Koroua and Kuia Early Intervention Service

Note: Contact the Service Specification Programme Manager, National Health Board Business Unit, Ministry of Health to discuss the process and guidance available in developing new or updating and revising existing service specifications.

Web site address of the Nationwide Service Framework Library: http://www.nsfl.health.govt.nz/

Koroua and Kuia Early Intervention Service SpecificationPU: MAOR0103

1.Introduction

This service is to focus particularly on meeting the special needs of Maori by providing appropriate Iwi/Maori-based services.

Koroua and Kuia or Elderly Services need to recognise Maori realities, the importance of whanau, hapü, and Iwi structures, and the role Koroua and Kuia play within these structures. The development of Koroua and Kuia programmes, and Maori Community Based Support Services have made impact on the health of Koroua and Kuia. However, it has become apparent that Koroua and Kuia services need to be based on the Maori social structures. Access should not be limited by the current assessment and co-ordination process. Koroua and Kuia are part of the Maori community and become recognised within their community. This Maori selection process should decide access to Koroua and Kuia programmes for each Iwi.

2. Maori Health

The service is expected to contribute to the reduction in health inequalities, the 13 priority Population Health Objectives, as well as the Maori health gain objectives, in particular, targeting services to impact on asthma, diabetes, injury prevention, smoking, hearing, mental health, oral health and immunisation, including violence prevention.

The Maori Health Strategy: He Korowai Oranga is referred to and Maori Health requirements are outlined in the General Terms and Conditions and Provider Quality Specifications. In addition the provider arm of the DHB is to develop and implement a Maori Health Plan that outlines how it will contribute to improving outcomes for Maori for the services contained in this service specification.

The Plan should include the following objectives as a minimum:

• How you will ensure that Maori utilisation is at least equal to the Maori population in the provider's catchment.
• How you will ensure your effectiveness and the acceptability and accessibility of services to Maori
• How links with primary care - general practice, community providers and Maori providers will be effective for improved outcomes in Maori health;
• How discharge planning and rehabilitation processes will meet the needs of Maori;
• Links with the DHB provider arm's Maori Health Plan and other contractual quality specifications, especially consultation with Maori.
• How these objectives will be monitored and measured for Maori health outcomes.

3.Kaupapa/Definition

This service is targeted to make gains towards the Crown’s objective for Maori health and improving the health status of Maori. Positive intervention for this age group, can help to introduce healthier lifestyles and changed habits. Enhancing positive social and functional activities of Koroua and Kuia.

4.Target Group

The target client group for each contract will be for Koroua and Kuia residing in a specified local area.

The definition of Koroua and Kuia is not limited by age. This service requirement definition does not limit this service to over 50.

The services provided by you are targeted primarily for Maori but do not exclude people of other cultures. However, and as a priority, the services delivered will focus specifically on the needs of Maori in the service boundaries.

4.1Known health status of target group

Four main causes of hospitalisation and/or death:

• respiratory system (asthma)
• cardiovascular
• cancers
• CORD.

5.Service Components

This service is to focus on meeting the special needs of Maori by providing appropriate Iwi/Maori-based services. The service will be run on a day programme basis, and will provide a range of activities with mentally and socially stimulating programs. It is expected that these programs will provide recreational and therapeutic benefit.

5.1Key Components of the Service

• Provision of health education/awareness programs including but not exclusive to the following areas:

– asthma

– nutrition

– diabetes

– breast and cervical screening.

• Assistance with personal care needs arising during the service user’s time at the day programme.
• Transport to and from the day program facility within a 20 km radius using a vehicle and driver, and support staff as necessary for safe and comfortable travel considering the service user’s mobility needs.
• Meal(s) as appropriate.

5.2Programme Plans

It is expected that the provider will develop the following plans.

5.2.1

• identifies agreed strategies for the improvement health status for all participants
• identifies positive areas of health status (eg, level of non- smokers, amount of weekly exercise)
• identifies priorities for the client and the service provider
• sets targets for improvement in these priority areas
• develops specific strategies to make these improvements
• develops a simple way of assessing whether these improvements have occurred
• links with appropriate agencies.

• current health status for the group is identified
• areas that have been agreed to be improved are identified
• priorities are identified
• targets for improvement in these priority areas are set
• specific strategies to ensure these improvements are developed
• develops a simple way of assessing whether these improvements have occurred.

5.2.2

5.2.3Wahine

Key health factors for wahine: breast cancer screening, cervical screening.

5.2.4Koroua and Kuia

Key health factors for koroua and kuia: hospitalisation, causes of death, life expectancy, injury, home support services.

6.Relationships and Linkages

The contracted provider of Koroua and Kuia Early Intervention services must have good linkages with:

• Maori providers and Maori organisations such as MWWL, Runanga a Iwi
• local general practitioners, practice nurses and their staff
• other local health care providers including ambulance services, community nurses
• local providers of social and community services, eg, RSA, WINZ, IRD
• hospital provider in respect to community health, public health programmes and hospital services.

You will have written protocols and systems in place to facilitate these linkages.

7.Provision and Level of Service

A day programme service is defined as operating an average of five hours per day. The service will operate (#) per week.

The service provider is required to provide services for a minimum of 10 koroua and kuia and not to exceed (#).

8.Service Coverage Area

The service will be provided in the following area (insert coverage area).

9.Outputs

Refer to the Annual Targets Schedule page.

9.1Reporting Requirements

• Provide a brief quarterly narrative report on your performance against the quality standards listed in the service specification.
• Provide a brief quarterly narrative report on the service, including the following:

– number of programmes completed

– staff training undertaken

– highlights, issues of concerns and any trends within the quarter

– list the type of programme/s and types of activities or specific health education/promotion programmes that focus on health and wellness undertaken at each promotional activity.

• Provide an audited financial report annually.

9.2Performance Measures

• All service and financial reports will be submitted by the due date required.
• All information/data requested in the reporting requirements of the service specification will be forwarded to the Monitoring Team – Ministry of Health, Dunedin Office.
• If for any reason you are unable to meet the reporting timeframes, you are required to contact the Monitoring Team – Ministry of Health, Dunedin office to request an extension.
• Establishment/maintenance of a client register (ie, age, sex, ethnicity, etc).

Ethnicity is recorded as perceived by the family/whanau. People may therefore perceive themselves as belonging to /ore than one ethnic group. Ethnicity is to be reported according to the following priority system: if perceived ethnicity includes:

• Maori, report as Maori
• Pacific, report as Pacific
• otherwise, report as Other

10.Quality Requirements

10.1Philosophy

The Ministry of Health wishes to purchase health services for people, which meet the needs of the communities served. In doing so, particular attention must be paid to health gain priority areas of:

• Maori health
• child health
• mental health
• asthma
• diabetes
• dental health
• injury prevention
• tobacco control
• alcohol and drug
• sexual health.

In regard to Maori health services specifically, the Ministry of Health sees this service as meeting the following Government and Ministry of Health objectives:

• ensuring purchasing arrangements enable greater participation by Iwi and Maori groups
• ensuring services provided for Maori are culturally appropriate
• being responsive to aspirations and interests of Maori
• recognising the tikanga and mana of each Iwi in the region
• being aware that Iwi have their own vision for health.

In addition to the general quality requirements, the following quality requirements apply to this service:

• provision of information to eligible people about hours of availability and ways of making contact in an emergency
• assessment of effectiveness and acceptability through promotional activity or public meetings, which are held at least six-monthly
• seek feedback from whanau that the service is meeting their needs and that knowledge about health has improved or increased.

10.2Staff Training – Disability, Violence and Abuse

Disability

Staff training must be given specifically in:

1. disability awareness to ensure disabled children/adults and disabled carers are given appropriate access and support
2. specific issues in the patterns and identification of abuse and interpersonal violence for these groups.

Violence/Abuse

Staff must have training in how to identify, support and refer victims of child/adult abuse and interpersonal violence. The agency must have protocols in place to support staff in this intervention.

11.Annual Targets Schedule

1. City/region or location of service

1. Total Maori population

1. Number of programme health plans to be achieved
2. Target number of clients assisted with asthma
3. Target number of clients provided with nutrition advice
4. Target number of clients provided with diabetes advice
5. Number of promotional activities to discuss breast cancer/screening
6. Number of promotional activities to discuss cervical cancer/smears
7. Number of promotional activities to discuss life changes
8. Number helped with fitness and mobility
9. Number assisted with management of asthma/CORD
10. Number assisted with management of diabetes

1. Total number of tane (under 50 years)
2. Total number of whaine (under 50 years)
3. Total number of kuia (50+)
4. Total number of koroua (50+)

1. Number of attendees
2. Number of new clients by age/gender/ethnicity* - Maori and non-Maori
3. Number of on-going clients by age/gender/ethnicity * - Maori and non-Maori

*Note: Clients should be counted “once”, even though they may benefit from several promotional activities.

Ethnicity is recorded as perceived by the family/whanau. People may therefore perceive themselves as belonging to more than one ethnic group. Ethnicity is to be reported according to the following priority system: if perceived ethnicity includes:

• Maori, report as Maori
• Pacific, report as Pacific
• otherwise, report as Other

13.Financial and Services Reporting

Service Reports

The provider will report on service delivery and programme development progress using the performance indicators specified in the Schedules.

Financial Reports

The provider will supply the following financial reports to the Ministry of Health annually.

The reports are to consist of an Income and Expenditure Account (accrued), Balance Sheet and a Cashflow Statement (not accrued).

Draft end of year reports (Income and Expenditure Account and Balance Sheet) are to be supplied to the Ministry of Health within one month of the end of the financial year, ie, 31 July 2000. The provider will use its best endeavours to have audited end of year financial reports (Income and Expenditure Account and Balance Sheet) supplied to the Ministry of Health within three months of the end of the financial year, ie, 30 September 2000.