DES Contractual Compliance

1. DES Contractual Compliance Training Program

2. Agenda

3. Program objectives • Build capability to understand the legal nature of the DES Deed and contractual obligations of DES providers • Understand the transactional element of the Department of Social Services and Disability Employment Services provider relationship and documentary evidence for key employment services milestones • Understand the importance of the frontline manager role in terms of DES provider compliance with the DES Deed • Use support mechanisms, tools and techniques to assist in effectively complying with the DES Deed

4. Learning outcomes • The key legislative and contractual compliance requirements associated with the provision of disability employment services • The relevance of key contractual requirements to your own role and responsibilities, and those of your organisation • How to ensure compliance with the DES Deed and guidelines via a range of appropriate methods • How to adjust plans, processes and procedures to improve performance against key contractual requirements

5. Topic 1 Understanding Compliance

6. The importance of compliance... Between October 2013 and January 2014 approximately 200 Eligible School Leaver registrations were subject to a targeted program assurance activity. The Department looked at the evidence from 22 providers and found that 25% of all the claims had the necessary evidence, 25% were identified as non-compliant by providers and 50% of claims were unclear, meaning the evidence was ambiguous and required further clarification. Of the 22 providers audited, 21 had claims recovered. Key findings from the activity indicated 72 had no direct registration form, 52 registrations had partial evidence missing and 14 registrations were out of scope.

7. Defining compliance • The Oxford English Dictionary defines ‘compliance’ as“action in accordance with request, command” • Section 72.1 of the DES Deed sets out what ‘compliance’ entails for DES providers: The Provider must, in carrying out its obligations under this Deed, comply with: (a) all relevant statutes, regulations, by-laws and requirements of any Commonwealth, state, territory or local authority, including relevant work, health and safety and industrial relations legislation and any legislation relating to the licensing of employment agents; and (b) any Commonwealth policies Notified by DEEWR to the Provider in writing, referred to or made available by DEEWR to the Provider (including by reference to an internet site), including any listed in this Deed.

8. Defining compliance

9. Key principles of compliance

10. DSS approach to program assurance

11. A risk based framework Risk based framework and mechanisms used by DSS includes: • Employment Services IT System which provides operational and management data • Contract management conducted by DSS account managers and contract managers, including site visits • Program evaluation • Stakeholder and client surveys • Targeted program assurance activities • Complaints and feedback from users of services

12. Prevention The DSS seeks to ensure that DES providers clearly understand: • their requirements and obligations under the Deed and guidelines • the standards of behaviour expected of them • how to use ES IT System to aid compliance DSS works with DES providers to: • raise awareness of correct procedures & appropriate evidence • identify and remedy areas of deficiency • provide supporting information • improve the ES IT System, and • provide additional tools to assist compliance

13. Deterrence Strategies used by the DSS to deter non-compliance include: • clearly communicating the ways in which providers will be monitored • publicising the DSS’s compliance program assurance activities • making providers aware of the range of sanctions that can be applied, and • publicising the results of program assurance reviews

14. Detection Risks are identified / detected through: • Desktop data analysis, data mining and actuarial modelling • On-line verification with Centrelink data • Complaints and feedback received from participants and/or DES provider staff • Industry intelligence • Information sourced by account managers and contract managers, including from site visits

15. Correction Where non-compliance is found, correction strategies used by the DSS may include: • Recovering payments which the provider was not entitled to claim • Reduction of the provider’s business share • Suspension of referrals • Imposing additional conditions of payment of fees • Imposing additional reporting requirements

16. Risk Differentiation Attitude to Compliance Compliance Strategy Wilful non-compliance or performance manipulation Use full force of sanctions HIGHER RISK Regular monitoring & review Actively exploits ambiguity / loopholes Deter by detection, moderate degree of sanctions Help to comply, lesser degree of sanctions Try to comply but don’t always succeed Willing to do the right thing Make it easy to comply, minimal or no sanctions LOWER RISK Periodic monitoring & occasional review Risk level continuum

17. The Employment Services Charter of Contract Management

18. Site monitoring by DSS contract managers • DSS contract managers review the provider’s performance in each Employment Service Area and at each site • Section 44 of the Deed – DES providers are required to provide DSS employees with reasonable access to: • Their premises and sites • Their information technology systems • All material, including that relevant to determining the provider’s financial viability; and compliance with relevant work, health and safety and industrial relations legislation, and its personnel

19. Core obligations of DES provider

20. 1. Maintain high standards of service and conduct • Internal policies and procedures to inform your approach to your work as a DES practitioner • The DES Deed and guidelines • The National Standards for Disability Services • The Service Guarantee • Employment Services Code of Practice Know how to use the system to your advantage so that you can both comply with DSS requirements and effectively deliver high quality employment services to participants

21. 2. Achieve key performance indicators DES Performance Framework: • Performance assessment and Star Ratingsto inform and support high quality outcomes • A commitment to quality through compliance with the National Standards for Disability Services • A Service Guarantee reflecting the services that participants can expect from DES providers • A Code of Practice that reflects the Australian Government’s expectations of how providers will interact with participants, employers and each other • A Charter of Contract Management that reflects what providers can expect of the Department of Social Services

22. 3. Document and report on service provision and key milestones

23. 4. Operate ethically and prevent fraud Section 13 of the DES Deed sets out the requirements in relation to DES provider conduct: 13.2 The Provider must not engage in any practice that dishonestly or improperly manipulates Records, Outcomes or the Services with the intention of maximising payments to, or otherwise obtaining a benefit for, the Provider or any other person. 13.3 The Provider must advise its officers and employees: (a) that they are Commonwealth public officials for the purposes of section 142.2 of the Criminal Code Act 1995 (Cth); and (b) that acting with the intention of dishonestly obtaining a benefit for any person is punishable by penalties including imprisonment.

24. What constitutes fraud? Example 1: • DES Provider was falsifying job placements and creating vacancies against a non-existent employer for the purposes of performance and financial gain • This scenario demonstrates intent and that deliberate deception was practiced for financial gain

25. What constitutes fraud? Example 2: • DES Provider claimed a JPF for a job seeker based on their written statement that they completed the required benchmark hours over a 10 day period • A DSS audit picked up that the job seeker did not get paid for the work hours according to Centrelink records • Upon further investigation, the job seeker later admitted that he misunderstood his employment arrangements at the time and didn’t realise that the initial period of employment was only a work trial and therefore he did not get paid • The JPF was recovered, however, no fraudulent activity had occurred as neither the DES provider or individual practitioner claimed the JPF as a deliberate act of deception • The claim was made based on the information that was provided at the time which was lead to be believed true and correct

26. 5. Use the ES IT System to aid compliance • The ES IT System is used by DES providers and their staff to document service provision and demonstrate compliance • Managers need to: • understand the ES IT System clearly • ensure staff know how, why and when to use the system and that they complete training in how to use the ES IT System

27. Core obligations of DES provider

28. Topic 2 Managing Service Quality

29. The foundations of service quality

30. Consider the issues - what are they? Review Activity Agreement / Employment Plan / Individual Plan Consultation with person with disability & stakeholders Balance rights of stakeholders Implement and monitor Compare possible benefits against possible harm Develop strategy to minimise risk Duty of care

31. Ethical decision making The Commonwealth Procurement Rules describe ethics and ethical behaviour as: Ethical relates to honesty, integrity, probity, diligence, fairness and consistency. Ethical behaviour identifies and manages conflicts of interests, and does not make improper use of an individual’s position. (Commonwealth Procurement Rules, p.18)

32. The REFLECT decision making model

33. National Standards for Disability Services

34. Indicators of practice Think about NSDS evidence in the following way: • Who has been involved in developing your service’s processes and systems – staff, management, people with disability, families, friends, carers and advocates? • What documentation do you have that might provide guidance on policy, practice or procedures relating to the indicators? • How do you communicate the key principles and concepts within these documents to staff, people with disability, families, friends and carers? • What everyday practice can you describe that might show how you apply your processes and systems relating to each standard? • How do you regularly review practices, processes and systems and who do you involve in these activities?

35. Quality documentation • Section 19.4 of the DES Deed states that: It is a precondition of the Provider’s entitlement to be paid any fees, funds, reimbursements, wage subsidies, NEIS payments or ancillary payments that it has, at the time it makes a claim for payment, sufficient documentary evidence to provide that the provider has delivered the relevant services in accordance with or otherwise has relevantly complied with, this Deed. • Documentary Evidence for Claims Payment Guidelines (p.8): The Documentary Evidence set out in the Deed and these Guidelines, together with the information required to be recorded in the Employment IT Systems is acceptable to the Department as sufficient proof of service provision.

36. What constitutes quality documentation? • Adheres to the DES Deed and recording and reporting requirements set out in the guidelines • Comprehensive, well structured, factual and evidence based • Based around meeting key milestones and evidence requirements • Fulfils the outcome requirements to ensure it effectively meets the claim payment requirements • Meets all legal requirements • Uses appropriate language and terms • Both mandatory and non-mandatory information is entered into the ES IT System as required

37. Topic 3 Quality Documentation Practices

38. DES program structure & compliance obligations – documentary evidence Providers are required to: • retain evidence of entitlement to fees, funds, reimbursements and ancillary payments • retain sufficient and appropriate documentary evidence to prove that services have been delivered in accordance with the Deed and to make claims • create & keep accurate Participant Services Records (i.e. Deed Records including Customer Feedback Register) about a participant that are directly created for the purposes of providing service • retain records according to the minimum retention periods (see Attachment C of the Records Management Guidelines)

39. Keeping good case notes Case notes should: • be well structured • use appropriate language • be comprehensive • be cognisant of the outcome requirements • meet legislative requirements, and • present appropriate and sufficient evidence Tips for recording good case notes...

40. Case notes – best practice • Guiding principle for deciding what information you should include in participant case notes, i.e. is the information is relevant to the employment service or support being provided? • When recording case notes: • Include a participant identifier on each page • Date the case note • Record the information as soon as possible after the event • Make sure the notes are legible if they’re handwritten • Ensure the author of the case note includes their name and signature • Understand the outcome requirements and make sure claim evidence forms meet all these requirements

41. Case notes – best practice • Refer to the additional evidence that ‘should’ be retained and try to collect and record this evidence wherever possible • Conduct regular internal audits of case notes to ensure they meet all requirements – where deficiencies are detected, take immediate steps to rectify them • Conduct case conference reviews for quality assurance purposes and to address any systemic issues • Organisational record keeping should align with ES IT System record keeping requirements • Provide regular training and updates for staff members regarding record keeping and compliance requirements

42. Quality documentation for each stage of the employment services process

43. 1. Program entry File must be set up on the ES IT System for the participant and, as a minimum, the following information must be entered into the System: • Participant registration information (including identification of the participant as a Special Class Client where applicable) • A record of attendance at the initial interview • A record of completion of the initial interview • An Employment Pathway Plan (including individualised contact schedule) • Confirmation of identity where it is a Direct Registration(Note: A CRN [Customer Reference Number] must be recorded and where the person does not have a CRN, a shell record must be created by DSS)

44. Direct registration eligibility requirements

45. 2. Assessment and planning Assessment, planning and employment assistance focuses on: • Establishing an individualised contact schedule and regularly meeting with the participant in accordance with the contact schedule and completing participation reporting requirements • Developing and maintaining an EPP to achieve employment goal • Identification of and referral to appropriate services • Keeping up to date file notes advising of contacts, progress, outcomes and review and update of the EPP • Addressing the barriers and interventions identified in the ESA/JCA over the period of service

46. Contact requirements

47. Employment Pathway Plan The EPP should include: • The frequency of contacts • The timing and details of vocational activities • The timing and details of non-vocational activities • Details of mandatory obligations • An identified employment related goal At each contact appointment: • participant progress should be reviewed to identify strengths, build employability skills & overcome barriers • the EPP must be reviewed & updated

48. Identification of and referral to services For identification of and referral to appropriate activities and services, review the EPP and consider: • Is the participant undertaking an activity? • Is the service or activity appropriate to the participant’s individual needs? • Would the participant benefit from participating in other activities?

49. 3. Job placement • Can claim a Job Placement Fee for placing a participant into a Job Placement, in which the participant achieves their Job Placement Hours within the required timeframe • The following information must be entered into the ES IT System within 28 days of the Job Placement Start Dates record: • The Job Placement Start Date • Details of the DES provider’s confirmation with the employer that the participant has started the Job Placement • Also within 28 days of the Job Placement Fee Date the following information must also be entered into the ES IT System: • The Job Placement Fee Date • Details of the DES provider’s verification with the employer that the participant has achieved the relevant Job Placement Hours in the Job Placement

50. 4. Post placement support