“Just because they have an intellectual
disability...”
A guide to the ID(CC&R) Act 2003 for offenders with
an intellectual disability.
Gary Wyatt
Compulsory Care
Coordinator
NIDCA
NIDCA
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We all have them – acronyms!!!!
ID(CC&R)
 Intellectual Disability (Compulsory Care and Rehabilitation)
Act 2003
CPMIP
 Criminal Procedure (Mentally Impaired Persons) Act 2003
NIDCA
 National Intellectual Disability Care Agency
RIDSAS
 Regional Intellectual Disability Supported Accommodation
Service
RIDSS
 Regional Intellectual Disability Secure Service
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We all have them – acronyms!!!!
Care Recipient
 Care Recipient is a person under a Compulsory Care Order
(Can be Special, Secure or Supervised)
Civil Client
 A person residing in RID’s services on a voluntary basis or
through any type of legal mandate (MH, PPPR)
NASC
 Needs Assessment and Service Coordination agencies
ID Eligibility
 A required that the person has an intellectual disability to
receive services from NIDCA
Section 29
 The formal process used by Corrections to refer a prisoner
to NIDCA
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NIDCA regions




NIDCA
Whangarei and Auckland
(Northern)
Cambridge (Midlands)
Wellington (Central and
National Office)
Christchurch and Dunedin
(Southern)
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Service Framework

The Ministry of Health developed a new service framework
for care recipients (under the ID(CC&R) Act), and to
support the “civil clients”.

This comprises of:
 National Intellectual Disability Care Agencies (which employ
the Care Co-ordinators)
 Regional/National Intellectual Disability Secure Services
 Regional Intellectual Disability Supported Accommodation
Services (which employ the Care Managers)
 Sexual Offender Treatment Programmes (SAFE, SOTP)
 Consult Liaison Teams
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Client Numbers
Total ID(CC&R) Act and High and Complex Service
Population
July 2013
ID(CC&R) (Secure & Supervised)
118
Mental Health Act
14
High & Complex "Civil"
141
July 2013 – Age Groups
11-20
20-30
31-40
41-50
51-60
Number of ID(CC&R) New Orders
61+
July 2013
Secure
12
Supervised
13
July 2013 - Gender
Female
7% 3%
Male
July 2013 - Ethnicity
6%
5% 2%
Asian
12%
European/Other
7%
27%
Maori
47%
22%
88%
34%
40%
Not Stated/Don't
Know
Pacific
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The numbers in perspective
ID Offender Population
= 0.84% (356)
Intellectual Disability (ID)
Population = 1% (42,600)
NZ Population = 4.26m
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Intellectual Disability (Compulsory Care
and Rehabilitation) Act 2003
What is it?
 When did it come into effect?
 Why?
 Who does it cover?

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A brief history of the ID(CC&R) Act
2003

Historically people with an intellectual disability who
offended were managed under the mental health system
until the Mental Health (Compulsory Assessment and
Treatment) Act, 1992 created an unintended legal gap,
which resulted in people being subject to criminal justice
dispositions (or not being charged for criminal offences).

The enactment of the Criminal Procedure (Mentally
Impaired Persons) Act, 2003, and the Intellectual
Disability (Compulsory Care and Rehabilitation) Act 2003
(ID(CC&R) Act), closed the legal gap.
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A brief history of the ID(CC&R) Act
2003

During the policy development phase for the new
legislation, a number of contentious issues emerged:
 Whether to include a civil commitment component for
people who had not offended (or been charged) but
whose behaviour was regarded as posing a
significant danger to others, or themselves [legal
provision was ultimately rejected by parliament, but
money was allocated to enhance intensive services]
 Whether to also include people with personality
disorder, ASD, or brain injury [decided to restrict the
Act to Intellectual Disability]
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A brief history of the ID(CC&R) Act
2003
This issue has re-emerged with the with the
latest UN Convention Independent monitoring
report. Recommendation 15:

NIDCA
Rec 15 - That the Ministry of Justice and the
Ministry of Health review arrangements for the
provision of appropriate detention facilities,
where needed, for people with an
intellectual/learning disability who have not
committed a criminal offence.
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A brief history of the ID(CC&R) Act
2003


NIDCA
And whether or not to include children and young
persons (under 17 years), or rely on the care and
protection or youth justice provisions in the Children,
Young Persons and their Families Act 1989. [decided
to only include children or young persons charged
with very serious offences, such as
murder/manslaughter, and whose cases would be
heard in the District or High Court]
However more and more Youth are being referred by
Criminal Courts for assessments and placement
under the ID(CC&R) Act
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Case Example “T”





Referred to NIDCA for a section 29 transfer
Placed into a secure facility.
Once parolled, remained within services at his
own choice for 6 years, under no compulsion.
Took on a “client representative” role within
organisation to speak on behalf of clients.
Recently offended after he had chosen to exit
NIDCA services in late 2012.
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Intellectual Disability
Is a Permanent impairment that…
 Results in significantly sub-average
intelligence (FSIQ 70 or below
[indicative]); and
 Results in significant deficits in at least
two areas of adaptive functioning; and
 Became apparent during developmental
period <18yrs
 Defined in the act (Section 7 ID[CC&R])
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Referrals to NIDCA

Referrals by appropriate agencies or
pathways to the ID(CC&R) Act 2003




CPMIP Act dispositions through Criminal Court
(94% of referrals)
MH Transfers for Former Special Patients (1%)
Section 29 ID(CC&R) Act referrals from Dept of
Corrections (5%)
Referrals from NASC agencies for the
person to be a civil client with NIDCA.
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ID(CC&R) Act 2003
The Act establishes statutory roles:
 Compulsory Care Co-ordinators (are
responsible for the operational administration of
the Act);
 Specialist Assessors (are responsible for
assessments to determine eligibility, risk and
rehabilitation needs);
 District Inspectors (lawyers appointed under
the MH (CAT) Act)1992 to safeguard the rights of
people subject to an order)
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ID(CC&R) Act 2003



Roles are statutory appointed by Director General
of Health
Care Coordinator role
Specialist Assessor (Health Assessor)






NIDCA
Determination or Confirmation of ID
Determine the Need for Compulsory Care
Determine the Level of risk and therefore care required
Consults with Caregivers, Family/Whanau, Welfare
Guardians
Initial assessments and ongoing six monthly reviews
Submit written report to Compulsory Care Coordinator
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Case Example “C”






Referred to NIDCA for a section 29 transfer
As at end of sentence, as well as other factors,
deemed not an appropriate referral.
Due to having no family support and a low FSIQ,
determined that he should be accepted as a civil
client.
Has ESO in place
Doing very well living in services. Has part time
work, shares house with 1 other person.
Minimized risk of re-offending
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Rehabilitation defined
With the inclusion of the word rehabilitation in the title it was
expected that a clear definition would be provided:
 “Rehabilitation, I notice, is not defined either in the bill
itself or in the Supplementary Order Paper. I would have
thought that with its inclusion in the title it should, perhaps,
have been defined. That would have made a good deal of
sense. It should have been defined so that we know exactly
what it is. (Heather Roy, Act Party,2003).”
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Rehabilitation defined...
Following a recent court of appeal case,
rehabilitation is taken to mean,
“Improvement of the character, skills and
behaviour of an offender through training,
counselling, education etc. in order to aid
reintegration into society. (VM vs Central
RIDCA)”
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Rehabilitation defined...
Recent research conducted indicates the need for greater clarity
around the implementation of rehabilitation. Particular points are:
 Care managers experience a tension between managing risk and
providing good rehabilitative outcomes (Kate Prebble, 2009)
 Rehabilitation needs to be more clearly articulated and understood
in the context of care and rehabilitation plans – to provide good
outcomes (Liz O’Callaghan, 2012)
 Human rights and dignity need to feature at the centre of the
rehabilitative process ( Amanda Smith, 2013)
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Risk versus rehabilitation

Risk management is a necessary part of a framework that is about
managing criminal offenders.

The need for containment needs to be balanced with appropriate freedoms
to facilitate rehabilitation.

Recognition of both the need for clarity regarding rehabilitation and the
need for appropriate risk management has led to the roll out of the RNR
Risk assessment tool for Specialist Assessors.

Soon we will be commencing an review of our model of care.

We want to make sure we are implementing effective rehabilitation that
provide the best life for care recipients following release.
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Rehabilitation...
“it doesn’t sit comfortably with me that we might have people,
you know have this as a very serious consequence or outcome
to offending and say that we’re providing care and
rehabilitation when actually all we’re doing is providing
containment and we’re not actually addressing because for
some of those people they’d be better off going to prison and
getting out after two years and carrying on with their lives
because you know the reality is that they get trapped in a
cycle where they have very little power to
change...(professional,2010)”
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How effective is criminogenic rehabilitation in mainstream
corrections?
Some programmes decrease recidivism.
 Some increase recidivism.
 Many prisoners do not want anything to
do with them.
 And they still get out at the end of the
sentence.
 Should the rules be different if you have
an ID?

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Care Recipients
The ID(CC&R) Act creates two categories of care recipients:
• Special care recipients who must always receive care
and rehabilitation in a secure facility, and
• Care recipients who can, depending on their individual
circumstances, either receive care and rehabilitation in a
secure facility, or a supervised setting.
The ID(CC&R) requires the Family Court to review the
appropriateness of care and rehabilitation plans.
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ID(CC&R) Act 2003
This Act provides for two different levels of
“care”
 Secure Care (Hospital or Community)
 Supervised Care
Levels of care provision are guided by the
care and rehabilitation plan, Needs
Assessment and Specialist Assessors
report (inc risk assessment)
 Length of Orders
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Referrals from Corrections
The Department of Corrections can make
applications for prisoners, who they
believe may have an intellectual disability,
to be transferred to the ID(CC&R) Act
 This is a legislated pathway under section
29 of the Act.
 It has very strict timeframes and
procedures
 Requires a good level of communication
from all parties

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Referrals from Corrections
Notification to NIDCA of intend to refer.
 Pre-assessment
 A Health Assessor appointed by NIDCA
must assess whether the person meets
the criteria for section 7 of the ID(CC&R)
Act.

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Referrals from Corrections
Most referrals are often triggered by a
psychologist, medical team member, PCO
or by a recommendation from the Parole
Board.
 The first stop should always be a call to
your local NIDCA to discuss the process
and possible options.

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Referrals from Corrections
The pre-referral assessment helps deal
with the 7 day assessment timeframe.
 If ID eligibility has been established.
 If ID is not established or the referral is
not appropriate.

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Referrals from Corrections

To assist with the various assessments
during the section 29 applications, the
Care Coordinator can apply to have the
prisoner transferred to a hospital secure
facility for the assessments to take place.
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Needs Assessment
All persons coming into NIDCA require a Needs Assessment to
be developed. This assessment should include input from;
 Care recipient
 Welfare guardian
 Parents/guardian – if care recipient is a young person
 Principal care giver
 Family/whanau
 Partner or significant other person
 Support person
 Lawyer
 Advocate
 Anyone else that the person wishes to be involved in the
assessment
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Referrals from Corrections
Decisions under section 39 of the act.
 Applications to the Family Court
 If the Care Coordinator decides that an
application under the ID(CC&R) Act for a
compulsory care order is appropriate, the
prisoner may be detained in the same
hospital facility until the outcome of the
application is heard by the Family Court

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Referrals from Corrections



Due to the primary focus of the act being
“rehabilitation”, a referral for rehabilitation under
the act should occur at opportune times for the
prisoner
Too early in a sentence = means the person may
have to return to prison if not paroled at the end
of the rehab programme
Too late into a sentence = presents with concerns
about continued detainment and lack of time to
do rehab programme. Also sees prisoners not
wanting to do the programme as they could be
released sooner if they stay in prison.
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Referrals from Corrections
Section 29 transfers to ID(CC&R) should
not be seen as a way on continued
detention if the person is at the end of
their sentence.
 A proactive approach should occur around
section 29 transfers so that the
rehabilitative focus of the act can be
utilised to assist the prisoner when
seeking parole.

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Referrals from Corrections



Over the years we have had inappropriate
referrals under section 29 when ongoing
detainment is sought at the end of a sentence.
Just because the person has an ID, does not
mean that ID(CC&R) should be used to further
detain the person.
Transfer should occur when the person still has a
period of sentence remaining as an alternative
option to prison and the ability to have offending
behaviours addressed by programmes specifically
designed for people with an ID
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Options under NIDCA and
ID(CC&R)
Access to Sexual Offender treatment
programmes for people with ID
 Vocational supports
 Residential Care
 Counselling (Relationship, Anger
Management, Drug and Alcohol)
 Supported Employment
 Referrals to mainstream disability support
services

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Case Example “K”




Referred to NIDCA for a section 29 transfer
Once order had been made under ID(CC&R), he
believed that his sentence had ceased, despite
assurances it was still active.
Assaulted staff at secure facility, took on “top
dog” role, failed to do programmes, assisted in
an escape.
ID(CC&R) order was cancelled and he returned to
prison to serve remainder of sentence.
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References and links
Te Korowai Whariki
www.tekorowaiwhariki.org.nz and click on
“Intellectual Disability Services”
 Local NIDCA Office

Guidelines ID(CC&R)
www.moh.govt.nz/ID(CC&R)
 Statutes www.legislation.govt.nz


Acknowledgments:

NIDCA
Amanda Smith, Lester Mundell, Anthony Duncan, Rachel Daysh
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