Part 4: Comprehensive case management
4.1
In this Part, we set out our findings about how well Work and Income was case managing sickness and invalids' beneficiaries to help them into work or help them participate in the community, as appropriate. We describe our findings about:
- information to help case managers and beneficiaries with their planning;
- engaging and planning with beneficiaries;
- Work and Income's expectations for periodic contact;
- using information about beneficiaries' work-readiness;
- case managers' use of provisions in the Social Security Act 1964;
- following regional advisors' recommendations;
- available services and referrals to those services; and
- case managers' use of the available tools, and the Ministry's monitoring of that use.
4.2
The Programme introduced a comprehensive case management model that was designed to provide individualised, needs-based case management support and services to beneficiaries.
4.3
The main focus of case management under this new approach was increased interaction between case managers and beneficiaries to:
- enable the beneficiary to set goals (for work or increased community participation); and
- help the beneficiary to work towards their goals by offering help with personal planning and providing access to a range of contracted and community services.
4.4
The overall objective was to increase the number of sickness and invalids' beneficiaries entering the workforce.
4.5
The success of this approach relies on the case manager actively engaging with the beneficiaries assigned to their caseload. This requires the case manager to periodically review the person's circumstances (including their health needs) and, depending on the person's circumstances, to identify support and services to help them into work where possible, or to help them participate more fully in the community.
Our overall findings
4.6
Based on our examination of a sample of beneficiary case files and interviews with Work and Income staff, comprehensive case management for sickness and invalids' beneficiaries had been limited to a relatively small group. This finding is supported by the limited number of Personal Development and Employment Plans prepared by sickness and invalids' beneficiaries.
4.7
The case management that had occurred had been largely reactive and was initiated by the beneficiary rather than Work and Income staff.
4.8
Some regions had begun to actively case manage specific subgroups of sickness and invalids' beneficiaries who appeared to be more ready for work. However, these strategies did not include the large group of long-term sickness beneficiaries.
4.9
The Ministry had a framework and expectations for the frequency and timing of engagement with sickness and invalids' beneficiaries. Based on this framework, case managers were expected to have contacted all sickness and invalids' beneficiaries (where appropriate) to initiate comprehensive case management. However, based on our sample, case managers had yet to initiate contact with a large number of sickness and invalids' beneficiaries.
4.10
The revised medical certificate (when completed as intended) provided useful information to Work and Income on the work-readiness of individual sickness and invalids' beneficiaries. It also provided indicative timings to help case managers plan for the beneficiary's return to work and identify the services required to help the beneficiary to return to work. However, based on our sample, case managers rarely acted on this information. This finding was supported by the comments made by GPs in response to our questionnaire.
4.11
Our interviews with case managers established that the factors most likely to be constraining more active case management were the case managers' workloads, and a reliance on beneficiaries to actively and willingly participate with Work and Income in planning.
4.12
Although the Act enables the Ministry to require sickness and invalids' beneficiaries to engage with case managers and participate in personal development and work planning, the Ministry had decided that sickness and invalids' beneficiaries would be invited to participate.
4.13
We consider that case management could be further improved and we have made eight recommendations in this Part.
Information to help case managers and beneficiaries with their planning
Medical certificates were not usually providing information that could usefully help with work planning. Where useful information was provided, case managers were not using it for work planning purposes.
4.14
The revised medical certificate contained two optional questions that related solely to planning.
4.15
The first question sought to establish whether a person's current treatment would have a material effect on their ability to participate in work planning. For example, a person undergoing intensive treatment such as chemotherapy or awaiting imminent surgery would not be able to take part in work planning as readily as a person with a longstanding but stable condition. In other circumstances, effective treatment might stabilise a medical condition enough to enable a person to consider options for returning to work.
4.16
The second question related to "other interventions which [sic] could assist the person into work". This question invited the health practitioner to suggest an intervention that could improve a person's ability to work. This information would enable Work and Income to consider referring the person to a service appropriate to the person's needs.
4.17
In our sample of case files, these questions were infrequently completed by health practitioners. Where they were completed, most of the responses simply recorded what treatment or other interventions were used (such as "drugs", "medication" or "counselling") rather than how treatment or a given intervention affected the person's ability to work. When adequate responses were given, we found no evidence that the responses were used by Work and Income staff to decide when best to approach the person to begin work planning.
Engaging and planning with beneficiaries
Case managers were actively engaging with certain groups of sickness and invalids' beneficiaries. However, the nature and frequency of engagement with many other beneficiaries had not changed.
4.18
The Ministry used the term "engagement" to describe a process where the beneficiary met with Work and Income staff (usually the case manager or an employment co-ordinator) to discuss their future and to identify ways that Work and Income could support them. People who might not have been quite ready to work could discuss how Work and Income could support them in reaching their goals for themselves and their families. This support could take many forms – training, part-time or casual employment, health services, or helping them overcome practical difficulties like childcare or transport. A beneficiary could prepare a plan as a result of this engagement.
4.19
Engagement could be initiated by a beneficiary or by Work and Income staff.
Focusing comprehensive case management on specific groups of beneficiaries
4.20
In June 2007, the Ministry carried out research to help it make decisions about investing in employment programmes and to inform the design of policy and services to meet the needs of sickness and invalids' beneficiaries. This research included profiling people receiving sickness and invalids' benefits. The Ministry also estimated the future financial costs for different groups of working-age beneficiaries.
4.21
Work and Income's national office used this research to identify groups of beneficiaries who ought to receive more comprehensive case management. It prepared guidelines for regions and service centres to develop strategies for identifying beneficiaries who ought to receive more comprehensive case management. These regional strategies included focusing on groups such as young people on the sickness benefit, beneficiaries with working partners, beneficiaries in part-time work, the longest-term sickness beneficiaries, and people who should possibly transfer from the sickness benefit to the invalid's benefit.
4.22
These regional strategies to target groups of sickness and invalids' beneficiaries represented a positive first step towards working more actively with beneficiaries. However, they addressed only a small proportion of the total population of some 134,000 sickness and invalids' beneficiaries, and excluded large numbers of longer-term beneficiaries. As we noted in paragraph 3.20, as at December 2008 nearly half of all sickness beneficiaries had been on the sickness benefit continuously for more than a year. The sickness benefit is meant to be a temporary benefit.
4.23
At the time of our audit, Work and Income had no strategy for helping this large group of longer-term beneficiaries into work or for exploring their needs. Except where contact was initiated by a beneficiary, case manager contact with this large group of sickness and invalids' beneficiaries was likely to be limited to periodic processing of medical certificates, and administering supplementary income support benefits and allowances.
| Recommendation 9 |
|---|
| We recommend that the Ministry of Social Development review the circumstances of longer-term sickness and invalids' beneficiaries to better identify those for whom work is an option, and provide them with appropriate case management and employment-focused services. |
4.24
For a large group of invalids' beneficiaries, contact was likely to be even more limited because of the longer intervals between medical reassessments (two or five years). At September 2008, 12,590 invalids' beneficiaries were scheduled for five-yearly reassessments. There were another 37,426 who, on the recommendation of the certificating health practitioner (or the national office of Work and Income), were not scheduled for any future medical reassessment. For this group, their medical conditions and ability to work were considered unlikely to ever improve.
4.25
Figure 2 shows a breakdown of reassessment periods for invalids' beneficiaries.
Figure 2
Reassessment periods for invalids' beneficiaries (as at September 2008)
Contact with beneficiaries who were classified as not needing reassessment
4.26
In our view, all sickness and invalids' beneficiaries should be periodically contacted by Work and Income, including those beneficiaries whose entitlement on medical grounds has been assessed as "never to be reassessed". The policy papers prepared by the Ministry at the start of the Programme noted that:
… many people on [invalids' benefits] do not have their eligibility reassessed – indeed, some people qualified for [invalids' benefits] under the old 75% impairment test, and have never been assessed on the 15 hour rule.
4.27
One of the features of the new system was supposed to have been "more frequent reassessment for some people who are currently seldom or never reassessed".
4.28
Although this group of beneficiaries might never be able to work, helping them plan for increased participation in the community might be appropriate. A periodic review could identify changes in circumstances that could affect the need for financial support and services, as well as any other types of support to achieve a beneficiary's goals for working or participating in the community.
4.29
Moreover, as treatment options and work environment innovations occur, some people who would not have been able to have much community participation or work in the past might now be able to.
| Recommendation 10 |
|---|
| As resources allow, we recommend that the Ministry of Social Development use the available information to determine whether invalids' beneficiaries classified as "never to be reassessed" should be more actively case managed. |
The Ministry's draft strategy
4.30
As our audit fieldwork ended, the Ministry was preparing a strategy to identify those beneficiaries who would benefit most from comprehensive case management. The Ministry's initial work had identified four categories for sickness and invalids' beneficiaries:
- those needing income support for only a limited time because they were expected to recover within a certain time, or those on an invalid's benefit and working part-time to capacity – the primary need to be met would be financial;
- those who were working part-time, or who were able to work part-time and needed employment assistance – these beneficiaries would need less intensive case management but more input from an employment co-ordinator;
- those who were likely to have the ability to work part-time or full-time if provided with the right resources – these beneficiaries would need comprehensive case management; and
- those who were unlikely to be able to work – these beneficiaries would need the right resources (likely to be community resources).
4.31
The Ministry's preliminary estimates of the numbers of beneficiaries in each category were that most beneficiaries (46% of invalids' beneficiaries and 65% of sickness beneficiaries) were likely to need comprehensive case management.
4.32
If applied effectively and supported by the necessary resources, the draft strategy had the potential to provide a more systematic and informed framework for Work and Income to engage with beneficiaries, especially those longer-term beneficiaries with whom it had limited contact.
Work and Income's expectations for periodic contact
Ministry expectations for frequency of contact were often not met. Priority cases and emergency appointments limited case managers' availability.
4.33
Work and Income provided guidance to its case managers on when to make contact with sickness and invalids' beneficiaries. Beneficiaries were assigned to one of three service groups according to their ability to work, as assessed through a structured discussion with Work and Income staff. When and how case managers were expected to make contact with a beneficiary depended on the service group to which the person had been assigned. However, the guidance noted that any such contact was an invitation to the beneficiary to work more actively with the case manager, and the person might choose not to participate.
4.34
Figure 3 shows the three service groups and when and how contact was expected to occur. Based on this framework, we expected the Ministry to have initiated contact with all sickness and invalids' beneficiaries by the time of our audit – either to better support them in the community or to discuss planning for a return to work.
Figure 3
Service groups, intervention points, and the frequency and methods of contact for sickness and invalids' beneficiaries
| Service group | Intervention point | Frequency | Method |
|---|---|---|---|
| Work Support – people who are able to work now | Initial application or within six weeks of initial application Reassessment |
Every six weeks | Case manager interview (in person) |
| Work Development Support – those people who might be able to work now but need extra support to do so, as well as people whose personal circumstances mean they are not able to work now but might be able to do so in the future with the right support in the right job. | For sickness beneficiaries Initial application First medical review (four weeks) Subsequent medical review |
Every 13 weeks | Case manager interview (in person or by telephone) |
| For invalids' beneficiaries Initial application or within six weeks of initial application interview Annual benefit review Invalid's benefit medical review Change of circumstances Completion of any activities or services |
At least once a year | Case manager interview (in person or by telephone) | |
| Community Support – people who have personal circumstances that mean they are considered unlikely to be able to work at all in the foreseeable future. These are mainly people receiving the invalid's benefit who have a severe illness or disability or a terminal illness. | Invalids' beneficiaries Initial application Annual benefit review Invalid's benefit medical review Change of circumstances Whenever beneficiary wants contact |
Yearly or as required/appropriate | Case manager interview (in person or by telephone) |
4.35
In our sample of case files, Work and Income had not contacted beneficiaries at the times shown in Figure 3. Overall, most of the contact was initiated by the beneficiary when they sought additional temporary financial support, rather than initiated and planned by the case manager to review the support and services provided to the person and, where appropriate, assess progress with their return to work.
4.36
We found cases where planned contact, or any other form of contact, between Work and Income and beneficiaries had been infrequent, occurring rarely over months or even years. This situation was corroborated by comments made in the context of a regional programme, carried out in Work and Income's Southern region, to establish whether beneficiaries were receiving their full and correct entitlement (see Figure 4). In analysing the results of that programme, the region reported:
Clients in general responded very well [to the programme] with some having been without contact from Work and Income for a large number of years.
Promoting more active engagement
4.37
Regions and service centres were looking for ways to promote more active engagement with beneficiaries. Initiatives included:
- using employment co-ordinators and regional health advisors and regional disability advisors to support case managers in identifying opportunities for active engagement;
- seeking to meet some sickness beneficiaries at the time of medical reassessments to discuss the contents of the medical certificate, any services to which Work and Income might refer them, and other support to help their return to work;
- setting aside time each week for case managers to identify and contact their assigned beneficiaries; and
- looking for opportunities to relieve case managers of time-consuming tasks (for example, using a single person to process medical certificates).
4.38
Figure 4 describes an initiative used by Work and Income's Southern region.
Figure 4
Southern region's initiative for sickness beneficiaries
| The Southern region established a team early in 2008 to interview sickness beneficiaries between the ages of 25 and 49 (in their own home or the local Work and Income office). The interviews were held to ensure that beneficiaries were receiving their full and correct entitlement, and to identify any opportunities or interventions that could help them return to work. This group comprised a total of 927 beneficiaries. Of these, 129 had recently had contact with Work and Income and did not need to be approached. Letters were sent to the remaining 798 to arrange an interview, and sanctions were used to ensure that beneficiaries responded. In all, 469 beneficiaries were interviewed during the programme, resulting in:
Lessons and benefits from the programme included:
|
* PATHS is a programme that helps people receiving a sickness benefit or invalid's benefit to access services that can reduce or remove health barriers to employment.
Availability of case managers limited by priority cases
4.39
Case managers have to follow specific rules for emergency appointments, new business and reapplications, and special needs and grant advances. Figure 5 sets out the timeframes associated with these rules.
Figure 5
Specific rules governing timeframes for appointments with beneficiaries
| Type | Examples of circumstances | Timeframe |
|---|---|---|
| Emergency | Eviction, medical, or dental emergency, non-payment of benefit, power disconnection notice, funeral, or food needs | Within 24 hours (must be seen on the same day) |
| New business/reapplications | A new beneficiary or a previous beneficiary with new or same service centre | Within 48 hours |
| Special needs grant/advance | Urgent and necessary need with no other way of meeting costs | Within five days |
4.40
Some case managers told us that the time available for actively engaging with beneficiaries was limited by the high numbers of medical certificates that had to be processed, and the need to attend appointments with other beneficiaries.
| Recommendation 11 |
|---|
| We recommend that the Ministry of Social Development investigate why contact with beneficiaries is intermittent and reactive, and introduce improvements to ensure that case managers engage systematically and actively with beneficiaries, in keeping with the Ministry's expectations for periodic contact. |
Using information about beneficiaries' work-readiness
Case managers were not always acting on information indicating that a beneficiary was ready to prepare for or seek work.
4.41
Engaging with sickness and invalids' beneficiaries was supposed to occur when a beneficiary expressed an interest in work, or when the medical certificate received from the health practitioner indicated that the person was ready to plan for or take up work.
4.42
The medical certificate asked the health practitioner for their opinion on the person's ability to work and to indicate the person's likely progress towards work. The health practitioner was required to indicate when the person was likely to be capable of:
- Work planning – that is, engaging with their case manager to determine what services were required to help the person into work. These services might include health interventions, but could also include vocational, educational, social, cultural, or legal services.
- Training – while a person might not be ready to start work, they might be able to undertake training. This could include vocational training or re-training, improving literacy, or gaining self-care skills.
- Light/selected duties – this option would be indicated when a person required a gradual return to work, working part-time hours initially or with modifications to the workplace or conditions of work. For example, a person might not be able to stand for extended periods or might need assistance with mobility.
- Part-time work (for fewer than 30 hours a week).
- Full-time work (for 30 hours or more a week).
4.43
While the stated purpose of this question was to determine the person's eligibility for a benefit, we consider the health practitioner's response also served as a significant opportunity for the case manager to start a conversation with the person about work planning, training, and work opportunities. Information on the readiness of beneficiaries for work planning, selected light duties, and part-time work was recorded in SWIFTT. However, in the service centres that we visited, this information was not consistently analysed by case managers to identify opportunities to work with beneficiaries. The Ministry needs to establish why this is not happening.
4.44
We identified examples of effective collaboration between Work and Income staff in referring beneficiaries for training, work planning, or job search. Successful outcomes we noted or were told of included beneficiaries re-training or finding work. We noted positive outcomes when Work and Income staff had responded effectively to sickness or invalids' beneficiaries who expressed a desire to work.
4.45
One positive outcome involved an invalid's beneficiary who suffered from degeneration of the spine. His work history involved hard physical labour. After a conversation between the regional health advisor and the case manager, he was referred to the employment co-ordinator to identify suitable job opportunities. This beneficiary indicated an interest in driving a truck, and arrangements were made for him to attend a heavy transport course as the first step towards gaining his truck licence.
4.46
We also noted instances where opportunities for engagement had been missed or where no follow-up action had been taken because of ineffective systems for ensuring timely and consistent engagement with work-ready beneficiaries. Twenty-one of a subgroup of 80 sickness beneficiaries in our sample had been assessed by the GP as ready for work planning immediately or within the following one to three months. Only four of the 21 were actively managed by the case manager (or employment co-ordinator, in one case).
Invalids' beneficiaries
4.47
In our sample of invalids' beneficiaries, action had been taken by the case manager in only two of 20 instances where the medical certificates indicated that the person was ready for work planning or part-time work. In one case, the case manager talked to the beneficiary about a referral to other services. The beneficiary wanted to consider the proposal but it was never followed up by the case manager. In the second case, the beneficiary had been referred to other services in 2007 but no action had been noted since that referral. There were a further three instances of young people pursuing full-time study and part-time work. In the remaining 15 instances, no action had been taken by the case manager in response to the comments in the medical certificate.
4.48
In our view, when there is only limited action or involvement by case managers, it is more likely that beneficiaries will build a history of benefit dependence and of absence from the workforce. It also limits the opportunities for beneficiaries to get the services and support available through Work and Income.
| Recommendation 12 |
|---|
| We recommend that the Ministry of Social Development ensure that Work and Income case managers contact sickness and invalids' beneficiaries about work planning if information indicates that they may be ready to prepare for or return to work. |
GPs' views on communication with Work and Income staff
GPs wanted more feedback from Work and Income staff.
4.49
We asked GPs to rate the quality of Work and Income's communication with them over the past 12 months on matters relating to sickness and invalids' beneficiaries. More than half (59%) of the 150 GPs who answered our questionnaire thought communication was poor or worse.
4.50
The main frustration expressed by those GPs who chose to expand on their response was not being contacted by Work and Income staff when they expressly asked for contact. GPs also noted that case managers were difficult to contact. In this context, the comment was made that the centralised handling of telephone calls to Work and Income did not help. Several suggested that beneficiaries should be given a Work and Income business card with the case manager's contact details to bring with them to the GP. The GPs expressed a preference for direct dial access to case managers.
4.51
Of the GPs who responded to our questionnaire, 69% thought that Work and Income responded "poorly", "very poorly", or did not respond to the comments that GPs made in the medical certificate about the person's needs. Some expressed concern that the only feedback that they received was through their patients, who might not be in a position to provide the best information about their interaction with Work and Income. Some thought that the present system should be improved by Work and Income staff providing the GPs with feedback on the action that had been taken in response to their comments.
| Recommendation 13 |
|---|
| We recommend that the Ministry of Social Development investigate ways of working more actively with general practitioners and responding to their comments in medical certificates. |
Case managers' use of provisions in the Social Security Act 1964
The full range of legislative sanctions was not used because the Ministry's policy was to invite rather than compel sickness and invalids' beneficiaries to engage with their case manager.
4.52
Under the Act, the Ministry can require all beneficiaries to (among other things):
- attend and participate in interviews;
- plan for personal development and work; and
- carry out any activity or rehabilitation (other than an activity or rehabilitation involving participation in work, voluntary work, activity in the community, unpaid work experience, or medical treatment) to improve the beneficiary's work-readiness or prospects for work.
4.53
The Act also provides for sanctions (reducing the amount of benefit paid) if beneficiaries fail to meet these obligations without a good and sufficient reason.
4.54
Although these legislative provisions were available, in practice the Ministry's approach was that individual sickness or invalids' beneficiaries should voluntarily engage in work planning. The Ministry took the view that, with limited resources, it was pragmatic to focus the efforts of its staff on people entering the benefit system and on beneficiaries who were willing and able to prepare for and seek work. It was also conscious that work planning might not be appropriate or might be complex for some sickness or invalids' beneficiaries.
4.55
Therefore, the Ministry had not used sanctions to require sickness and invalids' beneficiaries to prepare for work. This policy position was reflected in the information pack for service centre managers about the September 2007 changes associated with the Programme. It noted:
From September 2007 people with ill-health and disabled people will be invited to engage with [Work and Income]. They may have planning and activity requirements to support them into work, where work is an appropriate and realistic option for them. It is not appropriate for this group of clients to be sanctioned.
4.56
We found little evidence of Personal Development and Employment Plans for these beneficiaries. Several staff told us that such plans should be considered in only limited circumstances with this group. The then Minister of Social Development and Employment reported that, at the end of June 2008, only 5394 of some 129,000 sickness or invalids' beneficiaries had completed a Personal Development and Employment Plan.
| Recommendation 14 |
|---|
| We recommend that the Ministry of Social Development, where fair and appropriate, explore the full range of options for engaging with those sickness and invalids' beneficiaries who do not express an interest in preparing for or moving towards work. |
Following regional advisors' recommendations
Case managers were not always following the recommendations of the regional health advisors and regional disability advisors.
4.57
The role of Work and Income's regional health advisors and regional disability advisors included making recommendations to case managers about appropriate services and interventions for beneficiaries with complex medical or disability issues. Our examination of case files showed that recommendations made by regional health advisors and disability advisors were not always followed by case managers.
4.58
This means that beneficiaries with complex medical or disability conditions might not be able to take advantage of appropriate services and interventions that could help their return to work or increase their participation in the community.
| Recommendation 15 |
|---|
| We recommend that the Ministry of Social Development reinforce the need for Work and Income case managers to consistently follow the recommendations made by regional health advisors and regional disability advisors. |
Available services and referrals to those services
Each region was purchasing a number of training and vocational services aimed at addressing the particular needs of sickness and invalids' beneficiaries.
Additional training and vocational services
4.59
A number of training and vocational services were available to sickness and invalids' beneficiaries through Work and Income. We noted instances of staff in some service centres contacting sickness and invalids' beneficiaries whose needs might be met by referral to one or more of these services. Briefcase, an online caseload management database, was used to identify suitable people for possible referral.
4.60
The redesigned medical certificate made it easier to identify beneficiaries whose needs might be met by referrals to such services, because it required health practitioners to use codes to describe the person's condition. These codes replaced broad incapacity groupings used in the previous certificate. Using the codes, Work and Income staff had access to more specific descriptions of medical conditions to better identify which beneficiaries might be helped by a referral to services purchased through the Innovation Fund.
4.61
In the 80 sickness beneficiaries' case files that we examined, 21 beneficiaries were referred to and attended services or other interventions. A further eight beneficiaries were invited to seminars or referred to other specialist services but did not attend.
Health and Disability Innovation Fund for Pilot Health Services
4.62
As we noted in Part 2, from 2007 the Ministry was able to use the Innovation Fund to purchase services to help beneficiaries gain, retain, or move into work. These services were for people with mild to moderate mental health conditions, people awaiting medical treatment, people with chronic pain, and people who needed help with life skills in order to work.
4.63
The Ministry carried out research to identify the most relevant and cost-effective health and disability services for sickness and invalids' beneficiaries. This research included health-related literature reviews. To estimate the potential demand for each service, data was gathered on existing numbers of sickness and invalids' beneficiaries for each Work and Income region, numbers with particular incapacities, and the availability of other existing health and disability services.
4.64
Each region consulted with service centres to identify gaps in services before drawing up its annual service purchase plan. The Ministry was monitoring the uptake of the services provided through the Innovation Fund. At the time of our audit, the availability of services varied in the five regions we visited. Some contracts, such as those for mild to moderate mental health services with primary health organisations and district health boards, were still being finalised.
4.65
The 2009 Budget included an announcement that the Innovation Fund would not continue beyond 30 June 2009.
Case management tools and monitoring the use of those tools
Work and Income had the necessary procedural guidance, tools, and information systems to support case managers' engagement with sickness and invalids' beneficiaries. The Ministry needed to better monitor how case managers managed their caseloads, kept records, and used planning tools.
4.66
Briefcase was an online case management tool that enabled Work and Income staff to sort beneficiaries by various characteristics. They could sort, for example, by the type and length of time a person had been on the benefit, their type of illness(s), injury(s), or disability(s), whether they were in or had undertaken part-time work, and by the number of hours that were worked. It was, therefore, a useful tool to help case managers take a planned approach when working with their caseloads.
4.67
Case managers were also able to access reports in Briefcase that identified beneficiary groups that should be targeted first – for example, sickness and invalids' beneficiaries:
- with a recent work history, and who might therefore be able to work part-time or do light duties;
- with reported earnings;
- with medical conditions making them eligible to access the health and disability services available through the Innovation Fund or PATHS;
- who had been receiving the benefit continuously for more than 10 years; and
- who had partners who might be able to work.
4.68
Briefcase was not used consistently throughout the regions and its use was not systematically monitored. In the two service centres of one of the regions that we visited, Briefcase was used to varying degrees by the work broker, employment co-ordinator, programme co-ordinator, assistant service centre manager, service centre trainer, and service quality officer. It was used to a limited extent by only three of the 29 case managers.
4.69
Work and Income staff were provided with other online tools to record the type, extent, and outcomes of engagement with beneficiaries, including:
- journals;
- service plans; and
- an electronic recording system.
4.70
The Ministry's procedures required Work and Income staff to update the beneficiary's journal each time that they engaged and planned with the sickness or invalid's beneficiary, including noting any progress that the beneficiary had made in achieving their goals. The journals should have provided a single, readily accessible, and up-to-date source of information about the beneficiary's circumstances. However, we found that journals were seldom maintained for sickness and invalids' beneficiaries.
4.71
All interventions offered to a beneficiary could be recorded and tracked through a service plan. Service plans were used for:
- managing the activities and tasks that a beneficiary carried out;
- managing services offered to a beneficiary; and
- managing and issuing formal agreements.
4.72
During our audit, we noted that service plans were not used for sickness and invalids' beneficiaries. We also noted that the Ministry was developing its "Client Management System", and changes as part of that development should help to ensure that, where appropriate, service plans are completed for sickness and invalids' beneficiaries.
4.73
Case managers were recording details of engagement with beneficiaries in the electronic recording system, but because the system recorded all correspondence and interaction with the beneficiary, it was difficult to quickly establish what engagement has occurred. The electronic recording system also made it difficult to establish what, if any, plan existed to help the beneficiary back into work and what progress has been made.
4.74
Service centre managers did not routinely check the nature and extent of case managers' engagement with their assigned sickness and invalid's beneficiary caseloads. The extent of engagement with an individual beneficiary should be reflected in plans, case notes, and the journal of contact with the beneficiary that is maintained by the case manager.
| Recommendation 16 |
|---|
| We recommend that the Ministry of Social Development expand the scope of regular monitoring to help ensure that case managers maintain periodic contact with beneficiaries in keeping with Work and Income's guidance. |