Funding

General Funding Processes

Contact with the funding body is officially through the President of the health service. However, the CEO/ administrator usually is involved with the funding bodies in regard to funding needs, negotiations and accountability requirements, and will often be the first point of contact with government officers.

All applications for funding must be approved by the health board and signed by the president before submission.

If the application for funding is successful, the funding body will send a Letter of Offer to the service. This will include details of the grant, including its purpose and conditions. The health board must agree to these and the president sign an acceptance.

Most NT Aboriginal health services receive funds from one or more of the following:

1. Medicare Australia (Medicare and Pharmaceuticals)
2. Office for Aboriginal and Torres Strait Islander Health (OATSIH)
3. Northern Territory Department of Health (through Service Agreements)
4. Other sources
• Aged Care (DoHA)
• Rural Health Support, Education & Training (RHSET)

The following accountability requirements are commonly specified:

1. quarterly financial statements
2. performance indicators or service activity reports
3. annual Audited Statement.

Submission Package

It is useful to maintain a basic submission package to help with applying or tendering for the provision of services.

The submission package consists of:

• Certificate of Incorporation
• the constitution
• the latest annual report
• the latest audited financial statement
• a summary of current projects and funding
• a brief description of the demographics of the community.

The administrator should keep this package up to date.

Procedure for developing/submitting submission

• Discuss funding opportunity and purpose with the Health Board and if agreed prepare submission taking into account the relevance, the amount of funding available and the administrative load (effort to pursue and report on amount of funding).
• Always consider and include on (recurrent) costs eg leave loading, holiday pay, equipment maintenance/replacement, insurances etc
• Consider who should prepare, have input into the draft proposal before submitting to the Board.
• Final copy approved by the health board and signed by the chairperson before submission.
• If the application for funding is successful, the funding body will send a Letter of Offer to the service. This will include details of the grant, including its purpose and conditions. Check this thoroughly to ensure ....HS agrees to and can meet all the conditions.
• The Chair of the health board must sign the acceptance.
• Keep all records.

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Medicare Australia

Medicare

Medicare benefits are payable to a health service for professional services provided to an enrolled client by, or on behalf of, a registered medical practitioner employed by the service who has been issued a Provider Number by Medicare Australia under the provisions of the Health Insurance Act (1973).

Benefits are paid according to the type of service provided and listed in the Schedule as items, each of which has an allocated Item Number and a fee.See Medicare Reference Guide.

Application for Aboriginal Health Services to access Medicare

Aboriginal health services are permitted to access Medicare for services provided by, or under the supervision of, their salaried registered medical practitioners who have a Provider Number. This involves services being exempted from general provisions that do not allow doctors who work in services that receive government funds for doctors' salaries from accessing Medicare. The First Assistant Secretary of OATSIH is delegated to provide this exemption.

The steps involved in a service being deemed exempt are:

1. The service writes to the Territory OATSIH Program Director requesting the exemption.
2. The OATSIH Territory office prepares a recommendation to Central Office, Canberra.
3. Once the determination has been made, the Territory office advises the service of the approval of their application and provides information to assist the service in making the necessary arrangements.
4. The Central Office co-ordinates a periodic revision of the determination and previous determinations can be changed.
5. Central Office provides copies of the determination to Program Directors, Health Benefits Division and Medicare Australia.

Doctors employed by Aboriginal health services are generally salaried and Medicare payments are made to the health service rather than the doctor, unless the terms and conditions of employment of the doctor detail a different arrangement. Thus each service must enter into an agreement with their salaried medical officers to assign direct-billing Medicare claims to the service. This should be included in the doctor's contract of employment. An authorisation to this effect must be provided to Medicare Australia so that payments can be made directly to the health service rather than the doctor.

Provider Numbers

When a doctor wishes (and their employment contract allows) to continue to claim for Medicare Benefits for private practice work outside the health service employment, work performed for another employer, or for services provided out-of-hours, Medicare Australia can issue separate provider numbers. A different provider number is required for each location of practice. That is, provider numbers are specific to both doctor and practice location.

Not all registered doctors are automatically entitled to a provider number, or are only entitled to a number at specific locations. Medicare Australia can advise on eligibility matters.

 

Payment Arrangements

Make contact with the nearest Medicare Australia processing centre to establish billing arrangements. A Pay Group Link allows a doctor to direct their Medicare payments to their employer. To establish a Pay Group Link Medicare Australia requires:

• written authority from the doctor
• written endorsement of the arrangement from the service
• the doctor's Provider Number
• details of the service's bank account to allow for electronic lodgement into the service's bank account.

Medicare Australia provides information to services and their salaried doctors concerning eligibility, enrolment procedures and billing, and will also provide any necessary stationery.

Information to OATSIH

Each service that is primarily funded by OATSIH is required to provide their doctors' Provider Numbers and Pay Group details to OATSIH so that aggregate payment and usage data can be obtained from Medicare Australia. OATSIH uses aggregate expenditure data to analyse Aboriginal and Torres Strait Islander health within the broader health sector, and to monitor resource allocations for policy development. OATSIH must keep this information in strictest confidence in accordance with the Privacy Act. Failure to provide this information to OATSIH on request may affect the continuation of a service's right to access Medicare.

State/territory government agencies are normally ineligible to access Medicare benefits. The states/territories receive funding for the provision of health services through the Medicare Agreements (known as Health Care Agreements) and untied grants from the Commonwealth. In June 1996, the Commonwealth Minister of Health agreed to provide conditional access to the NT to enable them to increase the provision of medical services to Indigenous communities.

Exemptions under the provisions of Sub-section 19(2) of the Act are made on the following conditions:

• The NT agreeing to work with the Commonwealth to identify and fund medical services in agreed communities.
• The reallocation of recurrent savings under the arrangement to agreed communities for primary health services in partnership with the Commonwealth.
• Agreement to involve Aboriginal and Torres Strait Islander communities in the planning and organisation of services, with progressive transfer of responsibility for additional services to the community controlled sector.

Funds raised by State/Territory governments under these direct billing arrangements must be used to provide additional medical services to Aboriginal and Torres Strait Islander communities, but not necessarily in the same community in which the funds were generated.

Bulk billing

• Bulk billing can only be used when an enrolled client consults a doctor (except for the services listed below).
• The levels of fees are determined by the time the doctor spends with the client, or the complexity of the consultation if the doctor is vocationally registered, or by a specific procedure performed, eg suturing.
• Medicare will pay 100% of the schedule fee provided that the client is adequately identified. Thus the client must be registered with Medicare, and must have either a valid Medicare number, or name, date of birth and address to enable a match with the Medicare database. If neither of these is provided to Medicare's satisfaction, no payment will be made.
• The local Medicare office will provide Medicare numbers to doctors, if they can find the client on their database from the identification data provided by the doctor. If only two or three numbers are required, they will do this over the phone. If more are required, a list can be left with them.
• If newborn babies or others who are not enrolled with Medicare are seen, an enrolment form can be filled in, signed by the client (or carer) and sent to Medicare with the claim form.
• When there are 50 or so Medicare vouchers accumulated, a claim form must be filled in and signed by the doctor then sent to Medicare, which then provides payment to the service. Medicare provides a subsidy of $500 to services for establishing an electronic billing and payment system. An electronic system means that claims and payments are made more rapidly.

Services Provided by AHWs and Nurses

Medical services provided by AHWs and nurses under the direct supervision of a medical practitioner can be claimed under his/her provider number. However, medical services provided by AHWs and nurses working independently are not eligible to direct bill.

Medicare does not cover consultations that only involve AHWs. However, when a doctor is involved with an AHW in the consultation with a patient, it is deemed to be under the direct supervision of the doctor and the consultation time can include both the doctor's and AHW's time. However, never include waiting time.

The health service can bulk bill for the work of AHWs when they perform the following 'on behalf of a medical practitioner':

1. Spirometry (Item 11506)
2. Screening Audiometry (Item 11306)
3. 12 lead ECG (Item 11700)
4. Pelvic/ Abdominal Ultrasound assoc with pregnancy (Item 55041)
5. Follow up services (Item 10987)
6. Immunisation (Item 10988)
7. Wound Treatment (Item 10989)
8. Allied health (EPC) 10950.

Item 10987 allows for the provision of follow up services by a nurse or registered AHW on behalf of a GP. The service is provided to an Indigenous person who has received a health check. The follow up services relate to any issues identified in the health check with a maximum of 10 services per year.

Item 10993: Immunisation administered to either an adult or a child. The medical practitioner does not need to be present at the time of the immunisation.The nurse must be appropriately qualified and trained to administer the immunisation.

Item 10996: Wound Management. This item can be claimed for the treatment of any wound, except for normal post-operative aftercare, and can be provided in any location, except a hospital or day-hospital facility. The medical practitioner does not need to be present during the treatment of the wound. However, s/he must conduct an initial assessment of the patient in order to give instruction in relation to the treatment of the wound. Where a practice nurse provides ongoing wound management, the medical practitioner is not required to see the patient during each subsequent visit.

Pap smear services and preventive checks provided by a practice nurse (item 10994, 10995, 10998 and 10999)

Items 10994 and 10995 require taking of a Pap smear and at least one preventive check.

Item 10997 for a chronic disease follow up service for a client with a GP Management Plan, Team Care Arrangement or Multi disciplinary care plan provided by a practice nurse or registered AHW.

Item 10998: Cervical smear. This can be done by a nurse on behalf of and under supervision of a medical practitioner in a rural area.

Item 10999: Cervical smear. This can be done by a nurse on behalf of and under supervision of a medical practitioner in a rural area for a woman who has not had a pap smear in the last four years.

Reforms May 2010

Reforms to the MBS (implemented 1 May 2010) reduced 52 items in the relevant parts of the schedule. There are now 33 (previously 85) items. The explanatory notes relating to primary care items have been made clearer and support GPs and preventive health care activities.These changes and fee structures include:

• Attendance items out of consulting rooms
• After hours attendance items
• Prolonged attendance items
• Health assessment items
• Chronic disease management items
• GP multidisciplinary case conference items

Health Assessments (Group A14)
The following health assessments are undertaken under four new items:

• a Healthy Kids Check;
• a 45-year old health assessment;
• a type 2 diabetes risk evaluation;
• an older persons health assessment;
• a comprehensive medical assessment for a permanent resident of an aged care facility;
• a health assessment for a person with an intellectual disability; and
• a health assessment for a refugee or humanitarian entrant.

The four Aboriginal and Torres Strait Islander people’s health assessment items are collapsed into one item with no designated time or complexity requirements, with no distinction between an assessment provided in or out of consulting rooms. The length of the health assessment will be at the medical practitioner’s discretion. The following health assessments will be undertaken under one item:

• the Aboriginal and Torres Strait Islander child health assessment;
• the Aboriginal and Torres Strait Islander adult health assessment; and
• the Aboriginal and Torres Strait Islander older persons health assessment.

The health assessment item for services provided by a practice nurse or registered Aboriginal health worker on behalf of a medical practitioner is item number (10986).

The Explanatory Notes for all items affected by the MBS Review changes have also been revised to provide supporting information. The notes section is available on downloadable fact sheets on health assessment items.

Further Information MBS Primary Care Items.

Other information on Indigenous specific items can be found in Medicare Fact Sheets.

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Mental Health

There are a series of Item nos to encourage better care for those with mental health problems:

• Mental Health Plans (Annual) and Reviews ( 2 pa) enabling access to 12 sessions with accredited counsellor/ psychologist through Medicare. (Item 7210, 7212)
• Mental health consultations (Item 7213)
• Counselling services (Items 80150, 80170, 80110, 80135, 80000, 80010, 80100, 80020, 80120, 80145, 80160)

All GPs are encouraged to undertake accredited Mental Health Skills Training to assist these patients. Those who have not undertaken the training need to use the new Medicare item number 2702 for developing a Mental Health Treatment Plan. The items can be claimed in any general practice where medical practitioners are eligible to receive Medicare benefits. This includes Aboriginal medical services that have arrangements to claim Medicare.

Medicare Claims

Medicare staff offer training to clinic staff in how the system works. It is useful to a clerical worker who can make sure it works well and be the expert.

Manual Procedure

1. When a client presents staff will need to:

• fill out a medicare form with all the details except the service rendered, item number and fee
• provide this form to the doctor or AHW seeing the patient.

When the doctor sees the patients/he will need to:

• time the consultation and then fill in the voucher with service(s) rendered with item number, fee and name of doctor performing the service
• get the client to sign the voucher

Once a number of vouchers have accumulated (eg 50), the following needs to happen:

• check all forms are filled in correctly
• calculate the total amount to be claimed
• fill in medicare claim voucher
• witness the doctor's signature
• post the Medicare claims.

Staff also need to keep medicare numbers up to date. This requires:

• liaison with Medicare when numbers are in doubt
• filling in a Medicare enrolment forms for newborn babies, or where Medicare cannot provide a number.

Medicare Australia encourages services to participate in MedClaims, an electronic system that enables practitioners to transmit bulk-bill and Department of Veterans Affairs' claims, and receive payment and reconciliation reports electronically. However, this system requires specifically approved software and services should check carefully the conditions of MedClaims before agreeing to this claims system.

Supporting documentation must be forwarded to the Medclaims co-ordinator. Data may also be transmitted to the Australian Childhood Immunisation Register (ACIR). Medical practices with Medclaims use a personal computer, a modem and the services of software vendors and communications carriers that have agreements with Medicare Australia.

Further information, including application forms for practitioners, can be obtained by writing to:

Medicare Benefits Schedule (MBS) On Line

All services should ensure that they are on the Medicare Australia mailing list. The MBS is ann online publication. The Department will provide MBS subscribers with a CD of the MBS. This CD includes definitions and updates of fees for Item Numbers, any new Item Numbers, and the rules that apply. It can also be downloaded.

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Practice Incentives Program

The Practice Incentives Program (PIP) provides payments from Medicare Australia to eligible health services through a complicated formula involving loadings for various aspects of practice (eg arrangements for after hours care) and the Medicare billing patterns of that doctor or health service. Funding under PIP is only available to those servise who are accredited through RACGP via Australian General Practice Accreditation Ltd (AGPAL) or General Practice Accreditation Plus (GPA+). There are 13 elements and a range of MBS item numbers available under PIP for cycles of care for conditions such as Asthma and Diabetes.

The health service must apply to Medicare Australia to participate in the program. Once included, the health service has 12 months to become fully accredited and must keep Medicare Australia informed about changes in medical personnel.

The new PIP indigenous health incentive is available to all general practices and ACCHOs who are participating in PIP.

There are 3 types of payments.

1. Sign on payment – this includes obtaining consent from patients, having a recall system for patients with chronic disease and annotating PBS prescriptions.
2. Annual registration payment – this includes offering a health check to a 15year old+ indigenous person who has a chronic disease and has provided their consent.
3. Annual outcomes payment (2 tiers) this includes developing/reviewing a GPMP or uUndertake 2 reviews of the GPMP; or contributing to/ reviewing a multi disciplinary care plan for a patient of a residential care facility twice. The practice must provide the majority of MBS services (minimum 5) in the registration period.

Practice Nurse Incentive Program

The Practice Nurse Incentive Program (PNIP) starts on 1 January 2012 and provides incentive payments to services to support an expanded and enhanced role for nurses working in general practice. ACCHOs are eligible to apply for this.

ACCHSs are eligible for up to $25,000 per FTE GP for practice nurse or allied health professional employment. The list of allied health professions is broad, but excludes pharmacists and dentists/ assistants.
The criteria include being accredited or registered for accreditation using the current Royal Australian College of General Practitioners (RACGP) Standards for general practice.
Services not eligible for incentive payments under the PNIP may be eligible for grand parenting payments if they are financially disadvantaged by the removal of the six MBS practice nurse items.

The PNIP will also include:

• support for all accredited practices to employ an Aboriginal Health Worker instead of, or in addition to, a practice nurse (Registered Nurse or Enrolled Nurse) 
• support for Aboriginal Medical Services and Aboriginal Community Controlled Health Services to employ an allied health professional, such as a physiotherapist, dietitian or occupational therapist, instead of, or in addition to a practice nurse and/or Aboriginal Health Worker
• a rural loading of up to 50 per cent based on the Australian Standard Geographical Classification—Remoteness Areas (ASGC—RA)
• a loading for Aboriginal Medical Services and Aboriginal Community Controlled Health Services
• a one-off $5000 incentive to support eligible non-accredited practices to become accredited.

PNIP Guidelines

Services can apply for the PNIP from 1 October 2011, using the application form. Services currently registered with PIP need to apply. From 1 January 2012, services will be able to apply for the PNIP and supply the required supporting documentation via the PNIP Online system.

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General Practice Immunisation Incentive (GPII) Scheme

The General Practice Immunisation Incentives Scheme provides incentive payments to doctors and health services for immunising children. This is another complicated formula that involves payments for the act of immunisation, as well as for achieving full immunisation for the service's child clients (even if the immunisations are done elsewhere) and for achieving high rates of immunisations amongst the child population of that service.

Participation requires immunisations to be entered into a national database (Australian Childhood Immunisation Register) through which the immunisation status of children is determined.

The General Practice Network NT is involved in this program in the NT and can provide advice and assistance.

Mental Health Nurse Incentive Program

The Mental Health Nurse Incentive Program (MHNIP) funds community based general practices, private psychiatric practices and other appropriate organisations to engage mental health nurses to assist in the provision of coordinated clinical care for people with severe mental health disorders. Eligible organisations that can receive funding for this program include Aboriginal and Torres Strait Islander PHC funded by the Australian Government through OATSIH.

Better Access to Psychiatrists, Psychologists and General Practitioners

The Better Access initiative was introduced on 1 November 2006 and is one of 17 mental health measures being managed by DoHA. The initiative aims to improve access to services for people with a mental health disorder, and includes MBS items  that integrate allied health and GP care to improve early detection, treatment and management of people with mental illnesses in the community. The  items  are for mental health care  plans, review of plans and GP consults.

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Pharmaceutical Benefits Scheme

Medicare Australia is also responsible for administering the Pharmaceutical Benefits Scheme.

Prescriber Numbers

All doctors are issued with a Prescriber Number, which is specific to each doctor regardless of their location of practice. Application is not necessary as the number is automatically generated from the initial application for a Provider Number.

Prescription Pads

Medicare Australia will provide doctors with prescription pads and Authority Prescription Pads with their name, qualifications, address and Provider Number printed on them. Computer prescription forms are available. Use the specific order form to order prescription pads and post it to:

Prescription Pad Order Clerk
Pharmaceutical Branch
HIC
GPO Box 9826 Sydney NSW 2001
Tel. 02 9895 3295

Medicare Australia provides a Schedule of Pharmaceutical Benefits book to all doctors that lists all items on the PBS, and the conditions to be met for Authority Prescription approval.

Authority Prescription Applications

Certain pharmaceuticals require Medicare Australia approval, which can be obtained by telephone (1800 888 333) or mail application to HIC.
They will require the following information:

Patient:	Medicare Number
	Surname
	First Name
	Full residential address, including post code.
PBS Authority Prescription Number
Doctors Prescriber Number
Drug Information:	PBS Item
	Quantity required and number of repeats
	Daily dose
	Disease or purpose information

A new streamlined authority process has been introduced for some medications where an authority code can be quoted without ringing for authorisation. However, any increased quantities or repeats will require phone approval. The streamlined authority codes are included in the Schedule of Pharmaceutical Benefits.

Regulation 24

This regulation permits the dispenser to supply the patient with original and repeat supplies on the same day. The doctor must mark the prescription with the words 'Regulation 24' if satisfied that:

the maximum quantity is insufficient for the patient's treatment AND

the patient has a chronic illness or lives in a remote community where access to PBS supplies is limited AND

the patient would suffer great hardship trying to get the pharmaceutical benefit on separate occasions.

Section 100 Arrangements

Aboriginal health services, both community and NTDHCS-controlled, are entitled to access free pharmaceuticals listed under the PBS through arrangements with community pharmacists under Section 100 of the Act. Special application must be made to Medicare Australia, which needs to specify which pharmacist will supply the health services. A unique number is allocated to the service that is used on designated stationery to order pharmaceuticals in bulk from the nominated community pharmacist. This arrangement requires the health service to abide by certain conditions in the handling and dispensing of drugs.

To improve access to the Pharmaceutical Benefits Scheme, remote area Aboriginal health services (RAAHS) can use a new electronic order form (see below).

Only RAAHS approved by the Department of Health and Ageing, which have been issued with a six digit approval/registration number and a check digit number, can use the form to request PBS supplies from a community pharmacy or public sector hospital pharmacy.

Emergency Doctors Bag Supply

A small range of emergency drugs can be supplied to doctors free of charge. Each doctor can be issued with an Emergency Drug (Doctor's Bag) Order Form Book, which has one form for each month of the year in triplicate. Only one order can be made each month and is given in duplicate to a community pharmacist who will supply the doctor with the ordered drugs. The doctor must sign the form on receipt of the ordered drugs.

An Emergency Drug (Doctor's Bag) Order Form Book can be obtained through submitting a special order form to Medicare Australia (see below).

Schedule of Pharmaceutical Benefits

All services should ensure they are on the HIC mailing list to receive regularly new editions of the Schedule of Pharmaceutical Benefits book. This book includes all drugs listed under the Pharmaceutical Benefits Scheme, any restrictions and the rules that apply. The Schedule is published three times a year, effective 1 April, 1 August and 1 December each year.

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The Office of Aboriginal and Torres Strait Islander Health (OATSIH)

OATSIH operates within the Commonwealth Department of Health and Ageing (DoHA) and is responsible for the Commonwealth Government's Aboriginal and Torres Strait Islander Health Program. Aboriginal community controlled PHC service providers are the major recipients of OATSIH funds. OATSIH generally does not operate on a submission driven process. Rather it attempts to identify needs and fund PHC services accordingly. However, if the health service has a particular need that is not met, developing a written proposal and budget can be submitted to OATSIH at any time.

The Funding Agreement

Considerable changes have been made to OATSIH funding and reporting processes.

From 1 July 2011 when the Department of Health & Ageing (DoHA) enters into a new funding arrangement with an organisation previously funded via an Office for Aboriginal and Torres Strait Islander Health (OATSIH) Funding Agreement, a new single common funding agreement will be used.

It is called a Head Agreement for Multi Project Funding.
OATSIH, as the main funder of ACCHOs, has developed the new agreement that sets out the common terms and conditions for project funding provided to the ACCHOs and other funded organisations. The new agreement can be  a multiyear agreement with annual reporting.

It comprises a Head Agreement and Schedules. There are separate Schedules for each Division with the Department that is providing funding.
The Head Agreement outlines the definitions, project agreement, representation and warranty, confidentiality, termination, liability, disputes, notices, general and signing of the agreement.
Schedule 1 details the Program terms and conditions, and common reporting requirements (in Attachment A of Schedule 1).
Schedule 2 sets out the pro forma to be used for all subsequent schedules.
Schedules 3 and 4 are for OATSIH - Programs and projects in Schedule 3 and Auspice arrangements in Schedule 4 (where applicable).
Schedule 5 and up are used by other Departmental program areas, and follow the pro forma set out in Schedule 2.

The Head Agreement is signed by the Board and on behalf of the Department by the relevant State or Territory Manager. Each schedule is signed (according to the required delegation) by the relevant State or Territory office (STO) director or the Central Office (CO) delegate (normally a Director) where programs are managed centrally.

Themes
OATSIH has consolidated all policies and programs into seven business themes:

1. Primary Health Care (PHC) Project has a PHC base which includes funding for Healthy for Life, Improving Indigenous Access to Health Care Services, Sexual Health, Quality and Accreditation and ICT/IM. Funding for NACCHO and the Affiliates is included under this theme.
2. Child and Maternal Health Project includes New Directions Mothers and Babies Services, Australian Nurse-Family Partnership Program (“ANFPP”) and Strong Fathers Strong Families
3. Substance Use Project
4. Social & Emotional Wellbeing
5. Project for Closing the Gap in Chronic Disease
6. Remote Services Project – NT only- known as Expanding Health Service Delivery Initiative (EHSDI)
7.  Workforce

Requirement

Action Plans
An integral part of the funding agreement is the development of an Action Plan, and its and acceptance by the Department. The Action Plan details what activities the health service intends to undertake in the entire project period and what funding OATSIH has provided to carry them out. (up to 3 years). It is required to be reviewed annually.

Each organisation is contractually obliged to implement the Action Plan. Failure to implement the Action Plan can be a breach of the funding agreement.

The Action Plan has been developed into a new format and some transition time is being negotiated for the use of these.

Financial Requirements

Budget - funded organisations are obliged by the funding agreement to submit budgets for the project period (thus for three years, if on a three-year agreement). These budgets need to include separate budget lines for each key theme of the funding agreement.

Salaries and depreciation costs (excluding OATSIH-funded buildings) must be included within program / project expenditure. Future liabilities must be accounted for (for example, long service leave, annual leave, superannuation). Administration costs as a percentage of other costs in the budget should be reasonable; and any legal fees are to be shown separately and explained.

Reporting

Whole of program reporting requirements will include:

• Program Action Plan
• Program Budget Acquittal

Quarterly payments are linked to the discussion of the Program Action Plan by the STO project manager. Organisations delivering health services report annually using the OSR.

Financial Reporting Requirements

Project	Base/Measure	Report	How report is provided	Frequency of report
Primary Health Care	Primary Care Base • ICT/IM • Quality and Accreditation • Sexual health • Healthy for Life • NACCHO and Affiliates	OSR* NT AH KPIs# (for NT organisations) National KPI (H4L and ANFP services in 2011, all in 2012)	Web based NT AHKPI Portal Written report (web based in 2012)	Annual Biannual Biannual
Child and Maternal Health	New Directions Mothers and Babies Services	Measure specific report (Progress and Fidelity Report)	Written report	Biannual
	Australian Nurse Family Partnership Program	Measure specific report	Written report	Quarterly
	Strong Fathers Strong Families	Measure specific report	Written report	Biannual
Closing the Gap in Chronic Disease	Workforce expansion (COAG C2 Expand outreach)**	Measure Specific Report	Written report	Quarterly
Substance Use	Substance Use Base	OSR	Written report (web based in 2012)	Annual
Social & Emotional Wellbeing	Mental health Base Bringing Them Home Link Up Workforce support units (WSU) Training	OSR   Recording tool (for WSU and training)	Written report (web based in 2012) Spreadsheet of training attendance	Annual   Quarterly
Remote Service Delivery	Expanding Health Service Delivery Initiative CTG Dental	As per Primary Health Care	As per Primary Health Care	As per Primary Health Care
Workforce	No measures ***

#KPI: Key Performance Indicators
*OSR: OATSIH Service Report
**additional projects will be part of MHCDD (Tackling Smoking) and HWD (Indigenous workforce) schedules
***current workforce projects will be part of HWD (Indigenous workforce) schedule

Variation To Projects

Variations can be made to either the purpose or terms and conditions of the funding or to the budget. Request for approval of variations must be submitted to OATSIH in writing and should include any supporting evidence.

OATSIH Risk Assessment

OATSIH assesses the risk profile of each funded organisation at least every two years, or more frequently for organisations with higher risk profile. The process is outlined in their Funding Book

Insurances

OATSIH require the following insurances to be held by the health service:

Workers Compensation covering all staff

Public Liability Insurance

Professional Indemnity Insurance

Property insurance covering assets.

Contact

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Northern Territory Department of Health (DoH)

DoH delivers services directly and health staff employed directly by DoH are bound to follow DoH policies and procedures.

DoH also funds a number of Aboriginal health services with programatic funding and/or through service agreements with community councils. Strictly, it is the community council's responsibility to develop appropriate polices, although it often lacks the experience or resources to do this. Where these services employ an administrator, the development and implementation of appropriate polices will be their responsibility.

Service Agreement

The Service Agreement is the legal contract between DoH and the service provider and specifies the terms and conditions of the grant, and the services to be provided. The conditions in Service Agreements vary, but there are some standard clauses that are likely to apply.

The agreement will specify the amount of funding, financial reporting requirements and their expected frequency, outputs and outcomes, and performance indicators required.

The process of funding described under OATSIH above broadly applies to DoH funding arrangements as well. (see above).

Workers Compensation, Public Liability and Professional Indemnity insurances are likely to be compulsory.

Contact

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Other Funding Sources

General Practice Network NT (GPNNT)

General Practice Network NT (GPNNT) was formed through the merger the Central Australian Division of Primary Health Care (CADPHC), the Top End Division of General Practice (TEDGP) and General Practice Divisions NT (GPDNT) and General Practice and Primary Health Care NT (GPPHCNT).

GPNNT is responsible for the assessment and allocation of Relocation, Orientation, Training Grants and Training Scholarships and Remote Area Grants to support the recruitment and retention of doctors to the rural and remote areas of the NT. They also assess the suitability of overseas trained doctors(OTDs) to work in GP positions in the NT.

GPNNT Programs

Relocation grants

Relocation grants may be available to eligible GPs and their family to assist them relocate to an identified under-serviced rural or remote area within Australia.

GP Orientation and Training grants

Orientation and Training grants are available to GPs relocating to a new position in the NT, and cover costs associated with cross-cultural training, orientation to the NT/regional/and local Health systems, specific clinical orientation, 4WD courses and other relevant orientation as may be approved through the assessment process.

Rural Retention Program

The Commonwealth Department of Health & Ageing provides retention payments to doctors who continue to work in rural/remote communities for a year or more. GPPHCNT administers this program through Medicare Australia.

GP Locum Program

A locum subsidy is available to GP practices and community controlled health services to allow the incumbent doctor to take leave entitlements.

Remote Area Grants

Remote Area Grants are available to supplement salaries of GPs working in identified communities. These grants are attached to the specific community, although the funds must go to improve the doctor's salary.

Continuing Professional Development (CPD)

Rural and remote GPs and nurses can access CPD through GPNNT.

GP Recruitment

The agency can assist health services to assess and recruit doctors. This may include support for interested doctors to visit the community in which they are considering an appointment.

Other support

Family support weekends to enable doctors and their families to form networks and share common interests.

Applications

Application forms for all grants are available from the agency and can be downloaded from the website. If successful, formal agreements are signed before the release of funds.

Aged Care Programs (Department of Health and Ageing)

Aged care packages for communities are funded from the Department of Health and Ageing. This funding is usually granted to community councils, or other community organisations. However, in some situations, it may be appropriate for the health service to administer these programs. Generally, the programs focus on general home care, meals on wheels and assistance with domestic tasks.

The Aboriginal and Torres Strait Islander Aged Care Strategy was introduced in 1994 to meet the needs of older Indigenous people. The aim is to improve access to, and quality of, culturally appropriate care for older people aged 50 years and over from Aboriginal and Torres Strait Islander communities.

Rural Health Continuing, Education Sub-program (RHCE)

RHCE operates within the Department of Health and Ageing and provides access to professional training and support in rural and remote areas for medical specialists through Stream One Funding and for allied health professionals, nurses, general practitioners and Aboriginal and Torres Strait Islander Health Workers through Stream Two Funding.

Application guidelines.

National Health & Medical Research Council (NHMRC)

NHMRC funds are provided for research projects, and emphasise rigorous research conducted by properly trained researchers. Generally funds are available for up to three years. Usually a researcher with appropriate academic qualifications is required as the principal researcher. However, special funds are available for Aboriginal health research.

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Social Preventive Health

Indigenous Coordination Centres (ICC)

The Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) is the Australian Government's lead coordination agency in Indigenous Affairs. The Office of Indigenous Policy Coordination (OIPC) is within FaHCSIA and collaborates with government agencies in developing national policy.

OIPC was established on 1 July 2004. On the same day, programs formerly administered by the Aboriginal and Torres Strait Islander Commission (ATSIC) and Aboriginal and Torres Strait Islander Services (ATSIS) were transferred across a range of Government agencies. These programs in some way affect individual, family and community health. However, generally health services are funded through OATSIH in the Department of Health and Ageing.

A network of ICCs across Australia is responsible for local engagement with Indigenous Australians and the coordination of programs at the local and regional levels.

The following programs and services are administered through the ICCs based on former ATSIC-ATSIS regional offices:

• Alice Springs Transformation Plan
• Closing the Gap
• Families and Children
• Indigenous Family Safety Program
• Community Development Employment Projects (CDEP)
• Reconnect (FaHCSIA)
• Indigenous Housing
• Indigenous leadership Program
• Indigenous Womens program
• Land Rights Program
• Native Title Program
• Public Awareness Program

Other Government Agencies

This site links to the most significant Australian Government programs for Indigenous people.

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