Hawkesbury-Hills Division

1. ACAI Program atHawkesbury-HillsDivision of General PracticeCarla BoschProject Officer CDM & ACAI

2. Hawkesbury-Hills Division HHDGP North: Wisemans Ferry South: Parklea, Winston Hills East: Baulkham Hills, Castle Hill West: Bilpin, Kurrajong (Blue Mtns) Richmond, Windsor, LGAs: Hawkesbury, Baulkham Hills & Blacktown North _______________________________________________________________________________ Hawkesbury-Hills Division of General Practice2

3. RACFs within HHDGP boundaries ** Not participating in ACAI; did not participate in last yrs of ACGPPI ________________________________________________________________________ Hawkesbury-Hills Division of General Practice3

4. ACAI at HHDGP • Administration process: step-by-step • Agreements, reporting, financials • Why we chose the administration process implemented • Lessons learned • Critical success factors • Activities, outcomes & feedback _______________________________________________________________________________ Hawkesbury-Hills Division of General Practice4

5. Administrative Processes - agreements • All interested, eligible RACFs received copy of ACAI Guidelines • Developed individual agreements between HHDGP and participating RACFs • Based on GP NSW – HHDGP contract • States amount of funding available to that RACF • 75% of HHDGP ACAI budget ÷ no. low care beds in HHDGP x no. low care beds in that RACF = RACF allocated funding • States roles & responsibilities of HHDGP and RACF • Reporting schedule (of RACF to HHDGP) • Payment schedule (from HHDGP to RACF) • RACF engages AHP(s) _______________________________________________________________________________ Hawkesbury-Hills Division of General Practice5

6. Administrative Processes - reporting • Developed simple individual quarterly reporting templates (from RACF to HHDGP) • Based on reporting requirements to GP NSW • Some RACFs use template to keep record of AHP activities and submit multiple (monthly) to HHDGP • Reminder emails, phone calls, visits _______________________________________________________________________________ Hawkesbury-Hills Division of General Practice6

7. Administrative Processes - reporting ACAI Activity Report: to Hawkesbury-Hills Division of General Practice from St Elsewhere Aged Care Facility 01 April 2010 – 30 June 2010 _______________________________________________________________________________ Hawkesbury-Hills Division of General Practice7

8. Administrative Processes - financials • AHP invoices RACF for services provided • RACF pays AHP • RACF submits invoice to HHDGP • Project Officer checks invoice against ACAI Activity Report from RACF • Checks with RACF if unclear • Approves and submits to Finance Officer • HHDGP pays RACF _______________________________________________________________________________ Hawkesbury-Hills Division of General Practice8

9. Why choose this method? • Initially (2009-2010) quickest way to ensure available funds were utilised • ACAI did not commence in HHDGP until April 2009 • At consultation meeting, DoNs of interested RACFs readily agreed to these reporting and payment processes • Adapted contract & report templates from GP NSW • DoNs already knew which AHP services their residents would benefit from most _______________________________________________________________________________ Hawkesbury-Hills Division of General Practice9

10. Lessons learned • Initial set up time consuming but not too onerous • Ongoing work requires minimal time only • ACAI Activity Report templates work for DoNs as well as assist HHDGP reporting to GP NSW • Simultaneous staff education • Ensure RACF care staff on hand when AHP instructs resident re exercises • Difficulty limiting ACAI services to low care • Some “high care” residents want to participate in group exercise programs _______________________________________________________________________________ Hawkesbury-Hills Division of General Practice10

11. Critical success factors • Small number of low care facilities • DoNs/Care Managers involved from start • Built on very strong rapport & network already established during ACGPPI period • Gave decision-making authority to DoNs • i.e. not a bureaucratic process • Personal visits to DoNs (esp. new ones) • Continuing network meetings _______________________________________________________________________________ Hawkesbury-Hills Division of General Practice11

12. Activities, outcomes & feedback • Activities: • Exercise programs - falls prevention – individual and group • Outcomes: • Significant reduction in falls (very cost effective) • Increased mobility – improved well-being • Improved posture • Happy residents, happy DoNs, happy HHDGP! _______________________________________________________________________________ Hawkesbury-Hills Division of General Practice12

13. Activities, outcomes & feedback • Feedback: • Essentially all positive • DoN: “ one resident could not go from her bed to the toilet without staff assistance and now goes unaided” • Succinctly summed up by AHP - “I think it’s a great idea and we have been able to get significant functional outcomes achieved with many of the patients” _______________________________________________________________________________ Hawkesbury-Hills Division of General Practice13