National Respite September 2015 The Community Sector Challenge NDIS Transition Pilot what is it NDIS Challenges and Questions Trial Site Learnings The NDIS Readiness Checklist NDIS Resources ID: 557577
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Slide1
NDIS Transition Pilot Briefing
National Respite
September, 2015Slide2
The Community Sector
Challenge
NDIS Transition Pilot – what is it?
NDIS Challenges and Questions
Trial Site Learnings
The NDIS Readiness Checklist
NDIS Resources
Wrap-UpSlide3
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 LaurenceSlide4
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 Slide5
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 changeSlide6
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
?Slide7
3. NDIS Discussion
Regional Q&ASlide8
3. NDIS Discussion
MAD/Glad/Sad Exercise
Slide9
4 NDIS trial site progress
NDIS Access Requests
Eligible 85%
8%
6%
Ineligible
Excluded –
(age residency)
Average $34,900 (excluding large residences)
Range $5,000 - >$250,000
IFP amounts
Funding administration
NDIA 63%
32%
5
%
NDIA/Self
Self Managed
Top 3 supports by expenditure
Daily tasks/shared living 32%
Community participation 24%
Assistance in personal activities 14% Slide10
4 Case Studies
Service A: ~$5m
Community participation, personal care, life and living skills, therapy services, plan co-ordination
Strategic plan and mission ok – adapted quickly
Effective reduction in
funding
Gained 10-20% new clients, lost 5
%
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
Strategic plan foreshadowed NDIS – but still not prepared
Large drop in per hour funding
Clients steady growth 10%
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
Strategic plan relevant -
Now change Plan to drive for efficiency and growth
Gained more clients, lost some looking for faster
flexibility
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
Service B: ~$5m
Day programs, very high support needs, life and living skills, community participation
Service C: ~$20m
Social & rec, living skills, personal & home care, accommodationSlide11
Service D: ~$3m
Short Breaks, social & recreation, day programs, supported living, case management
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)
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
4 Case Studies
ctd
Service E: ~$2m
All types respite, social & recreation, after school and vacation, parent support
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
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
coordinationSlide12
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 profitablySlide13
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
t
ransport
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 costSlide14
5. NDIS Readiness Checklist
Make a plan e.g. strategic, transition, operations, communications
Talk to your clients
Focus on Quality – outcomes not outputs!
Know what you cost
Know your risks – including culture change, CMS, viabilitySlide15
6. Further Resources
CMS/NDIS Business Canvas Model Report
Thinking about organisation strategy:
https
://
www.youtube.com/watch?v=7aRJ7ovL-RU
Thinking about organisation purpose:
https
://www.youtube.com/watch?v=SKawTRAFOYY
National Respite’s NDIS round-up PDF
Services Preparing Families Resource
ADHC unit costing tools
IDF websiteSlide16
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.comSlide17
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!