Welfare programs should be integrated in a “one stop shop” to provide swifter access to assistance to those in need and better value for money to government, according to an outline business case for reform of the beleaguered system.
A $180,000 report, by consulting and accounting firm KPMG, recommends restructuring the way services for the elderly, disabled and unemployed are administered.
The report, which has yet to be officially released and is still under review by Cabinet, recommends government calculate a “standard rate” based on the cost of food, shelter and other basic needs in Cayman.
Individual welfare payments would then be calculated by deducting the applicant’s income from this basic figure.
Commissioned following a critical Auditor General’s report, which warned there was no accountability or coordinated strategy for the $50 million government spends annually on welfare, the KPMG report’s principal recommendation is the creation of a new agency that brings various welfare programs under one roof.
It suggests this approach will deal with many of the key issues, including lack of strategy and oversight for welfare payments and help eradicate fraud, waste and abuse in the system.
For those in need, it suggests integrating services in one hub will make the process of applying for aid swifter and more efficient.
Under the new proposal, welfare applicants, would be able to go through a “single door” to apply for assistance for healthcare, rental assistance or seamen and veteran’s benefits.
The report recommends that each client is seen by a case worker, who would coordinate with other departments to address social as well as financial needs.
It recommends compiling a single database of all people receiving any form of welfare to better inform policy and budgeting.
It cautions the new approach would need to involve the retraining of staff, as many of the Needs Assessment Unit’s intake staff are not social workers and are primarily tasked with assessing financial need.
“Getting staff members to adopt new working practices, change mind-sets, and commit to reforms takes time and considerable effort,” it warns.
Other potential problems highlighted include integrating computer systems and altering legislation to ensure data sharing between agencies. The report suggests centralized data but “localized services,” potentially including district offices or home visits from social workers.
It suggests grouping clients based on need, recommending four categories of aid: for older persons; persons with disability; persons with temporary disability; the unemployed and low income earners.
The report indicates that the new approach would free up time for case workers to address the “root cause” of each client’s issues, for example helping unemployed people find work.
Thought it anticipates the system reform will bring cost savings by lessening the need for expensive “crisis interventions” and cutting down on administrative duplication, it warns that the burdens on the welfare system are likely to increase.
“It is anticipated that there will be a doubling of the number of persons over 65 by 2030,” the report notes, cautioning that this will significantly drive up demand for programs including healthcare.
It also makes recommendations for more efficient delivery of government sponsored healthcare programs to those in need.
The report is still under review by Cabinet, but a draft has been released to a limited number of people including lawmakers and was discussed at a recent Public Accounts Committee hearing. Members expressed concern that it focused on the structure of the services, rather than on the programs themselves.
“I have some serious concerns that we are integrating systems that are not working, and there doesn’t seem to be a plan to correct the things that are not working in those units before we integrate them,” PAC chair Ezzard Miller said.