The 19-month average waiting time for an assessment of need, hampered by a creaking IT infrastructure, has been described as a "massive failing of the system", as more than 5,000 children remain in the pending category.
According to figures provided by the HSE to Cork East TD Seán Sherlock, some 5,078 assessment of need applications are overdue for completion, with 281 of these on the grounds of there being exceptional circumstances.
More than 4,500 of those overdue applications stretch beyond three months.
The HSE acknowledged "that the numbers of assessments overdue for completion remain high, although there had been some improvement in these figures in 2018 and 2019 prior to the Covid-19 public health emergency".
In August 2020, the HSE secured €7.8m to address overdue assessments of need, on what it described as a "once-off" basis.
After an assessment, a report provides information on the health needs of the child, and a list of the services that the child needs.
The HSE said funding to address a backlog of overdue assessments was secured in August 2020 at which time each Community Healthcare Organisation (CHO) developed plans to address their backlogs.
Those plans included overtime initiatives, recruitment of additional staff and procurement of private assessments, the health body said.
CHO areas with lower numbers of overdue assessments of needs had projected completion dates of December 2020, it said, while other areas will continue to address the backlog with an overall target date of May 2021 for project completion.
The number of overdue assessments as the end of 2020 reflects the fact that the project did not begin until September, as well as the impact of service closures due to Covid-19, the HSE said.
The length of time to complete the assessment of need under the Disability Act will vary depending on the person’s complexity of need, the HSE said.
However, the national average duration of the assessment process per report completed in the last quarter of 2020 is 19.83 months, it admitted.
The database is 20 years old and has not had the necessary upgrades or technical changes in recent years that are generally required by IT systems, it said.
Mr Sherlock said 19 months for an assessment of need is a massive failing of the system.
The Labour Party TD added: "Despite the monies being invested into the system, families are still languishing with no sign of their issues being addressed fully by the State.
"The ombudsman when he was before us in the committee, did suggest, without any ambiguity whatsoever, that some sort of a refund scheme, could be established for those families who wish to procure private assessments."
That needs to be addressed again, Mr Sherlock said.
"Having over 5,000 children awaiting an assessment of needs, let alone therapy interventions, cannot be allowed to continue."