Monitoring report on sensitive claims management released

A press release by ACC

The second independent monitoring report of ACC’s management of sensitive claims, prepared for the ACC Board by Dr Barbara Disley, was released publicly today.
The report follows an interim monitoring report released in May 2011, and assesses the progress ACC has made implementing recommendations made by an independent panel, which reviewed ACC’s sensitive claims clinical pathway in 2010.
The recommendations covered a wide range of actions, from improving communications with clients, to working closely with sector representatives to refine ACC’s systems and processes, and examining ways to ensure treatment and assessment is carried out by a well qualified, fit-for-purpose workforce.
Dr Disley found ACC has made excellent progress implementing one recommendation and good progress on another six recommendations. Some progress was noted on five recommendations, with progress on one recommendation assessed as “limited”. The final recommendation, involving establishing a process to independently monitor progress, was assessed as having been “achieved”.
Dr Disley sought in-depth input from ACC to compile the report, which was also informed by:
• an online survey of clients and service providers
• interviews with service providers and representatives of professional bodies
• feedback from the Department of Child, Youth and Family.

Summing up the findings of the report, Dr Disley said “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 areas.
“There’s still work to be done in some areas, and my report contains recommendations on how ACC can continue to make progress towards fully implementing the original recommendations made by the independent review panel.”
ACC’s General Manager of Claims Management, Denise Cosgrove, says the report provides a fair assessment of progress to date.
“We’ve worked hard to make many different types of changes aimed at improving services for our clients. I’m pleased that the report recognises the progress we’ve made in many areas. We acknowledge there’s still work to be done, but we’re committed to full implementation of the recommendations and keeping the momentum going by making ongoing improvements, and we’ll be seeking the right support to help us do that.”
Ms Cosgrove added that “a key focus for ACC moving forward is our commitment to client care and safety.”
A copy of the final report can be found here: Monitoring Report on the Implementation of the Recommendations from the Independent Panel’s Review of the ACC’s Sensitive Claims Clinical Pathway: 18 Months Follow up (PDF 525K) [Scoop copy: wpc112862.pdf]

http://www.scoop.co.nz/stories/PO1207/S00195/monitoring-report-on-sensitive-claims-management-released.htm

Acclaim Otago launches independent ACC survey

A press release from Acclaim Otago (Inc)

As a support group for injured people, Acclaim Otago is concerned that there is very little in the way of current and independent data available that accurately describes aspects of an injured person's experience with ACC.
Acclaim Otago’s president, Dr Denise Powell says, “This is especially obvious when talking about rehabilitation and Vocational Independence. We are hearing anecdotally, that people are being exited from ACC without first receiving meaningful rehabilitation”.
ACC has recently said that "rehabilitation always comes first" but Dr Powell says “We have no simple way of finding out if this is correct or not. ACC does not currently keep data that identifies what happens once a person exits the scheme and we believe that is a huge gap. This survey aims to find out what happens to people who are clients of ACC.”
“We hope to use the survey results to make recommendations that will substantially improve the experience of injured people in New Zealand. We believe any improvements we can identify to the scheme will benefit not just the ACC and their clients, but potentially generations of New Zealanders to come” Dr Powell states.
The survey can be found at https://www.surveymonkey.com/s/ACCLAIMsurvey1
Or by clicking the link on Acclaim Otago’s webpage www.acclaimotago.org
Or from Acclaim Otago’s Facebook page

http://www.scoop.co.nz/stories/PO1207/S00123/acclaim-otago-launches-independent-acc-survey.htm

Cool response to ACC payout offer

An article from the Dominion Post by Shane Cowlishaw

ACC has paid out almost $50,000 for eight privacy breaches in the past three years.
It refused to reveal the amount of each payment, other than to say that none was for more than $15,000. The payments contrast with offers of just $250 each to clients of the sensitive claims unit whose privacy has been breached in recent cases.
The corporation's privacy practices have been under the spotlight since The Dominion Post revealed in March that ACC had mistakenly released the names and details of 6500 claimants, including 250 sensitive-claims clients who are victims of sexual abuse and violent crimes. The blowout has seen the departure of ACC chairman John Judge, chief executive Ralph Stewart and board members John McCliskie, Rob Campbell and Murray Hilder. Both the privacy commissioner and auditor-general are investigating the breach.
Details provided under the Official Information Act show that, from 2009-11, ACC made eight payments totalling $48,897 for privacy breaches. It declined to provide a summary of each breach, although it agreed to provide a generic description.
Last month, ACC sent apology letters to those sensitive-claims clients who had expressed their anger at the recent breach and offered $250 if they agreed to stay silent. One client, who received her letter only last week, said she found the offer insulting. ACC had breached her privacy several times in the past and had been forced to pay her a "significant" amount, but despite this it kept happening.
"It's just crap, and it reeks of ACC trying to cover its rear end.
"I think for those that maybe this is a first time it may be reasonable. However ... I don't give a toss what they say about how much or how little the information is, the fact is my name and details were going around the countryside."
Lawyer John Miller, who specialises in ACC cases, said while the recent privacy breach may have been towards the lower end of the scale, many people knew that some clients had received thousands of dollars in other cases. It was hard to know if the $250 was simply a starting negotiating price from ACC, but regardless he believed the offer was a "derisory" sum that "just adds fuel to the fire".
"Rather than low amounts of money, it's often better sending a substantial gift basket with someone coming around apologising."
An ACC spokesman said it would be wrong to comment publicly on any details of financial settlements provided to clients. Details about how many $250 offers had been made and and accepted could not be provided at this stage, he said.

Privacy Breach Payouts (2009-2011)
Generic details of eight breaches provided by ACC:
2 – Released claim information to an unauthorised third party.
2 – Delay in providing personal information to a client.
1 – Requesting information from a medical provider that was not limited to the client's claim.
1 – Withheld personal information incorrectly and delayed in providing personal information to a client.
1 – Failed to provide personal information to a client.
1 – Released claim information to medical providers who were not relevant for the purpose of an assessment.

© 2012 Fairfax NZ News

http://www.stuff.co.nz/national/7243065/Cool-response-to-ACC-payout-offer

ACC change must not go too far

An editorial from the New Zealand Herald

Changing the "culture" of an organisation is a subtle exercise, requiring care to see that it does not go too far. The Minister in charge of the Accident Compensation Corporation, Judith Collins, has taken drastic steps to change its culture since the Bronwyn Pullar business. The previous chairman, chief executive, two board members and several officials have departed. Now it has been given new orders: improving "trust and confidence" has replaced "cost containment" as the first priority.
The minister had been under pressure to go much further and change the corporation's primary aim of rehabilitation. Labour and the Greens have criticised staff incentives to get patients back to work as soon as possible. They call it "depriving people of their entitlements". Inevitably, they believe, some people will be driven back to work too soon. It should be remembered that nothing in the Pullar case supported that suspicion. She was aggrieved that the corporation would not provide her with an income but gave the public no evidence to strengthen her claim. Her disclosures concerned other cases accidentally "leaked" to her in an email from ACC.
That privacy breach turned out not to be as serious as she had led the country to believe. The "patient details" were no more than names, a case number that could identify the nature of each name's claim, and an indication of the outcome of a review of their claim.
The Privacy Commissioner has told patients it was mostly inoffensive information at the lower end of seriousness. The corporation has offered them consolation payments of something less than $500. The sum seems proportionate to the offence.
It is much harder to restore a sense of proportion to criticism of ACC's culture. The attitude expressed in messages between ACC staff, which Ms Pullar had also obtained, was as telling as the tape of the meeting in which her supporter, Michelle Boag, mentioned the leak to ACC officers.
The careless language and loose accusations in ACC's internal exchanges were probably the reason the minister took drastic action. It was an insight into a culture that has been been too hard on some categories of claim, especially those requiring surgery, as Herald investigations had found. Too many rejections of those claims have been reversed on appeal.
But it would be too easy to replace that culture with one at the other extreme. ACC cannot be an automatic entitlement with no questions asked. It is an unusual system, copied by no other country, in its uncritical attitude to the cause of injury. "No-fault" compensation may be a good way to save lawyers' fees but the same unquestioning principle could not be applied to medical assessments. When ACC seeks a second opinion, though, its medical officers must not influence it as they clearly tried to do in the Pullar case.
ACC is funded by employers, motorists and taxpayers as insurance against sudden disability. It offers cover that ordinary commercial insurance provides elsewhere. Since New Zealand has to be competitive it is vital that ACC's costs are not out of line with workplace insurance in other places. It has to ensure it is paying out only for genuine injuries and for loss of income only for as long as the claimant is genuinely unable to work.
Ms Pullar reportedly received $1 million from a private company for the injury for which she also sought ACC support. Since private insurance can set its own premiums, within the bounds of competition, it can afford to be more lenient. As a public insurer, ACC has to be rigorous.
But it should also be sensitive, fair, considerate and dignified in its dealings with people and its discussions about them.
That is as far as the culture change need go.

© 2012 APN Holdings NZ Ltd

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10816711

Comments 'embarrassing' for ACC

An article from the Otago Daily Times by John Gibb

Recent comments by an ACC senior manager about sharply reducing long-term claimant numbers have been "very embarrassing" for the commission, a Dunedin lawyer says.
Peter Sara said the ACC had clearly not expected comments by ACC general manager Denise Cosgrove at an Institute of Actuaries of Australia conference in Brisbane would later be made widely available via internet and podcast.
Ms Cosgrove said ACC had faced major financial and other challenges but had since cut claims costs by $3.2 billion. ACC managers had "taken the low-hanging fruit", but now faced more complex claims which made rehabilitation and return to work "a bit harder", the conference transcript said. There had been targets for "actuarial release" and "stellar results", but there had also been adverse media coverage of issues such as "sensitive claims", involving sexual abuse, and elective surgery, she said. ACC administrators had done the right things but had "moved too fast and didn't take the sectors with us", the transcript said.
Mr Sara said he was a "very strong supporter" of ACC but was "appalled" by Ms Cosgrove's comment about "low-hanging fruit", made at the conference last November.
Dunedin ACC campaigners say the comments initially "flew under the radar" but have sparked parliamentary debate and media coverage since Green Party ACC spokesman Kevin Hague tabled in Parliament last month a transcript.
Mr Sara said many vulnerable, injured people had been viewed as "ripe for the picking" and had been removed from ACC scheme coverage in recent years, but in many cases rehabilitation had not been achieved. ACC's practices needed an "extreme makeover" if it was to recapture the public trust which had been lost, he said.
Darryl Frank, a Pricewaterhouse Coopers actuary, who has worked closely with ACC, told the conference there was "constant tension between the two sides of politics" in New Zealand and "differences in political ideologies". Labour governments were "typically increasing access to benefits" but this had been "to some degree reversed" by the National-led Government since 2009, given concerns about ACC finances, he said.
Dr Denise Powell, the president of Acclaim Otago, an ACC claimant support group, said a mask had slipped and the "incredibly blatant" truth had been revealed about the removal of large numbers of long-term claimants from ACC coverage in order to meet political objectives. She had listened to the conference on a podcast, and recalled "being quite shocked, sitting there with my mouth open".
Approached for comment, ACC lead media adviser Stephanie Melville said the term "low-hanging fruit" had been "used to describe the first raft of improvements"- that is "initiatives to yield rapid positive results to systems and process".
"It does not refer to individual clients or any attempt to stop people making claims."
No client was denied ACC help "before they're ready for vocational independence", she said.

© Allied Press Limited 2012

http://www.odt.co.nz/news/dunedin/215256/comments-embarrassing-acc