Innovating social services in Canada by giving clients greater choice, control, and flexibility - Canadian Government Executive
InnovationsService delivery
June 26, 2018

Innovating social services in Canada by giving clients greater choice, control, and flexibility

“Integration”, “transformation”, and “modernization” have become the prevalent buzzwords in the Canadian Human Services sector.

Everyone wants to change, become more efficient, and drive better value – all code for greater cost savings. But one important global trend in social services delivery that is only just starting to be investigated in Canada is that of providing greater choice and control to the client.

True transformation in the sector

For all the talk of back-office consolidations, digital transformations, reducing fragmentation, and better client journeys, it is greater choice and control through the use of client direct funding, that can be effective on a number of levels, even if difficult to implement.

One way to truly transform social services would be to give clients the choice to decide who they receive a service from, how they receive that service, and when they receive that service – in other words, a new paradigm of funding, with the ultimate objective of giving people greater flexibility and control over their wellbeing.

But does providing client choice and control actually work? Can it transform a person’s life and also provide systemic change to the way we fundamentally deliver social services?

Changing client outcomes for the better

Research consistently highlights the benefits to clients who are provided with greater choice and control. One of the single biggest human service reforms has been the implementation of the National Disability Insurance Scheme (NDIS) in Australia – a $22 billion reform to how disability services are funded and delivered across the country.

The Productivity Commission in Australia noted in their final report, Disability and Support Care (2011), that:

“Self-directed care is typically associated with greater satisfaction levels, perceptions of greater power and control over life decisions, without adverse effects on health.”

In addition, the Commission examined 27 American studies into self-directed funding spanning the last 25 years (the ‘Disability and Support Care Inquiry’). The evaluations consistently found that self-directed funding provides significant benefits to people with disability and their families. Positive results were found for those with physical, intellectual, and mental health disabilities, and for the non-elderly and elderly.

Positive findings were also outlined in a recent study undertaken on behalf of the Department of Health in Australia (Provider and consumer research regarding recent and future changes in home care, 2017) that noted benefits in terms of:

  • allowing individuals to control the type and nature of care they receive;
  • flexibility for consumers, due to the portability of funding;
  • better supply of care and reduced waiting times;
  • increased quality of service and value for money due to competitive forces in the market; and
  • access to a greater range, and more affordable services.

Can it really be done in Canada?

The change agenda in Human and Social Services across Canada presents the perfect opportunity to move towards a new way of providing services to those most vulnerable in the country and empowering people to control their support.

It is not an easy transition and the implementation will be difficult, but there are five non-negotiables to set these types of transformation on the right path, including:

1. A detailed understanding of the client cohort and their needs, and demand for services – getting a single source of truth is critical to make this approach work.

2. Planning and assessment must be undertaken independently of the service provider – it is important to remove any potential conflict of interest between the service provider and the funding package provided to a client.

3. A flexible and strong regulatory framework for service providers – the government needs to become a “system steward” under this approach, and they must ensure confidence in the system for both the user and provider.

4. Be transparent, be transparent, be transparent – this cannot be emphasized enough, as moving to this approach demands transparency of information and access to data to ensure the system is fully aligned.

5. Funding is based on need – not on some predetermined annual amount based on an outdated funding model.

By providing the client with greater choice and control, the level of funding must be sufficient to meet their needs, it must allow for new service providers to enter the system, and ensure the use of innovative (and high quality) service delivery mechanisms.

There is no doubt that we are seeing an appetite for these types of reforms here in Canada. In fact, there are already examples of direct client funding occurring across the country – consider BC Choices for Support in Independent Living, the Alberta Self-Managed Care Program, or the Ontario Passport Program. However, a more systemic and integrated approach is required, rather than a piecemeal approach.

Modernization is but only one brave decision-maker away.

 

About the Author

Martin Joyce is a Partner at KPMG in Canada where he heads up the National Human and Social Services Advisory Practice. A senior executive with experience across Non-Government, Government, and Commercial sectors, he is highly skilled at leading teams and building growth agendas for organizations. This includes three years in the Not for Profit sector in Australia, 11 years at KPMG in Australia as a Management Consultant, and two years in the KPMG Corporate Finance team with a focus on private equity. Get in touch by emailing him at martinjoyce1@kpmg.ca.

All views expressed here are the author’s own.

About this author

Martin Joyce

Martin Joyce is a Partner at KPMG in Canada where he heads up the National Human and Social Services Advisory Practice. A senior executive with experience across Non-Government, Government, and Commercial sectors, he is highly skilled at leading teams and building growth agendas for organizations. This includes three years in the Not for Profit sector in Australia, 11 years at KPMG in Australia as a Management Consultant, and two years in the KPMG Corporate Finance team with a focus on private equity. Get in touch by emailing him at martinjoyce1@kpmg.ca.

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The economic development agencies of 12 municipalities have banded together to bring their interests to the attention of foreign investors. The logic is that they are stronger as a team, and that they can direct investors to the city that will best meet their needs for setting up shop in the Great White North....
 
The City of Grande Prairie in Alberta has received a “green gov” award from Santa Monica-based Vision Internet, a government website developer. Related posts: Ontario flicks the switch on vehicle charging stations...
 
Governments and managers can promote innovation in Canada by crafting a culture of innovation in their bureaucratic environments....
 
Two weeks ago, CGE wrote about the selection of Toronto as a leading Intelligent Community, a recognition of its Prosperity Agenda and its innovations in technology and other sectors – despite the trials and tribulations of its mayor....
 
Despite the international media circus created by Mayor Rob Ford, Toronto has been named the 2014 Intelligent Community of the Year. The award was announced in June by the Intelligent Community Forum at the conclusion of the annual Intelligent Community Summit in New York. Related posts: Uber Canada boss suggests cities allow taxis to update biz model Montreal’s Bixi pedals out of debt and into the global market Building a Collaborative Advantage...
 
A regulator’s job is to fulfill its mandate in the public interest. The Canadian Radio-television and Telecommunications Commission (CRTC) has been using innovative ways to engage Canadians in public consultations. Related posts: CRTC warned of massive job losses in Canadian TV stations CRTC ruling nixes hope for lower mobile rates says small telecoms Nunavut, Nunavik, rural areas decry slow, unreliable Internet service...
 
but what does this mean when plugged back into your starting premise (we overestimate short-term impact and under-estimate long-term impact)? To me it suggests that government needs to re-engage with communities with more than just social media campaigns. They need to find ways to literally bring people together and get them talking (and not necessarily...
 
Innovate Manitoba is a not-for-profit community-based organization established in 2012 to act as a catalyst for innovation and to help close the commercialization gap....
 
Whether we are welcoming advanced technology into our homes, driving vehicles with more sophisticated safety and communications features, or taking advantage of new online services, innovation is an increasingly important measure of how well our modern economy is faring....
 
“Innovation” might be an overused buzzword in defence and security circles, but since the stand-up of the Canadian Innovation Commercialization Program (now Build in Canada Innovation Program) and the release of the Jenkins and Emerson reports, it has been central to the federal government’s message....
 
Ontario and Alberta have joined forces to encourage the development of research projects that will stimulate job growth, bring new products to market, and improve the products that already exist in both provinces....
 
For government to fulfill its mandate of serving citizens, considerable spending is continually required to support and improve current programs and services and to introduce new programs or services. Related posts: The importance of thinking outside the box CGE Leadership Series: Moving towards the workplace of the future The Future of Internal Audit...
 
The need to innovate has become so common a goal in government it has become a motherhood statement. However, the need to innovate is a real imperative that Alberta is making a priority, not only for its Ministry of Innovation and Advanced Education, but for the province as a whole....
 
While not all cities are created equal, great competition should bring out the best in them. More than ever cities are watching technology trends. Related posts: Pressing problems for cities require smarter use of resources Cultivating talent: How data can help governments build the economy Developing data to improve municipal performance...
 
It has long been postulated that tidy desks are more conducive to productivity in the workplace, and that an organized worker is a valuable asset to any employer. Worse, employees with messy desks are sometimes seen as lazy slobs by their co-workers. But a recent study…...
 
In “Public sector, disrupted”, a recent study published by Deloitte, a question is asked: why do organizations in the private sector offer higher quality services or products for a cheaper price, while organizations in the public sector do the exact opposite? Related posts: Saskatchewan public servants receive award for excellence Keeping pace: Technology's challenge to government service delivery Make your executive assistant key to your success...
 
We are only at the first phase of the Digital Age and our efforts require concerted action to develop the know-how to take advantage of the possibilities of this paradigm-shifting era....
 
In Smarter Information, Smarter Consumers, www.hbr.org, Richard H. Thaler and Will Tucker claim that the availability of information is changing consumer attitudes, and that government can learn a lesson from this....
 
A Saskatchewan team of geologists, physicists and palaeontologists is hunting for dinosaur DNA using a cutting-edge piece of equipment located in Saskatoon....
 
The judges are in place. The clock is ticking. The best in the world have come to Canada to compete. No, it’s not the 2010 Olympics in Vancouver. It’s Worldskills 2009 in Calgary....
 
At first glance, federal defence scientists focused on research supporting the Canadian Forces and geoscientists collecting scientific data on the Arctic seabed may seem like an unlikely pairing....
 
What is British Columbia doing to change its approach to scientific research and innovation as a result of the signals sent in the federal budget?...
 
In a knowledge-based global economy, continuous innovation is crucial to enable effective and efficient service delivery in the public sector and competitive advantage in the private....
 
There is no reason for Canada to be an innovation and productivity laggard. Governments can and should play a leadership role, and it is not all about spending…...
 
Saskatchewan’s Ministry of Environment is leading a new approach built on results-based regulations to enhance environmental protection while encouraging innovation....
 
Governments have long known that although across-the-board percentage cuts may meet fiscal targets, such cuts can harm ministries and departments for many years....
 
CGE Vol.13 No.4 April 2007 Education, creativity, research and innovation play a crucial role in Canadian society and Canada’s...
 
CGE Vol.14 No.3 March 2008 Innovation is one of those concepts talked about so often and yet realized so rarely that the word has...
 
CGE Vol. 14 No.5 May 2008 Ontario Premier Dalton McGuinty spoke with editor-in-chief Paul Crookall, as part of our series on the relationship between political le...
 
Today, thanks largely to the internet, the kind of creativity and innovation that used to take place primarily within the confines of corporate walls now occurs across large, loosely connected networks of firms and individual entrepreneurs....
 
When William Eggers wrote his landmark book, Government 2.0, in 2005, he predicted that governments around the world would have to embrace the information age, abandoning industrial age management concepts of hierarchy, specializati...
 
What exactly is hunger and why is it an important global issue?...
 
En décembre 2008, la fonction publique de la Colombie-Britannique a lancé Spark, un site Web interne visant à susciter la collaboration constructive au sein de l’organisation....
 
La fonction publique de l’Ontario œuvre dans la lutte contre les incendies depuis la fin du 19e siècle....
 
The Ontario Public Service has been in the business of putting out fires – literally – since the late 19th century....
 
In December 2008, the BC Public Service launched Spark, an internal website for constructive collaboration within the organization....
 
Once seen as stable, even glacial, the public service is now in a constant state of flux, adapting to new business models and an economy that is a moving target....
 
D’abord vue comme stable, même figée, la fonction publique connaît maintenant des changements continus et s’adapte à de nouveaux modèles d’affaires ainsi qu’à une économie en constante évolution....
 
Au cours de ma longue expérience auprès de différents ministres d’allégeances politiques diverses, je n’en ai jamais rencontré un seul qui aurait voulu qu’on lui mente ou qui ne se souciait pas de l’int&e...
 
Le leadership au sein des organismes du secteur public est l’un des acquis les plus importants du Canada. L’Institut d’administration publique du Canada (IAPC) et Deloitte ont salué fin novembre ce qui se fait de mieux en la...
 
CGE Vol.13 No.8 October 2007 A modern public service is one that is relevant, flexible and effective in dealing successfully with...
 
Quote of the week “An innovative APS starts with individual public servants wanting to try new ideas.” — APS Innovation Action Plan Editor’s Corner...
 
Le plus souvent, toutefois, nous devons nous affairer activement à trouver une solution nouvelle....
 
Sometimes innovation happens serendipitously – a Eureka moment, when the answer drops out of the sky. But more often, we have to create a novel solution. And for that, like any craft, it can be helpful to have tools....
 
2012 has the potential to be an important year for Canadian science and innovation policy, one to be remembered for many years....
 
As the Ontario Public Service readies for its involvement this April in Creativity and Innovation We know that today’s employee, our clients and Ontarians are demanding change. They are looking for us to be accountable, transparent and they need us to be more effective and efficient with their tax dollars....
 
TED is a non-profit community devoted to the theme of “Ideas Worth Spreading.”...
 
Becoming an innovative organization takes more than a call to “be innovative” or an invitation to submit ideas. What are you doing to lead innovation on your teams?...
 
Thousands of other research projects in Canada have become a reality – in large part due to investments made by the Canada Foundation for Innovation (CFI)....
 
Conducting a large number of detention reviews under difficult conditions and tight timeframes required leadership, a collaborative effort and support from all IRB personnel....
 
How can we increase productivity, build resilience and enhance quality of life in the rapidly changing 21st century?...
 
Innovation is critical and urgent as public servants continue to improve the quality and efficiency of public services while responding quickly to changing social and economic conditions....
 
To the reporters who’d gathered in the Alberta Legislature press room, the blue plastic bucket in reserved seating may have looked more like a janitorial oversight than the starring act of a new workplace safety ad....
 
Robert Louis Stevenson a déjà affirmé que « la politique est la seule profession où la formation n’est pas jugée indispensable ». Il avait tort....
 
You’ve made a good choice. If you’re in the public sector right now, you’re at the centre of the action....
 
CGE Vol.13 No.10 December 2007 David Crombie, former Toronto Mayor, Conservative Cabinet Minister, and Chancellor Emeritus of Rye...
 
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A single team or lab could never create the volume of ideas needed to make hundreds of small improvements in all aspects of a complex organisation. That became obvious to me while working for the New Zealand Post. I was in the Total Quality Service team, which had a year to develop comprehensive strategies to...