Review of the drug and alcohol prevention and treatment services sector

Date Commenced:
07/2013
Expected Date of Completion:
06/2014
Project Supporters:

Commonwealth Department of Health / Contract Research

image - Review Of Treatment Sector Square
Project Members
image - 1314146187 Chalmers Jenny 06
Senior Research Fellow
Ph 02 9385 0189
image - Lynda Berends Square
Senior Research Fellow
Ph 02 9385 0333
image - Philip Hull Square
Research Officer
Ph 02 8936 1105
image - 1314149988 Gomez Maria 06
Research Assistant
Ph 02 8936 1138
image - 1314150565 Kari Lancaster 05
Senior Research Officer
Ph 02 9385 0476
Project Main Description

This project sought to clarify Australian drug and alcohol treatment funding; current and future service needs; the gap between met and unmet demand; and planning and funding processes for the future.

This project aimed to deliver:

  1. a shared understanding of current drug and alcohol treatment funding;
  2. a set of planned and coordinated funding processes for future Commonwealth AOD funding rounds; and
  3. documentation to inform future Commonwealth funding processes which articulate with state/territory approaches and respond to the needs of individuals, families and their communities.

 

Rationale

The former Minister for Mental Health and Ageing, the Hon. Mark Butler MP, requested that the Department of Health (formerly Department of Health and Ageing) undertake a review of the drug and alcohol prevention and treatment services sector following the Substance Misuse Service Delivery Grants Fund, and Non-Government Organisation Treatment Grants Program funding rounds that were finalised in early 2012. The department conducted an open tender process to engage a consultant to undertake the review, with a team from the Drug Policy Modelling Program (DPMP) at the University of New South Wales, headed by Professor Alison Ritter, being the successful tenderer.

Aims

The Review aimed to achieve:

  • clarity as to the range of services currently funded by governments, their distribution and the demographic groups targeted by these services;
  • a common understanding amongst governments and the sector of current and future service needs and where there may be service gaps, either in relation to service type, geographic area and/or demographic groups;
  • clarity as to the type and timing of drug and alcohol funding activities undertaken by governments; and
  • the development of a resource/tools to help focus future government funding activities to ensure existing levels of resources (and any growth funding) are used as efficiently and effectively as possible to deliver quality, sustainable drug and alcohol services that respond to the needs of individuals, families and communities
Design and Method

Primary data collection used a rapid assessment methodology. This is a highly consultative and engaged approach to obtaining and analysing large amounts of data (both quantitative and qualitative) over a relatively brief period of time. Each state/territory health department and NGO AOD peak bodies across the jurisdictions participated in the rapid assessments. The research team sourced both quantitative and qualitative data, analysed records held, discussed and reviewed data with the stakeholder providing the data, and sought out the perspectives of the various stakeholders, and their interpretations of the data.

The rapid assessment approach provided for wide consultation as the core team is in situ with stakeholders, collecting and analysing, discussing and reviewing data as it comes to hand.

In addition to documenting service types and funding sources, we documented the types of treatment provided and who receives them. We refer to this as ‘met demand’. This is best completed by way of secondary analysis of treatment data. The datasets we are using include: the AODTS- NMDS, NOPSAD, the National Hospital Morbidity Database (NHMD), and Bettering the Evaluation and Care of Health data (BEACH). We conducted a gap analysis (difference between met and unmet demand) using the DA-CCP model (NSW Ministry of Health).

Aboriginal services were included within the review scope. The National Drug Research Institute (NDRI) at Curtin University undertook this work.  They collected and analysed data from stakeholders across Aboriginal and Torres Strait Islander communities.

The final report provided an analysis across all the components drawing on:

  • the working papers;
  • the Review Advisory Committee input;
  • consultations throughout with governments and peak bodies, including consumer representatives; and,
  • our further analytic work after all data collection is complete.

The final report is a confidential report delivered to DoHA. Its release will be determined by DoHA.


Approach

The review will have six components:

Component Areas to be covered
1. Service funding review
  • What types of agencies and treatment services are currently funded?
  • Who funds the services?
  • In what settings are services provided?
  • In what quantum are services provided? (amount of services: # of beds/# of episodes/# of outpatient “spots”)
  • Who is targeted by the services? (youth, women, homeless) and what is the extent of met demand?
2. Service planning analysis
  • What are the current jurisdictional planning processes, contractual arrangements, and tendering timelines?
  • Who are the current priority groups? How are they identified? How are they translated into funding decisions?
  • What are the state/territory reform plans?
3. Gap analysis
  • What is the gap between met and unmet demand?
4. Funding models review
  • What are the possible models for funding (e.g. tendering, unit costs, block grants), drawing on international literature and Australian models?
  • What are the potential varieties of procurement arrangements, including funding accountability (reporting requirements, payment by results)?
5. Innovation identification
  • How can innovation and diversity be maintained?
6. Analysis, interpretation and consideration
  • How should Commonwealth funds be best used (e.g. targeted to gaps, special initiatives, adding intervention capacity to existing systems, general)?
  • Is there duplication of funding?
  • What process of planning and contracting services would best meet needs, in terms of efficiency, simplicity and the ability to fill gaps?
  • What funding arrangements are recommended?

Each component will involve primary data collection, using the rapid assessment methodology and secondary analysis of a variety of datasets.           


Review Advisory Committee

The Department of Health established an advisory committee to provide expert advice to government regarding the review. The list of members of the Advisory Committee, and their area of representation can be found here.


Communication and consultation

Working papers formed the core of the communication strategy – giving stakeholders access to the workings and analysis of the review team throughout the 12 months. Nine working papers were prepared, and input sought, (these working papers are no longer available on the website. Requests for a copy of the working papers can be made to Alison Ritter via email a.ritter@unsw.edu.au).

The peak bodies were engaged as collaborators on the review. They were responsible for ensuring that stakeholders within their jurisdictions were kept up-to-date with progress and issues from the review as they arose.


Working papers

Working Paper No. 1: Estimating need and demand for treatment – a background briefing

Working Paper No. 2: Planning alcohol and other drug services in rural and remote areas

Working Paper No. 3: Alcohol and other drug treatment financing in Australia: Funding flows

Working Paper No. 4: The Non Government Organisation Treatment Grants Program (NGOTGP) and the Substance Misuse Service Delivery Grants Fund (SMSDGF) - a descriptive overview

Working Paper No. 5: The potential role of pay-for-performance in alcohol and other drug treatment funding: A literature review

Working Paper No. 6: "Hard to count" or unrecorded treatment utilisation for alcohol and other drugs

Working Paper No. 7: Australian alcohol and other drug treatment spending

Working Paper No. 8: Alcohol and other drug treatment utilisation in Australia

Working Paper No. 9: Planning processes for alcohol and other drug treatment in Australia

Working Paper No. 10: Approaches to purchasing alcohol and other drug treatment in Australia

Progress/Update

This project is now concluded and the final report submitted to the Department of Health.

Output
 

 

Benefits

The review provides an opportunity to detail what is occurring and establish principles for future planning, useful for all levels of government, service providers and, ultimately, the broader community.

Project Supporters

Commonwealth Department of Health / Contract Research

Project Research Area
Project Status
Completed

Project Contacts

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