Development of a Model for the Inspectorate for Social Assistance

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PART 2 Independent Social Assistance Appeals
TribunalSection 18,SAA,2004
THE NCOP PRESENTATION ( 20 May 2008
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Presentation Overview

• Background
• 2. The legislative framework
• 3. The proposed amendments
• The benefits derived from the amendments.
• The administration and service delivery model
• Progress on the establishment process
• 7. Conclusion

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1. Background As part of our
comprehensive mandate to alleviate poverty, an
array of social assistance grants is provided to
over twelve million beneficiaries, which
effectively translates into almost twenty five
percentage of the countrys population.
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Background (cont)1. The Constitution
of the Republic the right to have access to
social security, including, if they are unable to
support themselves and their dependants. 2. The
provision of social assistance places an
obligation on the state to take reasonable
legislative and other measures, within its
available resources, to achieve a progressive
realisation of such constitutional rights.
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2. The legislative framework

• The promulgation of both the Social Assistance
  Act (SAA), 2004 and the South African Social
  Security Act (SASSA), 2004, provides a
  legislative framework for the establishment of
  key social security institutions namely
• The South African Social Security Agency (SASSA)
  has been established as national state Agency,
  primarily to ensure effective management,
  administration and payment of social assistance
  grants. It became operationally effective as from
  1 April 2006.

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The legislative framework

• The Independent Appeals Tribunal is currently
  being established in terms of section 18 of the
  SAA, 2004, as an institution to process and
  manage (adjudicate) social assistance appeals.
• Whilst the establishment of the Agency has been
  fully actualized in every sense, the
  establishment of an Independent Tribunal has been
  amplified as a priority mandate derived primarily
  from the Constitution and the Social Security
  Legislation provisions as well as other related
  legislation that seeks to promote the following

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The legislative framework

• the right to just administrative action which is
  attained through compliance with a number of
  elicited standard procedures and guidelines when
  decisions are taken by respective administrators.
  (The promotion of the Administrative Justice Act)
  the Act further promotes that people
  (beneficiaries), reserve the right to review and
  appeal decisions made.

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The legislative framework

• the right of access to information provides for
  beneficiaries to have access to information held
  by the state. In a quest to protect their
  constitutional rights.

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3. The proposed amendment

• The proposed amendment
• The current legislative framework that governs
  the Independent Tribunal as an institution of
  government to consider and process social
  assistance appeals is detailed hereunder

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The proposed amendment

• The proposed amendment
• The current legislative framework that governs
  the Independent Tribunal as an institution of
  government to consider and process social
  assistance appeals is detailed hereunder

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The proposed amendments

• Section 18(1) of the SAA, 2004, provides that if
  an applicant disagrees with a decision that was
  made by the Agency, in respect to any matter
  regulated by this Act, that person or persons on
  his or her behalf may within 30 days of his or
  her gaining knowledge of that decision, lodge a
  written appeal with the Minister against that
  decision setting out reasons why the Minister
  should vary or set aside that decision.

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The proposed amendments

• Further more, in terms of section 18(2) the same
  Act, that
• The Minister may, after considering the appeal
  and the Agencys reasons for the decision-
• (a) confirm, vary or set aside that decision or
• (b) appoint an independent tribunal to consider
  the appeal in accordance with such conditions as
  the Minister may prescribe by notice in the
  Gazette, and that tribunal may, after
  consideration of the matter, confirm, vary or set
  aside that decision or make any other decision
  which is just.

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The proposed amendments

• The proposed amendment seeks to legislate the
  establishment of an Independent Tribunal as a
  quasi administrative institution that provide
  social assistance appeals services with a view to
  enhance the constitutional right of access to
  social security.

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The proposed amendments

• It is therefore proposed that section 18 of the
  principal be amended as follows by the
  substitution for subsection (2) of the following
  subsection
• (2) The Minister may , after considering
• (a) upon receipt of the applicants written
  appeal and the Agencys reasons for
• the decision,
• (a) confirm, vary or set aside that decision or
• (b) appoint an independent tribunal to consider
  the an appeal contemplated in
• subsection (1) in accordance with such
  condition as the Minister may prescribe by
  notice in the Gazette, and that tribunal may,
  after consideration

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The proposed amendments

• after consideration of the matter, confirm, vary
  or set aside that decision or make any other
• decision which is just. and
• (b) by the addition of the following subsection
• (3) If the Minister has appointed an
  independent tribunal in terms of subsection
  (2)(b) all
• appeals contemplated in subsection (1)
  must be considered by that tribunal.

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4.The benefits derived from the proposed
amendments

• 4.1 The administrative appeals process and
  mechanism provided in the proposed amendment of
  section 18 of the Social Assistance Act seeks to
  provide for an establishment of an independent
  institution dedicated primarily to consider and
  adjudicate social assistance appeals as a
  mechanism that enhances the right to access
  social assistance as a socio-economic right.

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4.The benefits derived from the proposed
amendments

• 4.2 Within a context of constantly escalating
  basic food prices, rising interest rates, the
  scourge of chronic diseases as well the deeply
  entrenched structural poverty and inequality
  the Independent Tribunal seeks to bring about and
  administrative review mechanism that is
  underpinned by the following key principles

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4.The benefits derived from the proposed
amendments

• Procedural fairness and objectivity in appeal
  decision making process
• Accessible services often customised in terms of
  appellants requirements, or barriers that may
  include language, culture as well a need for
  administrative assistance
• A comprehensive approach to consider unique
  social, economic and medical factors affecting
  the appellants
• An adjudication function that utilises a
  two-pronged approach i.e. administrative/document
  review or oral presentation (appellants invited
  to interface with the Tribunal members.

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4.The benefits derived from the proposed
amendments

• A fair review by authorised, independent and
  highly esteemed practitioners enlisted from the
  legal, medical and social sectors of the
  community. They constitute an independent
  tribunal or panel, duly appointed and assigned by
  the Minster (thus locating the function and
  related activities to duly authorised members as
  opposed to discretionary administrative authority
  often exercised by administrators/front line
  officers).
• A mechanism for a speedy resolve /non- protracted
  adjudication service at no cost (in contrast to
  overtly long and costly judiciary review
  systems).
• Nationally regulated standardised administrative
  procedures and guidelines that would ensure
  consistency in decision making and invariably
  reduce the risk of litigations.

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5.The administrative and service delivery model

• The independent tribunal institution currently
  being established is constituted as follows
• The Appeals Enterprise, which is the core
  adjudication unit responsible for appeals
  resolution. Some of the activities would include
  appeals verification, case analysis and
  adjudication through a two tier system. The first
  tier would largely be based on document review
  and information validation, and would be managed
  trough full time highly specialized Appeals
  Officers managing administrative process leading
  up to adjudication

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5.The administrative and service delivery model

• The second tier would comprise of a cluster of
  tribunal panelists (non-employees) that would
  then preside on all appeals including complex
  disability related cases. These panelists are
  enlisted from professional fields including legal
  (49), medical (35), and members of civil society
  (23) with good community standing. This brings a
  total of 107 independent tribunal members
  available on specific assignments depending on
  their availability which is managed through the
  scheduling.
• The Appeals Enterprise Corporate Support would
  largely provide for business policy framework,
  operations and administration support, including
  standards and guidelines.
• The Appeals Business Process and Information
  Management mainly focuses on the information
  management, data registry and workflow management
  and would require a capability and functionality
  that would be compatible to SASSA ICT framework.

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5.The administrative and service delivery model

• In giving effect to the adjudication mandate,
  independent tribunal is designed to follow two
  approaches in considering an appeal
• the oral hearing, wherein an appellant would be
  invited to present his/her case before the
  tribunal,
• or
• the document review, this would entail
  administrative and procedural review based on the
  available factual evidence

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5.The administrative and service delivery model

• Significant progress has been made in respect of
  the establishment process and the adjudication
  process has commenced using a centralized model
  at national level for the current financial year
  with plans to decentralize the function in all
  provinces over the MTEF period.

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2. The Independent Tribunal Adjudication
Function Road Map
TRANSITION (DSD/SASSA COLLABORATION) 1/04/06 -
31/03/09
POST TRANSITION 1/04/09 -
SASSA ADMINISTRATIVE ROLE
DSD ADJUDICATION ROLE

• Established Appeals Tribunal
• Organizational Component (DPSA)
• Funds Flow (NT)

• Ministerial Determination (s13(1)(a)(b)
• SASSA to provide administrative role, provide
  access to appellants
• Regional Office
• District Offices
• Local Offices

• Adjudication function
• Pre-adjudication assessment
• Adjudication by appointed tribunal members
• Document and oral approaches

• CHALLENGES
• Financial constraints to decentralize in 2008/9
• Infrastructural and structural outlay

SAA, 2004 as amended
SAA, 2004
Legislative Mandate
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6. Progress on the institutional business process
and model
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3.1. SASSA/DSD Collaboration
SASSA Process/QA refer to DSD
Advocacy Groups/Law firms
Application Verification Approval Payment
Decline and Automatic Appeal

• SASSA Regions
• Customer Care
• Capture
• Forward to HQ

• SASSA HQ
• Quality Assurance
• Electronic Forwarding
• Referral to DSD

• DSD
• Appeals Service Centre

Individuals
APPEALS TRIBUNAL CENTRE
Referral to DSD
Appeal Officer Medical
Appeals Registry/data office
Case Management Office
Appeals Adjudication
Appeal Officer Legal
Appeal Officer Policy
Referral Vary, set aside, payment

• CASE INTEGRATION BY CMO

Referral
PANEL commissioners)
SECRETARIAT
Judicial Review
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3.2.Proposed workflow processes
SASSA/DSD COLLABORATION (15/02/08 31/03/09)
DSD NATIONAL APPEALS TRIBUNAL
A PROCESS
SASSA HQ (QA)
REGIONAL Receive pre-adjudication info forward
REIMBURSE APPELANTS
ACCESS TO APPELANTS
Case Management and analysis
B PROCESS
ADJUDICATION Appeal Officers Panels Secretariat
DISTRICT Receive pre-adjudication info escalate
C PROCESS
LOCAL Help Desk Distribute appeal
forms Guidelines escalate
Develop Supply forms, guidelines
ADMINISTRATIVE ROLE
ADJUDICATION ROLE
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APPEALS SERVICE DELIVERY MODEL
PRE- ADJUDICATION ACTIVITIES
CASE ANALYSIS SASSA/IT
DATA/INFO UNIT Registry Call Centre
MEDICAL ASSESSMENT
LEGAL ASSESSMENT
Referral back for info
SASSA
DECISION TO APPELANT
ADJUDICATION APPROACHES
Regional District Local
Referral loop
DOCUMENTARY REVIEW
?Effect payment
Panel Decision
Confirm, Vary, Set aside, Any just decision
CASE MANAGEMENT OFFICE
APPELLANT REPRESENTATIVE
or

• QUALTY ASSURANCE
• Appeal Officer Medical
• Appeals Officer Policy
• Appeal Officer Legal

ORAL HEARING
PAJA s7(2)
JUDICIAL REVIEW
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3.4. Progress DSD/SASSA adjudication roles
DSD
APPEALS TRIBUNAL ADJUDICATION CHIEF APPEALS
OFFICER
APPEALS OFFICERS (EMPLOYEES)
REGIONAL APPEALS TRIBUNAL APPEALS OFFICER
ENLISTED PANELLISTS
TRIBUNAL PANEL
TRIBUNAL PANEL
TRIBUNAL PANEL
TRIBUNAL PANEL

• COMPOSITION OF TRIBUNAL PANELS
• LEGAL ADVISOR
• MEDICAL ADVSIOR
• MEMBER OF THE CIVIL SOCIETY

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7. FUNCTIONAL READINESS
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Progress at National Office.

• Currently acquiring office space for the National
  Office.
• Standard Operating Procedures finalised.
• Minister has appointed members in terms of
  section 18 of Social Assistance Act, 2004.
• A total number of 105 panel members were
  appointed.
• Legal practitioners 47
• Medical practitioners 35
• Civil Society 23
• Assignment will be administratively managed for
  both pre-adjudication and adjudication
  responsibilities

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CONCLUSION

• The NCOP to note and support as follows
• The proposed Social Assistance Amendment Bill
• 2. Progress in respect of the establishment
  process.

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• THANK YOU