and a budget. 

 

6. There are only a few ways that draft budgets can be changed 

There will only be limited circumstances where draft budgets can be changed. These include: 

• When a participant has extensive and/or complex needs. For example, significant behavioural support needs where plans are of high value, or if the participant needs increased temporary supports in an emergency; and/or, 
• The participant needs high cost supports that were not accounted for in the mandatory assessment. For example, specialist accommodation, high-cost or complex assistive technology or home modifications. 

 Amaze’s position: 

• Participant choice and control is an essential pillar of a successful NDIS and plans and plan budgets must be drafted to reflect the individual goals, ambitions and requirements of each participant, with a long-term focus. Plan budgets must be able to be changed to reflect each participant’s circumstances. 

 

7. Flexibility will finally be introduced to participant plans 

After sustained community pressure and advocacy, budgets will largely become flexible. The 15 support categories currently in place will be replaced with only two: 

• Flexible budgets: to be used for any disability support eligible under NDIS funding  
• Fixed budgets: where supports with high capital costs will be funded from 

This is a positive change that will make budget management and general plan administration much easier for participants.  

Amaze’s position 

• Amaze is pleased to see sensible reforms to the NDIS and congratulates the Australian Government for listening to the community about what works for them. 

 

What will this look like for participants? 

If the Government’s proposed changes are accepted by the Parliament, the application process will see several changes. The diagrams below will help you understand those changes. These diagrams have been developed by the NDIA.  

Diagram 1: Proposed Access and eligibility process for people aged 7 to 65 (from mid-2021). Taken from the NDIS Consultation paper: Access and Eligibility Policy with independent assessments pg.10.  

Download the diagram here 

Diagram 2: Proposed planning process for new and existing participants aged 7 to 65 (from late-2021). Taken from the NDIS Consultation paper: Planning Policy for Budget Flexibility pg.9.  

Download the diagram here 

 

Amaze has expressed some concerns about these changes. In our next article, we further highlight our concerns and ways that you can contribute your views on the change in the NDIS application process. 

Amaze’s view on proposed changes