Learning from the transition to NDIS: perspectives for CEOs in Aged Care

Written by Lauranne Beernaert, Sector Support Coordinator

How to successfully lead my organisation through change and uncertainty? Am I supported by the right Executive Leadership Team? These are  the type of questions that a dozen CEOs of Aged Care organisations tackled during a lively CEO Round Table discussion in mid-April 2022.

Facilitated by the former CEO of a disability organisation, this Round Table discussion offered a platform for CEOs to connect and consider the learnings from the shift in policy and service delivery that the disability sector went through into the lead up into the NDIS.

Key areas for consideration and tips:

Company Culture and Change

The volume of changes can be underestimated, which is why it is useful to engage early with the process and the pilot/consultations.

Transitioning to the NDIS required a major mindset shift: from care to outcomes focus, compliance and risk at the forefront, documentation of all supports and hours.  Workers were suddenly accountable for how they spent their hours so recording of billables/utilisation was a shift.

Tips: CEO visibility and engagement with top down, consistent messaging Praise the right behaviours and outcomes – broadly No tolerance for bad behaviours – investigate and act immediately Document participant outcomes and services delivered

Workforce, Awards and Unions

The disability workforce experienced a high turnover rate, with acute staff shortages in all settings and regions. There was a broad casualisation (30% in residential services, 70% in individual supports) which led to poor results. Underpayment was widespread, and Unions were either cooperative and/or militant.

Tips: Attract staff with recruitment campaigns, organize open days Retention payments for key people Educate your workers – Cert III or Cert IV Communicate with the Unions Volunteers have similar obligations to paid workers NDIS WC Check and supervision

The NDIS and changing goalposts

The NDIS has been a work in progress since the beginning, but people with disabilities and providers have struggled to understand the system. Pricing is based on the cost of a standard in which the NDIA has modelled all aspects of the business (worker, supervision, compliance cost, overhead of 12% and 2% profit margin – Disability Support Worker (DSW) Cost Model).

Tips: Select the right Client Information system to adapt quickly to changes, let the technology provider integrate the changes Focus on process improvement to reduce overhead Expect to be 2 months behind with claiming where changes are made to pricing Join peak bodies and other providers, CEO Forum as advocacy groups

Financial Results

Fee for service environment results in lower margins. Think about back-office processes (integration of systems and service claims) – sometimes a large investment in technology will be required. Eliminating leakages is key to survival.

Tips: Select technology support and automate processes to low claiming for support and eliminate billing leakage Hire a proactive CFO/similar who is a great analyst and challenges the organization to change Build meaningful financial reports and use them to manage business.

The Executive Leadership Team

Do you have the right Executive Leadership Team to support you?

Tips: Review the ELT and the next level down – do they have the right skills for the future environment? Mix the commercial skills with Sector specific skills Build a team and always communicate

Managing the Board

Several things to consider for Boards: size, succession planning, skills (commercial, clinical governance), who are often highly risk adverse.

Tips: Campaign for a paid Board, it gives the message it is a real job Inform the Board: be transparent with regular Board reporting, key performance indicators dashboard, and introduce the ELT and Senior Managers to build confidence Educate the Board (AICD Company Directors Course, visit services, explain main business drivers)

Concluding thoughts

• Margins are thinner and survival depends on economies of scale and efficient back-office systems and processes.
• The future is commercial and involves marketing and competition (position, branding).
• You need the right team to succeed, are you up to it personally? Does the ELT have sufficient commercial skills, and do they understand what is about to happen and are they ready to support you?

Contact details of the facilitator:
PAUL STIFF
MD PAUL STIFF CONSULTING PTY LTD
www.paulstiff.com.au