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Introduction

• Australian and International Context
• Current Policy and Program Settings and Key Facts

Australian and International Context

The Organisation for Economic Co-operation and Development’s (OECD) report issued 18 December 2007 on Sickness, Disability and Work: Breaking the Barriers: Australia, Luxembourg, Spain and the United Kingdom, volume 2 (often called the Four Countries Report), praises Australia for its emphasis on employment assistance and income support based on functional capacity, rather than incapacity.

JCA arrangements are particularly commended. The Australian approach to assessment, with its focus on function and capacity, is seen as a model for other countries with a more traditional approach based on diagnosis and incapacity (see Box 1). 

The OECD comments that some countries, which have in the past relied on the person’s own doctor to assess incapacity for income support purposes, are instead moving towards a model which draws on people with expertise in functional assessment and disability support, to assist people to work where they can do so with the right support. This is in line with current international thinking on disability, as evidenced for instance by the World Health Organisation’s International Classification of Functioning, Disability and Health (World Health Organisation, 2001).

The JCA Program was introduced in Australia in July 2006.  It replaced a number of existing assessments including Better Assessments, JSA Disability (DEI indicators), and the application for disability employment assistance processes. 

Under Better Assessment, people were streamed to different assessment processes according to their presenting medical condition.

Where further investigation of a person’s medical conditions was required, they were referred to an independent Medical Assessment Service Provider.

Where a person’s medical condition had been fully investigated, but further information about their work capacity was required, they were referred to an independent work capacity assessor.  These were contracted professionals with knowledge of labour market issues and experience in assessing the impact of medical conditions on ability to work.

In cases where a person had immediate, acute, or complex needs that would prevent them from attending or benefiting from a work capacity assessment (e.g. undiagnosed mental illness), they had their short-term non-vocational needs assessed by a Centrelink psychologist.

Better Assessments were sent to Centrelink, which made decisions about income support and referral to employment services. There was often a significant delay in referral to services.

In 2004, a Disability Support Pension Pilot was conducted to examine options to provide employment assistance to people on Disability Support Pension who volunteered for employment assistance.  This was followed in 2005 by the Better Assessment and Early Intervention pilots that were conducted to refine these arrangements, to test the concept of consolidated assessment and to identify short service gaps for short-term interventions. A further Direct Registration Work Capacity Assessment pilot was conducted in 2006. ¹

These pilots were generally considered to be successful, and some key features were incorporated into the new Comprehensive Work Capacity Assessment arrangements, now called JCA, which were introduced as part of the Welfare to Work package in July 2006. 

The National Employment Services Association (NESA), and providers who were involved in these pilots, consider that there are features of the Early Intervention pilots which should be incorporated into current arrangements, such as the ability to refer clients to the service of ‘best fit’, without regard for service caps.

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Current Policy and Program Settings and Key Facts

The Job Capacity Assessment program provides comprehensive work capacity assessment, combining referral to employment and related support services (such as literacy and numeracy training) with assessment of work capacity for income support purposes (such as for Disability Support Pension, partial capacity to work and exemptions from activity-testing due to medical conditions lasting more than 13 weeks). 

How the Job Capacity Assessment Program Works

• The JCA program is administered by the Department of Human Services (DHS), which sets the requirements for service delivery in service provider contracts and guidelines.
• Eighty per cent of JCAs are provided by Centrelink, CRS Australia and HSA Group, which are human services portfolio agencies. They are provided under agreements with DHS.
• The remaining 20 per cent of assessments are provided under contract by private providers selected by tender in 2006. The private providers are a mix of for-profit and not-for-profit organisations, the two largest being Advanced Personnel Management and Mission Australia.  Most are also employment service providers.
• JCA provider contracts have recently been extended to 30 June 2009.
• Although funding for the JCA Program is capped, DHS does not control referrals for assessment. People are referred for assessment by Centrelink and, in around 18 per cent of cases, by employment service providers. 
• Most people applying for Newstart Allowance are referred directly to Job Network by Centrelink, without a JCA.
• People are only referred for a Job Capacity Assessment if they have significant barriers to work, which are determined by Centrelink using the Jobseeker Classification Instrument (JSCI – this is currently being reviewed by DEEWR).

People are referred for a JCA if:

• they are applying for Disability Support Pension or undergoing a medical review of Disability Support Pension;
• they are on Newstart or Youth Allowance and applying for an activity test exemption of more than 13 weeks due to illness;
• they register directly with an employment service provider;
• they inform Centrelink or their employment service provider of a medical condition or disability that affects their work capacity and/or employment service needs;
• they have a significant change of circumstances, such as new medical evidence; and/or
• the Jobseeker Classification Instrument administered by Centrelink shows that they have significant barriers to work.

• DEEWR policy and program settings determine referrals and eligibility criteria for income support, activity test exemptions and referral to DEEWR funded employment assistance services.
• Since December 2007, FaHCSIA policy and program settings determine access to the Disability Support Pension.
• Job Capacity Assessors, who are allied health professionals, conduct the JCA and refer people to employment services (in around 83 per cent of assessments).
• As at 30 June 2008, there were 1,678 allied health professional Job Capacity Assessors providing assessments at 1,113 sites throughout Australia.
• Job Capacity Assessors interview the client, review the medical and other evidence and complete a JCA Report on DEEWR’s EA3000 system, which is used to manage the JCA Program. Through the EA3000 system, DHS pays providers a flat rate for completed assessments only, with loadings for Disability Support Pension assessments, remote assessments and interpreters.
• JCA providers receive reimbursement for specialist assessments where required. These are required for around five per cent of assessments, at an average cost in 2006‑07 of $730 per client referred, mainly for specialised assessments such as for intellectual impairment and acquired brain injury.
• JCA providers also receive reimbursement for short-term allied health professional interventions purchased through the Job Capacity Account; see the Job Capacity Account Program below.

(Click to see larger version of diagram)

• JCA appointments are booked by the referring agency, usually Centrelink, on EA3000 by selecting the first available appointment, generally within two days if the client can be contacted by phone, or three if an interpreter is required. If the client does not attend this appointment, for instance because they are sick, the Assessor contacts them and arranges another time. If they do not attend the second time, the Assessment is terminated as unable to complete and returned to Centrelink.  Centrelink determines whether to apply a participation failure.
• The JCA report is stored on the EA3000 system and is used by Centrelink, along with medical and other evidence, to make decisions about income support eligibility (such as for Disability Support Pension and partial capacity to work) and temporary incapacity exemptions.  About 50 per cent of assessments are related to an income support decision.
• When a Job Capacity Assessor refers a client to an employment service (around 83 per cent of completed assessments), the employment service provider uses the report in developing activity agreements with job seekers and assisting them to meet their participation requirements. 

First year of operation

In 2006-07, 375,296 JCAs were completed, just over the Budget estimate of 372,000.  Total expenditure was just over $100 million ($104 million including expenditure on the Job Capacity Account, see below).

The program met targets and benchmarks, with 82.4 per cent of assessments nationally being completed within 10 days of referral, including in remote areas.

The focus for the program in its first year was on implementation and building relationships. Input and advice was sought from a national stakeholder reference group, the JCA Reference Group, and also from other stakeholder organisations such as the National Welfare Rights Network.

Clarification of policy and changes to program arrangements and systems were made throughout the year, in response to issues as they arose.  This required some significant changes to the JCA Guidelines and processes, often involving manual workarounds pending systems changes.

A mobility access audit was conducted with the assistance of the Human Rights and Equal Opportunities Commission, finding that all 1,070 sites (now 1,113 sites) throughout Australia met mobility access requirements.

DHS met with remote JCA service providers in Alice Springs in March 2007 to discuss possible approaches to improving the quality and viability of remote services. A number of possible approaches were discussed with providers, but implementation was delayed due to redirection of resources to work on the Northern Territory Emergency Response.

A team of independent allied health professionals were contracted to audit the quality of Job Capacity Assessments, with 1,012 assessments audited from January to June 2007.

Work on training modules on assessing people with special needs commenced in consultation with key stakeholder organisations. Two mental health training modules were developed by the Centre for Mental Health at the University of Queensland.

An independent audit of implementation was conducted in May 2007 and its recommendations were implemented.

Second year of operation – 2007-08

In 2007-08, the volume of referrals for JCAs increased.  This was for two main reasons: Disability Support Pension transition clients are now subject to the 15 hour work capacity test for Disability Support Pension; and ‘grandfathered’ parenting payment clients are now subject to activity testing. 

As a result, more than 447,000 JCAs were completed in 2007-08. Expenditure this year was just under $150 million, including around $17 million for Job Capacity Account services.

Two key focuses have been around quality and remote services.

A total of 1,301 assessments were audited by DHS contracted independent quality auditors in 2007-08.

A national performance review and business reallocation was conducted from July to October 2007 with the assistance of the Australian Government Solicitor, finding that providers were generally meeting requirements.

These activities were accompanied by extensive work with the National Employment Services Association, JCA providers and our quality auditors, to improve performance reporting and performance review arrangements, with a strong focus on more extensive and rigorous measurement of quality. 

As a result of this work, new quality assurance and performance measurement frameworks were introduced from 1 July 2008, to provide broader, more rigorous and more balanced assessment of quality and other aspects of performance.

Work continued with the JCA Reference Group, the Commonwealth Ombudsman, other review and complaints bodies and stakeholder groups such as National Welfare Rights Network, to identify and address issues and ensure that the program meets the needs of clients, service providers and the Australian community. 

• On 2 June 2008, the Commonwealth Ombudsman, Professor John McMillan, released his Report on The Implementation of Job Capacity Assessments for the Purposes of Welfare to Work Initiatives. This report focuses on quality, appropriateness and communications. In response to the ten complaints referred by the Commonwealth Ombudsman on JCA matters between 1 July 2006 and 30 June 2008, the Department has made changes to systems and processes to address issues identified. It is currently working with the Ombudsman, Centrelink and other agencies to progress the recommendations of the Report.

A training module for assessing people who are deaf or hearing-impaired was introduced, and other training modules are currently under review in consultation with stakeholders.

Work with Centrelink and DEEWR has resulted in significant improvements to information technology systems to address issues identified by JCA providers and employment service providers in each quarterly systems release.  Further systems improvements are scheduled for the September 2008 release. 

As part of the Northern Territory Emergency Response, DHS officers were outposted to Darwin to co-ordinate the JCAs required due to lifting of remote area exemptions. A total of 5,830 assessments were conducted in 2007-08 due to lifting of remote area exemptions in the Northern Territory.

The Job Capacity Account Program

Job Capacity Assessors are reimbursed through the Job Capacity Account for purchasing short-term allied health professional services, such as counselling and pain management, for people referred to Job Network who need this assistance to become work-ready.  The JCA Guidelines currently set a maximum duration of Job Capacity Account services of 13 weeks.

A total of 23,603 referrals were made to Job Capacity Account services in 2006-07. In 2007-08, more than 33,000 referrals were made to Job Capacity Account services.

Initially, funding of $26 million a year was provided over four years. The Program started in July 2006 but take-up was slow at first, because JCA providers were just commencing themselves and needed time to locate appropriate services and negotiate arrangements.

However, by January 2007, referral to Job Capacity Account services had increased to the estimated level of 6.8 per cent of assessments, and since then has been around 7.5 per cent of assessments.  Expenditure in 2007-08 was around $17 million. The average cost of Job Capacity Account services per referred client is around $600, compared to the original estimate of $1,000. 

An independent audit of Job Capacity Account processes was conducted in 2007 and its recommendations implemented. 

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¹ Department of Employment and Workplace Relations, Job Network Disability Support Pension Pilot: Interim Evaluation Report, October 2004; Early Intervention and Engagement Pilot: Evaluation Report, September 2005.

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