8. Performing a support needs assessment
A support needs assessment is undertaken for all participants as part of the process of developing a statement of participant supports. The information collated from the various sources of information available will inform the supports the participant needs to attain their goals.
A support needs assessment involves:
- reviewing existing information;
- conducting a planning and assessment conversation;
- where necessary, requesting further information or reports to inform a participant's plan; and
- assessing risks and safeguards.
When performing a support needs assessment, the NDIA may also consider whether it is necessary to appoint a nominee or a child's representative to act on behalf of, or make decisions on behalf of a participant.
8.1 Reviewing existing information
In preparation for the planning and assessment conversation, the NDIA will review the following information, where provided:
- the Access Request Form;
- any evidence of disability, for example reports from medical practitioners, specialist clinicians or allied health professionals;
- assessment information provided by the participant, for example assessments previously arranged through other government agencies or disability service providers;
- the participant's statement of goals and aspirations; and
- any other relevant information that is available on the participant's record.
By reviewing existing information, the NDIA seeks to reduce the overall assessment burden for the participant by minimising the number of times information needs to be provided.
The NDIA will seek to identify any gaps in existing information which require discussion when conducting the later planning and assessment conversation.
8.2 The planning and assessment conversation
An important part of developing a participant's plan is the planning and assessment conversation. The planning and assessment conversation involves the NDIA conducting participant led discussions based on the participant's statement of goals and aspirations.
However, if a participant has not already completed their statement of goals and aspirations, the NDIA can support the participant to prepare their statement as part of the planning and assessment conversation.
The purpose of the planning and assessment conversation is to explore the participant's support needs, and identify specific supports which would assist the participant to achieve their goals, objectives and aspirations.
During the planning and assessment conversation, the NDIA will also talk to the participant about their preferred option for managing the funding for supports under their plan.
The NDIA will adopt a relationship based approach to the planning conversation with the aim of building a sustainable and supportive relationship between the NDIA, participants and their carers. This approach recognises that this process is not a single conversation, but will be one that evolves and matures as the participant progresses towards their agreed goals.
The NDIA will take an active listening role, gaining a rich picture of the participant's goals, aspirations, current life circumstances and supports to the extent the participant wishes to engage.
The NDIA will use the Planning Conversation Tool to guide the planning and assessment conversation.
When conducting the planning and assessment conversation, the NDIA will obtain the participant's consent to include the participant's family, carers and/or persons, where that is appropriate.
When preparing for the planning conversation, the NDIA will have regard to:
- the matters that must be in included in a participant's plan;
- the matters that must be considered when deciding to include proposed supports in a participant's plan; and
- the matters that must be considered when approving a statement of participant supports.
8.3 Requesting further information or reports to inform a participant's plan
For the purposes of preparing, or deciding whether to approve the statement of participant supports, the NDIA may request:
- that the participant, or another person, provide information that is reasonably necessary for the purposes of preparing, or deciding whether to approve the statement of participant supports (section 36(2)(a)); or
- that the participant do either or both of the following:
- undergo an assessment and provide to the NDIA the report of the person who conducts the assessment (section 36(2)(b)(i); or
- undergo a medical, psychiatric, psychological or other examination, conducted by an appropriately qualified person, and provide to the NDIA the report of the person who conducts the examination (sections36(2)(b(ii)).
Where further information is being sought from the participant the request should clearly specify:
- what information is required from the person or what action is required to be taken;
- how the person should provide the information or document;
- the timeframe for providing the document or performing the action; and
- the NDIA contact person to provide the information or document to.
The NDIA will only request further information or require a participant to undergo an assessment or examination where it is reasonably necessary to prepare, or decide whether to approve a statement of participant supports. For example, the NDIA may consider it necessary to make one of the requests outlined above for participant's with very complex care needs.
Also, before requesting further information or requiring that a participant undergo an assessment or examination, the NDIA will review existing information. Where existing information is inadequate or inconsistent, for example where older assessments do not accurately reflect a participant's current support needs, the NDIA will consider making one of the requests outlined above.
The power to request information or to require a participant to undergo an assessment or examination must be exercised carefully and in accordance with the objects and general principles in the NDIS Act.
The NDIA may prepare or decide whether to approve the statement of participant supports before all the information or reports are received but must give the participant a reasonable opportunity to provide them before making a decision (section 36(3)).
Where the NDIA has made a request that a participant undergo an assessment or examination, the NDIA will support the participant to comply with the request by providing assistance, including financial assistance where appropriate (section 6).
The NDIA will not reimburse participants for any costs associated with obtaining assessments or examinations which were not directly requested by the NDIA. For example, costs incurred relating to reports, assessments or examinations which were previously obtained for other incidental purposes.
8.3.1 Additional considerations for requesting assessments or examinations
In deciding whether to request that a participant undergo an assessment or examination, the NDIA will consider:
- how the assessment or examination will assist in preparing, or deciding whether to approve a statement of participant supports, including the nature of the information the report is expected to produce;
- the costs and benefits of the assessment or examination. For example, the direct and indirect costs to the NDIA, the participant or their carers compared with the benefits associated with clarifying support needs which are not readily identifiable or obtaining recommendations relating to the types of interventions which may assist the participant;
- the type of assessment or examination that is most relevant to the participant's needs and which is most likely to produce the information needed to prepare, or decide whether to approve a statement of participant supports;
- the independence and objectivity of the assessment or examination, for example, avoiding conflicts of interest when selecting a specialist assessor for the participant; and
- the specific information to be requested from the person performing the assessment or examination.
8.3.2 Timeframes for providing additional information or reports
The NDIS Act does not specify a timeframe in which a participant must provide to the NDIA information or reports in response to one of the requests outlined above.
The NDIA may proceed to prepare or approve a statement of participant supports before all the further information and/or reports requested from a participant are received, provided that the participant has been provided with a reasonable opportunity to comply with any request (section 36(3)).
Where it is expected that further information and/or reports requested from a participant are likely to take a long time to produce, the NDIA will consider finalising the statement of participant supports and reviewing the participant's plan when the further information and/or report is received.
8.4 Assessing risks and safeguards
People with disability should be supported to exercise choice, including in relation to taking reasonable risks, in the pursuit of their goals and the planning and delivery of their supports (section 4(4)).
One of the NDIA's functions is to ensure that a reasonable balance is achieved between safety and the right of participants to choose to participate in activities involving risk (section 118(1)(a)(v)).
All people learn through a process of trial and error, often learning as much from their mistakes as from their successes. The NDIA approaches risk management from the standpoint of putting in place reasonable safeguards which balance the need for participants to be safe from risk of harm while imposing the minimum necessary restrictions to allow participants to exercise choice and the control over their lives. This approach recognises participant's ability to take reasonable risks and make reasonable mistakes.
The development of plans through the planning and assessment conversation provides an opportunity for open discussion to identify and jointly explore the actual and potential risks to the participant. Participants should be supported to consider a range of safeguards and support mechanisms when developing their plans, determining their support requirements and implementing their plans.
The NDIA will discuss safeguards with participants in the following ways:
- Choice and control: Participants are empowered to make their own decisions about their supports and the management of their funding arrangements;
- Risk-based and person-centered approach: Safeguards are proportionate to the actual level of risk a participant faces, based on their functional capacity, natural support network and the supports available to them; and
- Presumption of capacity: Participants are presumed to have the capacity to exercise choice and control, and the NDIA will provide support when a person requires support to develop and exercise this capacity.
The participant should be encouraged to develop their own strategies and safeguards to reduce their potential exposure to harm or to manage the exposure. The following levels of safeguards can be used as a guide in the development of appropriate measures:
- Individual level safeguards: which include both informal and formal safeguards for participants;
- Informal safeguards: which acknowledge that participants are more likely to be safe when they are actively involved with their family and the community. The things that make people safe can be seen as the same things that are needed to have a good life. For example, caring relationships and enhanced opportunities for participation in daily life;
- Individual formal safeguards: which include rules for restrictive practices and serious incident reporting;
- Service level safeguards: Service level safeguards include quality frameworks, complaints mechanisms and workforce requirements such as qualifications, recruitment practices and performance standards. For many service providers, service level safeguards will be one of the requirements for registration with the NDIA;
- System level safeguards: The NDIA will use existing system level safeguards that currently exist to safeguard participants. These include internal and external processes for making complaints, processes to have decisions reviewed by an independent body and statutory powers; and
- Community based safeguards: The NDIA uses, and operates in the context of, existing community based safeguards that are not formally a part of the disability service system. These include advocacy organisations, community visitor schemes, Public Advocates or Guardians, Ombudsman offices and Discrimination Commissioners. People with disability can also use a range of safeguards available to the community including anti-discrimination, and consumer protection legislation.
Additional safeguards the NDIA can put in place through the participant's plan include:
- setting a shorter period before the participant's plan is reviewed;
- setting out arrangements for regular contact between the NDIA and the participant; or
- providing funding for supports to assist a participant to manage their own plan. For example, budget training.