3,662 needs assessments for children with disabilities overdue

3,662 applications for ‘assessment of need’ for children with disabilities were overdue at the end of last October, 30% of them in Cork and Kerry, says the HSE.

The national average duration of the assessment, per report completed, is now peaking at 18-and-a-half months. A decade ago, it took an average of 8.75 months.

An assessment of need (AON) allows children to be diagnosed and then apply for the resources they require. The HSE is obliged to begin the AON within three months of the application, which should be completed within another three months, including the furnishing of all reports on the resources required for the child.

But the system has become the focus of a number of High Court cases. An attempt by the HSE to overhaul the system and introduce a new standard operating procedure also ran into difficulty earlier this year. It was due to be implemented at the end of April, but has since been deferred, following concerns raised by trade unions and professional bodies.

In a response to a recent parliamentary question, Dr Cathal Morgan, head of operations, Disability Services in Community Operations in the HSE, acknowledged that the numbers of assessments overdue for completion remained high, although he said there had been some improvement. As of the end of last October, 3,662 applications for AON were overdue.

Of those, 1,115 were in Community Healthcare Organisation (CHO) 4, covering Kerry, north Cork, North Lee, South Lee, and west Cork. That is almost double the next highest figure, of 589, in CHO 9, which covers north Dublin.

Dr Morgan said the information is based on data extracted from the assessment officers’ system database and shows that the numbers that are overdue have continued to drop, from a high of 4,104 at the beginning of the year.

There were also 3,216 assessment reports and 1,750 service statements completed up to end of September 2018. Last year, 5,839 new, completed applications were received, 3,614 assessment reports were completed, and 2,455 service statements completed.

In the response, furnished to Independent TD Tommy Broughan, Dr Morgan said: “Since the commencement of Part 2 of the Disability Act, in June 2007, (The Act), the HSE has endeavoured to meet its legislative requirements, as set out in the act. However, as a consequence of a High Court ruling of December 2009, the effect of which was to open eligibility to all children born after June 1, 2002, the number of children aged five and over, and, in addition, of school-going age, has risen steadily as a percentage of all applications received. 

At the end of 2011, the figure stood at 26%, while, at end of 2017, this figure was 51%. This is a reflection that the AON process is an accumulative process, in terms of numbers of children seeking access. It should be noted that the clinical teams who complete the assessments are also the teams who deliver intervention.”

Dr Morgan also refers to more recent activity in the High Court, referring to the 37 applications for judicial review relating to delays for assessment of need, although he said “only one of these cases relates to the fact that the AON did not commence on time”.

In May, the HSE was ordered by Ms Justice Mary Faherty to complete a number of outstanding AONs within six weeks.

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