NDIA Plan Review Process Slammed by Ombudsman

People with disability are waiting up to nine months to have their National Disability Insurance Scheme plans successfully reviewed, a new report from the Commonwealth ombudsman has revealed.

Ombudsman Michael Manthorpe released a report into the National Disability Insurance Agency’s handling of reviews on Tuesday.

The report examined systemic issues plaguing the NDIA, including significant backlogs, delays in decision-making and poor communication practices.

Since mid-2016, 32 per cent of all NDIA complaints to the ombudsman related to the agency’s review process, particularly around delays.

While Manthorpe acknowledged the considerable pressure placed on the NDIA to meet bilateral targets since the NDIS’s national rollout, he stressed this must not be used as a reason to deprioritise or delay other work, including reviews.

“It is clear from this report there are a number of areas in which the NDIA can, and should improve its administration of participant-initiated reviews,” Manthorpe said.

“Without significant efforts to improve the timeliness of its approach and its communication with participants, there remains a risk that participants’ rights to review will be challenged and the review process will continue to be unwieldy, unapproachable and the driver of complaint volumes.”

Commonwealth Ombudsman: “a number of areas in which the #NDIA can, and should improve its administration of participant-initiated reviews.” Here are the 20 recommendations from the publicly available report. #disability #DisabilityRights pic.twitter.com/UuOoAeLojL

— Jo Arciuli (@JArciuli) May 15, 2018

In February 2018, the NDIA advised the ombudsman it was dealing with about 8,100 reviews, while also receiving around 620 new review requests every week.

The NDIA acknowledged some reviews were taking up to nine months to be completed.

In response, the NDIA implemented a new dedicated national team in November last year to address the backlog, but the ombudsman noted that “to date this approach has not been adequate to quickly and effectively work through the outstanding requests”.

By the end of January, the NDIA said it had triaged around 3,400 requests and completed around 1,500 reviews.

The report said while these initial efforts were welcomed, more needed be done to ensure “administrative drift or under-resourcing does not prevent participants from readily exercising their review rights”.

“Without significant efforts to improve the timeliness of NDIA’s administration of reviews and communication with participants, there remains a risk that participants’ right to review will be undermined and review processes will continue to lack fairness and transparency and continue to drive a high volume of complaints,” the report said.

The NDIA also acknowledged that the achievement of bilateral targets for access requests, plan approvals and scheduled plan reviews had been prioritised over internal reviews and unscheduled plan reviews.

The ombudsman warned they had received complaints highlighting instances where NDIA staff confused requests for unscheduled plan reviews with requests for internal reviews of a decision to approve supports.

“The inaccurate classification of review requests creates issues for participants – who are required to await the outcome of two processes (rather than one) before they can access their right to external merits review; and the NDIA – which unnecessarily expends time and staff resources on additional review processes,” the report said.

“As highlighted in our submission to the Productivity Commission’s inquiry into NDIS costs, ‘double handling’ of reviews will likely also drive additional complaints to the NDIA, which are a further drain on resources.”

To remedy these issues, the ombudsman made 20 recommendations to the NDIA, including to establish standard operating procedures requiring staff to acknowledge review requests within a specified timeframe, and to make information about current average timeframes for reviews publicly available.

The NDIA provided their response to the review in the ombudsman’s report, indicating they supported all 20 recommendations.

“The NDIA accepts the merit of each of the recommendations, and has started determining the most practical way to implement responses, including timeframes for resolution,” NDIA CEO Robert De Luca said.

Every Australian Counts campaign director Kirsten Deane, told Pro Bono News that the lengthy delays outlined in the report went against the essence of what the NDIS was meant to be.

“We fought for the NDIS because we wanted an end to the delays that happened under the previous system that left people waiting years for help, and it’s so terrible that we have found ourselves here again,” Deane said.

According to a report released today by the Commonwealth Ombudsman, the NDIA are receiving 620 new review requests a week. And despite a new team to clear the backlog, reviews are still taking too long #NDIS #NDISFunditFixit https://t.co/pZpYyeus7q

— Every Australian Counts (@EveryAustralian) May 15, 2018

Every Australian Counts recently conducted a survey with the disability community about what they wanted to see fixed with the NDIS, and Deane said reducing wait times was one of the top priorities.

“We got a really strong message that people are really sick of waiting. Sick of waiting on the phone, sick of waiting to hear the outcome of their NDIS application, sick of waiting for a planning meeting, sick of waiting for their plan to arrive and then if there are problems, they’re sick of waiting for a review,” she said.

“So they’ve really sent a very clear message that they want an end to the delays, but if there is a problem and going to be a delay, then they at least want to know about it.

“We want the NDIA to be upfront about what the time frames are, so at least then people know what they’re in for. Not knowing is almost as frustrating as the wait itself.”

Despite this, Deane praised the ombudsman’s “sensible and practical” recommendations and said it was now up to policymakers and the NDIA to take action.  

“One of the other really strong messages that we got through the survey was that all of the problems people identified were fixable,” she said.

“So it is really about everybody knuckling down and rolling up their sleeves and getting the job done.”

“People really want the NDIS to work. We still feel that the vision of the NDIS is right, the principles which sit underneath it are right, but it’s being let down by poor implementation.”