Section 13 of the Disability Act 2005 places an obligation on the HSE to keep and maintain records for the purposes of: identifying persons to whom assessments or services are being provided; identifying those services and the persons providing the services; specifying the aggregate needs identified in assessment reports which have not been included in service statements; specifying the numbers of applications made under section 9 of the Act and the numbers of assessments completed; specifying the number of persons to whom services identified in assessment reports have not been provided; and planning the provision of assessments and services to persons with disabilities. A system has been established in the HSE for maintaining the records required under section 13 of the Act.
Section 13 of the Act also obliges the HSE to submit a report in writing to the Minister in relation to the aggregate needs identified in assessment reports prepared including an indication of the periods of time ideally required for the provision of the services, the sequence of such provision and an estimate of the cost of such provision. The HSE is also obliged to publish this report annually. While the requirement in section 13(2) is to report on the aggregate needs identified in assessment reports, my Department is of the view that it would also be useful to report on needs which have not been met. The HSE has agreed to my request that this information is included in the annual reports.
The first annual report under section 13, covering information on 72 assessments completed in 2007, was submitted to the Minister for Equality, Disability and Mental Health in February 2009. The report is available on the HSE website at:
http://www.hse.ie/eng/services/Publications/services/Disability/DisabilityActjundec2007.html
A number of issues, particularly in relation to how record keeping arrangements work for young children, have become apparent since the HSE began working on the 2008 Report. The Act has only been commenced for children under 5 and in the case of these young children, a particular challenge for clinicians assessing such young children is in determining, in advance of providing a service, what quantum of services may be appropriate and necessary for the child in order to fully meet the needs identified in the Assessment Report and then reflecting the shortfall in an identification of unmet need.
A particular difficulty for HSE arises because the obligation is to report on aggregate need. In the case of any individual child, every clinician involved in the assessment process and service delivery could be asked to try and work out the ideal service provision for that child. This process is very time-consuming and not necessarily particularly scientific as individual children can and do react differently to intervention. If this process was extended to every child, clearly this would be overly bureaucratic and unnecessarily burdensome on the administration of the Act. My Department is of the view that an intensive process such as this in relation to each individual child would divert the attention of clinicians away from service intervention and in to administrative duties with no beneficial outcomes for children with disabilities.
My Department and the HSE are currently in discussions in order to identify the most suitable information gathering arrangements to meet the needs of individual children defined in terms of desired outcomes, to meet the administrative obligations imposed by the Act and also to ensure that reliable service planning data may also be collected.