AUSTRALIA’S REFORMING

COMMUNITY CARE SYSTEM

DR. GARY JACOBSON AND MARIKA KONTELLIS

OLD MATES

• THE HOSPITAL SYSTEM AND THE COMMUNITY CARE SYSTEM ARE OLD MATES

• HISTORICALLY, THERE HAVE BEEN SOME MINOR AND MAJOR “ISSUES” OF

DIFFERENCE

• TODAY- WE ALL KNOW THAT PATIENT FLOW, QUALITY CARE AND GOOD HEALTH

OUTCOMES DEPENDS ON COLLABORATION BETWEEN THE HOSPITAL AND THE

COMMUNITY CARE SYSTEMS

• WHAT WE NEED MORE OF IS INNOVATION – AND THIS CAN ONLY HAPPEN IF WE

DO COLLABORATE

WHAT DO WE MEAN BY COMMUNITY CARE SYSTEM

family/friends

Not for profit organisations

Private , for profit care

businesses

WHY NOT FOR PROFITS ARE STRESSING?

• BASICALLY – THE OLD FUNDING MODEL – BLOCK FUNDING – IS GOING

• IN ITS PLACE WILL BE ACTIVITY FUNDING OR CONSUMER DIRECTED FUNDING

• NOT FOR PROFITS WILL NO LONGER BLOCKS OF GOVERNMENT FUNDING TO

PROVIDE SERVICES THROUGH FUNDED PROGRAMS

• THE NEW FUNDING MODEL IS A FUNDAMENTAL AND MONUMENTAL SHIFT IN

RESOURCING NOT FOR PROFITS AND COMMUNITY CARE

NFP’S ROLE IN KEEPING PEOPLE AT HOME

• THERE ARE ABOUT 660,000 NOT FOR PROFITS IN AUSTRALIA

• HISTORY OF NFP SECTOR TAKES THEM BACK TO A TIME BEFORE GOVERNMENT

DEPARTMENTS, BEFORE SCHOOLS, BEFORE HOSPITALS

• IN THE 1980’S AND 1990’S, NFP’S GOT INTO HELPING PEOPLE STAY IN THEIR OWN

HOMES - BIG TIME

• THE HACC PROGRAM GREW AND GREW – THE FOCUS WAS TO KEEP PEOPLE OUT

OF INAPPROPRIATE AND PREMATURE INSTITUTIONALIZATION

• THIS INCLUDED NURSING HOMES, JAILS AND HOSPITALS

LET’S UNDERSTAND THE CHANGES

• CHANGES ARE OCCURRING ON MULTIPLE LEVELS

POLITICAL

MARKET

CUSTOMERS/CLIENTS

POLITICALLY • MORE FEDERAL CONTROL AND FUNDING, ESPECIALLY DISABILITY AND AGED CARE;

• MODEL OF MARKETISATION – LET THE MARKET DECIDE WHAT COMMUNITY CARE WILL

LOOK LIKE

• DIVISIVE TACTICS REGARDING PRIORITY – OLD PEOPLE, PEOPLE WITH DISABILITY,

HOMELESS PEOPLE, PEOPLE WITH DISABILITY ALL COMPETING FOR RESOURCES AND

ATTENTION

• CENTRALISED ASSESSMENT AND PLANNING;

• DESIRE TO HAVE LESS, BUT BIGGER ORGANISATIONS;

• GREATER CHOICE FOR PEOPLE AND;

• MAINSTREAMING OF SPECIALISED SERVICES;

THE MARKET

• PEOPLE WILL HAVE THE FUNDING, NOT THE ORGANISATION;

• NEW ENTRANTS ARE BEING ENCOURAGED;

• GOVERNMENT IS MOVING OUT (HOME CARE);

• MARKETISATION IS THE HOPE;

• MAINSTREAM SUPPORTS ARE NOT IN PLACE AND;

• GOVERNMENT WILL STILL HAVE LARGE-SCALE CONTROL.

CUSTOMERS

• MORE AWARE

• WIDER USE OF THE INTERNET, SOCIAL MEDIA

• HIGHER EXPECTATIONS

• SHARE THEIR EXPERIENCES IMMEDIATELY – VIA SOCIAL MEDIA;

• MOBILE TECHNOLOGY;

• TRACKING OF MOVEMENTS AND;

• SHARING OF DATA AND INFORMATION

IMPACTS • THE LANDSCAPE, THE MARKET AND THE PEOPLE THAT ACCESS IT ARE ALL

CHANGING.

• THE THINGS WE KNEW AND TOOK FOR GRANTED ARE NO LONGER APPLICABLE

…GOVERNMENTS WON’T FUND SERVICES BUT THEY WILL FUND PEOPLE;

• PEOPLE WON’T BE PASSIVE RECIPIENTS OF SERVICES BUT ACTIVE DEMANDERS;

• IT’S NOT ABOUT WHAT WE CAN PROVIDE BUT ABOUT WHAT PEOPLE WANT;

• THE MAIN DIFFERENCE BETWEEN A FOR-PROFIT AND NOT-FOR-PROFIT MAY BE

ONLY WHAT THEY DO WITH THEIR PROFIT (IF THEY MAKE ONE) –

• NFP’S NEED TO SHIFT FROM MANAGING FUNDING TO RUNNING A BUSINESS….

WHAT WE ARE SEEING IN THE SECTOR

• A BIT OF PANIC

• UNLIKELY, RUSHED ALLIANCES, TAKEOVERS OR MERGERS

• SHUT DOWNS

• STRONG EMERGING ORGANIZATIONS WHO ARE FOCUSED ON PURPOSE AND ARE NOT AFRAID TO

SHOW IT

• LOTS OF COMPETITION

• NEW ENTRANTS – FOR PROFITS AND NATIONAL PLAYERS

• RELIANCE ON GOVERNMENT DIRECTION

• SLOW, BUT EMERGING REALIZATION THAT WE HAVE TO CHANGE MODEL AND WORK TOGETHER

BETTER

OUR TAKE

• DEMAND FOR HEALTH AND COMMUNITY CARE SERVICES AND SUPPORT WILL

CONTINUE

• GOVERNMENT DOES NOT ALWAYS KNOW BEST

• THE USE OF TECHNOLOGY IN THE FUTURE OF HEALTH AND COMMUNITY CARE

CAN NOT BE UNDERESTIMATED

• THE HOSPITAL/COMMUNITY INTERFACE NEEDS TO BE STRENGTHENED

5 HOT TIPS FOR COMMUNITY CARE ORGANISATIONS

• THERE ARE MORE- BUT HERE ARE OUR TOP 5 TIPS …………………………..

#1 BIGGER IS NOT BETTER

• DON’T BE FOOLED THAT BY GROWING YOUR ORGANISATION, YOUR WILL BE IN

A BETTER POSITION TO DELIVER ON YOUR PURPOSE. WE HAVE WORKED WITH

A RANGE OF SOCIAL CARE BUSINESSES THIS YEAR AND THE MOST EFFECTIVE

ARE THOSE WHO ARE SMALL, NIMBLE AND DRIVEN BY THEIR PURPOSE.

#2 THE NOT FOR PROFIT SECTOR DOES NOT HAVE A MONOPOLY ON DOING GOOD

• WE ARE SEEING A NEW BREED OF “HYBRID-SOCIAL CARE BUSINESSES”.

THOSE WHO ARE MAKING A PROFIT AND AT THE SAME, DELIVERING A

POSITIVE SOCIAL IMPACT. COMMUNITY, NOT FOR PROFITS AND FAITH BASED

AGENCIES DO NOT HAVE A MONOPOLY ON DEEP, LASTING, POSITIVE SOCIAL

CHANGE.

# 3 BUILD YOUR THEORY OF CHANGE

• STOP. BE DISCIPLINED AND REALLY UNDERSTAND THE “WHY”. WHY YOUR

ORGANISATION EXISTS? WHAT IMPACT YOU WANT TO DO DELIVER. FOR

MANY NOT FOR PROFITS, THEIR “WHY” HAS BECOME LOST IN THEIR “HOW”.

THEIR “HOW” HAS MOSTLY BEEN ABOUT DELIVERING ON GOVERNMENT BLOCK

FUNDING CONTRACTS. AS THESE FUNDING ARRANGEMENTS CHANGE

ORGANISATIONS WILL NEED TO BE CLEAR ABOUT WHY THEY SHOULD EXIST.

#4 YOUR CUSTOMERS ARE YOUR FUTURE

• WITHOUT A CLOSE AND INTIMATE RELATIONSHIP WITH THE PEOPLE THAT YOU

EXIST TO SERVE, YOUR FUTURE IS BLEAK. KNOWING AND REALLY

UNDERSTANDING THE NEEDS OF YOUR CUSTOMERS IS THE KEY TO YOUR

SUCCESS. IF YOU DO NOT HAVE A DIRECT RELATIONSHIP WITH THE PEOPLE

WHO USE YOUR SERVICES, GET ONE.

# 5 CHANGE YOUR OPERATIONS

• DO NOT THINK THAT YOUR STAFFING STRUCTURE, INTERNAL SKILLS SET, IT

INFRASTRUCTURE AND CLIENT RELATIONSHIP DATA BASE WILL BE OKAY.

CHECK THEM AND ALIGN YOUR CAPABILITY WITH THE NEW WAY OF

WORKING. FOR MANY NOT FOR PROFITS, YOU WILL NO LONGER BE MANAGING

GOVERNMENT CONTRACTS. YOU WILL BE COMPETING FOR CUSTOMERS AND

SELLING TO THEM DIRECTLY

OUR FINAL MESSAGE

• WORK WITH OTHERS

• BUILD INTERFACES BETWEEN CUSTOMERS, HOSPITALS, CARE AGENCIES,

FAMILIES

• INVEST IN INNOVATION