BUDGET 2013 ANDRESULTS-BASED BUDGETING

CALGARY CHAMBER OF VOLUNTARY ORGANIZATIONS

MAY 28, 2013

Presentation Overview

• A Government of Alberta and Human Services Budget 2013 Overview

• The Results-based Budgeting (RBB) approach

• Disability Services Budget 2013 Overview

• The RBB approach with Disability Services

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Budget 2013 – Government of Alberta

• Budget 2013 - a tough budget (‘bitumen bubble’)– Revenue: $6.2B lower than forecast in Budget 2012.– Operating spending: flat year-on-year

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2012-13 Forecast

2013-14 Estimate

2014-15 Target

2015-16 Target

Operating Expense (net of in-year savings)

36,419 36,422 37,144 37,904

(millions of dollars)

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Budget 2013 – Government of Alberta

Source Budget 2013 Fiscal Plan Tables (Page 131). Note: Operational Expense includes operating expense, disaster/emergency assistance, amortization expense, inventory consumption expense, losses on disposal of capital assets, and general debt servicing costs. Figures above may not add due to rounding. Operational Expense does not include Capital Grants.

Budget 2013 – Human Services

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• Human Services Budget $4.3B– Operating spending: basically flat year-on-year

2012-13 Forecast

2013-14 Estimate

2014-15 Target

2015-16 Target

Operating Expense (net of in-year savings)

4,267 4,258 4,281 4,410

(millions of dollars)

Budget 2013 Approach

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Committed to Families and Communities

Outcome Focused

Guided by Alberta’s Social Policy Framework

2013-16 Human Services Business Plan

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Mission:To assist Albertans in creating the conditions for safe and supportive homes, communities, and workplaces so they have opportunities to realize their full potential

Core Business:Work collaboratively with community, industry, and business partners to deliver citizen-centred programs and services that improve quality of life for Albertans

Goals:1. Vulnerable Albertans are protected and supported in times of need2. Alberta has safe, fair, healthy and inclusive workplaces and a skilled labour force that contributes to economic prosperity3. In collaboration with communities and stakeholders, there are opportunities for all Albertans to succeed

Strategic Initiatives – Human Services

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Social Policy Framework

Poverty Reduction

Early Childhood Development

Information Sharing

RBB is about:

• Ensuring government programs and investments are achieving the outcomes Albertans want.

• Ensuring that government programs and services are being delivered in the most efficient and effective way possible.

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Results-based Budgeting (RBB)

RBB Major Lines of Business

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Cycle 1 Reviews – Oct 2012 to May 2013

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Review Programs (#) Ministries Value

($)

Supports for Disabilities(Supports to Albertans in Need)

9 HMSV $862 million

Early Childhood Development

10 EDUC, HMSV, HLTH

$677 million

Health Benefits 21 HLTH, HMSV $1,620 million

Cycle 2 Reviews – Mar 2013 to Dec 2013

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Review Programs (#) Ministries Value

($)

Income and Housing Supports (Supports to Albertans in Need)

30 HMSV, HLTH, MUNA, TBF

$2,285 million

Individual Capacity to Act (Supports to Albertans in Need)

11 HMSV $292 million

Cycle 3 Reviews – Jun 2013 to May 2014

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Review Programs (#) Ministries Value

($)

Prevention(Protecting Albertans)

22 HMSV, JSG, AGRI, CULT, HLTH, EAE, ABOR, SERV, TRNS

$209 million

Intervention(Protecting Albertans)

53 HMSV, JSG, ABOR, HLTH, MUNA, ESRD

$1,300 million

• Focus the review of programs and services on outcomes.Focus on Outcomes

• Align reviews with SPF outcomes for Albertans and SPF system and delivery outcomes.

• Reflect the SPF principles in program analysis.

Align with Social Policy Framework

• Develop policy considerations to guide the reviews towards the desired state. Develop Policy

Considerations

• Collect detailed program information to assess relevance, effectiveness and efficiency.Assess Current State

• Design the future state that aligns programs with the intended outcomes.Design Future State

• Provide advice and recommendations for changes needed in current state to support the achievement of the future state.

Provide Advice

RBB Review Approach

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Social Policy Framework Outcomes for Albertans

• free from fear of abuse and violenceSafe

• highest standard of health and well-beingHealthy

• career and work opportunities, with access to income supports when in need

Secure & Resilient

• develop knowledge, skills, and commitment to learningLifelong Learners

• feel welcomed in communities where they live, learn, and workIncluded

• participate in recreational activities and cultural experiences, and to engage in society

Active & Engaged

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Social Policy Framework System and Delivery Outcomes

• Policy is aligned across program areas so that tools & supports work togetherAligned

• Programs and services balance prevention and intervention, support the whole person, and recognize strengths and needs

Balanced

• Albertans can access and benefit from cohesive, flexible, timely, and informed services

Accessible

• Social programs and services are results-oriented and transparent and sustainable

Accountable & Sustainable

• Roles are complementary, balanced, and work together to achieve outcomesComplementary

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Relevant Effective Efficient

Results-Based Budgeting Program Reviews

Vision, Outcomes, Principles and Policy

Considerations

Alignment with Social Policy Framework

Programs that support better outcomes for Albertans

RBB Review Approach

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RBB Review Process

Challenge Panel

Review Plan Development

Outcomes Confirmed

Approval Process Implementation

Reviews Completed

Challenge Panel

Reviews Conducted

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Challenge PanelsChallenge panels consist of a Treasury Board Committee member, two MLAs as well as public members.

Support to Albertans in Need (Supports for Disabilities)Chair: Len Webber, MLA Calgary-FoothillsMLA: Jason Luan, MLA Calgary-HawkwoodMLA: Alana DeLong, MLA Calgary-Bow

Public Members:• Sol Rolingher, Barrister and Solicitor, Partner with Duncan &

Craig LLP• Robert Rosen, President, City Lumber• Corey Keith, President, Corey Keith & Associates Inc.• Carla Gregor, President & CEO, Good Samaritan Society• Neil Cameron, President, Alberta Pharmacy Association

Budget 2013 - Persons with Disabilities

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Support to Persons with Disabilities(thousands of dollars)

2011-12Actual

2012-13Budget

2012-13Forecast

2013-14Estimate

Change from Forecast Estimate

643,820 683,827 688,327 693,822 5,495

• $5.5 million increase from 2012/13 forecast• Transforming to outcomes based service delivery

system to support independence and community involvement

• Implementing Service Planning Approach based on need

• Improved employment support• Streamlined contracting and accountability

mechanisms

Budget 2013 - Children with Disabilities

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Family Support for Children with Disabilities(thousands of dollars)

2011-12Actual

2012-13Budget

2012-13Forecast

2013-14Estimate

Change from Forecast Estimate

130,929 144,007 137,122 143,020 5,898

• $5.9 million increase from 2012/13 forecast • Supports a wide spectrum of supports and

services for families with children with disabilities

Results Based Budgeting Supports for Disabilities In-Scope Programs

$14.0

$147.7

$18.4

$657.3

$6.7

$3.0

$0.8

$14.0

$0.8

$862.7

($ millions)

Total

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Results Based BudgetingFraming the Context

• In 2006, there were approximately 436,000 Albertans with disabilities of which 31,000 are children

• Majority need support to participate in society and maintain independence

• Nature and level of support varies widely (mild, moderate, severe)

• Types of supports are influenced by living environment and connection to family and community

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Results Based BudgetingFraming the Context

• The Government of Alberta funds disability supports which are most often delivered by community agencies

• Supports for disabilities includes personal supports, life skills training, caregiver supports and information

• Alberta’s disability policies, supports and services reflected common beliefs, best practices and leading delivery models of the day

• The philosophy of meeting the needs of persons with disabilities has changed significantly over time

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Results Based BudgetingFraming the Context

• The current system is comprised of discrete programs that were developed over time to meet different needs

• This results in a disproportion of supports being received by some clients vs. others

• Significant improvements to the efficiency and effectiveness of the PDD program have already been made

• Work is underway to introduce performance-based contracts with CBOs and implement common services access for social based programs

• This review will leverage current work and consider linkages with programs not part of this review to create a cohesive disabilities system 25

Results Based BudgetingAlignment of Outcomes

Category Outcome

GOA Strategic Plan • Support Vulnerable Albertans – Our most vulnerable Albertans are protected and supported so they can reach their full potential

Social Policy Framework Outcomes

Outcomes for Albertans• Safe - free from fear of abuse and violence• Healthy - highest standard of health and well-being• Secure & Resilient - career and work opportunities, with access to income supports when in need• Lifelong Learners - develop knowledge, skills, and commitment to learning• Included - feel welcomed in communities where they live, learn, and work• Active and Engaged - participate in recreational activities and cultural experiences, and to engage in

society

System and Delivery Outcomes• Aligned- Policy is aligned across program areas so that tools & supports work together• Balanced - Programs and services balance prevention and intervention, support the whole person, and

recognize strengths and needs• Accessible - Albertans can access and benefit from cohesive, flexible, timely, and informed services• Accountable & Sustainable - Social programs and services are results-oriented and transparent and

sustainable• Complementary - Roles are complementary, balanced, and work together to achieve outcomes

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Results Based BudgetingAlignment of Outcomes

Category OutcomeDisability Supports System (Proposed)

• The disability supports system is transparent and responsive based on the experience and outcomes of Albertans

• The disability supports system promotes healthy choices• The disability supports system supports all Albertans with disabilities based on needs and strengths

• Albertans with disabilities and their families receive integrated and timely assessment of needs and strengths

• Albertans with disabilities and their families understand what supports are available and are able to navigate the system

• Albertans with disabilities and their families actively participate in planning and decisions regarding supports

• Albertans with disabilities and their families receive integrated, timely access and ongoing support that adjusts to their changing needs

• Albertans with disabilities maximize their health and well being• Albertans with disabilities have a safe and stable living environment that is appropriate for their

needs• Albertans with disabilities are actively engaged and included in their communities• Albertans with disabilities maximize their independence and achieve their full potential.

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Results Based BudgetingMoving to the Desired State – Strategic Shifts

From Here To TherePrograms are assessed separately based on measurement of what activities are performed and what services are delivered. Funding is generally not linked to demonstration of outcomes.

Funding is linked to the achievement of outcomes

Measure the effectiveness as well as the efficiency of the delivery of supports for disabilities against a common set of system outcomes. Link support funding to the achievement of outcomes.

Each program determines access to supports separately based on a narrow range of eligible diagnoses or deficits.

Access to supports is based on needs and strengths of the individual and not diagnosis

Determine access to supports through a holistic assessment of support needs and strengths in different areas of a person’s life as well as the natural supports a person has.

Individuals and their families are placed or served within programs in which they are eligible; they are provided few options about available services within these programs.

Individuals share mutual responsibility and accountability for decisions regarding their supports

People with disabilities and their families participate in the planning process, make meaningful decisions about the supports they receive, and share responsibility for achieving positive results.

Most programs, providers and community partners deliver services under separate mandates and contracts, producing a disjointed service experience for some clients.

Services and supports for disabilities are integrated in the broader system

Accelerate the shift towards a fully integrated and sustainable service delivery model that provides clients with a consistent, high-quality experience that respects their full potential and dignity.

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FASD 1,900 clients

RAMP 675 clients

Brain Injury / Other

Disability Supports

4,050 clients

PDD 9,700 clients

FSCD8,600 clients

Age 18Programs by

diagnosis

31,000Children with disabilities

405,000Adults with disabilities

Other gov’t funded programs (e.g. AADL)

Family, community, and other non-government supports

Albertans with Disabilities - Programs Across Lifespan

UnmetNeeds

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PDD Current State

• A complex governance model (Community Boards / Ministry relationships)

• Increasing caseloads – especially extraordinarily complex cases – are driving program growth that is unsustainable (see following chart)

• Difficulty transitioning individuals from FSCD to adult programs

• Many adults with disabilities (FASD, Autism, Brain Injury) who do not meet PDD’s eligibility criteria for IQ, but have unmet support needs

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PDD Current State

• A complex service delivery system focused on activities rather than outcomes - individuals leading meaningful lives in communities

• Front-line staff wages are low, resulting high staff turnover, and leading to negative impacts on clients and negative impacts on staff

INDIVIDUALS, FAMILIES, GUARDIANS, SERVICE PROVIDERS AND STAFF HAVE TOLD PDD, “IT IS TIME TO

DO BETTER.”

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Impetus for Change

• Several studies and consultations were undertaken, and Ministerial direction was given to undertake the PDD Change Initiatives; consultations included:• What We Heard: Increasing Flexibility for Families

• What We Heard: Increasing Flexibility in the Contracting Process

• KPMG Report to the Minister: Administrative Review of the Persons with Developmental Disabilities (PDD) Program (September 2010)

• MLA Genia Leskiw’s Contracting Consultations

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Results-based BudgetingVision for Future System of Disability SupportsOne disability program• Albertans with disabilities and their families are actively involved and

supported by one Disability Program across their lifespan that respects the uniqueness of each individual.

• Needs and strengths guide the provision of support• Albertans with disabilities and the Disability Program work together to make

certain their functional needs and strengths are well understood and are the foundation of supports. This means that more Albertans with disabilities receive support, and that support is more equitably and appropriately distributed.

Services are consistent and accessible• Disability supports are readily accessible to any Albertan, in-person, by phone

(through a contact centre) or through the web. Common processes across the province ensure consistency, and support the provision of the right services at the right time.

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Results-based BudgetingThe Future System of Disability Supports

Services achieve results

Disability supports are structured and funded to help Albertans with disabilities to meet their goals for enhanced health and wellbeing, safe and stable housing, community inclusion and independence – ultimately allowing them to achieve their full potential.

Navigation is simple

Disability supports are well-integrated with the network of government and community supports required for holistic support. Common points of access, client coordinator positions and enhanced awareness of disabilities all facilitate improved navigation.

Services are integrated with other systems and the community.

The Disability Program promotes awareness of Albertans with disabilities to include them in their communities and works to address system and community barriers that impede outcomes from being achieved.

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Next Steps

• Implement budget decisions• Implement RBB policy shifts• Implement Quality of Life measures• Close Michener North and South side facilities• Implement new funding and contracting processes• Develop housing options to better support people

with complex service needs

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Questions/Discussion

Thank you.

Questions?

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