Reviews of NDIS cases have taken up to nine months to complete, and significant effort needs to be made to deal with the backlog of requests, an ombudsman's report has found.
The way the National Disability Insurance Agency, which administers the NDIS, handles reviews was the subject of 400 complaints received by the Commonwealth Ombudsman's office between July 2016 and January 2018, making up 32.5 per cent of all complaints made about the agency in the 18-month period.
In February the NDIA had about 8100 reviews still on the books, with more than 600 reviews being added every week.
In November 2017 the NDIA started a team to deal with the backlog of cases for review, but three months after it began it had completed just 1500 reviews and triaged 3400 requests for review. The report said it was not clear that the national team had made a difference in addressing the backlog.
If the agency didn't work to improve its review processes, the rights of those using the scheme would be undermined, the ombudsman said.
"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.
Participants of the NDIA are able to review decisions about the amount of support or equipment they receive, or how many hours of care they receive funding for.
The agency didn't identify or prioritise urgent cases for review, the report said.
"These delays are concerning to all participants, but pose a particular risk to those who may be at risk of losing services or experiencing deterioration in their capacity if their plan is not adjusted quickly."
The report said that complaints related to the handling of reviews focused on not acknowledging the request for review and not responding to inquiries about the review's status, including being told they would be called back and not hearing back from the agency. The agency told the ombudsman it didn't have formal documented procedures for acknowledging requests for a review.
A participant requested a review in October 2016, and spoke to an officer in December of that year, when she was told she would be contacted again about the review. She wasn't contacted by the agency until February 2017, the report said.
Participants were not always contacted even when the agency had accepted their request.
"In one case, a participant did not know why her plan was changed because the NDIA had not told her it had accepted (and given effect to) her request for a plan review."
The NDIA accepted the 20 recommendations made by the report, and said in its response to the report that it was committed to improving the way it deals with reviews and outlined actions taken to reduce waiting times and increase communication with recipients.
"Work has commenced on a number of initiatives to improve the administration of reviews," NDIA chief Robert De Luca said in the response.
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