January 31, 2018

Time to review the reviewers?

To paraphrase the old legal maxim, “Access delayed is access denied”.    While the NDIA has a process for requesting a review of a plan, we are finding lots of issues with the process:

  • clients don’t know that the process exists, aren’t told how to request a review and have no way of tracking the progress of the review
  • requests for review take too long – many find that the review has not been completed by the time the anniversary of the plan is up and a new plan may be applied

And it’s not just clients and advocates who are finding issues.  A recent report by the Australian National Audit Office found many issues with access and review, including:

Not adhering to the NDIA’s own access criteria:

“The ANAO reviewed the records of 20 individuals who were classified by the NDIA as having a moderate or severe intellectual disability but were found by the NDIA to be ineligible for the Scheme, to ascertain the reasons for the ineligible decisions. In eight cases the applicant had subsequently been found eligible for the NDIS, either as a result of internal review, or transition arrangements.

Of the remaining 12 cases:

  • ten had been correctly classified as NDIS ineligible because of phasing arrangements (eight cases); or age (two cases); and
    two were incorrectly classified as List A conditions—the evidence provided did not support a diagnosis of moderate or severe intellectual disability.”

Internal reviews conducted by the same person who did the initial plan:

“The 20 case reviews conducted by the ANAO included ten cases where the Original Decision Maker (ODM) had confirmed their original ineligible decision. The applicant or their representative was advised of the ODM decision in six of the ten cases. In two of these cases a letter was sent to the applicant stating that they did not meet the NDIS access requirements, one of which was clearly framed as the results of an internal review. Both letters mentioned (another) internal review, but neither mentioned the right to AAT review, which is the legislated next step where an internal review has already been undertaken”

Also disturbing that the right to AAT review wasn’t even mentioned in some cases.   Clearly the processes need refinement!

The NDIA’s response is included in the report, in part:

“The NDIA takes the ANAO audit recommendations seriously and is committed to strengthening control weaknesses through continuous improvement.

The NDIA acknowledges the audit findings and agrees with the four recommendations. Steps have already been taken to address a number of the recommendations and issues raised in the report.

As a general observation, the NDIA notes that the audit took place during a time of significant transition and growth. From 1 July 2016 until 31 March 2017 (the period covered by the audit), the NDIA processed 81,172 access decisions. By comparison, over the previous three years of trial a total of 37,946 access decisions were made.”

We continue to monitor the progress of clients we’re assisting, and doing all we can to ensure timely access to the NDIS.