NDIS Transition Pilot Briefing National Respite September 2015
NDIS Transition Pilot Briefing National Respite September, 2015
1. 2. 3. 4. 5. 6. 7. The Community Sector Challenge NDIS Transition Pilot – what is it? NDIS Challenges and Questions Trial Site Learnings The NDIS Readiness Checklist NDIS Resources Wrap-Up
1. Community Sector & Markets. . the idea that our sector can continue to meet society’s …needs by – contracting to government, – expanding and aggregating organisations, – driving for greater efficiency, and – further professionalising, regulating and circumscribing care… is a paradigm that is fundamentally flawed. I sense it is sapping the very ethos and moral drive of the sector and, with it, the wider community Tony Nicholson Brotherhood of St Laurence
1. Community sector in Australia • The market takeover of the community sector • The end of the peak body • Preserving who and what we are: – Social justice – for purpose – Volunteers – Community based • In a market mechanism • Independence from government
2. NDIS Transition Readiness Pilot • • • Tailored program for small and micro providers Ten week group program with consultants Marketing/Strategy/Quality Financial Sustainability/CMS Emphasis not just on knowledge and understanding Meaningful and practical change
3. NDIS Discussion State Perspectives What you said: – What will happen in emergencies under NDIS? – What is ILC? How can we be involved? – How does funding for accommodation work? – Will small/micros be sustainable? – How will we be able to pay for our indirect costs? – How will we provide transport? – Back of house – IT/CMS systems – How do we compete with bigger providers and get new clients?
3. NDIS Discussion Regional Q&A
3. NDIS Discussion MAD/Glad/Sad Exercise
4 NDIS trial site progress 8% 6% IFP amounts § Average $34, 900 (excluding large residences) § Range $5, 000 - >$250, 000 Self Managed Existin g 62% NDIA/Self New 38% Funding administration 32% NDIS Access NDIA 63% (age residency) Excluded – Ineligible Eligible 85% NDIS Access Requests 5% Top 3 supports by expenditure § Daily tasks/shared living 32% § Community participation 24% § Assistance in personal activities 14%
4 Case Studies Service B: ~$5 m Service C: ~$20 m • Strategic plan and mission ok – adapted quickly • Effective reduction in funding • Gained 10 -20% new clients, lost 5% • Strategic plan foreshadowed NDIS – but still not prepared • Large drop in per hour funding • Clients steady growth 10% • Strategic plan relevant • Now change Plan to drive for efficiency and growth • Gained more clients, lost some looking for faster flexibility Key insights • CMS/Business process has been a very strong focus • Key challenge is impact of price/margin squeeze on quality and person centeredness • Culture of accountability to clients not easy for all • 2 years on strategy being reviewed Key insights • Huge effort to get business process and costs under control • Focused on systems, and now on flatter structure and work redesign • Advice: earlier attention to – systems, – business process and – seek partnerships Service A: ~$5 m Community participation, personal care, life and living skills, therapy services, plan co-ordination Day programs, very high support needs, life and living skills, community participation Social & rec, living skills, personal & home care, accommodation Key insights • Scale helped manage transition, • Still huge challenge on systems and core business process • Now flattening structure • Quality – language & intent OK – Operationalising within $$$ is the challenge
4 Case Studies ctd Service D: ~$3 m Service E: ~$2 m Short Breaks, social & recreation, day programs, supported living, case management All types respite, social & recreation, after school and vacation, parent support • Very, very early transition no time to revisit strategic plan. • Almost overwhelmed by the admin, cash flow and business operation challenges • Lost some clients, but bigger share of wallet for others (e. g. ageing parents with new supports) • Now revising scope of services (personal care, household, older people) • Early transition • Strategic plan didn’t connect mission/values to a business model • 20 -25% more clients, lost 5% who wanted faster flexibility • Almost went under managing cash flow, business process and system – Only got unit costs 18 months in • Now revising strategic plan, and have a strong partnership for scale Key insights • Quality – big challenge to see client as support workers’ boss • Staff – NDIS price doesn’t cover cost of experienced staff, or short term accommodation • 2 years on strategy being reviewed • Moving to look at support coordination Key insights • CMS/Business process must be an early, strong focus • Quality: huge change to shift accountability from program to client focus • Had to seek a partner to get systems and scale economies • Moving to look at support coordination
Strategy, market, clients summary • Strategic plans and clear purpose help but – Must express in an operating model – Review after two years (changes in scope, structure and operating model) • Clients –new clients up to 25% – Growth imposes operational strains – Loss of clients who want faster flexibility • Quality – move from rhetoric to practice – Big culture change for some staff to see consumer as boss – Margin and price pressure – difficult choices to maintain quality • Marketing most rely on strong word of mouth – Reinforce with online/social media testimonials – Now turning to above the line marketing Strategy should define an approach to service and quality, and the approach and tools to deliver it profitably
Financial Sustainability & Systems • CMS & business process is the single biggest transition challenge: – Can easily send you broke • Price NDIS prices too low especially for – 1: 1 supports or complex needs, – short term accommodation – transport • Structure and job re-design essential to deliver a sustainable person centred service • Collaboration or mergers can be considered to reduce costs Manage cash flow and costs to survive with • Affordable plan to deliver desired level of service • Tools to understand (systems, unit costs) • Redesigned structure to eliminate cost
5. NDIS Readiness Checklist 1. Make a plan e. g. strategic, transition, operations, communications 2. Talk to your clients 3. Focus on Quality – outcomes not outputs! 4. Know what you cost 5. Know your risks – including culture change, CMS, viability
6. Further Resources • CMS/NDIS Business Canvas Model Report • Thinking about organisation strategy: https: //www. youtube. com/watch? v=7 a. RJ 7 ov. L-RU • Thinking about organisation purpose: https: //www. youtube. com/watch? v=SKaw. TRAFOYY • • National Respite’s NDIS round-up PDF Services Preparing Families Resource ADHC unit costing tools IDF website
6. Further Resources Consultant Details: CMS/Financial Sustainability Steve Beard stephen. beard@accpro. com. au Marketing/Strategy Melissa Bertolini melissa@purposeagency. com. au Strategy/Quality Michelle Dodd michelle-dodd@bigpond. com
7. Wrap- Up It is hard for small providers to make it alone in NDIS BUT If the sector works together it doesn’t have to be the death of choice or community values AND The time for action is NOW!
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