HIV Community and Health   Service Collaboration         Craig Cooper     Secretary / Treasurer
Presentation•   Populations and Positions•   Stories about People•   Collaborative Service Delivery•   Key Strategies•   H...
Populations• Young People• Sex Workers• People who Inject Drugs, and have a suspected or confirmed    substance dependence...
Positions• Youth Worker - NGOs• A&OD Family Therapist - NGO• Youth Health A&OD Counsellor – Community    Health•   A&OD Co...
Stories about People•   A Mother – 1992•   A Son – 2002•   A Dealer – 2004•   A Homeless Man - 2007
A Mother – 1992• A 32 year old sex working Mother of 2  children under 5 years of age, from Western  Sydney. Substance dep...
A Son – 2002• A 24 year old young man from the Inner-West of Sydney. Living and partying with mates; unemployed and attend...
A Dealer – 2004• A 38 year HIV positive Gay Man living in the  Inner-West of Sydney. Attending a court  ordered illicit dr...
A Homeless Man - 2007• A 48 year old CALD Man confirmed HIV and HCV co-infection from South-East and Inner- West of Sydney...
Collaborative Service Delivery    Themes from the engagement with and in response to    the before mentioned people (stori...
Drivers           Drivers & Inhibitors• Client rights and community need• Well written and designed service delivery model...
Key StrategiesClient Service Delivery:• Consult, listen and respond to the needs of the   people you’re working with and c...
Key StrategiesService Delivery Management:• Ensure you’re mindful of and complying with  legislation• Implement and be inf...
How to make it work?The Client:• Always have the person (instead of the  presenting issue, service context or  therapeutic...
How to make it work?Service Delivery Practice:• Informally and formally consult with partners and  stakeholders• Formalise...
In Closing1. The options and ways to collaborate betweenmainstream and specialist services are endless2. We need to build ...
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HIV Community and Health Service Collaboration

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This presentation by Craig Cooper (NAPWA) explores a client-centred service delivery approach in the context of mainstreaming HIV care. It also looks at the inhibiting and driving factors that activate or derail service
delivery collaboration for HIV services.

This presentation was given at the AFAO Positive Services Forum 2012.

Published in: Health & Medicine
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  • Amanda (not her real name) the goals of therapy were to keep her children and come to terms with her own childhood (her goals). Outcomes, kept her children, occasional sex work and substance use. She returned to education and full time employment, ceased contact with her family (all her choice) for safety reasons. Care coordination – I didn’t get it at first, fortunately Amanda was assertive and unashamed, and regularly disclosed with government services and health professionals about her HCV status, sex work, substance use and the care of her children.
  • Rob - I was the Manager and was handed the clientas a staff member resigned, after the assessment and engagement into the service was complete. The primary case management goals were to not get caught again with a large supply of drugs and to complete the program (remain in the community). The secondary and circumstantial goals were around PEP and the sharing and disposal of injecting equipment. Outcomes were he didn’t become a recidivist offender, he adhered to the PEP and didn’t sero-convert, he changed his trafficking behaviours and completed the program, remaining in the community.
  • Peter – was a client of one of my staff, during intake and assessment I overheard what was going on for Peter. I asked the staff member to re-direct the assessment and engagement. We liaised with the treating Dr, legal counsel and Deputy Chief Magistrate from the Downing Centre. The client wasn’t accepted because the charges moved from the Local Court to the District Court. The staff member lost his job (as a result of this and another client) and the client was lost to follow-up.
  • I was the HIV Manager at RPAH, and found out about Andy, from Dr Garsia. Dr Garsia asked if I would chair the care co-ordination meetings. Outcome Andy was discharged from an involuntary admission (locked ward), secured accommodation in a private nurse run supported accommodation service and remained engaged in Mental Health, HIV and HCV services. The main obstacles were:fear of the client and taking responsibility, and the nursing staff in the private facility in Redfern didn’t know how to care for a HIV positive man that was not on treatment.
  • ACOSS and CHF are examples of national leaders that we can partner with and that could be involved in the brokering of service arrangementsSpecialist services, including Mental Health, Drug and Alcohol, Disability, Immigration, Aboriginal Health and HIV
  • HIV Community and Health Service Collaboration

    1. 1. HIV Community and Health Service Collaboration Craig Cooper Secretary / Treasurer
    2. 2. Presentation• Populations and Positions• Stories about People• Collaborative Service Delivery• Key Strategies• How to make it work?
    3. 3. Populations• Young People• Sex Workers• People who Inject Drugs, and have a suspected or confirmed substance dependence disorder• Children and Families, under investigation or court orders• Aboriginal and Torres Strait Islander people and communities• Gay, Lesbian, Transgender and Queer• People engaged in the Criminal Justice System, and recidivist offenders• People with diagnosed co-morbidities• Homeless People• People with a profound Disability• People that are immigrating and have been refugees
    4. 4. Positions• Youth Worker - NGOs• A&OD Family Therapist - NGO• Youth Health A&OD Counsellor – Community Health• A&OD Counsellor – Hospital Campus• Management – A&OD, Criminal Justice System• Management – Hospital and Health based HIV & Hepatitis Services• HIV Service Management - NGOs
    5. 5. Stories about People• A Mother – 1992• A Son – 2002• A Dealer – 2004• A Homeless Man - 2007
    6. 6. A Mother – 1992• A 32 year old sex working Mother of 2 children under 5 years of age, from Western Sydney. Substance dependant; traumatic childhood; monitored by child and family services and the criminal justice system; self mutilating; working from home and the Great Western Highway; with multiple sexually transmitted infections and HCV positive
    7. 7. A Son – 2002• A 24 year old young man from the Inner-West of Sydney. Living and partying with mates; unemployed and attending an illicit drug court diversion program. Arrested for possession; blasting Tina; on PEP
    8. 8. A Dealer – 2004• A 38 year HIV positive Gay Man living in the Inner-West of Sydney. Attending a court ordered illicit drug diversion program for dealing large quantities of a range of substances. Only other service contact was an S100 prescribing GP on Oxford Street. Hosting bareback seeding and breeding parties for guys with an unknown HIV status
    9. 9. A Homeless Man - 2007• A 48 year old CALD Man confirmed HIV and HCV co-infection from South-East and Inner- West of Sydney. Acutely and severely psychotic; no permanent or fixed address for more than 10 years; multiple incarcerations; known to HIV services and the criminal justice system, but not in treatment or engaged in any services before Hospital admission
    10. 10. Collaborative Service Delivery Themes from the engagement with and in response to the before mentioned people (stories):• Person or client centred strengths based approach• Developing and maintaining relationships• Duty of Care; Infection Control; Access to and Retention with Multiple-Services, Harm Reduction• Care co-ordination and treatment adherence• Accountable and responsible caring professionals• Evaluation, review and client involvement in service design, delivery, and representations• Mainstream and specialist service compatibility
    11. 11. Drivers Drivers & Inhibitors• Client rights and community need• Well written and designed service delivery model• Staff and service agencyInhibitors• Doing what is comfortable and keeping busy• Fear and disagreement (excuses)• Power and Control, acting territorial• Lack of structural, policy or management support• Apathy, complacency and complicitness
    12. 12. Key StrategiesClient Service Delivery:• Consult, listen and respond to the needs of the people you’re working with and caring for• Always treat people with Dignity and Respect• Acknowledge the persons culture and resilience• Approach the treatment and care relationship with humour and positive regard• Maintain privacy and confidentiality (use of client release of information)
    13. 13. Key StrategiesService Delivery Management:• Ensure you’re mindful of and complying with legislation• Implement and be informed by best practice guidelines, research and findings• Understand and appreciate the role of service partners and their criteria for action
    14. 14. How to make it work?The Client:• Always have the person (instead of the presenting issue, service context or therapeutic construct) in the forefront of everything you do. This can be achieved by asking the person, what do you want and what can I do for you?• Ensure the service model is client or person centred, flexible and adaptive
    15. 15. How to make it work?Service Delivery Practice:• Informally and formally consult with partners and stakeholders• Formalise MOUs, Service Level Agreements, fee for service arrangements, and collaborative care coordination plans• Understand the agencies you and your clients are working with, including language, legislation, policy etc.• Evaluate and build a body of evidence and use this to improve service delivery and the partnership arrangement
    16. 16. In Closing1. The options and ways to collaborate betweenmainstream and specialist services are endless2. We need to build on an evidence base3. The range of service models and options needto be consistently synergistic4. The work needs to be expansive, instead oflimited5. Specialist and mainstream services both have aplace and need to be maintained Thank You
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