Primary Health Networks

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1 Primary Health Networks Activity Work Plan to Budget Central and Eastern Sydney PHN When submitting this Activity Work Plan to the Department of Health, the PHN must ensure that all internal clearances have been obtained and has been endorsed by the CEO. The Activity Work Plan must be lodged to Margaret Como via on or before 6 May

2 Introduction Overview The activities under the Services Annexure to the Primary Health Networks Programme Guidelines will contribute to the key objectives of PHN by: Increasing the service delivery capacity of the drug and alcohol treatment sector through improved regional coordination and by targeting areas of need, and Improving the effectiveness of drug and alcohol treatment services for individuals requiring support and treatment by increasing coordination between various sectors, and improving sector efficiency. Each PHN, in accordance with the guidance provided by the Department, must make informed choices about how best to use its resources to achieve these drug and alcohol treatment objectives, contributing to the PHN s key objectives more broadly. Together with the PHN Needs Assessment and the PHN Performance Framework, PHNs will outline activities and describe measurable performance indicators to provide the Australian Government and the Australian public with visibility as to the activities of each PHN. This document, the Activity Work Plan template, captures those activities. This Activity Work Plan covers the period from 1 July 2016 to 30 June To assist with PHN planning, each activity nominated in this work plan can be proposed for a period of between 12 months and 36 months. Regardless of the proposed duration for each activity, the Department of Health will require PHNs to submit updates to the Activity Work Plan on an annual basis. This Activity Work Plan template has the following parts: 1. The Strategic Vision of each PHN, specific to drug and alcohol treatment. 2. The Services Annual Plan to which will provide: a) A description of planned activities funded under the Schedule: Drug and Alcohol Treatment Activities, Item B.3 Services Operational and Flexible Funding b) A description of planned activities funded under the Schedule: Drug and Alcohol Treatment Activities, Item B.4 Services for Aboriginal and Torres Strait Islander people Flexible Funding 3. The Proposed Operational and Flexible Funding Stream Budgets for : a) Budget for Services Operational and Flexible Funding b) Budget for Services for Aboriginal and Torres Strait Islander people Flexible Funding 2

3 Annual Plan to Annual plans for to must: Provide a coherent guide for PHNs to demonstrate to their communities, general practices, health service organisations, state and territory health services and the Commonwealth Government, what the PHN is going to achieve (through performance indicator targets) and how the PHN plans to achieve these targets; Be developed in consultation with local communities, Clinical Councils, Community Advisory Committees, state/territory governments and Local Hospital Networks as appropriate; and Articulate a set of activities that each PHN will undertake, using the PHN Needs Assessment as evidence, and measuring performance against Local Performance Indicators (where appropriate) and targets to demonstrate improvements. Activity Planning The PHN Needs Assessment will identify local priorities which in turn will inform and guide the activities nominated for action in the to Annual Plan. PHNs need to ensure the activities identified in the annual plan also correspond with the Activity Objectives and Actions eligible for grant funding identified in Annexure A2 Services. The Drug and Alcohol Treatment Annual Plan will also need to take into consideration the PHN Objectives and the PHN key priorities. Services Funding From , PHNs will undertake drug and alcohol treatment planning, commissioning and contribution to coordination of services at a regional level, to improve sector efficiency and support better patient management across the continuum of care. Having completed needs assessments for their regions, PHNs will now identify the appropriate service mix and evidence based treatment types suitable to meet the regional need. The Drug and Alcohol Annual Plan will complement the information in the Needs Assessments, and should be used to record the activities you intend to fund. The Commissioning of Drug and Alcohol Treatment Services guidance document will assist you in understanding the Department s expectations in relation to activities that are in scope for funding, and will assist you in translating drug and alcohol treatment evidence into a practical approach. Measuring Improvements to the Health System National headline performance indicators, as outlined in the PHN Performance Framework, represent the Australian Government s national health priorities. PHNs will identify local performance indicators to demonstrate improvements resulting from the activities they undertake in relation to the commissioning of Services. These will be reported through the Six Month and Twelve Month Performance reports and published as outlined in the PHN Performance Framework. 3

4 Activity Work Plan Reporting Period and Public Accessibility The Activity Work Plan will cover the period 1 July 2016 to 30 June A review of the Activity Work Plan will be undertaken on an annual basis (in both 2017 and 2018) and resubmitted as required in accordance with Item F of the Schedule: Activities. Once approved by the Department, the Annual Plan component must be made available by the PHN on their website as soon as practicable. The Annual Plan component will also be made available on the Department of Health s website (under the PHN webpage). Sensitive content identified by the PHN will be excluded, subject to the agreement of the Department. It is important to note that while planning may continue following submission of the Activity Work Plan, PHNs can plan but must not execute contracts for any part of the funding related to this Activity Work Plan until it is approved by the Department. Further information The following may assist in the preparation of your Activity Work Plan: PHN Grant Programme Guidelines: Annexure A2 Services; Guidance for PHNs: Commissioning of Services; Services Needs Assessment Toolkit; PHN Needs Assessment Guide; PHN Performance Framework; Primary Health Networks Grant Programme Guidelines. Clause 3, Financial Provisions of the Standard Funding Agreement; Please contact your Grants Officer if you are having any difficulties completing this document. 4

5 Table of Contents 1. STRATEGIC VISION FOR DRUG AND ALCOHOL TREATMENT FUNDING (A) PLANNED ACTIVITIES: DRUG AND ALCOHOL TREATMENT SERVICES OPERATIONAL AND FLEXIBLE FUNDING... 7 PRIORITY AREA 1: GOVERNANCE AND OVERSIGHT REGION WIDE CONSULTATION STRUCTURE WITH DRUG & ALCOHOL TREATMENT SERVICE PROVIDERS DEVELOP A SET OF ACROSS SECTORAL FOUNDATION DOCUMENTS TO INFORM DECISION MAKING REGION-WIDE CLINICAL GOVERNANCE PRIORITY AREA 2: SERVICE CAPACITY ENHANCED REHABILITATION CAPACITY IMPROVED WITHDRAWAL SERVICE REFERRAL PATHWAYS DEVELOP AND IMPROVE AFTERCARE AND COMMUNITY CARE PATHWAYS PRIORITY AREA 3: SERVICES FOR HIGH NEEDS POPULATIONS IMPROVED ACCESS TO TREATMENT SERVICES FOR FAMILIES IMPROVED ACCESS FOR CULTURALLY AND LINGUISTICALLY DIVERSE (CALD) COMMUNITIES DEVELOP MORE EFFECTIVE MODELS OF TREATMENT FOR THE LGTBIQ COMMUNITY DEVELOP DISCHARGE RESPONSES TO EMERGENCY DEPARTMENT FREQUENT PRESENTERS TARGETED PLANNING AND CONSULTATION FOR THE NEEDS OF YOUNG PEOPLE PRIORITY AREA 4: MANAGING CLINICAL COMPLEXITY AND CLINICAL PATHWAYS RESPONDING TO HIGH RATES OF PHARMACEUTICAL DRUG MISUSE PROVIDING SUPPORT TO PRACTITIONERS TO GET INVOLVED IN THE TREATMENT OF DRUG & ALCOHOL PROBLEMS 21 PRIORITY AREA 5: POPULATION HEALTH RESPONSE REDUCING ALCOHOL RELATED HARMS PRIORITY AREA 6: APPROPRIATE SUPPORT STRUCTURES AND PROGRAM INFRASTRUCTURE APPLY BEST PRACTICE PRINCIPLES TO THE PLANNING AND COMMISSIONING OF SERVICES PERFORMANCE REPORT (B) PLANNED ACTIVITIES: DRUG AND ALCOHOL TREATMENT SERVICES FOR ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE FLEXIBLE FUNDING INDIGENOUS PARTICIPATION IN GOVERNANCE INCREASED SERVICE CAPACITY WITHIN CESPHN FOR SPECIALIST DRUG & ALCOHOL SERVICES DESIGNED FOR INDIGENOUS PARTICIPANTS UNDERTAKE A TARGETED SERVICE DEVELOPMENT INITIATIVE IN COLLABORATION WITH THE AHMRC IMPROVING MOVEMENT BETWEEN SERVICES FOR ABORIGINAL PEOPLE FLEXIBLE FUND TO IMPROVE DATA COLLECTIONS FROM AGENCIES PROVIDING DRUG & ALCOHOL SERVICES TO INDIGENOUS PEOPLE (A) PROPOSED BUDGET ( TO ): DRUG AND ALCOHOL TREATMENT SERVICES OPERATIONAL AND FLEXIBLE FUNDING (B) PROPOSED BUDGET ( TO ): DRUG AND ALCOHOL TREATMENT SERVICES FOR ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE FLEXIBLE FUNDING

6 1. Strategic Vision for Funding Central and Eastern Sydney PHN recognises that Drug & Alcohol problems, and the people that suffer from them, are not homogenous. These problems cross socio-economic boundaries and life experiences and can, and should, be treated as health disorders. There is no single response to all drug problems, and an effective treatment system requires a flexible range of treatments targeted to the diversity of drug problems, provided by a range of different service providers working collaboratively. We recognise the roles of the Non-Government sector, our primary care partners, private health organisations and both specialty and geographically delimited Local Health Districts and Networks in the provision of care to our population. We recognise the strength of diversity and partnership in achieving our goals. We recognise that drug use affects all parts of the human body and that effective care requires the availability of the spectrum of health specialist skills. We will drive better outcomes for our residents suffering from Drug or Alcohol disorders and their families through: More accessible treatment and increased service capacity Improving the quality of available treatments through research and transition of results to commissioning. Better connections between treatment services and easier transfer of care between sectors Building relationships across all organisations involved in care in our region Commissioning services for those populations with identified high treatment needs. Educating the community about Drug & Alcohol Disorders and their treatment Good governance and planning Building the capacity of the workforce Improving early intervention Developing innovative service models that are appropriate for our diverse community Addressing the program support needs of service providers Providing appropriate population health messages to our community This plan outlines our commitment to leading a robust, effective, patient-centred, evidence based treatment system for the people of Central and Eastern Sydney. CESPHN will serve as a commissioning organisation and develop quality primary health care services and associated interventions that deliver better health outcomes for patients, meet population health needs and reduce inequalities within the resources available. The commissioned services will address specific regional priorities and national health priorities as determined by the Commonwealth. 6

7 2. (a) Planned activities: Services Operational and Flexible Funding PHNs must use the table below to outline the activities proposed to be undertaken within the period to These activities will be funded under the Schedule: Drug and Alcohol Treatment Activities, Item B.3 Services Operational and Flexible Funding. Refer to PHN Grant Programme Guidelines: Annexure A2 Services and Guidance for PHNs: Commissioning of Services for the list of in-scope activities. It is emphasised that PHNs are to consider strategies to support the workforce in delivering the proposed activities through promoting joined up assessment processes and referral pathways, and supporting continuous quality improvement, evidence based treatment and service integration. Note 1: Please copy and complete the table as many times as necessary to report on each activity. Note 2: Indicate within the duration section of the table the period of time between 2016 and 2019 in which the activity will be undertaken. 7

8 Priority Area 1: Governance and Oversight An effective plan for a network of treatment agencies requires mechanisms for effective cross-sector and cross-agency collaboration, joint oversight and monitoring and shared planning principles. This section details our commitment to collaborative oversight and shared governance. Proposed Activities 1. Governance and Oversight Description of Drug and Alcohol Treatment Activity 1.1 Region wide consultation structure with Drug & Alcohol treatment service providers Establishment of a region-wide consultation structure with other service providers including NGO providers, community representatives, LHD s and speciality networks, primary health care providers and co-chaired by the PHN. The structure will have an agenda that allows for shared planning activity, shared service activity, the agreement to shared clinical governance structures and referral pathways. The purpose is to ensure alignment of commissioning and planning with concurrent planning and investment in other sectors, and to improve transitions of care between sectors. As above, this activity will attempt to engage all other sector providers within the PHN. No Invitations and explanatory information to be distributed in June First meeting July 2016 and thereafter quarterly. Participation will be by direct invitation. No external commissioning required. Local data collected by PHN on meeting membership and attendance 8

9 Proposed Activities Description of Drug and Alcohol Treatment Activity 1 Governance and Oversight 1.2 Develop a set of across sectoral foundation documents to inform decision making Under the auspices of the consultation structure established at 1.1 the following documents will be developed that incorporate the activities of each of the sectors providing Drug & Alcohol treatment with the CESPHN: Development of a regional Drug and Alcohol strategy including use of the Drug & Alcohol Services Planning (DASP) tool. Undertake detailed mapping exercise of capacity and resourcing of services within CESPHN and map the gaps against the outcomes of the DASP. Establish a role delineation framework for the PHN that outlines target areas of accountability and priority service delivery domains, and delineates these from NGO s, Aboriginal Controlled Community Health Organisations (ACHHOs) and LHDs. This will be a fully collaborative exercise with stakeholders within the. No Activity start date October Activity completion date June 2017 Activity will be commissioned via a mix of internal PHN project staffing and purchased external contractor support. External contactors will be sought with appropriate expertise in the Drug & Alcohol sector and with the technical skills necessary to complete the tasks. Internal records. 9

10 Proposed Activities Description of Drug and Alcohol Treatment Activity 1. Governance and Oversight 1.3 Region-wide Clinical Governance Establish a joint clinical governance framework including PHN funded service providers, ACCHOs and LHD clinical staff which provides for agreed referral pathways, case conferencing, complex case reviews and adverse event reviews. Review relevant health pathways in relation to drug and alcohol services and facilitate use by all providers. This will be a fully collaborative exercise with stakeholders within the participating in the agreed clinical governance structures, participating in decision making and data collection. No This activity will be instigated by the regional consultation group (activity 1.1) and is anticipated to begin in the latter half of the 2016/17 financial year. Participation will be by direct invitation. No external commissioning required. Local data collected by PHN on meeting membership and attendance 10

11 Priority Area 2: Service Capacity In order to meet the treatment needs of our population there needs to be a variety of service options and sufficient service capacity for each. The Drug & Alcohol program offers withdrawal services, hospital liaison services, outpatient and community services, residential and other rehabilitation services, aftercare and opioid substitution therapies. Different populations may require a different mix of services, and some people may come to services through specialist pathways, such as diversion from court or via maternity services. It is imperative that in enhancing service capacity that there is not duplication of effort with other providers and funding bodies, and that investment is contained to areas where the PHN can have the greatest impact. As such, and consistent with the primary mandates of our role, effort will be concentrated on primary, community, and non-government initiatives and will not focus on those treatment modalities that are the central remit of Local Health Districts. This section details our commitment to ensure the appropriate range of services, and improved access to them, based on population models. Proposed Activities Description of Drug and Alcohol Treatment Activity 2. Service capacity. 2.1 Enhanced Rehabilitation Capacity Drug & Alcohol rehabilitation services provide attitudinal and behaviour change skills to participants to achieve long term behaviour change with regard to drug or alcohol dependence. Services can be residential, day only or community outreach and are provided by a mixture of professional and peer workers. Residential services generally have extended stays and do not have geographic catchments. As such local modelling of service need is generally focussed on specific high needs populations. Epidemiologically based modelling by the NSW Drug & Alcohol NGO peak body, NADA, indicates that less than 50% of the need for rehabilitation places are funded in NSW. This activity will seek to expand the availability of rehabilitation places available within CESPHN, with a focus on innovative and non-residential models, as recommended by NADA. In year 1 successful services will be provided with necessary establishment costs as part of their funding. Escalation to meet award increases and CPI will be provided at an agreed rate. This activity will be undertaken in consultation with the peak NGO body, and will involve service delivery by NGO s with specialist skills in addressing drug or alcohol problems. No, but specific needs for this group will be addressed in a later section of this plan. Excluding planning and procurement, activity is anticipated to begin October, 2016 and, subject to acceptable performance review, continue until June 30,

12 Non-residential rehabilitation services will be procured with an intention to cover the entire PHN region. Should suitably innovative residential services be proposed that meet procurement criteria they will, by their residential nature, be available to people both inside and outside the PHN region. Commissioning will occur via an approach to the market, assessed against criteria of: Value for money, Likely treatment effectiveness of proposed model based on evidence, Geographical coverage, Able to target identified gaps from the needs analysis The capacity to provide holistic interventions and manage clinical complexity Corporate governance and capacity to capture and submit relevant performance data and Track record of agency in treating drug & alcohol problems. Monitoring and oversight will be via contractual agreement with selected service providers inclusive of appropriate KPI s, six monthly review and quarterly payment of funding. In the first cycle data will be sourced from that collected by contracted agencies as part of their treatment process and overall volume growth will be sourced from the NADA performance database. 12

13 Proposed Activities Description of Drug and Alcohol Treatment Activity 2. Service capacity. 2.2 Improved withdrawal service referral pathways Facilitate improved withdrawal management provision and service linkages through: Mapping the capacity of existing residential withdrawal services against the criteria for intake to understand where and how services may be enhanced. Request from LHD s details on withdrawal management arrangements for local hospitals including appropriate referral pathways and entry criteria and disseminate to service providers within the LHD. Facilitate GP assisted withdrawal in the home through engagement of two Drug & Alcohol nurse liaison staff Develop agreed referral pathways from GP assisted withdrawal to residential rehab facilities. These activities will require collaboration with LHDs, primary care providers and residential rehabilitation providers. No Our improved withdrawal pathways approach will begin with information requests to LHDs in July 2016, with the mapping project to also begin at this time. The outcomes of both projects will be completed by December The referral pathways project will begin in July2016, and be completed by June Liaison nursing staff will be in place by January 2017, and this project will continue until June, 2019, Purchasing will only be required for nursing liaison staff. These staff can be recruited via market advertisement and employed with an appropriate organisation selected from the market based process. Not applicable until data set developed 13

14 Proposed Activities Description of Drug and Alcohol Treatment Activity 2. Service Capacity 2.3 Develop and improve aftercare and community care pathways. Improve the capacity and accessibility of community treatment models for aftercare and community care through: Map existing continuing / after care programs, supported living / transitional housing programs to understand where enhancements could be made Develop and trial models of aftercare post discharge. Develop and trial psychosocial support models of care for the Drug & Alcohol field that involve in-reach to people s homes This will involve collaboration with non-government community Drug & Alcohol service providers No The mapping project will begin January 2017 and be completed by March 2017 Model development will begin January 2017 and be completed by June Trials will begin by October 2017 subsequent to commissioning of relevant services. Mapping project will be -wide. Trials will be geographically targeted. Commissioning will only be required for the trials and this will be a market driven approach, consistent with parameters identified at activity 2.1. Data will be collected from successful trial providers. 14

15 Priority Area 3: Services for High Needs Populations There are a number of identified populations from the CESPHN Drug & Alcohol services needs analysis that are high risk for drug and alcohol disorders and are over-represented in the CESPHN region. Indigenous populations are not included in this priority area as the needs of that population are addressed separately later in this plan. Proposed Activities 3. Services for High Needs populations 3.1 Improved access to treatment services for families Improved access for families and children will be achieved through: Description of Drug and Alcohol Treatment Activity Mapping of referral pathways into existing services for families and children across NSW and disseminate to all CESPHN service providers. Prioritising future commissioning related to this group. This activity will require collaboration with Non-Government service providers with appropriately configured treatment services to allow for the admission of families with children. No Mapping to begin January 2017 and be completed by March Distribution of advice to occur from April to June Commissioning proposals from organisations proposing enhanced services to families will receive additional weighting in commissioning processes outlined in activity 2.1. Targeted commissioning to be considered in activity plan 2017/18. Mapping project will be managed from the operational funding tranche provided to the PHN. Any commissioning will be progressed consistently with the principles applied in activity 2.1 and this cohort will be favourably weighted in addressing submissions through activity 2.1 Data will be collected from service providers through the mapping project. 15

16 Proposed Activities Description of Drug and Alcohol Treatment Activity 3. Services for High Needs populations 3.2 Improved access for Culturally and Linguistically Diverse (CALD) communities CESPHN will partner with the Drug and Alcohol Multicultural Education Centre (DAMEC) to: Investigate unmet need for CALD Drug & Alcohol worker or training options for Drug & Alcohol workers to work more effectively with CALD groups. Look to train multi-lingual staff in specialist Drug & Alcohol interventions. Utilise skills of existing groups with community reach to engage with communities. This will involve direct collaboration with DAMEC No Project to begin October 2016 and all elements to be complete by December This activity will be commissioned via targeted EOI to agencies with specialist expertise in CALD issues and with specialist skills in this area. DAMEC workforce data. 16

17 Proposed Activities Description of Drug and Alcohol Treatment Activity 3. Services for High Needs populations 3.3 Develop more effective models of treatment for the LGTBIQ Community. In partnership with the AIDS Council of NSW (ACON), we will: Develop appropriate population health interventions to target drug misuse within the community. Develop guidelines, and associated training, for treatment services on best practice approaches to working with LGBTIQ individuals regarding drug misuse problems. This activity will require collaboration with the ACON, treatment service providers within CESPHN and appropriate consumer and carer groups. No Joint projects to begin April 2017 and to be completed by June Negotiations with ACON for direct contracting approach given their unique specialist skills in this area, established consumer and carer networks, expertise and lack of a competitive market for the services they provide. ACON surveys. 17

18 Proposed Activities Description of Drug and Alcohol Treatment Activity 3. Services for High Needs populations 3.4 Develop discharge responses to emergency department frequent presenters Develop a trial of referral pathways and GP follow up protocols for identified frequent presenters to Prince of Wales (POW) Hospital emergency department. The trial will examine the benefits of co-ordinated and intensive GP aftercare arrangements as a preventative measure to reduce representations to hospital. POW has been chosen as the location as this is the source of the data captured by the needs analysis that indicated the existence of the cohort. This activity will require collaboration with SESLHD, and primary care service providers. In the longer term potential involvement of NGO after care providers dependent upon outcomes of model development. No Project to begin January 2017 and be completed June 2018 POW Hospital catchment geographical area. A research officer will be recruited to collect data for 12 months and work with local GP s and NGO s to build an aftercare approach for this clientele. SESLHD Emergency department database. 18

19 Proposed Activities Description of Drug and Alcohol Treatment Activity 3. Services for High Needs populations 3.5 Targeted planning and consultation for the needs of young people Develop a regional youth drug & alcohol plan including a model of care for youth Drug & Alcohol interventions that includes population health, community and residential components. Undertake specific consultation with relevant youth representatives. This activity will require collaboration with representative community groups, NGOs with experience working with young people, LHDs and general practitioners with a specialist interest in the health issues of young people. No Plan to begin in January 2017, and to be completed by June Youth consultations to begin from July 2016 This project will be managed from the operational funding tranche provided to the PHN. Not applicable at this point 19

20 Priority Area 4: Managing Clinical complexity and clinical pathways. The Drug & Alcohol treatment system requires an individual to navigate supports from a range of providers with different expertise and with different approaches to engaging in treatment. This can often be daunting particularly for individuals who are suffering from the psychological and physical effects of misuse, and those dealing with the stigma associated with such a disorder. Most people with long term drug or alcohol misuse problems suffer from a range of associated disorders that form the common sequalae of use. Appropriate treatment requires a range of psychological and physical health interventions provided by multiple practitioners. This section addresses the need to make the transfer of care and movement within the system as simple and Proposed Activities Description of Drug and Alcohol Treatment Activity 4. Managing Clinical complexity and clinical pathways 4.1 Responding to high rates of pharmaceutical drug misuse. Develop an education campaign for prescribers regarding pharmaceutical drug misuse. Collect and report data on misuse in the local region with comparisons with other regions This activity will require collaboration with general practitioners and LHDs. No Education campaign to be developed in October 2016 and be completed by June Data sets identified, collated and reporting relevant data by June The education campaign will be commissioned via targeted EOI to agencies with expertise in pharmaceutical drug misuse. Not applicable at this point 20

21 Proposed Activities Description of Drug and Alcohol Treatment Activity 4. Managing Clinical complexity and clinical pathways 4.2 Providing support to practitioners to get involved in the treatment of Drug & Alcohol problems. Promote access to the Drug and Alcohol Specialist Advisory Service (DASAS). Build liaison capacity between sectors to assist with increasing clinical understanding, referral pathways knowledge and movement of complex clients This activity will require collaboration with addiction specialists, LHDs and general practitioners. No DASAS promotion to begin October Clinical liaison staff to be commissioned January Commissioning of provision of clinical liaison services will be via a call to market using the relevant parameters as expressed in activity 2.1. Funding may be aggregated across this activity and the liaison staff activity referenced at 2.2 if that looks as if it will provide the most efficient and effective outcomes. MBS data and OTP data 21

22 Priority Area 5: Population Health Response An effective overall community response requires both treatment interventions for those with a disorder and population level interventions to reduce future prevalence. Proposed Activities 5. Population Health Interventions 5.1 Reducing alcohol related harms Utilise existing education materials for primary care practices to improve the community s approach to alcohol, where necessary explore development of CALD specific materials. Description of Drug and Alcohol Treatment Activity Facilitate training for General Practice to improve early interventions for drug & alcohol use. Engage with and work with local Community Drug Action Teams (CDATs) on agreed priorities for improving outcomes in local communities. This activity will require collaboration with expert agencies involved in population health responses and general practitioners. No From July 2016 and ongoing These projects will be commissioned via targeted EOI s to relevant organisations with the necessary expertise to develop the desired materials and/or training. NSW Health Stats 22

23 Priority Area 6: Appropriate Support structures and program infrastructure. An effective program, operating with best practice principles and reinvesting in its expertise, requires appropriate program support structures to facilitate the delivery of successful treatment outcomes. This section details the delivery of appropriate supports to enhance those program outcomes. Proposed Activities Description of Drug and Alcohol Treatment Activity 6. Program Support and Infrastructure 6.1 Apply best practice principles to the planning and commissioning of services. The PHN will provide appropriate approaches to its corporate governance to support service providers by: Building pricing structures into commissioning models that incorporate all the components of service provision including support costs. Building contract provisions into commissioning models that create greater certainty for services and their clients through reasonable contract periods and transparent and predictable processes for contract renewals Seeking access to state data on service capacity and resourcing to better map existing service delivery. Seeking access to the calculators and pivot tables in the DASP modelling tool from State or Commonwealth health agencies to receive more precise modelling information on staffing and resources. This activity will require collaboration with central health departments at state and federal level, and with peak bodies for NGO service provision in NSW. No Principles in place July 2016 and ongoing. This project will be managed from the operational funding tranche provided to the PHN. Not applicable at this point 23

24 Proposed Activities Description of Drug and Alcohol Treatment Activity 6. Program Support and Infrastructure 6.2 Performance Report Subsequent to the research identifying all available data sets, and consequent negotiation with relevant agencies the PHN will: Develop a regional performance report utilising KPI s from the relevant sources that provides an effective snapshot of the regions performance This activity will require collaboration with NGO s, peak bodies, LHDs, research agencies, state and federal health departments and primary care providers. No Project to begin in July 2018 and be completed by June This project will be commissioned following assessment of responses to targeted EOI s to appropriately skilled research agencies. Not applicable at this point 24

25 2. (b) Planned activities: Services for Aboriginal and Torres Strait Islander people Flexible Funding PHNs must use the table below to outline the activities proposed to be undertaken within the period to These activities will be funded under the Schedule: Drug and Alcohol Treatment Activities, Item B.4 Services for Aboriginal and Torres Strait Islander people Flexible Funding. Refer to PHN Grant Programme Guidelines: Annexure A2 Services and Guidance for PHNs: Commissioning of Services for the list of in-scope activities. It is emphasised that PHNs are to consider strategies to support the workforce in delivering the proposed activities through promoting joined up assessment processes and referral pathways, and supporting continuous quality improvement, evidence based treatment and service integration. Note 1: Please copy and complete the table as many times as necessary to report on each activity. Note 2: Indicate within the duration section of the table the period of time between 2016 and 2019 that the activity will be undertaken. 25

26 Proposed Activities Description of Drug and Alcohol Treatment Activity 1. Governance and Oversight 1.1 Indigenous participation in governance Ensure appropriate participation in consultation committee for Drug & Alcohol. (see activity 1.1 in Drug & Alcohol Treatment Services Flexible funding schedule above) Ensure ACCHO involvement in clinical governance structures for the Drug & Alcohol program within CESPHN This project will require collaboration with all relevant service providers participating in the consultation committee as identified in schedule 2 activity 1.1, ACCHO organisations and relevant Indigenous peak organisations. Yes July 2016 and ongoing. Participation will be via direct invitation subsequent to appropriate consultations within the PHN region. Local PHN records 26

27 Proposed Activities Description of Drug and Alcohol Treatment Activity 2. Service capacity 2.1 Increased service capacity within CESPHN for specialist Drug & Alcohol services designed for Indigenous participants Drug & Alcohol rehabilitation services provide attitudinal and behaviour change skills to participants to achieve long tern behaviour change with regard to drug or alcohol dependence. Services can be residential, day only or community outreach and are provided by a mixture of professional and peer workers. Residential services generally have extended stays and do not have geographic catchments. As such local modelling of service need is generally focussed on specific high needs populations. There are few Indigenous specific rehabilitation programs in NSW. There are no services for Indigenous women and their children. This project will commission additional services with weighting to be provided to services that can demonstrate innovative and culturally appropriate models of care, and services that demonstrate they can provide effective services for women and families. In year 1 successful services will be provided with necessary establishment costs as part of their funding. Escalation to meet award increases and CPI will be provided at an agreed rate. This activity will be undertaken in consultation with the peak body for ACCHO s, the AHMRC, local Indigenous organisations and relevant consumer and carer representatives. Yes Excluding planning and procurement, activity is anticipated to begin October 2016 and, subject to acceptable performance review, continue until June 30, Non-residential rehabilitation services will be procured with an intention to cover the entire PHN region. Should suitably innovative residential services be proposed that meet procurement criteria they will, by their residential nature, be available to people both inside and outside the PHN region. Commissioning will occur via an approach to the market, assessed against criteria of: value for money, specific track record of providing culturally appropriate services to Indigenous people likely treatment effectiveness of proposed model based on evidence, 27

28 geographical coverage and appropriate targeting of need, The capacity to provide holistic interventions and manage clinical complexity corporate governance and capacity to capture and submit relevant performance data and track record of agency in treating drug & alcohol problems. Weighting will be given to high needs groups such as families and women with children. Monitoring and oversight will be via contractual agreement with selected service providers inclusive of appropriate KPI s, six monthly review and quarterly payment of disbursement. In the first cycle data will be sourced from that collected by contracted agencies as part of their treatment process and overall volume growth will be sourced from the NADA performance database and available AHMRC data. 28

29 Proposed Activities Description of Drug and Alcohol Treatment Activity 3. Services for high needs populations 3.1 Undertake a targeted service development initiative in collaboration with the AHMRC. Working with the AHMRC, develop, disseminate and measure compliance with relevant guidelines for Drug & Alcohol services to assist in making them more culturally appropriate for Indigenous people This project will require collaboration with the AHMRC, ACCHOs and relevant Drug & Alcohol NGO peaks and NGO service providers. Yes January 2017 and completed by September Targeted EOI to services that have expertise in the provision of health care to Indigenous people, in consultation with the AHMRC. It is anticipated the liaison staff member will be employed by the relevant successful health service. Data will be collected from service providers and the AHMRC. 29

30 Proposed Activities 4. Clinical pathways 4.1 Improving movement between services for Aboriginal people Description of Drug and Alcohol Treatment Activity As an adjunct to activity 3.1 above, commission liaison staff, employed by culturally respected organisations to assist in managing complex transitions of care between service providers involving Indigenous patients. Develop health pathways to facilitate the movement of individuals through Indigenous specific and non-indigenous specific services. This project will require collaboration with the AHMRC, ACCHO organisations and relevant Drug & Alcohol NGO peaks and NGO service providers. Yes July 2016 and ongoing Targeted EOI to services that have expertise in the provision of health care to Indigenous people, in consultation with the AHMRC. It is anticipated the liaison staff member will be employed by the relevant successful health service. Data collected from successful agency contacted for service provision. 30

31 Proposed Activities Description of Drug and Alcohol Treatment Activity 5. Program support structures 5.1 Flexible fund to improve data collections from agencies providing Drug & Alcohol services to Indigenous people. A small pool of funding that can be applied to data collection improvements from Indigenous agencies to improve policy, planning and reporting for this group. This project will require collaboration with the AHMRC, ACCHO organisations and relevant Drug & Alcohol NGO peaks and NGO service providers. Yes July 2016 and ongoing Small amounts of funds will be made available to facilitate data collection from organisations receiving treatment services funding, and organisations that will contribute to the PHN performance report will be prioritised. A willingness to submit data to assist PHN performance reporting will be a mandatory criteria. Not applicable 31

32 3. (a) Proposed Budget ( to ): Drug and Alcohol Treatment Services Operational and Flexible Funding Please attach the PHN s proposed budget for this item in an excel file, ensuring that the information requested below is represented. PHNs must provide an indicative three year budget from to , noting there will be opportunities to revise the budget in early 2017 and early 2018 as part of the annual update and review process for the Activity Work Plan. This budget should reflect funding as provided under the Schedule: Activities, Annexure D Budget ( Services Operational and Flexible Funding Activity) Flexible Funding $ 1,544, $ 1,544, (b) Proposed Budget ( to ): Drug and Alcohol Treatment Services for Aboriginal and Torres Strait Islander people Flexible Funding Please attach the PHN s proposed budget for this item in an excel file, ensuring that the information requested below is represented. PHNs must provide an indicative three year budget from to , noting there will be opportunities to revise the budget in early 2017 and early 2018 as part of the annual update and review process for the Activity Work Plan. This budget should reflect funding as provided under the Schedule: Activities, Annexure D Budget ( Services for Aboriginal and Torres Strait Islander people Flexible Funding Activity) Flexible Funding for Aboriginal and Torres Strait Islander Communities $ 372, $ 372,

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