The Swamp Report

29 June 2012

New ACC service and purchase agreement a reasonable start

A press release from the ACC Futures Coalition

The ACC Futures Coalition has welcomed the new ACC Service and Purchase Agreement, saying that it represents a reasonable start to the rebuilding process for ACC but pointing out that there is much to be done and also areas that the new agreement does not address.
“We think that the Minister has set out some good first steps,” said ACC Futures Coalition spokesperson Hazel Armstrong. “They should go a long way towards strengthening ACC as a public institution for the coming year. We welcome the emphasis on rebuilding public trust and confidence in ACC, but trust takes a long time to build and, as the corporation has just found out, can evaporate rather quickly. There is a strong focus on better service, which is important on a day-to-day basis, but better outcomes over a long period of time will be required to turnaround public perceptions.”
“We are not convinced that this document will deliver that on its own. For example, there is nothing in here on the need to use independent medical assessors and the emphasis is still on getting people off the scheme using vocational independence rather than a genuine return to work. Both these factors have contributed to claimant disillusionment with the scheme and need to be addressed.”
“The Agreement still also reflects the government’s commitment to full funding and has artificially high asset targets for the work and earners accounts, both of which will contribute to higher levies,” said Ms. Armstrong.
“However, there are other aspects that we see as very positive, including the commitment to more timely resolution of disputes and greater use of mediation without going to review. We welcome both of these moves.”
“The next challenge for the Minister will come when she decides on the replacements for the board members who have gone, because it is the board that will have to interpret the agreement and ensure that it is applied. Will she appoint a board that reflects the broad range of stakeholders and interests in ACC or will she stick with those who understand the money side but not ‘the broader responsibilities ACC has to all New Zealanders’ as the Minister’s press release put it? The initial response of Paula Rebstock today on Radio Live was not encouraging. All she seemed to want to focus on was the privacy question when the issues facing ACC go much deeper. We await the next steps with interest,” said Ms. Armstrong.

http://www.scoop.co.nz/stories/PO1206/S00399/new-acc-service-and-purchase-agreement-a-reasonable-start.htm

ACC shows kinder face, cuts back-to-work goals

An article from the New Zealand Herald by Adam Bennett

ACC is to soften its drive to get long-term claimants back into work in the face of concerns it is pushing clients off its books before they are properly rehabilitated.
The corporation yesterday published its Service and Purchase Agreement for the 2012-15 period in which it sets out its targets and priorities. Improving "trust and confidence" was the corporation's number one priority in the agreement, replacing "cost containment" which was top of the list last year. Its second priority in this year's agreement is "improved management and security of private information".
Since March, the corporation has grappled with a massive privacy breach and ensuing scandal, a failed attempt to prosecute claimant and former National Party insider Bronwyn Pullar for blackmail, and an increasing spotlight on its controversial strategy to bolster its financial sustainability by moving costly long-term claimants off its books. That came top of a series of articles in the Herald highlighting ACC's tougher approach to elective surgery claims.
Figures obtained by the Herald last week showed the corporation cut the number of long-term claimants receiving weekly compensation by 3644 or 25 per cent to 10,773 in the three years since June 2009.
That was well ahead of targets. Last week ACC said its target for the 2012-13 year was a reduction of 253. In the agreement published yesterday that target was reduced to 200.
Acting ACC chairwoman Paula Rebstock said that as the number of long-term claimants declined, so did the targets for reducing that tally further.
She acknowledged "there was some discussion" about having the target slightly higher for the coming year, "but the board took the view that given the new priorities and the focus on addressing some of these other issues, that target would have to be slightly lower and we lowered it".
Those priorities and issues were spelled out clearly in ACC Minister Judith Collins' "letter of expectations" to former chairman John Judge in April which was also released yesterday.
While she said the corporation had done well managing its finances, the board had a broader set of responsibilities including "ensuring entitlements are delivered fairly and transparently to all New Zealanders".
"While the gains made by ACC over the past year are very pleasing, I am aware that the initiatives taken by the board to raise performance of ACC have had many and varied impacts on claimants, health providers, and other stakeholders" she went on to say. "ACC and the way it delivers services are now seen by many in a new light ... Recent events have not helped the public image of the corporation."
Greens ACC spokesman Kevin Hague said the new agreement was encouraging.
"I'd been looking at this document as a litmus test for whether Ms Collins' language about a culture change should be assumed to be empty rhetoric or whether it's likely to have substance, and very clearly in her letter of expectations and in the agreement ... she's actually followed through so far."
Claimants advocacy group the ACC Futures Coalition said Ms Collins had set out some good first steps.
"They should go a long way towards strengthening ACC as a public institution for the coming year" said spokeswoman Hazel Armstrong. "We welcome the emphasis on rebuilding public trust and confidence in ACC, but trust takes a long time to build and, as the corporation has just found out, can evaporate rather quickly."
However, the agreement said nothing about the need for ACC to use truly independent medical assessors and it still emphasised getting people off the scheme using "vocational independence".
"Both these factors have contributed to claimant disillusionment with the scheme and need to be addressed."

ACC'S TARGETS
For culling long term claimants:
* 2009-10: 100
* 2010-11: 1150
* 2011-12: 406
* 2012-13: 200
* 2013-14: 89
* 2014-15: 50

ACC confirms testing for claimants

An article from the Dominion Post by Vernon Small

ACC's methods are again under the spotlight after it confirmed using "neuropsychological and psychological assessments" to help decide if claimants were being straightforward. That came to light yesterday after claims it uses "lie detector tests" to see if claimants are telling the truth.
Claimant Margaret Read told Radio New Zealand that ACC would not believe her statements of brain and spinal injuries, nor evidence from specialists, and applied a lie detector test.
An ACC spokeswoman declined to comment on an individual case, but said the no-fault insurer did not use lie detector tests.
Asked if any of its processes could be interpreted as a lie detector test, she said that was subjective. "What seems to be being referred to is the use of measures in neuropsychological and psychological assessments to provide some indication as to whether the client is presenting in a straightforward manner; that is, not under- or over-reporting their symptoms," she said.
"Neuropsychological assessments administer tests which look at the client's cognitive functioning (thinking functions such as language, attention, speed of thinking, memory, flexibility in thinking and problem solving skills)."
They were used to help indicate whether "clients are either minimising or exaggerating their emotional symptoms such as anxiety and depressive symptoms". This was also to determine whether the assessment results truly reflected a client's current emotional functioning.
When a client displayed evidence of a lack of effort, under-reporting or exaggeration of symptoms, ACC would try to determine why "and then provide the appropriate help the client needs to progress in their rehabilitation".
Labour ACC spokesman Andrew Little said he was "gob-smacked" by the practice, which was evidence of the distrust ACC had for claimants. "It sounds like lie-detecting to me."
Claimants' medical state was what mattered, not their personality. "They seem to be using criteria other than `is this person injured as a result of an accident?'."
Ms Read said she was asked to take a lie detector test to prove she did have spinal and brain injuries, which she passed. ACC still did not believe her and she took her battle to the courts.
"You feel absolutely shattered into tiny pieces, you keep saying `but I'm the person who's injured – why do I feel I'm being punished, why am I being bullied'."
ACC later backed down, and awarded Ms Read compensation. Taking the lie detector test had made her feel like a criminal, she said.
Lawyer John Miller, who specialises in ACC cases, said he was not aware of anyone undergoing lie detector tests at ACC. But part of the problem was that it was like an insurance company, asking so many questions people felt they were suspected of making things up, he said.
The attitude from ACC was that it was trying to minimise people's entitlements, rather than help them. "It's terrible if you're injured being at the mercy of some claims officer's views of you," he said.
ACC dealt quickly and efficiently with most people, but his clients were those at the hard end of the spectrum. "The more difficult claimants find they are treated badly by ACC and are perceived as exaggerating."
People viewed health problems they could not see with suspicion, and ACC claims officers were no different, he said.
An independent report into ACC privacy and security practices, sparked by the leak of confidential information to whistleblower Bronwyn Pullar, has been put back by two months. The inquiry, commissioned by the Privacy Commissioner and the ACC board, now has a deadline of August 23, instead of the end of this month, ACC interim chairwoman Paula Rebstock said yesterday.
The delay was caused by the volume of information that needed to be gathered and assessed.

479 Otago names on ACC email

An article from the Otago Daily Times by John Gibb

The names of 479 Otago ACC claimants appear on a list of 6725 people mistakenly emailed to Auckland claimant Bronwyn Pullar late last year, in a major privacy breach.
The names of 137 people with "sensitive claims", involving rape and sexual abuse, were also included in the national list. Several ongoing high-level inquiries, including by the Privacy Commissioner, were sparked by the email mistake. The Otago Daily Times, through an Official Information Act inquiry to ACC on March 16, sought the number of Otago claimants involved.
Dr Denise Powell, the president of Acclaim Otago, an ACC claimant support organisation, said the figure obtained by the ODT this week showed the privacy issue clearly affected many Dunedin and Otago people as well as thousands of ACC claimants elsewhere in the country. It is understood the 479 Otago people had initiated about 700 Otago-related reviews of previous ACC decisions in the 12 months ending on June 30 last year.
Dr Powell said the 479 figure revealed the remarkably large number of people in Otago who had been dissatisfied with previous ACC decision-making in a single financial year.
"It makes it very real," she added.
Under New Zealand's official information legislation, requests for such information must be answered within 20 working days, with a time extension allowed in some cases, but "you must be told of the extension and the reasons for it", the Ministry of Justice advises. The ODT has also made a complaint to the Office of the Ombudsmen over the delays.
The delays were drawn to ACC's attention on May 24, but despite apologies and explanations about an oversight and administrative pressures, more than a further month went by before the information was provided.
In a letter to the ODT this week, ACC government services adviser Jon-Paul Bignold "sincerely apologises" and "sincerely regrets the undue delays" in handling the request.
"Unfortunately these delays were caused by administrative errors that resulted in your request remaining unanswered," Mr Bignold said.
Other ACC officials were approached yesterday to respond to criticism of the delays, and ACC trust issues, but no further comment was immediately available.
The emailed information sent to Ms Pullar involved a spreadsheet listing the names of ACC clients, relating to claims going through the Disputes Resolution Services Ltd review process between July 1, 2010, and June 30 last year. The spreadsheet had earlier been sent internally to dozens of ACC managers throughout the country.
Dunedin lawyer Peter Sara said a "significant number" of Otago people had been affected by the privacy breach, and he believed ACC had later deliberately "done a go-slow " over the release of the information sought by the ODT. A great deal of work, and not just offering some "bland phrases", would be needed if the public's trust in ACC was to be restored, Mr Sara said. And ACC administrators should be more mindful about "accountability to the Fourth Estate", he said.

28 June 2012

Interim board chair welcomes new priorities set for ACC

A press release from ACC

ACC’s interim Board Chair Paula Rebstock says ACC is a unique, no fault comprehensive Kiwi accident insurance scheme that we all pay for so people can get help if they have an accident.
“People expect and want us to be professional and respectful in the way we provide services to the public – that is what the Government’s priorities reflect and it’s the role of the ACC board and management to deliver that.”
The new priorities are:
• improved trust and confidence
• improved management and security of private information
• maintaining a focus on levy stability and financial sustainability
• providing high quality services for clients
• ensuring early resolution of disputes
• reporting on the performance of the accredited employer programme.

ACC has developed specific measures and performance targets relating to these priorities, which are outlined in the Service and Purchase Agreement 2012-15.
“The clear message in the Statement of Intent and the Service and Purchase Agreement is that there is a new set of priorities,” says Ms Rebstock.
“The Board and management of ACC understand we have to earn the trust and confidence of New Zealanders and we’re committed to doing that.”
Ms Rebstock says the way ACC manages people’s personal and private information is the subject of a large body of work that has only just begun, and there will be a lot more detail on that when the Privacy Commissioner and the Board complete the independent review of ACC systems and processes.
“We have been set some very clear targets and objectives to improve not only what we do, but how we do it.
“ACC is working to get better results for the injured, better support for levy payers and improve the relationship with the health sector. We will achieve this by investing equally in developing the capability of our people and supporting them with world class operating systems,” says Ms Rebstock.

http://www.scoop.co.nz/stories/PO1206/S00389/interim-board-chair-welcomes-new-priorities-set-for-acc.htm