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 & Community Services (through Service Agreements)
4. Other sources
• General Practice Primary Health Care
• Aged Care (DHAC)
• Rural Health Support, Education & Training (RHSET)
• National Health & Medical Research Council (NHMRC)

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.

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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.

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. However, medical services provided by AHWs and nurses working independently are not eligible to direct bill.

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. Immunisation (Item 10988)
6. Wound Treatment (Item 10989)

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.

Enhanced Primary Care Item Numbers include:

• Annual comprehensive physical, social, and mental assessments of Aboriginal clients over the age of 55 yrs or non-Aboriginal clients over 75 yrs in the health service, at a client's home or in a care facility (Items 704, 706)
• Child Health Check - Annual for kids aged 0-14 years of age (Item 708)
• Adult Health Check - every 2 years for adults aged 15-54 years (Item 710)
• 45 Year Old Preventive Health Check for people between age of 45-49 years who are at risk fo chronic disease (Item 717)
• Comprehensive Medical Assessments for residents of aged care facility (Items 712)
• Care plans (for those with Chronic Disease) and Reviews (Item 721, 725) and coordinating Team Care Arrangements (Item 723, 727) organised by GP but can involve AHWs and nurses. The previous multidisciplinary care plans (Items 720, 722, 724, 726 and 728) have been discontinued. Particpation by a doctor in plans coordinated by another provider alos attract a fee (Items 729, 731)
• Case conferencing involving a doctor and at least two other health professionals (eg a specialist, nurse, AHW, chiropractor) (Items 740, 742, 744, 746, 749, 757, 759, 762, 765, 769, 771,773).
• GP Medication Review involving referral to Pharmacist (Item 900, 903)

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

Whilst the doctor must be involved with these processes, and oversee them, the actual assessments, organisation of case conferences and preparation of care plans can involve AHWs and/or nurses.

Mental Health

A series of Item nos have been introduced 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)

Recent Medicare Initiatives

There are new MBS items for services provided by practice nurses:

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.

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.

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.

All GPs whether vocationally registered or not are eligible to claim the items. 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 details except the service rendered, Item Number and fee

provide this form to the doctor or AHW seeing the client.

When the doctor sees the client s/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 the Medicare Claim voucher

witness the doctor's signature

post to 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

All services should ensure that they are on the Medicare Australia mailing list to receive new editions of the Medicare Benefits Schedule (MBS) book. This book includes definitions and updates of fees for Item Numbers, any new Item Numbers, and the rules that apply. From November 1 2005 DoHA is introducing MBS Online which will enable users to access the MBS on line. Additional copies will be able to be purchased for $33.00.

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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+). A range of MBS item numbers are 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.

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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 CA Division of Primary Health Care and the Top End Division of General Practice have been involved in refining this program in the NT and can provide advice and assistance if necessary.

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
Medicare Australia
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:

Reply Paid No. 9857
PBS Authority Section
Medicare Australia
GPO Box 9857 Adelaide

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.

PBS Remote News is a quarterly newsletter developed by the Department of Health and Ageing, in consultation with relevant stakeholders. It is designed to provide useful information to remote area Aboriginal health services and pharmacists participating in the special PBS supply arrangements operating under the provisions of Section 100 of the National Health Act 1953.

The December 2004 issue clarifies the three options for ordering PBS medicines from supplying pharmacists.

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

Note that the process described here is broadly similar to other Commonwealth and NT funding arrangements.

The Funding Agreement or Funding Package includes the following documents:

Letter of Offer - The Letter of Offer is the formal offer of funds from the funding body to an organisation. It describes the amount and purpose of the funds, the name of the program under which the funds are made available, the duration and conditions of the funding agreement, and the documentation and information which must be sent to OATSIH before the funds can be released.

Terms and Conditions of Agreement is the formal contract between OATSIH and the health service and covers matters such as use of funds, budgeting and reporting, purchasing, insurance, disputes and compliance with law.

Acceptance of Funding Form is the means by which the health service formally agrees to the terms and conditions of the Letter of Offer and includes the purpose of the funding, the funding amount, the funding period, the name of the organisation and the funding identification. This must be signed by an elected office bearer of the health service under the organisation's Common Seal. This must be done before funds can be released.

Template for the auditing of the books.

Financial Requirements

Budget: The health service must submit a budget to OATSIH each financial year for ongoing funding. A proposed budget including any expected increases in expenditure or planned program expansion (forward estimates) should be provided to OATSIH for consideration mid-financial year. These items, of course, might not be approved. The budgets are assessed by OATSIH Project Officers. The Project Officer should negotiate with each organisation to assist in their assessment. A final agreed budget is included in the Acceptance of Offer.

The budget should include the following information:

Recurrent Salaries and wages costs - this includes salaries and wages and other related costs such as leave loading, superannuation, and maternity leave.

Recurrent Operational and Administrative costs.

Capital costs - this relates to the purchase of capital equipment such as computers and motor vehicles, and also of real property such as land and buildings.

Revenue receipts - these might include bank interest from funds and fees for services provided under the project.

Several sources of information are used in assessing budgets:

Schedule A - this is part of the Letter of Offer. It splits the budget into three sub-categories, or blocks; namely, capital, salaries and recurrent. These three block totals are adhered to as closely as possible because they represent a formal commitment to these areas of expenditure under the terms and conditions of the funding agreement

the periodic financial statement (PFS) and the audit report

the most recent field reports and organisational profiles.

Schedule A

Salaries - As a minimum, all staff should be paid in accordance with the Award or other workplace agreement and covered for superannuation and workers compensation. Allowances that may apply are district allowance, leave loading and the bilingual allowance. These may include personal travel expenses, personal use of vehicle and provision of accommodation, all of which needs to be detailed in salary and wages paid to staff.

Recurrent - This block covers all ongoing non-salary costs related to the running of the service

Capital - Capital is not automatically included as part of recurrent budgets. The process involved in approving and allocating money for capital items begins with a written request from the organisation. This is assessed and a decision is made by the relevant State/Territory office and Central Office (Canberra) prior to a Letter of Offer being generated. Requests for approval for capital purchases should reflect realistic costing. For example, if the request is for the purchase of a replacement vehicle, the costing should be developed from an actual quote and include the costs of insurance, freight and on-road costs for the first financial year, less the trade-in value for the replacement vehicle. Capital items may also have an implication for recurrent budgets (eg fuel). Generally OATSIH requires three quotes for the supply of capital items, although this may be varied where there are a limited number of possible suppliers in a remote area.

Use of end of year budget surplus is determined by the size of the surplus. Health services can allocate a surplus of less than 5% to capital and other acquisitions without OATSIH approval.

However amounts totalling more than 5% of the budget requires a letter of request of variance to the state/territory Director. Purchase of capital items must follow the rules applying to capital acquisitions greater than $5,000 (see table).

OATSIH Processes for Asset Acquisition

Purchase documents to be kept and sound purchasing practices followed

FundingLevel	Approval for New Funds	Approval for Release (or use) of Funds	Conditions for Release of Funds	Other Requirements
< $5,000	State/territory Manager	State/territory Director		Immediate release of funds - no documentation required
>$5,000	As above	As above	3 quotes submitted and Certificate for Purchase of Assets and Services issued by OATSIH	State/territory Directors can waive purchasing rules (e.g. accepting cheapest quote) if reasonable justification provided

Territory Directors can approve variations to or substitutions of budget items for existing approved projects without varying total grant amount.

Territory Directors can approve use of income derived from sale (or proceeds from insurance when an asset is lost or damaged) of assets originally purchased with OATSIH funds, and can approve an increase in funding related to the cost of replacing an existing funded motor vehicle.

Financial Reporting Requirements

The health service is required to provide to OATSIH the following financial reports:

a Periodic Financial Statement (PFS) quarterly

an Annual Return and Auditor's Report if the funds total more than $30,000 within three months of the end of the financial year

an Annual Return if the funds total less is less than $30,000

any other financial reports which OATSIH considers necessary. However, this should be included specifically in the funding agreement, or be part of a formal Review process.

All services are expected to provide the same level of information and detail in their financial reporting regardless of their size or range of services provided. However, organisations may apply to OATSIH to vary their financial reporting requirements. Via a Risk Assessment process, organisations which are meeting the reporting and financial requirements, in conjunction with adequate service delivery can be identified so that more flexibility can be built into their funding agreements. In this manner, organisations which are meeting reporting and financial requirements can concentrate on health outcomes rather than monitoring requirements.

Financial Requirements and Funding Release Timetable (quarterly payments)

Month	Action by services	Action by OATSIH
July		5th July: 1st quarter release
August	15th Aug - 4th quarter PFS (Apr/May/June)
September	30th Sept - Project performance report - Annual report & acquittal documentation	15th Sept: PFS analysis by OATSIH
October		5th Oct: 2nd quarter release 30th Oct: Annual acquittal of funds
November	15th Nov - 1st quarter PFS (Jul/Aug/Sep)
December		15th Dec: PFS analysis by OATSIH
January		5th Jan: 3rd quarter release
February	15th Feb - 2nd quarter PFS (Oct/Nov/Dec)
March		15th Mar: PFS analysis by OATSIH
April		5th April: 4th quarter release
May	15th May - 3rd quarter PFS (Jan/Feb/Mar)	mid-May: Letters of Offer
June		15th June: PFS analysis by OATSIH

Note that if PFSs are not returned by the due date release of funds may be delayed.

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.

Specific Funding Items

OATSIH has guidelines and application processes for the following:

Vehicle Replacements, Long Service Leave and Management Support

State/territory Directors have the authorisation to approve funding for:

the replacement of health service motor vehicles

relief staff to replace permanent staff members of a Service who go on Long Service Leave, or to pay out the Long Service Leave entitlement of a retiring staff member

Management Support for services that are experiencing difficulties with financial or staff management.

Each state/territory receives an annual allocation to cover these purposes.

Other Funding Items

Staff Training and Conference Funding
Funding for staff training is included in the budget as a loading to each Service's base funding for salaries. OATSIH funding should not be used for the purpose of overseas travel without approval from the Assistant Secretary.

Construction
Funding approval that includes an amount for purchase or construction of buildings requires different administrative procedures to other types of funding. Funding is available through the Capital Works Program to enable the purchase, construction and maintenance of health services. The Capital Works Program incorporates a range of activities, including purchase, construction, renovation, fit-out and emergency repair of clinics and health centres as well as staff housing.

Patient Information Recall Systems OATSIH will provide funding and policy advice for the installation and support of computer based patient information and recall systems

Service Activity Reports and Service Development and Reporting Framework

Service Activity Report (SAR) is an annual report required by the Department. It is ususally sent out late in the financial year.

The Service Development and Reporting Framework (SDRF) is a non-financial reporting framework that has two elements. The first is the development of and reporting against Action Plans. Through this the service must prepare a service plan and decide its own measures to assess progress. You must report twice yearly on these. OATSIH staff can assist services with this. The second element is the Quality Improvement Initiatives (QII). Every OATSIH funded service can receive funding once every three years to support quality improvement activities.

Insurances

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

Workers Compensation covering all staff

Public Liability Insurance for $5 million

Professional Indemnity Insurance

Property insurance covering assets purchased with OATSIH funds with value greater than $1,000.

Monitoring

OATSIH project officers are responsible for the administration and monitoring of funding to health services. Monitoring consists of a series of tasks, commencing with the Letter of Offer and continuing for the life of the project or until the funds are finally acquitted.

There are three sources of information used to assess projects:

Financial reports provide information on how funds are being spent and whether they are being used in accordance with the agreed project purposes

Services Activity Reports provide information about the services provided and client utilisation

Field visits by OATSIH project officers that assess the services, identify issues and problems, and assist with the development of strategies to address them.

Reviews

Under the terms of the Funding Agreement, OATSIH is able to review a service under certain circumstances. The health service should be informed of the intent to review and be given reasonable notice. However, the health service must make available to the review all documents and information relating to the finances, management and programs that are funded by OATSIH.

Other OATSIH Programs

OATSIH funds the folowing particular programs

Capital Works Program
Eye Health Program
Healthy for Life
Hearing Health
National Strategic Framework for Aboriginal and Torres Strait Islander Health
Petrol Sniffing Prevention Program
Primary Health Care Access Program
Sexual Health Program
Social and Emotional Wellbeing
Workforce Programs

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Northern Territory Department of Health & Community Services (NTDHCS)

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

NTDHCS also funds a number of Aboriginal health services 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 NTDHCS 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 NTDHCS funding arrangements as well. (see above).

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

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Other Funding Sources

General Practice and Primary Health Care NT (GPPHCNT)

General Practice and Primary Health Care NT (GPPHCNT) was formed through the merger of the NT Remote Health Workforce Agency (NTRHWA) and General Practice Divisions NT (GPDNT). GPPHCNT has taken on the functions of these two organisations.

GPPHCNT 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 Northern Territory.

GPPHCNT 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 can access CPD through the two Divisions of General Practice. All doctors can access these programs.

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 Aged Care)

Aged care packages for communities are funded from the Department of Health and Aged Care. 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 Strategy established Aboriginal and Torres Strait Islander Flexible Services which provide aged care services with a mix of residential and community care places that can changed as community needs vary. Funding is provided on an annual basis.

Rural Health Support, Education and Training Program (RHSET)

RHSET operates within the Department of Health and Aged Care and is focused on improving health systems in rural Australia for both Indigenous and non-Indigenous populations. It provides short term (generally 1-3 years) project funding only, and will generally not fund health service delivery as such. However it will consider funding innovative pilot programs, and developmental programs that have the potential to enhance delivery.

Applications must be made on RHSET application forms.

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 services that wish to undertake a research project to answer a particular question, and the NHMRC will help find appropriate researchers.

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Social Preventive Health

Office of Indigenous Policy Coordination (OIPC)

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.

OIPC administers the following programs through Indigenous Co-ordination Centres (ICCs) based on former ATSIC-ATSIS regional offices:

Indigenous Women's Development Program

Indigenous Women's Program

Land Rights Program

Native Title Program

Public Information Program

Repatriation Program.

Other Government Agencies

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

 

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