25 February 2015

Changes to ACC sensitive claims and Ministry of Justice funding

An article from Counselling Aotearoa News by Irene E M Paton
There have been significant changes in the services offered by both of these major third party funders. The Government has moved to a model of having a ‘supplier’ who holds the contract and contracts with ‘providers’ to do the work.
With ACC, there are a number of NZAC members who have been granted a supplier contract. These can be found on www.findsupport.co.nz. This explains about the new process and for more detailed information go to: www.acc.co.nz/for-providers/integrated-services-for-sensitive-claims/index.htm.  It offers a lot more services to clients (social work, family/whanau, group work) and more support for providers (cultural advice and active liaison).
I think it will be more respectful of clients as the supplier can choose who will do the assessments and the counsellor is paid to attend the sessions with the client if necessary. There is more of a sense of working together as a team in the best interests of the client’s healing and growth.
Unfortunately the previous funding for couples who needed support to rebuild or repair their relationships (Section 9s and 10s) has been withdrawn.
Now the Ministry of Justice (MOJ) has developed a new system whereby couples who want to make parenting agreements have to go through a process called Family Dispute Resolution (FDR) before they are able to take the matter to Court.
There are exceptions to attending FDR where the parties are unsuitable for the mediation process.  Couples under the threshold can have government funding for the FDR process and there are two main suppliers - Fairway and Family Support. They also need to attend a Parenting Through Separation Programme and are offered three sessions to prepare them for mediation and free legal advice.  More information can be found on www.justice.govt.nz/family-justice.
Other suppliers have been appointed to provide non-funded or partially-funded work. These can be found on www.justice.govt.nz/family-justice/about-children/making-decisions-about-children/new-process/justice-providerslist.
These are challenging times and we are being invited to adapt to a new culture. A colleague, Paul Muir, and I have set up two new companies to supply both of these services (www.cfdr.co.nz and www.optimumsolutions.co.nz). It has been hard work to go through the tendering process, however we are hoping that we will be able to offer quality services to clients.
© 2015 NZAC


18 February 2015

Therapy out of reach for many survivors of sexual abuse

An article from NZ Doctor by Reynald Castaneda
A Wellington GP is calling on ACC to recruit more sensitive claims counsellors, saying abuse survivors encounter long delays before their first therapy session.


ACC’s sensitive claims process has improved over the years, but survivors still face barriers because of a lack of counsellors, Doctors for Sexual Abuse Care deputy chair and GP Cathy Stephenson says.
Ease of access is important for people with a physical and/or mental injury suffered as a result of sexual abuse or sexual assault. Even the smallest inconvenience can discourage them from seeking help, Dr Stephenson says.
For example, when assisting one of her clients to find a counsellor in a different city, she called nine counsellors from a list of 10, and all were fully booked. Left to make these calls on their own, the client wouldn’t persist after being told “no” several times, she says.
Another problem is counsellors who can take new clients will not accept victims of sexual abuse, Dr Stephenson says. This is “fair enough” as they shouldn’t be overwhelmed by too many such cases.
ACC sexual violence strategy manager Emma Powell says the system is still evolving after multiple makeovers in the past several years.
 “We couldn’t have changes overnight … relationships had to be repaired within the sector to a point where we could all be working collaboratively,” Ms Powell told New Zealand Doctor.
“We want people to come forward and we want people to access services … this is not one of those [services] where we try to reduce people [coming] forward”, she says.
Changes to ACC’s sensitive claims pathway began five years ago after an independent review. ACC has been tinkering with this pathway since then, with recent changes going live at the end of last year.
More than 118 individuals and organisations offer sensitive claims services under the new contract, with approximately 800 providers including counsellors, Ms Powell says.
Survivors no longer have to get approval from ACC to see a counsellor, she says. But if more therapy sessions are needed, an individual assessment needs to be completed. If approved, the client can receive other types of treatment, including psychiatric and psychological help as well as financial compensation if they were earning at the time of the abuse. If a client is declined, in that the client’s mental issues are not caused by the sexual abuse incident, the client is redirected to other pathways which can help them.
“ACC doesn’t just say sorry, that’s it … it’s a very different system these days.”
Survivors who do not reach the assessment stage because they volunteered not to continue with any more counsellor sessions are also marked as “declined” in ACC’s books.
In the financial year 2013/14, 5118 sensitive claims were lodged and 3595 (70 per cent) marked as “declined”.This is a jump from 4828 claims lodged in 2012/13 (65 per cent were “declined”) and 4430 claims lodged in 2011/12 (63 per cent were “declined”).
Asked whether this conflated use of “declined” hides the real number of claims turned down by ACC, Ms Powell says survivors receive a personalised service even with this “accept or decline” system. Real numbers are revealed after audits are completed.

In essence
Wellington GP Cathy Stephenson says ACC needs to enlist more sensitive claims counsellors because survivors encounter long delays before their first therapy appointment.
ACC says the system has been improving in the past five years and dramatic changes cannot happen overnight.
Survivors don’t need approval from ACC to have an appointment with a counsellor, but must go through an assessment if more sessions or treatment are required.

© 2015 MIMS (NZ) Ltd


04 November 2014

Health insurer, physio group among suppliers of ACC sexual abuse counselling

An article from the New Zealand Family Violence Clearinghouse
Australian health insurer Medibank, Active Physiotherapy (now called Active+) and Auckland doctors' network Procare are among 173 successful applicants to become "suppliers" of ACC-funded sexual abuse counselling.
"Suppliers" are a new management layer created as part of ACC's sensitive claims system redesign. "Suppliers" will contract with counsellors and psychologists who will remain the service "providers."
Counsellor and co-chair of TOAH-NNEST Tania Blomfield expressed concern about whether non-specialist suppliers would understand privacy issues and other sensitivities associated with sexual abuse, and whether they were seeing sexual abuse counselling as a "potential money-spinner."
As part of the system redesign, ACC will raise the level of funding it provides from the current $83 per hour to new rates dependent on the qualifications of the counselling provider. Providers will no longer be able to charge clients a "top-up" fee. This is intended to reduce the barriers to victim/survivors to access counselling. However, Ms Blomfield expressed concern that some providers could end up worse off if the suppliers charged large administration fees.
ACC recently announced that under the redesign, it would:
  • Fund access to 48 therapy sessions over 12 months
  • Provide the full cost of counselling sessions
  • Allow claimants to 'shop around' for a therapist of their choice
  • Provide therapists with travel funding to allow them to travel to people in isolated regions
  • Support the inclusion of family members and support people during the recovery process where appropriate.
© 2014 New Zealand Family Violence Clearinghouse


29 October 2014

Question to Minister

9. IAIN LEES-GALLOWAY (Labour—Palmerston North) to the Minister for ACC: Is she satisfied that just 54 percent of the public expressed trust and confidence in ACC according to the corporation’s 2014 Annual Report?

Hon Nikki Kaye (Minister for ACC): No, I believe that ACC needs to do more to rebuild trust and confidence with New Zealanders. I am confident that ACC has a significant programme of work under way to achieve this. I am also pleased that the annual report shows trust and confidence has been trending upwards for the past few years.

Iain Lees-Galloway: Did former Minister Judith Collins damage public trust and confidence in ACC when she admitted that every New Zealander is paying too much for ACC because the Government is using excessive levies to create the perception that it will achieve a fiscal surplus in the current financial year?

Hon Nikki Kaye: Well, firstly, I disagree with the statement made in that question. But what I can say in terms of levies is that under our Government we have announced $480 million in levy reductions. That is incredibly significant, and it is a bit rich to get a lecture after the previous Labour Government left us with a huge deficit in 2008-09 of $4.8 billion.

Iain Lees-Galloway: I am going to seek leave to table a media statement, but that is because the Minister refuted the premise of my question—

Mr Speaker: Order! Members need to understand that the purpose of tabling a document is not to make a political point.

Iain Lees-Galloway: The purpose is not to make a political point.

Mr Speaker: Well, I think that in the way it has been described to me, it is very much about making a political point. The reason people seek leave to table documents is that it is information that is not readily available to members, may be difficult to source for members, and may be informative to members. If it is something that has been in the media, particularly media that is freely available to members, I do not intend to start putting the leave.

Chris Hipkins: I raise a point of order, Mr Speaker. In a ruling that you made—it was either earlier this week or last week—you referred us to a Speaker’s ruling that requires any statements made in a question to be authenticated, so if there is any factual material in a question, it needs to be authenticated. If a member is not able to table a document to authenticate that claim, what is the appropriate way for them to authenticate any claim that they might be making in a question?

Mr Speaker: The member, I think, is confused between a primary question and a supplementary question. The authentication is required for a primary question, and that is required in the process when it is lodged to the Clerk’s Office, and they will be accepted with authentication. With regard to supplementary questions, I have to judge relatively immediately whether it is a reasonable question, and I do that, but it is not as if there is an ability to then table information that substantiates the authentication of a supplementary question. So in this case, the primary question was authenticated, it was immediately answered in the very first word by the Minister, and we have now moved to a supplementary question. The way forward, as I continue to advise the House, is further incisive supplementary questions.

Iain Lees-Galloway: Does the Minister accept—

Hon Dr Jonathan Coleman: World weary—he’s not happy. That’s a big sigh.

Iain Lees-Galloway: Are you all right? Does the Minister accept that over the 6 years that National has been in Government, New Zealanders have overwhelmingly come to perceive ACC as difficult to deal with, likely to breach their privacy, likely to litigate against claimants, and overcharging them for the privilege; if not, why not?

Hon Nikki Kaye: No, I do not accept all of the statements made by that member. What I can say is what I have said in answer to the primary question: there is more work to do. Obviously, by a percentage that shows 54 percent public confidence, we have to do better. Let me outline some of the progress that we have made. Firstly, you can see at an investment level that ACC is now essentially fully funded. That is an extraordinary achievement for this Government, given that we were left in a situation of a debt of $4.8 billion in terms of deficit. Secondly, at an organisational level it is very clear—and I am meeting with the board tomorrow—that it has a huge programme around both updating information and communication technology systems to ensure that we have better progress around issues like privacy but also that a huge amount is being done in terms of claims management. I am confident that ACC is on the right track.

Iain Lees-Galloway: Will this morning’s article in the New Zealand Herald damage public trust and confidence in ACC, given that it detailed an attempt to cover up information about fraudulent activity, that the cover-up itself was bungled, that when pressed about the extent of fraud, ACC could only say that the information it used was not robust, and that an accurate figure for the level of fraud has not been provided?

Hon Nikki Kaye: In terms of the article in the New Zealand Herald, I do not believe that it will actually damage public trust, because you need to understand that the data is—and I want to outline why, for a number of reasons—11-year-old data. The data was from 2,000 clients, and that is out of a total of about a billion claims. So, firstly, it was a very small sample. I also understand that the figure that was quoted of 8 percent to 10 percent was not the proportion that was fraudulent; it was the proportion that needed another look. So it is old data, it is a small sample, and it is ropey.

Iain Lees-Galloway: Given that the Minister is not satisfied with the level of public trust and confidence in ACC, does she believe that the two initiatives to address public trust and confidence listed in the service agreements between ACC and former Minister Collins, which are “refresh our communications strategy” and “social media”, will be enough to improve confidence in ACC, or does she think it might take something a little bit less superficial than that?

Hon Nikki Kaye: In terms of the corporation’s programme to improve public confidence, there is a range of initiatives. There is a range of initiatives. The member is referring to a different document. He is not referring to the annual report. If he reads the annual report, he will see that not only is there a significant investment plan in terms of dealing with the privacy issues, and not only is the ACC doing a huge amount around sensitive claims, which is very important, but, thirdly, the Government is looking at the long-term funding policy. When he drills down, when he does the work and reads the annual report, he will see that one of the areas where we do need to improve public confidence is around businesses’ interaction with the ACC. There is a huge amount to do in terms of that administration side because that is where the public confidence is partly very low.

Marama Fox:

    [Authorised te reo text to be inserted by the Hansard Office.]

    [Authorised translation to be inserted by the Hansard Office.]

Hon Nikki Kaye: Just in terms of the translation of that question, I got only half of it, I think—

Mr Speaker: I invite Marama Fox to either repeat it in Te Reo, or, if she wants to, she can now repeat the question in English—whichever she would rather do.

Marama Fox: Perhaps I will repeat it in English. How is the Minister planning to address the projected 10 percent increase in new sensitive claims each year, and what plans does she have in place to involve whānau in the recovery process?

Hon Nikki Kaye: That is a very good question. Firstly, one area where the Government is very focused, and also the corporation is very focused, is the prevention of sexual violence. We have a strategy and an action plan around that, and they involve a number of Government agencies. The second thing I would say is I am advised that ACC is currently in the final stages of tendering for new suppliers and providers around some of those sensitive claims. That is very important so that we have more providers. Thirdly, with regard to family and whānau support, I am pleased to confirm that family and whānau of sensitive claims clients will receive support through the introduction of up to 20 hours of family and whanau support, depending on family need. I can confirm that this will be available by the end of the year.

Hon Te Ururoa Flavell: I raise a point of order, Mr Speaker. Tēnā koe, Mr Speaker. Can I just ask the Minister with respect to the question, because I was not listening to the translation, for further information, just in case other members, Māori members, use Te Reo and we have to switch into English, which defeats the purpose. Was the issue that the Minister did not get a good translation, that the Minister did not get a translation, or that the translation was unclear—just for the purposes of—

Mr Speaker: I am sure I can answer that on behalf of the Minister. The Minister did not manage to realise it was going to be in Māori. She did not grab the headpiece in time to listen to the translation, so she picked up the latter part of the—[Interruption] I will let the Minister explain her own reasoning.

Chris Hipkins: I raise a point of order, Mr Speaker.

Mr Speaker: No, I am going to hear from the Hon Nikki Kaye first so we will get an explanation.

Hon Nikki Kaye: I was listening, and I heard only half, I think, of what the translation was, and other members may be able to confirm that.

Chris Hipkins: I am happy to speak to this, because I also was listening to the translation, and the translation bore very little correlation to the question that was then asked in English. This is quite a serious issue for the House, because we previously had a situation where questions were asked first in Te Reo Māori and then in English, and we moved to a system where we had simultaneous translation. If that translation is not going to actually translate what is asked, then we are going to have to reassess that. I listened very carefully to the translation. I can fully understand why the Minister did not understand what the question was. I did not understand what the question was either.

Mr Speaker: Thank you. I appreciate that. When I finally got my headpiece on, again, I found much the same as the member Chris Hipkins has said. We need to now investigate whether it was an issue to do with the translation, because it is critical, if we are going to rely on the translator, that we have an accurate interpretation of the question that is asked. Otherwise, it could lead to all sorts of difficulties for a Minister. I will look into the matter.

23 October 2014

Abuse claim oversight switch stuns providers

An article from the New Zealand Herald by Simon Collins
Australian health insurer Medibank has won a bid to manage sexual abuse claims for the Accident Compensation Corporation (ACC).
The company, which is being sold by the Abbott Government in a share float expected to fetch up to A$5.5 billion ($6.1 billion), is one of 173 successful bidders to become "suppliers" of sexual abuse counselling - a new management layer that will contract with counsellors and psychologists who will remain the service "providers". Other successful bidders include Active Physiotherapy, now called Active+, and Auckland's biggest doctors' network, Procare.
Counselling leaders are alarmed. Manukau counsellor Tania Blomfield, who co-chairs the national network of sex abuse counselling agencies, said she was concerned that "private sensitive information is going into databases outside of the sector".
"It scares me that they may be seeing this as a potential money-spinner," she said.
ACC has lifted funding from a standard $83 an hour at present to new rates which will stay about the same for counsellors with diplomas but will increase to about $100 an hour for those with master's degrees or $130 an hour for physiotherapists, or more for clinical psychologists. But counsellors who go into the new integrated contracts will no longer be able to charge clients "top-up" fees of up to $90, and some could end up worse off if the supplier companies managing the contracts take a big cut for administration.
"From the client's perspective, which is what it's all about, this is going to be a lot better than the existing system, but the question is going to be how badly do the providers get screwed along the way," Ms Blomfield said.
Medibank NZ general manager Andrea Pettett said the company approached about 700 of the 900 ACC-registered counsellors and received indications of interest from more than 100 of them. The company also operates the Healthline phone service for the Ministry of Health and is believed to be on a shortlist of three, along with Lifeline and a company owned by Procare and Christchurch doctors' network Pegasus, in another tender to integrate Healthline with other helpline services.

Sex abuse tender

Why are sex-abuse counselling contracts being re-tendered?
ACC's new "integrated contracts" include assessing clients' needs as well as providing counselling. Until now most counsellors have not had contracts but simply billed ACC for hours worked.

Why can insurance companies and physiotherapists bid?
ACC has opened up the criteria for assessments to allow clients to choose their assessors and counsellors. Until now ACC decided who did the assessments.

What will change for sexual abuse survivors?
They should get a more integrated service, fully funded by ACC. Counsellors in integrated contracts can no longer charge clients extra fees above the ACC subsidy.

Why are counsellors worried?
Some counsellors worry that insurance and physiotherapy companies won't understand privacy issues and other sensitivities in sexual abuse cases.
© 2014 APN New Zealand Ltd