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Number of Deaths in Aged Care Residential Facilities - MSD

Chris Johnston made this Official Information request to Ministry of Social Development

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From: Chris Johnston

Dear Ministry of Social Development,

Could you please provide a data set in Excel or csv file with the following columns - for the last 5 years by month to the end of March 2020 for the whole of New Zealand.

Column 1 to 5
- Residential Facility Name
- Level of Care (E.g. Rest Home, Dementia, Hospital Level)
- Physical Address
- Geocoded Location - NZTM
- DHB within which the Residential Care Facility resides
Column 6 - Number of Residents at the Start of the Period
Column 7 - Deaths During Period - whether the person died in the facility or in another facility (such as a public hospital)
Column 8 - Age Group at Death (in 10 year bands)

I only expect MSD to provide numbers for those residents that it knows about through its systems - for example you may not know about people paying privately.

I would expect that these numbers are available from the MSD's payment system for subsidised people in residential care - for example where NationalSuper is paid direct to the facility, and via any income testing declaration and needs assessment forms submitted. Residents should be able to be counted and tracked via their MSD number (which records their date of death and age at death).

If there are any commercial or privacy issues with the above dataset then please discuss. There may be ways that you can communicate:
A - the % Death Rate per Facility (Column 7 / Column 6)
B - wider Age Groups (e.g. 10 year bands to 90 then everyone above 90)
C - Hide the Facility Name

I would prefer the raw data though so please consult early so that we can agree and the MSD can meet the OIA timeline.

Yours faithfully,

Chris Johnston

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From: OIA_Requests (MSD)
Ministry of Social Development

Tēnā koe Chris Johnston,

 

Thank you for your email received 7 April 2020, under the Official
Information Act 1982. Your request has been forwarded to the appropriate
officials at National Office to respond. You may expect a decision
regarding your request to be sent to you as soon as possible.

 

The Ministry is focussing its resources on supporting New Zealanders
through COVID-19 by administering welfare support during this
unprecedented time.  Resources within our business units, where
information for OIA requests is drawn from, is limited or unavailable. 
Staff have been redeployed to assist the frontline with the processing of
welfare payments and/or Ministry hardware (such as laptops) have been
reprioritised.  As such, there will be a delay in you receiving a response
from the Ministry.

 

Thank you for your patience and understanding during this time. 

 

Ngā manaakitanga,

 

Official and Parliamentary Information team   |  Ministerial and
Executive Services

Ministry of Social Development

 

Our Purpose:
We help New Zealanders to be safe, strong and independent
Manaaki Tangata, Manaaki Whānau

 

------------------------------- This email and any attachments may contain
information that is confidential and subject to legal privilege. If you
are not the intended recipient, any use, dissemination, distribution or
duplication of this email and attachments is prohibited. If you have
received this email in error please notify the author immediately and
erase all copies of the email and attachments. The Ministry of Social
Development accepts no responsibility for changes made to this message or
attachments after transmission from the Ministry.
-------------------------------

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From: Chris Johnston

Dear OIA_Requests (MSD),

This request is *because* of COVID19.

Please prioritise it as it may help inform public policy and reduce the:
- Economic damage that MSD are currently funding, and
- Chaos that you are experiencing.

Yours sincerely,

Chris Johnston

Link to this

From: OIA_Requests (MSD)
Ministry of Social Development

 

 

Dear Chris Johnston

On 7 April 2020, you emailed the Ministry requesting, under the Official
Information Act 1982, the following information:

o A data set in Excel or csv file with the following columns - for the
last 5 years by month to the end of March 2020 for the whole of New
Zealand.

 

o Column 1 to 5

o Residential Facility Name
o Level of Care (E.g. Rest Home, Dementia, Hospital Level)
o Physical Address
o Geocoded Location - NZTM
o DHB within which the Residential Care Facility resides Column 6 -
Number of Residents at the Start of the Period Column 7 - Deaths
During Period - whether the person died in the facility or in
another facility (such as a public hospital) Column 8 - Age Group
at Death (in 10 year bands)

 

We have transferred your request to the Ministry of Health. The
information to which your request relates is believed to be more closely
connected with the functions of the Ministry of Health. In these
circumstances, we are required by section 14 of the OIA to transfer your
request.

You will hear further from the Ministry of Health concerning your request.

 

Nā mātou noa, nā

 

Official and Parliamentary Information team   |  Ministerial and
Executive Services

Ministry of Social Development

 

------------------------------- This email and any attachments may contain
information that is confidential and subject to legal privilege. If you
are not the intended recipient, any use, dissemination, distribution or
duplication of this email and attachments is prohibited. If you have
received this email in error please notify the author immediately and
erase all copies of the email and attachments. The Ministry of Social
Development accepts no responsibility for changes made to this message or
attachments after transmission from the Ministry.
-------------------------------

Link to this

From: Chris Johnston

Dear OIA_Requests (MSD),

Please do not transfer this to the Ministry of Health.

I have already asked them for the information from their systems. i am explicitly asking for the information from the MSD systems. This is because I am going to compare the information between the MoH and MSD systems to assess:
a) Accuracy
b) Pattern

I have also asked for related information from the DIA - so that I am compare both the MSD and MoH data.

In this way NZ will get a better picture of what has occurred in Residential facilities.

So for this request under thew OIA I am not asking for the best information in NZ, or the information directly from the MoH, I am asking for the data as seen through the lens of the MSD's systems.

Therefore you are not required to hand this request onto the MoH under Section 14 - as the MSD's data is the "version of events" that I need.

The clue to this approach that I am asking MSD for is in the two paragraphs that I requote below:
"I only expect MSD to provide numbers for those residents that it knows about through its systems - for example you may not know about people paying privately.

I would expect that these numbers are available from the MSD's payment system for subsidised people in residential care - for example where NationalSuper is paid direct to the facility, and via any income testing declaration and needs assessment forms submitted. Residents should be able to be counted and tracked via their MSD number (which records their date of death and age at death)."

Please confirm that you have now taken control of this request back form the MoH and are underway again to answer my question from your databases.

Yours sincerely,

Chris Johnston

Link to this

From: OIA_Requests (MSD)
Ministry of Social Development

 

Dear Chris Johnston

Thank you for emailing us your concerns regarding your request.

 

For this particular request, the  information to which your request
relates is more closely connected with the functions of the Ministry of
Health.

 

However, the Ministry of Social Development will endeavour to respond to
your second request (copied below) as best we can.

 

Kind regards,

 

The OIA_Requests team.

 

 

 

 

Dear Ministry of Social Development,

 

Could you please provide a data set in Excel or csv file with the
following columns - for the last 5 years by month to the end of March 2020
for the whole of New Zealand.

 

Column 1 - DHB within which the Person resides Column 2 - Age Group at
Death (in 10 year bands) Column 3 - Number of People Receiving National
Super at the Start of the Period Column 4 - Deaths During Period - that is
MSD is notified to stop paying National Super/Pension and/or a date of
death was obtained by any means (eg death notice)

 

I only expect MSD to provide numbers for those residents that it knows
about through its systems.

 

I would expect that these numbers are available from the MSD's payment
system for  National Super. People should be able to be counted and
tracked via their MSD number (which records their date of death and age at
death).

 

If there are any commercial or privacy issues with the above data set then
please discuss. There may be ways that you can communicate:

- via a geographic groups different to DHBs (that can be aggregated to
DHBs by me)

- wider Age Groups (e.g. 10 year bands to 90 then everyone above 90).

 

I would prefer the raw data though so please consult early so that we can
agree and the MSD can meet the OIA timeline.

 

Also please communicate any caveats or lag with the data that the MSD is
aware of. For example "90% of data may come in within 1 month and after 3
months the number is within 1% of the true number".

 

Yours faithfully,

 

Chris Johnston

------------------------------- This email and any attachments may contain
information that is confidential and subject to legal privilege. If you
are not the intended recipient, any use, dissemination, distribution or
duplication of this email and attachments is prohibited. If you have
received this email in error please notify the author immediately and
erase all copies of the email and attachments. The Ministry of Social
Development accepts no responsibility for changes made to this message or
attachments after transmission from the Ministry.
-------------------------------

Link to this

From: Chris Johnston

Dear OIA_Requests (MSD),

I have complained to the Ombudsman about your response.

Please reconsider.

Your lack of engagement in releasing the data from your point of view on this request limits my ability to do my analysis.

The biggest effect is likely to be in Residential Care. Having data sets from many agencies enhances the statistical analysis as it enables the differences in lenses to be compared => different insights.

I look forward to your response on the broader superannuation dataset - but the effect of any excess deaths over summer will be more muffled in this dataset.

Yours sincerely,

Chris Johnston

Link to this

Ministry of Social Development


Attachment attachment.gif
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Kia ora

Thank you for your request for official information which was transferred
from the Ministry of Social Development for:

"Could you please provide a data set in Excel or csv file with the
following columns - for the last 5 years by month to the end of March 2020
for the whole of New Zealand.

Column 1 to 5
- Residential Facility Name
- Level of Care (E.g. Rest Home, Dementia, Hospital Level)
- Physical Address
- Geocoded Location - NZTM
- DHB within which the Residential Care Facility resides Column 6 - Number
of Residents at the Start of the Period Column 7 - Deaths During Period -
whether the person died in the facility or in another facility (such as a
public hospital) Column 8 - Age Group at Death (in 10 year bands)

I only expect MSD to provide numbers for those residents that it knows
about through its systems - for example you may not know about people
paying privately.

I would expect that these numbers are available from the MSD's payment
system for subsidised people in residential care - for example where
NationalSuper is paid direct to the facility, and via any income testing
declaration and needs assessment forms submitted. Residents should be able
to be counted and tracked via their MSD number (which records their date
of death and age at death).

If there are any commercial or privacy issues with the above dataset then
please discuss. There may be ways that you can communicate:
A - the % Death Rate per Facility (Column 7 / Column 6) B - wider Age
Groups (e.g. 10 year bands to 90 then everyone above 90) C - Hide the
Facility Name

I would prefer the raw data though so please consult early so that we can
agree and the MSD can meet the OIA timeline."

The Ministry's reference number for your request is: H202002080.

As required under the Act we will endeavour to respond to your request no
later than 13 May 2020, being 20 working days after the day your request
was received.  

If we are unable to respond to your request within this time frame, we
will notify you of an extension of that time frame.

If you have any queries related to this request, please do not hesitate to
get in touch.

Please note, due to the emergence of Covid-19 the Ministry has diverted
significant resources to responding to the pandemic. This may impact on
our ability to respond to your request. If you would like to reconsider or
refine your current request, this may enable us to respond more quickly.
You can notify us of any changes to your request by responding to this
email.

Ngā mihi

OIA Services
Government Services
Office of the Director-General
Ministry of Health
E: [email address]

show quoted sections

Link to this

Ministry of Social Development


Attachment attachment.gif
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Kia ora Chris

Apologies for the double handling. The Ministry of Health is already
working on a response to your request.

As the request transferred from the Ministry of Social Development is the
same as the request the Ministry of Health is currently working, you will
receive a response under reference number H202002127.

Ngā mihi

OIA Services
Government Services
Office of the Director-General
Ministry of Health
E: [email address]

show quoted sections

Link to this

From: Chris Johnston

Dear Ministry of Social Development,

I repeat that I have asked for independent data sets from MoH and MSD based on their unique systems.

I do not want this request transferred or combined. It undermines my planned analysis.

I have asked the Ombudsman to rule on this.

Yours faithfully,

Chris Johnston

Link to this

Ministry of Social Development

I could provide from the payment data the following once covid-19 work
allows

Column 1 to 5
- Residential Facility Name
- Level of Care (E.g. Rest Home, Dementia, Hospital Level)
- Physical Address

- DHB within which the Residential Care Facility resides
Column 6 - Number of Residents at the Start of the Period
Column 7 - Deaths During Period  
Column 8 - Age Group at Death (in 10 year bands)

for 30 June each year
but it would not include rest home residents who pay the maximum because
DHBs do not pay anything towards the cost of their care and they are
therefore not required to be in the payment database (up to a half of the
around 5,000 such residents are in the data at a zero payment rate)

My data does not have
 - Geocoded Location - NZTM
- whether the person died in the facility or in another facility (such as
a public hospital)
Professor Heather McLeod ishas done a lot of work in this area and is
likely to have the data you seseek
Heather McLeod and Associates Ltd
 P.O. Box 70
Hanmer Springs 7360
NEW ZEALAND
 
Tel: 03 315 7973
[mobile number]
E-mail: [1][email address]
Web-site: [2]www.heathermcleodnz.com
 
Please email me back to say whether you w want the part of the information
thayou seek  that I can providet I can provide

Ross Judge
Principal Policy Analyst
Healthy Ageing Team
Health System Improvement and Innovation Directorate
Ministry of Health
133 Molesworth Street
Level 3 South
(04) 816 2049
021 245 0496

show quoted sections

References

Visible links
1. mailto:[email address]
2. http://scanmail.trustwave.com/?c=15517&a...

Link to this

From: Chris Johnston

Dear Ministry of Social Development (& Ross Judge at the MoH)

Thank you for the details of Heather - I will contact her.

Thank you for illustrating that the MoH cannot answer an OIA question directed specifically at the MSD. This OIA should be answered by MSD which has a unique system separate to the MoH that can give us a different but related measure of the deaths in residential facilities because they pay the National Super for residents paying the maximum.

I anticipated at the beginning that there are very different views of "the elephant in a dark room" by the MSD and MoH so you should each answer my query as separately posed to you.

This OIA should never have been redirected to the MoH and has only caused delay on your side - but where you are still required to meet a deadline.

MSD's OIA

Get two datasets together -
1) Those people who have had Asset Tests for entry into residential care, and
2) Those people paid National Super who are physically residing in Residential facilities as recorded by the MSD systems.

You can infer form matching the data via the MSD number the people in the facility and when they died.

You may state that the business process does not guarantee which facility they were in if the person or their relatives did not update their address in the MSD system. My statistical techniques/model will overcome this. Do not worry about that - give me what you have.

MoH's OIA

Some hints:
1) Look at the Residential Facility invoices, and Inpatient National Minimum Dataset matched through the NHI system.
2) DHBs have a contingent future liability if a resident's assets run below the asset testing threshold - so this is the reason that Needs Assessments (NAs) and Service Co-ordinations (SCs) are done. Records of NAs and SCs are also recorded against an NHI number in the MoH's systems. residence in a facility of a person paying privately is therefotre recorded by the MoH as they may have to pay for them, and they also need to ensure that no more than the licensed number of residents are there..
3) The address of all people in the NHI are geo-coded - this provides you with the location of the residential facility.
4) If the PerOrg database (or the equivalent MoH application for providers these days) that records the details of all licensed and contracted residential facilities does not provide it - which it should. The MoH and DHBs shopuld not be paying for any physical facility that has its physical locations licensed, audited and inspected. It is not enough to license the legal entity..
5) Date of Death - The NHI also records the date of death - wherever they died - even if they died in hospital. The invoice from the residential facility will also detail the date that the bed occupancy in physical facility ended so that payment for that person can end and a new person can be registered as starting in that facility.
- Even if a resident died in a public hospital the date of death is thus available from two MoH systems.
- Even if a resident were paying the maximum their date of death comes at least through the NHI system.
6) Location of death - the National Minimum Dataset (NMDS) tells you (because the inpatient discharge date and death date is the same) whether they died in public hospital. Match by NHI number across the residential invoices and NMDS.

For ongoing surveillance, and in order to have assessed this information and framed its strategy for COVID19, Therefore this dataset should already exist.

In lieu of the actual datasets I will accept all reports and analysis that the MoH has undertaken (internally or reported to the Government) of the death rates amongst older people prior to and during the COVID19 period.

Therefore the subsequent statement may say "My" but it is false as far as the "MoH" systems are concerned. The data is there.
===
My data does not have
- Geocoded Location - NZTM
- whether the person died in the facility or in another facility (such as a public hospital) [NOTE I am not asking for WHERE they died - just that they DID die].
===

Yours faithfully,

Chris Johnston

Link to this

From: Chris Johnston

Dear Ministry of Social Development (and Ross Judge, MoH)

I have just received info back from Heather McLeod on the work she has done.

it appears to be very generic..... and will not answer my questions.

If you can convince me that the MoH or MSD has already done the analysis, and has the reports, then I could accept your finished works rather than providing the datasets. Otherwise we will need to proceed with the datasets. Feel free to invite me to ring you if you want to consult/discuss.

Yours faithfully,

Chris Johnston

Link to this

From: Chris Johnston

Dear Ministry of Social Development,

I have received a notification from the FYI.ORG.NZ website that this OIA is overdue.

Could you please give me an update on status?

The Ombudsman's office has confirmed to me that that they have engaged with my complaint on this OIA. It would be good to bring this to a rapid close.

Yours faithfully,

Chris Johnston

Link to this

From: OIA_Requests (MSD)
Ministry of Social Development


Attachment 20200511 OIA Response Letter JOHNSTON.pdf
269K Download View as HTML


Tçnâ koe Chris,

 

Please find attached the Ministry’s response to your Official Information
Act request.

 

Nâ mâtou noa, nâ

 

Official and Parliamentary Information team   |  Ministerial and
Executive Services

Ministry of Social Development

 

Our Purpose:
We help New Zealanders to be safe, strong and independent.
Manaaki Tangata, Manaaki Whânau.

 

------------------------------- This email and any attachments may contain
information that is confidential and subject to legal privilege. If you
are not the intended recipient, any use, dissemination, distribution or
duplication of this email and attachments is prohibited. If you have
received this email in error please notify the author immediately and
erase all copies of the email and attachments. The Ministry of Social
Development accepts no responsibility for changes made to this message or
attachments after transmission from the Ministry.
-------------------------------

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