30 June 2010

ACC matters - cautiously optimistic!

An article from ANZASW NoticeBoard by Cathy McPherson
On May 7 I attended a hui in Wellington, requested by the Sensitive Claims Advisory Group at our last meeting in March, when ACC admitted that they need some assistance to fill in the “gaps” in service left by their new Pathways. The meeting was faciltated by Graham Bashford. While Peter Jansen was in attendance, he had no role to play in the meeting, and in fact appeared extremely subdued... SCAG members were not entirely sure what to make of this development. Approximately 60 attended the meeting.
The week before the meeting, there was an announcement by the Minister of Justice that the Minister of Social Development would be undertaking a “stocktake of Government spending on specialised sexual violence services. The terms of reference are expected to be finalised soon, and she expects to report back by the end of the year. The aim of the stocktake is to build on TOAH NNEST’s work, establish what the Government is already purchasing, what the current and long term demands for services will be, identifying opportunities for efficiency and effectiveness and considering future funding options”.
As a consequence of this announcement, we were informed the day before the meeting by ACC that “the agenda for the ACC facilitated workshop would include the time to develop a statement from the group to provide to the Minister.”

Impressions of SCU Workshop:
The workshop was attended by approximately 60 people including SCAG, representatives of Police, child and adolescent and adult mental health, representative of Commissioner for Children, Massey University and ACC including James du Plessis and David Rankin, and Denise Cosgrove, the new General Manager of Claims Management, as well as some claims managers.
ACC was actually asking and listening as to how to fill the gaps left by the new Pathways.
They made a clear statement that they recognized there were clear gaps in the system, and that ACC were committed to doing everything they could to address these “within the constraints of the legislation”. Furthermore, they stated they would record and forward the gaps highlighted by us to the review panel.
Graham Bashford went on to outline the history of the changes and the current situation of which the most salient point was a recognition of clear delays, namely that they have approved claims within three days when all the information has been present, but that the current average is 47 days. (This was challenged by SCAG as we have it well-documented that clients have been waiting for decisions from last year).
It was also acknowledged that the approval rate is very low. It appears that ACC see a clear difference between their legislative responsibility and clinical responsibility, as the phrase “within the constraints of the legislation” kept coming up.
Concern was expressed that a great number of ACC counsellors have either left the profession or have taken on new positions because of the almost zero approval rate by ACC.
ACC for the first time stated that over the years, ACC had become the default provider of counselling services for sexual abuse survivors even when mental health, difficulties prior to the sexual abuse, prior alcohol and drug issues etc were in existence. One of the suggestions at my discussion table (which included Kim McGregor, David Rankin, James Du Plessis, Commisioner for Children rep, Police rep, DSAC rep) and the suggestion was from the ACC people that funding for counselling have contributions from Health and Ministry of Social Development.
Police expressed concern about how much more difficult it is to obtain a prosecution when complainant is not adequately supported through that process and may be legally discredited due to mental health diagnosis.
It was acknowledged by those present that the present system was clinically unsafe and that the present process was not working either for ACC or for clients.

Some of the suggestions from the meeting:
Clear call for long term goal to be implemented of TOAH NNEST framework; namely a multi-ministry and cross agency response that is seamless and well funded and can respond quickly to the acute situation of disclosure.
Also a clear indication that some sort of short-term emergency response needs to be implemented immediately to stop the decline. Various ideas were tabled, including going back to four sessions for all new claims to hold clients until a decision is made by ACC re approval of claim.
Finding culturally safe ways of working within the Pathways.

ACC made the following commitments:
To document and discuss suggestions at next SCAG - I will report back on this after the June 19 meeting.
To inform both the CEO of ACC and the Minister of the outcomes and content of this meeting as a matter of urgency.
To record our concerns and suggestions unedited and as discussed.
To pass on outcomes of the meeting to the review.

At the end of the day, SCAG members came away feeling cautiously optimistic and hoping this was not just window-dressing. We were quite impressed with Denise Cosgrove but only time will tell. We certainly came away believing that our concerns have been listened to, and look forward to the departure of Graham Bashford, and hopefully Peter Jansen as well.
Also the Review Committee has just been announced for the promised six month review of the Pathways. There will be an opportunity for us all to make submissions to this Committee. I am trying to get an address to send submissions to and will publicise this as soon as I have it.
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