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Page 14 House of Representatives Wednesday, 30 November 2016 receive a medical certificate. So we do not need reams of medical evidence in all cases. We make contact with doctors and treating health professionals. Mr HILL: But you said at the outset that they need to provide all the raw medical evidence they have, which is then assessed. Dr Charker: Relevant to their claim, that is right. Mr HILL: I can understand why the general community is confused. I have got more questions, but we will share the call around. CHAIR: Mr Hehir, would you or any of the officials of the audit office like to make any comments on the evidence you have heard thus far from the Department of Human Services? Mr Hehir: No. Ms Wilson: Perhaps there is something that I should clarify about manifest grants and what the status of those and the criteria for those are, which might be of some assistance to the committee. It is probably quite important to understand that the terms and criteria around manifest grants are not in fact legislated. It is a policy guidance. As my colleague, Dr Charker, identified, there can be variability from person to person. But in terms of current policy, for the purposes of DSP, the term 'manifest grants' means grants made where policy allows a DSP claim to be determined based on the presenting of medical evidence without the need for further assessment. So, it is to short cut the process for those where it is clearly evident that they have and would have, under any circumstances, an entitlement to DSP. Manifest grants may be made where a person: has a terminal illness (life expectancy of less than 2 years with significantly reduced work capacity during this period), has permanent blindness (meets the test for permanent blindness for social security purposes), has an intellectual disability where supporting evidence clearly indicates an IQ of less than 70, has an assessment indicating the person requires nursing home level care, has category 4 HIV/AIDS, or is in receipt of a DVA disability pension at special rate (totally and permanently incapacitated (TPI)). Two lists of medical conditions are available to help decision makers determine whether a person falls within some of the above manifest categories— Which I have just mentioned. For example, how do I assess whether somebody has a terminal illness, what nursing home level of care is involved and/or the intellectual disability or IQ criterion? Those processors were improved and clarified around 2002 in response to some recommendations from the Commonwealth Ombudsman, which the Department of Social Services and Centrelink took on board in updating and providing more guidance to decision-makers about whether or not somebody meets the manifest criteria. Within DHS, and my colleagues have already mentioned the health professional advice unit and the health professionals that they employ within DHS, that unit is available to help decision-makers with considering those criteria as to whether somebody meets the manifest criteria under policy and does not need to proceed to further assessments. I just thought that might be of some help to the committee. CHAIR: If I could just turned to the implantation of the audit recommendations. Dr Charker, could you just give us an update in terms of where the implementation of those recommendations are up to and any additional work that Department of Human Services has thought necessary arising from the implementation of those recommendations? Dr Charker: There were, of course, four recommendations, as the committee would be aware. We fully accepted and have fully or partially implemented all four of them. A couple of them related only to DHS; a couple of them are joint between DHS and DSS. Of course, my DSS colleagues can provide their input into those which pertain to them. In relation to recommendation 1, which was the DHS to review the guidance that we provide to assessors on the level of detail included in job capacity assessment reports and requiring delegates to clearly specify any changes that they make to job capacity assessment reports, we advise that this audit recommendation is now fully implemented by DHS. We have implemented and published training and revised procedures which clearly outline the level of detail required in job capacity assessment reports. We have updated several of our internal so-called operational blueprints, which are quite detailed internal instructional material, to ensure that our job capacity assessors have clear and current guidelines on assessing work capacity using the impairment tables and undertaking a job capacity assessment. The assessors receive regular training— PUBLIC ACCOUNTS AND AUDIT COMMITTEE
Wednesday, 30 November 2016 JOINT Page 15 CHAIR: I will have to attend a division in the Senate. I would like you to continue but this is the point I would like to make. I am curious to know why the Department of Human Services thought it unnecessary to make a submission. I acknowledge it is not mandatory but this is exactly the sort of information that would have been very useful for our deliberation and the following seven to 10 minutes could have been used on other issues. Please continue. It is useful; it is necessary. But I would like an explanation to the deputy chair why the department thought it unnecessary to make a submission. Dr Charker: I apologise for any inconvenience that has caused. To continue in outlining the progress against the audit recommendations, recommendation 1B, which was requiring delegates to clearly specify any changes they make to job capacity assessment reports, has also been fully implemented. We have provided instruction on the requirement for people to clearly document any changes that they have made. We have developed a training package to advise delegates of the steps to follow should they disagree with a job capacity assessment report and the action to be taken should they need to override it. Recommendation 2 was for DHS in conjunction with DSS to include options in risk profiling to better identify recipients whose medical conditions have a greater prospect of improvement. We also have fully implemented this recommendation. We continually work with DSS closely to ensure risk profiling and review processes are appropriate and we continually work to refine these in light of the current risk based medical review activity. To implement this recommendation, we have actually got two separate activities which are relevant. One is that we run a departmental wide— ACTING CHAIR (Mr Hill): I will just check with the members. Clearly you are reading so you could table this in follow-up. Would you prefer to ask another question or use up government time on this? It is up to you. Because I know both of you had questions. Ms FLINT: I am waiting for a response because otherwise I may well be asking questions that are going to go precisely to these points. ACTING CHAIR: I can go to one of you after you have finished and then we can go back because the chair and I agreed we would share time rather than alternate people between government and opposition. Dr Charker: In relation to recommendation 2, there are two separate activities which are relevant to implement this recommendation. The first is that we run at department wide customer compliance program which looks at risk indicators across all our programs. Work has been done in recent months to refine indicators used to identify non-income related potential risk to payment integrity. The second stream of activity is the current budget measure which was announced in the 2016-17 budget about medical risk based reviews of DSP recipients. We drew on the results of the previous under 35 2014-15 budget measure work as well as expertise in service profiling from our service colleagues to identify a set of what we think are more sophisticated risk indicators to identify recipients suitable for review. Recommendation 3 was that DSS and DHS develop a more complete set of external and internal performance measures for the effective delivery of DSP and that we both agree a more consistent approach to the collection and publication of income support recipient data. We have partially implemented this audit recommendation because it is joint with DSS so we are working with DSS to implement it. I will defer obviously to DSS colleagues to talk about that. On 3A, we are working to develop new internal operational and management information reports. We are developing a revised key performance measure for DSP claim timeliness with DSS to take into account the recent changes to the DSP assessment process which have been canvassed already today. A task force which looked at the end-to-end DSP claim process has recently concluded and we are now implementing some of its recommendations, which include centralising the reporting function, developing DSP productivity targets and identifying required staffing levels to manage DSP inflows. Recommendation 3B is about the more consistent approach to the collection and publication of income support recipients data. This recommendation is also partially implemented at the current time. We are continuing to have bilateral discussions with DSS on that specific element of the recommendation, looking at trying to expand the range of data which is publicly available on data.gov.au. We have also agreed business rules around the manifest data. ACTING CHAIR: That was covered in the DSS submission. Is there anything else to add before you address the chair's question before he left? Dr Charker: The last thing was a brief update on the final ANAO recommendation, recommendation 4, where we have part of partially implemented—that is, a joint action item—with DSS as well. In relation to the chair's question, the specific question around why we had not provided this and tabled it in a submission, we PUBLIC ACCOUNTS AND AUDIT COMMITTEE
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