TIME VALUE OF MONEY. COMPOUNDING Determining the future value of present money.
Value for Money & Policy Review of Disability Services.
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Value for Money & Policy Review of Disability Services
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Transcript of Value for Money & Policy Review of Disability Services.
Value for Money & Policy Review of Disability Services
Background Information:
The National Federation of Voluntary Bodies Providing
Services to People with Intellectual Disability is a national
umbrella organisation for voluntary/non-statutory agencies
who provide direct services to people with intellectual
disability in Ireland
61 Member Organisations who account for in excess of 85%
of this country’s direct service provision to people with an
intellectual disability
Section 38 & Section 39 Organisations
2000 – Largest investment ever in services development
2004 – Health Act – Service Level Agreements (SLAs)
2005 – Report of Comptroller & Auditor General
2009 – Value for Money Report
Value for Money & Policy Review of Disability ServicesEvaluation of the efficiency and effectiveness of
disability services in Ireland.
The review was overseen by a Steering Group, chaired by Mr. Lawrence Crowley.
Its primary purpose was to:a) assess how well current services for people with
disabilities meet their objectives and support the future planning and development of services; and
b) to make recommendations that will ensure that the very substantial funding provided to the sector is used to maximum benefit for persons with disability, having regard to overall resource constraints.
Value for Money & Policy Review of Disability Services
Expert Reference Group on Disability Policy was established to look specifically at:existing disability policy; and assess whether it needs to be changed to
better meet the expectations and objectives of people with disabilities.
Oversaw a public consultation process:more choice;more control.
Value for Money & Policy Review of Disability Services
The over-riding focus of the recommendations is on:
a programme of Governance;
delivery-model change; and
a detailed upgrading of information in
respect of precision, scope and format.
Value for Money & Policy Review of Disability Services1.Administration & Governance:
The national disability function within the HSE must be strengthened and given a central directional role in funding, shaping and driving the Disabilities Service Programme.
2. Person Centred Services & Supports:HSE should drive migration towards a person-centred model of services and supports through the Service Level Agreement process. Note work already being done in this regard: Genio Projects; Next Steps Project.
3.Commissioning & Procurement:Re-shaping of certain services and models.
Value for Money & Policy Review of Disability Services
4.Resource Allocation:A national resource allocation model should be developedSupports Intensity Scale (SIS);In-Control;InterRAI.
5. Information Infrastructure:Strategic information requirements should be established.National Disability Databases;Service Level Agreements.
Value for Money & Policy Review of Disability ServicesIMMEDIATE ACTIONS:
1. The Service Level Agreement process Improvements to information gathering; and performance monitoring.
2. Standardise Financial Reporting –
Development of a common coding system to enable expenditure to be tracked, analysed, and compared at national, regional and local levels.
3. A unique identifier should be put in place to
facilitate:a) Individual Needs Assessment;b) Person-Centred Planning;c) Individualised Budgeting.
Value for Money & Policy Review of Disability ServicesIMMEDIATE ACTIONS (continued):
4. Examination of Value for Money Findings
i. Audit of Rosters:Rationalise staff deployment across service units in accordance with client need and cost effectiveness.
ii. Skill Mix:National guidelines should be developed to advise on the appropriate mix of professional and non-professional staff.
iii. Unit Cost:
HSE should work jointly with service provider to critically examine existing cost bases in the light of the findings and recommendations contained in Chapter 5 of the Value for Money Review.
iv. Average Costs:Pending the development of a resource allocation model, the Service Level Agreement process should be used to reduce current direct pay costs.
Value for Money & Policy Review of Disability Services
IMMEDIATE ACTIONS (continued):
5. Policy Appraisal
6. Implementation PlanA robust Implementation Framework should be developed which takes account of the policy appraisal.
Value for Money & Policy Review of Disability ServicesIMPLEMENTATION PLAN:
a)Disability Programme Objective more choice; More control.
b) Economy & Efficiency a Framework to assess need, identify outputs and
outcomes and plan and monitor resource usage.
c) Effectiveness Develop national indicators to objectively measure the
effectiveness of the Disability Services Programme.
d) Governance & Accountability Role of the National Disability Unit of the HSE; SLAs agreed with Regional Director of Operations and
Integrated Service Area Managers.
Value for Money & Policy Review of Disability Services
IMPLEMENTATION PLAN (continued):
e) Information Framework
f)Funding Framework Block Grant Funding no longer sufficient to
address degree of accountability and transparency required.
g) Future Policy Direction g) Current objectives are still valid, but the policy
approach used to deliver these objectives has not been effective.
Continued sustainability of the current policy approach is questioned.
Value for Money & Policy Review of Disability Services
Existing services should be re-configured;
New resource allocation models developed;
Transition from traditional programme type to
more individual costing approaches can take place;
All future developments will be delivered in line
with the new vision.
Cuts in on-going funding 2008 - 2012
83,1
54,0
71
80,2
69,5
32
74,6
90,3
83
70,0
19,5
45
69,5
25,7
26
50,000,000
55,000,000
60,000,000
65,000,000
70,000,000
75,000,000
80,000,000
85,000,000
2008 2009 2010 2011 2012
2008 2009 2010 2011 2012
Growth in service user numbers 2008 - 2012
14
46
15
73
15
91
16
37
16
63
1100
1150
1200
1250
1300
1350
1400
1450
1500
1550
1600
1650
1700
2008 2009 2010 2011 2012
2008 2009 2010 2011 2012
Growth in Residential Places 2008 - 2012
41
5
42
8
43
8
44
8
46
0
350
375
400
425
450
475
500
2008 2009 2010 2011 2012
2008 2009 2010 2011 2012
