Primary Health Networks Drug and Alcohol Treatment Activity Work Plan 2016-17 to 2018-19 Hunter New England & Central Coast Please note: This Activity Work Plan was developed in response to the HNECC PHN Drug and Alcohol Needs Assessment 2016, which was produced following considerable community consultation around Drug and Alcohol Need in the HNECC PHN region. The Needs Assessment and subsequent Activity Work Plan are recognised by our organisation as snapshots at a particular point in time and we are committed to recognising, understanding and responding to the ongoing and changing health needs of our region. This Plan was approved by the Department of Health on October 1, 2016 1
About this plan The Drug and Alcohol Treatment Activity Work Plan will help guide the Commissioning of HNECC PHN Drug and Alcohol Treatment services in the Hunter, New England and Central Coast region. This Drug and Alcohol Treatment activity work plan forms part of the annual reporting mechanism required by the Department of Health. The Drug and Alcohol Treatment Activity Work Plan provides a snapshot of how HNECC PHN will respond to Drug and Alcohol Treatment need across the Hunter, New England and Central Coast regions following on from the development of the HNECC PHN Needs Assessment 2016. HNECC PHN is committed to working on an ongoing and regular basis with its community to ensure health needs are understood and adequately responded to, and Activity Work Plans are updated to reflect this as deemed appropriate by the organisation. This Activity Work Plan has been developed in response to the Drug and Alcohol Treatment Needs Assessment 2016 and with consideration of the HNECC PHN Commissioning of Funding Guiding of Indigenous Services: Principles which can be found on the HNECC PHN website. These guiding Principles were developed in consultation with the region s Aboriginal and Torres Strait Islander community, ACCHOs and other Indigenous health organisations. 2
Introduction Overview The activities under the Drug and Alcohol Treatment 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 Drug and Alcohol Treatment Activity Work Plan covers the period from 1 July 2016 to 30 June 2019. 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 Drug and Alcohol Treatment Activity Work Plan template has the following parts: 1. The Strategic Vision of each PHN, specific to drug and alcohol treatment. 2. The Drug and Alcohol Treatment Services Annual Plan 2016-17 to 2018-2019 which will provide: a) A description of planned activities funded under the Schedule: Drug and Alcohol Treatment Activities, Item B.3 Drug and Alcohol Treatment Services Operational and Flexible Funding b) A description of planned activities funded under the Schedule: Drug and Alcohol Treatment Activities, Item B.4 Drug and Alcohol Treatment Services for Aboriginal and Torres Strait Islander people Flexible Funding 3
Annual Plan 2016-17 to 2018-2019 Annual plans for 2016-17 to 2018-2019 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 2016-17 to 2018-19 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 Drug and Alcohol Treatment Services. The Drug and Alcohol Treatment Annual Plan will also need to take into consideration the PHN Objectives and the PHN key priorities. Drug and Alcohol Treatment Services Funding From 2016-17, 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. 4
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 Drug and Alcohol Treatment Services. These will be reported through the Six Month and Twelve Month Performance reports and published as outlined in the PHN Performance Framework. Activity Work Plan Reporting Period and Public Accessibility The Drug and Alcohol Treatment Activity Work Plan will cover the period 1 July 2016 to 30 June 2019. A review of the Drug and Alcohol Treatment 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: Drug and Alcohol Treatment 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 Drug and Alcohol Treatment Services; Guidance for PHNs: Commissioning of Drug and Alcohol Treatment Services; Drug and Alcohol Treatment 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. 5
1. Strategic Vision for Drug and Alcohol Treatment Funding Drug and alcohol treatment services across the Hunter, New England and Central Coast regions are visible, accessible, integrated and appropriately resourced to handle the service demands of the community. Key elements of this strategic vision are: Visibility services are known to other health professionals, other service providers (e.g. social services, community services, law enforcement etc.) and the community. Accessibility services are easily accessible to those who need them and are provided in regions where individuals require treatment. Waiting times for access to services do not negatively impact patient outcomes nor deter individuals from seeking treatment. Integration different providers understand and work closely with each other to ensure collaborative relationships are developed and nurtured. Region-wide planning occurs at an appropriate level, utilising a patient-centred approach, to ensure: o decisions that may impact parts of the system are fully understood by all stakeholders o evidence-based, efficient and effective treatment services are supported o referral pathways and service integration occurs seamlessly between providers. Resourcing services that provide treatment for population groups within the community that are most vulnerable receive the greatest support. All HNECC PHN Activity Work Plans and health planning across the organisation are developed and initiated through a Quadruple AIM lens. 6
2. (a) Planned activities: Drug and Alcohol Treatment Services Operational and Flexible Funding PHNs must use the table below to outline the activities proposed to be undertaken within the period 2016-17 to 2018-19. These activities will be funded under the Schedule: Drug and Alcohol Treatment Activities, Item B.3 Drug and Alcohol Treatment Services Operational and Flexible Funding. Refer to PHN Grant Programme Guidelines: Annexure A2 Drug and Alcohol Treatment Services and Guidance for PHNs: Commissioning of Drug and Alcohol Treatment 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: Note 2: Please copy and complete the table as many times as necessary to report on each activity. Indicate within the duration section of the table the period of time between 2016 and 2019 in which the activity will be undertaken. 7
Proposed Activities Drug and Alcohol Treatment Priority Area / Reference (e.g. Priority Reference 1, 2, 3) Activity Title / Reference (e.g. Activity 1.1, 2.1, etc.) Description of Drug and Alcohol Treatment Activity Priority Area 1: Address the increased demand for access to specialist drug and alcohol treatment 1.1 Increase the service delivery capacity of the drug and alcohol treatment sector and contribute to a greater regional continuum of care The HNECC PHN Drug and Alcohol Health and Service Needs Assessment identified a current undersupply of treatment places and service-types, particularly specialist services for identified vulnerable populations within the Hunter, New England and Central Coast catchment. Various estimates put the percentage of demand being met at between 30% & 50%. Of particular concern, waitlists for a residential rehabilitation bed ranges between 3 to 6 months and the transitioning of clients between treatment-settings (specifically pre & post residential services) further heightened the risk of relapse as a result of regional gaps in service provision for continued care. HNECC PHN will release a selective Request for Tender (RFT) seeking proposals from providers of Drug and Alcohol treatment services in the HNECC catchment. The aim of this activity is to increase treatment and support placements within existing providers to better meet demand, especially for identified vulnerable populations and contribute to a greater continuum of care for clients through the commissioning of new drug and alcohol service-types, to address regional gaps in service provision. Drug and Alcohol treatment providers who provide services for the following identified vulnerable populations, or are able to evidence suitable capacity to do so, will be targeted for this activity-funding; Individuals with co-occurring substance use and mental health disorders Aboriginal and Torres Strait Islander peoples Pregnant Women (including Women with young children) Youth (16 24 years) Individuals exiting the criminal justice system The following service-types deemed in scope for this activity-funding will include; Withdrawal management; Specifically; 8
Support clients who are receiving withdrawal management services in Local Health District Clinics or primary care settings through case management / care coordination with aim of enabling improved access to placement in treatment services and reducing the onset of relapse whilst awaiting treatment placement, or; Provide withdrawal management services in an existing outpatient treatment setting (residential or non-residential day program) through off-site prescribing and on-site dispensing with pathways to post-acute withdrawal support and relapse prevention Psychosocial Counselling; Rehabilitation Day Program and other intensive non-residential programs; Specifically; Provide treatment and support for clients awaiting placement in residential programs, or post residential-treatment support Residential Rehabilitation (only applicable for those providers with existing infrastructure and additional capacity) In the delivery of service-type as listed above, Providers will be expected to; Provide case management or coordinated care for each client to enable access to appropriate health and allied support services Deliver brief intervention including reduction and overdose prevention information Engage families/carers and significant others in the delivery of treatment programs HNECC PHN will commission drug and alcohol treatment services to which utilise the following evidenced-based interventions; Cognitive behaviour therapy (CBT) Dialectical behaviour therapy (DBT) Acceptance and commitment therapy (ACT) Contingency management (CM) Community reinforcement approach Couples and family treatments Relapse Prevention (RP) Motivational Enhancement Therapy (MET) Collaboration This activity will not be a joint implementation, however consultation has been undertaken with NSW health services, Local Health Districts, Indigenous-health providers and the Non-government AOD peak body to consider regional need, currently funded services to avoid duplication and also to support greater regional coordination of service provision within the HNECC catchment. 9
The determination of the service-type specifications were developed on advice from the Network of Alcohol and Drug Agencies (NADA) and the NSW Ministry of Health. Indigenous Specific No. Duration 1/01/2017 30/06/2019 Coverage This activity will cover the entire HNECC PHN catchment, comprising of 15 SA3 s, however certain Local Government Area (LGAs) and regions will be targeted for commissioning as areas of greatest need as evidenced through the evaluative criteria in the Request for Tender process. Note that a number of the AOD services within the HNECC PHN provide treatment for clients from across the state and in some cases from throughout Australia. This includes the largest residential rehabilitation facility in Australasia. Commissioning approach This activity will be included in the commissioning process, the key stages of which are: open Expression of Interest for providers to deliver services in 2016-17 (with a possible 12-month extension); select request for tender issued; evaluation of submissions; and contract negotiation and execution with successful tenderers. This activity will be monitored through a comprehensive annual planning and quarterly reporting cycle. The provider will also provide an evaluation report at the completion of the Program, which will include qualitative and quantitative data, clinician and consumer feedback and indicators of the benefit of the service. This data will inform HNECC PHN s ongoing Needs Assessment and Commissioning cycle. Data source Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) aggregated by PHN catchment Data provided by Commissioned Providers to HNECC PHN in Annual and Quarterly reporting 10
Proposed Activities Drug and Alcohol Treatment Priority Area / Reference (e.g. Priority Reference 1, 2, 3) Activity Title / Reference (e.g. Activity 1.1, 2.1, etc.) Description of Drug and Alcohol Treatment Activity Priority Area 1: Address the increased demand for access to specialist drug and alcohol treatment 1.2 Support the workforce undertaking HNECC PHN Commissioned Services The aim of this activity is to support the workforce responsible for the successful delivery of PHN commissioned services, especially those commissioned to establish new services and who have not previously offered the commissioned service-type. Specifically, this activity seeks to support region-specific and integrated approaches to drug and alcohol treatment services; to align existing drug and alcohol services within the region with the establishment of new services; based on the local needs of clients and with a focus improved local care coordination. Capacity building and workforce development initiatives in scope for this funding include, but are not limited to; Activities that promote linked assessment processes and referral pathways between new and existing providers; Continuous quality improvement- including clinical governance arrangements; Staffing qualifications and professional development to ensure service provision is responsive to the changing needs of the community; The delivery of evidence-based treatment approaches; The development of local service integration and coordination solutions; Measures for ensuring appropriate data collection and reporting systems to report against local performance indicators; Activities that ensure targeted and culturally appropriate drug and alcohol treatment for Indigenous Australians which are linked with broader Indigenous health services; Activities that promote stepped care models based on, and tailored to regional need; and Activities that better support local integrated treatment and referral pathways to support clients with comorbid mental health disorders. The development of progressive / culturally appropriate local models of care will also be considered. Collaboration This activity will not be a joint implementation, however consultation will be sought with NSW health services, Local Health Districts, Indigenous-health providers and the Non-government AOD peak body in determining further opportunities for collaborative capacity building opportunities i.e. HNECC Catchment-specific Drug and Alcohol Symposium, local systems-based approaches that support change in alcohol and drug use and issues in practice environments etc. 11
Indigenous Specific No. Duration 1/01/2017 30/06/2017 Coverage This activity will cover the entire HNECC PHN catchment, comprising of 15 SA3 s, however certain Local Government Area (LGAs) and regions will be targeted where new drug and alcohol services have been commissioned to ensure for integration with existing service provision. Commissioning approach This activity will be included in the commissioning process, the key stages of which are: open Expression of Interest for providers; select request for tender issued; evaluation of submissions; and contract negotiation and execution with successful tenderers. This activity will be monitored through a comprehensive annual planning and quarterly reporting cycle. The provider will also provide an evaluation report at the completion of the Program, which will include qualitative and quantitative data, clinician and consumer feedback and indicators of the benefit of the service. This data will inform HNECC PHN s ongoing Needs Assessment and Commissioning cycle. Data source Data provided by Commissioned Providers to HNECC PHN in Annual and Quarterly reporting Proposed Activities Drug and Alcohol Treatment Priority Area / Reference (e.g. Priority Reference 1, 2, 3) Activity Title / Reference (e.g. Activity 1.1, 2.1, etc.) Description of Drug and Alcohol Treatment Activity Priority Area 2: Address the need for improved regional care coordination and service integration amongst drug and alcohol treatment and support providers within the Hunter, New England and Central Coast Catchments 2.1 Establish Regional Drug and Alcohol Practice Networks within each of the sub-regions of the Hunter, New England and Central Coast Catchments The HNECC PHN Drug and Alcohol Health and Service Needs Assessment identified that networks between service providers are varied and are often dependent on informal communication, restricting the coordination and continuum of care for clients within the treatment system. The HNECC PHN will seek to establish Regional Drug and Alcohol Practice Networks, or provide support where existing through formalised partnerships, within each of the Hunter New England and Central Coast Catchments, to improve the coordination and 12
integration of drug and alcohol treatment practices and other relative service systems across Primary Health Care, State Health Services, Aboriginal Community Controlled Health Services and Non-Government Services (including cross sectoral where required). The Networks will seek to establish region-specific linkages with drug and alcohol treatment providers across all treatment-settings (as listed above), mental health treatment providers as well as broader health and allied community services where required, to contribute to a greater regional coordination and continuum of care for clients who experience substance misuse and/or cooccurring mental health disorders. The objectives of the Networks may include; Improving access to drug and alcohol treatment services within each region, through the promotion of referral pathways and service-entry requirements, joined up assessment (where applicable) and wait-list durations Improving the efficiency and reducing duplicity within local drug and alcohol treatment services through the development of localised, integrated care solutions to ensure for a greater continuum of care for clients Improving the exchange of information between Primary Health Care, State Health Services, Local Health Districts, Aboriginal Community Controlled Health Services and Non-Government Drug and Alcohol Treatment Services Identifying localised emerging drug and alcohol treatment demands, access barriers and exploring solutions from a grassroots level Identifying emerging challenges for local drug and alcohol workforces Identify quality improvement for regional service integration and coordination Contribute to the continuing planning of health and service needs of the HNECC PHN from a regional perspective Develop and deliver community education and awareness campaigns in collaboration with Community Drug Action Teams (CDATS) Collaboration Indigenous Specific HNECC PHN will lead the establishment of the Regional Drug and Alcohol Practice Networks, in collaboration with Local Health Districts, State Health Services, Non-government Organisations and respective peak bodies and Primary Health Care Providers including the Aboriginal Community Controlled Health until such time as a lead agency is appointed. No, however the Aboriginal Community Controlled Health Sector will be integral in the establishment and maintenance of the Regional Networks Duration 1/01/2017 30/06/2019 Coverage This activity will cover the sub-regions of the Hunter, New England and Central Coast Catchments 13
Commissioning approach Data source This activity will not be commissioned. Data against these indicators will be collected from internal data sources. This does not form part of a national data set. Data collection will commence from activity commencement date 1 July 2016. 2. (b) Planned activities: Drug and Alcohol Treatment 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 2016-17 to 2018-19. These activities will be funded under the Schedule: Drug and Alcohol Treatment Activities, Item B.4 Drug and Alcohol Treatment Services for Aboriginal and Torres Strait Islander people Flexible Funding. Refer to PHN Grant Programme Guidelines: Annexure A2 Drug and Alcohol Treatment Services and Guidance for PHNs: Commissioning of Drug and Alcohol Treatment 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: Note 2: Please copy and complete the table as many times as necessary to report on each activity. Indicate within the duration section of the table the period of time between 2016 and 2019 that the activity will be undertaken. Proposed Activities Drug and Alcohol Treatment Priority Area / Reference (e.g. Priority Reference 1, 2, 3) Priority Area 3: Address the increased demand for access to specialist drug and alcohol treatment services for Aboriginal and Torres Strait Islander Peoples 14
Activity Title / Reference (e.g. Activity 1.1, 2.1, etc.) Description of Drug and Alcohol Treatment Activity 3.1 Increasing the service delivery capacity of the Aboriginal Community-Controlled Health Sector and mainstream drug and alcohol treatment providers in providing culturally-appropriate, holistic treatment and support for Aboriginal and Torres Strait Islander Peoples presenting with substance use disorders HNECC PHN will release a selective Request for Tender (RFT) seeking proposals from the Aboriginal Community Controlled Health Sector and mainstream drug and alcohol treatment providers for the provision of drug and alcohol treatment and support services in the HNECC catchment. The aim of this funding is to increase the capacity of Aboriginal Community Controlled Health Services and mainstream drug and alcohol treatment providers in providing holistic, comprehensive and culturally appropriate drug and alcohol treatment and support services for Aboriginal and Torres Strait Islander Peoples, particularly those services that target the following priority cohorts; Indigenous peoples with co-occurring substance use and mental health disorders Pregnant Indigenous women and/or those with young children Indigenous Youth (16 24 years) Indigenous peoples exiting the criminal justice system The following service-types deemed in scope for this activity-funding will include; Withdrawal management; Specifically; Support clients who are receiving withdrawal management services in Local Health District Clinics or primary care settings through case management / care coordination with aim of enabling improved access to placement in treatment services and reducing the onset of relapse whilst awaiting treatment placement, or; Provide withdrawal management services in an existing outpatient treatment setting (residential or non-residential day program) through off-site prescribing and on-site dispensing with pathways to post-acute withdrawal support and relapse prevention Psychosocial Counselling; Rehabilitation Day Program and other intensive non-residential programs; Specifically; Provide treatment and support for clients awaiting placement in residential programs, or post residential-treatment support Residential Rehabilitation (only applicable for those providers with existing infrastructure and additional capacity) 15
Culturally appropriate progressive models of care will also be considered Collaboration Indigenous Specific This activity will not be a joint implementation, however consultation has been undertaken with NSW health services, Local Health Districts, Aboriginal Community Controlled Health Organisations and Non-government specialist AOD treatment providers to whom provide services to Aboriginal and Torres Strait Islander Peoples, to consider currently funded services to avoid duplication and support greater regional coordination of service provision within the HNECC catchment. YES Duration 1/07/2016 30/06/2019 Coverage This activity will cover the entire HNECC PHN catchment, comprising of 15 SA3 s, however certain Local Government Area (LGAs) and regions will be targeted for commissioning as areas of greatest need as evidenced. Note that a number of the Aboriginal Community Controlled AOD services within the HNECC PHN region provide treatment for clients from other PHN regions both within NSW and interstate. Commissioning approach This activity will be included in the commissioning process, the key stages of which are: open Expression of Interest for providers to deliver services in 2016-17 (with a possible 12-month extension); select request for tender issued; evaluation of submissions; and contract negotiation and execution with successful tenderers. This activity will be monitored through a comprehensive annual planning and quarterly reporting cycle. The provider will also provide an evaluation report at the completion of the Program, which will include qualitative and quantitative data, clinician and consumer feedback and indicators of the benefit of the Service. This data will inform HNECC PHN s ongoing Needs Assessment and Commissioning cycle. Data source Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) aggregated by PHN catchment OchreSTREAMS online services report Data provided by Commissioned Providers to HNECC PHN in Annual and Quarterly reporting 16
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