AOD Sector Reforms
Neos Zavrou
AOD Sector Reforms
THE PROBLEM –
• 108+ AOD service providers
• Poor quality data
• Many barriers
• Poor service integration
• Inadequate funding
• Limited performance management
2011 Victorian Auditor General Report
AOD Sector Reforms
SOLUTION (Victorian Government):
• Re-commission *all* AOD Services
• 30+ service types  6 functions
• 16 Catchments
• 2014: Adult (16+) community-based services
• 2015: Residential & Youth services
• Activity-based funding model
• Place-based, integrated services
AOD Sector Reforms
Intake & Assessment
Counselling
Care & Recovery
Non Residential Withdrawal
Residential Withdrawal
Residential Rehab
Youth Services
Catchment Based Planning
Service Streams
Key Reforms
Affecting Client Referrals
Prioritise complex & most in need
Catchment-based Intake & Assessment
• Screening
• Mandated Complexity Tool
• Identifies those ready for treatment & substance
dependence
Mandated Assessment Tool
 Drug use  Risk  Physical & mental health issues
 Legal  Financial  Employment  Housing
 Family & social relationships  Strengths & supports
 Treatment Plan
Mandated Assessment Tools
ASSIST
Records
substances
used & risky /
harmful use
Mandated Assessment Tools
AUDIT
Used to
identify
dependent
alcohol use
Mandated Assessment Tools
DUDIT
Used to identify
dependent use
of drug(s) other
than alcohol
Mandated Assessment Tools
Kessler 10
(K10)
Used to determine
presence and
severity of
psychological
distress
Mandated complexity tool
1. ALCOHOL AND OTHER DRUGS (AUDIT AND DUDIT SCORES)
 Male
A1 
A2 
A3 
 Female
AUDIT≤15
AUDIT 16-19
AUDIT 20+
D1 
D2 
D3 
Low Risk
[A1 and D1]
A1 
A2 
A3 
DUDIT≤5
DUDIT 6-24
DUDIT 25+
AUDIT≤15
AUDIT 16-19
AUDIT 20+
Likely Misuse
[A1 and D2], or
[A2 and D1], or
[A2 and D2]
D1 
D2 
D3 
DUDIT≤1
DUDIT 2-24
DUDIT 25+
Likely Dependence
[A3 or D3] or
both
2. COMPLEXITY (LIFE ISSUES)
Is the client’s total K10 score 30 or greater?
Is the client homeless? Does the client have housing issues (e.g. living in a boarding house)?
Is the client currently unemployed and not involved in study or training?
NUMBER OF “YES” RESPONSES IN THIS SECTION (value between 0-3):
No=0
Yes1
 No
 No
 No
 Yes
 Yes
 Yes
Eligibility for AOD Treatment
TIER 1
Low Risk
TIER 2
Likely Misuse
Likely
Dependence
+
Provide
information and
advice, psychoeducation,
telephone
counselling, brief
intervention, etc.
If K10≥30, refer to mental health services
If housing instability or homeless, refer to
housing services
If unemployed, refer to employment
services
COMPLEXITY = 0
TIER 3
ADMINISTER FULL ASSESSMENT
Consider referral to face-to-face specialist AOD service or other
non-specialist services and programs as required (e.g. physical
health or criminal justice).
COMPLEXITY = 1
TIER 4
ADMINISTER FULL ASSESSMENT
Consider referral to face-to-face specialist AOD service and other
non-specialist services and programs (e.g. housing, employment).
TIER 5
PRIORITY FOR ADMINISTRATION OF FULL ASSESSMENT
Consider referral to face-to-face specialist AOD service.
Consider recommendation for care and recovery coordination.
COMPLEXITY ≥ 2
Care & Recovery (CRC) &
AOD Transitional Housing
• AOD Supported Accommodation now part of CRC
• CRC treatment stream = seamless & integrated care
for most complex clients
• Transitional housing only for eligible CRC clients
– i.e. assessed as complex & with treatment have
stabilised AOD use e.g.:
 Exiting Residential Rehabilitation
 Post AOD counselling and/or similar + CRC support
+ significant reduction in AOD use & risk behaviours
+ no access to stable accommodation
Facilitating Access & Supporting
Treatment
Complexity = Homelessness, housing,
employment and mental health
(psychological distress):
The sector has been reformed to
prioritise your clients
Facilitating Access & Supporting
Treatment (cont)
Get to know….
 your catchment based Intake & Assessment Provider
• May provide a CRC worker
• May offer screening & assessments at your sites
• Your staff can use the tools speed the process
 your local AOD treatment providers
• May offer counselling and non residential
•
withdrawal at your sites
Can reassess client complexity and reclassify
clients even after referral
Catchment Planning
• Who is doing catchment planning in your area?
Tell them about your clients & their families:
o
Identified minority/language groups
o
Specific needs not met by AOD services
o
Concerns about identified drugs
o
Resources / ideas your service has or is aware of
• Ask to be part of the Advisory Group
Questions?