HIP Alignment
Jackie Kearney
February 2013
Overview
• Responding to demographic changes
• The journey so far
• Why change
• Why now
• Your concerns
• Where to from here – working together
Demographics
Our population is:
Increasing
Getting older
Experiencing more chronic
illness
Have higher expectations then
ever before
Want to stay at, or close to,
home
Using more hospital services
The role of HIP in the health system- substitution
and diversion
Aim to provide least restrictive care option
Directly admit to subacute
Care at home
Right Time
Right Place
Ambulatory
Right Cost
Right Care
Responding to the demographics –thinking
differently
The Health Independence Program is a
model of care not a discharge destination
‘Demand for HIP services will increase as future
health services’ and consumer expectations
continue to demand more emphasis on community
treatment (p1)’
The journey so far
• HIP guidelines (2008)
– Promote interdisciplinary care
– Integration and streamlining of programs to achieve
better continuity of care for clients
• Subacute Planning Framework (2009)
– Capability framework for levels of service and expected
suite of services
– Regional self sufficiency
– Informs department service development and funding
allocation decisions
Preparing for future demand
• Common processes and core principles
• Using skilled workforce more effectively and efficiently
• Minimise duplication – for staff – for clients
• Build flexible and multi-skilled workforce to deliver care in a
variety of settings
• Delivered based on client need and not by program boundaries
• About managing demand in restrained economic climate
(P3)
HIP Objectives
The HIP objectives are to:
simplify the service system
produce efficiencies
minimise duplication
improve equity
enhance co-ordination
reduce fragmentation
flexibility in service delivery
Processes supporting the HIP model of care
2008/09: Health services asked to submit a HIP Implementation Plan
2009/10: Progress report for access; initial needs identification;
appropriate setting; and corporate governance
2010/11: Progress report for assessment; transition and exit;
interdisciplinary approach; and care coordination
A HIP funding stream
Funding approach……..from this
…to this
Why Now?
• Feedback from services
• Significant progress in implementation of guidelines by the sector
 It is the next step
 Assessment suggest program streams are limiting
integration
• Opportunities for greater integration
• Change focussed on model of care
 Model supported by ABF funding approach not driven by it
 clearer picture for services of their activity
 change is coming – be the driver not the passenger
Concern 1
‘Our service does not have the capacity to
deliver full suite of services’
• Continue to deliver what you are funded for.
• Existing relationships can continue – use the transition
period to see where improvements in integration can be
made.
• Suite of services you are required to deliver is based on
the SCF
Concern 2
“We all report different things”
• In the PAC SACS and HARP villages different languages are
spoken.
• ABF is introducing a new national language. It will become the
dominant language
• HIP will provide the common language for the components of
care
• ABF will provide the language for reporting activity = Service
Event
• Over time we will move to a common language
Concern 3
“We will shift to cheapest model of care”
• Same clients just different funding approach
• Clinical need should drive care not funding streams
• Funding should support efficient care – HIP objectives aim
for this
• We will monitor maintenance of effort
Concern 4
“We have different geographic catchments
and eligibility criteria”
• Service development is based on local need and existing
relationships – often historical
• Opportunity to review what is working and what needs
changing
• Process to align catchments and eligibility
• Use the transition period to support this
• It will not be a ‘one size fits all’
Concern 5
“Our service won’t flow the funding to the
health independence program”
• Funding will flow to your health service identified as HIP
• The department sets and monitors activity not expenditure
at program level
• Health services will continue to allocate budgets internally
• Same budget - block funded – transitional in line with ABF
approach
Addressing the concerns – risk management
What the department will do:
• Provide program reports to health services
• In 2013-14 the reports will:
– Provide activity via service streams
– Give you an overall HIP activity report
– Shadow the new national Service Event activity language
• Monitor maintenance of effort
• Working with you to define and clarify components of care –
opportunities to benchmark
• Clear departmental expectations detailed in the 2013-14 Policy
and Funding Guidelines
What next
• Afternoon workshops will ask you to focus on exploring the
components of care delivered in the HIP
• Discussion paper informed by today and will identify key issues
and implementation steps
• Working with health services to identify implementation steps
based on current readiness including aligning boundaries
• Ongoing conversation between services and DH to guide further
implementation, including the alignment of Residential In-Reach
funding.
• Continue to meet as program to discuss and develop model.
Key Messages
• Part of the HIP journey – this is a transition time
• No overall reduction in HIP funding across
system as a result of the consolidation
• Clinical needs should determine care
not funding boundaries
• ABF is a potential enabler for the care
you want to deliver
• DH will monitor maintenance of effort
• One size will not fit all
• Aim to remove boundaries to improve
service delivery
To conclude – your job this afternoon
The model of care we are working towards
Better articulating the components of care that make up HIP