Expression of InterestProvision of Tasmania Medicare Local Care Coordination Service

for Chronic Disease and Aged care

APPLICATIONS CLOSE 15 November 2013BackgroundIn December 2012, Tasmania Medical Local (TML) signed contracts with the Australian Government to manage three of the Tasmanian Health Assistance Package elements for the next three years.

One of these elements is “Improving Care Coordination for People with Chronic Disease and Aged Care Clients” Program (the Care Coordination Program).

In Tasmania an increasing community burden of chronic disease coupled with an ageing population and an ageing health workforce are among the main challenges affecting the future sustainability of the health care system. Tasmania’s population is ageing at a rate faster than anywhere else in Australia. A major consequence of the ageing Tasmanian population will be the steady growth in burden of disease from cancers, diabetes, ischaemic heart disease, and neurological disorders.

Tasmania also has a significantly higher rate of potentially preventable hospitalisations than the Australian average for a number of diseases and conditions including COPD and congestive cardiac failure. Although lower than the national average, more than half of Tasmania’s avoidable hospitalisations are secondary to chronic health conditions, primarily avoidable admissions for diabetes complications and COPD.

There is strong evidence that better coordination of the care of people with chronic disease achieves improvements in their quality of life and health outcomes and as a result reduces unnecessary and inappropriate use of health services, including potentially avoidable emergency department presentations and hospitalisations.

Vision

The care of Tasmanian’s with chronic disease is better planned and managed and inappropriate utilisation of health services is reduced.

Aims

To pilot improved arrangements for comprehensive, evidence-based care coordination for people with chronic and/or complex conditions, and for aged care clients (whether living in in a residential aged care facility or in the community.

To develop and test hospital avoidance strategies for people with complex health needs.

Objectives

To improve access to necessary services to help support improved health outcomes for Tasmanians - particularly for people with chronic and/or complex conditions;

To reduce inappropriate and avoidable service utilisation across the health care sector - particularly in relation to potentially avoidable hospitalisations, emergency department presentations and emergency admissions involving people with complex chronic care needs; and

To contribute to making the Tasmanian health care system more sustainable.

The aim of the Care Coordination Program is to pilot improved arrangements to support the planning and implementation of comprehensive, evidence-based care coordination for people living with chronic or complex conditions, and for aged care clients (whether living in residential aged care facilities or the community). Hospital avoidance strategies will be developed and tested.

Tasmania Medicare Local (TML) is seeking expressions of interest from organisations to deliver TML Care Coordination to enhance/increase their existing Care Coordination service.

Funding PeriodThe funding is available in the first instance for seven (7) months from December 2013 – June 2014 and will be awarded on a competitive basis. Subsequent funding for 2014-2015 and 2015-2016 will be available based on performance against Program KPIs.

Program KPIs:

Number of clients/patients assisted under the program (Target – 100 to 120 client/patients serviced within the program per annum per provider)

Compliance with Program data collection and reporting requirements (templates appended)

o Monthly reportso 6 month reporto 12 month report

Demonstrated compliance with flexible funding arrangements and reporting.

This Commonwealth Department of Health funded Program has no recurrent funding identified beyond 30 June 2016. For this reason it is incumbent on applicants to

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demonstrate that their proposed service model is designed such that a sustainable on-going service is predicated beyond this date.

Funding Available A maximum of $75 000 for 2013-2014 (GST exclusive) is available per successful application. (Subsequent program funding to a maximum of $100 000 per annum for 2014-15 and 2015-16 will be made available to selected providers based on performance against KPIs.)

Funding can be used, for example, to cover:

Direct costs:

Clinician/coordinator salary Medical consumables/equipment Clinical software for confidential client notes (Medical Director, Best Practice or

alternative) Chronic disease database (cdm Net), data interrogation tools such as Pen Cat Computer/phone Infrastructure costs including vehicle access where relevant

Administrative costs (up to 20%):

Training for staff (must be related to the program) Insurance costs IT support, software and maintenance

The list above is indicative only and is not intended to be exhaustive. Please specify in your application if you intend to use funding to build on, or enhance, an existing service.

Eligible organisationsExpressions of interest are invited from organisations interested in providing the TML Care Coordination model.

general practices/consortiums of general practices; non-government organisations; private hospitals; community groups; and not-for-profit organisations.

Key considerationsThe Care Coordination Program must be delivered in line with the TML Care Coordination Guidelines (see appended) unless there is a specific agreed amendment with the funder.

Organisations/Providers that are commissioned to deliver Care Coordination will be expected to:

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Deliver the Program through the process and format prescribed in the TML Care Coordination Guidelines provided.

Be currently delivering services to the target group; Be able to demonstrate a good understanding of current health services available to

these clients; Provide care coordination services through existing or newly recruited qualified

health workers/professionals; Set and meet targets for the numbers of clients that will be enrolled through the

program according to contractual agreements; Enrol/consent clients to the program in accordance with agreed eligibility criteria and

through an informed consent process aligned with a client centred approach for goal setting and care;

Enrol clients for Personally Controlled Electronic Health Record, PCeHR; Utilise electronic clinical information systems to collect client data (as agreed with

TML) and share clinical information between providers; Wherever possible ensure the client’s general practitioner remains central to the

client’s care plan and that the GP is kept informed about the care of their client; Have access to and use the available Flexible Funding Pool in accordance with the

eligibility criteria defined by TML allocated in ‘a price per client’ ratio. Meet all contractual activity and financial reporting requirements specified by TML

including reporting on the number of participants receiving care under the program and the health conditions affecting them;

Work with an independent program evaluator for the duration of the project Utilise a model of service delivery that supports a sustainable, on-going service

beyond program end date – 30 June 2016.

Service delivery models that address one or more of the following issues/needs will be well regarded:

Builds on existing service provision; Ensures appropriate servicing of rural/remote locations; Targets the needs of vulnerable groups; Uses an interdisciplinary approach.

Tasmania Medicare Local will;

Provide support and guidance to the successful organisations to enable providers to implement the program, and ongoing support and advice over the length of the contract;

Provide adequate training in the use of data capture and interrogation; Build capacity and skills within the organisation to deliver the service; Provide support/training to enable organisation to fulfil the reporting requirements 6

and twelve month reports; Provide templates for reporting (financial and written) and capturing of data; Provide network opportunities with the TML Care Coordination team across the state.

Evaluation of the submitted EOI will be based on the following criteria:

The demonstrated experience of the provider in similar service delivery and the primary health care sector;

The level of community need identified and how well the proposed service supports the delivery of increased access and increased service provision to the community;

Level of consistency with the Care Coordination Guidelines; How well the proposed service has addressed the future sustainability of the service; The proposed cost of the service;

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Lodgement of applicationsThe Care Coordination expression of interest application form must be used and emailed as an attachment in either MS Word or PDF format to Lynette Purton lpurton@tasmedicarelocal.com.au. Hard copies are to be marked ‘Private and Confidential’ Posted to:Attention: Lynette PurtonPO Box 358 Ulverstone Tasmania 7315

Phone 6425 0800 or 0400 317 825 if further information is required.

APPLICATIONS to be lodged by: 15 November 2013

All applications will be acknowledged in writing after the closing date.

Assessment processIt is anticipated that applicants with successful expressions of interest will be identified by an Evaluation Committee and successful applicants acknowledged by 22 November 2013 with interview/negotiation process to determine the service/project specifications after that date.

It is expected that the service/project will commence by 1 December 2013 and that funding recipients will have contract/reporting responsibilities to TML.

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Tasmania Medicare LocalProvision of Care Coordination ServicesExpression of Interest Application Form

Your answers should not necessarily be limited to the size of the text boxes below (boxes will expand as required when typed in). However, please keep responses to the minimum

necessary to provide sufficient detail in the response.

Registered business name:

ABN (Please ensure the ABN aligns with the registered business entity):

Registered street address:

Please complete if your registered business is a trust:

Trust name:

Trust ABN:

Trustee name:

Trustee ABN/ CAN:

Trading Name (if applicable)

Street address where the service will be provided from (if applicable)

Organisation mailing address

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Contact officer for this application (for day-to-day contact)

Name:

Position title:

Tel ( ) Mobile Fax ( )

Email address:

Project Manager (person with overall project responsibility)

Name:

Position Title:

Tel ( ) Mobile Fax ( )

Email address:

Accreditation status (Is your organisation accredited, and against what standards?)

1. What type of service/s does your organisation currently offer the community?

2. Outline the need for this service in your catchment area (i.e. are there other organisations in your area that offer this service? Why is yours different or better placed to meet the need, etc.?)

3. Please describe how your organisation is placed to deliver against the identified need(s)?

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4. Describe the service/ model your organisation will use to offer Care Coordination services and how the TML Care Coordination Guidelines will be implemented within this model?

5. How will your organisation ensure provision of appropriate workforce?

6. Please describe the scope of your client/patient base and comment on how this correlates with the scope of the TML Care Coordination Program?

7. Reporting Compliance - Please outline your ability to comply with the collection, collation and data reporting requirements for program implementation.

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8. Please provide a brief project plan

Activity Timeframe

9. Please provide an indicative budget breakdown of proposed expenditure

Budget

Item of Expenditure Cost (exc. GST)

Clinical Service:

Salaries

Other Clinical Expenses (Please Specify)

Sub-Total

Administration (Specify Major Expenses)

SubTotal

Total costs (ex. GST)

Add 10% GST if applicable

Total (inc. GST)