Updated Activity Work Plan 2016-2019: Drug and Alcohol Treatment COORDINARE - South Eastern NSW PHN When submitting this Activity Work Plan 2016-17 to 2018-19 to the Department of Health, the PHN must ensure that all internal clearances have been obtained and the document has been endorsed by the CEO. The Activity Work Plan must be lodged to <name of Grant Officer> via email <email address> on or before 17 February 2017.
Overview This Drug and Alcohol Treatment Activity Work Plan covers the period from 1 July 2016 to 30 June 2019 and is an update to the Activity Work Plan submitted to the Department in May 2016. To assist with PHN planning, each activity nominated in this work plan can be proposed for a period of up to 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. Important documents to guide planning The following documents will 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. Guidance for PHNs: Commissioning of Drug and Alcohol Treatment Services The Guidance for PHNs: Commissioning of Drug and Alcohol Treatment Services document (available on the PHN Secure Data Portal) has been developed to assist PHNs in understanding the Department s expectations in relation to activities that are in scope for funding, and will assist in translating drug and alcohol treatment evidence into a practical approach. The high-level activities in scope under Flexible Funding allocations include: Early intervention (including Brief Intervention) Counselling Withdrawal Management (with pathways to post-acute withdrawal support) Residential Rehabilitation (with pathways to post-acute withdrawal support) Day Stay Rehabilitation (and other intensive non-residential programs) Post treatment support and relapse prevention Case management, care planning, and coordination Supporting the workforce through activities which promote joint up assessment and referral pathways, quality improvement, evidence based treatment, and service integration. Activities relating to planning and consultation are to be funded under the Operational Funding allocation. Key principles underpinning activity requirements Drug and Alcohol Treatment Activity Work Plans are also expected to satisfy the following key principles underpinning drug and alcohol activity requirements: i. Proposed activities are evidence-based and in-scope of funding as detailed in Guidance for PHNs: Commissioning of Drug and Alcohol Treatment Services.
ii. Proposed activities are clearly aligned with priorities identified in the corresponding Needs Assessment. iii. The majority of total Flexible Funding available is allocated to the delivery of specialist drug and alcohol service delivery (i.e. direct treatment activities) as opposed to nontreatment activities (e.g. workforce development, also in scope of this funding). iv. Detailed budgets are provided outlining funding for three years (2016-17 to 2018-19) with a clearly identified allocation for each activity (including sub-activity) type. v. Proposed activities for Indigenous-specific and mainstream services are clearly delineated, including evidence of consultation and engagement from local key Indigenous stakeholders. vi. Governance arrangements are clearly articulated, and include representation from key regional stakeholders such as Local Health Networks (or equivalent), State Government and specialist drug and alcohol service providers. This funding is intended to complement existing Commonwealth and state and territory funded drug and alcohol treatment activities. Therefore, it is expected that existing state and territory funding, strategies, and frameworks are considered in the development of your Annual Plan to ensure services are complementary and do not duplicate existing efforts.
1. Strategic Vision for Drug and Alcohol Treatment Funding Our strategic vision is informed by analysis of the disparate drug and alcohol related needs across our region, and stakeholder participation. 19 organisations (including Aboriginal Community Controlled organisations), with 46 points of input, contributed to our drug and alcohol needs analysis, which fed into this Activity Work Plan. People in South Eastern NSW who have drug or alcohol treatment needs will achieve better outcomes through COORDINARE s focus on: population health messages and community education early intervention innovative service models for diverse communities accessible and improved quality treatment increased service capacity strong relationships and easier transfer of care between treatment services and sectors commissioning services for people with identified high treatment needs good governance and planning workforce capacity building service provider program infrastructure and support needs We embrace diversity and partnership in responding to the multiple and complex drug and alcohol treatment needs of the people of South Eastern NSW, including the engagement of non-government organisations (NGOs), our primary care partners, private health organisations and Local Health Districts (LHDs). For example, we formed an expert and geographically representative evaluation panel for our drug and alcohol Request for Proposal: Clinical Director, NADA General Practitioners x 2 (North and South) LHD Drug and Alcohol Managers x 2 (North and South) Aboriginal representative cultural guidance Consumer representative lived experience COORDINARE actively seeks consumer participation in the design and delivery of services, whilst recognising the sector-wide challenges associated with this strategy. All activity is subject to our structured corporate governance approach. Our Board and, where appropriate, our Clinical Councils and Community Advisory Group, receive regular reports and review progress. Our contracts expect that providers operate within the guiding principles of our Clinical Governance Framework, in line with clinical best practice. Our systems and processes establish clear support and accountabilities with providers, which include reporting mechanisms and audit. COORDINARE has agreed regular meetings with both LHDs. We are jointly exploring COORDINARE/ LHD bi-annual sector planning and review forums, and a region-wide consultative and advisory mechanisms. COORDINARE recognises that no single agency or approach can respond to the range of drug and alcohol related needs. We pursue collaborative opportunities in our day to day practice and in commissioning activities, forming linkages within and beyond the drug and alcohol sector. We
emphasise the importance of families and communities, and the potential for the broader human services system to add value to traditional drug and alcohol treatment approaches. This is particularly relevant for our Aboriginal and Torres Strait Islander peoples and communities. One example: our Service Development and Performance Manager Drug and Alcohol has joined the ACI Drug and Alcohol PHN Working Group, with three projects (to be ratified) for 2017: 1. Aboriginal Drug and Alcohol Workshop - effective drug and alcohol treatment approaches 2. Drug and Alcohol Shared Care Model of Care 3. Data Collection
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. Note: 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. Please copy and complete the table as many times as necessary to report on each activity. Priority Area 1: Governance and Oversight This section details our commitment to collaborative oversight and shared governance, improved relationship building, planning and clinical review. This section is developed in recognition of the need for effective partnerships in leadership to drive system change and improvement. Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity 1.1 Region wide liaison with D&A treatment service providers. Modified activity 6
Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration Indigenous Specific Duration Coverage Commissioning method Approach to market 1. Governance and Oversight Establishment of region-wide consultative and advisory mechanisms with other service providers that allow for greater collaboration including shared planning, shared service development, a joint approach to referral pathways and potentially clinical governance arrangements. It is anticipated that arrangements will include Local Health Districts, local NGO s, ACCHO s and primary care providers and as well as improving alignment of commissioning and planning, will also help to improve transitions of care between sectors. Specific initiatives will include: Holding regular meetings with the Local Health District executive and management of drug and alcohol services Exploring COORDINARE/ LHD bi-annual planning and review forums. Developing a drug and alcohol consumer participation approach. Organisations such as LHDs, local NGOs, ACCHOs, primary care providers, human services sector providers who work with people who require drug and alcohol treatment services. This activity is a stakeholder engagement and consultation approach. As above, this activity will attempt to engage all other sector providers within the PHN. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. Region-wide forum invitations and explanatory information was distributed in June 2016, and the first meeting held in July 2016. Planning for the other activities commenced in January 2017 and will be ongoing. Entire PHN region N/A N/A 7
Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration Indigenous Specific 1.2 Progress cross sectoral foundation projects to underpin future decision making Modified activity 1. Governance and Oversight Under the auspices of the consultation structure established at 1.1 the following projects are occurring on a cross sectoral basis: Development of a regional Drug and Alcohol strategy including use of the Drug & Alcohol Services Planning tool this Activity Work Plan maps the first phase of this strategy. Capacity and resourcing mapping exercise within PHN with associated gap analysis using population modelling the COORDINARE Drug and Alcohol Needs Analysis represents the first phase of this strategy. Cross sectoral role delineation framework that outlines each sector s target areas of accountability and priority service delivery domains, and delineates these from other sectors. This activity will identify and prioritise people who require drug and alcohol treatment services in different parts of the region with different geographic, demographic and experiential needs. Stakeholders described at 1.1 will participate in this process, amongst others including our Clinical Councils and Community Advisory Committee. This will be a collaborative exercise with stakeholders within the PHN region. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. Duration Activity start date July 2016. Activity completion date December 2017 Coverage Entire region 8
Commissioning method Approach to market N/A N/A 9
Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity 1.3 Region-wide Clinical Quality mechanism. Modified activity 1. Governance and Oversight Develop a joint clinical quality assurance mechanism which could include PHN funded service providers, Aboriginal community controlled organisations and LHD clinical staff to assist in developing quality approaches such as agreed referral pathways, case conferencing processes, cross service complex case reviews and adverse event reviews. This activity will be further developed in line with COORDINARE s Clinical Governance Framework. Target population cohort Consultation Collaboration Indigenous Specific Duration Coverage Commissioning method Approach to market GPs and organisations such as LHDs, local NGOs, ACCHOs, primary care providers, human services sector providers who work with people who require drug and alcohol treatment services. This activity is a stakeholder engagement and consultation approach. Stakeholders within the PHN region will participate collaboratively. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. 2017 2018 financial year Region-wide coverage N/A N/A 10
Priority Area 2: Service Capacity Service capacity must be built to match the gaps in the suite of available treatment services, that reflect the needs of local populations and there diversity. The Drug & Alcohol program offers withdrawal services, outpatient and community services, court diversion, residential and other rehabilitation services, hospital liaison services, aftercare and opioid substitution therapies. It is imperative that in enhancing service capacity there is not duplication of effort with other providers and funding bodies, and effort is 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 Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort 2.1 Enhanced Rehabilitation Capacity Existing activity 2. Service capacity. Expanded access to drug and alcohol rehabilitation services that reflect the needs of the local population. Services can be residential, day only or community outreach and are provided by a mixture of professional and peer workers. Local modelling of service need is generally focussed on specific high needs populations. Epidemiologically based modelling by the NSW drug and alcohol NGO peak body, NADA, indicates that less than 50% of the need for rehabilitation places are funded in NSW. This activity expands the availability of rehabilitation services available within the PHN, with a focus on innovative and non-residential models, as recommended in the NADA toolkit. Residents of South Eastern NSW who require drug and alcohol treatment services. 11
Consultation Collaboration Indigenous Specific Duration Coverage Commissioning method Widespread consultations with drug and alcohol treatment services, Aboriginal Community Controlled Organisations, LHD and other relevant stakeholders. With the peak NGO body, and NGO service providers with specialist skills in addressing drug or alcohol treatment needs. No, however the RFP will include a component for the provider to describe their strategy for ensuring cultural safety for Aboriginal and Torres Strait Islanders. Excluding planning and procurement, activity is anticipated to begin February 2017 and, subject to acceptable performance review, continue until June 30, 2018, with an option to renew for another 12 months. Rehabilitation, withdrawal, psychosocial counselling and support, and/or aftercare services will be commissioned with an intention to respond to the highest needs of the 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 followed an approach to the market, assessed against criteria relating to: 1. The Treatment Model 2. Organisational capacity 3. Resource management, including value for money Approach to market Weighting is to proposals that demonstrated: Innovative models Stepped care approaches Coverage of identified geographic gaps such as Eurobodalla and the Monaro region Streamlined entry and assessment processes Services for families with children Commissioning for this activity will allow for co-commissioning with other service providers such as LHDs or state health departments, or commissioning with other PHNs across geographical boundaries. Request for Proposal (RFP) process as an open tender. 12
Monitoring and oversight will be via contractual agreement with selected service providers inclusive of appropriate KPIs and six monthly review. Contracts include key deliverables which are oversighted by a Service Development and Performance Manager, and include evaluation and outcome measures. Key monitoring and evaluation features include: An iterative process relating to accuracy and relevance of the product occurs between the contractor and COORDINARE, prior to the final deliverable being agreed. Service provision will be reviewed for value for money and consumer outcomes. We will work with providers to ensure that funds are allocated and expended effectively. We will develop a regular, scheduled, internal review mechanism, with feedback to the provider, in a continuous improvement cycle. Internal reporting to Executive and the Board includes evaluation of the process and outcome of the contract. 13
Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity 2.2 Improved use of withdrawal service referral pathways Modified activity 2. Service capacity. Promote use of Clinical Care and Referral Pathways developed by clinical work groups and the HealthPathways program, which will engage services to outline withdrawal management arrangements for local hospitals and NGOs including appropriate referral pathways and entry criteria. Through relevant HealthPathways, this activity will enable: GPs to be better placed to provide assisted withdrawal in the home agreed referral pathways from GP assisted withdrawal to residential rehab facilities dissemination of information to service providers within the SESNSW PHN catchment Implementation will occur through education events, redesign and system improvements and will include GPs and other relevant service providers. This will activity will help patients avoid going to hospital for withdrawal management, which can effectively be managed outside of hospital, improving overall care coordination across the region. We will monitor the impact of this activity to assess whether the approach makes any difference to GPs who make referrals. Target population cohort We will apply a continuous improvement approach to the process of Electronic Medical Record (EMR) automatic discharge summaries that can be sent to GPs, which is dependent of client consent at the commencement of treatment. People who require medicated and/or structured withdrawal management as part of their drug and/or alcohol treatment. GPs and drug treatment service providers 14
Consultation Collaboration Indigenous Specific Stakeholder engagement occurs regularly through GP Cluster meetings across the region; provision of feedback mechanisms on each HealthPathways page, and through regular provider surveys for prioritisation and evaluation of pathways. NGO and consumer/carer engagement in this process will be by invitation. In 2017, further consultation will include consumer groups to inform the development of a HealthPathways consumer portal. These activities will require collaboration with Local Health Districts, primary care providers and NGO service providers to No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. Duration March 2017 and will be completed by June 2018. Coverage Commissioning method Approach to market Region-wide coverage N/A N/A 15
Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration Indigenous Specific 2.3 Develop and improve aftercare and community care pathways. Existing activity 2. Service Capacity Improve the capacity and accessibility of community treatment models for aftercare and community care through: Mapping existing and continuing after care programs, step up/step down, supported living / transitional housing programs to understand where enhancements could be made, ensuring they are documented through the HealthPathways program Commissioning trials of innovative models of aftercare current models include SMART (Self Management And Recovery Training) and Be SMART (for families) People who are exiting care arrangements with rehabilitation and withdrawal management services, and who may be transitioning to community living and/or other support providers. The activity will consult with LHDs, NGO and Aboriginal drug and alcohol treatment service providers, AMS Collaboration, as a co-design process, will include the successful provider for the trial project, consumer representatives, the LHDs and COORDINARE No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. Duration The mapping project will begin January 2017 and be completed by December 2017 Trial Commissioning will begin July 2018 and be completed by June 2019. Coverage Mapping project will be region-wide. Trials will be geographically targeted. 16
Commissioning method Approach to market Commissioning will only be required for the trials and this will be a market driven approach, consistent with parameters identified at activity 2.1. Favourable weighting will be applied to evidence based, step up/step down approaches. Open tender for 2018-19 trial: Monitoring and oversight will be via contractual agreement with selected service providers inclusive of appropriate KPIs and six monthly review.contracts include key deliverables which are oversighted by a Service Development and Performance Manager, and include evaluation and outcome measures. Key monitoring and evaluation features include: An iterative process relating to accuracy and relevance of the product occurs between the contractor and COORDINARE, prior to the final deliverable being agreed. Service provision will be reviewed for value for money and consumer outcomes. We will work with providers to ensure that funds are allocated and expended effectively. We will develop a regular, scheduled, internal review mechanism, with feedback to the provider, in a continuous improvement cycle. Internal reporting to Executive and the Board includes evaluation of the process and outcome of the contract. 17
Priority Area 3: Services for High Needs Populations Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity 3.1 Improved access to treatment services for families Existing activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration Indigenous Specific 3. Services for High Needs populations Improved access for families and children will be achieved through: Map referral pathways into existing services for families and children across NSW and disseminate to all service providers in the SENSW PHN catchment. Recommend evidence-based treatment approaches for family-sensitive drug and alcohol treatment services current models include Be SMART Allocate a small amount of funding, approximately $100,000 to be available to commissioned services from activity 2.1 in year 1 to make the services more family-sensitive. Prioritise future commissioning related to this group. Children raised in families with parental substance use, parents with children or adolescents who have substance use, other family members of individuals who have substance use. The activity will consult with LHDs, NGO and Aboriginal drug and alcohol treatment service providers, AMS as well as with key child and family services such as the Family Referral Services, FACS. This activity will require collaboration with NGO service providers that provide family-sensitive treatment services. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. 18
Duration Coverage Mapping to begin January 2017 and be completed by March 2017. Distribution of advice to occur from April to June 2017. Commissioning proposals from organisations proposing enhanced services to families received additional weighting in commissioning processes outlined in activity 2.1. Targeted commissioning to be considered in activity plan 2017/18. Region-wide coverage Commissioning method Commissioning was progressed consistently with the principles applied in activity 2.1 Approach to market Open tender for the provision of family-sensitive programs, as part of the RFP under 2.1 Monitoring and oversight will be via contractual agreement with selected service providers inclusive of appropriate KPIs and six monthly review.contracts include key deliverables which are oversighted by a Service Development and Performance Manager, and include evaluation and outcome measures. Key monitoring and evaluation features include: An iterative process relating to accuracy and relevance of the product occurs between the contractor and COORDINARE, prior to the final deliverable being agreed. Service provision will be reviewed for value for money and consumer outcomes. We will work with providers to ensure that funds are allocated and expended effectively. We will develop a regular, scheduled, internal review mechanism, with feedback to the provider, in a continuous improvement cycle. Internal reporting to Executive and the Board includes evaluation of the process and outcome of the contract. 19
Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration Indigenous Specific 3.2 Improved planning for service responses for youth Modified activity 3. Services for High Needs populations Develop a regional youth drug and alcohol component of our Regional Drug and Alcohol Strategy. Review, analyse and be informed by existing, relevant youth-focused plans eg, those relating to drug and alcohol use, mental health, homelessness, employment Explore the feasibility of a regional youth advisory forum, or identify an existing youth council or advisory group such as those operated by headspace, local Council or the youth homelessness sector. Ensure Aboriginal young people are an integral part of this activity. Young people with substance use. Local Councils, youth-specific services both drug and alcohol and mental health focussed (such as headspace), NGO drug and alcohol treatment services, LHDs, AMS will be invited to participate in this activity. This activity will require collaboration with representative groups with experience working with young people. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. Duration Plan to begin in January 2017, and to be completed by June 2018. Young people s participation in regional liaison group to begin in July 2017. Coverage Commissioning method Approach to market Region-wide coverage N/A N/A 20
Priority Area 4: Managing clinical complexity and clinical pathways. Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration Indigenous Specific 4.1 Improving the management of mental health and drug & alcohol co-occurring disorders Modified activity 4. Managing Clinical complexity and clinical pathways Ensure representation of mental health provider(s) in drug and alcohol consultative and advisory mechanisms Review, analyse and be informed by the Comorbidity framework for action (NSW Health), and subsequent training/workshops and other opportunities People living with co-morbidity of substance misuse and mental illness. LHDs, Mental health and drug and alcohol service providers, AMS and other NGO support services, consumers, GPs This activity will require collaboration with representative community groups, consumers, LHDs and GPs with a specialist interest in mental illness and/or drug and alcohol misuse. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. Duration Consultative and advisory mechanisms to begin in July 2016. Coverage Commissioning method Approach to market Region-wide coverage N/A N/A 21
Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration Indigenous Specific 4.2 Responding to high rates of pharmaceutical drug misuse. Modified activity 4. Managing Clinical complexity and clinical pathways Develop materials to raise awareness and assist GP s to manage requests for opiate medications. General Practitioners, which will assist people who use opiate medications in preventing and responding to misuse With General Practitioners, LHDs, Addiction Medicine Specialists, Managers of Nursing Services, and other subject matter experts. This activity will require collaboration with general practitioners and LHDs. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. Duration March 2017 December 2017 Coverage Commissioning method Region-wide coverage A think tank of subject matter experts will: scope the challenges and potential pathways for people with pharmaceutical drug misuse who present to GPs this will include all those professionals who are listed under Consultation, above. develop the Terms of Reference for commissioning relevant resources to assist GPs manage requests for opiate medications oversight the EOI process The resources will be commissioned via targeted EOI to agencies with expertise in pharmaceutical drug misuse such as the RACGP, NDARC, NPS Medicine Wise. 22
Approach to market EOI Monitoring and oversight will be via contractual agreement with selected agencies inclusive of appropriate KPIs. 23
Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration Indigenous Specific 4.3 Providing support to address reluctance of some practitioners to get involved in providing drug and alcohol treatment. Modified activity 4. Managing Clinical complexity and clinical pathways Promote access to the Drug and Alcohol Specialist Advisory Service (DASAS) to ensure clinicians receive timely and informed advice.develop appropriate HealthPathways, which will build liaison capacity between sectors to assist with increasing clinical understanding, referral pathways knowledge and movement of complex clients. This will include exploring pathways for people coming out of prison who need stabilisation relating to drug and alcohol use, and who need to be linked into GPs and pharmacies. Both the Illawarra-Shoalhaven and Southern NSW/ACT HealthPathways programs will be involved in this activity. Explore barriers, and solutions, to GPs taking up treatment approaches for people who have drug and alcohol use. Facilitate access to additional clinical expertise as identified through ongoing planning and consultation with service providers. People who have complex needs and require drug and alcohol treatment services. This activity will require consultation with addiction specialists, LHDs, general practitioners, professionals in the criminal justice system to design a model of care. This activity will require collaboration with addiction specialists, LHDs, professionals in the criminal justice system and general practitioners in the implementation. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. 24
Duration DASAS promotion to begin March 2017. Coverage Commissioning method Approach to market HealthPathways development to commence from January 2017. Access to additional clinical expertise to commence from March 2017 (subject to further planning and consultation). Region-wide coverage Subject to identification of additional clinical expertise requirements. Monitoring and oversight will be via contractual agreement with selected service providers inclusive of appropriate KPIs and six monthly review. Contracts include key deliverables which are oversighted by a Service Development and Performance Manager, and include evaluation and outcome measures. Key monitoring and evaluation features include: An iterative process relating to accuracy and relevance of the product occurs between the contractor and COORDINARE, prior to the final deliverable being agreed. Service provision will be reviewed for value for money and consumer outcomes. We will work with providers to ensure that funds are allocated and expended effectively. We will develop a regular, scheduled, internal review mechanism, with feedback to the provider, in a continuous improvement cycle. Internal reporting to Executive and the Board includes evaluation of the process and outcome of the contract. 25
Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration Indigenous Specific 4.4 Targeted approaches to methamphetamine use. Existing activity 4. Managing clinical complexity and clinical pathways Prepare resources for addressing the multiple consequences of long-term methamphetamine use, with particular reference to psychiatric consequences of use and blood borne virus risk. A think tank of subject matter experts will: review, analyse and be informed by current and promising methamphetamine specific, and stimulant treatment programs in the Illawarra Shoalhaven LHD and other regions what do we already have, and what needs to be done? develop the Terms of Reference for commissioning assessment guidelines oversight the EOI process The resources will be commissioned via targeted EOI to agencies with expertise in pharmaceutical drug misuse such as the Chapter of Addiction Medicine of the RACP, BDI and NDARC. Trial methamphetamine specific treatment interventions. People who use methampetamines and other stimulants General practitioners, the Chapter of Addiction Medicine, Black Dog Institute, research agencies and LHDs. This activity will require collaboration with general practitioners, the Chapter of Addiction Medicine, Black Dog Institute, research agencies and LHDs. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. 26
Duration Guidelines: February 2017 June 2017. Trials: July 2017 for completion by June 2018. Coverage Commissioning method Approach to market Region-wide coverage The guidelines will be commissioned via targeted EOI to agencies with expertise in pharmaceutical drug misuse such as the Chapter of Addiction Medicine of the RACP, BDI and NDARC. Trials will be commissioned via a call to market. Request for Proposal (RFP) process as an open tender. Monitoring and oversight will be via contractual agreement with selected service providers inclusive of appropriate KPIs and six monthly review.contracts include key deliverables which are oversighted by a Service Development and Performance Manager, and include evaluation and outcome measures. Key monitoring and evaluation features include: An iterative process relating to accuracy and relevance of the product occurs between the contractor and COORDINARE, prior to the final deliverable being agreed. Service provision will be reviewed for value for money and consumer outcomes. We will work with providers to ensure that funds are allocated and expended effectively. We will develop a regular, scheduled, internal review mechanism, with feedback to the provider, in a continuous improvement cycle. Internal reporting to Executive and the Board includes evaluation of the process and outcome of the contract. 27
Priority Area 5: Population Health Response Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration Indigenous Specific 5.1 Reducing alcohol related harms Existing activity 5. Population Health Interventions Promote existing brief intervention resources for addressing risky drinking behaviour in GP settings using relevant HealthPathways.. Co-plan annual population health strategies with the Illawarra Shoalhaven and the Southern NSW LHDs. People who engage in risky drinking behaviour. LHD and GPs This activity will be implemented with expert agencies such as NCETA, RACP and RACGP. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. Duration January 2017 June 2019 Coverage Commissioning method Approach to market Region-wide coverage 28
Priority Area 6: Appropriate Support structures and program infrastructure. Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity 6.1 Apply best practice principles to the planning and commissioning of services as indicated in the NADA toolkit. Existing activity 6. Program Support and Infrastructure The PHN will provide appropriate approaches to its corporate governance to support service providers by (as extracted and informed by the NADA toolkit): Building pricing structures into commissioning models that incorporate the 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. Seek access to state data on service capacity and resourcing to better map existing service delivery in HealthPathways. Target population cohort Consultation Seek 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. People who require drug and alcohol treatment services, through engaging treatment service organisations in quality corporate governance practice. This activity will require consultation with health departments at state and federal level, and with peak bodies for NGO service provision in NSW. 29
Collaboration Indigenous Specific Duration Coverage Commissioning method Approach to market Implementation will require collaboration with health departments at state and federal level, and with peak bodies for NGO service provision in NSW. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. Principles in place July 2016 and ongoing. Region-wide coverage 30
Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration Indigenous Specific 6.2 Performance Report Existing activity 6. Program Support and Infrastructure Develop a regional drug and alcohol performance framework utilising KPIs from the relevant sources that provides an effective snapshot of the region s performance. The framework will provide a suite of indicators that measure aspects such as resource availability, efficiency, outcome, population measures and key clinical governance indicators. Collaborate with the Illawarra Shoalhaven and the Southern NSW LHDs to align data collection and reporting mechanisms. People who use drug and alcohol treatment services, who will benefit from continuous improvement based on performance reporting. Consultation, in particular, with the Commonwealth Department of Health and NADA, as agencies in the process of developing KPIs for drug treatment services. This activity will require collaboration with NGOs, peak bodies, LHDs, research agencies, state and federal health departments and primary care providers. No, however, includes engagement and participation of Aboriginal and Torres Strait Islander peoples, communities and organisations. Duration Project to begin in July 2018 and be completed by June 2019. Coverage Commissioning method Region-wide coverage This project will be commissioned following assessment of responses to targeted EOIs to appropriately skilled research agencies such as the Drug Policy Modelling Program at NDARC. 31
Approach to market Targeted request for Proposal (RFP) process. Monitoring and oversight will be via contractual agreement with selected service providers inclusive of appropriate KPIs and six monthly review. Contracts include key deliverables which are oversighted by a Service Development and Performance Manager, and include evaluation and outcome measures. Key monitoring and evaluation features include: An iterative process relating to accuracy and relevance of the product occurs between the contractor and COORDINARE, prior to the final deliverable being agreed. Service provision will be reviewed for value for money and consumer outcomes. We will work with providers to ensure that funds are allocated and expended effectively. We will develop a regular, scheduled, internal review mechanism, with feedback to the provider, in a continuous improvement cycle. Internal reporting to Executive and the Board includes evaluation of the process and outcome of the contract. 32
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. Note: 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. Please copy and complete the table as many times as necessary to report on each activity. Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity 1.1 Indigenous participation in governance Existing activity 1. Governance and Oversight Ensure appropriate participation of Aboriginal and Torres Strait Islander peoples in the region-wide consultative and advisory mechanisms and other identified consultation/participation activities, using existing advisory structures such as Community and Clinical Advisory Councils and COORDINARE Aboriginal Health CEOs Advisory Group to identify appropriate membership. Ensure ACCHO involvement in clinical governance structures for the drug and alcohol activities within COORDINARE 33
Target population cohort Consultation Collaboration Indigenous Specific Duration Coverage Commissioning method Approach to market Map and distribute information relating to the availability of Aboriginal-specific drug and alcohol treatment services Aboriginal and Torres Strait Islander peoples who require drug and alcohol treatment services, and their families and communities. This activity is a consultative strategy. All relevant service providers, ACCHO organisations and Aboriginal peak organisations. YES July 2016 and ongoing. Region wide N/A N/A 34
Proposed Activities Activity Title (e.g. Activity 1, 2, 3 etc.) Existing, Modified, or New Activity Needs Assessment Priority Area (e.g. Priority 1, 2, 3, etc.) Description of Drug and Alcohol Treatment Activity Target population cohort Consultation Collaboration 2.1 Increased service capacity for specialist D&A services designed for Indigenous participants Modified activity 2. Service capacity This activity will commission additional capacity to provide drug and alcohol treatment services for Aboriginal and Torres Strait Islander peoples. Services can be residential, day only or community outreach and are provided by a mixture of professional and peer workers. Aboriginal and Torres Strait Islander specific rehabilitation programs are limited in availability in NSW. There are no specific services for Aboriginal and Torres Strait Islander women and their children. In 2010-2011, Urbis Consulting undertook a feasibility study and developed a business case for a residential rehabilitation service for Aboriginal women and children on the South Coast of NSW. The COORDINARE Aboriginal Health CEOs Advisory Group recommended revisiting this proposal as a priority for drug and alcohol treatment services in SENSW. This activity has engaged contractors to undertake a Rapid Review of the business case from 2010-11; provide advice on which elements remain current, which could be updated, and which elements could be implemented from April 2017; with a view to developing a cohesive and sustainable approach to drug treatment services for Aboriginal women and children in SENSW. This activity will then commission relevant services, as recommended through the Rapid Review. Aboriginal women and children, their families and communities. Extensive stakeholder engagement will take place following the outcome of the Rapid Review, and will be guided by the COORDINARE Aboriginal Health CEOs Advisory Group. It will include Aboriginal and Torres Strait Islander Elders, organisations, consumers and communities, and drug and alcohol treatment services providers. This activity will be undertaken in consultation with the peak body for ACCHO s, the AHMRC, local Aboriginal and Torres Strait Islander organisations and relevant consumer and carer representatives. 35
Indigenous Specific YES Duration Rapid Review: January February 2017 Activity: April 2017 June 30, 2019 Coverage Commissioning method Approach to market Drug and alcohol 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 that is informed by the outcomes of the Rapid Review, and the guidance of the COORDINARE Aboriginal Health CEOs Advisory Group, and will include reference to: Need Appropriateness Capacity of the project to add to the evidence base Potential for impact in the longer term Capacity to delivery Value for money Approach to market to be determined. Monitoring and oversight will be via contractual agreement with selected service providers inclusive of appropriate KPIs and six monthly review.contracts include key deliverables which are oversighted by a Service Development and Performance Manager, and include evaluation and outcome measures. Key monitoring and evaluation features include: An iterative process relating to accuracy and relevance of the product occurs between the contractor and COORDINARE, prior to the final deliverable being agreed. Service provision will be reviewed for value for money and consumer outcomes. We will work with providers to ensure that funds are allocated and expended effectively. We will develop a regular, scheduled, internal review mechanism, with feedback to the provider, in a continuous improvement cycle. Internal reporting to Executive and the Board includes evaluation of the process and outcome of the contract. 36