Summary Report from Commonwealth Ombudsman on the NDIA’s handling of reviews
Summary: Report from Office of the Commonwealth Ombudsman Administration of reviews under the National Disability Insurance Scheme Act 2013: REPORT ON THE NATIONAL DISABILITY
INSURANCE AGENCY’S HANDLING OF REVIEWS – This is a short summary of a report undertaken by the Commonwealth
Ombudsman into complaints they have received by NDIS participants regarding review process. The outcome of this report is the NDIA have agreed to commence a number of initiatives to improve their review practices.
Between July 29016 and January 2018 the Office of the Commonwealth Ombudsman received 400 complaints that were, at least in part, about the NDIA’s administration of reviews. This represents 32.5 per cent of all complaints made to them about the NDIA during this period.
Of particular concern is the issue of delays in completing reviews. In February 2018, the NDIA advised the Ombudsman it had around 8,100 reviews on hand, and it was receiving around 620 new review requests each week. The NDIA has acknowledged some reviews are taking up to nine months to be completed.
Participants may seek a review of the NDIA’s decisions on two grounds.
- Participant can ask the NDIA to review their NDIS plan. This is called an ‘unscheduled plan review’. Participants can do this at any time but usually happens if a person’s circumstances change.
- Participant can ask for a review of a decision. This is called an ‘internal review and usually happens if a participant is unhappy with a decision.
The Ombudsman have made twenty recommendations to help improve the current situation so that reviews are handled in a more consistent and timely manner and that people are aware of the status of reviews.
The NDIA have accepted the recommendations and have commenced a number of initiatives to improve their review practices. These actions include
- Review and re-design end-to-end processes and supporting guidance for requesting and completing reviews.
- Review contact centre scripts and publish them for frontline staff to access.
- Develop and implement processes for contacting participants who have a pending request and inform them of the process moving forward.· Implement processes to ensure multiple (conflicting) letters are not sent to participants post review
- Formalise processes for prioritising urgent cases
- Develop practices that ensure participants are provided with an adequate explanation for decisions relating to unscheduled plan reviews.
For detailed information
The details of the report, recommendations and NDIA response are available here http://www.ombudsman.gov.au/__data/assets/pdf_file/0029/83981/Report-on-NDIA-administration-of-reviews-under-the-Act_1.pdf
Nature of Complaints
The Ombudsman has received complaints about the NDIA’s handling of requests for review by participants as well as how well they provide participants with reasons for the decisions they make.
HANDLING REQUESTS FOR REVIEW
Participants complained because the NDIA 1) did not acknowledge their requests for a review or 2) the NDIA did not respond when they enquired about the status of their review request. Case study 1 provides an example of these issues.
The third problem occurred when 3) NDIA staff confused requests for unscheduled plan reviews and requests for internal reviews of a decision to approve supports. This led to delays. Case Study 2 provides an example of this problem.
PROVIDING NOTICES OF DECISIONS
The Ombudsman have also received complaints about the NDIA’s communication of review decisions. These complaints occurred when the NDIA
- Didn’t give written notice to the participant of NDIA’s decision to conduct a review,
- Didn’t provide clear and sufficient reasons for a decision; or
- Gave incorrect advice to participants on their review rights.
Case Study 3 provides a good example of these complaints that people have made.