The audit revealed large differences in the amount of home care benefit granted to children that have the same need for care. The Office of the Auditor General points out that families with special-needs children must be able to expect that all applications for home care benefit receive similar treatment regardless of where they live and that everyone receives the benefits to which they are entitled according to the regulations.
According to the National Insurance Act, the purpose of home care benefit is to provide financial compensation for special supervision or care that is required as a result of permanent illness, damage or disability. The current regulations that govern the home care benefit scheme leave a great deal to the professional judgement of the person processing the individual case. The Office of the Auditor General investigated how this professional judgement is exercised, by asking social security offices and the County Offices of the National Insurance Service in each county to process identical applications for home care benefit. There was wide variance in the decisions in most cases. In some of the test cases, the decision varied from denying the application to awarding the applicant a higher level of benefit, representing a difference of more than NOK 60 000 per year.
Inadequate overall monitoring on the part of the Ministry of Health and Social Affairs and the National Insurance Administration and inadequate co-ordination within the national insurance service seem to have entailed that the individual County Offices of the National Insurance Service and social security offices have established their own practices for the allocation and measuring out of home care benefit. The Office of the Auditor General points out that there is a need to implement measures with a view to establishing and guaranteeing equal treatment in this area.
The Ministry of Health and Social Affairs is very concerned that families with disabled children have such varied access to the social security benefits to which they are entitled under the National Insurance Act. The Ministry stated that it will initiate a number of measures in the national insurance service, and that by the end of 2000 a plan of action shall have been prepared for the national insurance service’s work in connection with applications for home care benefit. The National Insurance Administration is going to assess whether processing in this area should be transferred to fewer social security offices, as, according to the Ministry, this would result in greater knowledge of the field among the agencies that process applications.
The Report is available in Norwegian on the Office of the Auditor General’s website – www.riksrevisjonen.no – or can be ordered from the University bookshop Akademika, tel. +47 22 11 67 70.
The Report will be closed on Monday 6 November at 12 noon.