NDIS Transition Pilot Briefing

National RespiteSeptember, 2015

1. The Community Sector Challenge2. NDIS Transition Pilot – what is it?3. NDIS Challenges and Questions4. Trial Site Learnings5. The NDIS Readiness Checklist6. NDIS Resources7. 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 NicholsonBrotherhood 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 PerspectivesWhat 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 progressNDIS Access

Exist-ing

62%

New 38%

NDIS Access Requests

Elig

ible

85%

8% 6%

Inel

igib

le Ex

clud

ed –

(a

ge re

side

ncy)

Average $34,900 (excluding large residences)

Range $5,000 - >$250,000

IFP amounts

Funding administration

ND

IA 6

3%

32%

5%

ND

IA/S

elf

Self

Man

aged

Top 3 supports by expenditure

Daily tasks/shared living 32% Community participation 24% Assistance in personal activities 14%

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, accommodation

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 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=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 website

6. Further Resources

Consultant Details:CMS/Financial SustainabilitySteve Beardstephen.beard@accpro.com.au

Marketing/StrategyMelissa Bertolinimelissa@purposeagency.com.au

Strategy/QualityMichelle Doddmichelle-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!