THE MANUAL OF SOCIAL

PROCUREMENT

Continuity in Service Provision

Knowledge Preservation

Recipients at the Service Center

Supervision and Control

Competitive Bidding and

Pricing

Flexibility and Innovation

Drawing Conclusions

Setting and Measuring Standards

Competition in the Service of Quality

Service Providers as Partners

Published in Hebrew: Tamuz 5777 | July 2017

The Manual of Social Procurement

The Department for Governance and Social Affairs

at the Prime Minister’s Office

In accordance with Government Resolution 1950, dated September 11, 2016,

on the Adoption of the Recommendations of the Government Team for the

Improvement of Social Services Provided by Outsourcing.

Written by: Dr. Hila Tal-Avitan

Editors: Nimrod Degani, Tamar Peled-Amir

Head of the Department for Governance and Social Affairs: Ehud Prawer

Translated into English in July 2018 by IGMI LTD

Part 1: Preface 5

Chapter 1: Introduction 7

Chapter 2: The engagement Life Cycle 9

Chapter 3: How to Begin 11

Chapter 4: How to Continue - activities required for managing the engagement 14

Part 2: Recommendations for Formulating and Managing an Excellent Engagement 15

Chapter 1: Service recipients of the Center 17

Chapter 2: Service Providers as Partners 21

Chapter 3: Setting and Measuring Standards According to the Change Theory 31

Chapter 4: Competition in the Service of Quality 40

Chapter 5: Continuity in Service Provision 50

Chapter 6: Competitive Bidding and Pricing 54

Chapter 7: Flexibility and Innovation 57

Chapter 8: Drawing conclusions 63

Chapter 9: Knowledge preservation 65

Part 3: Supervision and Control 69

Part 4: Summary of the Recommendations 79

Part 5: Appendices 85

Appendix 1: Assisted in writing the Manual 87

Appendix 2: Tips for Conducting Consultation 88

Appendix 3: Tools for the Chapter on Setting and Measuring Standards 92

Appendix 4: Government Resolution on Government Policy on the

Provision of Social Services 96

Appendix 5: Government Resolution on Adopting the Recommendations

of the Government Team to Improve the Provision of Outsourced of Social Services 98

TABLE OF CONTENTS

Part 1

Preface

“I have never tried that before, so I think I should definitely be able to do that.”Astrid Lindgren, Pippi Longstocking

6

77

Chapter 1

Introduction

Hello,You must be the director of a social service provided by outsourcing You must be reading me because you have to engage someone in the provision of your ser-

vice, and you wish to verify that the social service under your responsibility is a professional

one, tailored to the needs of the citizens, continuous, provided under appropriate terms,

available and accessible wherever and whenever necessary.

Who am I?I am the outcome of the recommendations of the Government Team for the Improvement of the Provision of Outsourced Social Services, for-mulated through an inter-sectoral cooperation within the framework of the roundtable of the Prime Minister’s Office.The team acted by virtue of Government Resolution No. 2034 (HC / 37) dated September

28, 2014, with regard to the government’s policy of providing social services. On September

11, 2016, the government approved Resolution No. 1950, adopting the recommendations of

the Government Team for the Improvement of the provision of outsourced social Services.

As part of this Resolution, the Prime Minister’s Office, alongside the Accountant General’s

Department in the Ministry of Finance and the Social Ministries, were tasked with formulat-

ing the social services outsourcing manual.

The Resolution also states that “the Manual shall express the following principles with re-

gard to engaging suppliers of outsourced social services:

A. Setting standards for the social service and its quality, verifying and creating a re-

wards and sanctions regime, based thereof.

B. Defining a work process, in cooperation with the Ministry’s entities relevant to formu-

lating the tender, alongside consultation, in a manner corresponding to the principles

of equality and legality, with external entities relevant to the outsourcing process,

during the preparations for drafting a tender, and while drawing conclusions, moni-

toring and supervising, as well as in knowledge preservation during the tender’s life

cycle.

C. Increasing competition before and during the engagement’s period, improving flexi-

bility in operating the service and encouraging innovation.

D. Ensuring congruence between the engagement’s content and the control content in

the supervision process, as well as increasing the monitoring’s transparency.”

8

LEGAL CLARIFICATION

This manual is an instrument designed to serve the managers of social services in engaging for the provision of social services. The purpose of this manual is to assist social service managers, who are the professionals qualified to provide the service under their responsibility. The manual includes a wide range of courses of action. Evidently, it is impossible to apply the totality of them in each and every engagement, taking into consideration, inter alia, the unique characteristics of each engagement, its scope, and the resources and means for its management. Implementation will therefore be carried out subject to the characteristics of each engagement and its circumstances. This manual does not stipulate or limit the Mandatory Tenders Law, 5753-1993, and the legal rulings in their matter, and each government Ministry must act in accordance with the provisions therein. Use of this manual will be at the discretion of the service managers, the directives of the legal adviser of the relevant Ministry, the specific context, and the provisions of any law.

99

Chapter 2

The Engagement Life Cycle

The purpose of the present chapter: Clarifying the engagement life cycle and its effect on the outsourcing administration; outsourcing is a cyclic rather than a linear process.

The conclusion of an engagement is usually accompanied by entering into new one. A new

engagement often occurs upon termination of a previous one. These engagements nourish

and influence subsequent ones.

The engagement’s life cycle consists of three stages. At each stage there are certain activi-

ties to be carried out to ensure an excellent engagement.

1. Planning the engagement and drafting

its documents

2. The tendering process, up to awarding the engagement

3.Managing the engagement’s

life cycle

10

The three stages of the engagement life cycle are:

1. Planning the engagement and drafting its documents:

Since an engagement is a cyclic process, a new engagement usually begins before the

end of the current one. We are presently at a juncture at which we have to look and

examine the existing engagement and decide how the service will be provided later

on. At this stage you plan and define all the engagement characteristics required for

its success, based on the previous one. This stage requires much input, and can last a

long time. This is a critical step to the engagement’s success, since what you do not

define during its course will be difficult to change or add in the future. Please note,

it is recommended to initiate this stage about a year before you want the new engage-

ment to begin operating.

2. The tendering process up to the winners’ selection

This is a stage where the extent of your activity is limited, since the tender has already

been published. However, holding a providers’ conference, the manner in which you

will respond to the bidders’ questions, as well as the extent by which you will expedite

the various factors to end the process, are all very significant.

3. Managing the engagement’s life cycle

Now that you have an engagement, you can start providing the service. But this is not

the time to rest on your laurels; on the contrary. As any married couple will surely tell

you, marriage does not end with the wedding ceremony; it only begins there. So it is

with an engagement - it does not end with the choice of providers, it only begins there.

Now is the time to begin managing the engagement and providing the service. This is a

lengthy stage, spreading over all the engagement years and requiring considerable in-

put. You are responsible for administering this stage in cooperation with all the relevant

entities within and without the Ministry.

In the following chapters you will find two flow charts representing the activities you must

perform during the engagement life cycle. The first chart, in the chapter “How to Begin,”

refers to activities that must be carried out in the engagement’s first (Planning the engage-

ment and drafting its documents) and second stage (“The tendering process up to the win-

ners’ selection”).

The second chart, in the chapter “How to proceed,” refers to activities that must be per-

formed in the third stage (Managing the life cycle of the Engagement).

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Chapter 3

How to BeginActivities required during the planning and drafting stages of the engagement documents

The purpose of this chapter: Presenting the main activities to be carried out in the first two stages of the engagement’s life cycle – “Planning the engagement and drafting its documents” and in the second stage, “The tendering process up to the winners’ selection’.

4. Write the engagement documents based on the knowledge you have accumulated in the process, so that you can:

5. Publish the tender and select a winner - make sure to grant sufficient submission time and listen as much as possible to potential service providers.

1. Start working with your engagement team

Dra

ftin

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ub

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ing

2. Carry out a debriefing of your last engagement

3. Listen! To people in your Ministry and other government Ministries, to existing and potential service providers, to service recipients, local authorities, and advocacy groups

Set standards and indicators of the service; define control and supervision policy; set a high degree of competition.

Set best competitive bidding and pricing; set a flexible, innovative service that preserves knowledge; reduces regulatory and financial burden from service providers.

Cre

ati

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an

in

fra

stru

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6. Very good! Now that you have created an outstanding engagement, start managing it

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Action 1: Start working with your engagement team

The procurement unit in your Ministry is the one assembling the engagement team

and setting the dates of its meetings. The engagement team consists usually of

representatives of the units responsible for engaging in your Ministry: Procurement,

Accounting, Budgets, and the Legal Department. The composition of the team can

vary from Ministry to Ministry, and there are Ministries where it also includes the IT

unit, the Audit unit, and the Measurement unit.

The Ministry where you work has accumulated a great deal of knowledge about

outsourcing social services. Do not ignore all that knowledge. Serial writing of en-

gagement documents often creates a “Communication Breakdown” due to a lack

of dialogue among writers, so that original intentions are lost between drafts written

by different people.

Writing based on a common work and learning process, will allow you to concen-

trate in one room the knowledge of all people and entities involved, and write the

best possible tender.

Action 2: Debrief your last engagement

There are lessons to be learned even from successful activities. We will draw con-

clusions from all the components of the last engagement. For example, the com-

patibility’s extent of the standards and indicators that were set, the manner in which

monitoring has been carried out, the extent of incentives given to the service pro-

vider for improvement, etc.

Conclusions should be drawn by debriefing through the AAR (After Action Review)

methodology. For more on drawing conclusions and the AAR debriefing methodol-

ogy, see Part 2 of the manual in the chapter “Drawing Conclusions.”

Action 3: Listen to people in your Ministry and other government Ministries, to

existing and potential service providers, to service recipients, local authorities,

and advocacy groups.

There are many people involved in providing your service and similar social ser-

vices. Whether they are government officials either from your Ministry (for example,

service supervisors, and managers of other services) and from other government

Ministries, or those outside the government: existing and potential service provid-

ers; service recipients and their families; local authorities and welfare offices, advo-

cacy groups and experts.

Mark V after completing the task

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Mark V after completing the task

Choose, to which of these people you want to listen.

How can you listen?

Hold meetings, conduct surveys and questionnaires, publish a public appeal, etc.

Please note: it is very important that all team members will be familiar with the

service recipients and service providers and will be part of the consultation pro-

cess. For further information, see chapter ‘Service Recipient at the Center’ and the

chapter ‘Service Providers as Partners’. For further details on listening when creat-

ing an engagement, see part 2 of the manual ‘The Service Recipients at the Center’

and the chapter ‘Service Providers as Partners’. In addition, for tips on how to hold

meetings and questionnaires, see the Appendix ‘Tips for Consultation’.

Action 4: Draft the engagement documents based on the knowledge you have

accumulated in the process, so that you can establish an excellent engagement

The outcome indicator of the first three activities will be excellent engagement

documents, including: accurate and comparable standards and indicators, compre-

hensive control methods and congruence between the engagement documents

and the supervisor’s work, high competitiveness, optimal competitive bidding and

pricing, flexible, innovative and knowledge-preserving service, and the reduction of

regulatory and financial burden of service providers. For further details on the com-

ponents of an excellent engagement, see Part 2 - ‘Recommendations for Creating

an Excellent Engagement and its Management’ and part 3 - ‘Recommendations for

Supervision and Monitoring’.

Action 5: Publish the tender and select a winner - here too, make sure to listen as

much as possible to potential service providers.

The tender process is a legal process in which the activities you can perform are

limited. But here too - listen as much as possible by holding a providers’ conference

and answer clarification questions. For further details, see the second part of the

manual ‘Service Operators as Partners’.

Action 6: Very good! Now that you’ve established an excellent engagement, start

managing it.

Move on to the next chapter...

The purpose of this chapter: Presenting the main activities to be carried out in the third stage of the engagement life cycle - ‘Managing the Engage-ment’s life’.

Congratulations! You have an excellent engagement. Now is the time to manage it.

Although the tender process is long and arduous, it is not the end of the engagement, but

rather its beginning. Now that we have defined the basis for the engagement and have

selected our service providers, we are required to manage the engagement for the rest of

its life cycle. So here are the things that you need to keep in mind in order to manage an

excellent engagement:

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Chapter 4

How to ContinueActivities required in managing the engagement

Drawing conclusions through debriefings

Continuity in service provision

while preventing stagnation in quality

Transparency and accessibility of

information regarding all service components, including standards and pricing

A continuous competition that

allows the service recipient, inter alia, to choose between providers

Updating the indicators at a

predetermined junction

Cooperation and consultation with

the service recipients and their families

Strengthening

the partnership with service providers

360o monitoring, transparent, and accessible

Rewards and sanctions

Part 2

Recommendations for

Formulating and Managing

an Excellent Engagement

1717

FROM: REPORT OF THE GOVERNMENTAL TEAM ON IMPROVING THE OUTSOURCING OF GOVERNMENT SERVICES‘The starting point of the process of formulating the teamwork was examining the social service from the perspective of the service recipient, therefore we first defined the main needs of the citizen from the social service he receives:A. A professional service tailored to his needs - including a high service standards, innovation, dif-

ferentiation, and a consideration of the service recipient as an individual.B. Appropriate conditions - both physically and in the interpersonal interaction between the citizen

and the service provider.C. Availability and accessibility - the ability to receive the service, including geographically, cultur-

ally, economically (where the citizen is required to pay for the service) and physically.D. Continuity - of the professional staff, especially in long, intensive services, and especially for a

population needing continuity at the interpersonal aspect. ‘

Chapter 1

Service Recipients at the CenterActivities required in managing the engagement

The purpose of the chapter: enabling service recipients to take an active part in shaping the way it is provided.

How can you know the needs of service recipients?First and foremost, by asking them.

Service recipients and their families know when the service they receive is appropriate

and suited to their needs. They can tell when the service is available and is sufficiently

accessible to them, and when its continuity is important to them.

Among the service recipients there are those who are reticent to speak out - the helpless

service recipients. It is possible to encourage them to speak out (see examples below) and

they can also be heard through their family members who care for them. Each time a rec-

ommendation appears in the chapter regarding service recipients, it can also be applied to

their family members.

Of course, as a public servant you work in a world of legal, budgetary, and other constraints.

You cannot always respond to the wishes and needs of the service recipients. By listening

to them and to their families, you can carry out more informed decision-making and plan

better services.

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1. Ask the service recipients and their family members for their opinions, already when planning the engagement.Before you formulate your engagement, it is important that you hear from the service recip-

ients what works fine and which points should be improved. This is the place to hear their

opinions about changes you’ve contemplated, about the degree of suitability of the monitor-

ing method and so forth. How can you ask for their opinion? You can do this by meeting with

representatives of the service recipients, or by conducting a survey among them. For tips on

how to hold meetings and questionnaires, see the Appendix ‘Tips for Consultation’.

2. Ensure the existence of accessible complaint mechanisms in the service. Make it possible for service recipients to notify you when something in the service provision

is not working properly. This will make your control and supervision more effective. For fur-

ther information, see the chapter ‘Supervision, Enforcement, and Service Termination’.

3. Make the information about the service transparent and accessible to the service recipients.Publish and make accessible the service standards and indicators, its pricing and its

monitoring results. For further details, see chapters: ‘Competition in the Service of Qual-

ity’, ‘Competitive Bidding and Pricing’, ‘Supervision, Enforcement and Service Termina-

tion’. This perspective will improve the coordination of expectations about the service,

and will enable service recipients to better understand its characteristics. It will also

enable them to stand up for their rights in its implementation.

4. Make it possible for service recipients to choose their service provider.In services where this is possible, the service recipients must be empowered by provid-

ing them a choice between providers. In addition to empowering the service recipient,

this will create an ongoing competition among service providers and push the service

towards a higher standard. Please note, that if you did not make the information about

the service transparent and accessible as detailed in the previous recommendation,

the chances of an informed and optimal selection of service recipients will be reduced.

For more on the advantages of the service recipient’s choice and tender instruments that

enable this choice, see the chapter ‘Competition in the Service of Quality’.

5. Use the opinions of service recipients, or those commissioning them on their behalf, for the purpose of rating the quality of the bid in the tender.When you move towards a new engagement and make the service providers compete

on the basis of their quality, you should dedicate part of the score to the opinion of the

service recipients and their families or service customers such as local authorities and

welfare offices. You can get their opinion through surveys, for example. For further de-

tails on surveys, see Appendix ‘Tips for Conducting Consultation’. For further details on

the quality of the bid, see the chapter ‘Competition in the Service of Quality’.

6. Include service recipients in the process of determining its indicators. For further details, see the chapter ‘Setting and Measuring Standards According to the

Change Theory’.

MODEL TENDER: MINISTRY OF HEALTHNational School for Mental Health Rehabilitation, Integration, and Recovery - Mental Health DepartmentE. 7. Accompanying steering committees of courses.

E. 7.A. Members of the steering committee:

E. 7.A.1. Chairman of the Steering Committee, Academic Director of the National School for Vocational Training

E. 7.A.2. Deputy Academic Director,

E. 7.A.3. Representatives of the National School for Vocational Training.

E. 7.A.4. Representatives of the Ministry of Health: Director of instruction, training, and assimilation of

models in the rehabilitation system, and representative of regional rehabilitation coordinators.

E. 7.A.5. A representative of a rehabilitants’ organization, or a representative of family members in

courses for family members.

E. 7.A.6. Students’ representative.

E. 7.A.7. A representative of the academic institution operated by the provider.

E. 7.B. The role of the steering committee: To discuss the contents of the course, the teaching staff, the guidance in the workshops, the learning conditions and any other component presented in the students’ feedback, or according to the opinion of the course coordinator and the school’s executive staff, and to examine the need to make changes and / or preserve existing situation.

E. 7.C. Location and frequency of committee meetings: The limited steering committees will meet in the school at the end of each academic year and / or the start a new course.

E. 7.D. The Provider shall be responsible for scheduling the Committee meeting in coordination with the Ministry; for summoning the participants to the Committee and preparing them for the Committee; for preparing a status report and presenting issues for discussion and submission for approval by a representative of the Ministry; for writing a protocol during the meeting; for providing refreshments.

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7. Establish steering committees with representation of service recipients. A steering committee is a definite and permanent channel for the discourse of knowl-

edge, mutual learning, and finding common solutions to problems that arise during the

provision of the service. In many services it is customary to establish a Service Steering

Committee and to appoint representatives of the service providers. This is a welcome

and recommended practice, but it is also recommended to provide representation for

the service recipients themselves, present and past, in steering committees of this type.

Representation on the steering committees will enable service recipients and their

families to be part of the service operation process on an ongoing basis, thereby

influencing its policy. See, for example, the tender published by the Ministry of Health,

which combines two types of service recipients in the steering committee: Recipients

of direct service - students at the National School for Mental Health Rehabilitation - and

indirect service recipients, for the sake of whom the training is being carried out - the

mentally disabled.

E. 7.E. At the end of each meeting of the Committee, and no later than 30 days from the date of the meeting of the Committee, the Provider shall deliver to each of its participants an orderly summary of the meeting, with at least the following details: the date and time of the Committee’s meeting; the main issues raised and discussed; the names and roles of the participants; decisions taken; timetable and responsibility for carrying out tasks. It is hereby clarified that before the protocol is distributed to the Committee’s participants, the minutes will be submitted to the Ministry for approval.

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8. Establish positions of ‘expert associates’ and ‘quality trustees’ in the service.The intention is to integrate people from the service recipient population, past and pres-

ent, as having a say in the processes of evaluating the service and its operation. Their

operation can be paid or voluntary - according to the definition of the job and its intensity.

This is based on the understanding that those who have received the service in the past,

or face the same challenges as service recipients, will better understand their needs.

The integration of past service recipients in the service can also help in obtaining information

from service recipients, who are sometimes afraid to criticize the service and its providers.

MODEL PROJECT: THE NATIONAL INSURANCE AND THE MINISTRY OF HEALTH ‘Expert associates’The project has set itself the goal of integrating people coping with mental illness at work in psychiatric hospitals as part of the hospital staff in a designated role, called ‘expert associate’, operating within the framework of the psychiatric hospital.

MODEL PROJECT: MINISTRY OF HEALTH Quality Service Trustees - Rehabilitation Sector, Mental Health departmentJob Definition - Quality Service Trustee:1. Accompanies the data collection process in the project to evaluate outcome indicators in the ser-

vice.2. Assists residents in filling out the questionnaires and ensures that the residents fill the question-

naires of the outcome indicators reliably and without bias.3. Helps the service director in transmitting the database collected in the results indicators project to

the Ministry of Health.4. In charge of work improvement and optimization with the quality reviewers.5. Ensures that the system cooperates with the reviewer.6. Mediates in meetings between the quality reviewers and the residents in order to fill out the ques-

tionnaires.7. Responsible for the participation of residents and their families in the steering committees 8. Ensures that representatives of residents and families are participating in the system’s steering

committees9. Responsible for the validity of confidentiality waivers.

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Chapter 2

Service Providers as Partners

The purpose of this chapter: Leveraging the partnership of service providers for the success of the service.The provision of social services to citizens is a joint action of the social Ministry and the

service providers that it has chosen to carry out the task.

The partnership between the Ministry and the providers is not symmetrical. The Ministry

commissions, designs and supervises the service; the Ministry selects its partners in carry-

ing out the task, and the Ministry can terminate the partnership if necessary.

However, this asymmetry does not negate the value of the partnership and its contribu-

tion to the success of the service provision.

It is also clear that our interests do not always correspond to the service providers’. Business

service providers wish to make money. Nonprofit providers have an agenda that they want

to promote.

But along our various interests, we also have a common goal - to provide quality service to

the service recipient.

Please note that the partnership with service providers is not automatic; it depends on two

conditions:

1. The service providers are partners only during the engagement period. Prior to the

engagement, they are only potential partners. You have no obligation to engage with

them, and they have to compete in the tender process like all other potential partners

2. A service provider shall be considered a partner only if he provides quality service

which meets the standards we have defined.

The bottom line is that as the one who orders a service, you can choose how you look at the

service providers: as providers or as partners. My point is that referring to service providers

as partners will result in better service to the citizen. This is because partnership produces:

1. Professional coordination and aiming towards common goals – the partnership estab-

lishes a common language between you and the providers, thus assisting in your work

and coordination.

2. A Commitment of service providers – Considering service providers as partners give

them a greater motivation and commitment to service quality.

3. Adapting the service to the changing needs of the citizen –the service providers are

in daily contact with the service recipients, they encounter daily their needs and desires.

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In this sense, they associate you with the ‘field’.

4. Knowledge preservation and management - Service providers accumulate extensive

professional knowledge in the framework of service provision. The partnership enables

you to share the staff’s professional knowledge with the ‘field’.

As you continue reading the manual you will find many recommendations that will pro-

vide you the instruments to manage and handle the service providers when they do

not meet your requirements. For example, recommendations regarding the establishment

of comparative indicators, increased competition, transparent supervision and a sanction

scale. Ostensibly, there is a contradiction between this chapter and the following chap-

ters of the manual. But actually, there is no contradiction at all. We are interested in cre-

ating a reality of ‘the righteous shall prosper, the wicked shall suffer’: a service provider

that acts as a partner, providing quality service, demonstrating commitment to service

recipients, helping to renew and deepen professional knowledge - should be heard and

rewarded accordingly. A service provider that does not act as a partner will be handled

accordingly, and if necessary we will terminate the partnership.

The recommendations in this section fall into two categories:

• Strengthening the aspects of the partnership between you and the service providers in

a way that will improve the quality of the service.

• Reducing the regulatory and financial burden imposed on the service providers, in order to

enable them to focus their efforts on providing the service instead of dealing with this burden.

Strengthening the aspects of the partnership between you and the service providers

in a way that will improve the quality of the service.

9. Consult existing and potential service providers prior to drafting the engagement.

Service providers operate in the ‘field’ and are familiar with both the needs of service recip-

ients and the resources required for providing the service.

Please note that if you conduct the consultation process prior to drafting the engagement,

you will have a more open and direct discourse. As you progress in drafting the tender,

holding a consultation may invalidate the tender, and therefore you will have to execute it

with utmost care for equality and transparency, accompanied by the legal counsel in your

Ministry.

Beyond holding meetings prior to drafting the engagement, there are also three ways of

consultation, which are anchored in the Accountant General’s regulations and are part

of the tendering processes:

It is important to remember that the consultation process must be conducted subject to any law. The ability to be heard by decision-makers is of great value to various stakeholders, such as service providers and service recipients. Special care must be taken to maintain equality, especially with regard to service providers and potential providers.

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A. Publish an RFI if necessary.

Regulation 14A of the Mandatory Tenders Regulations allows you to make an early, pub-

lic request for the information you need regarding the engagement. This can help you

learn about the potential bidders’ market, the characteristics of the required service,

its pricing, the needs of service recipients, etc. Such an appeal must be published in a

manner that ensures equality, and subject to the approval of the Tenders Committee.

In order to increase the effectiveness of the appeal, it is important that you publish it in

a variety of ways and in accordance with the target audience (in newspapers, on the

Internet, through dedicated mail distribution, etc.). The advantage of this instrument is

that it is easy to make and can be used to get much information. Before you publish

it – plan who in your unit will help you process the feedback.

B. Hold a providers’ conference if necessary.

You may determine, at the time of drafting the tender, whether you wish to hold a provid-

ers’ conference after its publication. A providers’ conference allows you to learn about

the potential market of the tender providers (those attending the conference and who do

not), the issues concerning potential bidders, and ambiguities that arose from the tender

documents. In the framework of a providers’ conference, the participants will be able to

ask questions about the tender, but the binding answers that you must give can only be

written in the framework of answers to clarification questions. Therefore, if you decide to

hold a providers’ conference, you will also be obliged to allow clarification questions. You

may require the participation of potential bidders in the conference as a condition for the

submission of a tender bid, or leave them with the choice whether to participate.

C. Allow clarification questions.

A clarification process can be held without a providers’ conference or as a complement

to one. This process is very valuable, because it allows to receive information about

the tender from the potential providers and allows to improve the correspondence be-

tween the wording of the tender and the intention of the Ministry in its drafting, and

sometimes even to repair certain parts of it. For further details on the Providers’ Confer-

ence and clarification questions, see Financial and Economic Regulations Directive No.

7.4.10 ‘Clarification Questions and providers’ conference Tour’.

10. Establish and develop the professional doctrine together with the service providers

in a systematic manner

Your service providers possess great knowledge! They are very familiar with the service

recipients’ population; they are also very familiar with the employees who provide

the service directly, as well as with their abilities and needs; they are often experts in

the field of service provision. Therefore, in the course of the engagement, consult

“Tell me and I forget. Teach me and I remember. Involve me and I learn”. Benjamin Franklin

24

systematically with the service providers, along with the professional division, the

supervisors etc. For further details, see the chapter ‘Knowledge Preservation’.

11. Establish forums.

Establish, for example, a forum of the directors of the organizations that operate the ser-

vice for you, or a forum of advocacy groups operating in the field of service. Of course,

you should set the composition of the forum according to your professional needs, but

it is important that you define its existence. You should schedule meetings in advance,

according to your needs - for example, once a year or once a quarter. Define the forum’s

cooperation space - is this where you listen to participants? Is this where mutual learn-

ing will take place, with an ultimate binding product?

12. Conduct instruction and training courses for the service providers’ employees.

Some social services work towards the improvement of the service quality throughout

the engagement by training the service providers’ employees. These training programs

establish a common language with service providers and their employees. They en-

hance the aspects of partnership and push the service towards a better quality. A good

ex ample of such training can be seen in the National School for Mental Health Rehabil-

itation established by the Rehabilitation section of the Ministry of Health Mental Health

Department.

13. Establish a Joint Steering Committee for the Service.

For further details, see the chapter ‘Service Recipients at the Center’.

MODEL TENDER: MINISTRY OF HEALTHEstablishment of the National School for Mental Health Rehabilitation, Integration, and Recovery E.1.E. Thousands of professionals from various professional sectors - social workers, occupational ther-

apists, nursing staff, psychologists, psychiatrists and others (rehabilitation counselors, mentors, professional support staff, and others) - are presently involved in the rehabilitation system.

E.1.F. This is an array of services, based on involvement and partnership with the rehabilitants and their families. Some of them are themselves now serving as staff members in the various systems.

E.1.G. Over the last few years, the National School for Mental Health Rehabilitation, Integration and Recovery has developed training and courses designed to promote and develop correct and innovative professional thinking in order to serve and help advance the target population and to provide skills related to these roles and to the initiation of new Rehabilitative interventions in the field of psychiatric rehabilitation.

E.1.H. A consistent and up-to-date training of professionals engaged in psychiatric rehabilitation is a prerequisite for providing quality and effective services. The National School for Mental Health Rehabilitation, Integration, and Recovery serves as an ethical, conceptual, theoretical, and prac-tical basis for the instruction and training of professionals as rehabilitation workers in mental health. In this way, it serves as a basis for promoting and improving the service quality for the welfare of the person who is coping with a mental handicap, and his family.

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14. Get assistance from the service providers for monitoring.

For further details, see the chapter on ‘Supervision and Control’.

Reducing the regulatory and financial burden imposed on service providers

It is important to clarify that the financial costs of the service providers are embodied

in the price they demand. In addition, due to the fact that 60% of the outsourced social

service providers are non-profit organizations, the significance of the financial difficul-

ties is particularly high. By their very nature, many non-profit organizations lack a high

funding capability, and the money they are forced to invest in financing costs could

have been invested in their customers.

In addition to all these important reasons for reducing the burden on service providers,

I remind you of the issue of competition. A financial and regulatory burden constitutes

an entry barrier for small and medium-sized providers, thereby harming competition.

Following the Government Resolution No. 1950 on adopting the recommendations of

the Government Team for the Improvement of the Provision of Outsourced Social Ser-

vices, the Accountant General has published the Financial and Economic Regulations

Directive 7.11.6 on engaging in the provision of social services, in which she lays out

several arrangements, the main ones being detailed below. These arrangements allevi-

ate the burden imposed on social service providers.

Now you might say, ‘I am convinced that this is important, but why is it my responsibili-

ty? After all, the Ministry has an accounting department and legal counsel. This chapter

seems relevant to their occupation and not to mine’. Your presence in this professional

discussion is important, since it is important that you work in all content areas that

can influence the success of your engagement. You are the one who needs to speak

on behalf of the service providers when planning the engagement, in order to ensure

the maximum quality of service they can provide to your service recipients. The more

the service provider will be available to provide the service itself, and the less it will be

involved in solving regulatory and financial hurdles, the greater the likelihood of quality

service for the service recipient.

15. Establish long-term engagements (with clear exit options).

Understanding the importance of continuity in some of the engagements, Government

Resolution No. 1950 established two new alternatives to long-term engagements of up

to five years - authorization to commit, and multiannual agreements. For further details

on these alternatives, on the importance of continuity and what needs to be done in or-

der to avoid the dangers of a long-term engagement, see only the chapter ‘Competition

in the Service of Quality’.

16. Set payment on the basis of milestones.

Setting a milestone for organizing during the planning of the engagement.

When a service provider starts to provide a service, he often requires a period of orga-

nization. For example, he must train staff, purchase equipment, renovate a building, etc.

26

During this time, the provider is required to bear the organizational costs. But in the

routine payment method he begins to receive payment only when he starts to provide

the actual service. This imposes a financial burden on the service provider. In order to

alleviate this burden, it is possible to set payment by milestones, with the first milestone

being the organization of the service.

Please note that this is not an advance. In milestones, we do not pay for future activities.

We pay for organizing only after it has been carried out. It is important to emphasize that

with milestones we do not add a budget to the provider for organizing. The value of the

engagement remains the same, but we spread the payment in a manner that takes into

consideration the activities required to organize the service.

A milestone for preventing a delay in payments.

There are engagements in which approval of payment for execution takes a long time.

In order to prevent delay of payment to the service provider for a service that has been

already provided, the Ministry’s accountancy may pay up to 70% of the payment prior

to the completion of the required tests.

17. Allow the assignment of right to the banks in order to receive credit.

‘Assignment of right - a written instruction from a beneficiary (entitled to receive pay-

ment) to transfer or assign his right to receive payment in favor of a third party’.2

What does this actually mean?

The service provider goes to the bank with the engagement he has signed for the

service he provides for you, and with the approval of the Ministry’s Accountant for the

assignment of rights. He receives a loan from the bank. If he does not return the loan to

the bank, the bank now has the right to enter his bank account and take the money that

the Ministry paid him for the service he has provided.

2. Financial and Economic Regulations 1.6.8, 'Foreclosure, assignment of Rights, Offset of Debts'.

FROM: FINANCIAL AND ECONOMIC REGULATIONS DIRECTIVE NO. 7.11.6 ON THE SUBJECT OF ENGAGEMENT FOR THE PROVISION OF SOCIAL SERVICES1.1 Milestones for payment1.1.1 In the process of engagement for receiving outsourced social services, the Tenders Committee may set conditions of payment to the provider according to the following milestones:1.1.1.1 Payment for construction and organizational costs. 1.1.1.2 In order to make it easier for the provider in engagements where the process of approving the

performance prior to the payment takes a long time, the Accountant is authorized to approve a payment of up to 70% of the payment prior to the completion of the tests required for the final approval of the payment, subject to the following conditions:

1.1.1.2.1 Receipt of a preliminary performance report or any other document required in the context of the engagement in respect of the said amounts.

1.1.1.2.2 Approval by the senior professional body responsible for receiving the service. 1.1.2 The payment shall be made in accordance with the provisions of the Financial and Economic

Regulations Directive, ‘Payment Dates’, No. 1.4.3.

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Thus, the bank will have reduced the risk of providing a loan to the service provider, and

therefore it is easier for the provider to obtain a loan from it.

Why is it important? Because, as we have said before, companies and especially as-

sociations often encounter financial difficulties. An assignment of right can help them

achieve a necessary ‘breathing space’.

18. Allow an offset order (in lieu of a guarantee) for a performance guarantee. ‘Performance Guarantee’ – A guarantee by the provider selected for executing the

engagement’.

‘An Offset Order’ – An unconditional consent of an entity that receives payments from

the Government, according to which a Ministry accountant may delay or offset any

amount, up to the ceiling determined in the offset letter, of any payment due to that en-

tity from the Government without the Accountant General having to explain or demand

the disposal of the said amount from the entity. The offset order also includes an irrevo-

cable undertaking by the entity to return any amount claimed, if there are no payments

to offset them. See the text of the undertaking in Appendix C.3’

So what does that actually mean?

When a provider is required to provide a guarantee, he is actually required to deposit a

significant amount of money (about 5% of the engagement’s value) and use that money

until the completion of the engagement. This creates a financial burden on the service

provider.

The Financial and Economic Regulations Directive regarding guarantees has been

updated and a provision has been added to it pursuant to Government Resolution

No. 1950, which relates to offset order in long-term engagements in the field of so-

cial services. The directive makes it possible to implement an offset order (which up

until the date of the last Financial and Economic Regulations Directive in the matter of

guarantees was called ‘a provision in lieu of a guarantee’).

The offset order may remind one a little of the assignment of right, but here it is oppo-

site the Ministry and not opposite the bank. The offset order means that if the service

provider violates the agreement between him and the State, the State can offset and

withhold payments.

FROM: FINANCIAL AND ECONOMIC REGULATIONS DIRECTIVE NO. 7.11.6 ON THE SUBJECT OF ENGAGEMENT FOR THE PROVISION OF SOCIAL SERVICES1.2 Assignment of right1.2.1 In the event that a request is received from a provider to assign a right to a third party within the

context of an engagement for the provision of social services, the Accountant may consider such an engagement as special circumstances for the approval of the assignment in accordance with the provisions of the Financial and Economic Regulations Directive, ‘Foreclosure, Assignment of Rights, Offset of Debts’, No. 1.6.8.

3. Financial and Economic Regulations 7.7.1, “Guarantees”

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FROM: FINANCIAL AND ECONOMIC REGULATIONS DIRECTIVE 7.7.1, ON GUARANTEES.1.1. Offset order in long-term engagements in the field of social services.1.1.1 The Tenders Committee of a Ministry that wishes to enter into a long-term engagement to

perform work in the field of social services or to procure services in this field, shall be entitled to decide that the circumstances allow the winning provider to submit an offset order as a substitute for the submission of a performance guarantee document (hereinafter: ‘an offset order’).

1.1.2 Insofar as it has been decided to submit an offset order, it will be filled in accordance with Ap-pendix C - according to the wording of the offset order and an irrevocable undertaking, signed by the authorized signatories of the bidder and attached as an appendix to the engagement of engagement.

1.1.3 The Ministry shall be entitled to withhold payments due to the provider in the amount of the offset order that has been requested, already from the first payment due to the provider, in-cluding for a service performed by the provider, even before an invoice has been submitted. In addition, the Ministry will be entitled to offset the funds that are held as aforesaid, in any situation in which the forfeiture of the performance guarantee could have been required, should the Ministry have required a performance guarantee.

1.1.4 Submitting an offset order shall be required from a provider as a condition for signing the engagement of engagement.

1.1.5 An offset order shall apply to an amount equal to the amount of the performance guarantee that would have been required in accordance with clause (?) above.

1.1.6 If the provider wishes to exercise the possibility of submitting an offset order as a substitute for a performance guarantee letter in the engagements subject of this Article, the Ministry’s Accountant shall perform a Financial Strength Test, designed to examine the provider’s ability to pay his debts. In examining the financial strength, the Ministry will examine parameters such as: the ratio between assets and liabilities and the ratio of liabilities to equity.

1.1.6.1 If the provider does not pass the Financial Strength Test, he will be required to submit a per-formance guarantee for the purpose of signing the engagement agreement, and an offset order may not be sufficient.

1.1.7 At the end of each year of the engagement, the Ministry will conduct a Financial Strength Test of the provider, as stated in Article 1.1.6 (hereinafter: ‘Annual Financial Strength Test’). If the provider does not pass the Annual Financial Strength Test, the provider will be required to submit a performance guarantee as a condition for continuing the engagement with him. After the performance guarantee has been submitted as stated, the offset order submitted by the provider will be canceled.

1.1.8 The Tenders Committee shall include in the tender documents, reference to the following issues:1.1.8.1 A clause stating that the bidder who wins the tender will be able to submit an offset order as a

condition for signing the engagement and as an alternative to a performance guarantee letter.1.1.8.2 Details of the requirements that the provider will be expected to comply with, including the

Financial Strength Test, in order to determine that he is financially stable for the purpose of substituting the demand for a performance guarantee by an offset order.

1.1.8.3. A clause according to which a provider found to be unstable financially will be required to submit a performance guarantee for the purpose of signing the engagement agreement, in which case an offset order will not suffice.

29

1.1.9 The engagement contract will specify that if the provider does not pass the Annual Financial Strength Test, he will be required to submit a performance guarantee as a condition for continuing the engagement with him.

1.1.10 Insofar as it is not necessary to implement the offset order, the amount that has been delayed on the date set in the tender documents shall be transferred to the provider on the expiry date of the performance guarantee.

1.1.11 The Senior Deputy Accountant General, Director of the Social Ministries Division, May, for special reasons that will be recorded, exempt an entity from a Financial Strength Test as a condition for the provision of an offset order as a substitute for a performance guarantee letter.

1.1.12 Reporting. 1.1.12.1. In each calendar year and until the end of the first quarter of the following year, the Ministry

Accountant shall transfer to the Senior Deputy Accountant General in charge of the Social Minis-tries, a report concerning the engagements where an offset order has been signed in long-term engagements in the social services field. This report will include reference to the following issues:

1.1.12.1.1 The number of engagements in which an offset order has been signed.1.1.12.1.2. The financial scope of all engagements in which an offset order has been signed.1.1.12.1.3. Confirmation of the performance of an Annual Financial Strength Test for each provider, and

details regarding the provider’s compliance with the parameters determined by the Ministry for the purpose of the engagement.

1.1.12.1.4 Details of the engagements in which the Ministry is required to exercise the right of offset pursuant to the offset order. The details will include the purpose of the engagement, the financial scope of the engagement and the circumstances that led to the exercise of the right of offset.

1.1.12.1.5 Details of the engagements in which the provider filed for bankruptcy or insolvency. For each such engagement, the Ministry shall attach the Financial Strength Test performed in accordance with Article 1.1.6.

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FROM: FINANCIAL AND ECONOMIC REGULATIONS DIRECTIVE 1.4.3 AS REGARDS SETTING PAYMENT DATES

1.1.1. As a rule, the Ministry’s accountant shall independently set the payment dates for each provider and for any other entitled entity at the following times:

1.1.1.1. A bill / invoice that will be submitted on the 1st and 15th of the month will be paid at the beginning of the government payment date of the following month.

1.1.1.2. A bill / invoice that will be submitted on the 16th and 24th of the month will be paid in the following month, according to the date of submission of the bill, i.e., exactly 30 days from the day the bill was submitted.

1.1.1.3. A bill / invoice that will be submitted between the 25th and the 30th of a month will be paid on the 24th of following month i.e. at the end of the government payment date of the following month.

1.1.2. The payments detailed below will be paid on the date of the nearest government payment date to the date of submitting the bill to the Ministry, and not in accordance with the provisions of Section 1.1.1:

1.1.2.1. Payments that are essentially intended for the payment of wages and salaries (such as payment to a manpower company, etc.).

1.1.2.2. Payments to subsidized entities, in accordance with Financial and Economic Regulations Directive, ‘Subsidies’, chapter 6.

1.2. Exceeding the payment date 1.2.1. The Ministry’s Accountant shall be entitled to approve an exception to the instructions in this

Directive and to advance a payment date.1.2.2. The Accountant confirming an exception and advance of the payment date shall prepare a

document detailing the reasons and justifications for the exception and the advancing of the payment date. This document will be attached to the payment documents.

19. Be aware of payment schedule instructions.

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Chapter 3

Setting and Measuring StandardsAccording to the Change Theory

The purpose of this chapter: Defining standards and indicators in a manner that will lead to an excellent service.

20. Set standardsWhat are standards actually?

Standards are guidelines or norms that we define for the service we provide. When

you start planning your engagement, it is important that you define how you want the

service to look.

There are two types of standards you must define:

A. Set standards to ensure existential security.

These are standards that relate to the infrastructure of service provision, such as struc-

ture, cleanliness, and food at a basic level. These standards are intended to ensure

the safety and dignity of the service recipient. They are set regardless of the purpose

of the service and regardless of the Change Theory underlying it. In most cases, these

standards have already been set in the service in various ways: in licensing, through the

legislation by virtue of which it is enforced or supervised, by the Ministry’s procedures,

by the Social Work Regulations or the CEO’s circulars.

B. Set standards relating to the Change Theory.

When you operate a particular social service, it is important that you determine what

the underlying change theory is. Change theory describes the desired change that

is expected to occur due to the intervention and certain activities. The standards in

this group will relate to the intervention and activities we seek to perform as part of the

Change Theory. For example, determining individual weekly treatment for drug addicts

in addition to the distribution of a drug substitute. We will generally strive to measure

standards associated with Change Theory using outcome indicators.

For example, if I am responsible for youth at risk, I have to ask myself what change I

would like to see in the behavior of the youth who will receive the service. Do I want to

prevent them from dropping out of school? Or do I want to see them integrated into the

job market? It is important that I define in advance what I consider to be a service suc-

cess. After determining the results to which I aspire (depending on the characteristics of

the population of service recipients and my available scope of action), I will define what

activities, and resources are required to achieve the results I have defined.

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The definition and measurement of Change Theory can be done with the help of

the extended logical model on the next page. This is a logical model adapted to the

manual, and we have reversed the order of work. As you can see in the model, your

Change Theory should start to be determined from the results. Once we have defined

the results, we determine the activities to be taken in order to achieve them, and then

determine the inputs needed in order to perform the activities.

Please note that the desired results are not determined independently of our scope of

action, which includes, inter alia, our authority, the resources we possess, the charac-

teristics of the population of service recipients, etc.

Even when setting the Change Theory of the service, it is advisable to consult the ser-

vice recipients and their families, the service providers, advocacy groups etc.

The extended logical model

Situation1. Needs 2. Problems 3.Population characteristics

Scope of action1. Goals 2. Values 3. Authority 4. Partners

5. Resources available to us

Results

External variables AssumptionsHow we can achieve the results

Outputs Inputs

Short-term resultsThe plan’s short term impact on the target audience (up to one year)

Long term resultsThe plan’s long term impact on the target audience (over one year)

The activities we do in order to get results:1. Meetings2. treatments3. Lessons

Resources we invest in order to carry out the activities:1. Human Resources2. Time3. Money4. Infrastructure

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21. Set clear service indicators.

Why should you set indicators for the service you provide?

Measurement requires conceptualization of the Change Theory both by the profes-

sional body and by the service provider.

• Measurement drives towards achievements - it gathers all the partners in the service

operation (both the Ministry, which commissions the service and the service providers)

to achieve the desired goals and to focus on them. Measurement enables effective

control - in order for the service provider to meet the required standards and correct

defects, our control instrument must be as clear and accurate as possible. For further

details, see the chapter “Supervision and Control”.

• Measurement establishes a broad and authoritative factual basis of ‘what we’ve

done’ - it enables us to monitor the manner in which the service was provided and

to carry out a learning and evaluation process that to improve the functioning of the

service.

• Transparent measurement enables the service recipient to be aware of his rights

and to insist on their implementation, and promotes competition between service

providers.

A. Establish outcome indicators for standards relating to the Change Theory.

This is the best way to push for improved service quality. Outcome indicators measure

the changes expected by the service recipients, or by the community. The outcome

indicators reflect the value that we seek to produce and constitute the purpose of

the service activity, even though outcome indicators are not under the exclusive

control and responsibility of the service provider and are influenced by the external

environment and other factors. See, for example, the outcome indicator in the Mental

Health Department of the Ministry of Health: The rate of returnees to psychiatric hos-

pitalization within 30 days of their release. Of course, the rate of re-hospitalization is

affected not only by the quality of treatment they’ve received during the hospitalization

period. Thus, for example, patients released from hospitalization return to a different

environment in terms of their family and employment status, and this environment can

also have an effect on the need for re-hospitalization. However, it is important to set

outcome indicators, because without outcome indicators it will be difficult to lead the

service provider to focus on a higher quality service for service recipients.

B. Define output indicators after you have established outcome indicators for standards

that relate to your Change Theory.

Output / process indicators - these are the activities you perform in order to achieve

the desired results. Outputs are operations that are under the responsibility and control

of the service provider. The output is an instrument for assuring success of therapy, and

it is directly related to the Change Theory.

For example, the first secondary-standard we mentioned earlier, requiring that every

patient in a psychiatric hospital has a drug treatment plan, defines the following indi-

cator: 80% of the patients will have a documented treatment plan in their files within 5

days of being admitted to the hospital.

34

C. Define input / infrastructure indicators and a structure according to the standards of

existential security and the Change Theory.

The third type of indicators is the basis for the activities we measured through the

output / process indicator, and these are the input / infrastructure and structure in-

dicators. These indicators relate to the inputs that are required in order to prepare for

the establishment or operation of the service, which lead to the conversion of resources

(budgets and manpower) into operations. For example, making a building available to a

hostel for mentally ill people, located in a residential area (so as to enable integration of

its residents into the community).

D. If necessary, break down the standard into components.

Sometimes, in order for us to define a standard in a way that makes it possible to

carry out measurements, we need to break it into components. Thus, for example,

the Mental Health Department has a holistic standard of detailed and comprehensive

treatment plan for the psychiatric hospital at an early hospitalization stage. If we do not

break this standard into components, we will not know whether the treatment plan is

detailed and comprehensive enough. Therefore, the Mental Health Department de-

fined this standard as composed of six different components (secondary-standards):

1. Drug therapy program; 2. Psychotherapeutic treatment plan; 3. Mental and physi-

cal diagnosis; 4. Social characteristics (leisure, income, employment, and housing);

5. Assessment of rehabilitation needs; 6. Estimated needs in daily functioning.

A relevant indicator was defined for each of the 6 secondary-standard components.

(Below I will give an example of such an indicator.)

E. Avoid micro-management - go for outcome indicators when the Change Theory

allows it.

Services with multiple output indicators are characterized by micro-management and

inhibit innovation and flexibility. There are services where the outcome indicator is the

essence of the service. In such services it is possible to waive the output indicators

and leave only outcome indicators. For example, if you have an engagement for com-

pletion of matriculation exams, you can define for the service provider the pedagogical

methodology in advance: the number of staff members, the number of students in the

class, the number of hours of study, etc. Or, alternatively, you can define for him (along

with standards of existential security) outcome indicators only, such as the percentage

of students who are required to complete matriculation and by what score. This will

leave the way open for innovative learning methods. For further details, see the chapter

‘Flexibility and Innovation’.

F. Standardize intervening factors when comparing providers on the basis of indicators.

Results may be influenced by external variables. For example, when comparing hos-

pitals, it is impossible to ignore the fact that different hospitals have different patient

profiles. Therefore, when the Ministry of Health determined a measure of mortality fol-

lowing heart attacks, it took into consideration the patients’ profile when setting the

required indicator level. Hospitals with a large percentage of female patients received

35

a ‘factor’ in the indicator, compared to hospitals with male patients. This is because fe-

male patients tend to have a higher mortality rate following heart attacks, due to their

blood vessel structure.

Please note that the measurement you define in the tender will serve as a control in-

frastructure for the quality of the service provision. As will be discussed in more detail

in the chapter ‘Supervision and Control’, a congruence is required between your supervi-

sion and control work and what you defined in the tender.

G. Define in advance, for yourself and for the service provider, the expected implemen-

tation of the indicators.

Any use will require monitoring of compliance with the indicators, and you can read this

in detail in the chapter ‘Supervision and Control’.

The following are the possible uses of indicators

1. Discourse with the service provider - Measurement is an important instrument in your

work relationship with the service provider. It will help both of you to conduct a pro-

fessional dialogue about how to provide the service, strengths and weaknesses in its

provision, and how to improve its quality.

2. Rewards and fines - measurement will enable you to establish a reality of ‘the righteous

shall prosper, the wicked shall suffer’’, thus creating a high motivation to improve the

service quality.

1. Discourse with

the service provider

2.Rewards and

fines

3.Payment

4. Selecting

service providers

The provider’s profitability relates to compliance with the indicators.

Allows feedback to the provider, pushing for improvement.

Exists outside the current engagement.

36

See, for example, the Ministry of Education’s ‘Third Semester - Summer Semester’ ten-

der. The purpose of the engagement is to enable students to pass the matriculation ex-

ams in one of the compulsory subjects in which they had difficulty or had failed in their

studies during the regular school year.

3. Paying the service provider - this refers not only to rewards or fines, but to the fact that

any payment to a provider is determined on the basis of the output indicators or the

result determined in the engagement documents. Unlike compensation on the basis

of the inputs, compensation on the basis of output and results produces an incentive

for the service provider to improve the service quality. Compensation based on inputs

alone can even impair the achievement of desired outcomes in terms of patients. Thus,

for example, a provider who is compensated for the residents who reside in his institu-

tion and not for their rehabilitation may prefer to leave the residents in his possession

rather than transferring them to integrating frameworks.

See for example the Ministry of Health’ new tender for the provision of health services

to students:

MODEL TENDER: MINISTRY OF EDUCATIONThird Semester - Summer Semester, Secondary Education Division1.1 Calculating according to examine es’ achievements1.1.1 Examinees’ achievements will be divided into 4 categories where each category defines the

score range. The bonus or the malus paid to the contractor will be calculated in accordance with an examinee’s mark. Details of the categories and the amount of bonus / malus to the examinee will be as follows:

Category Final Score Range Bonus / malus amount per examinee

A. 54-0 NIS 500 -

B. 64-55 NIS 100 +

C. 84-65 NIS 150 +

D. 100-85 NIS 250 +

1.1.2 In the event that there is a deviation between the average of the matriculation exams in the third se-mester program and the average score submitted by the students at the questionnaire level in the third semester, the compensation deducted from the contractor’s account will be calculated as follows: (1) Deviation of 20-25 points on the average of one questionnaire - compensation of NIS 20,000. (2) Deviation of 26-30 points on the average of one questionnaire - compensation of NIS 30,000. (3) Deviation of more than 30 points on the average of one questionnaire - compensation of NIS 40,000.

1.1.3 Grade reports will be provided to the contractor by the Department of Secondary Education. The Ministry will prepare a grade report according to the categories and calculate the bonus / malus payments in each life cycle separately.

1.1.4 The Contractor shall take into account that the sum of the bonus payments for one year after the deduction of the malus shall not exceed NIS 100,000.

37

‘For further details, see the chapter ‘Competition in the Service of Quality’.

4. Selecting service providers - the indicators will allow us to compare service providers

and choose better providers in the next engagement, or in engagements for similar ser-

vices. For further details, see the chapter ‘Competition in the Service of Quality’.

Select one of the four activities listed above for each indicator you define. When select-

ing an action, consider the age of the service. A new service provided by you for the first

time, or a veteran service that is first provided by a new provider, is often characterized

by difficulties in operation and construction, along with a greater likelihood of ‘surprises’

regarding the service provision. Therefore, in new services avoid applications with signifi-

cant implications for the service provider, which could pose a risk in its provision, such as

results-based payment, or even rewards and fines. On the other hand, in a service that has

been provided for more than two years and where the organization has been completed,

it is important to try integrating applications with significant implications.

H. Define your red lines in advance.

What is the required minimum which, in your opinion, you will never waive? For the most

part, our red lines are directly related to existing security measures. They are especially

important when it comes to the population of helpless service recipients.

Crossing red lines can lead you to discontinue the engagement with the provider or to

cancel his license. In order for you to terminate an engagement or to cancel a license, it

is important that you operate in an orderly and transparent manner: that there will be a

record of the inspection reports, that the service provider will receive his right to a hear-

ing, etc. It is also important that you prepare in advance a procedure for transferring

service recipients from the system of that service provider to another system.

A state of termination of an engagement and cancelling a license is an extreme situa-

tion that no one wants, but it is essential that you have this option so that you can pro-

tect your red lines.

Here is an example of the importance of defining the red lines: You may, for example,

be able to accept a temporary situation of staff shortages and even impose sanctions

against the service provider. (For further details on the ranking of sanctions, see the

‘The Customer has allocated a budget as specified in Section 1.0 of the Tender for the purpose of performing the Services 9.1. However, the actual consideration will be transferred to the provider according to the actual performance of outputs and inputs and taking into consideration the control score of the Ministry ... The Min-istry of Health will monitor and supervise the manner of providing the services as detailed in Article 12 of the agreement, and shall grade the provider for them ... The control scores shall be weighted for the calculation of the consideration to the provider... The structure of the controls and their exact nature will be determined during the first year of the engagement. An example of the controls is hereby attached as Appendix F1 for the benefit of the bidders

38

chapter ‘Supervision and Control’). However, it is important that you define in advance

for how long, for example, you are willing to accept this situation? At what extent of staff

shortages constitutes a real danger to the safety and lives of service recipients?

It is essential that both you and the service provider understand when a defect can be

contained (even if the provider is penalized) and when a defect is a breach of your rela-

tionship and will lead to termination.

I. Set a time point in advance to update the standards.

Usually, after providing service for two years, we see that it is necessary to correct

the trend graph of the indicators. Set in advance an intervention point where it will

be possible to examine and update the setting of the indicator vis-à-vis the service

provider. This means that when you establish a new and extended engagement for a

new service or with a new provider, avoid defining indicators in advance throughout the

engagement period and set an update point after two years.

The younger the service, the more important it is for you to test for each indicator if

its definition requires flexibility. Flexibility in the indicator means that you can exam-

ine the indicator throughout the life cycle of the engagement and make the necessary

adjustments. Flexibility always comes at the expense of certainty. Uncertainty makes

it difficult for service providers and recipients alike. Therefore, it is important to focus it

where we think it’s most needed.

J. Avoid multiple indicators.

There is no rule of thumb for the number of indicators to be set. However, multiple indi-

cators harm both our focus and that of the provider.

Measurement requires an array of reporting and supervision, and a system of drawing con-

clusions and managerial references when an indicator is a success and when it does not

meet our expectations. Therefore, it is important for us to ascertain that we have set an indi-

cator not just perfunctorily, and that it is of value. We should also ask ourselves what kind of

burden the indicator constitutes for the provider. For example, is it an indicator that the data

for its testing are in a computerized database, or whether the provider’s employees will be

required to search for the data throughout various printed documents.

K. Include partners in setting the indicators.

The success of the service does not depend on one factor. Therefore, all the affecting

and affected factors should be mapped and included in the setting process, including

the service providers themselves. Consultation is especially important when setting

subjective indicators, such as satisfaction of service recipients and their families. For

further details, see the chapter ‘Cooperation and consultation’.

L. Examine the service indicators through ‘gender’ glasses.

Why should you? Gender testing will give you an additional perspective on the needs of

your male and female service recipients and will allow you to be accurate and provide

better results. In addition, the instrument for gender assessment leads to a complex

examination of the service recipients and their needs, as well as to representation of

39

various population groups, such as those with special needs, populations that do not

speak Hebrew, etc. To see how this can be done, see the end of the chapter ‘Instrument

for Integrating Gender Considerations into the Assessment’.

See Appendix C, ‘Instruments for Breaking down and Measuring Standards,’ a table for

defining indicators and instruments for assessing their quality.

4040

Chapter 4

Competition in the Service of Quality

The purpose of the chapter: Maximizing the tender potential in order to improve the service quality.

Why should you create competition in social procurement?

Before dealing with the ‘How’, let’s say a few words about the ‘Why’. The word ‘com-

petition’ is, ostensibly, foreign to your business. Competition implies for us economic and

commercial issues. How is it connected to the most sensitive places where we meet the

citizen?! Let us therefore begin by clarifying that competition is not a goal but a means. It

is a means of improving the quality of service provided to the citizen.

First of all, let’s refute five false premises that sometimes arise when talking about

competition:

Premise 1: The purpose of the competition is to save money. Not true: Our goal of the

competition is to receive the highest quality service possible for its recipients, not nec-

essarily to save money. However, the financial savings can help us increase the variety of

service components provided to the service recipient or, alternatively, provide the service

to as many service recipients as possible.

Premise 2: Competition is just about the price. Not true of social services. In the social

services, we will make sure that competition is mainly about quality. Thus, for example,

competition can be about the variety of services provided by the service provider, the qual-

ity of the professional staff, the service innovation, and so forth. Competition between ser-

vice providers prevents stagnation. It pushes the service provider towards better quality

and affordable prices.

Premise 3: Competition is a ‘Zero-Sum’ game. Exactly the opposite. In most engage-

ments, we will prefer several winners over one single winner. We prefer several winners

for two main reasons: 1. Multiple winners will ensure us a continuous competition through-

out the life cycle of the engagement. 2. It puts in place an alternative to the provider. In the

past, professionals have encountered situations where they wanted to replace a service

provider who did not meet the required standard, but there was no one to replace him. It is

very important that in the social services we have a number of providers so that we can, if

necessary, terminate an engagement with a provider who does not meet our requirements.

Premise 4: Competition occurs only during the selection of the winners. In order to con-

tinuously push the quality of service throughout the years of the engagement, it is essential

that we also establish continuous competition throughout the engagement years.

Premise 5: Competition impairs the continuity of the service provision. There is indeed

41

some tension between competition and continuity; however, in the next chapter, we will see

how we can manage this tension and maintain the continuity of service provision where it is

needed, alongside a competitive dimension in the engagement.

22. Define the level of competition that suits you.

Before starting with recommendations for increasing competition, it is important that

you define the level of competition that suits you. The best level of competition is the

one that will push the providers to improve the service on the one hand, while keep-

ing it manageable on the other. Also, it is important to remember that competition has

a price alongside its benefits. For example, many times new providers need an ‘adjust-

ment’ period and it takes some time before they meet the required standards.

When we talk about competition, it is important to distinguish between two periods:

The tender period - the period in which we select the tender winners. The relevant

questions for us during this period are questions regarding the threshold conditions,

the manner in which the tender competition will be carried out - such as price, quality or

a combination thereof - the number of possible winners and so forth.

The engagement period - after the winners have been selected, the period of ser-

vice provision begins; this period can spread over years. During this period, it is es-

pecially important that we establish continuous competition. Moreover, the longer the

engagement period, the more critical the competition is, throughout the term of the

engagement. This is in order to reduce the stagnation in service provision and to main-

tain the vigilance of service providers in relation to its quality. The relevant questions

to us during this period are questions regarding differential compensation, customers’

choice, etc. Why is it important? Competition during the engagement’s life cycle is the

best way to ensure a constantly improving service that keeps flexibility and innovation

alongside the highest professional standard.

The recommendations before you are divided into two parts. The first part is about

competition during the life cycle of the engagement.

This is the most important competition for improving the service. The second part

discusses competition during the tender period. This competition is essential for us

in order to be able to establish an effective competition during the life cycle of the

engagement.

23. Increase competition during the life cycle of the engagement.

A. Allow the service recipient or the service customer to choose between service providers.

A choice between the service providers during the engagement is the most effective

way to establish continuous competition throughout the life cycle of the engagement.

The main tender instrument for making such a choice is a Framework Tender (also

known as a List Tender).

‘Framework Tender - a public tender in which more than one provider is selected, and

according to the terms thereof, framework agreements will be signed with each frame-

work tender provider, and the identity of the provider from which any order of goods,

work or services will be made will be selected every once in a while through a com-

42

petitive process of individual application, during the term of the framework agreement,

under the terms of the Framework Tender. ‘4

Who gets to choose?

A Framework Tender allows selection between the various service providers who won

the tender. It can allow us, as a Government Ministry, to choose between service pro-

viders. But more importantly, it allows us to give the choice to the service recipients and

their families (by using vouchers, for example), or to the service customers, such as a

local authority or welfare offices. Both alternatives are good and effective in ensuring

competition during the life cycle of the engagement, and the choice between them is

usually based on the characteristics of the service.

Below you can see two examples of different Framework Tenders. The first passes the

choice to the service recipients, while the second allows a choice to service customers.

Example 1: A tender where the choice is made by the service recipients themselves

can be seen in the Service for Rehabilitation Through Accommodation of the Mental

Health Department. The rehabilitation committees of the Ministry determine the eligi-

bility of the mentally handicapped person for rehabilitative service. A mentally handi-

capped person who has been found eligible (received a voucher) by the Committee can

choose the hostel or the assisted living facility he’s interested in, and get it following

the approval of eligibility. The Ministry pays the providers according to the number of

service recipients who enjoy the service of the provider.

Example 2: A Framework Tender where the choice is made by the service customers

can be seen in a joint tender of three departments in the Ministry of Labor, Welfare, and

Social Services for the operation of summer camps. In this tender, it is the local authority

that chooses various service providers, in accordance with the criteria specified in the

tender documents.

4 Financial and Economic Regulations Directive regarding Framework Tender, No. 7.21.5.

MODEL TENDER: MENTAL HEALTH DEPARTMENT, MINISTRY OF HEALTHTender No. 43/2016 for the procurement of Rehabilitation Services Through Accommodation for the mentally handicapped in the communityWHEREAS: The provider declares that he is aware that the Customer will procure services, if any, according to his needs and budget only and according to the professional discretion of the Customer and based on the rehabilitative and social needs of the service recipients, taking into consideration the wishes of the residents / rehabilitants and their families or their guardians, and of the Customer.

43

MODEL TENDER: MINISTRY OF LABOR, WELFARE, AND SOCIAL SERVICES

Operating day camps for children, youth and young people with disabilities belonging to the population under the care of the Rehabilitation Department, the Department for the Treatment of People with Developmental Disabilities and the Service for the Treatment of People with Autism, in nationwide deployment2. Choosing a provider for operating a summer camp2.2.1 When the need arises to operate a summer camp, the local authority will apply to the providers in the database of camp operators, according to the geographical distribution, availability of the database provider, the needs of the population in terms of type of disability, the relevant sectors and ages, at least 90 (ninety) days prior to the date designated for the start of the summer camp; for vacation packages scheduled for the summer vacation – by May at the latest; all as detailed in Appendix 1 attached hereto. The referral of the participants to a summer camp will be done by the social services departments in the local authorities after examining the individual suitability of the candidate to the summer camp, according to the quotas received by the local authorities, the budget available to them, and the needs of the population.

2.2.2 The list of providers in the database shall be forwarded to the local authorities in accordance with the characteristics of the providers as detailed in their bids in Appendix 2.

2.2.3 The selection from the providers list, of the provider to operate the camp is the responsibility of the local authorities, and will be done in a manner that will best meet the special needs of the participants. Notwithstanding the aforesaid, it is hereby clarified that the Ministry reserves the right to initiate the opening of a summer camp directly.

2.2.4 It is hereby clarified that the providers may apply to the local authorities and offer to op-erate a summer camp.

2.2.5 The selection of a provider to operate the camp will be carried out according to the fol-lowing criteria, in accordance with the characteristics of the camp as presented in the response to this tender in Appendix 2:

2.2.5.1 The framework’s specialization type:

2.2.5.1.1. Age of the treated population.

2.2.5.1.2. Type of disability.

2.2.5.1.3. Gender

2.2.5.1.4. Sector

2.2.5.1.5. Function level

2.2.5.2 Proximity of the camp to the place of residence of the participants.

2.2.5.3 If more than one suitable provider is found for the purpose of operating the camp, the Authority will perform a round of rotation between the relevant providers, with the se-quence of providers being carried out by lot.

44

B. Rate service providers and make the rating accessible to the public.

It is not enough to give the customers a choice; it is important to give him the instru-

ments to make an informed choice.

Using the comparative indicators that you’ve already defined according to the chapter

‘Setting and Measuring Standards According to the Change Theory’, it will be easier for

you to rate service providers.

I will expand later on the issue of control. In the meantime, I would say that it is import-

ant to be able to compare service providers, and transparent control is the basis of this

comparison capability.

Comparison between providers will enable providers, service recipients, and us, to un-

derstand where each service provider is in relation to another, allowing you to select

the best providers in the next tender. The very understanding - that the rating will affect

the chances of winning the next tender - is expected to push the providers towards

improvement already in the current tender.

C. Pay according to service quality.

Pay and reward the service providers differentially, based on the quality of the service

they provide.

This is one of the most effective methods of pushing for improved service quality.

24. Increase competition during the tender process

In order to increase competition, we are often required to allow the entry of providers

who have not entered so far. It is important to emphasize that we do not intend to lower

the professional standard that we require, since we will not compromise as regards the

quality of service provided to the citizen. Recommendations regarding the providers market

A. Know the history of tenders in similar fields.

We have already mentioned the importance of drawing conclusions. Drawing conclusions

will serve us to improve the engagement in many areas, one of which is competition. It

is important that you test the service’s previous engagements. Try, together with your

SAMPLE SERVICE: MEDICAL ADMINISTRATION, MINISTRY OF HEALTHThe ‘Stars’ Model - a model for incentivizing neonatal intensive care units.The ‘Stars’ model is designed to improve the conditions of neonatal intensive care units. The incen-tivizing model measures inputs and results according to the standard recommended in the Medical Administration circular, published in December 2013, in the areas of personnel, infrastructure and in-fections in neonatal intensive care units.Five of the outstanding neonatal intensive care units receive double funding for each premature baby.The results of the examination were widely published in the media and were made accessible to the public.

45

engagement team, to figure out whether and how to establish a new engagement that

will encourage more competition. For example, why were some of the bidders disquali-

fied? Was the threshold condition, of providing a structure ahead, too harsh? Are these

relatively small providers, for whom the deployment scope was too large?

B. Know your service providers market.

It is important to map your service providers market at the planning stage. Ask who

are the current service providers? Who are the potential service providers - those who

can provide the service, but have not applied in the past? Who are the providers who

sent clarification questions in the previous tender, but eventually did not submit bids for

the tender? Which providers operate in similar services in the Ministry or other Ministries?

C. Reaching Out.

Make contact with potential providers on your own initiative, and interest them in

providing you with the service. Try to understand what prevented them from compet-

ing in your tenders in the past. As long as you operate transparently and equitably, you

need not be afraid to speak with current and potential service providers, provided that

this is done outside the framework of the tender process and without discussing or in-

volving any of them in specific tender conditions.

D. Nurture a ‘Baby Provider’.When there is a limited pool of providers, new providers can be encouraged to enter

the market by creating a ‘baby provider’. This is a new provider, who has no experi-

ence in providing our service and does not have an existing infrastructure for its provi-

sion. As such, the provider’s various organizational costs must be taken into account.

In order to prevent a change in the way the service is provided to the existing service

recipients, it is recommended that you install and nurture the baby provider in a new

institution rather than an existing one.

For example, if you are operating nine hostels for girls at present and you decide to run

a tenth hostel, say that the tenth hostel can only be run by a baby provider. After sev-

eral years, the baby provider will have experience and will be able to compete for the

operation of the nine other hostels, like the other existing providers.

Please note that at first you may need to allocate a higher budget to the baby provid-

er, since, unlike other providers, he will have to provide infrastructure. When the pool

of providers is limited, it is worthwhile for us to allocate a higher budget for the baby

provider, with the understanding that in the long run the service quality will improve

and that the price will be more competitive. (This need to provide additional funding

to the baby provider does not exist in tenders for new services, since all providers are

required to provide infrastructure.)

In addition, you will need to prepare for a more professional close accompaniment of

the baby provider in order to ensure that he will be able to meet your requirements like

other providers.

46

E. Split the service into several regions

The country can be divided into separate service provision regions. This division will

enable small and medium service providers, to compete for the provision of services by

reducing the scope of service. Another advantage is that sometimes different regions

are characterized by a different population composition, which requires cultural and

language adaptation when providing the service.

Splitting into regions does not have to be just on a geographical basis. The service can

be split in the first place in different sectors, such as Arab, ultra-Orthodox and general

population.

You might worry that splitting into geographical regions will make it difficult for you to find

providers in less profitable regions (for example, those with relatively few service recipients).

In order to deal with this problem, it is possible to perform a ‘regions tie-in’ during the compe-

tition. For example, in order to win a tender for the provision of service in a profitable region

with many service recipients (such as the central region), the provider will also have to pro-

vide service in a region with fewer service recipients (such as the Arava region).

Recommendations on threshold conditions

Please note that before we understand how threshold conditions can be set in a way that

encourages competition, it is important to remember for a moment the importance of con-

trolling compliance with threshold conditions. When you set threshold conditions for the

service, make sure that they do exist throughout the engagement. This is often called

engagement control, and it checks whether the provider meets the tender requirements

throughout the engagement period.

For example, are the threshold conditions, on the basis of which the provider has been selected,

actually met? To the extent that you have determined that service providers must have a degree

in social work, it is not sufficient to verify that the employees do indeed meet this condition at the

time of signing the engagement. Do not assume that the quality of the team remains the same

throughout the engagement period. Employees, as is well known, are replaced, and you must

ensure that compliance with the threshold conditions is maintained.

The identity of the person responsible for the engagement control varies frequently between the

Ministries. Sometimes this is the Accountant and sometimes the professional supervisor himself.

Even if the engagement control is not imposed on you, as the provider of the service, you

have a responsibility to ensure that the engagement control does indeed exist and that

the provider indeed meets the requirements of the tender.

F. Allow entities without a license to bid for the tender (if they win, the license will be a

condition for the engagement).

In services with a tender alongside licensing (for example, ‘Homes for Life’ in the Minis-

try of Labor, Welfare and Social Services), the providers are required to comply with the

licensing requirements that the Ministry grants them as a regulator, as well as with the

tender requirements that the Ministry sets as a service customer. It is understood that

the professional entity will not waive the fact that the service providers will meet the

licensing requirements.

47

However, the Ministry of Labor and Social Affairs concluded that in order to allow a

wider range of providers to bid for their tenders, it is also possible to allow providers

without a license to bid, while making it clear to them that after winning the tender they

will be required to comply with the licensing requirements within the time specified in

the tender, as a condition for operating the service.

G. Give greater weight to the bid’s quality over experience.

Normally, we feel safer to work with experienced providers and with those we already

know. There is no doubt that the provider’s experience is an important factor; but rely-

ing on the provider’s experience may be a barrier to the entry of new service providers.

For example, if, in a certain service, there are only two experienced service providers,

a requirement of experience in the same service as a threshold condition will deter

competition.

In order not to rely solely on the bidder’s experience, it is possible to give greater weight

to additional parameters of the bidder and to refer also to the quality of the proposal

and the quality of the nursing staff. There are several parameters for grading quality:

• The quality of the bidder: interviews, reviews, audit reports, professional examina-

tions, satisfaction surveys of engagements concluded with him, etc.

• The quality of the nursing staff: professional experience, level of education, recom-

mendations, the training that the provider gives to the staff, interviews with the staff

members themselves, etc.

• The quality of the bid: quality of the treatment plan, standard of treatment, service

innovation, quality of the building, location and accessibility of the building, mainte-

nance of the planned building, etc.

• When you choose a bidder based on the quality of the bid to which he commits itself in

the tender, it is especially important that you carry out engagement control through-

out the engagement, to make sure that the quality, for which the selected provider has

been selected, is met.

H. Specify your demands about the experience.

It is worthwhile to rethink about the experience that you demand as a threshold condi-

tion. A particular provider may not be experienced in providing the service you require,

but his hired staff may include people who have provided this service. In this case, it

is necessary to examine whether it is important to you that the provider himself be

experienced, or is it enough that his employees are. It is also advisable to consider

whether you could be satisfied with a provider with experience in a service similar

to ours, or someone who has experience with a service-recipient population that is

similar in character to ours.

Recommendations regarding a building

I. Go easy with the requirement to provide a building in advance

In many tenders, bidders are required to present in advance a building in which they

intend to provide the service. This requirement was set in order to prevent a situation

48

whereby a bidder winning a tender may not succeed in locating a building, and his win

will be disqualified.

However, the requirement makes it difficult for small- and medium-sized service pro-

viders, who do not have buildings, to enter the tender. Therefore, check whether the

requirement to provide a building can be waived as a condition for winning in services

where possible (services that are not 24/7 services). It should be made clear to the pro-

viders that once they have won, they will be required to provide a building compatible

with the requirements defined in the tender documents and within the period specified

in the tender, as a condition for entering into an engagement for operating a service.

J. Allow provision of the service in a public building.

In some cases, it is possible to distinguish between the service and the institution. For

example, when tendering an educational service, providing it in a kindergarten or a

school building (such as an after school care, or the KAREV program). In this case, the

service provider can dispense with some of the fixed costs, resulting in a significantly

lower entry barrier.

Please note, that when you operate a service in a public institution outside the regular

hours of the institution, as in after school care for example, there are accompanying

operating costs, such as toilet paper, electricity, and so forth. Define in advance who will

be responsible for the operating costs while providing the service: The provider of the

service, the public institution, or the local authority.

K. Consider the possibility of combining a public service with a private one in the same

building.

There are services where the institution provides both public and private services. For

example, some nursing homes house three groups of elderly people: the elderly who

pay from their own pockets; the elderly who are budgeted by the Ministry of Labor, Wel-

fare, and Social Services, and the elderly which are budgeted by the Ministry of Health.

This option of the service provider, to provide private and public service at the same

institution increases his profitability, and as such, increases his profitability in the tender.

Recommendations regarding the reduction of the regulatory and financial burden

L. Write a simple and easy-to-understand tender.

One of the things making it difficult for small service providers to compete in tenders is

the complexity of the tendering process. Many tenders are too long and difficult to un-

derstand. Bidding for them requires inputs that make it difficult for a small provider. This

problem is a general government problem, which is intensified by the fact that there is

no similarity between the tenders, and each tender requires learning and grappling with

it again. Make sure that the tender brochure is clear and easy to fill.

M. Allow sufficient submission period.

As mentioned above, the organization for a tender requires many inputs. Do not lose

potential providers just because they did not have enough time to bid. An additional

49

consequence of short submission time may be inferior bids that do not adequately

meet the submission requirements and make the winner selection process difficult and

lengthy. Therefore, try to provide a minimum of 40 days of submission time, and in more

complex tenders (which require, for example, the provision of a building and extensive

personnel recruitment), allow a longer submission time.

N. Alleviate as much as possible the financial burdens that you impose on service pro-

viders.

For further details, see the chapter ‘Service Operators as Partners’.

For further reading on increasing competition, see also Financial and Economic Regula-

tions Directive No. 7.12.7 regarding the integration of tiny, small, and medium businesses

into government tenders.

5050

Chapter 5

Continuity in Service Provision

The purpose of the chapter: Creating continuity in the service provision where necessary, while avoiding stagnation in its quality.

Alongside the great importance of the competition described in the previous chapter, conti-

nuity and persistence are also important. The need for continuity is often common to both the

service recipient, the service provider and to the Government, each from its own perspective:

• The citizen’s perspective - allows continuous treatment, which is required in cases

where therapeutic relationship exist (e.g., populations with special needs).

• The Government’s perspective - diverting resources invested in the endless tenders’

extension for the preparation of quality tenders, ensuring good service to the citizens

and to the State. It also reduces the costs of engagements where the cost of uncertainty

is reflected in the pricing of the service.

• The service provider’s perspective - long-term planning enables investment in infra-

structure and training of employees, receiving credit from financing sources, continuity

in the engagement and prevention of ‘interim periods’ and ‘retroactive’ payment, and

eliminating the need for continuous engagement in extending engagements.

25. If necessary, establish continuity of service provision.

In the framework of Government Resolution No. 1950, two possibilities were put forward

for carrying out long-term engagements. Understanding the importance of continuity in

some engagement types, Government Resolution No. 1950 established two new alter-

natives to long-term engagements of up to five years – an authorization to commit, and

multiannual agreements. For further details on these alternatives, on the importance of

continuity and what needs to be done in order to avoid the dangers of long-term en-

gagement, see also the chapter ‘Competition in the Service of Quality’.

1. Authorization to Commit - Government Resolution No. 1950 states that ‘The Ministry

of Finance shall encourage the use of authorization to commit to a period of up to five

years in social services, intensive services provided in institutions that operate 24 hours

a day, 7 days a week (24/7), and in institutions where extensive social services are pro-

vided to patients on a daily basis - over NIS 200 million per year - or those provided in

accordance with the law (hereinafter: ‘Institutional Services’). In the event of cancella-

tion of an engagement prior to its termination, a new authorization will be obtained for

entering into a new engagement. ‘

51

Who should use the Authorization to commit instrument?

Services provided in accordance with the law – we do not mean services regulated

by law, but services that the law requires the Government to provide. For example, the

State requires the Ministry of Education to provide educational services for sick children

in their homes (the Free Education for Children with Disabilities Law, 5761-2001). As

such, it is almost certain that the State will continue to provide the service in the next

budget years.

Services provided in institutions operating 24/7 - such institutions constitute a kind of

home for their residents, whether it is a permanent home (nursing home), or a temporary

home (boarding school). Therefore, there is a need for a high level of continuity of treat-

ment for those in this kind of institution. In addition, such institutions require the provider

to provide a relatively extensive infrastructure, requiring considerable resources.

A service provided on a daily basis in the amount of more than NIS 200 million a year

- such intensive services require the service provider to provide a broad infrastructure,

and enjoy a relatively high level of commitment by the Government, resulting in a high

level of certainty for continued service provision.

What is an Authorization to Commit?

Israel’s budget is managed in cash. Every year or two (depending on the budget law),

the state budget is set and is approved by the Knesset. Government Ministries are

required to act according to the budget law approved in the Knesset, and therefore

cannot commit to expenditures beyond the budget period. Operating in compliance

with the Budget Law is very important, but on the other hand it creates difficulties when

planning long-term continuous projects. For example, we know that the construction of

a railroad from Tel Aviv to Jerusalem takes several years and cannot be completed in a

single budget year. For this purpose, the solution called ‘Authorization to Commit’ was

formulated.

How does it work? During the drafting of the tender, the total budget of the engage-

ment is defined, in coordination with the Budget Division of the Ministry of Finance; for

example, in NIS million over five years (NIS 200,000 per year).

2. A Multiannual Agreement - As you have seen above, we operate within the frame-

work of the Budget Law, and therefore we cannot make commitments in a cash budget

over several years, but a work-order-based agreement can certainly be implemented

over several years. In this type of agreement, we define in advance the scope of each

work order.

For example, we want to implement an engagement over five years, when each year

we will be asking to provide diagnoses for 500 children at a cost of NIS 500,000. The

total scope of the engagement will amount to NIS 2.5 million in this case, but the ser-

vice provider knows that it is necessary to have a new work order for each year of the

engagement. In other words, if a work order is not issued for next year due to lack of

budget, the provider will only provide service for the first year of the engagement and

will be paid only for it.

52

Issuing a new annual work order will require your approval (the professional fac-

tor) as well as the Ministry Accountant’s. In addition, each year the service provid-

er will be required to renew his insurance and guarantee / offset order.

FROM: FINANCIAL AND ECONOMIC REGULATIONS DIRECTIVE NO. 7.11.6 ON ENGAGEMENT FOR THE PROVISION OF SOCIAL SERVICES

1.2. Multiannual agreement1.2.1. The Tenders Committee may determine that the engagement will be valid for a period of up

to five years. 1.2.2. The engagement shall be done as follows:

1.2.2.1. Approval of the initial engagementAt the time of approval of the initial engagement, the Tenders Committee will approve the value of the accrued engagement throughout the entire period of the agreement, regard less of the approval of an annual budget only in the designated regulation.1.2.2.1.1. The agreement signed with the provider, the service provider, will be valid for the

entire period of the engagement.1.2.2.1.2. It should be clarified to the provider that the realization of the engagement will be

in compliance with periodic work orders, which will be actually issued subject to an existing budget in the Ministry and in compliance with the Budget Foundations Law.

1.2.2.2. Approval and realization of work orders1.2.2.2.1. Approval of the first work order will be made upon approval of the initial engagement

by the Tenders Committee, in accordance with the budget available for execution of the engagement, as stated in Article 1.1.2.2.1. At this time, the Tenders Committee will approve the accompanying documents, such as insurance and guarantee (if required) corresponding to the commissioning period of the work.

1.2.2.2.2. The rest of the work orders that will be issued to the provider in the framework of the engagement will be produced when the following cumulative conditions are met:

1.2.2.2.2.1. Approval of the senior professional official responsible for the service, that the winning provider has fulfilled his obligations, in accordance with the provisions of the agreement, to the satisfaction of the professional official.

1.2.2.2.2.2. Approval of the Ministry’s Accountant and his signature on the existence of a budget for the work order in the relevant budgetary ordinance and the ordinance number for the commissioning period of the work.

1.2.2.2.2.3. Renewal of the guarantee, or in lieu of the guarantee, insofar as it exists, and its period update, as required.

1.2.2.2.2.4. Providing insurance renewal documents and its period update, as required.1.2.2.2.2.5. Renewal of any other documents required in accordance with the engagement

agreement. 1.2.3. The process of approval of a MERKAVA work order will be carried out in accordance with the

Financial and Economic Regulations Directive, ‘Approval Mechanism for Purchase Orders’, No. 7.13.2.

53

Please note that a multiannual agreement has a built-in advantage over other arrange-

ments for long-term engagements. This is because the agreement’s default is that it

ends every year of the engagement, and if we want to continue the engagement with the

provider we must issue a new work order. This means that if you are dissatisfied with the

quality of the service provided by the service provider and you do not wish to continue

to engage with him, you can simply not issue a new work order at the end of the year of

the engagement, and you are not required to act proactively to cancel the engagement.

26. Prevent stagnation in the quality of a continuous service.Alongside the many advantages of long-term engagements, the extension of engage-

ments without insisting on initiating activities to push towards improvement of ser-

vice alongside, will result in stagnation in the service quality. In order for us to estab-

lish an innovative and high-quality service for its recipients, it is very important that you:

A. Establish a significant competition in the tender period, in accordance with the rec-

ommendations in the chapter ‘Competition in the Service of Quality’.

B. Establish a significant competition in the life cycle of the engagement. For exam-

ple, by giving the recipient a choice. Of course, in a service that requires continuity

(such as nursing homes), those already receiving the service would naturally not wish

to replace the service provider. But new service recipients arrive throughout the term

of the engagement, and they must be given the choice of provider.

C. Establish an effective and transparent control. (For further details, see the chapter

‘Supervision and Control’).

D. Keep the option to terminate the engagement and to impose sanctions on service

providers when required (for further details, see the chapters ‘Supervision and Con-

trol’ and ‘Setting Standards and Indicators in the Service of Change Theory’).

E. Have additional qualified bidders - A list tender, which allows you to carry out an en-

gagement with more than one provider, will make it easier for you to transfer service

recipients from a provider whose engagement you were forced to terminate, to an-

other service provider. For further details, see the chapter ‘Flexibility and Innovation’.

F. Draw conclusion at least once a year - In a prolonged engagement spread over a

number of years, we will not wait with the review to be carried out to its end for the

purpose of drawing conclusions about the engagement, but we will conduct an inves-

tigation at least once every engagement year.

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Chapter 6

Competitive Bidding and Pricing

The purpose of the chapter: setting competitive bidding and pricing of the service to ensure the most effective and efficient engagement.

27. Be involved in the competitive bidding process of your engagement.There are two common approaches to competitive bidding of outsourced social

services:

• Competitive bidding for quality - the tender defines the required service and the

cost of its provision. Bidders are required to prove that their service level will be the

highest. Competitive bidding for quality requires the setting of pricing / rates for

the service.

• Competitive bidding for a price - the tender defines the required service, and the

bidders are asked to specify the price they are demanding for its provision. In a com-

petitive bidding of this type the winner will be the one who proposed the lowest

price for the provision of the service. Although we will have set pricing for the service

in the competitive bidding for a price, in social services it is important to set a mini-

mum price for the provision of the service. This is in order to avoid any ‘bids at a loss’.

Bids at a loss are bids in which the provider quotes an amount lower than the cost of

the actual service provided. A bid at a loss may lead the service provider to reduce

the standard to which he has committed itself in order to reduce his losses. This will

impair the quality of the service provided to the service recipient. The Ministries use

different methods to avoid bids at a loss. For example, setting a price band in the en-

gagement documents, in which it is possible to compete for both price and quality.

The most common method is setting an estimate. What is an estimate? An estimate is

an instrument for evaluating the bids submitted in the tender, including for the purpose

of considering whether there is room to disqualify a proposal submitted at a significantly

lower or higher cost than the estimate. The estimate must be placed in a closed envelope

in the tender box before the deadline for submission of bids in the tender, and it cannot

be changed after this date. The estimate should express the total cost of the engage-

ment to operate the service, detailing the various components, as much as possible.5

You are not required to select a binary (‘either… or’) option for the competitive bidding.

Many tenders combine the two methods. For example, 70% of the tender score can be

based on the quality of the bid and 30% on its price.

In social services tenders the role of competition is to ensure quality. In the event that

we choose to carry out a competitive bidding on price, we will do so by setting a clear

quality standard, which will be a threshold condition for an engagement.

5 Financial and Economic Regulations Directive on preparing an Estimate, No. 7.4.5

55

When will we prefer a higher weight on competition for price? When the providers mar-

ket is big and sophisticated, and a real competition for price is possible; when the service

quality is very clear and easy to define; when economic efficiency is especially important

to us (For example, when our first priority is to include as many service-eligible people as

possible).

Please note that the push for quality service is less influenced by the competitive bid-

ding manner when selecting the winners, and is mainly influenced by the creation of

continuous competition throughout the life cycle of the engagement.

The manner in which pricing (of service components) and competitive bidding (between

potential service providers) are determined has a decisive impact on the success of the en-

gagement. Therefore, although these are areas that may not be within your area of exper-

tise (economics and budget), it is important that you be involved at this stage and that you

express the needs and characteristics of the service for creating a congruence between the

required service and the selected models.

28. As part of the consultation process prior to drafting the engagement documents,

spend some time also on pricing and competitive bidding.

• When you and the engagement team consult professional departments that operate

similar services in your Ministry and in other government Ministries, check with them

how they initiated competitive bidding and set pricing on the services they order.

• When you and the engagement team consult service providers, check with them how

they assess the operating costs of the service. It is also important to consult with

providers of similar services in the private sector, to the extent that they exist, so that

you will have an established assessment of the costs of providing the service, market

characteristics of potential providers etc.

29. Set the pricing standards for all those responsible for pricing in your Ministry.

Pricing the service reflects all the standards that make it. It is important to remember:

What you do not include in the standards of the service, and what you will not bring into

the pricing process with the Budget Division, will probably not be included in it. The

standards that you propose to the Budget Division must be realistic a priori and in the

context of the environment in which we operate.

Of course, the needs you define, do not constitute a final pricing, but rather the be-

ginning of a process of working together with the Budget Division of your Ministry

on pricing the service. Pricing in social services takes place in a world which requires

a balance between the desire for a wider service scope and the high quality of its

provision. Pricing is also conducted in a world of budgetary constraints that are not

always under our control. This is a complex task, both professionally and ethically.

Your job is to define all the service components necessary for meeting the standards

you have defined - both the standards of existential security and the standards of

Change Theory.

It is therefore important that you present three levels of standards to those responsible

for pricing in your Ministry:

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A. The infrastructure to ensure existential security - Define which standards are need-

ed to ensure existential security for service recipients. For example, specify the char-

acteristics of the building required to provide the service so as to ensure the welfare

and safety of service recipients; set the required standards of personnel in order to

ensure the provision of a service that respects its recipients, and so forth.

B. The inputs and outputs required to achieve the goals of Change Theory - as you

have seen in the chapter ‘Setting and Measuring Standards’, beyond setting stan-

dards to ensure the existential security of service recipients, it is important that you

also set standards for your Change Theory. What are the standards required in order

for you to achieve the results you expect from providing the service? What therapeu-

tic or educational activities do you expect the provider to provide? For example, let’s

say you run an educational service for youth at risk and want to reach a high rate of

high-quality matriculation graduates among program participants. You have defined

that in order to achieve this outcome, participants also need private lessons. In this

case, you will need to define the frequency and extent of the required lessons and

other variables that can affect the cost of the lessons.

C. Inputs and outputs to push the service towards excellence - include instruments for

pushing the service towards excellence. For example, bonuses for service providers

for meeting outcome indicators that you have defined; quality baskets that reward

compliance with high quality standards; pricing that will allow new providers to enter

and expand the market; reward for innovative components in a service provided by

the service providers etc.

30. Be part of the committee that sets the pricing

It is important to avoid a situation where pricing is set by just one person. It is more

appropriate to set prices in a transparent and orderly committee, as some of the social

Ministries already do. This committee should also include the service manager or other

relevant professional. This is in order to fully present to the Committee the professional

requirements for the provision of the service and the manner in which the pricing of

the service will affect the nature of its provision. The Committee is also an opportunity

to think about the pricing formula and alternatives to it according to the incentive you

wish to give. Setting the pricing in a committee will help us in setting a more accurate

pricing and competitive bidding as well as more appropriate to the characteristics of

the market.

31. Make sure it reflects the pricing and its components

It is important that the Committee’s work and products be as transparent to the public

as possible. If the tender includes competitive bidding for quality, and the pricing / rates

are determined accordingly, this pricing should be published as widely as possible, as

set for the purpose of providing the service. Transparency in pricing will help, on one

hand, the service recipients and their families to know what they are entitled to re-

ceive from service providers, and, on the other hand, it will help service providers to

know how the Ministry has reached the set price.

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The purpose of the chapter:1. Creating a flexible engagement;2. Creating innovative services that offer therapeutic and educational

solutions that have not been tried in the past.

32. Establish an engagement with a flexible operating space.Very often, after having established the engagement, we see that there are things that

we would like to change. After all, it is well known that there is no wisdom like ‘the wis-

dom of hindsight’. Sometimes it is difficult to predict the number of customers who will actually receive the

service. For example, in emergency services such as women’s shelters, it is not possible

to accurately predict the scope of the demand, but at the same time the infrastructure

for providing the service must exist.

Another example: in times of national emergency, such as war, there are many chang-

es that can occur in the scope of the services required. For example, a state of war

will increase the referral to Resilience Centers. Since we cannot anticipate a national

emergency, we must establish an engagement that will respond to such unexpected

situations.

A. Set in the tender documents the possibility of updating the specification and the

price of the service during the term of the engagement.

MODEL TENDER: MINISTRY OF EDUCATIONVariable Volumes Tender No. 33 / 10.2016: Supply of an instrument and an audio card for the use of matriculation examinees‘All volumes of activity detailed above are annual estimates. It is hereby clarified that since this is a Variable Volumes Tender, the Ministry reserves the right and at its sole discretion to increase or reduce the quantity of packages to be supplied at each time, as detailed above, in accordance with the Ministry’s considerations and the current annual budget for the tender. Any change in the volume of activity is subject to the prior written approval of the Tenders Committee as well as an agreement signed by the Ministry’s Accountant and authorized signatories. In addition, the Ministry may change the quantities from section to section only with the prior approval and signature of the Ministry’s Accountant and the Ministry’s authorized signatories, provided that there is no deviation from the budget limit. ‘

Chapter 7

Flexibility and Innovation

58

B. Consider using a Framework Agreement.‘A framework agreement - an agreement for the procurement of goods, work or services that

was concluded with a framework tender provider on a specific subject and for a specified

period, when details of the goods, work or services provided in its framework, as well as their

quantity or scope, are unknown at the time of signing the agreement, and is determined by

the customer through issuing an order from time to time, during the term of the agreement. ‘ 6

A framework agreement is also called a tariff agreement. It is designed for services

where we find it difficult to anticipate the number of service recipients or the number of

service components we need. In this situation, we set a rate for the service recipient or

the service component and do not commit in advance to the scope of the engagement.

For example, a service that provides diagnoses for children with learning disabilities.

Suppose that it is difficult to accurately predict the number of children with learning dis-

abilities to be diagnosed, but we know the price we are willing to pay for that diagnosis.

The tender has set the rate for diagnosis and the expected range of children who will

need it (say, between 1,000 and 1,700). The Framework Tender will allow us to issue a

work order on the number of diagnoses we actually require, and thus we will have suf-

ficient budget to provide all the children with the service, but we will not lose money for

a service that was not actually provided.

When is a framework agreement less appropriate? In cases where the provider is re-

quired to provide an expensive infrastructure, such as a building, or a staff that must

be there at all times, whether or not service recipients arrive. For further details, see

Financial and Economic Regulations Directive 7.21.5.

C. Make a correct use of your options.

• Indicate in the tender documents the duration of the engagement period, including

the right of option to extend the engagement.

• Indicate the scope of the engagement, including the right of option to expand the

engagement.

What is a right of option? This is a right granted to the Ministry by virtue of the agree-

ment to extend the engagement for additional periods, or to expand the engagement

to additional matters, as defined in the agreement.

For further details, see Financial and Economic Regulations Directive No. 7.4.17, which

concerns the exercise of the right of option.

D. Prepare yourself in advance for an emergency.

What is the meaning of an emergency? There are two main types of emergency situa-

tions, and our recommendations here will prepare you for both:

The first is a situation of physical danger to service recipients, such as war, fire, or snow-

storm. The second situation is an economic collapse of the provider. The Ministries do

perform financial strength tests of the service providers in order to minimize our expo-

sure to this risk, but the risk still exists, and the provider may lose his ability to continue

providing the service. The risk level in this situation is particularly high in 24/7 services

which involve the residence of service recipients.

We do not know when we will find ourselves in a state of emergency, but we can as-

sume that this situation may occur at some point, and hence:

6 Financial and Economic Regulations Directive on Tender No. 7.21.5.

59

D. 1. Establish an emergency procedure.

It is important that you define in advance how you will operate in an emergency. What

kind of therapy or social response it is important to provide to your service recipients

in an emergency? How can you provide your service recipients with the information

they need about emergency service provision? In cases where it is necessary to evac-

uate service recipients from 24/7 systems, how do you intend to transport them? For

example, does the Ministry have an agreement with transportation companies that you

can use? Will the service provider’s employees be able to reach the service provision

location during an emergency?

D. 2. Specify and clarify in the engagement documents your requirements from the pro-

vider during an emergency.

If you expect service provision to continue during an emergency situation, it is im-

portant that you define this for the provider and also discuss how the service will be

provided in this situation. For example, will it be in the structure in which the service is

provided normally, or in an alternative location? Will it be provided by all the staff that

provides the service or only part of it? Is there a therapeutic or educational program

that the provider is required to act upon during an emergency?

D. 3. Set qualified bidders when selecting the winners.

This recommendation is especially relevant in the case of a Framework Tender (which

we have elaborated on in the chapter ‘Competition in the Service of Quality’), since in this

tender you have a standing engagement with several providers at the same time. Make it

clear to the providers who bid in the tender, that in an emergency they will be required to

backup other providers. During a physical emergency, such as a fire in a particular city, you

may require a provider in another city to receive some of the service recipients, who will

be referred by you from the fire area. When a provider collapses, service providers may be

required to receive the service recipients of the collapsed provider.

MODEL TENDER: THE SERVICE FOR THE TREATMENT OF AUTISTIC PERSONS IN THE MINISTRY OF LABOR, WELFARE, AND SOCIAL SERVICESOperating seventeen out-of-home institutions (‘Homes for Life’) for the population on the autism spectrum, of all ages, nationwide.Without derogating from the provisions of this Tender, from the provisions of any law and from the case law, the Ministry may, at its sole discretion:4.10.1. Select a bidder as a second or third qualified bidder, according to the mechanism detailed

in Article 3 of the tender, with respect to the entire framework of the subject of the tender. Without derogating from the provisions of the introduction to this Article, a bidder selected as a winner for the provision of services subject to the tender in respect of one or more partic-ular clusters, shall serve as an additional qualified bidder for the purpose of provisioning the services under this tender in one or more other clusters (hereinafter - ‘the Additional Qualified Bidder’), in accordance with the following:

4.10.1.1. The Additional Qualified Bidder may serve as such only in the clusters that were included in his proposal and for which he was not selected as the winner.

4.10.1.2. The order of referral to Additional Qualified Bidders, in the case of more than one Additional

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33. Promote innovation and flexibility in service provision.

In order to provide the best services, which are also adapted to the needs of the citi-

zen, it is important to encourage innovation in the services. Innovation means dealing

with problems in a way that has not been tried in the past, either through new ideas or

through the use of solutions that exist in other content areas. For example, as an attempt

to address the loneliness of elderly people in retirement homes in Washington, D.C., a

kindergarten was opened in the nursing home. This is a new solution that has not been

tried in the past, which deals with the problem of service recipients through an instrument

from a completely different content field.

A. Define a sphere of the service where it is possible to propose innovative activities

in advance.

This area may be part of the service provided in the framework of service provision, or

in one of the other frameworks in which the service is provided.

Qualified Bidder, will be carried out depending on their scores, weighted in the relevant additional cluster, highest to lowest.

4.10.1.3. The engagement with the Additional Qualified Bidder will be implementable only after the ex-piry of the validity of the proposals of the bidders who have been selected as second and third qualified bidders, as far as they have been selected, as stated in Article 4.5.2 above.

MODEL TENDER: MENTAL HEALTH DEPARTMENT, MINISTRY OF HEALTHThe procurement of rehabilitation services through accommodation for the mentally handicapped in the community2. A Unique Hostel: ...

2.6. A unique new model of hostel - this tender offers the option to submit a proposal for the estab-lishment of a hostel in a unique service model that is not offered in advance by the Ministry in this tender. The Ministry of Health intends to receive innovative ideas on a service model from the bidders, which can be applied individually.It is clarified that the structural model of the proposed service will be inside the building of a supportive community only.

2.6.1. If the bidder has proposed a new professional intervention model in a small supportive commu-nity model for adults or young people, a fee for the operation of a small supportive community will be paid to that bidder (if declared winner of the tender), according to the appropriate rate appearing in Articles 11.3.2.2 and 11.3.1.2 of the agreement.

2.6.2. If the bidder has proposed a new intervention model (different from the models detailed in this tender) for one of the special populations, the said bidder will be paid (if declared winner of the tender) the appropriate rate appearing in one of the sub-Articles of Section 11.3.3 of the agreement.

Programs should present at least the following topics:• Bidders who commit themselves under the program, that no more than 8 people will live in the main

building as a supportive community, will receive the full score for this component (up to 5 points).• The intervention methods proposed by the bidder and their innovation and the extent of their ex-

perience in their operation. The bidder must specify research and / or theoretical sources or other sources upon which the intervention methods proposed by him are based (up to 7 points).

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In the Challenge / Problem Tender, there is a focus on presenting the challenge that

requires a solution, while avoiding an early definition of the essence of the solution and

its characteristics. This is in order to enable the presentation and examination of many

innovative ideas from different content worlds. Challenge Tenders are tenders in every

respect, but they were written with the aim of removing from the bidders barriers which

characterize the work with government agencies, and to encourage referrals from enti-

ties that are not accustomed to bidding in tenders.

Challenge Tenders can be established in new services, but also in existing services, for

certain areas that you will want to develop.

MODEL TENDER: THE IT AND DIGITAL HEALTH DEPARTMENT AT THE MINISTRY OF HEALTH Digital solutions for dealing with the burden in internal and emergency medicine wards.The IT Department (hereinafter: ‘the Department ‘) at the Ministry of Health (hereinafter: ‘the Customer’ or ‘the Ministry’) hereby appeals to submit proposals for digital solutions to cope with the burden in internal and emergency medicine wards.The health system in Israel faces significant challenges due to the demographic growth, increasing life expectancy and the multiplicity of chronic diseases; all this in light of the shortage of medical personnel and infrastructure and health services. In addition, the hospitals congestion in Israel is exceptional in relation to the OECD countries and reaches 250% occupancy during peak periods in some hospitals. This problem is particularly acute in emergency wards (‘emergency rooms’) and in internal medicine wards... The solution for hospitals congestion should be a multi-disciplinary and systemic solution... However, as a complementary step towards such solutions, there is a wide range of digital solutions that can help patients, their families and the hospital staff to reduce congestion and improve its han-dling. Such solutions may be solutions that will eliminate the need for some hospitalizations, which will make it possible to shorten parts of them, or will make it easier for the patients and their families and the medical staff to cope with the hospitalization process.This tender is the first in a series of ‘Problem Tenders’ issued by the Ministry, which are tenders seeking to find solutions based on digital tools for the challenges of the health system. These tenders focus on presenting the problem while avoiding a preliminary definition of the essence of the solution, in order to enable many innovative ideas that originate in different content worlds to enter the health system without adhering to an a priori assumption about the characteristics of the desired solution to the problem.In order to maintain the principles of the tender laws and their goals, including transparency and in-tegrity in decision making, equality, efficiency, savings and competition, a two-stage winning process is hereby defined. In the first stage, a number of proposals are selected, proposals which the Ministry considers appropriate for examining their suitability to the health system and their ability to effectively improve the problem defined in the tender. This proof is provided through a Concept of Proof, in the framework of which the proposed solution is implemented and its effect examined. In the second stage, the proposals that successfully passed the Concept of Proof are awarded the tender.All the documents attached to this Tender (hereinafter: the ‘Tender Documents’) constitute an integral part thereof and should be deemed complementary to each other. A bid submitted in this tender consti-tutes a commitment by the bidder to comply with the terms of the agreement in the wording attached to the tender documents.

62

B. Allow scoring for past innovation when selecting the winner.

C. Provide flexible rewarding.

For example, allow to switch between quality baskets during the life cycle of the en-

gagement. For further details, see the chapter ‘Competition in the Service of Quality’.

MODEL TENDER: MINISTRY OF LABOR, WELFARE, AND SOCIAL SERVICESOperating three transition apartments for women victims of violence - in a live city, with mixed Arab and Jewish population, in Be’er Sheva, for the general population and in Beit Shemesh, for the ultra-Orthodox religious population ‘Independent projects / initiatives will be examined (such as: a new treatment framework, an innovative project with children and / or youth, projects in the field of abuse victims, etc.), beyond the require-ments from the bidder under the tender requirements of the Ministry or other public entities, carried out by the bidder during the last five years prior to the last date for submission of the proposals.

Each initiative will be evaluated according to the way it is constructed and its profundity, its originality, its therapeutic results and its achievements...Each initiative will be evaluated as stated, and will win accordingly up to 5 points.

The score in this criterion is cumulative and can reach a maximum of 15 points.

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The purpose of this chapter: improving the engagement and establishing a learning culture in the management of engagements

A learning culture is an important key to the success in any organization. There are

always lessons to be learned, even from successful activities. In order to maintain a true

learning culture, it is important to carry out a process of drawing conclusions following

any significant action, and not only when a failure happens or a problem arises. Drawing

conclusions cannot allow true and open learning if it is identified only with failures or with a

search for the culprits.

Regular drawing conclusions processes will also enable us to preserve organizational

knowledge. For further details, see the chapter ‘Knowledge Preservation’. The learning

culture should be part of the whole engagement process, and not only when we seek

to extend an existing one. Therefore, the following three recommendations are divided

accordingly into the three stages of the engagement life cycle where we wish to draw con-

clusions:

34. Draw conclusions about the tendering process upon its completion.

Do not wait until the end of the engagement in order to draw conclusions about the

tendering process. Draw conclusions when all the partners in the tender process are

still available and the information and insights are still fresh. Drawing conclusions at

this stage will focus on the process itself and its results. For example, how many bidders

did we expect and how many bidders were there ultimately? How long did we expect

the tender process to continue?

35. Draw conclusions before terminating an existing engagement, in order to decide

whether to proceed in a similar format.

It is important to draw conclusions before the end of the engagement (usually three

months beforehand) in order to be able to make decisions based on it. Drawing con-

clusions at this time will relate to all components of the engagement life cycle and will

include all the factors involved. In addition to learning, it will also help us in our decision

whether to continue the existing engagement, terminate it or establish a new engage-

ment. For example, the compatibility extent of the standards and indicators that were

set, the manner in which monitoring of the service was performed, the extent of incen-

tives for improvement that the service provider had, etc.

Chapter 8

Drawing Conclusions

64

36. Use the AAR methodology for drawing conclusions.

The After-Action Review (AAR) methodology was developed by the US Army for de-

briefing after operational activities. True, we deal with social procurement and not in

battles, but this methodology has been adopted worldwide for many content areas and

is very suitable for the field of procurement.

The AAR methodology has five guidelines, and you and the team that drafts the tender

should take them into account while drawing conclusions:

1. The professional discussion will be conducted in an open and honest manner;

2. The entire team will take part in the process of drawing conclusions (meaning all the

partners responsible for the tender);

3. There will be a focus on the engagement results;

4. Ways to preserve success factors will be identified.

5. Recommendations for overcoming obstacles will be developed.

These are the four questions you and the engagement team should ask about the various

components of the engagement, as they appear in the manual (Service providers as

partners, standards and indicators, competition, flexibility and Innovation, Knowledge

preservation, Control and Supervision):

1. What did we expect to happen?

Example: We expected to be able to provide a diagnostic service for 200 students.

2. What actually happened?

Example: We provided diagnostic services to 200 students, although there was a

demand for 250 students.

3. What worked well, and why?

Example: The diagnoses were provided on time and with the required professional

standard.

4. What can be improved and how?

Example: If we had included an extension option in the tender, we could have

provided more diagnoses for more children according to demand.

In order to draw conclusions on the subject of the engagement, make use of The

Financial and Economic Regulations Directive ‘Knowledge preservation and Drawing

Conclusions in the Work of Tender Committees’, No. 7.2.9.

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Chapter 9

Knowledge Preservation

The purpose of the chapter: creating a continuous and sustained knowledge infrastructure, essential to quality service

Knowledge preservation is a challenge that preoccupies organizations from all content fields

and all around the world. The challenge of Knowledge preservation is more obvious when

we perform outsourcing and we are not the body that provides the service directly. This is be-

cause in the course of providing the service itself, a great deal of knowledge is accumulated

about the service recipients and appropriate methods of work and care. It is important that this

knowledge reaches us, the Government, as it is critical in order to plan the best way to provide

the service. Also, if we do not act to preserve the knowledge that the provider has, we may find

ourselves in a hopeless situation when replacing him. Therefore, preserve the knowledge.

When it comes to Knowledge Preservation, it is necessary to distinguish between two types

of knowledge:

1. Explicit Knowledge - This knowledge is unambiguous and can be observed, like facts,

numbers, databases, websites, formulas, codes, etc. Due to the fact that this knowledge

type can be easily documented, it is also easier to share and pass on. For example, pa-

tient files.

2. Implicit Knowledge - knowledge that is rooted in experience, context, and values. Im-

plicit knowledge is difficult to transfer, and even more difficult to ‘capture’. For example,

staff’s insights into patient preferences.

The first recommendation in the chapter refers to implicit knowledge and the rest of the

recommendations relate to explicit knowledge.

37. Produce insights and establish a doctrine during the engagement with the service

providers, service recipients, and experts.

There are different ways to produce knowledge. In any way you choose to implement

it, it is important that you define that eventually, you will have a definite and bind-

ing product: an updated service indicator, a policy document, a new work method,

a work procedure, etc. Below are two examples of ways to produce knowledge to be

used by the Ministry of Labor, Welfare, and Social Services:

A. Study groups

In the Ministry’s foster care service, knowledge is preserved through study groups,

which consist of district supervisors and service providers. The study groups discuss

66

professional issues, such as matching a foster family with a child. At the end of the joint

study process, we will write a policy document detailing professional instruments and

guidelines for the conduct of the service. This document is added to the professional

guidelines required in the tender. The participation of service providers in the study

group is voluntary, but since the final product binds them in current and future tenders,

they have a great interest in being involved.

While in this example, the study groups consist of Ministry workers and service provid-

ers only, study groups can also include service recipients, their families, and experts.

B. Knowledge communities

In addition to other Knowledge Preservation activities, the Ministry has been operating virtual

knowledge communities over the last ten years. In these communities there is a professional

forum for discussion and consultation, alongside the possibility of studying professional liter-

ature, as well as knowledge and information relevant to professionals. The communities in-

clude the professionals from the Ministry’s headquarters and its districts, the welfare offices

in the local authorities, the service providers, advocacy groups, and academia. The Ministry

operates 32 knowledge communities with more than 13,000 members.

38. Define in the engagement documents, what knowledge the service provider must

preserve, and in what manner should he transfer it to the Ministry.

Define in the tender the duty of the provider to document and preserve all the knowl-

edge and information he has accumulated during the years of operating the service,

and to transmit it to the Government on an ongoing and accessible basis during the

term of the engagement and at its conclusion, as well as within the framework of an

overlap with a new provider, if selected. For example, instruct that patient files will be

transferred to the Ministry.

39. Connect Knowledge preservation to the control and the supervisors.

Your supervisors are your main Knowledge preservation unit. They are the ones who

come into direct contact with the service provider. This should also be expressed in the

consultations for knowledge preservation (see next Article).Supervisors have another

important role to play in determining the quality of knowledge required for preserva-

tion. It is not enough to ask the service provider to transfer knowledge to you in order

to preserve knowledge; you need to define what knowledge is important to you. For the

most part, we find an overlap between the subjects that the supervisor investigates and

the knowledge that must be preserved.

40. Give preference to a situation whereby the service’s computerized management sys-

tem is a Ministry system.

A Ministry computerized system allows you to access the information produced through

it during the engagement and allows you to store this information easily even in the

case of replacing a service provider. See, for example, the New Student Health Tender,

which requires the service provider to record all the relevant information in the comput-

erized system of the Ministry.

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41. Establish in the engagement documents a procedure for ‘passing the baton’ from

the outgoing service provider to the incoming one.

Define in advance what information the outgoing provider must transmit to the incom-

ing provider, in what manner and at what period of time.

MODEL TENDER: MINISTRY OF HEALTHPROVIDING STUDENT HEALTH SERVICES

‘Health records management and documentation’The Health Record is ‘Israeli National Vaccination Record ‘- a computerized record.

The health staff must manage the health record, according to the principles of recording and re-porting.

At the beginning of the year, health records will be opened for each new student (usually in first grade), which will include the following details: First and last name, ID number, date of birth, par-ents’ names, student’s address, phone number, school name, class, updated health information related to the student (chronic diseases, drugs taken regularly, sensitivities, abnormal side effects after previous immunizations), detailed information on past immunizations.

The Health Record should be updated yearly regarding the state of health and according to any relevant new information, including demographic details, obtained from health statements or oth-erwise by the parents.

One full health record should be maintained for each student, documenting all examinations and vaccinations performed on the student, findings, side effects, follow-up as necessary and other relevant records.

All staff activities will be recorded in the following records:

– A personal health record. All past vaccinations should be documented.

– The student’s personal vaccination record booklet (which is permanently in his home), in which the vaccinations received by the student are recorded regularly. The service provider must issue vaccination record booklets for new immigrant students and for students who have lost their vac-cination record booklet.

– A school / class health record - A record should be maintained that includes a data summary for all students in a class, as regards activities and test results, to monitor health problems of the students.

Non-computerized health cards and any medical documents should be kept in a locked place in the school and only the school’s health staff will have access to them.

In special situations, when it is not possible to record directly on the computer, the registration will be performed on a class record and will be recorded as soon as possible on the computer. ‘

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Part 3

Supervision

and Control

7171

Supervision and Control

The purpose of this part: To establish a control that will provide you with infrastructure to improve the service

The objectives of the control are:

1. To ensure quality service on the part of the service provider, alongside constant im-

provement in service quality.

2. To warn immediately of defects in the service provision and provide a response. The

emphasis being on preserving the rights of service recipients who are helpless in inten-

sive frameworks.

This chapter will answer three main questions:

1. What should be checked in the framework of the control?

2. How should the control be performed?

3. How will we use the control findings to improve the service?

1. What should be checked in the framework of the control?

42. Inspect the existence of all the standards you have set for the service, both within

the scope of the engagement as well as under license.

Remember that we discussed two types of standards in the chapter ‘Setting Standards

and Measuring Them through Change Theory’?

1. Standards of existential security - it is essential to ensure that the service is provided

in a manner that does not endanger its recipients and respects them. Standards of ex-

istential security are important in all social services. We cannot accept a situation where

the basic physical safety needs of our service recipient are harmed. Controlling the

standards of existential security becomes more critical as:

a. The population of service recipients is helpless and unable to report. For example,

infants and toddlers, people with mental and intellectual disabilities, people in long-

term care, etc.

b. The scope of the service is spread over a larger number of daily hours, especially in

the institutional services (services where the service recipient stays 24 hours a day).

In order to examine the existence of existential standards in institutional services

for the helpless, it is also necessary to conduct surprise inspections.

2. Standards relating to Change Theory - Without optimal control of these standards,

we cannot guarantee quality service to its recipients. In the framework of controlling

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these standards we will ensure that the service is indeed provided in accordance with

the Change Theory that we have defined. Through this control, we will also be able to

update our Change Theory if necessary and to make it more accurate. This control will

focus on output and outcome indicators, such as the treatment methods used, the rate

of successful rehabilitation following treatment, etc.

2. How should the control be performed?The basic layer for each control is control and work methods, which bring the Govern-

ment’s perspective to the world of control. Here we shall refer, for example, to the work

of the Supervisor and to the control methods recommended for use.

Here we add a 360° control layer - a control that also brings the perspective of service

recipients and their families, as well as the perspective of service providers.

The two layers together will produce the most effective control, but in any case the basis

for integration is the existence of a layer of orderly government control, which warns of

defects in real-time, monitors their repair and pushes the service towards a standard as

high as possible. Articles 43-49 specify recommendations relating to control activities

and methods from the Government’s perspective. Articles 50-52 specify recommenda-

tions relating to control procedures and methods that comprise the 360° control, taking

into account the perspective of service recipients and their families as well as the per-

spective of service providers.

Control based on the Government’s perspective

43. Convert your engagement into control.

You should establish, already when drafting your engagement documents, the condi-

tions to enable you to supervise the service provider in the best possible manner. Make

sure that the content of the tender coincides with the role of the Supervisor and his

work, and vice versa. Include in the tender all the facts that the Supervisor will inspect

and devise the control reports prior to the publication of the tender.

44. Take ownership of the Ministry-inclusive monitoring picture.

It is you who are responsible for the supervision and control picture of the service as

a whole, even if you are not the only one to take part in its execution. The identity

of the controllers is sometimes made of several different elements in the Ministry

besides you:

1. Supervisors and service controllers, both national and regional (of course, not all

social services have dedicated supervisors and controllers).

2. Some of the Ministries have control units, which control several services simultane-

ously (for example, the Ministry of Health has control nurses).

3. The Ministry’s Accountancy and the Tenders Committee - In some of the Ministries,

the control of the administrative aspects (sometimes referred to as engagement

control) is performed by the Ministry’s Accountancy and the Tenders Committee.

Even when there are officials in the Ministry, besides you and your subordinates,

who are responsible for service control, you, as the service director, are responsible

73

for ensuring that the control is indeed carried out and encompasses all components

of the service as required, and that the defects within its framework are corrected.

45. Carry out surprise inspections as well as inspections at different times of the day.

This will ensure continuous tension at the provider’s. As I mentioned, surprise inspec-

tions are especially important to ensure the existence of standards relating to exis-

tential security. This recommendation is more emphasized when your service is an

institutional service for the helpless.

46. Carry out inspections also by supervisors who have no experience in supervising

that particular institution.

For example, the Southern District Supervisor will come for supervision in the Northern

District. This method can help reduce ‘regulatory capture’. When a supervisor conducts

a service inspection over many years, he has a certain perception of the supervised

entity. The entry of a new agent into the inspection life cycle can bring new angles of

observation.

47. Perform differential monitoring.

Manage your monitoring inputs as needed. Thus, for example, you can inspect a new

provider or a provider where defects have been found more frequently, and in return

you can exercise less monitoring over a veteran provider, who has already met the

monitoring requirements.

48. Have your ‘finger on the pulse’

Adjust the control reports and work methods during the life cycle of the engagement.

Do not wait until the creation of a new engagement in order to update your inspection

reports or inspection methods.

49. Implement an annual work plan for the inspector (supervisor).

Set in the work plan the frequency of controls in each framework, the reports that the

inspector is required to produce, the monitoring methods that he is required to imple-

ment, the follow-up method for correcting defects and output and the outcome indica-

tors of the inspector’s work.

360° monitoring picture of the service - adding the perspective of service recipients

and their families and the perspective of service providers

Only monitoring that will bring in both the service provider’s viewpoints and the service

recipient’s perspective can produce a complete monitoring picture of the service.

Understanding the contribution of the service recipients’ perspective and the viewpoint

of service providers of the world of monitoring, Government Resolution No. 1950

defined the importance of transparency in the monitoring world. There are three

main activities that you must perform in accordance with the Government’s Resolution

in order to increase transparency in monitoring:

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50. Make the standards that you require accessible.

Only a service recipient who knows what the service should include from the outset

(for example, the number of staff members who are supposed to work at the day care

center) can inform you when there is any deviation.

51. Perform a monitoring as transparent as possible.

Government Resolution No. 1950 states that institutional services (24/7) will be trans-

ferred to transparent monitoring. This means that the monitoring outcomes will be up-

loaded in a uniform and comparable form to the Internet. Of course, the intention is

not to disclose personal data of service recipients, but rather to bring to the public

the rate of compliance of the service providers with the standards required from

them when providing the service. Monitoring reports brought to the general public will

enable comparison between the providers of the various services of the same service.

This will also increase the ability of service recipients and their families to monitor the

quality of the service they receive and to make an informed choice between different

service providers. For further details, see the chapter ‘Competition in the Service of

Quality’.

52. Make the results of the monitoring accessible.

Do not be content with publishing on the Ministry’s website. Work proactively to make

the information accessible to service recipients and their families, whether by display-

ing the information in the institution providing the service, or by requiring the service

provider to distribute the information to the mailing list of service recipients and their

families.

In addition to making the monitoring world transparent, there are two other main ways in

which you can express the perspectives of service recipients and providers:

SAMPLE PROGRAM: MINISTRY OF HEALTH‘The National Program for the Evaluation of Outcome Measurement in the Mental Health Rehabil-itation Community in Israel (Psychiatric Rehabilitation Routine Outcome Measurement PR-ROM project)The objective of the National Program: The National Program for the Evaluation of Outcome Mea-surement in the Mental Health Rehabilitation Community in Israel aims to provide updated, systematic and routine information about the process and impact of psychiatric rehabilitation services in Israel and to establish a sustainable infrastructure for monitoring outcome indicators for consumers of rehabilita-tion services on an ongoing basis. All this in order to improve the process of rehabilitation and personal recovery, to enable the provision of meaningful, effective and accessible feedback to all stakeholders (policy makers, rehabilitation staffs of rehabilitation services, service recipients and their families), to develop policies, to increase the ability to make informed and evidence-based decisions, to establish incentives to improve the service and to provide data for research purposes.Data collection source: The data are collected from three different sources: 1. Questionnaires that include self-report of service consumers. 2. Questionnaires distributed to the staff in the rehabilitation services and include their assessment of the outcome indicators of the service consumers (as will be

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53. Ask service recipients and providers for their opinion.

a. Perform satisfaction surveys among service recipients and their families. Don’t be the only factor determining the service quality. Check also with the custom-

er - the recipient of the service himself.

b. Interview the service providers as part of the implementation of monitoring. Thus, for example, in the Ministry of Welfare, when the supervisor comes to a boarding

school, he also asks the counselors to fill out questionnaires.

detailed below). 3. Information from the Information and Evaluation Division at the IT Department of the Ministry of Health, which includes demographic data, data on the consumption of rehabilitation services and information from previous hospitalization.The implementation process: All rehabilitation service consumers are invited to participate in the pro-gram and anyone who gives their consent, by signing the informed consent form, is asked to complete all the questions. The data collected from each service consumer undergo a process of statistical pro-cessing, and, based on them, three main products were constructed:The products of the national program: The first product is personal feedback to the person himself, i.e. a ‘situation snapshot’: The objective of the situation snapshot is to make accessible a reflection of the summary of a person’s answers by means of diagrams that reflect their self-perception in relation to a wide range of the life areas examined. Thus, the feedback provides each consumer with an oppor-tunity to receive a visual summary that he or she can learn from. It can also be used by the consumer and staff as the infrastructure for planning, building, implementing and monitoring the personal reha-bilitation program over time. This process enables a person to gain greater ownership of his personal rehabilitation process and promotes a change in the degree of desire and need. Similar feedback is provided to professionals on the questionnaires they filled out for the consumers they work with. Pro-viding feedbacks to each of the parties creates an opportunity for comparison and discussion about the process of rehabilitation and recovery of the service consumer.The second product is a feedback report distributed to each institution for all service consumers who filled out the questionnaire. The feedback report includes a summary and three parts: The first part presents demographic findings about the service consumers and the data collected about the dif-ferent areas of life of service consumers; The second part presents the perceptions of staff members re-garding the areas that the consumers filled (in a comparative manner); The third part presents average data of all the frameworks that are similar in character to the specific service in that district.The feedback, prepared by the program team, is forwarded to the rehabilitation services and a copy is sent to the Ministry of Health’s district rehabilitation team. One of the goals of the feedback is that the rehabilitation services will use this report to build the annual work plan, which will address aspects that require improvement and change, and those that require preservation, based on the data learned. Finally, an annual report summarizing all findings at the national level is submitted to the Rehabilita-tion Department of the Ministry of Health’s Mental Health Division and will be published with complete transparency to all interested parties. The purpose of the report is to provide an overall picture and help shape the policy...’

76

54. Allow service recipients and providers to express their position on the service quality.

a. Establish an accessible mechanism of complaints, including anonymous com-

plaints. It is important that the service recipient and his or her family have a direct contact

with you. In services where the service recipient depends on the service provider,

you should establish an anonymous communication channel. For example, in the

Methadone distribution center run by the Ministry of Health, there is a box where pa-

tients can leave anonymous complaints and comments. An anonymous complaints

mechanism will also enable the employees of the service provider to warn you of

defects that they are exposed to during the service provision without fear that this

will damage their relationship with their employer.

b. Encourage the involvement of parents and families of service recipients.

For example, if there is still no parents’ committee in the boarding school for which

you are responsible, encourage the parents to set up such a committee. This will al-

low you to be in direct contact with them and as well as a further perspective on the

quality of service provided at the boarding school.

c. Ask the service provider for self-monitoring.

The service provider’s self-monitoring adds the provider’s point of view, but does

not diminish from the responsibility of the Ministry to service quality.

Ask the service provider to conduct a periodic self-examination regarding his com-

pliance with the terms of the tender. The more clearly defined are the service char-

acteristics and indicators, the easier it will be for providers to monitor themselves.

For further details, see the chapter ‘Setting and Measuring Standards According to

the Change Theory’. Self-monitoring has three main advantages:

1. Creating a responsibility with the service provider and thus implementing the re-

quired standards.

2. More efficient management of ministerial monitoring inputs.

3. It is possible to determine the frequency of monitoring the service providers ac-

cording to their level of self-monitoring and the degree of conformity with the

findings of the Supervisor’s monitoring.

During the work of the government team, it was found that in many engagements, the

service provider was never required to submit regular reports. This makes it difficult

for the Supervisor to work, and he must collect all the information himself. Therefore,

it is important, already at the time of drafting the tender, that you define the infor-

mation on which you wish to get reports, and define in advance the manner and for-

mat by which you expect the monitoring and reporting to take place. For example,

ask the provider to monitor and report on the quality of the food he provides, the terms

of employment of the employees, the number of classes held at the institution, etc.

C. How should I use the monitoring findings?

55. Set a hierarchy of rewards and sanctions.

It is important for the supervisor and you to have instruments to improve the service

by ranking positive and negative responses based on the monitoring findings. Such a

77

hierarchy does not eliminate the possibility of recommending termination of service

when so required, but it also provides the Supervisor with instruments for situations

where, even if a service quality problem arises, it does not justify termination of the

engagement but rather an action for improvement. These instruments (such as fines,

shortening the duration of the license period, etc.) will make it unequivocally clear to

the service provider that he must improve the service he provides, but will reduce the

potential harm to patients due to the replacement of providers.

It is also important to establish, alongside the sanctions hierarchy a reward hierarchy

(such as higher rates for higher quality services, recognition of outstanding service pro-

viders, etc.). For further details on the pay scale, see the chapter ‘Competition in the

Service of Quality’.

Please note that imposing sanctions require the creation of a mechanism of hearing

and granting the right to be heard by the service provider.

The following is an example of possible sanctions hierarchy:

1. Fines

It is possible to define in advance for the service provider that in case of non-compli-

ance with the required standard, the tariff to which he is entitled will be reduced. It is

important to remember that if you wish to retain the possibility of imposing fines on

service providers, you must define and specify this in your contract documents.

2. Differential monitoring / reducing the license degree - Make use of the fact that you

are a regulator when establishing a sanctions hierarchy. Tie the license to the tender.

Licensing is a regulatory instrument available to the service customer in some social

services. The authority to license stems from the law, such as the Supervision of Hos-

tels Law and the People’s Health Ordinance. It is recommended to combine licensing

as a supervisory instrument - within the tender and as part of the arrangement of the

relationship with the service provider.

The tender for geriatric hospitals includes five ‘Criteria for determining the duration of

Fines / reducing the quality basket

Reducing the licensing rating

Stopping patients’ referral

Termination of engagement / cancellation of license

78

licensing for geriatric institutions’. The maximum licensing time is two years, while the

minimum licensing time is three months. This sequence also includes licensing for a

period of one year as well as licensing for a period of six months. An institution that is

licensed for three months is in danger of being closed. The higher the quality of the

institution, the longer will be its licensed.

Compliance with an inspection that requires an extension of licensing requires many

inputs from the provider, and therefore the existence of graded licensing constitutes a

significant incentive to improve compliance with the criteria required by the Ministry.

3. Stopping patients’ referral - this is a ‘penalty card’ for the service provider, warning

him that if he does not correct the defects and raises the standards, the next step will

be termination of the engagement. This step will be easier to implement when our en-

gagement has been made through a Framework Tender, and we can refer new patients

to other service providers. For further details on framework tenders, see the chapter

‘Competition in the Service of Quality’.

4. Termination of engagement - This is the most extreme and rare penalty, and neither

you nor the service provider derive any gain from this. But it must appear across the

sequence in case there is a service provider that does not meet your standards and

oversteps the red lines of the indicators you have set. Quality measurement will pro-

vide you with an important instrument in case you decide to terminate an engagement

before its due date.

56. Separate the enforcing entity from the monitoring entity.

The supervisor’s work has a built-in duality. This arises when, on the one hand, the

Supervisor advises the institution, and on the other hand, he supervises it. While the

situation has professional advantages, it creates difficulties in imposing sanctions. As

a response to this duality, it is recommended that imposing sanctions on the service

provider will follow a staff decision with the participation of the Supervisor, and not just

by the Supervisor.

57. Set in advance a detailed mechanism for terminating an engagement and replacing

a provider.

It is important that you will also be prepared for a scenario in which you are required

to terminate an engagement. Especially if the nature of your service providers requires

stability and continuity. In various social services it is necessary to provide in advance,

for example, a procedure for evacuating patients in an institution that must be closed

down. In the chapter ‘Competition in the Service of Quality’ and in the chapter ‘Flexibili-

ty and Innovation’ we have shown examples of the types of engagements that will make

it easier for you to implement this procedure.

58. Establish a mechanism for correcting defects.

Define in advance how you intend to track the correction of defects that you found in

your monitoring. Define in advance to the service provider what is the time period with-

in which he can act to correct the defect before imposing on him sanctions from the

above-mentioned hierarchy.

Part 4

Summary of the

Recomendations

8181

Chapter 1

Summary of recommendationsActivities required in managing the engagement

Part 2: Recommendations for establishing and managing an excellent engagement Chapter 1: Service Recipients at the Center 11

1. Ask the service recipients and their family members for their opinions, already

when planning the engagement. 18

2. Ensure the existence of accessible complaint mechanisms in the service. 18

3. Make the information about the service transparent and accessible to the

service recipients. 18

4. Make it possible for service recipients to choose their service provider. 18

5. Use the opinions of service recipients, or those commissioning them on

their behalf, for the purpose of rating the quality of the bid in the tender. 18

6. Include service recipients in the process of determining its indicators. 18

7. Establish steering committees with representation of service recipients. 19

8. Establish positions of ‘expert associates’ and ‘quality trustees’ in the service. 20

Chapter 2: Service Providers as Partners 21

9. Consult existing and potential service providers prior to drafting the engagement. 22

A. Publish an RFI if necessary. 23

B. Hold a providers’ conference if necessary. 23

C. Allow clarification questions. 23

10. Establish and develop the professional doctrine together with the service providers

in a systematic manner 23

11. Establish forums. 24

12. Conduct instruction and training courses for the service providers’ employees. 24

13. Establish a Joint Steering Committee for the Service. 24

14. Get assistance from the service providers for monitoring. 25

15. Establish long-term engagements (with clear exit options). 25

16. Set payment on the basis of milestones. 25

17. Allow the assignment of right to the banks in order to receive credit. 26

18. Allow an offset order (in lieu of a guarantee) for a performance guarantee. 27

19. Be aware of payment schedule instructions. 30

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Chapter 3: Setting and Measuring Standards According to the Change Theory 30

20. Set standards. 31

A. Set standards to ensure existential security. 31

B. Set standards relating to the Change Theory. 31

21. Establish clear service indicators. 33

A. Establish outcome indicators for standards relating to the Change Theory. 33

B. Define output indicators after you have established outcome indicators for

standards that relate to your Change Theory. 33

C. Define input / infrastructure indicators and a structure according to the standards

of existential security and the Change Theory. 34

D. If necessary, break down standards into components. 34

E. Avoid micro-management - go for outcome indicators when the Change Theory

allows it. 34

F. Standardize intervening factors when comparing providers on the basis of

indicators. 34

G. Define in advance, for yourself and for the service provider, the expected

implementation of the indicators. 35

H. Define your red lines in advance. 37

I. Set a time point in advance, for updating standards. 38

J. Avoid multiple indicators. 38

K. Include partners in the process of setting the indicators. 38

L. Examine the service indicators through ‘gender’ glasses. 38

Chapter 4: Competition in the Service of Quality 40

22. Define the level of competition that suits you. 41

23. Increase competition during the life cycle of the engagement. 41

A. Allow the service recipient or the service customer to choose between service

providers. 41

B. Rate service providers and make the rating accessible to the public. 44

C. Pay according to service quality. 44

24. Increase competition during the tender process. 44

A. Know the history of tenders in similar fields. 44

B. Know your service providers’ market. 45

C. Reach Out 45

D. Nurture a ‘Baby Operator.’ 45

E. Split the service into several regions. 46

F. Allow entities without a license to bid for the tender (if they win, the license

will be a condition for the engagement) 46

G. Give greater weight to the bid quality over experience. 47

H. Specify your demands concerning experience. 47

I. Go easy with the requirement to provide a building in advance. 47

J. Allow provision of the service in a public building. 48

83

K. Consider the possibility of combining a public service with a private one in the

same building. 48

L. Write a simple and easy-to-understand tender. 48

M. Allow sufficient submission time. 48

N. Alleviate as much as possible the financial burdens that you impose on service

providers 49

Chapter 5: Continuity in Service Provision 50

25. If necessary, establish continuity of service provision. 50

26. 26. Prevent stagnation in the quality of a continuous service. 53

Chapter 6: Competitive Bidding and Pricing 54

27. Be involved in the competitive bidding process of your engagement. 54

28. As part of the consultation process prior to drafting the engagement documents,

spend some time also on pricing and competitive bidding 55

29. Set the pricing standards for all those responsible for pricing in your Ministry. 55

30. Be part of the committee that sets the pricing 56

31. Make sure it reflects the pricing and its components 56

Chapter 7: Flexibility and Innovation 57

32. Establish an engagement with a flexible operating space. 57

A. Set in the tender documents the possibility of updating the specification and the

price of the service during the term of the engagement. 57

B. Consider using a Framework Agreement. 58

C. Make correct use of your options. 58

D. Prepare yourself in advance for an emergency. 58

• D. 1. Establish an emergency procedure. 59

• D. 2. Specify and clarify in the engagement documents your requirements from

the provider during an emergency. 59

• D. 3. Set qualified bidders when selecting the winners. 59

33. Promote innovation and flexibility in service provision. 60

A. Define a sphere of the service where it is possible to propose innovative activities

in advance. 60

B. Allow scoring for past innovation when selecting the winner. 62

C. Provide flexible rewarding. 62

Chapter 8 Drawing Conclusions 63

34. Draw conclusions about the tendering process upon its completion. 63

35. Draw conclusions before terminating an existing engagement, in order to decide

whether to proceed in a similar format. 63

36. Use the AAR methodology for drawing conclusions. 64

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Chapter 9: Knowledge Preservation 65

37. Produce insights and establish a doctrine during the engagement with the service

providers, service recipients, and experts. 65

38. Define in the engagement documents, what knowledge the service provider must

preserve, and in what manner should he transfer it to the Ministry. 66

39. Connect Knowledge preservation to the control and the supervisors. 66

40. Give preference to a situation whereby the service’s computerized management

system is a Ministry system. 66

41. Establish in the engagement documents a procedure for ‘passing the baton’

from the outgoing service provider to the incoming one. 67

Part 3: Supervision and Control 69

42. Inspect the existence of all the standards you have set for the service, both within

the scope of the engagement as well as under license. 71

43. Convert your engagement into control. 72

44. Take ownership of the Ministry-inclusive monitoring picture. 72

45. Carry out surprise inspections as well as inspections at different times of the day. 73

46. Carry out inspections also by supervisors who have no experience in supervising

that particular institution. 73

47. Perform differential monitoring. 73

48. Have your ‘finger on the pulse’ 73

49. Implement an annual work plan for the inspector (supervisor). 73

50. Make the standards that you require accessible. 74

51. Perform a monitoring as transparent as possible. 74

52. Make the results of the monitoring accessible. 74

53. Ask service recipients and providers for their opinion. 75

A. Perform satisfaction surveys among service recipients and their families.

B. Interview the service providers as part of the implementation of monitoring.

54. Allow service recipients and providers to express their position on the service

quality. 76

A. Establish an accessible complaints mechanism, including anonymous complaints. 76

B. Encourage the involvement of parents and families of service recipients. 76

C. Ask the service provider for self-monitoring. 76

55. Set a hierarchy of rewards and sanctions. 76

56. Separate the enforcing entity from the monitoring entity. 78

57. Set in advance a detailed mechanism for terminating an engagement

and replacing a provider. 78

58. Establish a mechanism for correcting defects. 78

Part 5

Appendices

Ms. Iris Florentin Senior Deputy Director, Social and Personal Services

Department, Ministry of Labor, Welfare and Social Services.

Mr. Hanan Paritzky Senior Deputy Director, Budget and Economics, Ministry of

Labor, Welfare and Social Services.

Ms. Natalie Leon Head of Tenders, Administration, Economics and Tenders

Division, Ministry of Labor, Welfare and Social Services.

Ms. Ayala Meir Director of the Service for the Welfare of the Individual and the

Family, Department of Social and Personal Services, Ministry of

Labor, Welfare and Social Services.

Mr. Hagai Dror Deputy Director, Planning and Pricing Division, Ministry of

Health.

Mr. Haim Huppert Budget and Pricing Division, Ministry of Health.

Dr. Irit Laxe Director of the Standards and Monitoring Department,

Geriatrics Department, Ministry of Health.

Ms. Orit Lev Director, Medical Services Department, Purchasing

Department, Ministry of Health.

Ms. Ronit Dudai Rehabilitation Supervisor, Mental Health Division, Ministry of

Health.

Dr. Anat Aka-Zohar Head of Quality, Service, and Safety Administration and Head

of the National Quality Indicators Program in Hospitals in

Israel, Ministry of Health.

Attorney Eilat Melkmann Deputy Legal Advisor, Ministry of Education.

Ms. Orna Mittmiger Director of Purchasing, Tenders and Engagements

Department, Ministry of Education.

Ms. Keren Hahiashvili Coordinator of Social Ministries, Accountant General Division,

Ministry of Finance.

Mr. Tal Granit Education and Welfare Referent, Accountant General Division,

Ministry of Finance.

Adv. Naama Kaufman-Pass Deputy CEO (Industry), Ministry of Economy.

Ms. Orit Pais Senior Coordinator, Economics, and Infrastructures

Department, Prime Minister’s Office.

Mr. Tzvika Goldberg CEO of ‘Be-Atzmi’ and Chairman of the Round Table for the

Third Sector at the Prime Minister’s Office.

Adv. Yaron Keidar Consultant, ‘Shitufim’ organization.

8787

Appendix 1

Assisted in writing the Manual

8888

Appendix 2

Tips for Conducting Consultation

Before you start consulting, it is important that you answer three questions:

• What are the main questions that you wish to clarify - what are the questions you will

wish to clarify about the service? What are the questions you will ask about the service

provider’s team? Are they about infrastructure? Are they about service pricing? Do they

concern the satisfaction of patients? Etc.

• What is the purpose of the consultation process - in relation to any issue - are you looking

for information that you think you lack? Are you looking for alternatives to problems you’ve

identified and wish to solve? Do you want to confirm previous thoughts - concerns, sugges-

tions for change? Do you want to recruit partners for the ideas you want to implement? Etc.

Once you have defined the issues you are about to consult about, as well as the pur-

pose of your consultation, you are ready to move on.

• Who do you wish to consult, and who do you want to conduct a cooperative process with:

Conduct a short mapping of all the relevant factors and decide whether you want to bring

them together or meet them in separate sessions: Service recipients, their families, service

providers - owners and employees, organizations operating within the service (national ser-

vice girls, volunteers, non-profit organizations, etc.), experts, advocacy groups, and so forth.

It is always preferable to hold a separate minimal intra-ministerial process, which

will precede the external process, in order to plan the consultation process together

with your partners in the Ministry and the Government. The intra-governmental partners

should also take part in the consultation sessions and thus will be able to get a direct im-

pression of what is being said there, and even respond and ask questions themselves.

As you have more regular partners’ forums, like a knowledge community, or a steering

committee, etc., you should consider having a specific discussion with them about the

format of the engagement later on.

Things to consider when planning a consultation meeting:• Consider the place and date of the meeting.

Try to establish an accessible meeting place for most participants. For example, if most

of the participants live and work in the north, do not set the meeting place in Jerusa-

lem even if your office is there. Prefer a meeting place close to a parking lot, available

public transportation, and accessibility for people with disabilities.

When it comes to reaching service recipients and their families, it is preferable to arrive

at their place rather than inviting them to your office.

The quality of the meeting place, in terms of atmosphere, acoustics, accessibility and

89

similar variables, is very important and has an impact on the quality of the meetings.

Before you set a date for the meeting, check that this is not a religious holiday of one

of the religions in Israel, that the education system works on this day, that the time is

convenient for most of the participants and does not require, for example, service re-

cipients who come for consultation to lose work hours due to their participation in the

meeting.

• Managing the meeting.

Define in advance who will open the meeting, how will it go on (turn-taking, time divi-

sion between questions, who gives the floor, what role you want to have in the meeting

- facilitator, listener only, would you like someone else to run the meeting, etc.).

Now that you begin the consultation session, pay attention to the fol-lowing points:

• It is important to coordinate expectations with the participants at the start of each

consultation process. Explain to the participants the significance of the consultation

process, in what context and at what stage of the formulation of the tender you are

holding it, what will be done with what is being said, who will hear them and what they

can influence, what they can talk about, and what issues are open for discussion. If

there are issues you do not intend to discuss, you should define them in advance.

• Check the participants’ expectations as well. Make sure that all of you are coordi-

nated regarding the goals of the meeting and its possible effects. Keep in mind that

participants may want to talk about topics that you did not plan to discuss. Listen

open-mindedly to their suggestions. You do not have to accept them, but it is import-

ant to understand that raising them expresses their motivations for discussion, and as

much as possible - it is better to include them in the discussion.

• At the end of the meeting - summarize. Try to emphasize the main points that have

been raised and especially what the meeting emphasized and what you learnt from it.

Do mention again, what happens from here onward - is the meeting a one-time event?

Will there be a follow-up? And if not - will a summary be distributed? How will they even-

tually know if their words were really heard and taken into account?

In any case, it is always recommended to distribute a summary of the main points that

were raised during the consultation, which will be sent to all the participants, along with

thanks for their participation in the meeting and for the things they shared with you.

The number of meetingsUsually, one meeting will be sufficient for collecting information, ideas, and directions of

thought from a particular group.

When conducting separate discussions with several groups, consider whether to concen-

trate the effort and hold a series of meetings on the same day or to separate them, mainly

in order to enable you to draw conclusions and to progress in your thinking between meet-

ings. When the issues you wish to discuss are more complex, or when you expect it will take

time to get the participants involved, as well as in situations where you want to ‘crack’ a

certain difficulty or actually formulate a new policy or work approach - you may need more

90

than one meeting. In this situation, it is recommended to coordinate expectations on that

too with the participants and to prepare accordingly.

Questionnaires and surveysConsultation can of course be held not only in meetings. Questionnaires and surveys are

an accessible and useful tool that requires relatively limited inputs and allows simultaneous

access to a wide range of people. This tool is especially useful when you want to gather

information and ideas and you do not need to discuss and work together or establish direct

and interpersonal contact with the participants.

Things to consider when preparing surveys and questionnaires:

• Prepare a short questionnaire;

• Distribute the questionnaire in varied ways as much as possible: online (responsive -

that is, accessible from mobile devices and tablets) and physical - relevant to target

audiences;

• Formulate your questions clearly - in easy language, adapted to the audiences you wish

to be answering;

• Formulate short questions. In every question – focus on one clear issue and not more;

• With regard to each question, check with yourself whether you really have anything to

do with the answer;

• Do not ask questions that may lead to answers whose implementation is beyond your

reach;

• Limit the amount of answers to be sent (in words, in pages) so you do not get over-

whelmed;

• Always leave an open field for respondents to write things they wish to raise with you;

• Consider whether you want to allow respondents to attach files / send you more information.

E-government has developed a survey instrument available and easy to use.

For use go to e-government site: http://e.gov.il/PRODUCTS/Pages/GovShare.aspx

In addition to the relatively accessible means of cooperation mentioned above, you may

want to conduct consultation and cooperation processes that will require more inputs (if, for

example, you will want to hold more meetings, reach wider audiences, conduct a process

over longer periods) or wish to conduct a process concerning which you would like to con-

sult with cooperation experts due to exceptional complexity. For example, when there are

many objections in the field that may be difficult to manage in a consultation session, or you

may feel that special means are needed to reach less accessible target audiences (people

with special needs, populations that do not have access to the Internet, etc.).

In these situations, you are faced with the possibility of using cooperative services provid-

ers that can be operated within the framework of a specific Framework Tender:

Central Tender No. 23-2015 ‘For the Planning and Execution of Cooperative Processes in

Government Ministries’ is intended to enable Ministries that wish to conduct cooperative

processes to do so through an external expert who specializes in collaborative processes.

The tender is relevant to all the cooperation instances you will need, whether it is intra-min-

91

isterial or inter-ministerial cooperation, expert inclusion, organization inclusion, and public

inclusion. It includes a variety of cooperative services, including physical cooperation ser-

vices (such as focus groups, roundtables and conferences), online cooperation services

(such as consultation, forum and online survey) and complementary services (such as map-

ping of affecting and affected, content reviews, etc.) You will be able to operate through it

ways of cooperation that are relatively difficult to operate alone. In order to be assisted by

an organization that specializes in cooperation in the framework of the tender - first check

whether the Ministry in which you work has already activated a cooperation tender. You can

check this with the Policy Planning Department of your Ministry, or with the Government

and Society Division at the Prime Minister’s Office. If the Ministry has already selected the

‘house provider’ for cooperation, you can use the tender within a short time. If the Ministry

did not activate the tender, you can examine together with the Policy Planning Department

of your Ministry whether it is all right to establish an engagement within the framework of

the tender - for your unit or for the Ministry as a whole.

In any case, you can be assisted by the cooperation team in the Government and Society

Division of the Prime Minister’s Office in everything related to the planning of the consulta-

tion and cooperation processes that you wish to activate: shituf@pmo.gov.il

9292

Appendix 3

Tools for the Chapter on Setting and Measuring Standards

Table for defining optimal indicators

Here you have a table with important aspects to keep in mind when defining an indicator.

Examples of possible responses are in the column of the first indicator.

Name of Indicator Indicator 1 (Example) Indicator 2 Indicator 3

Name of IndicatorPercentage of program graduates who work full-time

Type of indicator (output, output, input)

Output

Desired indicator rate * Indicate if there is a ‘red line’

Desired rate - 80% Red line - from 50%

Date of measurement of the indicator (fixed / median / annual / multiannual)

A year from the end of the employment program

Source of information for measurement

Follow-up to be performed on behalf of the Department

Implementation of the indicator (discourse / provider selection / reward and fine / payment / termination of service)

The burden that the measurement imposes on the service provider

No burden

93

yes no

1. Have you defined the improvement in the service that you wish to achieve through the indicator?

2. Have you defined what will be considered an implementation of the indicator (provider selection, rewards and sanctions, etc.)?

3. Is your indicator comparable?

4. Have you set the measurement dates for the indicator?

5. Do you plan and intend to check compliance with the indicator's objectives?

6. Have you set a preset time for raising standards for the indicator?

7. Does the examination of the indicator impose a reasonable burden on the provider?

8. Have you conducted a cooperative process in order to determine the indicator?

A tool for evaluating indicator quality - answer yes to as many questions as possible

🙁 Between 1 and 3 positive answers - you’re not there yet.

Read again the chapter on standards in the service of Change Theory and see

what can be improved in the indicator.

😐 Between 4 and 6 positive answers - the indicator is qualitative,

but not excellent...

🙂 Between 7 and 8 positive answers - wow, your indicator is super quality.

Well done!

94

Gender assessment instrument for social services

This tool was developed in a joint work process as part of CET ‘In appreciation’ conference

Guiding principle Leading questions Examples

The population of service recipients

Check whether

gender

characteristics of

service recipients

are relevant to its

success

According to existing literature and

knowledge, does this phenomenon have

different expressions among men and

women?

Having criminal records is more

common among boys than among girls.

Does this phenomenon have different

expressions among diverse social groups?

The proportion of women among the

poor is higher than their proportion in

the population.

Have more or less effective strategies been

documented for different groups?

Methods to encourage male and female

students to increase mathematics are

effective in a different way for boys and

girls (prestige and employment future

vs. interest and challenge).

Service components

Check whether the

Change Theory is

adapted to gender

differences

Is the Change Theory based on universal

concepts? Or does it include human

diversity?

In intervening to reduce poverty,

reference will be made to the status of

single mothers and elderly women and

specific intervention strategies will be

formulated for them.

Did the theory take into account the gender

characteristics of the players?

An intervention program to encourage

employment will address the need

for young families for an accessible

framework for their children.

Measurement planning

Build a platform

which allows all

interested parties to

influence the setting

of indicators

Have all stakeholders been identified and

has a method been devised to involve them

in the assessment process?

Haredi (Ultra-Orthodox) representatives

will be included in the process of

setting the indicators in a service that

encourages employment.

Were gender considerations integrated in

the platforms design?

Discussions take place at times that

allow the presence of single mothers.

Were the expectations and perceptions of

success of those affecting and affected by

the program been taken into account?

Research expectations are clarified

through interviews with a sample of the

affecting and affected.

95

Guiding principle Leading questions Examples

Design methods

of collecting

and analyzing

information that

will enable under-

represented groups

and muted groups

to be expressed

Has an effort been made to reach difficult-

to-sample female service recipients?

An effort will be made to reach groups

that do not speak Hebrew.

Are collection methods adapted to target

group characteristics?

Questionnaires will be formulated both

in male and female form.

Were cultural muting processes taken into

account?

For example, interviews about sexual

activity will be conducted under strict

privacy conditions.

Is the data collected in such a way that it

is possible to distinguish and analyze by

gender, ethnicity, religion and other diverse

groups, with emphasis on peripheral

groups and excluded populations?

For example, a socio-demographic

mapping will be carried out in

the framework of the evaluation

questionnaires and the data will be

analyzed on the basis of this mapping.

Formulation of conclusions and their accessibility

Present conclusions that reflect and relate to differences in gender reality

Are the findings presented by segmentation in relevant variables?

A service for the integration of boys and girls at risk in military / civilian service will demonstrate its effectiveness by gender and sector and religious orientation.

Do the conclusions relate to differences in the reality of subgroup life?

The evaluation of a program for occupational integration, will present the complexity among single mothers.

Disseminate and make accessible the conclusions and recommendations

Are the findings presented in a way accessible to broad audiences?

Graphical and available (online) accessibility of the findings.

Were the findings presented to female service recipients or their representatives?

Holding a presentation session with the community or with specific affected groups.

9696

Appendix 4

Government Resolution on Government Policy on the Provision of Social Services

Resolution No. 2034 (HC / 37) dated September 28, 2014; the 33rd Government, headed by Benjamin Netanyahu.Subject of the decision: Government Policy on the Provision of Social Services

It has been decided,

To ensure the realization of the State’s responsibility with regard to the provision of social

services, and to promote the quality and availability of the social services provided by the

Government for the benefit of service recipients.

In this Resolution:

‘Social service’ - educational services or therapeutic services (including mental health, so-

cial, medical, and para-medical services) provided by the social Ministries, either directly or

indirectly.

‘Roundtable’ - the roundtable established by virtue of Government Resolution No. 3190 of

24.2.2008.

1. To instruct the Government representatives at the roundtable, headed by the Direc-

tor-General of the Prime Minister’s Office, to formulate a plan to improve the manner

of providing outsourced social services (hereinafter: ‘the Plan’) by November 30, 2015.

Recommendations with budgetary effect will be agreed upon by the Director-General

of the affected Ministry and the Budget Director and the Director General of the Prime

Minister’s Office or their representatives. All recommendations regarding welfare will be

approved by the Director General of the Prime Minister’s Office and the Director Gener-

al of the Ministry of Social Affairs and Social Services.

2. The Plan will address, inter alia, the following issues: standards for the provision of social

services, administering outsourcing processes, models for engagement arrangements,

regulation of social services, including monitoring, control, measurement, supervision,

enforcement, and means for preserving, developing, and gathering knowledge.

3. The Plan will be formulated in a joint dialogue between the members of the roundtable,

including representatives of local government, the third sector, and those parts of the

business sector working for public purposes, and in consultation with other parties that

are relevant to the discussion, including social service providers from the business sector.

4. It is hereby clarified that the existence of the joint discourse within the framework of the

roundtable does not detract from its functions, its duties, its powers, and the manner in

which the Government’s discretion is exercised.

97

5. During the formulation of the program, its suitability will also be examined for social

services provided by the government, not through outsourcing, or educational or thera-

peutic services that are subsidized by the government.

6. Taking into account the provisions of this Resolution, the Government’s Resolution con-

cerning the reduction of the regulatory burden shall not apply to regulation in the field

of social services.

9898

Appendix 5

Government Resolution on Adopting the Recommendations of the Government Team to Improve the Provision of Outsourced of Social Services

Government Resolution No. 1950 of September 11, 2016; The 34th gov-ernment, headed by Benjamin Netanyahu.

The subject of the decision: Government Resolution on Adopting the Rec-ommendations of the Government Team to Improve the Provision of Out-sourced of Social Services

Pursuant to Government Resolution no. 2034 (HC / 37) dated September 28, 2014, regard-

ing the formulation of a plan to improve the provision of outsourced social services, and on

the basis of the recommendations of the team established in this decision:

‘The social Ministries’ - the Ministries of Education, Health, Labor, Welfare, and Social Services.

‘Social service’ - educational services or therapeutic services (including mental health, so-

cial, medical, and para-medical services) provided by the social Ministries, either directly or

indirectly.

‘Outsourced social service’ - a service provided through extra-governmental service pro-

viders, purchased by the government, with full or partial funding. The government assumes

responsibility for the provision, regulation, and supervision of these services, and does not

finance it through grant support.

It is hereby clarified that the Resolution does not apply to health funds, hospitals, schools

and kindergartens, as well as to services provided through outsourcing as part of an en-

gagement with a local authority.

1. The purpose of this Resolution is to improve the quality of the social services provided

by outsourcing through the following principles:

A. Strengthening the control and management capabilities of government Ministries in

relation to outsourced social services, and streamlining and improving the process of

their procurement and operation.

B. Strengthening the system of supervision and inspection of outsourced social services

in order to ensure their quality.

C. Reducing the regulatory burden, including reducing the financial burden imposed on

service providers in order to enable them to focus on ensuring the quality and avail-

ability of the service.

99

In order to realize the purpose and principles of the decision, the following steps will be

carried out:

Developing and imparting a doctrine

2. To instruct the Prime Minister’s Office, together with the Accountant General’s Depart-

ment in the Ministry of Finance and the social Ministries, based on the recommendations

of the team that worked on the matter, to formulate a ‘Manual for managing the process

of outsourcing social services’ (hereinafter: the ‘manual’) by 30.06.2017. The manual will

include guidelines for streamlining and improving the outsourcing process, so as to im-

prove the social service provided to the citizen. Accordingly, the manual will express the

following principles regarding the outsourcing of social services:

A. Setting standards for the social service and its quality, establishing a measurement

system and creating a mechanism of rewards and sanctions based thereof.

B. Defining a work process that includes the Ministry officials relevant to formulating the

tender, together with consultation in a manner that corresponds to the principle of

equality and legality with external authorities relevant to the outsourcing process. This

should be done, inter alia, as groundwork towards drafting a tender and drawing con-

clusions, monitoring and supervising, as well as knowledge preservation throughout

the life cycle of the tender.

C. Increasing competition before and during the period of the engagement, increasing

flexibility in operating the service and encouraging innovation.

D. Ensuring congruence between the content of the engagement and the control con-

tent of the supervision process, and increasing the transparency of the monitoring.

3. To instruct the social Ministries:

A. To establish, together with the Prime Minister’s Office and the Accountant General’s

Department at the Ministry of Finance, by 30.09.2017, a joint training program for the

elements involved in the process of outsourcing social services in government Minis-

tries, with the aim of instilling the doctrine that underlies the Manual.

B. To formulate tenders in accordance with the manual (hereinafter: ‘2nd Generation Ten-

ders’), commencing with the completion of the formulation of the training program

formulated in accordance with Article 3 (a) and subject to the provisions of Article 6 (c).

C. Starting January 1, 2017, to conduct a learning process together with the Prime Minister’s

Office on the subject of determining outcome indicators for outsourced social services.

4. To instruct the Ministry of Finance and the Prime Minister’s Office to examine, upon

completion of the Manual, in cooperation with the social Ministries, the possibility of de-

veloping on its basis standardized tenders and engagements for social services.

Long-term engagements

5. Given the importance of the continuity of the inter-personal relationship underlying many so-

cial services, to instruct the Ministry of Finance to allow for validity periods of up to 5 years, in

agreements relating to outsourced social services in one of the following manners:

100

A. The Ministry of Finance will encourage the use of authorization to commit to a period

of up to five years in intensive social services provided in institutions that operate 24

hours a day, 7 days a week (24/7), as well as in institutions where social service is pro-

vided to patients on a daily basis, on a large scale (over NIS 200 million per year), or

those provided by law (hereinafter: ‘Institutional Services’). In the event of cancellation

of an engagement prior to its termination, a new authorization will be obtained for the

execution of a new engagement. ‘

B. ‘Homes for Life’ - All engagements for institutional services in the Ministry of Labor,

Welfare and Social Services will be implemented in accordance with the existing ar-

rangement in the Ministry of Labor, Welfare and Social Services known as the ‘Homes

for Life’ arrangement.

C. A multiannual agreement conditional on a work order - the Accountant General will

amend the Financial and Economic Regulations Directives by January 31, 2017, so that

the government Ministries will be able to sign agreements for the procurement of so-

cial services for periods of up to five years in an arrangement whereby during the term

of the engagement the services will be procured according to annual work orders.

The work order will be made at the request of the professional officer responsible for

the service subject to his satisfaction with the provider and subject to the Accountant

confirming the existence of available funding.

Social Procurement Upgrade Plan

6. To instruct the social Ministries to implement a tri-annual plan to upgrade the social

procurement, which will refer to the improvement of social procurement management,

including improvement of the tender processes and improvement of the control over

the services (hereinafter: ‘the Plan), and for that purpose:

A. The social Ministries will formulate and publish the Plan by April 1, 2017 on the website

of every Ministry. The social Ministries will be able to update the Plan from time to time

as necessary.

B. The social Ministries will define tenders that, due to their special importance, will be

discussed by the Director General of the Ministry, at key milestones to be determined

by him. Their special importance will be the result of their size (a tender for an engage-

ment for at least NIS 30 million annually or more) or of their unique characteristics, to

be defined by the Director General, or when starting a service through outsourcing for

the first time.

C. The Ministry of Health and the Ministry of Labor, Social Services and Social Services

will implement the Plan in central units that encompass a significant part of social out-

sourcing in the Ministries, namely: The Medical Administration of the Ministry of Health

and the Department of Personal Social Services in the Ministry of Labor, Welfare, and

Social Services.

D. Once the tri-annual Plan of upgrading social procurement is completed, the Director

General of the Ministry of Labor, Welfare, and Social Services will examine how to apply

the Plan to the rest of the outsourced social services provided by his Ministry.

E. In light of the relatively limited scope of social services operated by the Ministry of

101

Immigration and Absorption, it was decided that it will be exempt from obligations

stemming from this Resolution, but will be free to utilize the infrastructures that will be

developed as a result thereof.

F. The social Ministries will assign a Deputy Director General who will be responsible for

implementing the Plan, and will report on its progress to the Ministry’s administration

twice annually.

G. The social Ministries will update their Ministry’s outsourced social services book once

a year. These books include a list of all the outsourced social services provided by the

Ministry. The updated Social Services Book of 2014 is attached hereby.

H. To instruct the Director General of the Ministry of Labor, Social Affairs and Social Ser-

vices to work jointly with the Ministry of Finance and the Prime Minister’s Office in

each of the years of the Plan in order to adopt a main tender at the Ministry (herein-

after: ‘Flagship Tender’).

Strengthening control and supervision

7. In order to strengthen the efficiency of the control of outsourced social services, the

control should include the following components: inspections at regular intervals; com-

patibility between the content of the engagement and the work of the Supervisor and

the controls; comparable indicators; comparable monitoring reports; instruments for

incremental rewards and sanctions and a clear, transparent mechanism for their im-

plementation; monitoring the correction of defects; comprehensive supervision of the

institution, its employees, service recipients and their families. For the purpose of the

existence of these components, it is necessary to instruct:

A. The Ministry of Health and the Ministry of Labor, Welfare and Social Services, in co-

operation with the Prime Minister’s Office, to formulate templates for public inspec-

tion reports on outsourced institutional services by 30.06.2017. When formulating the

templates, it should be taken into account that the intention is to use them digitally in

the future.

B. The Ministry of Health and the Ministry of Labor, Welfare and Social Services to formu-

late appropriate inspection reports for each service on the basis of the templates that

will be formulated as aforesaid and to apply a gradual use of these reports starting in

2017. Public inspection reports on all the outsourced institutionalized services oper-

ated within the units specified in Article 6 (c) will be published by December 31, 2019.

C. The social Ministries must formulate a work plan to improve the control of outsourced

social services by 01.04.2017. The plan will refer to the above, including timetables for the

publication of the standard control reports and the training as detailed below (‘the work

plan). The work plan will be updated periodically. Implementation of the work plan for im-

proving the control of the Ministry of Health and the Ministry of Labor, Welfare and Social

Services will be carried out in accordance with the units specified in Article 6 (c).

D. The social Ministries, in cooperation with the Prime Minister’s Office, to formulate a

joint training program for outsourced social services supervisors by September 30,

2017. The purpose of the training will be to assimilate the doctrine of outsourcing so-

cial services and the control aspects affected by it, with an emphasis on the role of

the control by the Supervisor of the outsourced services.

102

Transparency

8. To instruct the social Ministries to publish on the Ministry’s website:

A. Starting in 2017 and every year thereafter by December 31 of that year, detailed work

plans for the upgrading of procurement and improvement of control for the following

year and a performance report for the previous year’s plan.

B. New tenders that will be formulated in accordance with Article 3 (a), alongside their

regular publication, in the designated place where the information about the program

will be concentrated.

C. The updated outsourced social services book, updated according to Article 6 (e).

D. The monitoring reports on social and institutional services, to be filled as per the template

of the monitoring reports, designed in accordance with Section 7 (b) above, starting 2018.

9. To instruct the Ministry of Justice to examine jointly with the Prime Minister’s Office and

the Social Ministries the manner in which data about non-profit social services, out-

sourced by the government, can be presented on the GuideStar website (the database

of non-profit organizations in Israel).

Reducing the regulatory burden, including reducing the financial burden imposed on

service providers

10. To instruct the Accountant General to amend as required the provisions of the Financial

and Economic Regulations Directive by January 31, 2017, to include the following refer-

ences:

A. With respect to the performance guarantee, to enable the Tenders Committee to ex-

empt the provider from performance guarantees for special reasons that will be re-

corded, including the possibility to include the explanation that these are tenders in

social fields, and to order alternative measures, if necessary.

B. To take a lenient approach in assigning a right to banks in order to accept receipts

under agreements for the outsourcing of social services?

C. To consider favorably the establishment of a payment model that includes milestones

that enable the payment to be scheduled in a way that will take into account the pro-

vider’s organization costs.

11. To order the Ministry of Labor, Social Affairs and Social Services to formulate, by June

30, 2017, together with the Ministry’s Accountant, a plan for streamlining the payment

process to social service providers, based on a reexamination of the payment approval

process in order to facilitate its timely receipt.

12. To put in writing the announcement of the Ministry of Labor, Social Affairs and Social

Services that it will establish, by the first half of 2017, an online system for the approval

of dedicating funds, which will reduce the approval times for payment to the service

providers and the cancellation the ‘leave-stay’ practice, within the framework of which,

all the committees’ approvals for service recipients in out-of-home frameworks are can-

celed, for the purpose of checking the Ministry’s records update, and the local author-

ities are required to renew them. Until the online system is activated, and in order to

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avoid payment differences, the Ministry’s accountant will act to reduce the damage to

the current payment system.

Budget and manpower

13. Budget sources and human resources standards were set for this Resolution in

an agreement between the Ministry of Finance, the Prime Minister’s Office and

the Ministries of Labor, Welfare and Social Services, and of Education and Health,

and they will be anchored within the framework of the State Budget for 2018-2017.

The Prime Minister summarizes and instructs the Director-General of his Office to exam-

ine the following issues:

• The required transition period between the existing tenders and the upgraded ten-

ders that will be written in accordance with this Resolution.

• Formulating a central database tender for external legal advice for drafting tenders in

order to shorten duration periods.

• Examining with the Minister of Finance the need for streamlining measures in the field

of government procurement as a whole.