This report analyses the results of our audits of the Stronger Communities cluster agencies for the year ended 30 June 2021.

Our preferred approach is to table the ‘Report on State Finances’ in Parliament before any other cluster report. This is because the 'Report on State Finances' focuses on the audit results and observations relating to the Total State Sector Accounts, in effect a consolidation of all government agencies. This year the 'Report on State Finances' has been delayed due to significant accounting issues being considered in the Total State Sector Accounts and which may impact the Treasury and Transport clusters.

As there are no outstanding matters relating to audits in the Stronger Communities cluster impacting the Total State Sector Accounts we have decided to break with normal practice and table this cluster report ahead of the ‘Report on State Finances’.

What the report is about

The results of the Stronger Communities cluster agencies' financial statement audits for the year ended 30 June 2021.

What we found

Unqualified audit opinions were issued for all 30 June 2021 financial statements of cluster agencies.

Eleven of the 15 cluster agencies required to submit 2020–21 early close financial statements and other mandatory procedures did not meet the statutory deadline. Five agencies did not perform all mandatory procedures.

The implementation of AASB 1059 'Service Concession Arrangements: Grantors' had a significant impact on the Department of Communities and Justice's (the department) 2020–21 financial statements. The department applied a modified retrospective approach upon initial adoption at 1 July 2020 and recognised service concession assets and liabilities of $1.0 billion and $1.2 billion respectively (relating to three correctional centres with private sector operators).

The department was, this year for the first time, able to reliably measure Incurred But Not Reported (IBNR) claims relating to its Victims Support Scheme. The department recorded a liability of $200 million at 30 June 2021. Liabilities for Child Sexual Assault IBNR claim continue to be not recorded on the basis they are unable to be reliably measured.

The number of monetary misstatements identified during the audit of the financial statements for the cluster increased from 61 in 2019–20 to 72 in 2020–21.

What the key issues were

The number of issues reported to management decreased from 191 in 2019–20 to 172 in 2020–21. However, 45 per cent were repeat issues related to information technology, governance and oversight controls.

Seven high risk issues were identified in 2020–21, an increase of five compared to last year. High risk issues related to deficiencies in IT access controls at Sydney Cricket and Sports Ground Trust; a lack of a formal agreement between the Office of Sport and Planning Ministerial Corporation over the management of a sporting venue; asset revaluations at both Fire and Rescue NSW and the Trustees of the Anzac Memorial Building; and three issues related to revenue recognition control deficiencies at New South Wales Aboriginal Land Council and two of its subsidiaries.

What we recommended

Cluster agencies should ensure all applicable mandatory early close procedures are completed and the outcomes provided to the audit team in accordance with the deadlines set by NSW Treasury.

We recommend cluster agencies action recommendations to address internal control weaknesses promptly. Focus should be given to addressing high risk and repeat issues.

This report provides Parliament and other users of the Stronger Communities cluster’s financial statements with the results of our audits, our observations, analysis, conclusions and recommendations in the following areas:

• financial reporting
• audit observations.

Financial reporting is an important element of good governance. Confidence and transparency in public sector decision making are enhanced when financial reporting is accurate and timely.

This chapter outlines our audit observations related to the financial reporting of agencies in the Stronger Communities cluster (the cluster) for 2021.

Appropriate financial controls help ensure the efficient and effective use of resources and administration of agency policies. They are essential for quality and timely decision making.

This chapter outlines our observations and insights from our financial statement audits of agencies in the Stronger Communities cluster.

Findings reported to management

The overall number of findings has decreased, but the level of repeat issues increased

Breakdowns and weaknesses in internal controls increase the risk of fraud and error. Deficiencies in internal controls, matters of governance interest and unresolved issues were reported to management and those charged with governance of agencies. The Audit Office does this through management letters, which include observations, related implications, recommendations and risk ratings.

In 2020–21, there were 172 findings raised across the cluster (191 in 2019–20). 45 per cent of all issues were repeat issues (32 per cent in 2019–20).

Repeat issues largely related to weaknesses in controls over information technology (IT), governance and oversight.

A delay in implementing audit recommendations increases the risk of intentional and accidental errors in processing information, producing management reports and generating financial statements. This can impair decision‑making, affect service delivery and expose agencies to fraud, financial loss and reputational damage. Poor controls may also mean agency staff are less likely to follow internal policies, inadvertently causing the agency not to comply with legislation, regulation and central agency policies.

2020–21 audits identified seven high risk findings

High risk findings were reported at the following cluster agencies. Two high risk findings reported in 2019–20 were resolved.

The table below describes issues commonly identified across the cluster by category and risk rating.

The number of moderate risk findings decreased from prior year

Seventy‑eight moderate risk findings were reported in 2020–21, representing a 22 per cent decrease from 2019–20. Of these, 43 were repeat findings, and 35 were new issues.

Moderate risk findings reported in 2020–21 include:

• weaknesses in governance arrangements, including outdated policies and procedures and arrangements that do not align with NSW Government guidelines, such as the NSW Government Procurement Policy Framework and NSW Cyber Security Policy
• weaknesses in user access administration including:
  • user access reviews
  • monitoring of privileged user access and activities
  • password policy configuration
• cyber security improvements including:
  • implementation and update of governance arrangements
  • monitoring of third‑party system access
  • patch management improvement
• outdated instruments of financial delegation and non‑compliance with established financial delegations
• weaknesses in supplier and employee masterfile maintenance.

 Appendix one – Misstatements in financial statements submitted for audit

Appendix two – Early close procedures

Appendix three – Timeliness of financial reporting

Appendix four – Financial data

Copyright notice

© Copyright reserved by the Audit Office of New South Wales. All rights reserved. No part of this publication may be reproduced without prior consent of the Audit Office of New South Wales. The Audit Office does not accept responsibility for loss or damage suffered by any person acting on or refraining from action as a result of any of this material.

What the report is about

This audit assessed whether adults in custody have effective access to health services. The audit examined the activities of Justice Health and Corrective Services NSW.

What we found

The majority of custodial patients receive timely health care, but a small proportion of patients are not receiving care within target timeframes.

Eleven per cent of scheduled health appointments are not attended, and agencies can do more to understand the reasons for non-attendance.

Demand for mental health care exceeds service capacity and some patients are held in environments not appropriate for their needs.

Justice Health's information systems do not support the effective transfer of medical records as patients move around the prison network.

Not all patients are released from custody with a discharge plan.

Justice Health's system managers do not receive sufficiently detailed reports to understand strategic risks or opportunities to improve access to health services.

Public and private prison health operators do not report against consistent performance measures.

Justice Health is mandated to assess health services in private prisons. This conflicts with its role as a contracted provider of health services in the private prison system.

What we recommended

Enhanced reporting on patient access to health services, to identify risks and challenges across key service areas.

Identification and implementation of the improvements required for information to be shared across the custodial network and with external health providers.

Development of a framework to govern and monitor costs for patient health escorts and movements.

Development of a framework to govern responsibilities for mental health services.

Progression of infrastructure plans that address the lack of specialist accommodation for mental health patients and aged and frail patients.

Collaboration to align the performance measures to enable benchmarking between public and private prison health services.

Action to remediate the conflicting monitoring arrangements of public and private prison health operators.

Access to health services in custody

This audit examined whether adults in the New South Wales public prison system have effective access to health services. In making this assessment, we considered whether Justice Health and Corrective Services NSW effectively cooperate and coordinate so that patients have timely access to health services, systems and practices support continuity of care, and access to health services is monitored and reviewed.

As part of this audit, we assessed actions undertaken by Justice Health and Corrective Services NSW in managing the first COVID-19 outbreak in 2020. However, due to the timing of this audit report, this audit does not report on the agencies’ response to managing the current outbreak of COVID-19 in September 2021.

Health services in New South Wales prisons are delivered by both public and private operators. The public prison system is made up of 33 correctional centres and the Long Bay Hospital. All health services in the public prison system are delivered by the Justice Health and Forensic Mental Health Network (Justice Health).

In the public prison system, Justice Health is responsible for the clinical care of patients with physical and mental illnesses. Clinicians provide health assessments, treatments, medication management, and some counselling services in prison health clinics. Patients are triaged by primary health nurses and if they require treatments or medication, they are referred to prison‑based doctors including specialists or other clinicians. Patients requiring complex or emergency care are transferred to hospitals or other specialty services outside the prison complex.

Private operators deliver health services in three private prisons through contract arrangements with Corrective Services NSW. Justice Health delivers health care at one correctional centre via a contract arrangement with Corrective Services NSW. In total, contracted health service operators deliver health care to approximately 25 per cent of the New South Wales prison population.

Justice Health is required by law to monitor the performance of contracted health service providers in New South Wales prisons, including services provided at the John Morony Correctional Centre. The Auditor‑General’s mandate does not permit a direct examination of information held by private sector entities, however this audit does assess the effectiveness of Justice Health's role in monitoring health services in private prisons.

Corrective Services NSW is responsible for security in public prisons, including the facilitation of patient access to health care at prison health clinics and the transfer of patients to hospitals and other health services outside of the prison environment. Corrective Services NSW also delivers behaviour‑based psychology services. Some are delivered as behaviour modification courses that aim to reduce criminal and offending activity amongst the prison population. These programs may be linked to parole or other custodial conditions. Other psychology services include counselling for people with self‑harming or suicidal behaviours.

Research from the Australian Institute of Health and Welfare indicates that people in custody are more likely than the general population to be affected by chronic and acute illnesses, including higher rates of mental illness and communicable diseases¹. In March 2021, there were 13,063 adults in custody in New South Wales.

The objective of this performance audit was to assess whether adults in the public prison system have effective access to health services. In making this assessment, we considered whether Justice Health and Corrective Services NSW effectively cooperate and coordinate so that:

• patients have timely access to health services
• systems and practices support the continuity of health care
• access to health services is monitored, reviewed, and reported across the network. 

1. Key findings

The majority of custodial patients receive timely health care, but a small proportion of patients with priority appointments are not receiving care within target timeframes

Approximately half of all health care provided by Justice Health is immediate. It is delivered to 'walk‑in' patients as soon as they present at prison health clinics. Most of these patients are receiving daily medications, while a small proportion require urgent or immediate care for injuries or illnesses. The other half of prison health care is delivered via scheduled appointments. Patients waiting for health appointments are given a priority rating according to the time within which they should be seen by a clinician.

Patients requiring the most time‑critical care are given a Priority 1 rating. These patients should receive treatment within one to three days. In December 2020, the average wait time for Priority 1 treatment was five and a half days, almost double the target. This is an improvement on wait times in June 2019, when the average wait time was just over 13 days. Justice Health does not assess or measure the impacts of delayed care on these patients.

According to Justice Health, the high numbers of ‘walk‑ins’ contribute to increased wait times for medical appointments. In addition, some specialty health clinics operate weekly, which means that patients cannot be seen by specialists within a one to three‑day timeline. Security events such as prison lockdowns can also contribute to increased wait times, as they limit the access that patients have to prison health clinics during out‑of‑cell hours.

If patients need emergency medical treatment, they are transferred to hospitals in line with Justice Health's policy. In 2020, just over 1,000 patients were transferred to hospital for emergency medical care.

A significant proportion of prison health appointments are not attended, and not enough is being done to understand the reasons, or to improve attendance rates

In 2020, 11 per cent of all scheduled health appointments in prison clinics were not attended. This amounts to approximately 60,000 appointments over the year. Non‑attended appointments have flow‑on impacts on wait times and backlogs for scheduled health appointments. Understanding why they occur is necessary to improve efficiencies in scheduling and patient access to health services.

In 2020, the most common reason for non‑attended health appointments was: 'patient unable to attend'. Justice Health clinicians use this when patients do not arrive at the prison health clinic at the scheduled time, and clinicians lack any other information to explain the non‑attendance.

The second most common recorded reason for non‑attended appointments was: 'cancelled by Corrective Services NSW'. These cancellations are due to operational or security reasons, including prison lockdowns. Data from Justice Health indicates that in 2020, there were an average of 12 lockdowns per week across New South Wales prisons.

A range of factors can impact on patient attendance at appointments, some of which are unavoidable. That said, more can be done to understand and reduce non‑attendance. For example, there is potential for Corrective Services NSW to implement tighter protocols to update information about patient availability on the daily movement lists. This might include checking whether patients are willing to attend appointments. Similarly, there is potential for Justice Health clinicians to implement tighter protocols to check patient lists ahead of scheduled appointments, and to re‑schedule appointments where patients are unavailable.

Demand for mental health care exceeds service capacity and some patients are held in environments that are not appropriate for their needs

There is a high demand for mental health services in New South Wales prisons. In March 2021, at least 143 mental health patients were waiting for access to an acute or sub‑acute mental health unit across the New South Wales prison system. The average wait time for a mental health facility was 43 days. Seventeen patients had wait times of over 100 days. Patients waiting for sub‑acute mental health services had longer wait times than those waiting for acute mental health services.

There are limited mental health beds for women across the New South Wales prison network. There are ten allocated beds for women at the Mental Health Screening Unit at Silverwater Correctional Complex, and no allocated beds for women at Long Bay Hospital.

A lack of bed availability in the Forensic Hospital means that, as of February 2021, 63 forensic patients were being held in mental health facilities in mainstream prisons, when they should have been accommodated in the Forensic Hospital. Some of these forensic patients have been held in mainstream prison facilities for decades.

Cross‑agency co‑operation and planning is required to identify and build infrastructure that will reduce wait times for mental health beds. Over several years, Justice Health has developed, reviewed, and worked to progress a strategic plan for NSW Forensic Mental Health that includes enhanced mental health bed capacity across the NSW system. The latest version of this strategic plan remains in draft and has yet to be approved by the NSW Ministry of Health.

In 2016, Corrective Services NSW commenced a Prison Bed Capacity Program. It was focussed on enhancing capacity across the prison system and did not include specialist health beds. More recently, Corrective Services NSW has been developing a business case to improve the provision of specialist health care facilities across the network, including mental health facilities.

Justice Health's clinical information systems do not support the effective transfer of health appointments or medication records as patients are moved to new prison locations

Justice Health's clinical information systems are multiple and complex. There are five health information systems that include a mix of electronic and paper‑based records. Information management systems contain clinical records, appointment information, medication records, dental records, and specialist health information. Corrective Services NSW maintain separate information systems relating to prison records and psychology treatment information.

The transfer of people across different correctional centres is a frequent occurrence. In 2020, there were over 41,000 movements between correctional centres. People are transferred for a range of reasons including for security purposes, or to be located closer to hospitals or specialist health services.

Justice Health receives a list of patient transfers one day prior to transfer. Nurses are required to prepare medications and clinical handovers for patients with complex health conditions. These handovers are verbal, however short timeframes mean that handover is not always possible.

While each patient's electronic health records are available across the network, transfer of appointment waitlists must be done manually. There is no automatic alert within the information systems to tell staff that a patient has been moved to another prison. There is a risk that if appointment records are not manually updated, or if staff at destination clinics are not contacted, then appointments will be overlooked.

Justice Health is working with eHealth NSW to develop an improved Electronic Medication Management (EMM) program with expected delivery in late 2021. The EMM has potential to improve the transfer of patient medication records, but it will not fully remediate all inefficiencies of the current systems.

Corrective Services NSW and Justice Health do not engage in sufficient joint planning to improve efficiencies in transports or escorts to health services

Corrective Services NSW and Justice Health do not engage in joint system‑level planning to mitigate the risks and the costs associated with transferring patients to health clinics in prisons, or non‑prison‑based health care. There are no protocols, and limited sharing of information to improve efficiencies in planning and coordinating patient transfers.

Corrective Services NSW does not collate or report on the costs of transporting patients to hospitals and specialist care. While there is data on the overall cost of medical escorts, estimated to be $19.9 million in 2020, Corrective Services NSW is not able to disaggregate this data to determine the reasons for transfers or the system‑level costs. For example, Corrective Services NSW does not know how many prison lockdowns occur when hospital transfers are required.

Medical escorts to specialist health services and hospitals increase the costs to the prison system and contribute to risks in prison management. Medical escorts contributed to 16 per cent of metropolitan prison lockdowns at the peak in 2018, though escort numbers have since been declining. Some Local Health Districts report significant concerns around safety incidents and assaults on staff during medical escorts to hospital.

Corrective Services NSW does not know if transport costs have increased since the 2016 Prison Bed Capacity Program which expanded prison beds in regional New South Wales. To date, there has been no assessment of the cost of taking patients to tertiary hospitals or specialist services. Corrective Services NSW has identified this as an area for improvement.

Justice Health's system managers do not receive sufficiently detailed reports on wait times for health care, to understand strategic risks or opportunities for system improvement

Justice Health's senior executives receive monthly reports on patient wait times for services in prison health clinics. These reports contain headline data about the numbers of days that patients wait for scheduled health appointments by their allocated priority level. Wait time data are averaged across all New South Wales prison health clinics. With some exceptions, almost all executive level reports describe system‑wide appointment wait times without offering further specific detail. For example, there is limited information which would allow managers to understand the performance of specialty health groups, or to make any comparative analysis of the performance of different prison facilities.

Executive reports are also not detailed enough to indicate whether prisons with particular security classifications offer greater or lesser access to health services. It is not possible to assess whether patients in metropolitan or regional prisons have different levels of health service access. This prevents managers from identifying strategic risks across the prison network, targeting resources to the areas of greatest risk, and making strategic improvements in system performance.

Trend data on wait times for the different health specialty areas is also required to enable senior managers to compare wait times across prison facilities, security classifications, and localities.

In response to the preliminary findings of this audit, Justice Health has made some improvements to its executive‑level wait time reports. This includes additional detail on health appointment wait times by prison facilities and wait times by health specialty areas.

It is not possible to compare or benchmark the performance of public and private prison health operators or to compare prison health against community health standards

It is not possible to compare or benchmark the performance of the public and private prison health operators in New South Wales using the current Key Performance Indicator (KPI) data. KPI data do not correlate across the public and private systems.

Justice Health reports to the Ministry of Health on 44 prison health KPIs. The 44 KPIs for the public prison system do not align with the seven KPIs the private health operators report against in their contracts with Corrective Services NSW. This means that public and private operators focus on different service areas. For example, private operators have a performance measure for ensuring that custodial patients are provided with release plans. Justice Health does not have a similar measure.

The KPI specifications for the private prison health system were developed by Corrective Services NSW with input from the Ministry of Health. The KPI specifications for the public prison health system were developed by the Ministry of Health in collaboration with Justice Health. There is no rationale for the difference in performance indicators across the public and private systems.

Private providers currently deliver prison services to 25 per cent of the prison population of New South Wales. This proportion has been increasing since 2016. Public and private health operators deliver comparable health services so there is scope to compare performance across the systems.

Justice Health aligns its standard for prison health services with a 'community’ standard of health care access. However, with existing health monitoring measures, it is not possible to assess how well Justice Health is tracking against community health standards with available data from most health specialties.

There is an inherent conflict of interest in Justice Health's monitoring role of health services in private prisons, as Justice Health is also a provider of health services in a private prison

There is a legislated requirement for Justice Health to monitor the performance of private health operators in New South Wales prisons. This monitoring role is described in the Crimes (Administration of Sentences) Act 1999.

Justice Health's monitoring role includes the collection and analysis of health performance data from private health operators, and periodic site visits to assess health service performance. Justice Health reports the findings of monitoring activities to Corrective Services NSW, the contract manager for private prisons.

Justice Health's monitoring role commenced in the late 1990s. In recent years, this role has expanded as the NSW Government has increased the number of privately managed prisons across the state. Justice Health now monitors health services in four private prisons, accounting for approximately one quarter of all custodial patients in the New South Wales prison system.

In 2018, Justice Health was awarded a contract to provide health services at the John Morony Correctional Centre. Justice Health also monitors the health services this Correctional Centre. The timing of the 1999 legislation did not anticipate that Justice Health would be a provider of the services it is required to monitor.

Justice Health has taken steps to maintain independence and transparency in its monitoring role by establishing a number of arms‑length governance arrangements. Justice Health set up a Commissioning Unit that operates independently from its service delivery operations. Justice Health also established an alternative reporting chain via a Board subcommittee to oversee the performance of health providers in private prisons.

Despite all actions to establish independence, the monitoring role confers dual responsibilities on the Chief Executive of Justice Health as both an operational manager of health services in a private prison and as a manager responsible for monitoring these same services. As a result, the Chief Executive of Justice Health has access to information about the overall performance of the private prison health system in New South Wales.

As a competitor for the provision of health services in privately operated prisons, Justice Health has access to information to which other private health providers do not. This potentially gives Justice Health a competitive advantage over other private health operators.

2. Recommendations

By December 2022, Justice Health should:

1. enhance reporting on patient access to health services to ensure that system managers can identify risks, challenges, and system improvements across key areas of its service profile

2. in collaboration with the NSW Ministry of Health, identify and implement the required improvements to its health information management systems that will enable effective transfers of patient clinical records and appointment information across the custodial network and with external health providers.

By December 2022, Justice Health and Corrective Services NSW should:

3. develop a joint framework to govern and monitor the costs of their common and connected responsibilities for patient health movements across the prison network and to external health services

4. develop a joint framework to govern their common and connected responsibilities for mental health services.

By December 2022, Justice Health and Corrective Services NSW, in collaboration with the NSW Ministry of Health, should:

5. progress infrastructure plans and projects that address the lack of specialist accommodation for mental health patients and aged and frail patients

6. standardise and align the key performance indicators that monitor the performance of health operators in public and private prisons so that system‑wide benchmarking is possible.

By December 2022, the NSW Ministry of Health should:

7. take action to remediate the conflicting monitoring arrangements of public and private prison health operators.

Appendix one – Response from agencies

Appendix two – About the audit

Appendix three – Performance auditing

Copyright notice

© Copyright reserved by the Audit Office of New South Wales. All rights reserved. No part of this publication may be reproduced without prior consent of the Audit Office of New South Wales. The Audit Office does not accept responsibility for loss or damage suffered by any person acting on or refraining from action as a result of any of this material.

Parliamentary reference - Report number #356 - released (23 September 2021).

What the report is about

Results of the financial statement audits of the public universities in NSW for the year ended 31 December 2020.

What we found

Unqualified audit opinions were issued for all ten universities.

Two universities reported retrospective corrections of prior period errors.

Universities were impacted by the COVID-19 pandemic with student enrolments decreasing in 2020 compared to 2019 by 10,032 (3.3 per cent). Of this decrease 8,310 students were from overseas.

In response to the pandemic, each university provided welfare support, created student hardship funds, provided accommodation and flexibility on payment of course fees. State and Commonwealth governments provided additional support to the sector.

Six universities recorded negative net operating results in 2020 (two in 2019). The combined revenues of the ten universities from fees and charges decreased by $361 million (5.8 per cent).

Despite the impact of the COVID-19 pandemic, which will continue to impact the financial results of universities in 2021, enrolments of overseas students in semester one of 2021 increased at two universities. This growth meant that total overseas student enrolments increased by 7,944 or 5.8 per cent across the sector as a whole. However, eight universities experienced decreases in overseas student enrolments compared to semester one of 2020. All universities have experienced growth in domestic student enrolments.

What the key issues were

There were 110 findings reported to universities in audit management letters.

Three high risk findings were identified. One related to the continued work by the University of New South Wales to assess its liability for underpayment of casual staff entitlements. The other two deficiencies were at Charles Sturt University, relating to financial reporting implications of major contracts, and resolving issues identified by an internal review of its employment contracts to reliably quantify the university’s liability to its employees.

What we recommended

Universities should prioritise actions to address repeat findings. Forty-five findings were repeated from 2019, of which 23 related to information technology.

Further information

Please contact Ian Goodwin, Deputy Auditor-General on 9275 7347 or by email.

This report analyses the results of our audits of the financial statements of the ten universities in NSW for the year ended 31 December 2020. The table below summarises our key observations.

1. Financial reporting

2. Internal controls and governance

3. Teaching and research

This report provides Parliament with the results of our financial audits of universities in NSW and their controlled entities in 2020, including our analysis, observations and recommendations in the following areas:

• financial reporting
• internal controls and governance
• teaching and research.

Financial reporting is an important element of governance. Confidence and transparency in university sector decision making are enhanced when financial reporting is accurate and timely.

This chapter outlines our audit observations on the financial reporting of universities in NSW for 2020.

Financial results

The graph below shows the net results of individual universities for 2020.

Appropriate and robust internal controls help reduce risks associated with managing finances, compliance and administration of universities.

This chapter outlines the internal controls related observations and insights across universities in NSW for 2020, including overall trends in findings, level of risk and implications.

Our audits do not review all aspects of internal controls and governance every year. The more significant issues and risks are included in this chapter. These along with the less significant matters are reported to universities for management to address.

Universities' primary objectives are teaching and research. They invest most of their resources to achieve quality outcomes in academia and student experience. Universities have committed to achieving certain government targets and compete to advance their reputation and their standing in international and Australian rankings.

This chapter outlines teaching and research outcomes for universities in NSW for 2020.

Appendix one – Status of 2019 recommendations

Appendix two – Universities' controlled entities

What the report is about

The report assessed how effectively the Department of Communities and Justice is responding to homelessness through the NSW Government’s Homelessness Strategy.

It also assessed the effectiveness of the department’s efforts to address street homelessness in its COVID-19 response.

What we found

The strategy was designed to build evidence to inform future state-wide action rather than to end homelessness.

The department received significantly less funding than it sought for the strategy.

Actions delivered under the strategy have a narrow reach in terms of locations and number of people targeted for assistance.

The strategy will have limited short-term impact on homelessness across NSW, but it is building evidence on what works to prevent and reduce homelessness.

The department effectively implemented a crisis response to assist over 4,350 people sleeping rough into temporary accommodation during the pandemic.

While there was an effective crisis response to assist people sleeping rough during the pandemic, more will need to be done to ensure a sustainable response which prevents people returning to homelessness.

What we recommend

The department should:

• provide advice to the NSW Government on sustainably addressing demand and unmet need for homelessness supports
• commence development of a comprehensive strategy to address homelessness, linked to the government’s 10-year plan for social housing and 20-year housing strategy
• enable input to key decisions on homelessness policy from partner agencies, the specialist homelessness services sector, the community housing sector, Aboriginal people, and people with lived experience of homelessness
• partner with Aboriginal stakeholders and communities to design and implement a strategy for early identification and responses to the needs of Aboriginal people vulnerable to homelessness; and build the capacity and resourcing of the Aboriginal Community Controlled Sector to deliver homelessness services
• evaluate the homelessness response to COVID-19, integrate the lessons learned into future practice, and develop protocols to inform actions in future emergencies or disasters
• regularly collect client outcomes data and feedback and use this to drive improvements to responses to homelessness.

Further information

Please contact Ian Goodwin, Deputy Auditor-General on 9275 7347 or by email.

Homelessness exists when a person does not have suitable accommodation alternatives. A person is considered to be experiencing homelessness if their current living arrangement:

• is in a dwelling that is inadequate; or
• has no tenure, or if their initial tenure is short and not extendable; or
• does not allow them to have control of, and access to space for social relations.

The number of people experiencing homelessness in New South Wales increased by 37 per cent between the last two censuses, from 27,479 in 2011, to 37,715 in 2016. New South Wales recorded the largest increase of all the states and territories in both the number of people experiencing homelessness and in the homeless rate (from 40.8 to 50.4 persons per 10,000).

The NSW Government's primary service response to homelessness is crisis, temporary and transitional accommodation, and support services, funded at more than $1.0 billion over four years from 2018–19. These are ‘commissioned services’ delivered by non‑government organisations under contracts with the Department of Communities and Justice (the Department) and out of scope for this audit. We assessed how the Department manages contracts for specialist homelessness services in our 2019 audit 'Contracting non‑government organisations'.

The policy framework for the NSW Government's response to homelessness is the NSW Homelessness Strategy 2018–23 (the Strategy), which is examined in this audit. The Department is responsible for the development, implementation, monitoring and evaluation of the Strategy. The Strategy comprises 21 actions, ten of which directly target people at risk of, or already experiencing, homelessness through measures such as:

• screening high school students for the risk of homelessness and providing supports
• assisting vulnerable people to maintain their tenancies in social housing or the private rental market
• providing purpose‑built social housing.

These ten actions comprise $160 million of the Strategy's $169 million funding.

In December 2019, the first evidence of the COVID‑19 virus emerged. People sleeping without shelter or in public places (sleeping rough) typically live in communal arrangements, with some having limited access to basic hygiene supplies or showering facilities. These factors may increase the risk of transmission of COVID‑19 amongst this population.

In response to the pandemic, the NSW Government provided additional funding for the Department to institute a range of actions aimed at preventing vulnerable people from becoming homeless, and people sleeping rough from contracting or transmitting the virus. These were informed by, but separate to, actions under the Homelessness Strategy.

This audit focused on the temporary accommodation provided to individuals experiencing street homelessness during the pandemic, and the new 'Together Home' program established in 2020 to transition people with experience or history sleeping rough from temporary accommodation into more sustainable longer‑term housing.

This audit assessed how effectively the Department is implementing the Homelessness Strategy and addressing street homelessness in its COVID‑19 response. In making this assessment, the audit examined whether the Department:

• has effectively developed an evidence‑based Strategy and established supporting arrangements to implement it
• is ensuring the Strategy is achieving its objectives and outcomes
• is effectively supporting people sleeping rough into temporary accommodation during COVID‑19 and to transition into more sustainable longer‑term housing.

1. Key findings: the Homelessness Strategy

The Strategy's geographical and client reach is limited because it is building the evidence base on what works

The Department's objectives to intervene early, provide effective supports and create an integrated person‑centred system to address homelessness are clear, but are not being pursued state‑wide.

There were existing gaps in the available evidence which made it difficult for the Department to develop a holistic, state‑wide, long‑term solution to homelessness. Some of the actions under the Strategy have a degree of supporting evidence. Other actions are intended to generate evidence through pilots and by evaluating existing programs more robustly.

At least one Strategy action is available in each of the Department's 16 districts, and there are examples of the Department rolling out practice changes from Strategy pilots across the state. However, progress towards the Strategy aims is confined to pockets where actions are being trialled.

Once fully implemented, Strategy actions will be available in only a quarter of the state's 128 local government areas and will support approximately 8,200 people ‑ which equates to around 22 per cent of the number of people who were experiencing homelessness at the time of the last census in New South Wales in 2016 more than 37,000 people. This does not include the number of people at risk of homelessness.

A key gap in Strategy actions is addressing Aboriginal homelessness.

The Department received significantly less funding than sought and designed the Strategy to build the evidence base rather than eliminate homelessness

The Department could not meet the evidence threshold for a cost benefit analysis required by a Treasury business case, given the limited evidence available locally and internationally on what works to prevent homelessness or intervene earlier. The Department sought new, targeted investment to extend a small number of initiatives with proven effect, and to build the evidence base about other measures that work, rather than the quantum of funding required to end homelessness in New South Wales.

Even so, approved funding was significantly less than that sought by the Department. It repurposed existing resources, dropped some proposed actions and scaled others down to fit within the final funding envelope. It directed 95 per cent of the total Strategy funding to supports and accommodation for people at risk of or experiencing homelessness.

The Department intends to use the gathered data from implementation of the Strategy to expand effective prevention and early intervention measures after it concludes, subject to budget approval. It expects that, over time, these initiatives will reduce the demand for crisis services.

Actions may not be scaled up at the end of the Strategy's term, perpetuating the Strategy's limited reach and narrow impact on homelessness

The Department's approach of testing interventions and building the evidence base through the Strategy was well described and provided a clear rationale in its original advice to government. An evaluation framework has been designed to generate sufficient evidence on the overall Strategy and its individual actions for a cost benefit analysis to support a future budget bid.

The Department intends to use the findings from interim evaluation reports, due by September 2021, to determine the programs and pilots with promising evidence that should continue to the end of the Strategy term. It expects this to enable more qualitative and quantitative data to be available to the evaluations, as well as to support service continuity.

However, delays in delivery of some actions under the Strategy, and the time taken for outcomes to be achieved and show up in the data, will impact on the strength of the evidence available at the mid‑term and final Strategy evaluation points. This raises a risk that future funding for a comprehensive Strategy will not be secured ‑ and prevention and early intervention activities not continued or scaled up beyond pilot sites ‑ if the evidence on effectiveness is incomplete, mixed or unclear when the Strategy concludes.

Given its limited reach, even if the existing Strategy actions were retained, and no expansion occurred, it would continue to have a narrow impact on homelessness in New South Wales. This sits against a backdrop of increasing need for housing and homelessness supports in the state that may become more acute once the full economic impacts of the COVID‑19 pandemic are felt.

2. Key findings: the COVID‑19 response to homelessness

The Department effectively planned and implemented its homelessness response to the pandemic and reduced the risk of transmission of COVID‑19 for people sleeping rough

The Department's crisis response focused on people sleeping rough due to the public health risk of COVID‑19 transmission amongst this group.

The Department engaged with the specialist homelessness services sector from mid‑March 2020 to modify service delivery, advise on infection control and plan extra supports. It explored options with temporary accommodation providers to support self‑isolation for clients, and scaled up its assertive outreach patrols by staff, specialist caseworkers and health professionals to support people sleeping rough into crisis or temporary accommodation for safety.

The Minister directed the Department to address street homelessness in the COVID‑19 response using the Government’s second stage of stimulus funding. The Department procured hotel, motel or serviced apartment accommodation for 400 people who were sleeping rough, or unable to physically distance in large crisis accommodation centres, within a week of the ministerial direction, building on existing programs. The Department provided advice to the Minister on the need to adjust existing policy settings to meet the forecast demand for temporary accommodation services.

The Department secured additional temporary accommodation when and where it was required, to accommodate the number of people sleeping rough who wanted support. Between 1 April 2020 and 31 January 2021, the Department provided temporary accommodation to 32,158 individuals, of which 4,355 people were sleeping rough, totalling more than 70,000 nights of temporary accommodation and services.

The Department met regularly with NSW homelessness peak organisations and established a Taskforce involving other government agencies, peak organisations, and service providers, to assist in quickly executing the measure and resolving issues arising. The Taskforce built on existing collaborative arrangements in place to support cross‑sectoral coordination, enabling it to respond quickly to COVID‑19.

The Department worked with NSW Health and health providers to ensure its COVID‑19 response to homelessness was in line with health guidelines. As of May 2021, just one participant in the Department's enhanced temporary accommodation program had contracted COVID‑19.

The Department does not know how many people sleeping rough who were assisted with enhanced temporary accommodation have returned to homelessness

Within metropolitan Sydney, the Department established a specialist housing team, and contracted a non‑government provider, to connect people placed in hotels with support services, provide tailored support, and to assist and monitor their transition to longer‑term housing.

The Department’s data indicates that between May 2020 and 31 January 2021, over 1,800 people who had previously been sleeping rough had been engaged in this program, more than four times the expected client numbers. Almost half moved into further accommodation when they left the program, including people supported with longer‑term housing such as social housing, community leasing under the Together Home program, and private rental arrangements.

However, the Department did not track the housing outcomes for clients who were not provided with this support, or who disengaged from services. The Department advises that this would have required additional resourcing to do so.

The Department offers assistance to people in temporary accommodation to find longer term options, and has a policy to not knowingly exit someone from temporary accommodation into homelessness. However, it does not track housing outcomes for every client if they do not engage with the Department's housing or funded support services. It intends to conduct research in the future to better understand what happens to people who leave temporary accommodation without seeking further assistance from the Department.

The Department cannot identify precisely how many people sleeping rough who were assisted during COVID‑19 have returned to rough sleeping or other forms of homelessness. The Department’s data suggests that 72 per cent of the approximately 4,000 people formerly sleeping rough who left temporary accommodation between April 2020 and April 2021 left with an unknown housing outcome. This includes people who were not eligible for social housing, were stranded due to border closures, or who disengaged from the Department or funded support services.

The Department also has limited data to understand whether the enhanced temporary accommodation program was more effective in helping to connect participants with services and support them into stable accommodation, than previous approaches.

The Together Home program was established quickly to assist people into more permanent accommodation but will not meet demand as a standalone response

The Department established the Together Home program in September 2020 to provide longer‑term accommodation to people who were sleeping rough during the pandemic. Community housing providers head‑lease properties in the private rental market for two years and sub‑lease these to clients, while ensuring they receive additional support, such as health services, to help them maintain the lease.

Under the initial tranche of funding, the Together Home program aimed to support 400 people sleeping rough. This target was met by April 2021. Due to increased rental demand in many areas of the state, there were some delays in securing properties in certain areas. In addition, people on temporary visas, or with existing public housing debt, are ineligible for this program.

A further $29.0 million was provided to this program through the 2020–21 NSW Budget, creating 400 additional program places. However, the total number of 800 Together Home places will not be sufficient to provide housing for the more than 4,000 individuals who were sleeping rough prior to entering enhanced temporary accommodation.

The Department advises it is using a range of ‘business‑as‑usual’ options to assist other people sleeping rough into stable accommodation outside of the Together Home program. These options include social housing, supported transitional accommodation, subsidised private rental, boarding houses, and referral to mental health and substance addiction rehabilitation facilities.

The Department’s latest annual state‑wide street count suggested that the number of people sleeping rough across New South Wales decreased by 13 per cent between February 2020 and February 2021. The Department has acknowledged that it could do more to monitor and support the housing outcomes for people in temporary accommodation after they exit.

The Department has plans to secure longer‑term housing options for Together Home clients after the two‑year program, through commissioned community housing and private rental assistance. However, it is not clear how this will overcome existing housing challenges given the complexity of needs amongst this client group, the limited availability of affordable rental properties and the existing scale of unmet need for social housing.

3. Recommendations

By July 2022, the Department of Communities and Justice should:

1. use data and analysis identified through the Homelessness Strategy 2018–2023 and provide advice to the NSW Government on sustainably addressing demand and unmet need for homelessness supports

2. use the evidence obtained through the Homelessness Strategy 2018–2023 to commence development of a comprehensive strategy to address homelessness, linked to the government’s ten‑year plan for social housing and 20‑year housing strategy

3. establish and sustain governance arrangements that enable input to key decisions on homelessness policy from partner agencies, the specialist homelessness services sector, the community housing sector, Aboriginal people and people with lived experience of homelessness

4. in partnership with Aboriginal stakeholders and communities, design and implement a strategy for early identification and responses to the needs of Aboriginal people vulnerable to homelessness; and build the capacity and resourcing of the Aboriginal Community Controlled Sector to deliver homelessness services

5. evaluate the homelessness response to COVID‑19 and integrate the lessons learned into future practice; and develop protocols to inform actions in future emergencies/disasters

6. establish and sustain a means to regularly collect client outcomes data and feedback; and use this to drive improvements to responses to homelessness.

This chapter considers how effectively the NSW Homelessness Strategy was developed and is currently being implemented by the Department of Communities and Justice.

This chapter examines how effectively the Department of Communities and Justice addressed homelessness in its response to the COVID‑19 pandemic, and how well it is applying lessons learned from the pandemic to future policy and service development.

Appendix one – Response from agency

Appendix two – Actions within the NSW Homelessness Strategy 2018–23

Appendix three – Reported progress on Homelessness Strategy actions to date (unaudited)

Appendix four – Key homelessness data collections

Appendix five – Temporary accommodation for people sleeping rough standard practice vs COVID 19 response

Appendix six – Key measures in the COVID 19 response to homelessness

Appendix seven – About the audit

Appendix eight – Performance auditing

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