Assessment of need for people with disabilities
The Disability Act 2005 provides for, among other things, the assessment of need of people with disabilities and the consequent drawing up of Service Statements.
The assessment of need is carried out or arranged by Assessment Officers who are independent officers of the Health Service Executive (HSE). After the assessment, a Service Statement is drawn up by a Liaison Officer (sometimes referred to as a Case Manager). There is an independent complaints and appeals machinery for people who are dissatisfied with the assessment, the Service Statement or with the subsequent provision of services.
The Health Information and Quality Authority (HIQA) has adopted standards for the assessment of need.
At present only those children who were born after 1 June 2002 are eligible to apply for an assessment under the Disability Act (regardless of their age at the time of application).
Who is entitled to an assessment
Your child is entitled to an assessment of need if you consider that they have a disability.
The disability legislation states that a "substantial restriction'' means that they have a restriction which is permanent or likely to be permanent, results in a significant difficulty in communication, learning or mobility or in significantly disordered cognitive processes, and means that he or she has a need for services to be provided continually or that they have the need for services to be provided early in life to ameliorate the disability.
If parents or legal guardians are of the opinion that their child has a disability, they should apply. The Assessment Officer will make the final decision.
Getting an assessment
You must apply on behalf of your child to the HSE in writing (through your Local Health Office, using the official application form) and the HSE must acknowledge your application within 14 days. This acknowledgement must tell you the date on which the assessment will start. The Act provides that the assessment must be started within three months of the application and must be completed without undue delay - there is no specific time limit on its completion. The regulations, however, provide that the HSE must complete the assessment within three months unless there are exceptional circumstances. If there is a delay in completing the assessment you must be told the reason and given a timescale for completion.
Your child may be refused a HSE assessment if they had an assessment in the previous 12 months. You may, however, look for a new assessment if there has been a change in circumstances or further information is available or you consider that there was a mistake of fact in the assessment report.
Carrying out the assessment
The HSE has appointed Assessment Officers who are independent in carrying out their functions. They are based in Local Health Offices and they will help you to fill in the application form and give you whatever information you need. The Assessment Officers can carry out the assessment themselves or arrange for other HSE employees or other experienced people to do so. These people are called assessors.
The assessment must be carried out in accordance with the standards adopted
by the Health Information and Quality Authority (HIQA). These standards deal
with a range of issues, including Garda
clearance for the people carrying out the assessment, the provision of
clear and accessible information to applicants and their representatives and
the handling of confidential information.
The aim of an assessment is to decide what health and education needs arise from your child's disability and what services they require to meet those needs. Health services include personal social services and include services provided directly by the HSE and services provided on behalf of the HSE (many of the services for people with intellectual disabilities are provided by voluntary bodies on behalf of the HSE).
You will be encouraged to take part in your child’s assessment.
If the assessment identifies a potential educational need, the Assessment Officer refers the matter to the Special Education Needs Organiser (SENO) who is an employee of the National Council for Special Education (NCSE). The SENO will notify the Assessment Officer of the response from the education sector.
The assessment identifies needs: it does not take account of the costs of
providing for those needs or whether the capacity to provide services to meet
the needs is present.
When the assessment is complete, the Assessment Officer writes an assessment report which is given to you, to the HSE and, if appropriate, to the NCSE. You will receive the Service Statement (see below) at the same time. The assessment report sets out whether your child has a disability and, if they have, it sets out:
- A statement of the nature and extent of the disability
- A statement of the health and education needs arising from the disability
- A statement of the appropriate services to meet those needs
- A statement of the period within which a review of the assessment should be carried out (this must be no later than a year from the date the assessment report is issued)
Service statements and delivery of services
As already stated, the assessment of need takes account of your child's needs - it does not address the question of whether or not those needs can be met. The Service Statement does take into account if those needs can be met and how this can be done. So, the assessment of need does not take available resources into account but the Service Statement does.
The HSE has appointed Case Managers and designated them as Liaison Officers to draw up Service Statements. The Service Statement is based on the assessment report and sets out the health services that will be provided to you and the time within which they will be provided.
When drawing up the Service Statement, the Liaison Officer must take a number of factors into account. These include:
- The assessment report
- Your child's eligibility for services under the Health Acts (these include GP services, free or subsidised prescribed drugs, medicines and appliances, hospital and residential care services; there is a clear entitlement to some of these services but many of them are services which the HSE is not obliged to provide)
- Any approved standards and codes of practice which apply to the services identified in the assessment report
- The practicability of providing the services identified in the assessment report
- The need to ensure that the provision of the services by the HSE would not cause the HSE to spend more money than it is legally entitled to spend
- The advice of the NCSE about the capacity of an education service provider to afford the service in question (if this arises - not in the case of under-fives)
The Liaison Officer may amend a Service Statement if circumstances change.
The Liaison Officer must complete the Service Statement within a month of
receiving the assessment report. You are given a copy of the Service Statement
with your child's assessment report. The HSE, the NCSE and education service
provider are also given a copy if appropriate.
The regulations specify that the Service Statement must be written in a clear and easily understood manner and it must state:
- The health services which will be provided
- The location(s) where the health service will be provided
- The timeframe within which they will be provided
- The date from which the statement will take effect
- The date for review of the provision of services specified in the Service Statement
- Any other information that the Liaison Officer considers to be appropriate including the name of any other public body to which the assessment report has been sent
Delivery of services
After the Service Statement is drawn up, the Liaison Officer then arranges the delivery of services with the various service providers.
If needs other than health or education (for example, housing or transport) are identified, the Assessment Officer can refer the matter to the relevant public body such as the local Housing Authority or public transport service.
Complaints and appeals
If you are not happy with the assessment or Service Statement, you can make a complaint under the Disability Act 2005 to the HSE, who will arrange for your case to be reviewed. You can complain if:
1. Your child is found not to have a disability and you do not agree
2. The assessment is not done in line with the standards set by the Health Information and Quality Authority
3. An assessment is not started and completed within the agreed timeframes
4. You believe that the content of your child's Service Statement is inaccurate or incorrect
5. The services in your child’s Service Statement are not being delivered.
If you are unhappy with the outcome of your complaint you can appeal to the independent Office of the Disability Appeals Officer. The decision of the Appeals Officer is final and may only be appealed on a point of law to the High Court.
Implementation of complaints and appeals decisions
If the HSE or the education service provider fails to implement the Appeals Officer's decision or the settlement agreed in the appeals mediation process or the recommendation of a Complaints Officer (where that has not been appealed) within three months, you or your representative or the Appeals Officer may apply to the Circuit Court for an order directing its implementation.
How to apply
A parent or legal guardian applies on behalf of the child (or the HSE if the child is in care).
Applications must be made in writing on a standard form which is available from your Local Health Office or by contactingthe HSE information line: 1850 24 1850.
The HSE has an information leaflet Assessing
your child's needs (pdf).