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?