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PART 2 Independent Social Assistance

Appeals Tribunal

Section 18,SAA,2004

THE NCOP PRESENTATION (20 May 2008

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Presentation Overview 1. Background

2. The legislative framework

3. The proposed amendments

4. The benefits derived from the amendments.

5. The administration and service delivery model

6. 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 country’s

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 Agency’s 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 applicant’s written appeal and

the Agency’s 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 appellant’s 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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Established Appeals Tribunal

•Organizational Component

(DPSA)•Funds Flow

(NT)

Legislative MandateLegislative MandateLegislative MandateLegislative Mandate

2. The Independent Tribunal Adjudication Function –Road Map

SAA, SAA, 20042004SAA, SAA, 20042004

SAA, SAA, 20042004

as amendedas amended

SAA, SAA, 20042004

as amendedas amended

TRANSITION (DSD/SASSA COLLABORATION)

1/04/06 - 31/03/09

TRANSITION (DSD/SASSA COLLABORATION)

1/04/06 - 31/03/09

POST TRANSITION

1/04/09 -

POST TRANSITION

1/04/09 -

SASSA SASSA ADMINISTRATIVE ADMINISTRATIVE

ROLEROLE

SASSA SASSA ADMINISTRATIVE ADMINISTRATIVE

ROLEROLE Ministerial

Determination (s13(1)(a)(b)

SASSA to provide administrative role, provide access to appellants:

Regional OfficeDistrict OfficesLocal Offices

Ministerial Determination (s13(1)(a)(b)

SASSA to provide administrative role, provide access to appellants:

Regional OfficeDistrict OfficesLocal Offices

DSD ADJUDICATION DSD ADJUDICATION ROLEROLE

DSD ADJUDICATION DSD ADJUDICATION ROLEROLE

Adjudication function• Pre-adjudication

assessment• Adjudication by

appointed tribunal members

• Document and oral approaches

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

CHALLENGES Financial constraints to

decentralize in 2008/9 Infrastructural and structural

outlay

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6. Progress on the institutional business process

and model

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3.1. SASSA/DSD Collaboration

ApplicationVerification

ApprovalPayment

ApplicationVerification

ApprovalPayment

SASSA Process/QA & refer to DSDSASSA Process/QA & refer to DSD

Appeals Registry/data

office

Appeals Registry/data

office

Appeal Officer: Legal

Appeal Officer: Legal

APPEALS TRIBUNAL CENTREAPPEALS TRIBUNAL CENTRE

•CASE INTEGRATION BY CMO•CASE INTEGRATION BY CMO

ReferralVary, set

aside, payment

ReferralVary, set

aside, payment

Decline and Automatic

Appeal

Decline and Automatic

Appeal

SASSA Regions

•Customer Care•Capture

•Forward to HQ

SASSA Regions

•Customer Care•Capture

•Forward to HQ

Advocacy Groups/Law

firms

Advocacy Groups/Law

firms

SECRETARIATSECRETARIATPANEL

commissioners)PANEL

commissioners)

Referral to DSD

Referral to DSD

Referral

Referral

Judicial ReviewJudicial Review

Appeal Officer: Medical

Appeal Officer: Medical

Appeal Officer:Policy

Appeal Officer:Policy

Case Management

Office

Case Management

Office

Appeals Adjudication

Appeals Adjudication

SASSA HQ•Quality

Assurance•Electronic Forwarding

•Referral to DSD

SASSA HQ•Quality

Assurance•Electronic Forwarding

•Referral to DSD

DSD•Appeals Service

Centre

DSD•Appeals Service

Centre

IndividualsIndividuals

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3.2.Proposed workflow processes

SASSA/DSD COLLABORATION (15/02/08 – 31/03/09)

SASSA/DSD COLLABORATION (15/02/08 – 31/03/09)

RE

IMB

UR

SE

AP

PE

LA

NT

SR

EIM

BU

RS

E A

PP

EL

AN

TS

AC

CE

SS

TO

AP

PE

LA

NT

SA

CC

ES

S T

O A

PP

EL

AN

TS

REGIONALReceive pre-adjudication

info & forward

REGIONALReceive pre-adjudication

info & forward

DISTRICTReceive pre-adjudication

info & escalate

DISTRICTReceive pre-adjudication

info & escalate

LOCALHelp Desk

Distribute appeal formsGuidelines & escalate

LOCALHelp Desk

Distribute appeal formsGuidelines & escalate

Case Management and analysis

Case Management and analysis

ADJUDICATIONAppeal Officers

PanelsSecretariat

ADJUDICATIONAppeal Officers

PanelsSecretariat

Develop Supply forms,

guidelines

Develop Supply forms,

guidelines

ADMINISTRATIVE ROLEADMINISTRATIVE ROLE ADJUDICATION ROLEADJUDICATION ROLE

SASSA HQ(QA)

DSD NATIONALAPPEALS TRIBUNAL

A PROCESS

A PROCESS

B PROCESS

B PROCESS

C PROCESS

C PROCESS

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DATA/INFO UNIT

RegistryCall Centre

DATA/INFO UNIT

RegistryCall Centre

APPEALS SERVICE DELIVERY MODELAPPEALS SERVICE DELIVERY MODEL

CASE MANAGEMENT

OFFICE

CASE MANAGEMENT

OFFICE

CASE ANALYSISSASSA/IT

CASE ANALYSISSASSA/IT

Referral loop

Referral loop

PRE- ADJUDICATION ACTIVITIESPRE- ADJUDICATION ACTIVITIESPRE- ADJUDICATION ACTIVITIESPRE- ADJUDICATION ACTIVITIES

LEGALASSESSMEN

T

LEGALASSESSMEN

T

MEDICAL ASSESSMEN

T

MEDICAL ASSESSMEN

T

QUALTY ASSURANCE

Appeal Officer: Medical

Appeals Officer: Policy

Appeal Officer: Legal

QUALTY ASSURANCE

Appeal Officer: Medical

Appeals Officer: Policy

Appeal Officer: Legal

Panel Decision

AD

JUD

ICA

TIO

N A

PP

RO

AC

HE

SA

DJU

DIC

AT

ION

AP

PR

OA

CH

ES

APPELLANTREPRESENTATIVE

RegionalDistrictLocal

JUDICIAL REVIEW

SASSA

DOCUMENTARYREVIEW

ORAL HEARING

DE

CIS

ION

TO

AP

PE

LA

NT

DE

CIS

ION

TO

AP

PE

LA

NT

Confirm, Vary,

Set aside, Any just decision

?Effect payment

PAJA s7(2)

or

Referral back for info

Referral back for info

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3.4. Progress DSD/SASSA adjudication roles

APPEALS OFFICERS

(EMPLOYEES)

APPEALS OFFICERS

(EMPLOYEES)

DSDDSD

APPEALS TRIBUNALADJUDICATION

CHIEF APPEALS OFFICER

APPEALS TRIBUNALADJUDICATION

CHIEF APPEALS OFFICER

REGIONAL APPEALS TRIBUNAL

APPEALS OFFICER

REGIONAL APPEALS TRIBUNAL

APPEALS OFFICERENLISTED

PANELLISTSENLISTED

PANELLISTS

COMPOSITION OF TRIBUNAL PANELS•LEGAL ADVISOR

•MEDICAL ADVSIOR•MEMBER OF THE CIVIL SOCIETY

COMPOSITION OF TRIBUNAL PANELS•LEGAL ADVISOR

•MEDICAL ADVSIOR•MEMBER OF THE CIVIL SOCIETY

TRIBUNAL PANEL

TRIBUNAL PANEL TRIBUNAL PANEL

TRIBUNAL PANEL

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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:

1. The proposed Social Assistance Amendment Bill

2. Progress in respect of the establishment process.

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THANK YOU