Service Proposal Guide Medical Outreach Indigenous Chronic Disease Program 1November 2013-30 June 2016
INTRODUCTION The Service Proposal Guide has been developed by the Outreach in the Outback team at Rural Health West to assist you in completing a proposal for funding under the Australian Government Medical Outreach Indigenous Chronic Disease Program (MOICDP). The contents of this proposal pack are: 1. Guide for completing the Service Proposal 2. Service Proposal form 3. Budget for Service Proposal You are encouraged to read the Medical Outreach Indigenous Chronic Disease Program Service Delivery Standards. This document has been developed by the Australian Government Department of Health and Ageing. Each question in the Service Proposal form has a corresponding section in the service delivery standards with helpful information about how to answer the question and the specific detail to include. Please ensure you read each section carefully and complete all questions. The boxes provided will expand automatically as you type and are not indicative of the length of your response. The Outreach in the Outback team is able to assist you if required. How to complete your Service Proposal form To complete the service proposal form: 1. Read the Service Proposal Guide carefully and use it to assist you in completing the Service Proposal form. 2. Read the Service Delivery Standards developed by the Department of Health and Ageing found at www.outreachintheoutback.com.au 3. Ensure you have completed both parts of the Service Proposal form including the itinerary and budgets for each team member in each location visited. 4. Submit the form and any accompanying paperwork (requested if necessary in the proposal) to the Outreach in the Outback team. 5. The closing date for this funding round is 4pm (Western Standard Time) on 26 July 2013. 6. Receipt of Application will be acknowledged by email. 7. All proposals must be signed by the applicant and posted, scanned or faxed to: Post: MOICDP Service Proposal Outreach in the Outback Rural Health West PO Box 433 Nedlands Western Australia, 6909 Scan: outreachintheoutback@ruralhealthwest.com.au Fax: +61 8 6389 4501
What happens to your proposal once it is submitted? Once you have submitted your proposal it will be assessed by the Rural Health West Working Group and then endorsed by the State based Advisory Forum. Following that, all endorsed proposals must be approved by the Australian Government Department of Health and Ageing in Canberra. You will be notified in writing of the outcome of your proposal as soon as the Department of Health and Ageing has advised Rural Health West of the outcome. Contact Please contact us if you have any questions regarding your application. Outreach in the Outback Rural Health West Ph: +61 8 6389 4500 Email: outreachintheoutback@ruralhealthwest.com.au BEFORE YOU BEGIN Background, Aims and Objectives of the MOICDP The Medical Outreach Indigenous Chronic Disease Program (MOICDP) is the consolidation of two Indigenous chronic disease focused programs. The two programs that form the MOICDP are - Medical Specialist Outreach Assistance Program Indigenous Chronic Disease Program (MSOAP-ICD) and the Urban Specialist Outreach Assistance Program (USOAP). The MOICDP will build on the foundations of these two programs whilst bringing in line USOAP funding model with the MSOAP-ICD to include a multidisciplinary approach to deliver outreach services. All organisations and individual service providers supported through MOICDP are required to ensure that their services meet the service delivery standards by providing an efficient, effective and quality service to Indigenous patients. MOICDP will focus service delivery on the following chronic conditions: Diabetes Cardiovascular disease Chronic respiratory disease Chronic renal (kidney) disease Cancer The objectives of MOICDP are to: Increase the access to multi-disciplinary care in primary health care settings Increase the range of services offered by visiting health professionals to prevent, detect and manage chronic disease more effectively. Outreach services supported through the MOICDP will improve access to health services for people living in urban, rural, regional and remote Western Australia. They will link with the broader ongoing health reform agenda to develop an integrated health service where local services and outreach services work together to provide communities with the range of services they need to remain healthy.
Models of care Outreach: service provision provided to urban, rural, regional, remote and very remote communities by service providers travelling to these locations from a larger town. This is the preferred model under the MOICDP. Hub and spoke: service provision provided both in a central town and the service provider(s) travelling to remote communities. Cluster: service provision to multiple communities from a variety of service providers located in different communities within the cluster. Coordination is paramount in this model to ensure a united approach to care.
Funding Agreement and Service Period The funding round is an open competitive round and successful Applicants will be offered a one year Service Provider Agreement which will be required to be signed before receiving any funding. All outreach services supported under the MOICDP will be reviewed annually by Rural Health West and the State based Advisory Forum to ensure that the service continues to meet the needs of the community and the MOICDP. A service not fulfilling the requirements of the MOICDP may be reconsidered and funding may be allocated to an alternative area of need in the relevant region. MOICDP is a Team Approach The MOICDP focuses on a team approach to health care. However it may not be necessary or possible for team members to deliver an outreach service at the same time. Therefore, issues relating to the coordination and continuity of care of patients, sequencing of visits, managing the impact on the community and costs related to travel should be considered when planning services to these communities. The multidisciplinary approach of this measure requires a coordination and case management function. What Services are Eligible for Funding? The MOICDP supports outreach services provided by the following health professionals: Specialist medical services Allied health professionals Nursing services Combination of eligible services (i.e. multi-disciplinary team) Outreach GP services Funding is also available for: Coordination and administration of these services Cultural awareness and safety training for participating service providers Upskilling / training Professional support that is associated with outreach services Program administration costs for the successful applicant What Services are Not Eligible for Funding: Elective cosmetic surgery Stand alone training Research activities Alternative health services for example Chinese Medicine, reflexology Capital expenditure for health service delivery Purchase of medical equipment Purchase or leasing of motor vehicle Salaries for health professionals Hospital services
GUIDELINES FOR COMPLETING THE SERVICE PROPOSAL FORM 1. BUSINESS AND CONTACT DETAILS 1a. Full legal trading name of the organisation/business (This is the organisation that will hold the Service Provider Agreement with Rural Health West) We require the registered business name and Australian Business Number of the applicant in order for Rural Health West to provide a Service Provider Agreement (contract). This organisation will be the Service Provider. The Service Provider can be the organisation or an individual as long as there is a registered business name and ABN. 1b. Authorised representative of the organisation (This is the representative who is responsible for signing the Service Provider Agreement with Rural Health West. Eg Director or CEO) This person is the nominated senior representative of the organisation/business listed in 1a. They will be responsible for signing the Service Provider Agreement and will receive correspondence from Rural Health West in regards to their contract. This includes communication in regards to final approval of the service from the Australian Government Department of Health and Ageing. This person is responsible for liaising with the Program Coordinator (Question 1c.) about the implementation of the service and the administrative requirements in order to access the allocated funding. If there are any changes or concerns with service delivery, please contact the Outreach in the Outback Team. 1c. Program Coordinator (This is the representative who is responsible for providing Rural Health West with coordinating the outreach service including Service Activity Reports and Invoices. N.B. Rural Health West can only accept invoices and service reports from the organisation with which we have the Service Provider Agreement) This person will be Rural Health West s contact for service related enquiries. This person will be responsible for coordinating the service and supplying Rural Health West with Service Activity Reports (from the Health Professional) and invoices in order to access the allocated funding. All Outreach in the Outback programs operate on a fee-for-service basis. Therefore, we require the evidence of service completion (through our Service Activity Report form) and corresponding invoices in order to release the allocated funding. It is important to note, that if Rural Health West does not receive invoices or Service Activity Reports, we cannot report to the Australian Government that the service is completed. This could affect your allocated funding in the future. If there are any changes or concerns with service delivery, please contact Rural Health West to discuss your options. 1d. Declaration Please sign indicating that all information you have provided is correct and accurate.
2. PROPOSAL DETAILS 2a. Targeted Chronic Disease This short description will allow us to quickly identify your proposal. Please refer to the front section of these guidelines or our website for a list of the 5 targeted chronic diseases. For example: Renal, Diabetes or Cardiovascular Diabetes Cardiovascular disease Chronic respiratory disease Chronic renal (kidney) disease Cancer 2b. Model of Care Outreach: service provision provided to urban, rural, regional, remote and very remote communities by service providers travelling to these locations from a larger town. This is the preferred model under the MOICDP. Cluster: service provision to multiple communities from a variety of service providers located in different communities within the cluster. Coordination is paramount in this model to ensure a united approach to care. Hub and spoke: service provision provided both in a central town and the service provider(s) travelling to remote communities. 2c. ASGC-RA and location of service The Australian Standard Geographical Classification Remote Area system allocates towns on a scale of RA1 (major cities) to RA5 (remote). Services delivered to Aboriginal and Torres Strait Islander communities RA1(major cities) - RA5 (very remote) are eligible to be supported under MOICDP. For more information on ASGC-RA and to search for the score of your communities please visit http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/content/ra-intro Please list all locations that the health professionals will visit as part of this service The primary focus of the MOICDP will be to deliver services to locations with a majority Aboriginal and/or Torres Strait Islander population with a high prevalence of complex and chronic health conditions or where a significant proportion of the Aboriginal and Torres Strait Islander community in the location have chronic health conditions. 2d. Details of the facilities available to host this service. It is important that facilities in the host location are available and adequate to provide an effective service. Please provide information about the facilities that will host this service. 2e. Type of health professionals/service. Please list the specialty/discipline of the health professionals who will work together to deliver this service. Preventative health services provided by allied health professionals are eligible for support following referral by a medical specialist or primary health care service provider. The MOICDP measure is a multidisciplinary team based program. 2f. Who will provide this service? Please list the names of the health professionals who will work together to deliver this service. If the health professionals are not yet recruited, please list the specialty/discipline required and note that they are not yet recruited/identified. It is the responsibility of the applicant to ensure all health professionals providing this service are appropriately registered and qualified with the relevant skills required.
Student or Registrar staff Please provide details of students or registrars that will assist with this service. Note: Travel costs for registrars who accompany visiting medical professionals in order to gain exposure to rural practice will be supported. Backfilling of the registrar s position will not be paid under the MOICDP. Commencement date of the service. Date service is due to commence. Number of visits per financial year This is the number of occasions per financial year that the team will visit each town listed. Eg. Town X: 2 Town Y: 2 This is not indicative of days per visit. One visit could be multiple days. Number of consultation sessions per visit This is the number of consultation sessions the team will complete over each visit. 1 session is equal to 3.5-4hours. If there are different numbers for each team members, please list these. For example, the general practitioner may provide 3 consultation sessions over 2 days while the dietician may provide only 2 sessions over 2 days. An eligible session comprises of consultations with one or more patients at the host location for the above time frame. The program does not support surgical procedures or in-hospital care. Description of service Please provide us with an understanding of the way the service will look and how it will be delivered effectively to the community. Your answer should cover each point requested and demonstrate the practicalities of providing the service. Points to cover: How will each health professional travel to the community and are there linkages with other services travelling? What services will be provided to patients? Consultation sessions/procedural sessions/telemedicine sessions/combination How will patients access the service? For example, will they come to a central point or will the health professionals travel out from a hub? How will the community members get referrals? How will community members be notified of the pending visit? How will follow ups be provided? How does this service integrate with other existing services? How do the team members interact with each other including visiting schedules, referrals and their unique roles within the team? Will there be any upskilling to local health professionals at the host location? Will there be any professional support/case management or follow up between the team members and local health professionals after the visit or in between visits? Referral Processes and Pathways Please describe the referral process and pathway in practical terms that will be used to identify patients.
3. BILLING 3a. Can the health professionals claim against the Medicare Benefits Schedule? Under exceptional circumstances it is accepted that a claim against the Medicare Benefits Schedule is not possible. If a health professional is unable to claim against the Medicare Benefits Schedule or charge patients private fees then a workforce support payment may be paid. This is generally the case when patient attendance is not assured or patient compliance is uncertain, particularly in remote and very remote Aboriginal communities. A work force payment and a claim against the Medicare Benefits Schedule is not allowed. All invoices must be submitted within two (2) months of the service being delivered. Are you able to confirm that all invoices will be issued to Rural Health West within 2 months of services being delivered? 4. CULTURAL SAFETY AND AWARENESS 4a. Have all health professionals completed cultural and safety and awareness training? All host organisations will ensure that the health specialists meet the requirements of cultural safety and awareness appropriate to the nominated service locations. The method of training delivery is flexible and may take the form of: Formal cultural awareness course provided by facilitators/presenters; Self learning cultural awareness education program eg. Online course; and /or As a part of the host organisation s orientation program. 4b. How will the visiting health professionals be orientated to the host location? Please describe the process of orientation to the host site.
5. EVIDENCE OF NEED AND COMMUNITY CONSULTATION 5a. Does this service address an identified need in the community Why should this service be supported? Communicating with the targeted community about their needs and demonstrating how you will work together is a requirement of this program. Please demonstrate how you have consulted with the community to identify their needs and how you will work together to provide an effective service that can be accessed by community members. What services in this discipline are already in the community and/or the region? What gaps have been identified? Through your consultation process, you should identify gaps in health care in the targeted community and/or region and your proposal should demonstrate how your service will positively effect this need. Outreach in the Outback has also completed a gap and equity analysis for each region which is available on our website. Please describe the consultation process undertaken with stakeholders and health providers in the region to determine the community health needs. Practical points to consider might be the role of different organisations or individuals to assist with: Facilities for consultations and telemedicine sessions if applicable; Referrals; Advertising planned visits to the community; Coordinating patient travel; Holding patient records or utilising existing patient management systems; and Ensuring follow ups are completed if required. We encourage you talk with key stakeholders in the community and/or region including individual Aboriginal Medical Services, regional WA Country Health Service, Medicare Locals and Regional Aboriginal Health Planning Forums. These stakeholders may provide advice to identify priorities and service gaps in the targeted region and/or community. 6. QUALIFICATIONS Please tick the appropriate box to declare that as the Service Provider for this proposal you will ensure all health professionals are appropriately qualified and/or registered under Western Australian State Law. Additionally, you will ensure all health providers have a Working With Children clearance.
7. ITINERARY Please provide an example of the itinerary for the service. If your team does not travel together for the entire time, please submit multiple examples to depict the variety of itineraries. For example, if 1 member travels for 5 days while the other member travels for 3 days. You should give an indication of how many sessions will be conducted and whether they will be consultative or procedure based. Please also illustrate if the health professionals will provide any upskilling to local health professionals. One session is 3.5-4hours Example Monday Tuesday Wednesday Fly commercial flight Perth to Kalgoorlie PM Consultations in AM Consultations in PM Overnight Kalgoorlie Procedures in AM Upskilling local nursing staff PM Fly commercial flight Kalgoorlie to Perth PM 8. BUDGET For further information on the categories below, please refer to the Medical Outreach Indigenous Chronic Disease Program Service Delivery Standards, November 2012 issued by the Australian Government Department of Health and Ageing. These are available from www.outreachintheoutback.com.au Please note: All budget items are considered by the Australian Government Department of Health and Ageing before approval of the service; The budget for the financial year forms the basis of an annual service plan for the period 1/11/2013 30/6/2016; Service delivery and service budgets will be reviewed annually. Service Provider (your organisation name): Host location of service: Specialty/Discipline: Health professional s base location: Number of visits per financial year: Number of consultation sessions per visit: Can the health professional claim against the Medicare Benefits Schedule for their service? ITEM Rate Unit Qty Travel Charter airfare Commercial airfare Hire vehicle hire fee Hire vehicle fuel -1600cc and under or 4WD Hire vehicle fuel -1601cc-2600cc Hire vehicle fuel - 2600cc and above Private vehicle fuel-1600cc and under Private vehicle fuel-1601cc-2600cc The Australian Government Department of Health and Ageing require a separate budget for each location and each health professional. Please submit separate budget sheets with your proposal. This also assists us to match this form to your proposal as well as to cross check the budget. Remuneration for health providers should be sought through the Medical Benefits Scheme (MBS). Workforce Support Payments may be provided when MBS payments cannot be claimed or are not assured and/or patient compliance with appointments is uncertain. Per Visit Cost (Ex GST) Visits per annum Annual Cost (Ex GST) This program will cover the cost of travel by the most efficient and cost effective means to and from the host location. Commercial flights will be costed at the economy class level and should be fully flexible. For charter airfares please provide a written quote. As the program is competitive, we strongly encourage applicants to look into a number of different ways for health providers to travel to the host location and consider the cost effectiveness of each travel mode. Where possible, ensure that the team travel together or with other services travelling to the host location is an important consideration.
Private vehicle fuel- 2600cc and above Taxi Parking Accommodation Travel and accommodation costs for Registrars and Students can be funded however no other budget items can be claimed. Up to $100.00 per visit per person may be claimed for either taxi fares or parking. Rates between $120 and $240 per night should be sought where possible although it is recognised that in some locations this may not be possible and consideration will be given on a case-by-case basis. If you would like assistance please contact the Outreach in the Outback team. Breakfast Lunch Dinner Incidentals (from day 2 onwards) Administration Funding for breakfast on the first day of the visit and dinner on the last day is not available. However, if your itinerary reflects an early morning start or a late return, these meals may be funded. Incidentals may only be claimed from day two onwards Funding for administrative support can be sought for assistance with the delivery of outreach services such as organising appointments, pathology, processing correspondence and following up with the patients at the outreach location. Administrative support Administrative support should be sourced locally and funding is available for 1 person per team, at $150 per one day (two sessions) or at $75 per half day (one session). Administrative support can only be claimed for the consultation hours undertaken by the visiting health professional and is not available for travelling time or when the health professional is providing upskilling. The program cannot fund travel, meals or accommodation for administrative staff. Room hire Equipment lease Fees incurred in hiring appropriate facilities at the host location can be funded. The suggested maximum fee payable is $200 per day (excluding GST). Consideration will be given to assisting with clinical/medical equipment lease arrangements. Any lease quotes must include budget for replacement parts and maintenance to ensure equipment meets required standards. The period of lease may not exceed the end date of the contract Rural Health West has with the service provider. Funding may also be available to assist with transportation costs of equipment on commercial transport. The program will not cover the cost of purchase of equipment or the lease of portable and/or information technology equipment. Service Coordination Funding for coordinating the service from the service providers base location is available to arrange travel and clinic room hire. Funding is according to the complexity of the service visit. A single location visit with one health professional - $75.00 per visit A multi disciplinary team visiting multiple locations - $100 - $150 per visit. To maximise patient care, in multiple outreach locations and multi disciplinary teams, funding for coordinating patient care from the service providers base location is available for : Care Coordination Coordinating the team; Following up patient appointments and other services; Patient pathology; Case management; Patient correspondence and notes; Case conferences; and Liaising with other health professionals. Funding of $150.00 can be claimed per consulting session.
Workforce Workforce Support Payment Financial support (at sessional rates) may be available to private specialists, general practitioners and allied health professionals, who provide outreach in RA4 (remote) and RA5 (very remote) to mainly Indigenous communities. A Workforce Support Payment may be considered only when other payment options have been exhausted. A Workforce Support Payment may be paid in circumstances where access to MBS payments cannot be guaranteed and/or patient compliance with appointments is uncertain. Visiting health professionals who accept a workforce support payment will be precluded from claiming any MBS payment for the delivery of services to the designated outreach location(s). They are also not eligible for other workforce payments such as Absence from Practice Allowance. Workforce Support Payments will be considered on a case-by-case basis by the Department. If endorsed, they are paid per consultation session. For example, if the visiting health professional conducts 2x 4hr sessions over a 3 day visit, the payment would be for those two sessions. The base rates for a 3.5-4 hour consulting session are: Medical Specialist - $1,000.00 per consulting session Allied Health and other health professionals - $500 per consulting session Visiting health professionals may wish to provide incidental or informal educational activities to local health services at the host location. Upskilling should take place at the host location for this service and should aim to complement existing training in the area. The aim of this activity would be to develop specific skills, share knowledge and/or enhance ongoing patient care. Upskilling Absence from Practice Allowance Backfilling for salaried health professionals Telemedicine and ehealth The program can cover the costs of facility hire during the upskilling activity as well as an hourly rate for non-salaried private health providers. Administrative support during upskilling or travel by local providers is not covered nor is the allocation of Continuing Professional Development points as the program is not accredited. Upskilling is conducted outside of consultation sessions. Evidence must be provided that this upskilling occurred through the Service Activity Report. Upskilling is not a requirement of health professionals providing outreach services and cannot be supported as a stand alone activity under the MOICDP. An APA is payable to non-salaried private health professionals to compensate for loss of business opportunity due to the time spent traveling to and from the host location. The hourly rate for the APA should be consistent with the fee-for-service hourly rates in Western Australia. Work Force Payment and Absence from Practice Allowance cannot be claimed in the same sessions. ie morning travel APA claimed - no consulting session payment can be claimed for the same morning. Salary costs of backfilling salaried medical staff who provide approved outreach services will be covered. Evidence of the position being backfilled is required through the Service Activity Report. Any claims made against the MBS by salaried health professionals for the outreach services supported under the MOICDP would render void any claim to cover backfilling costs. Salary costs of backfilling registrars and/or other accompanying health professionals will not be paid. Financial support is available for the use of telemedicine as a supplement, and not as a substitute, to usual face-to-face consultation. This is at sessional rates for the health professional and facility hire may also be funded. Funding is not available for capital costs associated with the establishment of a telemedicine service. Costs such as hire of venue and equipment, associated with consultations using this medium may be covered. MOICDP supports the use of e-health initiatives and access to and use of video conferencing for patients consultations and to support continuity of care. The funding for non MBS supported Telemedicine sessions is $250.00 per hour. Evidence of Telemedicine sessions is required through the Service Activity Report. Per visit total Please provide a total for the per visit cost Annual total Please provide a total cost of this service for the year