Transcript from the session. - Calgary Chamber of Voluntary Organizations

BUDGET 2013 AND
RESULTS-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
2
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
Operating
Expense (net of
2012-13
Forecast
2013-14
Estimate
2014-15
Target
2015-16
Target
36,419
36,422
37,144
37,904
in-year savings)
(millions of dollars)
3
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.
4
Budget 2013 – Human Services
• Human Services Budget $4.3B
– Operating spending: basically flat year-on-year
Operating
Expense (net of
2012-13
Forecast
2013-14
Estimate
2014-15
Target
2015-16
Target
4,267
4,258
4,281
4,410
in-year savings)
(millions of dollars)
5
Budget 2013 Approach
Committed to Families and
Communities
Outcome Focused
Guided by Alberta’s Social
Policy Framework
6
2013-16 Human Services Business Plan
Mission:
To assist Albertans in creating
the conditions for safe and
supportive homes,
communities, and workplaces
so they have opportunities to
realize their full potential
Core Business:
Work collaboratively with
community, industry, and
business partners to deliver
citizen-centred programs and
services that improve quality of
life for Albertans
Goals:
1. Vulnerable Albertans are
protected and supported in
times of need
2. Alberta has safe, fair,
healthy and inclusive
workplaces and a skilled
labour force that contributes
to economic prosperity
3. In collaboration with
communities and
stakeholders, there are
opportunities for all Albertans
to succeed
7
Strategic Initiatives – Human Services
Social Policy Framework
Poverty Reduction
Early Childhood Development
Information Sharing
8
Results-based Budgeting (RBB)
RBB is about:
• Ensuring government programs and investments are
achieving the outcomes Albertans want.
• Ensuring that government programs and services are
being delivered in the most efficient and effective way
possible.
9
RBB Major Lines of Business
10
Cycle 1 Reviews – Oct 2012 to May 2013
Review
Programs
(#)
Ministries
Value
($)
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
$1,620 million
11
Cycle 2 Reviews – Mar 2013 to Dec 2013
Review
Programs
(#)
Ministries
Value
($)
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
$292 million
12
Cycle 3 Reviews – Jun 2013 to May 2014
Review
Programs
(#)
Ministries
Value
($)
Prevention
(Protecting
Albertans)
22
HMSV, JSG, AGRI,
CULT, HLTH, EAE,
ABOR, SERV,
TRNS
$209 million
Intervention
(Protecting
Albertans)
53
HMSV, JSG, ABOR, $1,300 million
HLTH, MUNA,
ESRD
13
RBB Review Approach
Focus on Outcomes
Align with
Social Policy Framework
Develop Policy
Considerations
• Focus the review of programs and services on
outcomes.
• Align reviews with SPF outcomes for Albertans and SPF
system and delivery outcomes.
• Reflect the SPF principles in program analysis.
• Develop policy considerations to guide the reviews
towards the desired state.
Assess Current State
• Collect detailed program information to assess
relevance, effectiveness and efficiency.
Design Future State
• Design the future state that aligns programs with the
intended outcomes.
Provide Advice
• Provide advice and recommendations for changes
needed in current state to support the achievement of
the future state.
14
Social Policy Framework Outcomes for Albertans
Safe
Healthy
Secure & Resilient
Lifelong Learners
Included
Active & Engaged
• free from fear of abuse and violence
• highest standard of health and wellbeing
• career and work opportunities, with
access to income supports when in need
• develop knowledge, skills, and
commitment to learning
• feel welcomed in communities where
they live, learn, and work
• participate in recreational activities and
cultural experiences, and to engage in
society
15
Social Policy Framework 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 & • Social programs and services are resultsSustainable
oriented and transparent and sustainable
Complementary
• Roles are complementary, balanced, and work
together to achieve outcomes
16
RBB Review Approach
Results-Based
Budgeting
Program Reviews
Alignment with
Social Policy
Framework
Programs that
support better
outcomes for
Albertans
Vision, Outcomes,
Principles and Policy
Considerations
Relevant
Effective
Efficient
17
RBB Review Process
Outcomes Confirmed
Review Plan Development
Challenge Panel
Reviews Conducted
Challenge Panel
Reviews Completed
Approval Process Implementation
18
Challenge Panels
Challenge 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-Foothills
MLA: Jason Luan, MLA Calgary-Hawkwood
MLA: 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
19
Budget 2013 - Persons with Disabilities
• $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
Support to
Persons
2011-12
with
Actual
Disabilities
2012-13
Budget
2012-13
Forecast
2013-14
Estimate
Change
from
Forecast
Estimate
(thousands of
dollars)
683,827
688,327
693,822
5,495
643,820
20
Budget 2013 - Children with Disabilities
• $5.9 million increase from 2012/13 forecast
• Supports a wide spectrum of supports and
services for families with children with
disabilities
Family
Support for
Children
with
Disabilities
2011-12
Actual
2012-13
Budget
2012-13
Forecast
2013-14
Estimate
Change
from
Forecast
Estimate
(thousands of
dollars)
130,929
144,007
137,122
143,020
5,898
21
Results Based Budgeting
Supports for Disabilities In-Scope Programs
($ millions)
$14.0
$147.7
$18.4
$657.3
$6.7
$3.0
$0.8
$14.0
$0.8
Total $862.7
22
Results Based Budgeting
Framing 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
23
Results Based Budgeting
Framing 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
24
Results Based Budgeting
Framing 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 Budgeting
Alignment 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
26
Results Based Budgeting
Alignment of Outcomes
Category
Outcome
Disability 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.
27
Results Based Budgeting
Moving to the Desired State – Strategic Shifts
From Here
To There
Programs are assessed separately
Funding is linked to the
based on measurement of what
achievement of
activities are performed and what
outcomes
services are delivered. Funding is
generally not linked to demonstration
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.
28
Albertans with Disabilities - Programs Across Lifespan
31,000
405,000
Children with disabilities
Adults with disabilities
FASD 1,900 clients
FSCD
8,600 clients
Other gov’t funded programs (e.g. AADL)
Family, community, and other
non-government supports
Brain Injury /
Other
PDD
Disability
9,700 clients Supports
4,050 clients
RAMP
675 clients
Unmet
Needs
Age 18
Programs by
diagnosis
29
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
30
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.”
31
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
32
Results-based Budgeting
Vision for Future System of Disability Supports
One 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.
33
Results-based Budgeting
The 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.
34
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
35
Questions/Discussion
Thank you.
Questions?
36