Economic & social issues in providing LTC Fiona Cromarty October 2011

2 > TAC Background > Drivers for change > Independence Model > Early signs of success > Challenges yet to be solved > Where to next…our vision Agenda.

3 > compulsory transport related personal injury insurance > established by Transport Accident Act 1986 > owned by the Victorian Government > “corporatised” – independent Board and management > $8.3B assets, $8.5B liabilities as at June 2011 > approximately 800 staff > TAC Headquarters moved to regional city of Geelong 2009 (some smaller offices in Bendigo, Dandenong and Melbourne) Background - Transport Accident Commission Strategy Corporate Goals in balance

Background - TAC Divisions. 4

Background - Claims. 5

Background – TAC 2015 Strategy. 6

Drivers for change in Independence Liabilities increasing rapidly – Attendant Care and substitutable services costs are predicted to continue growing Claims Management weren’t focused on Client Outcomes – what was all the expenditure of benefits really achieving? Client Satisfaction was plateauing – Clients are increasingly aware of their rights Growing need for a holistic planning approach – no coordination of treaters ‘It’s not our liability but is it our problem?’ 7

The Independence Model at a glance… 8

The Independence Model 9 Phase 1: CURRENT Early Support Team: Manages all new Independence claims, one point of contact providing face to face service and all decision making. Leads development, implementation and tracking of Independence plan. New claims management tools Revised communication products for clients and providers Streamlined discharge process for attendant care services Pilot outcome measures Phase 2: From December 2011 Independence plans introduced for current clients Clearly identified client goals that support improving independence wherever possible Funded support services linked to client goals Collaborative planning process involving clients, providers and the TAC Measurement of goal attainment Client outcome measures that are standardised and measure changes in well-being and community integration

Evaluation of Independence model Research collaboration with ISCRR will conduct a process, impact & outcome evaluation of the Independence model (five year program) – Process: are the Independence initiatives being implemented as intended? – Impact: is the Independence model increasing the capacity of the TAC to respond to client, provider and organisational needs and is there a consequent improvement in the underlying determinants of desired outcomes? – Outcome: have the Independence initiatives led to improved client outcomes, client experience, scheme viability and claims management efficiency and effectiveness?

11 Early signs of success ‘Getting to know the clients and their families so early post accident allows for the development of trust. This then enables us to encourage families and clients to see their potential for independence in what ever shape of form that may be’. Early Support Coordinator – Sarah Bull

Other challenges – not yet solved The needs of individuals change over time Attendant Care sector Workforce demand and supply Alignment to Independence philosophy National Disability Insurance Scheme (NDIS) and National Injury Insurance Scheme (NIIS) 12 Radical change will be required to meet individual needs and expectations

What else are we doing? Accommodation Sector wide demand and supply issues for accommodation TAC has established Residential Independence Pty Ltd (RIPL) Property Trust RIPL will develop accessible accommodation across the state, setting new benchmarks in universal design Current Projects include:  Six independent living units in Lilydale  Sourcing suitable land to meet TAC’s current areas of need in Melbourne’s outer suburbs and regional areas 13

14 What else are we doing? Provider Strategy – Independence as part of TAC independence projects will support clients in their journey towards independence, in line with the strategic objectives of TAC 2015 – client outcomes, client experience, and scheme viability The Strategy focuses on key components – all interrelated:  Developing and implementing new service models – attendant care and accommodation  Capability and capacity  ABI and behaviours of concern  Developing partnerships

Where to next…. Reduce mundane administrative burden on our staff – be more efficient and effective with our time Develop staff capability to facilitate Independence an 15 Where to next….our vision > Online capability enabling interaction between the client, TAC and providers >All services align to client goals >Range of service options available to meet all individual needs Our clients are empowered and enabled to achieve greater independence and better health, vocational and quality of life outcomes