Koroua and Kuia Early Intervention Service

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Koroua and Kuia Early Intervention Service Powered By Docstoc
					                                    DHBNZ

                                on behalf of all DHBs




   KOROUA AND KUIA EARLY INTERVENTION
                SERVICE

STATUS:                    CURRENT




DATE PUBLISHED ON NSF LIBRARY              JULY 2002

DATE TO BE REVIEWED
Koroua and Kuia Early Intervention
Service

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.


     4.1 Known 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.


     5.1   Key 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.


        5.2     Programme Plans
                It is expected that the provider will develop the following plans.


5.2.1


Targeted       Positive                Action required                            Performance measures
 group        outcomes
               sought

General       Improved    Development of a health plan which:             A programme plan is developed in
              health                                                      which:
                             identifies agreed strategies for the
              status
                              improvement health status for all               current health status for the group
                              participants                                     is identified
                             identifies positive areas of health             areas that have been agreed to be
                              status (eg, level of non- smokers,               improved are identified
                              amount of weekly exercise)
                                                                              priorities are identified
                             identifies priorities for the client and the
                                                                              targets for improvement in these
                              service provider
                                                                               priority areas are set
                             sets targets for improvement in these
                                                                              specific strategies to ensure these
                              priority areas
                                                                               improvements are developed
                             develops specific strategies to make
                                                                              develops a simple way of
                              these improvements
                                                                               assessing whether these
                             develops a simple way of assessing               improvements have occurred.
                              whether these improvements have
                              occurred
                             links with appropriate agencies.
5.2.2

Targeted         Positive                   Action required                         Performance measures
 group          outcomes
                 sought

General      Decision making     Assist participants on making              How client rate this program and
             Increased self-     decisions related to health issues.        specific aspects of it (positive and
             esteem and          Assist individuals with strengthening      negative).
             confidence to self- whanau, hapü and Iwi links.                The number of individuals assisted with
             manage health                                                  identifying whakapapa.
             care

Specific   Management of         (#) Promotional activity on asthma         The number of asthma health education
strategies asthma                education provided with involvement        and promotional activity that have been
                                 of specialists services.                   held.
                                 Assist in identifying asthma for at risk   The number of individuals identified as
                                 or potential clients.                      being asthmatic.

             Improved nutrition Provide specialised nutritional advice      The number of clients provided with
                                consistent with modern knowledge            nutritional advice (#).
                                and Maori tradition.                        The number of improved nutrition health
                                 Promote advice to reduce fat intake.       education and promotional activity that
                                                                            have been held.
                                 Promote weight loss.



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

 Targeted       Positive                  Action required                           Performance measures
  group        outcomes
                sought

Target         Prevention    Give information at promotional activity       The number of promotional activity at
population     of and        and to whanau and women about breast           which information is given about breast
(50–64+)       screening     cancer.                                        cancer (#).
               for breast    Promote the breast cancer screening            The specific ways in which the breast
               cancer        programme (50+ years).                         cancer screening programme has been
                                                                            promoted.
                                                                            Feedback from wahine that the
                                                                            promotion has helped in their
                                                                            knowledge about the importance of this
                                                                            service.

Target         Promotion     Give information at promotional activity       The number of promotional activity at
population     of cervical   and to whanau and wahine about cervical        which information is given about cervical
(20–70         screening     screening.                                     cancer (#).
years)                       Promote the national cervical cancer           The specific ways in which the
                             screening programme.                           importance of cervical cancer screening
                                                                            has been promoted.

               Promotion    Give information at promotional activity        The number of promotional activity at
               of positive  and to whanau and wahine about                  which information is given about
               life changes menopause and life changes.                     menopause and life changes (#).
5.2.4 Koroua and Kuia
Key health factors for koroua and kuia: hospitalisation, causes of death, life expectancy,
injury, home support services.


 Targeted        Positive                  Action required                     Performance measures
  group         outcomes
                 sought

Target        Promoting and     Give advice and support to koroua       The number of koroua and kuia and
population    maintaining       and kuia about improving their          their whanau who have been assisted to
(50+)         fitness and       mobility and fitness.                   improve mobility and fitness (#).
              mobility of
                                Mirimiri services provided as required. The number of koroua and kuia who
              koroua and kuia                                           have been assisted by the mirimiri
              – Korikori                                                service.
              Tinana
              Programme

              Management of     Assist clients with the process of      The number of people assisted (#).
              diabetes          accessing specific diabetic services.
                                Give advice on the ways to prevent
                                diabetes or reduce its impact among
                                koroua and kuia.




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.


     9.1 Reporting 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.


     9.2 Performance 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

     10.1 Philosophy
           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.

10.2    Staff 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             (insert coverage area)
2. Total Maori population           (Insert Maori Percentage of
                                    population)   population
Promotional activities                                                     Total Numbers
3. Number of programme health plans to be achieved
4.   Target number of clients assisted with asthma
5.   Target number of clients provided with nutrition advice
6.   Target number of clients provided with diabetes advice
7.   Number of promotional activities to discuss breast cancer/screening
8.   Number of promotional activities to discuss cervical cancer/smears
9.   Number of promotional activities to discuss life changes
10. Number helped with fitness and mobility
11. Number assisted with management of asthma/CORD
12. Number assisted with management of diabetes
Client make-up*
13. Total number of tane (under 50 years)
14. Total number of whaine (under 50 years)
15. Total number of kuia (50+)
16. Total number of koroua (50+)
Number of attendees
17. Number of attendees
18. Number of new clients by age/gender/ethnicity* - Maori and
     non-Maori
19. 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.

 Service reports for each quarter               Report due by
     st
 1 quarter ended 30 September                   20 October
     nd
 2        quarter ended 31 December             20 January
     rd
 3 quarter ended 31 March                       20 April
     th
 4 quarter ended 30 June                        20 July



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

 Financial reports                              Reports due by
     st
 1 quarter ended 30 September                   20 October
     nd
 2        quarter ended 31 December             20 January
     rd
 3 quarter ended 31 March                       20 April
     th
 4 quarter ended 30 June                        20 July


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.

				
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