Sexual violence services – the real story

A blog post by Jan Logie

What has really led to the Government’s changing stance on funding for sexual violence services?
People have been congratulating me on this news yesterday and I have to admit working with the sector through this process has given meaning to my time in Parliament and I am proud of the work we have done on this.  I am a bit embarrassed by the congratulations in the context of the thousands of submissions and years and years of work by incredible advocates which really got the result.
While I’ll need to see the dollars in the budget, and hear that the Government is working closely with the specialist providers, especially Nga Kaitiaki Mauri, to design the new model before I relax, I do want to reflect on the journey to this point.
The 70s and 80s saw women coming together to voluntarily support women who had experienced sexual violence. The Government provided some funding from the mid 80s. There was a period of new general services, the Pacific Island Women’s Project, and kaupapa Maori services being set up to respond to the growing need. These groups were advocating for the prevention of sexual violence – law reform and social change as well as supporting victim/survivors. It wasn’t until the mid 90s that we had the first ethnic women’s organisation, Shakti and in the late 90s the Male Survivors of Sexual Abuse Trust set up. There are still obvious gaps.
ACC alongside MSD were the major funders for sexual violence support services. The services were always under-valued and certainly not recognised for the amazing life-saving and at times world leading responses to sexual violence that they were and are. Sexual violence has been one of those very difficult topics to talk about in any context so that always made the services a bit of an easy target for funding cuts.
Despite Maori women being more likely to experience sexual violence in New Zealand and kaupapa Maori approaches being far more successful we have lost almost all of our specialist kaupapa Maori sexual violence services. There was a time when there were over twenty services but now there are fewer than five.
The Taskforce for Action was initiated by Labour in the wake of public horror about Louise Nicholas’s experiences. Louise did not have access to the right help, from our justice system or social services, when she needed it and that is one of the reasons she has been so actively advocating for increased funding for years.
The Taskforce for Action came out in 2009 calling for a national prevention plan and proper resourcing of the sexual violence sectors, basically all the same things that the select committee has recommended again 6 years later.
Maori and non-Maori specialists gave hundreds of hours of their time, voluntarily, in the Taskforce for Action on Sexual Violence. They spent hours and hours strategizing and organising and lobbying to try and ensure that victim/survivors had access to the services they needed. If this had been implemented there would have been no need for the select committee inquiry.
But even while the National party Minister for Justice called the Taskforce for Action the best road map the country had ever had for addressing sexual violence, the Government was in the process of gutting ACC support for victim/survivors. The Government told ACC that they had to make savings. In 2009 they saved $3.2billion dollars by going after, amongst other things, the “low hanging fruit” of sensitive claims. These changes resulted in a 36% decline the number of claims being lodged and even more shockingly the number of accepted claims going from 60% to 3.6% in just two years. Specialist agencies stopped using ACC because they thought it was unsafe for survivors and the number of ACC counsellors halved. During the inquiry into sexual violence funding we heard from a man whose partner had killed herself because she couldn’t get the support she needed over this time.
Many therapists and counsellors and volunteers just kept going, under increasing strain themselves, because they knew that people were depending on them. This was a truly awful time in New Zealand’s history.
Public concern over these changes forced Minister Nick Smith to initiate a review in 2010.The Disley report in 2010 made fourteen recommendations to fix the mess. Considerable effort has been made since then by ACC, the community and others to try and restore ACC. In the select committee report much has been made of the improvements to ACC. A new model is in place and it is much better but we are still not there yet.
Ahead of the budget and future work, I just want to celebrate the bloody minded tenacity of survivors and advocates who have kept going through this very dismal time. I genuinely and wholeheartedly hope the Government doesn’t let us all down again.

© 1996-2015 The Green Party of Aotearoa New Zealand

https://blog.greens.org.nz/2016/04/01/sexual-violence-services-the-real-story/

ACC sex abuse processes 'need review'

An article from Stuff by Paloma Migone

ACC needs to urgently review its assessment process for adults who were abused as children and left with mental health problems, an independent report says.
Dr Barbara Disley today released the second monitoring report of ACC's progress on the development and implementation of 14 recommendations given by a 2010 Sensitive Claims Clinical Pathway review. In the report, she said there were concerns within the sector over the processes around independent assessment for cover.
"While there have been improvements including the ability of the support counsellor to attend these assessments with the client, the narrow range of tools applied to determining mental injury and the limited number of professional groups who can administer these tools leads to bottle necks and delays in cover determination," she said.
"ACC needs to urgently review the assessment processes within the adult claims coverage context and broaden the range of tools and professional groups capable of undertaking these assessments."
Disley said it was particularly important for adult survivors of child sexual abuse as the needs of the group were often complex and required specialist knowledge.
"A specific focus on the needs of this group needs to be now initiated," she said.
The number of clients that moved through the cover assessment process was low, falling dramatically since 2007 to 2011 from 5919 to 235 respectively. It could be that the recently-implemented 16 support sessions available were sufficient for some clients, but ACC needed to ensure that the process of cover determination itself was not to blame.
Disley also said Maori must be given priority as progress in that area has been slower than expected. The process for children and adolescents in relation to accessing immediate support and moving through the cover process had improved however.
Overall, Disley found ACC had made "excellent progress" implementing one recommendation and good progress on another six.
"In the 18 months since the initial, independent review, ACC has made significant changes to the way it deals with sensitive claims, and these changes have seen considerable progress achieved in many years."
However, she said: "There's still work to be done in some areas."
The 2010 review, requested by then ACC Minister Nick Smith, made 14 recommendations, including that a process be established to independently monitor the development and implementation of the review's suggestions.

© 2012 Fairfax New Zealand Ltd

http://www.stuff.co.nz/national/7292703/ACC-sex-abuse-processes-need-review

Recent Sensitive Claims Advisory Group (SCAG) meeting

Information from the New Zealand Christian Counsellors Association

The Sensitive Claims Advisory Group (SCAG) met on the 18th and 19th October in a working session to focus on:
* Service issues, gaps and improvements for children and adolescents
* Approaches to mental injury assessment and alternatives to DSM-IV
* Feedback on the implementation of the 16 hours of support
* Support for returning clients
* Sexual abuse provider workforce development needs

Outcomes from the session included:
* Agreement on a number of principles for working with children and adolescents and subsequent recommendations for further service improvement and development.
* Formation of a working party to focus on and progress child and adolescent service improvements. The working party will included representatives from the New Zealand Association of Psychotherapists, New Zealand Association of Counsellors, Aotearoa New Zealand Association of Social Workers, New Zealand College of Clinical Psychologists and Te Ohaakii a Hine - National Network Ending Sexual Violence Together (TOAH-NNEST). The first meeting will be held on 2 December in Wellington. ACC is also investigating a range of possible representatives from the wider sector including health, education, DSAC and Maori and Pacific groups to act as a secondary consultation and advisory group.
* Generation of a range of alternative assessment methods for mental injury which are currently being reviewed by ACC.
* Establishment of a Maori working group to focus on developing culturally appropriate and safe services for Maori with the first meeting on 26 November in Wellington.
* Endorsement for ACC to work closely with the professional bodies representing service providers to establish a process for addressing quality and workforce issues.
* Identification of a preferred approach for working with Pacific people in sensitive claims and discussion regarding the formation of a working group.

http://www.nzcca.org.nz/acc/

ACC independent review supports national outcry to stop pathway

An article from Te Whariki Tautoko by Ripeka August–Tampeau

Ka tangi te titi, ka tangi te kaka, ka tangi hoki ko au.
Kii mai koe ki ahau, he aha te mea nui o te ao?
Maku e kii atu he tangata, he tangata, he tangata.
(Author unknown)

You ask me “what is the most important thing in this world” and
I must reply “It is people, it is people, it is people”.

And that is exactly what the Independent Review Panel clearly concluded in their recommendations to the Minister of ACC, Nick Smith. The review concluded the pathway needed an urgent overhaul to its generic clinical pathway process to better support the needs of victims of sexual assault. ACC’s response was immediate with the introduction of the much needed counselling support sessions.
The review panel is also clear that immediate changes to the pathway are not possible. As a result ACC have supported the recommendations and started working with the Sensitive Claims Advisory Group (SCAG) to begin developing and implementing a new clinical pathway based on the recommendations.
The Independent Review panel addressed serious concerns to the poor response by ACC to Maori victims of sexual assault and their whanau. As a result of the clinical pathway many Maori counsellors refused to support this pathway further reducing the already under representation of ACC Maori counsellors. The damage of the clinical pathway was felt by many and was responded to by many. Recently, ACC general manager and SCAG members agreed to a separate working group to develop and implement a tikanga Maori pathway and this is to happen as soon as possible.  
Although Maori are happy that changes have begun, there is still the thought “will ACC follow through”. It is clear there is still further work for ACC to do and in consultation with Maori stakeholders to “get it right”.

http://www.tewharikitautoko.org.nz/portfolios/acc-scag

The sensitive claims pathway for Maori

Erina Smith from Te Karere talks to counsellor Ripeka August-Tampeau and ACC's Denise Cosgrove

Maori healthworkers are overjoyed at the new recommendations that have been put to ACC regarding their sensitive claims pathway for sexual abuse victims. There is a Maori pathway to heal Maori victims of sexual abuse.
Ripeka August-Tampaeu: "The changes that we recommended have finally been addressed and now we're goign to get on and do something about it." This is a result of an independent review of the changes ACC made to their sensitive claims pathway for sexual abuse victims in order for them to receive help. "The recommendation that we put in was to have a separate pathway for Maori or an alternative pathway for Maori to have and out of that look at tamariki and rangatahi as well.  So we're looking at starting that as soon as possible."
Te Karere followed Ripeka August and other Maori sexual abuse workers in July when they put forward their submissions to the independent review panel. Their work has paid off. "We'll be bringing together a group of rangatira Maori within the field of sexual assault and rangatira Maori within te ao Maori to come together and develop a pathway."
ACC agree that action is required in some areas. Denise Cosgrove: "So we've done some really good work already with the sector on understanding their issues and concerns with the pathway and how we can make that and facilitate that process better for our clients." Despite the challenges of this job, the positive thing is that Maori now have the power to be able to build their own pathway to heal their own people.

© 2010 Television New Zealand Ltd
http://tvnz.co.nz/te-karere/2010-wednesday-video-1027496

Sunlight is the best disinfectant

An article from Beehive Chat by Tariana Turia

Last week's announcement by ACC to provide up to sixteen counselling sessions to sexual abuse survivors while their claim is being dealt was welcome news. Last year ACC implemented a new policy that required people subjected to sexual abuse to prove they had suffered a mental injury before they would pay for counselling.
I cannot think of a worse ordeal for anyone who has endured the life-changing crisis of sexual abuse, to have to then prove that it had affected their mental health and wellbeing. And so I am not at all surprised that when the Clinical Review Panel looked into the impact of the policy changes, they found that only half as many victims of sexual assault are applying for ACC support this year compared to last. But if that is not bad enough, many who do apply are declined or face significant delays in getting support. Fliss Newtown's comments in this newspaper over the weekend that she is receiving two new enquiries a week from sexual abuse survivors is consistent with other reports I have received over the motu.
A World Health Organisation study in 2007, found that one in four New Zealand girls is sexually abused before the age of fifteen, the highest rate of any country studied. The rate is even higher for Maori women and for women with disabilities. And yet despite the high rates of prevalence, sexual abuse is still something that society fails to recognise as being significant.
Sexual abuse has devastating impacts on the lives of far too many New Zealanders. It decimates your confidence, it can destroy your faith and trust in others, it literally throws your life out of balance. Childhood sexual abuse has been shown to effect educational chances; the impacts are played out in courtrooms and prison cells and hospital beds and drug and alcohol treatment units and psychiatric institutions.
I am pleased that ACC has recognised the importance of providing immediate support for sexual abuse survivors but we cannot put all the responsibility on Government agencies to fix this problem. Quite simply ACC is the ambulance at the bottom of the cliff.
Of course Government must ensure we have quality services available and effective programmes to provide immediate support for individuals and whanau dealing with sexual abuse. But most importantly we have to look in our own backyard and be sure that we are doing everything we can to ensure the safety of our own family and community. It is unacceptable to know that sexual abuse is going on and to do nothing about it.
I know that for families facing this issue, the road to creating a safe environment is long and fraught with so many challenges. But we must mobilise public support and attention to ensure we bring it out into the open. As they say, sunlight is the best disinfectant. The bright light of scrutiny and openness enables all of us the opportunity for change.

© 2010 Maori Party
http://www.maoriparty.org/index.php?pag=nw&id=1216&p=beehive-chat-sunlight-is-the-best-disinfectant-hon-tariana-turia.html

Counsellor welcomes ACC rethink on abuse

An article from the Wanganui Chronicle by Laurel Stowell

A partial back-track by ACC on treatment for people who have been sexually abused is a step towards a more compassionate system - but not a fix, Wanganui counsellor Fliss Newton says.
In September last year ACC moved to a new treatment pathway, requiring proof that people who had been raped or otherwise sexually abused had suffered a "mental injury" before it would pay for their counselling. Before that Ms Newton, an ACC accredited counsellor, saw about five people a week who had been sexually abused, and she had about two new inquiries a week.
Since then ACC has offered counselling to many fewer people. Ms Newton has been seeing one such client a week, and others doing similar work in the city have also had drastically reduced numbers.
Yesterday ACC announced it would offer 16 hours counselling to people who had been sexually abused while they were waiting to see if their claims would be accepted.
Ms Newton said the 16 hours would help to relieve their pain and anxiety as they waited, often for many months, unsure where else to get help. And for some, 16 hours' counselling would be all they needed. "In my 20 years of doing this work I have had two clients that have needed really long-term help. One went to over 100 hours, but 80 per cent would get through in 16 to 20 sessions."
She still didn't like the new treatment pathway. "However, this is a good stop gap, I suppose."
Te Tai Hauauru MP Tariana Turia also welcomed the decision to give people who have been sexually abused 16 hours' free counselling while their ACC claims were being dealt with. "Everyone who has experienced sexual abuse has a right to basic support regardless of whether or not their claims stack up to ACC's criteria for sensitive claims, so I am pleased to see that the corporation has realised this."
Current statistics showed approximately one in four New Zealand girls were sexually abused, and the rate was even higher for Maori women and those with disabilities.
Despite the prevalence of sexual abuse, it was still something that society failed to recognise as being a devastating influence on far too many New Zealanders, she said.

© APN News & Media Ltd 2010
http://www.wanganuichronicle.co.nz/have-your-say/news/counsellor-welcomes-acc-rethink-on-abuse/3919218/

Turia welcomes counselling support for sexual abuse victims

A press release from the Maori Party

Maori Party co-leader Tariana Turia is welcoming the decision to enable survivors of sexual abuse to receive up to 16 hours free counselling while their ACC claims are being dealt with.
“Advocates representing survivors of sexual violence including rape have expressed to me their concern about counselling services not being made available while sensitive claims were being considered by ACC,” Mrs Turia said. “Everyone who has experienced sexual abuse has a right to basic support regardless of whether or not their claims stack up to ACC’s criteria for sensitive claims, so I am pleased to see that the corporation has realised this.”
Mrs Turia said current statistics reveal approximately one in four New Zealand girls is sexually abused and the rate is even higher for Maori women and people with disabilities.
Sexual abuse, despite the high rates of prevalence, is still something that society fails to recognise as being a significant and devastating influence on far too many New Zealanders, she said. “I will be keeping a close eye on the review currently being undertaken into how ACC deals with sensitive claims.
“The cost of sexual abuse to individuals, families and the nation is huge – it impacts on education, destroys the health and wellbeing of individuals and families and is played out in courtrooms, prison cells, hospital beds and drug, alcohol treatment units and psychiatric institutions.
“We must value the counsellors, therapists, social workers and those who keep our crisis services alive.”

http://www.scoop.co.nz/stories/PA1008/S00192/turia-welcomes-counselling-for-abuse-victims.htm

Concerns about ACC heard by a review committee

A news report from Te Karere




http://www.youtube.com/watch?v=DCOVbxYZTk8

ACC changes - background information

An article from ANZASW NoticeBoard by Cathy McPherson

In May 2009 ACC counsellors received forms requesting information on qualifications, recent training and preferred treatment modalities - no reason for this was given, though it was obviously in preparation for selecting preferred treatment modalities.

On August 10 2009 Dr Peter Jansen, Senior Medical Advisor to ACC, and Ann Aitcheson began rolling out ACC’s “Clinical Pathways”, the plan to radically change how the Sensitive Claims Unit managed new claims. This came as a complete shock to all counsellors, psychotherapists, social workers and some psychologists working with survivors of sexual abuse. ACC intended these new pathways to be implemented on 14 September - a whole three weeks’ notice!

The Clinical Pathways project had been developed away from counsellors, psychotherapists and social workers. SCAG was ignored and TOAH NNEST (Te Ohaakii A Hine - National Network Ending Sexual Violence Together), which had been working with Government Ministers for two years, had heard nothing about what was being planned either.

Further, the Clinical Pathway has been implemented without consultation with Maori, and lacks connection with appropriate pathways to help Maori claimants. In discussions with Maori members of various professional bodies, many Maori feel the mainstream systems again have not yet recognized the resources and richness of healing methods for dealing with victims of sexual violence which can be used by Maori counsellors. There have been numerous attempts as groups and individuals to keep the Maori voice vocal. Although the new system is in place now it is important to continue to challenge this ACC process, and its lack of safety for Maori clients particularly. Pacific Island groups had not been consulted either, nor any other ethnic groups.

SCAG members believed that the announcement of the new Pathways was deliberately chosen to occur between the SCAG meeting in March (where there was no mention of the new Pathways) and the next scheduled meeting in October.

Widespread anger and discontent from all NZ counselling, social work and psychotherapy associations along with organisations such as Rape Crisis (as well as clients and ex-clients) directed at ACC and the Minister of ACC, Nick Smith, in response to the proposed changes. Bowing to pressure from professional bodies, Peter Jansen then decided to delay implementation date by a month while ACC “consulted” with professional organisations. Submissions were called for. Consultations, however, constituted professionals being informed what the clinical pathways entailed.

SCAG members wrote to Nick Smith requesting a meeting. Despite numerous follow-up calls, no meeting eventuated because of his firm refusal to meet with us.

September 18 at the NZAC Conference in Hamilton, Peter Jansen and David Chapman attended an ACC Forum along with a vocal group of counsellors. Dr Jansen would not back down on his desire to see the Pathways implemented, and continued to reiterate that ACC was following the Massey Guidelines and “best practice”. Some counsellors walked out in protest at his refusal to hear their concerns and put the changes on hold until further full consultation.

In media interviews Dr Jansen told reporters that claimants who are denied counselling can easily access counselling through other community agencies, mental health providers, etc, which most counsellors in every region believe is not the case.

September 30 TOAH NNEST met with ACC and its Tauiwi caucus presented ACC with their Principles for the Development of a Clinical Pathway. ACC insisted on using DSM-IV even though there are other assessment methods which show clear links between the abuse and its effects.

ACC met with SCAG on October 2 and SCAG requested an urgent workshop to precede implementation of the Pathways. This request fell on deaf ears. However, it was announced that the Pathways would be delayed yet again for another two weeks to further “consult”. No actual consultation took place.

During the period from early October to the implementation of the Pathways on October 27 ANZASW along with members of all counselling associations took every opportunity to issue press releases, write to ACC and Nick Smith, talk with government and opposition MPs and spread the word through community agencies and local and national media. On October 28, a day after implementation date, further changes to Pathways announced. ANZASW, together with other professional bodies, makes yet another press statement about our concern about unsafe, unethical practices.

Press releases on the ethical implications of the Pathways given to media by NZAC.

On October 27 an online petition with almost 4000 signatures, calling for the Pathways to be stopped, was presented to Parliament. Many professional announce that they will not accept futher ACC referrals under the new system.

The same day ACC Minister Nick Smith announced an “independent” review of the ACC Pathways which would be finalized after six months (after repeatedly stating that the Government was not getting involved in the issue).

By the time you are reading this column no doubt other significant events will have taken place. One of the positive outcomes of these struggles is that the counsellor, psychotherapy and social work associations are communicating with one another, strategising, sharing experiences and supporting one another through this exhausting process.

MASSEY UNIVERSITY HAS NOW DISTANCED THEMSELVES FROM ACC’s USE OF THEIR RESEARCH SAYING IT IS BEING INAPPROPRIATELY INTERPRETED – which makes their frequently quoted “best practice” a mockery and vindicates what professionals have been saying all along.

Why are we objecting to the Clinical Pathways?
• Lack of safety particularly for Maori. There have been continued promises for ‘hui’ with Maori that never eventuate.
• Lack of safety for Pacific Island clients.
• Lack of action about different arrangements for children and adolescents, even though these have been promised by Peter Jansen.
• Lack of consultation with professionals in the field.
• Misuse of Massey Guidelines (2008) e.g. that 16 sessions is a suitable limit for most counselling survivors of sexual abuse. ACC was taking a comment made about a specific set of circumstances - adult victim of one sexual assault - and applying it to all survivors, e.g. childhood sexual abuse survivors who may have suffered numerous events and possibly numerous abusers. As stated above, Massey have finally spoken up about misuse of their research.
• Unethical aspects of the new Pathways - e.g. multiple assessments carried out at the beginning of ACC’s new process where many clients are likely to be unsafe. Clients would not have enough time to develop a therapeutic alliance with one counsellor – critical for positive outcomes for the client.
• The risk that some clients may become emotionally/psychologically unstable early in the disclosure process, where there is no provider clearly accountable to ‘hold’ the client through that early process of trying to establish a claim, is significant.
• There may be mental health casualties when potential claimants’ requests for help are not easily accepted, or their claims declined.
• Longer-term therapy with more complex clients under ACC is likely to disappear. Offering shorter term affectual symptomatic relief, on its own, is likely to lead to poor results.
• Insistence on the use of DSM-IV and assessment of ‘mental injury’ so early in the counselling process may create problems for people’s career paths, insurance prospects and future travel, and is quite inappropriate for children and adolescents. Somehow, requirement of mental injury has been transformed into a requirement for mental illness diagnosis with no legislative change. A legal challenge has been commenced on this issue.
• ACC foisting the Pathways on us under the guise of ‘concerns’ that it has regarding some ACC counsellors working too long with their clients, or that many counsellors are unable to write satisfactory ACC reports, is short-sighted. ACC could easily monitor these “rogue” counsellors and suggest targeted training to bring them up to the mark; it did not need to change the whole system.
• The preference for clinical psychologists and psychiatrists to carry out client assessments so early in the process, instead of permitting counsellors to complete their own assessments, when psychologists, on the whole, have not been the main group in the past who are experienced in delivering treatment interventions to traumatized clients, is limiting and not best practice. ACC does not appear to value the establishing of the therapeutic relationship as a tool for healing.
• The overseeing of the continued treatment (after the assessment) of the client’s therapy by ACC psychologists is another problem, which reduces therapeutic creativity, adherence to CLIENT and provider goals together, and inhibits other modalities effective operations. This was NOT a recommendation by the Massey Guidelines researchers!!
• Lack of clarity of choice for clients as to who carries out their assessments or becomes their later counsellor provider.
• Lack of consultation with Mental Health and NGOs about ACC’s expectation that declined clients will be absorbed by these organisations.
• Victims of crime (sexual abuse survivors) are being exploited by ACC in the name of saving money, despite the National-led government promise to create better outcomes for these people.
• SOCIAL WORKERS ARE NOT DEEMED TO BE ABLE TO USE DSM-IV SO NEED TO REFER TO A PSYCHOLOGIST FOR THEIR CLIENTS TO BE ASSESSED - WE BELIEVE THIS TO BE INSULTING TO OUR PROFESSION.
• Privacy requests by ACC in the new pathways go too far for the purposes of the ACC’s need for information at the point of entering the ACC system. Clients may lose many aspects of their own privacy if they sign the form required at the outset by ACC.

In conclusion, at this point of writing (early November 2009) we are still hopeful that there can be some turnaround or embargo placed on the ACC’s Clinical Pathway. We desire ACC to hold proper consultation with clinically-trained professionals who have already worked in this specialized area of trauma treatment. From this ACC could develop improvements that will make it safer and more ethical for clients and providers, for Maori and Pakeha, for complex needs clients, and for children and adolescents to receive the ACC rehabilitation under the ACC regulations which they are entitled to as victims of crimes.

These issues affect all of our profession. Please make your protest known to ACC. This is a social justice issue as vulnerable clients are now being denied the help they are entitled to.

You can email the architect of these changes with your concerns: peter.jansen@acc.co.nz.

Please email me with any concerns or ideas on how we can challenge this extremely abusive process: cathy.mcpherson@goalscentre.co.nz.

Copyright © 2010 Aotearoa New Zealand Association of Social Workers
http://anzasw.org.nz/user/file/428/NB%20December%20Final.pdf

Questions for written answer

19852 (2009). Lynne Pillay to the Minister for ACC: In terms of the preparation for the implementation of Sensitive Claims Clinical Pathway, have all necessary tools been developed, if so what tools, if not why not?
Hon Dr Nick Smith (Minister for ACC) replied: Yes. ACC has the tools it needs in place for clients, providers, and its own staff. Many of these tools are available online. These include processes and procedures, FAQs, forms, letters, data capture and reporting tools, and induction processes. These tools will continue to be improved on the basis of experience, and new tools will be developed as the need arises. For example, as part of the work with Corrections, tools will be developed specifically for use in the prisons. Further work is being done on tools specifically for use with children and young persons.
http://www.parliament.nz/en-NZ/PB/Business/QWA/9/0/0/QWA_19852_2009-19852-2009-Lynne-Pillay-to-the-Minister-for-ACC.htm

21300 (2009). Lynne Pillay to the Minister for ACC: In terms of the preparation for the implementation of Sensitive Claims Clinical Pathway, have all systems been clearly communicated enabling professionals in the field to advise clients on the process and what they can expect, including the timeframe for assessment and approval ?
Hon Dr Nick Smith (Minister for ACC) replied: Yes. ACC has kept in contact with its providers, and has provided information by email, post, workshops, presentation, personal communications, and online. Timeframes for assessment and approval are also available with the expectation that when a claim is made the required information is provided to enable a decision.
http://www.parliament.nz/en-NZ/PB/Business/QWA/e/d/f/QWA_21300_2009-21300-2009-Lynne-Pillay-to-the-Minister-for-ACC.htm

21476 (2009). Lynne Pillay to the Minister for ACC: Has ACC implemented the clinical pathway in advance of having in place the appropriate treatment plan for Maori?
Hon Dr Nick Smith (Minister for ACC) replied: No. Cultural competence is included in each treatment provider’s contract with ACC. Both the Code of Health and Disability Services Consumers' Rights, and relevant professional standards, require all health providers to take account of cultural aspects. ACC has published guidance on Maori preferences to ensure providers can meet these requirements. These are the Hauora competencies which can be found on ACC’s website at: www.acc.co.nz . ACC has a dedicated Pae Arahi (Maori Cultural Advisor) with the Sensitive Claims Unit and also works closely with Dr Catherine Hong (Manager of Cultural Services, ACC) to address issues for people of other ethnicities. Each treatment plan developed for clients takes into consideration the client’s clinical and therapeutic needs, as well as their context which includes cultural needs, geographical location, employment or other relevant circumstances.
http://www.parliament.nz/en-NZ/PB/Business/QWA/1/4/5/QWA_21476_2009-21476-2009-Lynne-Pillay-to-the-Minister-for-ACC.htm

21533 (2009). Lynne Pillay to the Minister for ACC: What sensitive claims, since 1 November 2009, are now pending with ACC that involve counselling for sex abuse victims and/or victims of domestic violence in Wairarapa?
Hon Dr Nick Smith (Minister for ACC) replied: Between 1 November and 11 December ACC received seven claims from the Masterton District. ACC has sought more information from providers for four of these claims and the other three are waiting for clinical assessment.
http://www.parliament.nz/en-NZ/PB/Business/QWA/2/2/1/QWA_21533_2009-21533-2009-Lynne-Pillay-to-the-Minister-for-ACC.htm

22490 (2009). Lynne Pillay to the Minister for ACC: Does the victim of a sex crime have to be classified as having a mental illness before ACC will fund any treatment?
Hon Dr Nick Smith (Minister for ACC) replied: Mental injury has always been a requirement, defined under legislation, in order for ACC to accept cover for a sensitive claim. There are two exceptions. These are intervention in the immediate aftermath of assault/abuse when the Doctors for Sexual Abuse (DSAC) and Sexual Assault and Treatment (SAAT) contracts apply, and treatment for physical injuries that have resulted from the assault. In these situations ACC contributes to a wide range of services, such as District Health Boards and general practice or other primary care services.
http://www.parliament.nz/en-NZ/PB/Business/QWA/a/c/e/QWA_22490_2009-22490-2009-Lynne-Pillay-to-the-Minister-for-ACC.htm

ACC accused of discriminating against Maori and women

A news report from Te Karere



http://www.youtube.com/watch?v=rd6FHVV3mFY

ACC changes discriminate against Maori women

Press release from the National Collective of Independent Women's Refuges Inc

Women’s Refuge supports the views of the National Council of Women, expressed this week in their media release outlining the discriminatory treatment of Māori women by ACC
“Although Māori women are most likely to be clients for ACC subsidised counselling, this has not been adequately considered in the implementation of the ACC Sensitive Claims clinical pathway,” says Denise Reynolds, Kaiwhakahaere for the National Collective of Independent Women’s Refuges.
Ms Reynolds says, “Although Māori kaupapa models for counselling may be in development, we are very concerned that Māori women’s needs have not been prioritised by ACC, when they are evidently in the highest risk group. Nor have Māori providers been adequately consulted and we agree with the National Council of Women, that communication must be opened up, as a matter of urgency.”
“Failure to consult with Māori on this issue, is in fact a breach of the Crown’s obligations under the Treaty of Waitangi as well as a breach of the United Nations Declaration on the Elimination of All Forms of Racial Discrimination to which New Zealand is a signatory.”
Heather Henare, Chief Executive for Women’s Refuge says, “Limiting accessibility to these services breaches other international obligations too, such as the Convention on the Elimination of All Forms of Discrimination Against Women under which states are obliged to ensure women’s equality and guarantee a number of rights. I believe the state has a legal and moral duty to provide accessible, voluntary support services for women victims of sexual abuse.”
She says, “Sexual abuse is a form of violence. Some 80% of women who access Refuge services have a history of sexual abuse or rape.”

http://www.scoop.co.nz/stories/PO0912/S00148.htm

Maori Party looks at claims of ACC discrimination

Press release from the Maori Party

The Maori Party will be looking into claims that Maori women are being discriminated against by ACC.
“We are very concerned to hear from the National Council of Women that Maori women in need of counselling for issues like rape and sexual abuse are not getting the service they need because of what appears to be a flawed policy of ACC,” Maori Party MP Rahui Katene said.
“We are also concerned to hear that ACC has cancelled hui that it promised to hold to sought out this issue."
The council claim that ACC’s sensitive claims clinical pathway not only discriminates on the basis of gender but also on race.
Maori are more likely to be a client for ACC subsidised counselling and women over all make up 82% of the claimants with Maori women being heavily represented in that percentage.
“We’ve heard stories that Maori women are leaving Maori counselling services in tears because they can not be guaranteed that the counsellor will be the one they deal with all or most of the time,” Mrs Katene said.
“It takes so much courage and strength for these women to even step through the door of a counselling service that it would be really unfair to expect them to keep baring themselves over and over again to different counsellors – they need to be given an assurance of security and stability.”
The council claimed that ACC was in breach of the United Nations’ Convention on the Elimination of All Forms of Racial Discrimination: because of its sensitive claims clinical pathwa policy.
“We’ll be talking with the minister responsible for ACC to see exactly what is happening,” Mrs Katene said.

http://www.scoop.co.nz/stories/PA0912/S00167.htm

Discrimination against Maori women

Press release from NCWNZ

More information about the ACC Sensitive Claims clinical pathway is coming to light, says the National Council of Women of New Zealand (NCWNZ); this information suggests not only discrimination on the basis of gender, but also on race.
According to ACC, Maori are more likely to be a client for ACC subsidised counselling. Women over all make up 82% of the claimants; and while it is known that Maori women are heavily represented in this percentage, ACC is currently unable to confirm what the actual ethnicity breakdown is.
“The SC clinical pathway was implemented in advance of ACC establishing what, or which kaupapa Maori treatment plans will be utilised,” said Elizabeth Bang, NCW National President. “Best practise would have set Maori women’s treatment needs as the first priority, given they are the majority population at risk.”
Hui that have been promised by ACC and the Minister of ACC to resolve this highly significant problem have been cancelled. It is not clear whether future Hui will include Maori providers and their representatives working at the coal-face, being invited to the consultation table.
“Some Maori counsellors are feeling particularly frustrated, as they have young Maori women arriving at their doors, wanting to access ACC subsidised counselling; but no guarantees can be made to these young women that the counsellor sitting opposite them will be on the ACC recommended treatment providers list,” says Elizabeth Bang. “These women are leaving in tears. The Maori providers have tried to open the lines of communication with both the Minister’s office and ACC, but no progress eventuates.”
The SC clinical pathway breaches the United Nations’ Convention on the Elimination of All Forms of Racial Discrimination:
Article 1 of the Convention defines "racial discrimination" as any distinction, exclusion, restriction or preference based on race, colour, descent, or national or ethnic origin which has the purpose or effect of nullifying or impairing the recognition, enjoyment or exercise, on an equal footing, of human rights and fundamental freedoms in the political, economic, social, cultural or any other field of public life.
Whether a particular action or policy discriminates is judged by its effects.
In seeking to determine whether an action has an effect contrary to the Convention, it will look to see whether that action has an unjustifiable disparate impact upon a group distinguished by race, colour, descent, or national or ethnic origin.
“Since Maori women are more likely to be affected by the changes to ACC, why are they the last to be consulted” questions Elizabeth Bang.
Information received from ACC suggests that they have now identified areas of importance where ACC will further develop advice or parts of the pathway. These include assessment of children and adolescents, counselling using kaupapa Maori models, clients in prison, clients who have alcohol and other drug dependencies, clients with intellectual disability.
“This ship is already sailing and we have no idea have ACC is currently processing claims from Maori women. Are they being held on to till ACC makes a decision on kaupapa Maori models, and when exactly will that be happening?” concluded Elizabeth Bang.

http://www.scoop.co.nz/stories/PO0912/S00091.htm