FREQUENTLY ASKED QUESTIONS: Innovative non-residential rehabilitation Department of Health and Human Services Victoria

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1 FREQUENTLY ASKED QUESTIONS: Innovative non-residential rehabilitation Department of Health and Human Services Victoria CONTACT:

2 CONTENTS 1. CONTEXT What are we aiming to deliver? What is non-residential rehabilitation? How is non-residential rehabilitation different from counselling? TARGET GROUPS Who can access this service? Is this just for people who use ice? Can we use non-residential rehabilitation as a step-up or step-down pathway into residential rehabilitation? Should clients complete withdrawal before entering non-residential rehabilitation? Will there be consideration given to working with dual diagnosis clients? Will the program allow for smoking? Will consumers be able to input into the design of the initiative? PROGRAM STRUCTURE Does the non-residential rehabilitation program need to run for 8 hours a day, 5-days a week? How would we get referrals into the non-residential rehabilitation program? LOCATIONS Where will these services be delivered? Will these services operate as statewide services? My organisation is not in one of the Local Government Areas listed in the invitation for submissions. Does that mean I am not eligible to apply? Will the program need to run from a fixed location, or can it be delivered in a mobile/ portable way? FUNDING How much funding will each service receive? Will there be a different price paid for standard and complex clients? Will services receive the same DTAU loadings as other treatment services? Will there be service level targets for Aboriginal clients?

3 5.5 Will there be targets for total number of clients treated? How many programs will be funded? Will there be an annual funding round? Will the funding for this initiative fund infrastructure and other capital costs? Will the funding for the initiative cover transport and myki costs? SUBMITTING AND ASSESSING PROPOSALS Is my organisation eligible to apply? My organisation is part of a consortia delivering funded adult community based alcohol and drug services. Do I have to apply through the Consortia Lead? What role will the DHHS health regional offices have to play?

4 1. CONTEXT 1.1 What are we aiming to deliver? In March 2015 the Victorian Government released the Ice Action Plan. The plan provides new funding of $45.5 million in urgent investment to help tackle the growing use of methamphetamines in the Victorian community and the harms associated with use. The Ice Action Plan includes $18 million over a 4 year period to expand drug treatment and rehabilitation allowing more people to get the help they need sooner. Through this investment, we aim to support at least 500 more clients per year to access innovative models of non-residential rehabilitation with a focus on rural and regional communities. 1.2 What is non-residential rehabilitation? Rehabilitation programs are intensive, structured interventions to address psychosocial causes of drug dependence though evidence-based treatment, with the aim of sustainable recovery. This typically includes motivational enhancement, cognitive behavioural therapies and individual and group counselling, self-help and peer support, and supported reintegration into the community and re-engagement with recreation and activities. The key difference between non-residential rehabilitation and traditional bed based rehabilitation services is that people do not live on site but rather live at home while participating in day time activities, so that connections with family, friends and community can be maintained throughout the rehabilitation period. Providers will be able to propose innovative, evidence-based programs that may involve day programs and/or other types of service delivery. 1.3 How is non-residential rehabilitation different from counselling? Non-residential rehabilitation is a more intensive structured program over a period of weeks, which includes both counselling and a range of other program elements designed to build life skills and promote general wellbeing, such as financial management and nutrition. Counselling provided as part of a non-residential rehabilitation service might include cognitive behavioural therapies to teach coping skills and related therapies such as relapse prevention, mindfulness, mood management, motivational enhancement, narrative therapy and family counselling. 2. TARGET GROUPS 2.1 Who can access this service? Non-residential rehabilitation services will be aimed at supporting people who are at risk of short-term harm as a result of their alcohol and/or drug problem and needing intensive 4

5 support. Clients will be identified based on assessment utilising the common screening and assessment tool and using clinical discretion. Non-residential rehabilitation will be an option for some clients who require more intensive support than individual counselling, particularly those for whom the ability to maintain links with home, family and friends will be part of achieving sustainable recovery. For example, clients who have access to family support and stable housing, or who have dependent children may find a community based rehabilitation option well suited to their needs. 2.2 Is this just for people who use ice? Many clients are poly-drug users and services must provide responsive models of service delivery that are suitable for a wide range of drug types. However, in recognition of the increasing prevalence of crystal methamphetamines, services need to ensure that the particular needs of clients recovering from methamphetamines are catered for. 2.3 Can we use non-residential rehabilitation as a step-up or step-down pathway into residential rehabilitation? Non-residential rehabilitation aims to provide an alternative to residential programs for clients requiring a rehabilitation program. However, care planning should always be flexible to reflect the clinical assessment of a client s needs and, in some cases, it may be appropriate for clients to transition from residential rehabilitation into non-residential rehabilitation. 2.4 Should clients complete withdrawal before entering non-residential rehabilitation? Clients who have not undergone withdrawal, a confirmed period of abstinence, or stabilisation of use of drugs of dependence are generally not considered suitable for rehabilitation programs. Withdrawal or pharmacotherapy prior to admission may therefore be required in order for the client to be able to commit, participate in and benefit from the program. Evidence suggests that methamphetamine clients that have completed withdrawal treatment may still experience protracted symptoms that impact on their ability to engage early in the program and this may need to be considered in program design. 2.5 Will there be consideration given to working with dual diagnosis clients? All funded alcohol and drug services are expected to provide person-centred care which responds to the needs of individual clients, including mental health conditions. This includes working with other service providers and health professionals, as required, to ensure that their health needs are supported. 5

6 2.6 Will the program allow for smoking? It is anticipated that all services will implement a non-smoking policy during the program. However, the way that the program is structured may incorporate breaks or free time in which clients who smoke can choose to do so outside non-smoking areas. 2.7 Will consumers be able to input into the design of the initiative? Consumer participation and involvement is an important part of service design and review as reflected in the Client Charter. The involvement of consumer representatives in program design is therefore required. 3. PROGRAM STRUCTURE 3.1 Does the non-residential rehabilitation program need to run for 8 hours a day, 5-days a week? No, there is flexibility around how it can be delivered. The structure of the program should reflect the needs of the client group. The hours of operation may vary accordingly, as can modes of service delivery, provided the integrity of the structured program and the client experience is maintained. 3.2 How would we get referrals into the non-residential rehabilitation program? The non-residential rehabilitation programs to be established through this funding should operate as an integrated part of the alcohol and drug treatment system. Intake and assessment services are the critical point of access for clients, are responsible for initial screening and assessment, and will provide referrals to non-residential rehabilitation services. This will usually be part of a client s care plan that may include other components of care, including any pre-conditions that might need to be met before participation in the nonresidential rehabilitation program commences (e.g. completion of a course of withdrawal), and plans for post-rehabilitation and follow up (e.g. through engagement with community based counselling and support). Where the need for a non-residential rehabilitation program is identified after the initial assessment, the client may be referred directly after a review of their care plan. Where this occurs, the non-residential rehabilitation provider will be required to share information with the intake and assessment provider. 4. LOCATIONS 4.1 Where will these services be delivered? The Premier s Ice Action Taskforce identified ice as a particular concern in rural communities. This initiative aims to maximise access for clients in non-metropolitan areas, including regional 6

7 towns, rural areas and outer-metropolitan locations where access to existing rehabilitation services may be difficult. A range of Local Government Areas have been identified as potential priorities for additional services based on a range of data (Attachment 1), although proposals targeting communities in other locations will be considered where the submission demonstrates a compelling case for investment. 4.2 Will these services operate as state-wide services? Yes, as occurs with residential rehabilitation or other treatment services, people can elect to receive this anywhere in the State. No client should therefore be refused access to screening, assessment or treatment on the basis of their place of residence. 4.3 My organisation is not in one of the Local Government Areas listed in the invitation for submissions. Does that mean I am not eligible to apply? The list of locations included in the invitation to submissions shows Local Government Areas where current data suggests there is high demand. It is intended to provide guidance only. The Department of Health & Human Services acknowledges, however, that there may be other rural, regional or growth Local Government Areas where there is high demand for services or where local people find accessing services difficult. The full list of in scope Local Government Areas is provided as an attachment to this document. Organisations outside these areas who wish to make submissions should include information and available evidence on local needs in order to support their submission. 4.4 Will the program need to run from a fixed location, or can it be delivered in a mobile/ portable way? The location of the program should always be appropriate to the service model and the needs of the clients. It is expected that it may be most convenient for clients to attend a single location for those components of the program that involve group work for the duration of the program. However, potential providers may wish to consider offering programs at different locations over the course of the year to cater for different client groups. Innovation in modes of delivery is also encouraged. For example, proposed programs may include remote access components such as on-line modules. 7

8 5. FUNDING 5.1 How much funding will each service receive? The amount of funding provided for each service will depend on the nature and scope of the proposals received. Organisations submitting for funding should therefore ensure that the program is costed to ensure that it is viable. This equates to approximately $7,358 per client, including oncosts, consumables and related accommodation and administration costs. However, the Department will be seeking to maximise client access as well as effectiveness, so any opportunities to reduce the cost per client while maintaining the quality and integrity of the program should be considered. Services will be funded through an allocation of Drug Treatment Activity Units (DTAU) for courses of non-residential rehabilitation. Funding packages will be made available based on the projected number of courses of treatment per year. 5.2 Will there be a different price paid for standard and complex clients? No. 5.3 Will services receive the same DTAU loadings as other treatment services? Yes, as with other services funded using the DTAU, loadings will apply for forensic and Aboriginal clients. Aboriginal clients attract a price loading of 30%, and forensic clients attract a price loading of 15%. If a client is both Aboriginal and a forensic client, only the 30% Aboriginal loading will apply. Services should therefore consider the likely representation of these clients group in programs, as it will impact on the number of clients that can be accommodated within a given DTAU allocation. 5.4 Will there be service level targets for Aboriginal clients? No, not unless the proposed non-residential rehabilitation program is specifically designed to deliver services to this client group. However, services will be asked to demonstrate that there are appropriate measures being taken to ensure that services are accessible to and meeting the needs of the local community. This includes services being able to demonstrate culturally safe practice and responsiveness to the needs of Aboriginal clients. Submissions that target particular client groups, within the established program parameters, will be considered. 5.5 Will there be targets for total number of clients treated? The allocation under the Ice Action Plan aims to provide services for at least 500 people per year state-wide. 8

9 Please note that the department will be seeking to maximise client access as well as effectiveness, so any opportunities to increase the number of clients who can be supported, while maintaining the quality and integrity of the program, should be identified in proposals. In , targets will be adjusted to allow for a minimum of three months establishment, with services commencing no later than October How many programs will be funded? The number of clients supported per program may vary and will depend on the model proposed, the duration of the program and the number of participants in each program. The overall number of programs funded will therefore be shaped by the nature and mix of proposals received but, based on previous experience, we estimate there maybe capacity to fund approximately six programs. 5.7 Will there be an annual funding round? No, funding will be allocated on a recurrent basis to allow for sustained service provision. Like all funded services, funding is subject to satisfactory performance and, given this is a new service type, evaluation results may also shape future service requirements and delivery. 5.8 Will the funding for this initiative fund infrastructure and other capital costs? Funding has been allocated recurrently for service delivery only. No funding is available for development of capital however there is scope for successful providers to use some of the establishment funding for minor works, repairs or purchases that may be required to support the establishment of the program. 5.9 Will the funding for the initiative cover transport and myki costs? This can be considered as part of the proposed service model. If an organisation proposes to cover or subsidise client costs such as transport, this should be included in the program costings. 6. SUBMITTING AND ASSESSING PROPOSALS 6.1 Is my organisation eligible to apply? All agencies that currently deliver drug treatment services as well as any community health service may be eligible to apply. To be considered for funding, agencies will need to: Demonstrate capacity and experience in delivering effective, evidence based alcohol and drug treatment services. Have an existing contractual arrangement with the Department of Health & Human Services, and an established record in complying with its terms and conditions. 9

10 Have current accreditation within existing accreditation frameworks by an entity that is certified by the International Society for Quality Health Care or the Joint Accreditation System of Australia and New Zealand. Have capacity and willingness to report on service delivery, and participate in program evaluation and review. 6.2 My organisation is part of a consortia delivering funded adult community based alcohol and drug services. Do I have to apply through the Consortia Lead? Submissions will be accepted from any agency that meets the eligibility criteria outlined in the program documentation This may include services that are not currently the lead agency in a consortia that provide non-residential alcohol and drug treatment services. However, agencies will be expected to demonstrate that appropriate client pathways have been put in place including addressing linkages with other relevant services such as nonresidential treatment providers, intake and assessment and the wider health and community services sector. 6.3 What role will the DHHS health regional offices have to play? Submissions for funding will be assessed according to established criteria as outlined in the invitation to submit by a panel convened and chaired by the Department of Health and Human Services. Regional Office staff will be an important part of this process, providing information about service performance, local needs and how the proposed program will work in the context of local service provision. They will also be responsible for overseeing implementation of successful proposals and ongoing performance management. 10

11 Attachment 1: In scope Local Government Areas identified as potential priorities for investment Ballarat Campaspe Cardinia Casey Glenelg Greater Bendigo Greater Geelong Greater Shepparton Horsham Hume Latrobe Maribyrnong Melton Mildura Mitchell Warrnambool Whittlesea Wyndham 11

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