United Nations Public Service Awards Case Studies

The Australian Department of Veterans’ Affairs (DVA) is mandated to support those who serve or have served in defence of Australia. The Client Liaison Unit (CLU) of DVA was established in mid-2007 to coordinate services for vulnerable, ‘at-risk’ clients. These clients are members of the veteran and defence force communities and include veterans, war widows and widowers, serving and former defence force members, eligible Australian Federal Police members with overseas service, and the dependants and carers of these groups.

A priority for DVA is to meet the needs of its clients to have access to the benefits and support services to which they are entitled. Failure to meet this need can significantly affect a client's well-being, and undermine community confidence in the Department’s ability to meet its obligations. However, it can be extremely challenging in some instances to provide support for clients who may have complex needs or mental health issues and struggle with traditional service delivery approaches. Often these clients present with behaviours that include threats to harm themselves or others, aggression, frustration, anger, and complete withdrawal from a system that provides for their support.

In regular client surveys DVA had consistently attracted high service delivery satisfaction rates. Then, in 2005 a survey targeting clients under 45 years of age revealed significantly lower satisfaction levels. This coincided with an increase in the number of younger clients requiring DVA services, due to legislative initiatives and government determinations, including those with complex claims involving multiple pieces of legislation. Departmental business groups operated to administer individual pieces of legislation rather than holistically address the client’s needs across all of DVA’s services and other agencies.

Some new clients were experiencing difficulties with the Department’s traditional approaches. Complaints were rising and there was an increase in the escalation of problems into crises for clients with mental health issues and/or very complex needs.

In early 2006, DVA established the Younger Veterans Task Force to oversee initiatives developed to address issues raised in the 2005 client survey, including strategies to improve the claims processes and provide more integrated client case management. Following a Coroner’s report into the unfortunate suicide of a client in 2006 and extensive questioning in a Senate Estimates Hearing in May 2007 on a second suicide, the Minister for Veterans’ Affairs and DVA’s Secretary proposed that the Department adopt a more proactive approach to client service.

This began the planning process to establish the CLU and provide it with the tools that would identify and assist DVA’s most vulnerable clients. The traditional method of service delivery limited the ability of staff within a business group to know when a client was making contact with other areas in the Department, or whether the client was not accessing services they needed. This lack of holistic care created “blind spots” for DVA that could undermine support for ‘at-risk’ clients. The CLU was to take responsibility and accountability for managing the risks in delivering services to vulnerable clients. They were to be pathfinders who facilitated coordinated support.

What is the initiative about? (the solution)
The CLU has increased DVA’s service delivery efficiency, improved service quality, introduced a new approach to clients ‘at-risk’ or vulnerable and contributed to a changing service delivery culture. Short term advances have been consolidated and are developing into long term changes benefiting clients, staff and other community service providers. The CLU has become an integral part of DVA’s service delivery environment, receiving around ten approaches per day from other DVA business groups requesting advice on best-practice when dealing with clients 'at-risk' or with complex needs. It has also directly resolved over 47 crisis issues and created comprehensive records for over 290 ‘at-risk’ clients, enabling holistic care and freeing up processing resources for more efficient and timely claims assessments. Additional key short term benefits have included better quality of information for vulnerable and ‘at-risk’ clients to help reduce their distress, improved management of threatening or dangerous situations to assist staff and client safety, new Departmental critical incident procedures, and new support systems for staff managing clients with complex needs. The CLU has pioneered areas of proactive service delivery. Its staff have developed processes that notify clients in advance about events that are known to trigger distress (e.g. pension reviews), and introduced a new comprehensive training package for DVA staff covering subject areas such as the identification of vulnerable clients and how to best assist them. This is based on predictive modelling research commissioned as part of the initiative. Due to the nature of the initiative, quantitative impact measures are not available. However, internal feedback from DVA's business groups has been very positive in recognising that the CLU has increased the Department's capacity to assist 'at-risk' clients leading to an improvement in client satisfaction levels and a reduction in staff stress levels. Positive feedback has also been received from the Minister for Veterans’ Affairs and the Commonwealth Ombudsman. The Ombudsman wrote to commend the CLU for, "…providing a level of support that appears to have gone well beyond that which can normally be expected by clients." and "…translating complex legislation into plain English for a client…". Through work with other business areas within DVA, the CLU is continuing to facilitate a cultural shift in the Department’s approach to service delivery, gradually changing staff expectations from process or function-based service delivery to a more holistic, client-centric, proactive approach. Positive client outcomes include early identification and care of those who are ‘at-risk’; changes to service delivery practices that reduce dangers; development of best practice strategies in this area; and improved client satisfaction. Again, while quantitative measures of success are not readily available, the CLU is pursuing opportunities with other agencies who share mutual clients and this inter-agency interaction has been extremely positive. Further networking is anticipated. The CLU is influencing service delivery styles that will allow DVA to reach out to vulnerable clients to ensure that their needs are being met and that they are receiving their entitlements in full.

Who proposed the solution, who implemented it and who were the stakeholders?
The leadership for the initiative was provided by the then DVA Secretary and his senior management colleagues. As well as the sensitivities around vulnerable clients, it was the need to have a project governance board with sufficient power and an holistic vision of client services that led to the decision to exclusively use the highest internal governance committee, the Executive Management Group (EMG), for this project. The Secretary provided specific directions in planning for the establishment of the CLU. They provided the initial drive and fostered the cooperation across DVA’s business groups required to firstly develop the CLU, and then to allow it to be established as a highly effective client service unit. To facilitate the CLU establishment, the EMG convened an initiation project team from within the Service Delivery Division. The team combined expertise in project management, significant experience with client contact, and service delivery and detailed legislative and procedural knowledge relating to provision of benefits and services to clients across all of DVA’s services. The stakeholders included those DVA clients who had been identified as having complex needs by various business units within the organisation. A total of 187 clients initially met the criteria for referral to the CLU. There is now an average of 35 clients active at any one time. All DVA business groups were major stakeholders as individual staff had initial interactions with clients and the managers had to deal with escalated issues. The CLU also relies on the business groups for technical knowledge, advice and training on matters of policy. The office of the Commonwealth Ombudsman was considered a stakeholder because if DVA could reduce the number of dissatisfied clients then fewer would make their way to that office. The office of the Minister was also a key stakeholder as a number of the CLU clients were also known there due to their frequent appeal of decisions, challenges to legislation and submission of complaints. Once selected, the CLU staff became the implementation project team who developed a comprehensive business plan and mission statement. This implementation phase involved extensive consultation with various parties including VVCS - Veterans and Veterans Families Counselling Service, experts in the provision of mental health counselling. External agencies, including Beyond Blue, the Australian Centre for Posttraumatic Mental Health, Monash University and DVA social work advisors, were also approached to ensure that the needs of the target clients for the CLU were prioritised and appropriately addressed in the planning process. The CLU was officially launched in October 2007.

Describe how and when the initiative was implemented by answering these questions
a. What were the strategies used to implement the initiative? In no more than 500 words, provide a summary of the main objectives and strategies of the initiative, how they were established and by whom.
The key objective of the initiative was to improve the level of service offered to those clients identified as vulnerable and ‘at-risk’ and who presented with complex issues. The CLU was tasked with facilitating a co-ordinated and holistic delivery of service while developing improved relationships with these clients. Other tasks included developing a predictive model to determine early indicators of ‘at risk’ behaviours and designing a training package to better equip all client service staff with the skills to proactively manage client behaviours before they escalate or lead to relationship breakdown. Senior management endorsed the decision to create a small team in one location that would become the single point of contact for identified clients. A team of highly qualified staff with proven client service skills were selected to staff the CLU and became the project implementation team. The CLU manager guided their strategic activities. The team environment readily allowed for peer support during and post client interactions. Stakeholders at a planning workshop agreed that referral to the CLU would be based on evident behaviour. The CLU staff began to profile identified clients into four behaviour categories: persistent escalators; self harm or homicidal; multiple and/or complex needs and angry, abusive and aggressive. By identifying the behaviour of the client, the team were able to consider different techniques to best achieve an effective and successful relationship. Team skills were enhanced by accessing specialised training including “Dealing with Difficult Clients” provided by the NSW Ombudsman’s office, and suicide prevention training provided through ASIST (Applied Suicide Intervention Skills Training). The early recognition that mental illness severely impeded a client’s ability to deal with bureaucracy and the complexity of legislation administered by DVA resulted in an additional focus on mental health literacy training to strengthen the skills of the CLU staff. To be an effective single point of contact for clients throughout Australia the CLU staff needed to have comprehensive DVA business knowledge as well as knowledge of services provided by other Government agencies and community based services. Individual CLU staff were allocated as business group liaison officers. In addition to the obvious benefit of increasing their business knowledge, this also led to the development of networks across the Department. These in turn increased and improved the profile of the Unit. Interaction with key business groups led to the development of protocols for mutual exchange of information with the VVCS and DVA’s fraud investigation group for clients deemed “‘at-risk’” or vulnerable. The networking extended externally to other government agencies and service industries involved in providing services to CLU clients, including ComSuper, Centrelink, the Australian Taxation Office, the Family Courts, Federal and State Police, hospitals and medical officers. The CLU retains an ethos of continuous improvement which allows DVA to respond to the evolving needs of its clients. The strategies initially implemented for a few clients are being incorporated into more practical and responsive approaches to service delivery for all DVA clients across all business groups.

b. What were the key development and implementation steps and the chronology? No more than 500 words
In early 2007, low client satisfaction levels, reported poor relationships between clients and DVA, and increased numbers of clients in crises led to the preliminary investigation of behavioural characteristics of clients in these circumstances with the aim of creating a predictive model that would allow proactive intervention. In June 2007 the Secretary released a notice advising all DVA staff of the intention to set up the CLU and inviting business groups to submit the names of clients who had come to their attention through either escalated complaints or threats of self harm. Within four weeks of project approval the CLU was established as a unit of six Client Liaison Officers and a manager. Staff were selected on the basis of their demonstrated strong client focus, flexibility, resilience, well developed liaison and communication skills and capacity to respond appropriately to sensitive issues. The project team conducted a workshop for internal stakeholders, including the newly selected CLU staff, which aided in the development and articulation of the purpose, objectives, benefits and realistic outcomes for the CLU. This scoped the CLU’s role and set clear boundaries for interaction between the CLU and other DVA business groups. The CLU was not a critical response unit and its staff were not decision makers or claims advocates and could not fast-track processing, but would add value to the relationship with the identified client by managing relationships. It was agreed at the workshop that, “the Client Liaison Unit exists to manage the relationships between clients and DVA for those who are vulnerable and/or have complex needs”. At the same time a project officer began building a data base to isolate a set of quantitative indicators from the detailed case histories of the identified clients. A consultant was engaged to later analyse the data to create a predictive model for proactive identification of clients who are vulnerable or ‘at-risk’. Participants at a risk assessment workshop identified risks, risk triggers and existing controls that would mitigate them. The workshop also recorded additional strategies that would need to be developed and implemented to minimise risks. Following the workshop, CLU staff commenced training to increase their technical knowledge, to develop their skills in identification of and coping with depression, boundary setting when dealing with querulous clients, forming agreements with clients about service expectations, dealing with suicidal clients and, importantly, team building. At this time the CLU staff were also actively involved in the analysis of details of clients identified by the business groups with some input from a consultant to allow profiling according to behaviour type. On 1 October 2007 the National Manager Client Contact issued a Businessline to all staff detailing the role of the CLU and the protocols and criteria for client referral. Within 3 months of conception the CLU had accepted its first referral. A centrepiece of the CLU's implementation has been the ongoing development of an innovative Predictive Model. The first report from the analyst was handed down in July 2008.

c. What were the main obstacles encountered? How were they overcome? No more than 500 words
One of the initial major obstacles was the ambivalence of other DVA service delivery staff. Their fear of interference by the CLU in their processes initially blinded them to the potential advantages. The CLU provided information sessions, business group liaison officers and one-on-one support with vulnerable clients. Evidence of initial successes quickly demonstrated the value that could be added from the involvement of the CLU and they became more reliant on the services of the CLU. This reliance created another challenge, the management of referrals of clients into the care of the CLU. The CLU developed protocols and criteria to assist business groups with the decision to refer a client and also published guidelines for the referral process. While the CLU wants to assist each business group to manage its relationship with vulnerable clients the CLU cannot afford to take on inappropriate referrals as this would impact on its ability to find successful outcomes for those clients within the defined target group. However, by providing support and advice to the business groups and by publishing articles, attending team meetings and one-on-one training, this challenge has been well managed and contained. The definition of the limit of the duty of care to clients that could, and should, be provided by the CLU within its resource capacity was another obstacle to be overcome. It was obvious that not all solutions to the complex issues being experienced by a client could be provided by DVA. It was agreed that the relationship between the client and DVA was to be the primary focus and the team regularly conference cases to reach an agreement about external referrals and the level of involvement in non-DVA issues. A major obstacle for the CLU was lack of access to client information stored on independent IT systems across a number of business groups. This meant that the initial identification of potential CLU clients came from individual management records. The CLU was able to negotiate access to existing systems and the system enhancements required to facilitate the recording of sensitive client information. Another obstacle that was overcome was the decision to locate the CLU in one of DVA’s nine state-based offices and give them responsibility for all DVA clients Australia wide. Not only did this mean that the majority of CLU business had to be conducted by telephone, but clients and staff had to become accustomed to dealing with staff from an office in a different state. The CLU staff were empowered to establish a positive and trusting relationship with their clients. Further, they established networks with other service delivery staff and enhanced their credibility through successes. However, each situation is considered on its merit and there have been a few occasions when an interstate face-to-face consultation has been arranged. Some of the greater successes of the team have resulted from their unique approach to obstacles and their ability to overcome them.

d. What resources were used for the initiative and what were its key benefits? In no more than 500 words, specify what were the financial, technical and human resources’ costs associated with this initiative. Describe how resources were mobilized
The provisional budget for the implementation was drawn from the Client Contact group budget allocation within DVA’s Service Delivery Division taking into account the expected key elements of the initiative. Ongoing costs have been budgeted through normal Departmental allocation processes. The key elements of the initiative were the establishment of a discrete unit of six staff, the provision of appropriate training to enable these staff to deal with clients ‘at-risk’, and the provision of adequate systems support to record client details and produce management data. Funding was also allocated for special research that was commissioned to develop models that have guided proactive client services. A project team of existing staff was appointed to take carriage of the initiative and ensure that the required resources were available and additional monies secured where necessary. By the end of June 2007 the project team had selected staff and a member of the project team had been appointed as the CLU manager responsible for providing leadership in the development of procedures and guidelines for the unit. Another project officer was appointed to compile detailed case histories of ‘at-risk’ clients identified by the business groups and to develop a data base in which to record the histories. As the selected staff were drawn from existing DVA service delivery resources, additional staff costs were minimised. The overall cost of CLU staff for the first year of operation (the 2008-09 financial year) was $500,000. Resources were also allocated for externally sourced specialist training for team members and for consolidating the unit through team building. External training that promoted mental health awareness and coping strategies for dealing with ‘at-risk’ clients was delivered by a variety of government and community organisations at a total cost of $19,500. Training associated with DVA benefits and services was sourced from within the Department and absorbed by business groups. In keeping with the CLU objective of focusing on the client and developing an understanding of the unique nature of DVA’s clients, a staff training package was developed with the assistance of a training consultant. Further costs totalling $270,000 were incurred for the development of a Client Liaison Unit Data Organiser (CLUDO) system which now supports the CLU. CLUDO is a central repository for recording details of clients who have either been identified by, or referred to, the CLU. The system is used to record client data that can be extracted to predict likely behaviour outcomes based on risk profiles and patterns of behaviour. This is then used to assess assistance that may be offered to clients proactively. Finally, a university based research consultant who specialised in predictive modelling was engaged to assist in the recognition of potential clients. The consultant analysed comprehensive CLU client profiles related to risk and querulous / complex needs behaviours and developed a list of primary and secondary predictor characteristics for certain behaviours. The cost of this initial analysis was $40,000. It is expected that ongoing research and analysis will be undertaken to ensure the currency of results.

Is the initiative sustainable and transferable?
This initiative is being sustained with the support of all DVA business groups, senior managers and the Minister who recognise the improvements that it has delivered to the quality of DVA’s service delivery. The CLU has proven its value in efficiently and effectively addressing emerging client problems within the regulatory environment that was implemented when DVA assumed administrative responsibility for increasing numbers of younger clients. The CLU initiative is financially sustainable given its efficiencies and the low total cost. A direct comparison of the administrative cost per client of CLU clients, which is higher, with the DVA’s average administrative cost per client is invalid. CLU clients would generally consume increasingly higher amounts of staff time than the average DVA client without CLU intervention, leading to higher than average administrative costs on a per client basis. The efficiencies of CLU intervention, albeit difficult to measure, provide the basis of a financially sustainable unit. The CLU staff are critical to the sustainability of the unit and it is recognised that they perform a demanding and at times stressful job and strong support networks and training are provided to CLU staff. DVA provides support through senior management, the Employee Assistance Programme, professional counsellors and colleagues to provide psychological first aid. These supports go further than DVA just fulfilling its duty of care obligations to employees; there is a genuine acknowledgement and appreciation of the demanding work undertaken by the CLU and a determination to monitor and maintain the health of the CLU staff who work with DVA’s most vulnerable clients. The work of the CLU is being disseminated across Australian Government agencies where mutual clients exist. This is most evident in the Memorandum of Understanding currently being finalised between DVA and ComSuper ( the agency administering Commonwealth Superannuation). ComSuper and DVA exchange information where decisions of both agencies affect mutual clients and the CLU proactively determine what Departmental and/or community supports need to be put in place for the effected client. There is also a close relationship between DVA and the Department of Defence as serving and ex-serving members of the Australian Defence Force (ADF) make up a substantial segment of DVA’s clients. The CLU utilises existing protocols for exchanging information with the Department of Defence which assists the CLU to provide appropriate supports for clients, particularly those who have recently discharged from the ADF. Significant research has been done regarding proactive identification of clients who could benefit from CLU intervention. This has been the subject of a paper to the Senior International Forum resulting in interest for this approach from veterans’ affairs organisations internationally. The work of the CLU could be replicated across Australian Government agencies that have common clients. The establishment of the Government’s Interdepartmental Working Group provides a platform for future developments. Each agency would require its own CLU equivalent with knowledge of that agency’s legislation and policies. These units could potentially work as an interagency virtual team with the focus on the client.

What are the impact of your initiative and the lessons learned?
The CLU provided a window for the Department to identify the problems that were being experienced by a new generation of veterans and ADF members and has clarified areas where service delivery could be improved. Established service delivery processes were failing ‘at-risk’, vulnerable clients and those with complex needs resulting in, at times, highly visible and catastrophic events. The CLU pioneered proactive service delivery using new research analysis that identifies those clients ‘at-risk’. It has increased understanding of these clients and their reactions to stressors, and, by working with other business groups, has facilitated the commencement of change in DVA’s service delivery culture. The initiative is assisting other business areas with the management of clients with complex needs. A CLU representative is assigned to each service delivery business group to assist with delivering messages to identified clients. When additional support is provided for these clients, business groups are free to focus on their primary business with improved efficiency. Further benefits are gained as business groups become aware of mutual client activity through CLU intervention, frequently reducing confusion and client anxiety. The CLU has developed and utilises techniques for handling difficult situations. It notes actions that distress clients, records all negative feedback and can intervene prior to an event taking place. By identifying risks early, negative reactions including approaches to the Minister, media involvement and potential negative health events can be avoided. The CLU is able to undertake comprehensive assessments of clients and ensures that they receive DVA or external support as required. It gives DVA a complete picture of the services being provided to clients and enables the Department to better identify gaps in clients’ care which may lead to distress. A system for recording comprehensive client contact records was implemented to support this approach. The CLU is staffed by experienced personnel who have been able to identify business improvement opportunities. For example, previously a pension granted on a temporary basis could be reviewed with a resultant unexpected change in entitlement. The CLU ensures that these clients are now notified in advance of review dates. The lessons learnt as a result of the initiative have led to the development of a new, comprehensive training package for DVA client service staff that includes topics on the identification of clients with special needs and how to best assist them. The CLU uses two ‘purpose-built’ predictive models to guide its client relationship management and improve the recognition of clients who are vulnerable and/or with complex needs Since implementation, the CLU has provided significant input into shaping DVA's policies and procedures for delivering services to clients. This initiative allowed DVA to learn about the value of risk mitigation through proactive identification of problems and the capacity of the Department to undertake a transformational change through interventions at the individual client level. DVA will formally evaluate the CLU and assess its impact on client satisfaction levels through regular comprehensive surveys. Current informal feedback has provided sufficient encouragement to ensure that the CLU initiative continues.


Institution Name:		Department of Veterans Affairs
Institution Type:		Government Agency
Contact Person:		Vicki Pethybridge
Title:		Ms
Telephone/ Fax:		07 3223 8896
Institution's / Project's Website:		07 3223 8304
E-mail:		vicki.pethybridge@dva.gov.au
Address:		259 Queen Street
Postal Code:		4000
City:		Brisbane
State/Province:		Queensland
Country:		Australia

The Problem

Solution and Key Benefits

Actors and Stakeholders

(a) Strategies

(b) Implementation

(c) Overcoming Obstacles

(d) Use of Resources

Sustainability and Transferability

Lessons Learned

Contact Information