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This document is available as a PDF on the internet at: www.health.vic.gov.au/pfg

© Copyright, State of Victoria, Department of Health, 2014

This publication is copyright, no part may be reproduced by any process except in accordance with the provisions of the Copyright Act 1968.

Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne.

Printed by Doculink Australia, Port Melbourne. Printed on sustainable paper.

August 2014 (1406004)

Contents

Ministers’ foreword 1

Acronyms and abbreviations 3

Part 1: Overview, key changes andnew initiatives 5

1.1 Overview 6

1.2 Victorian Health Priorities Framework 8

1.3 Accountability framework 10

1.3.1 Policy and funding guidelines 10

1.3.2 Statement of Priorities 10

1.3.3 Health service and Ambulance Victoria performance monitoring framework 11

1.3.4 Community service organisations: accountability and service agreements 11

1.3.5 Multi-Purpose Service tripartite agreements 11

1.3.6 Notification obligations 12

1.4 Budget highlights 13

1.4.1 Output initiatives 14

1.4.2 Asset initiatives 15

1.4.3 Boosting elective surgery capacity 17

1.5 Service performance 18

1.5.1 Health service performance measures 18

1.5.2 Quality benchmarking 18

1.5.3 Performance monitoring for community service organisations 19

1.6 System improvements and innovation 20

1.6.1 Commission for Hospital Improvement 20

1.6.2 Health Innovation and Reform Council 21

1.6.3 Mental Health Act implementation 22

1.6.4 Hand hygiene 22

1.6.5 Telehealth 22

1.6.6 Ageing, aged care and supported residential services 23

1.6.7 Acute and subacute services 24

1.6.8 Specialist clinics access 27

1.6.9 Ambulance services 27

1.6.10 Community health services 28

1.6.11 New consumer participation and experience policy 28

1.6.12 Patient experience: Victorian Healthcare Experience Survey 29

1.6.13 Meeting the needs of Victoria’s diverse populations 29

1.6.14 Tuberculosis Control Program 30

1.6.15 Implementation of changes to the Assisted Reproductive Treatment Act 2008 30

1.6.16 Private Health Care Facilities Bill 2014 30

1.7 The pricing and funding framework for Victorian health services 31

1.7.1 Pricing and funding framework 31

1.7.2 Commonwealth funding 32

1.8 Funding reforms 2014–15 33

1.8.1 Marginal WIES pricing 33

1.8.2 WIES peer groups 34

1.8.3 Ambulance Victoria 34

1.8.4 Normative pricing 34

1.8.5 Pricing for quality 34

1.8.6 Specified grant consolidation 35

1.8.7 Non-admitted radiotherapy and allied health 35

1.8.8 Blood funding 35

1.8.9 Updates to the admitted mental health model: towards an activity-based model 36

1.8.10 Home and Community Care: transition to the Commonwealth Government 36

1.9 Data and reporting changes 38

1.9.1 Revisions to the Victorian hospital admission policy 38

1.9.2 Data collection changes 38

1.9.3 Health service environmental management planning and reporting 39

1.9.4 Victorian WorkCover Authority 39

Appendix 1.1: Summary of modelled budgets 2014–15 40

Ministers’ foreword

Victoria's health system continues to lead the nation in providing responsive, integrated and innovative healthcare options. The Victorian Government has a clear plan to meet the challenge of a growing population and increased demand for service and provide quality healthcare for all Victorians. The Government also recognises that improving patient access to health services is fundamental to Victorians' quality of life.

The 2014–15 State Budget delivers total funding of $15 billion to the Victorian health system and over the next four years will provide an additional:

•  $1.4 billion to support hospitals

•  $190 million to boost elective surgery

•  $156 million to better support Victorians with mental illness or drug and alcohol addiction

•  $60 million to enhance access to health services during peak winter demand

Central to meeting this commitment to the health of all Victorians are specific funding measures that will boost the capacity of essential hospital services including critical care, maternity services and emergency departments across the system. Emergency departments will also receive increased funding to better identify, respond and intervene early in instances of family violence and sexual assault. Health service capacity will also be increased in order to improve patient access during periods of peak demand including over the winter months.

Elective surgery capacity will receive a boost in order to meet increasing levels of demand and ensure that more patients are treated sooner. The Victorian Government is also increasing funding to meet growth in demand for ambulance services, as well as expanding the Victorian Patient Transport Assistance Scheme to enhance access to health services for rural and regional Victorians.

Advice from the Health Innovation Reform Council will continue to support the effective efficient delivery and management of quality health services and the reform of the public health system. The health system will also respond to changes in demand by improving bariatric patient care through service consolidation and access to services by increasing the number of bariatric procedures undertaken. Therewill also be a boost to alcohol and drug services, including expansion of drug treatment services tosupport more effective education and treatment responses. The Government is also supporting health services to respond to clinical and non-clinical violence and aggression by patients, staff and visitors. The Government has legislation before the Parliament to ensure emergency workers are protected (Sentencing Amendment (Assaults on Emergency Workers) Bill 2014).

A significant change for the coming year is the introduction of Victoria's new Mental Health Act 2014. Thenew legislation is a key element in the government's mental health reform agenda and places individuals and families at the centre of mental health treatment and care. Funding has been committed to the implementation of key mental health initiatives and to growing mental health services including new Prevention and Recovery Care units and continued housing support for people with a mental illness through the Doorways project.

In the coming financial year, the Victorian Government will support capital projects and infrastructure improvements including state-of-the-art cardiac services at Sunshine Hospital, Latrobe Regional Hospital redevelopment, Boort Hospital redevelopment, expansion of Healesville Hospital and expansion of the Austin Hospital short stay unit.

Funding will also support the replacement of critical engineering infrastructure in hospitals, such as lifts, boilers and electrical equipment, and will continue the replacement of medical equipment in metropolitan and rural health services.

In the community, there will be a new Barwon Health North facility and a new building for Moyne Community Health Service in Port Fairy. There will also be increased support for older people through the Home and Community Care (HACC) program to assist them to remain living in their homes for longer. Victorians with diabetes will be supported to manage their conditions with free access to insulin syringes and pen needles through the National Diabetes Syringe Scheme (NDSS).

This year, the Commonwealth Budget had a significant impact on finalising health service budgets. In particular, the National Partnership Agreement on Improving Public Hospital Services was not renewed beyond 30 June 2014 and the Commonwealth foreshadowed changes to its funding arrangements from 2017 onwards.

Despite these complications, Victorian health service budgets will increase significantly in 2014–15. The net positive result is a consequence of a strong State Budget outcome, which included increased funding for winter demand and additional competitive elective surgery. This additional State funding also allowed Victoria to attract growth funding from the Commonwealth.

The Victorian Government will continue to vigorously pursue the best interests of Victorian health services in its negotiations with the Commonwealth.

Hon David Davis MP Hon Mary Wooldridge MP

Minister for Health Minister for Mental Health

Minister for Ageing

Acronyms and abbreviations

ABF activity based funding

ACAS Aged Care Assessment Service

ACS Australian Coding Standard

ACSQHC Australian Commission on Safety and Quality in Health Care

ADA Australian Dental Association

AHPACC Aboriginal Health Promotion and Chronic Care

ALOS average length of stay

AN-SNAP Australian National Subacute and Non-Acute Patient Classification

AR-DRG Australian Refined Diagnosis Related Groups

CDBS Child Dental Benefits Schedule

CLABSI central line associated blood stream infection

CMI Client Management Interface

CMI/ODS Client Management Interface/Operational Data Store

CPC community palliative care

CSO community service organisation

DEECD Department of Education and Early Childhood Development

DRG diagnosis related group

DuV dental unit of value

DWAU dental weighted activity unit

DVA Department of Veterans’ Affairs

FOBT faecal occult blood test

GEM Geriatric Evaluation and Management

GLBTI Gay, Lesbian, Bisexual, Transgender and Intersex

HACC Home and Community Care

HARP Hospital Admission Risk Program

HDSS health data standards and systems

HIP health independence program

HITH Hospital in the Home

i-SNAC interim-subacute and non-acute classification

ICSP Individualised Client Support Packages

ICU intensive care unit

IHCS Integrated Hepatitis C Service

IHPA Independent Hospital Pricing Authority

KMS Koori Maternity Services

LOP length of phase

MICA Mobile Intensive Care Ambulance

MHCSS mental health community support services

MPS Multi-Purpose Service

NAESG Non-Admitted Emergency Services Grant

NBCSP National Bowel Cancer Screening Program

NDSS National Diabetes Syringe Scheme

NEAT National Emergency Access Target

NEC national efficient cost

NEST National Elective Surgery Target

NEP national efficient price

NETS Newborn Emergency Transfer Service

NHS National Health Service (United Kingdom)

NHT nursing home type

NIV non-invasive ventilatory

NPA national partnership agreement

NSQHS National Safety and Quality Health Service

NWAU national weighted activity unit

PAS performance assessment score

PARC Prevention and recovery care

PCP Primary Care Partnership

PDI The Peter Doherty Institute for Infection and Immunity

PRISM Program Report for Integrated Service Monitoring

PSRACS public sector residential aged care service

SACS subacute ambulatory care services

SLA Statistical Local Area

SoP Statement(s) of Priority

SRHS Small Rural Health Service

TAC Transport Accident Commission

TB tuberculosis

TCP transition care program

VADS Victorian Ambulance Data Set

VAED Victorian Admitted Episodes Dataset

VALP Victorian Artificial Limb Program

VEMD Victorian Emergency Minimum Dataset

VIC-DRG Victorian-modified Diagnosis Related Group

VINAH Victorian Integrated Non-Admitted Health

VHIA Victorian Hospitals Industrial Association

VPCS Victorian Product Catalogue System

VRSS Victorian Respiratory Support Service

VWA Victorian WorkCover Authority

WAU weighted activity unit

WBD weighted bed day

WIES weighted inlier equivalent separation

WOt weighted occupancy target

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Part 1: Overview, key changes andnew initiatives

1.1  Overview

The Victorian Government is responsible for ensuring a wide range of health services are delivered to the Victorian community. The Department of Health plans, develops policy, funds and regulates health service providers and activities that promote and protect the health of Victorians. Through the department, the government funds more than 500 organisations to provide various health services to Victorians including:

•  acute and subacute healthcare delivered through public hospitals and in community settings

•  mental health and alcohol and other drugs services delivered through public hospitals and community service organisations (CSOs)

•  residential and community care for older people, support and assistance to enable people to function independently in their own homes, positive ageing programs, and healthy and active living

•  health promotion and protection through emergency management, public health and related preventative services, education and regulation

•  emergency transport and ambulance services through Ambulance Victoria.

The Victorian health policy and funding guidelines (the guidelines) represent the systemwide terms and conditions (for funding, administrative and clinical policy) of funding for government-funded healthcare organisations.

The guidelines reflect the government and department’s role as a system manager and underpin the contracts at an organisational-level (Statements of Priorities (SoPs) and service agreements). They set out the requirements that funded organisations must comply with in addition to their contractual and statutory obligations, outline activity that is required in order to receive funding, and detail expectations of administrative and clinical conduct.

The guidelines are relevant for all funded organisations including health services, community service organisations (CSOs), and other funded organisations such as Ambulance Victoria.

The Victorian health system continues to evolve as it works towards the aims of the Victorian Health Priorities Framework 2012–2022. This year the guidelines are presented in four parts. The 2014–15 guidelines separate the pricing and funding models from the administrative and clinical conditions of funding. The aim here is to improve the clarity and accessibility of the guidelines. The structure of the guidelines is also designed to enable CSOs to locate relevant information throughout the document.

Part 1: Overview, key changes and new initiatives provides an overview of the accountability framework for funded organisations and introduces the most significant developments in funding, policy, government priorities and service delivery for the coming year.

Part 2: Pricing and funding arrangements for Victoria’s health system details the pricing and funding arrangements for public hospital services and for all other outputs provided by the department.

In order to receive funding from the Victorian Government, all funded organisations must comply with standards and policies that ensure the delivery of safe, high-quality services and responsible financial management. Part 3: Conditions of funding details the relevant standards and policies that may apply.

Tables detailing the modelled budgets for 2014–15 are included in Part 4: Funding and activity levels. Activity tables detail the 2014–15 targets for a range of programs across the health system.

In addition to these guidelines, funded organisations are expected to comply with all relevant policy documents and guidelines. A list of key policies and guidelines can be found at www.health.vic.gov.au/pfg>.

Hospital Circulars provide updates on changes that affect health services during the year. These are available at <www.health.vic.gov.au/hospitalcirculars/index>.

Funded organisations should always refer to the Policy and funding guidelines website for the most recent version of the guidelines, as items may be updated throughout the year.

Where these guidelines refer to a statute, regulation or contract, the reference and information provided is descriptive only. In the case of any inconsistencies or ambiguities between these guidelines and any legislation, regulations and contractual obligations with the State of Victoria acting through the department or the Secretary to the Department of Health, the legislative, regulatory and contractual obligations will take precedence. Each funded organisation should refer to the relevant statute, regulation or contract in order to ascertain all the details of its legal obligations. If any funded organisation has any question in relation to its legal obligations it should seek independent legal advice.