Social Enterprise Partnerships

1

• Social EnterprisePartnerships

Market Based Approachesin Mental Health and
Disability
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Persons and Relationships
NCOSS Seminar

• Disability and mental health profound social
  policy and service system failure
• Social policy has traditionally been about
  dispensing items (payments, services) not
  facilitating the self-determination of persons or
  the strengthening of their relationships
  (families, social networks, communities)
• Person-centredness an ethic to be employed in
  assessing service systems, funding arrangements,
  and decision-making processes

Social Enterprise Partnerships
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Persons, Relationships
NCOSS Seminar

• Social policy reform getting the right
  configuration of civil society, markets and
  public supports
• Market based approaches not as an end in
  itself, but as a means to implement
  person-centredness in social policy

Social Enterprise Partnerships
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Outline
NCOSS Seminar

• Definitions
• Why social policy failure?
• The supply-side service delivery paradigm
• Four platforms for social policy reform
• Eight structural innovations in a reform agenda
  for disability and mental health
• Obstacles to reform

Social Enterprise Partnerships
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Definitions
NCOSS Seminar

• Civil Society voluntary interactions,
  relationships and associations for mutual benefit
  and service to others
• Civil society can be weak or strong
• Social Capital the capacity of individuals and
  communities to freely and voluntarily associate
  with each for mutual benefit and service of
  others
• Social capital can be high or low

Social Enterprise Partnerships
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Thinking historically
NCOSS Seminar

• Historically, Australias key social
  organisations have been membership-based
  associations - mutuals, friendly societies,
  provident societies- churches- labour
  movement societies

Social Enterprise Partnerships
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Thinking historically
NCOSS Seminar

• 1960s onwards major decline in these
• membership-based associations
• Expansion of state activity and politics
• Cultural loss of a self-help ethos
• Cult of youth and modernity
• Case study Altona Community Hospital

Social Enterprise Partnerships
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Today Human Services
NCOSS Seminar

• From social collectivity to instrumentalism
• From self-help to service delivery
• From internal resourcing to external funding
• High degree of state regulation
• How do we understand this change and what does it
  mean?

Social Enterprise Partnerships
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A service delivery paradigm
NCOSS Seminar

• 1975 2005
• Global social and political trend to absorb
  voluntary, charitable and mutual forms into a
  public service delivery framework, as instruments
  of social policy

Social Enterprise Partnerships
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The Supply Side Service Delivery Paradigm 1975 -
2005
NCOSS Seminar

• Features
• Externally funded agencies delivering services to
  clients
• Agencies were accountable, not to their clients
  but to their funders
• Agencies were program-based, discipline-based,
  not person/individual/community-based
• Outcomes were measured intra-agency, not across
  provider/program/discipline boundaries

Social Enterprise Partnerships
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The Supply-Side Service Delivery Paradigm 1975
2005
NCOSS Seminar

• Extraordinary fragmentation across provider
  types, disciplines, jurisdictions, sectors
• Deep information/power asymmetries between
  consumer/client and service system
• Little capacity for social capital formation
• Little means for facilitating social
  relationships or the self-determination of persons

Social Enterprise Partnerships
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Exhaustion of the paradigm
NCOSS Seminar

• Indigenous affairs passive welfare
• Disability and mental health passive welfare
• A new paradigm in indigenous affairs
• A new paradigm in disability and mental health
  from supply-side to demand-side

Social Enterprise Partnerships
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Four Platforms for New Social Policy
NCOSS Seminar

• Person-centred and relationship-centred thinking
• New governance models for persons and
  relationships
• Funds-pooling and budget-holding mechanisms
• Person-centred information systems

Social Enterprise Partnerships
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Four Platforms for New Social Policy
NCOSS Seminar

• Person-centred and relationship-centred thinking
• From supply-side delivery to demand-side
  personalised configurations of support and
  resources for individuals/families and their
  relationships

Social Enterprise Partnerships
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Four Platforms for New Social Policy
NCOSS Seminar

• New governance models for persons and
  relationships
• New forms of association for individuals,
  families and communities in exercising
  self-determination
• Governments need to learn to work with these
  associations rather than exclusively with service
  providers

Social Enterprise Partnerships
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Four Platforms for New Social Policy
NCOSS Seminar

• Funds-pooling and budget-holding mechanisms
• Aggregation of resources from various funding
  streams in a single person-centred budget holder
• Mechanisms for pooling financial allocations from
  various funding streams, and transacting payments
  to providers

Social Enterprise Partnerships
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Four Platforms for New Social Policy
NCOSS Seminar

• Person-centred information systems
• Consolidated record of supports, interventions
  and care plans
• Transferable across provider, program and
  disciplinary boundaries

Social Enterprise Partnerships
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Eight Innovations in a Reform Agenda (1)
NCOSS Seminar

• System-wide intermediaries or brokers between
  consumer/client/person and provider
• Consumer intermediaries are needed to enable
  people with disabilities and mental illnesses and
  their families to hold pooled funds, act as
  brokers, and purchase their preferred supports
  (individually or collectively)
• Must be independent of providers

Social Enterprise Partnerships
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Eight Innovations in a Reform Agenda (2)
NCOSS Seminar

• Consolidated person-centred consumer-held
  information systems
• Consumer intermediaries not providers are the
  critical entity needed to perform this function
• Wrap Around Kids, Coffs Harbour

Social Enterprise Partnerships
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Eight Innovations in a Reform Agenda (3)
NCOSS Seminar

• Individualised funding packages across service
  and program types
• The precedent and methodology of individualised
  packages is now established in sections of aged
  care, disability, education and chronic illness
  management

Social Enterprise Partnerships
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Eight Innovations in a Reform Agenda (4)
NCOSS Seminar

• Transparent pricing mechanisms for services
• All publicly funded services should be required
  to develop pricing for episodes of service or
  care, easily accessible by consumer intermediaries

Social Enterprise Partnerships
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Eight Innovations in a Reform Agenda (5)
NCOSS Seminar

• System-wide recognition of individualised social
  networks
• Individualised funding packages should include an
  allocation to resource the co-ordination of these
  networks in disability and mental health, and for
  these networks to assume case management
  functions (or to select and appoint case managers)

Social Enterprise Partnerships
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Eight Innovations in a Reform Agenda (6)
NCOSS Seminar

• Competition between consumer intermediaries
• Consumers must be free to choose their
  intermediary and to move from one to another
  this is the key to making market mechanisms work
  in disability and mental health

Social Enterprise Partnerships
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Eight Innovations in a Reform Agenda (7)
NCOSS Seminar

• Competition between providers
• The purpose here is NOT to commercialise
  providers or turn them into corporate look-alikes
  that process has already happened as agencies
  competed to win government contracts
• The purpose is to get providers to compete to win
  the allegiance of consumers and their
  intermediaries

Social Enterprise Partnerships
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Eight Innovations in a Reform Agenda (8)
NCOSS Seminar

• Long term financial asset development
• People with disabilities and mental illnesses
  require long-term financial assets long term
  planning and investment is not possible when the
  paradigm is about short-term dispensation of
  services
• Financial and property management businesses as
  investors in disability and mental health not
  just charitable donors to the service suppliers

Social Enterprise Partnerships
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Obstacles to Reform
NCOSS Seminar

• Managerial culture in government, service
  providers
• Paternalistic culture amongst politicians
• Oppositional culture in advocacy and activist
  groups
• Vastly undeveloped infrastructure on demand-side

Social Enterprise Partnerships
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2 Elm StreetNorth Melbourne 3051www.
partnerships.org.auPhone (03) 9326
4481 vern_at_partnerships.org.au
Vern Hughes Executive Director
Social Enterprise Partnerships