Cost-cutting responsible for ACC counselling delay

Press release from the New Zealand Labour Party

ACC Minister Nick Smith’s denial that he’s responsible for major delays processing claims for sexual abuse victims is contradicted by an ACC newsletter which puts the blame squarely on Government cost-cutting, says Labour’s Victim’s Rights spokesperson Lynne Pillay.
“Yesterday I released figures showing there were 420 sexual abuse claim decisions pending in August - up from a consistent average of less than 72 a month earlier this year. That’s an increase of over 500 per cent.
“A spokesman for Nick Smith is quoted today laying the blame on ACC, saying it was a clinical matter and the Minister did not intervene in claim eligibility matters.
But his attempt to shift the blame for the delays is completely contradicted by an ACC newsletter sent to Sensitive Claims providers in July,” says Lynne Pillay.
“It says a number of providers have raised concerns about the delays and ‘we understand some of the frustration and acknowledge there have been issues’.
“It says rising claim numbers have created added pressure and ‘as staff numbers are calculated on the previous year’s claims, this has put ACC staff under stress…In today’s financially constrained environment, it isn’t possible to simply recruit more staff. Our approach is to streamline the service…’
“This, in conjunction with the explanation on the front of the newsletter which states how ACC is changing how it works to keep ‘a close eye on expenditure, in line with government expectations’ makes it entirely clear that a refusal to employ extra staff to meet victims’ needs is behind the delays,” Lynne Pillay says.
“Nick Smith needs to come clean and accept responsibility for forcing victims of sexual abuse to be left stranded and without counselling for months. He must give an assurance that the problem will be rectified immediately and establish clear timelines for processing such claims.
“There is already considerable scepticism among sensitive claim providers that proposed changes to the processing of ACC funded counselling claims for victims of sexual abuse, due next month and set to tighten eligibility criteria, are driven by cost-cutting, not service improvement imperatives.
“The deliberate decision not to employ more staff to process claims only deepens those concerns and is a shocking way to treat victims of serious assaults. It will put people off seeking counselling, just as the toughened ‘mental injury’ eligibility tests will. This is not ‘Value for Money’ this is ripping victims of crime off.”

http://www.scoop.co.nz/stories/PA0909/S00423.htm

Counselling delays for abuse victims unacceptable

Press release from the New Zealand Labour Party

ACC figures show victims of sexual abuse are being left in limbo and without counselling for months while it delays decisions about whether their claims will be accepted, says Labour’s Victim’s Rights spokesperson Lynne Pillay.
“The (attached) figures show a steep rise in the number of sensitive claims waiting to be resolved by ACC around the country and fewer being accepted.
“It’s just not good enough. The last thing a victim of a sexual assault needs to face is lengthy dithering by the very agency which is supposed to fund their counselling. It’s simply unacceptable,” says Lynne Pillay.
“The figures, released to me by ACC Minister Nick Smith, show decisions pending on 103 sensitive claims in Auckland in August – up from an average of four a month last December. Only five claims were accepted in August, compared to 55 in December.
“In Canterbury there were 63 sensitive claims awaiting resolution in August, while in Wellington there were 32 and in the Waikato 31 – all up from an average of four in the months from December to April. These delays are matched by declines in the number of claims accepted,” Lynne Pillay said.
“Increases in the number of these claims awaiting decisions, and reductions in those accepted, are also evident in most other regions throughout the country.
“Sexual abuse counsellors are deeply concerned about the impact of the delays and so is Labour. Equally concerning are the comments from ACC today on Radio New Zealand, which suggest the agency is preparing to tighten the criteria around accepting sensitive claims.
“ACC Minister Nick Smith must provide an immediate explanation as to what is going on. Labour has already raised serious concerns about proposed changes to the delivery of ACC funded counselling for victims of sexual abuse.
“There have been smoke and mirror messages from the Government over the detail of these changes, due to be introduced next month. But it is clear they are designed to reduce costs through reduced counselling. It now appears fewer claims may also be accepted – and victims could be re-traumatised in the process as they face long delays waiting for an answer,” Lynne Pillay said.
“The Government appears so focused on cost-saving, it has forgotten it is dealing with victims of serious crimes who don’t deserve this appalling treatment.”

http://www.scoop.co.nz/stories/PA0909/S00402.htm

Concerns for ACC Counselling for Sexual Abuse

Joint press release

We are counsellors, psychotherapists and psychologists in the Nelson region who are all accredited providers of counselling for sexual abuse for ACC Sensitive Claims Unit. We are trained, experienced and committed professionals.
ACC policy makers are introducing drastic changes in the delivery of this important service which has been available to the people of NZ for many years. Proposed ACC changes create a significant professional dilemma for practitioners. In response, counsellors and psychotherapists are forced to decide whether to continue or whether to discontinue with the provision of ACC funded counselling services. If they continue they are concerned that they will breach their Code of Ethics.
Some have already reluctantly decided to withhold services by not taking on new clients under ACC funding. This stand is taken out of regard for the safety of individuals seeking our help and in our belief that this is in the best public interest.
It is vital for us to stress that we are not withdrawing our counselling services from our current clients. Of course we will continue to work with anyone to whom we have already made a therapeutic commitment.
We have many objections to the proposed changes, such as:

• breaks and delays in continuity of service especially at the outset of counselling when the client is extremely vulnerable
• exclusion of provider (counsellor) in treatment assessment and goal setting
• disregard for the need for specific training or experience in treating sexual abuse in those selected as service gatekeepers at SCU
• disregard for the value of the therapeutic relationship. Clients may now be directed to a named counsellor by ACC (who is different from the person they first chose to see).
• invasive information seeking by SCU e.g. from GP
• arbitrary limitation on sexual abuse therapy, regardless of whether it is for a single assault on an adult, sexual abuse on a child, or an adult with history of childhood sexual abuse
• massively inappropriate administrative costs for counselling (Currently administrative costs are more than nine times the costs allocated for counselling!)
• treating persons who have been sexually abused as ‘unwell’ (through use of psychiatric diagnosis) rather than as victims of crime
• cultural insensitivity for Maori and Pacifica clients
• insensitivity for special needs of children and adolescents

We ask that ACC: -

• Collaborate with those who are treatment providers both in planning and implementing changes
• Decide on changes after an evaluation of the service and adjust only what is necessary, maintaining what is running well.
• Work with providers to eliminate ethical and practice concerns the current proposed pathway raises.
• Realistically assess resource accessibility and availability for sexual abuse treatment agencies and Mental Health Services given the extra unfunded workload shift being proposed.

As stated before, some counsellors and psychotherapists have already withdrawn their services and will not be taking on new clients. If proposed ACC changes go ahead unaltered we anticipate that many more will join, as to breach our code of ethics is unacceptable to us.
WE URGE ACC TO STOP THE PROPOSED PATHWAY PROCEEDING

Ana Dorrington, MNZAC and DAPAANZ
Angela Fanning, MNZAC
Barbelle Boaz, Registered Psychotherapist
Bets Stallard, MNZAC
Briar Haven, MNZAC
Burke Hunter, Registered Psychotherapist, MNZAP
Christine Gillespie, Registered Psychotherapist, MNZAP
Elaine Partridge, MNAC
Geoffrey Samuels, MNZAP, MNZCCP, Registered Clinical Psychologist
Madeleine Pryce, MNZAC
Mary Jerram, Registered Psychotherapist, MNZAP
Marylyn Tait, Interim Registered Psychotherapist, NZAP (provisional)
Renee Alleyne NZAC ANZPA
Rosella O’Neil, MNZAC
Stacey Bowker, MNZAC
Susan Hawthorne, Registered Psychotherapist, MNZAP
Yvonne Audier, MNZAC

http://www.scoop.co.nz/stories/PO0909/S00287.htm

Counsellors up in arms over Minister's decision

Press release from the New Zealand Association of Counsellors

Nick Smith’s refusal to discuss proposed changes for treatment of victims of sexual abuse has counsellors up in arms,
The NZ Association of Counsellors is shocked that Minister for ACC, Dr Nick Smith, has declined a request to meet with counselling organisations to discuss the proposed changes to ACC Sensitive Claims Counselling.
NZAC wrote to Dr Smith on 18 August requesting a meeting with the minister and followed up with phone calls to his office. The minister has offered no explanation for his refusal.
NZAC will again write to Dr Smith requesting a meeting to explain its concerns about the “ACC Clinical Framework and Clinical Pathways” due to come into force on October 12, 2009.
ACC’s planned changes include: frequent assessments by psychologists or psychiatrists where clients may be required to re-tell their trauma history, without the benefit of a therapeutic alliance they would have built up with a counsellor at this point.
NZAC spokesperson on ACC counselling, Elayne Johnston, says potential delays in ACC deciding whether to accept or decline claims, while assessments are taking place could leave clients stranded and very vulnerable. Having just begun to open up about their abuse they will have to wait for up to 9 months to hear whether their counselling may continue. Under the previous system clients were often able to continue counselling while assessments were organised and carried out, on the basis of clinically necessity, and ACC recognised this by backdating fees. The new system specifically precludes this – which is like opening someone up on the operating table and them having to wait for months before you get permission to perform the operation.
She says counsellors who offer ACC counselling for victims of sexual abuse label the proposed changes unethical and unworkable. Some have indicated that they will no longer work as ACC providers if these changes go ahead. She believes that this will result in fewer survivors being able to access ACC counselling and the survivors’ mental health, their families, workplaces and communities will suffer.
Mrs Johnston says the NZAC code of ethics states “counsellors shall avoid doing harm...” NZAC believes harm may be done to the already traumatised victims of sexual abuse by requiring extra assessments. Many ACC clients have suffered severe sexual abuse as children and only find the courage to seek help for the ongoing psychological symptoms once they are adults. ACC counsellors are often the first people to witness their clients’ traumatic stories. A therapeutic relationship between counsellor and client is paramount to healing.
Being told by ACC that this work can be done in “16 sessions” and is really no different to treating a broken leg is insulting to both clients and counselling professionals.
Eric Medcalf, Ethics Convenor for NZAC says that counsellors have an ethical responsibility to address any changes made by ACC Sensitive Claims Unit according to their ethical code. One of the core aspects of counselling in the code is social justice. ACC is not an insurance company; it is a vehicle for government health and social policy. The funding of rehabilitation services to survivors of sexual abuse crimes shows that governments in the past have recognised this and its value for our country’s mental health.
The government campaigned hard on injustice and victims rights during the last election and it is disappointing to see the Minister for ACC turn away from the professionals who work with some of our most traumatised members of society.
ACC counsellors will gather at a forum at the NZAC Conference at Kingsgate Hotel in Hamilton on 18 September 2009 to meet with representatives of ACC and discuss their opposition to the proposed changes.

http://www.scoop.co.nz/stories/PO0909/S00166.htm

Questions for written answer

14045 (2009). Hon David Parker to the Minister for ACC: What percentage of sensitive claims relate to childhood sexual abuse?
Hon Dr Nick Smith (Minister for ACC) replied: I am unable to provide the Member with an answer to his question, as ACC is unable to provide a percentage of all sensitive claims lodged which relate to childhood sexual abuse. This is because ACC must consider the date of injury for this type of claim as being the date on which treatment was first sought, which could be years after the event. In order to provide a robust answer, a manual search would need to be completed of all sensitive claims to establish which claims relate to childhood sexual abuse. I do not believe such an undertaking would be efficient use of ACC’s resources.
http://www.parliament.nz/en-NZ/PB/Business/QWA/c/f/d/QWA_14045_2009-14045-2009-Hon-David-Parker-to-the-Minister-for-ACC.htm

14046 (2009). Hon David Parker to the Minister for ACC: What percentage of sensitive claims relate to childhood physical abuse?
Hon Dr Nick Smith (Minister for ACC) replied: ACC’s Sensitive Claims Unit primarily manages claims for mental injury as a result of certain crimes that are detailed in Schedule 3 to the Injury Prevention, Rehabilitation, and Compensation Act 2001. The Sensitive Claims Unit may additionally manage the rehabilitation of a physical injury that occurred at the same time as a covered sensitive claim. However, I refer the Member to my answer to Parliamentary Question for Written Answer 14045 (2009) with regard to why this information is not readily available.
http://www.parliament.nz/en-NZ/PB/Business/QWA/9/8/7/QWA_14046_2009-14046-2009-Hon-David-Parker-to-the-Minister-for-ACC.htm

Question to Minister: Safety in the home campaign - Accident and injury data

Dr JACKIE BLUE (National) on behalf of MICHAEL WOODHOUSE (National) to the Minister for ACC: What accident and injury data has led the Accident Compensation Corporation this week to run a high-profile campaign on improving safety in the home?
Hon Dr NICK SMITH (Minister for ACC) : There are two worrying trends in home injury data. First, 573 New Zealanders died in accidents in the home last year. That is more than the 375 killed in road accidents and the 123 killed in workplace accidents combined. The campaign is intended to raise awareness of home injuries, because public discussion tends to focus on those accidents on the road and in the workplace. The second worrying trend is the 36 percent increase in the last 2 years in the cost of people injured in the home, which now exceeds $640 million per year.
Dr Jackie Blue: What are the implications of these sharp increases in accident compensation costs for accidents in the home for the Accident Compensation Corporation (ACC) and for levy payers?
Hon Dr NICK SMITH: Home accidents are paid through the earners levy, which is currently $1.70 per $100 of earnings. This increase and other increases across the scheme are putting huge pressure on the current levy. Although we can push out the full funding date to try to constrain levy increases in the work and motor vehicle accounts, that has very little effect on the earners account. Earners levy increases are inevitable, but the Government is doing everything possible to try to constrain costs. The campaign we are running is part of a broad strategy to better manage the scheme’s costs.
Hon David Parker: How can the victims of sexual abuse receiving treatment through the scheme have any confidence that the Government is properly looking after their interests, given the conflicting statements made last sitting week, when, firstly, the Hon Pansy Wong confirmed on 25 August that there were new clinical guidelines—saying, indeed, this is a new guideline—and a day later the Hon Nick Smith said that no final decisions have yet been made?
Hon Dr NICK SMITH: I am surprised by the linkage the member makes between home injuries and the issue of sexual offending.
Hon David Parker: Where does most sexual abuse occur?
Hon Dr NICK SMITH: Well, they are different categories, and properly so. It is a sensitive area. The Government has said that the clinical guidelines for dealing with such sensitive claims will be addressed by clinicians, not by politicians.
Hon David Parker: How can the Minister maintain his assertion that no final decisions have been made, when ACC is already advertising for the triage clinical psychologist who will be “leading and coordinating the new triage process for sensitive claims”, and will the Minister or his staff be making an urgent telephone to the corporation after question time today to find out what really is happening?
Hon Dr NICK SMITH: I say to the member that, no, I will not. I note that the change in dealing with sensitive claims was launched by none other than Steve Maharey, now of Massey University, when he was a Labour Party member of Parliament. Frankly, I am surprised at members opposite stooping to the level of using sensitive sexual claims as an area in which to play politics.
Hon David Parker: I seek leave to table a copy of the ACC advertisement for the triage clinical psychologist for the sensitive claims project, which the Minister said has not started yet.
Mr SPEAKER: Leave is sought to table that document. Is there any objection? There is none. [Interruption] The dilemma is that I had actually said there was no objection, prior to the Minister saying he did object. Therefore I had ruled on the matter.
Hon Dr NICK SMITH: I raise a point of order, Mr Speaker. The reason I objected is that the member in seeking the leave made an incorrect assertion at the end. That was the reason for the objection.
Mr SPEAKER: We do not need to pursue this matter any further. I have dealt with it. The document can be tabled.
http://www.parliament.nz/en-NZ/PB/Debates/Debates/e/f/1/49HansD_20090908_00000060-Questions-for-Oral-Answer-Questions-to-Ministers.htm