Aged Care

Older persons are supported to stay healthy and well in their place of residence

Access Support Access to Care - Health Services

Increase individual and community access to health care services.

Delivery of services to support staying well at home, including support for self-navigation and service access via My Aged Care, preventing decline in function and staying well in place.

CSAPHN Regional LHNs

Health Literacy Support Access to Care - Health Education

Increase individual and community access to resources that effectively assist use of health knowledge and understanding, increasing choices and supporting decisions.

Facilitate supporting older people to access to information and services.

Partner with peak bodies and relevant groups for collaborative on activity to facilitate knowledge, understanding and support decision making.

CSAPHN

COTA

Dementia Australia

Alzheimer’s Australia SA

Palliative Care SA

Workforce Support Health Services - Workforce Training and Development

Potentially Preventable Hospitalisations (PPH)

Support Access to Care - Health Services

Health professionals are supported to increase skills, knowledge and capability, and improve workforce sustainability.

Increase individual and community access to health care services.

Delivery of skill and knowledge opportunities to improve workforce capability in deliver of quality care including: dementia, palliative, functional fitness.

Work in partnership to implement effective service models to support GP care and management of older persons staying well in place.

Active Ageing

CSAPHN

System integration and coordination

Improve integration of systems and coordination of care across health services for improved individual health outcomes and experience of health care.

Explore opportunities for facilitating safe transition of care between home, RACF and hospital.

CSAPHN SA Health

Rural Support Service (RSS)

CSAPHN SA Health Regional LHNs SAAS

Rural Support Service (RSS)

Medication management Potentially Preventable Hospitalisations (PPH)

Access to specialist services to support ageing well

Improve the Health System - Health Technology

Support Access to Care - Health Services

HealthPathways Improve the Health System - System Integration & Coordination

Increase health service implementation and application of technical solutions to improve integration of systems and coordination of care across health services.

Increase individual and community access to health care services.

Facilitate delivery of service utilising technology to support access and integrated multidisciplinary care, including telehealth.

Facilitate access to medication reviews and support for medication management for people living at home and in RACF.

CSAPHN ADHA

CSAPHN WBSA

Improve integration of systems and coordination of care across health services for improved individual health outcomes and experience of health care.

Prioritise aged care pathways in the HealthPathways project. CSAPHN APHN

WBSA

Identify referral pathways and services for community physical activity for older persons

CSAPHN APHN WBSA

Alcohol & Other Drugs

Identified

Delivery of specialist AOD services Aboriginal and Torres Strait Islander Health

Engage with StakeholdersCommunity

Engage with Stakeholders - Health Service Sector

Increase knowledge and understanding of community health and wellbeing needs to support CSAPHN with effective commissioning of activity and advocacy for communities.

Increase knowledge and understanding of local, state and national health service sector to support CSAPHN with effective commissioning of activity and advocacy for primary health care.

Work with Aboriginal communities to implement communityspecific responses and support models to address identified drug and alcohol issues and hospital separations.

Further engagement and consultation with the sector via ongoing community and service provider consultation forums.

Improve the Health System - System Integration & Coordination

Improve integration of systems and coordination of care across health services for improved individual health outcomes and experience of health care.

Encourage and nurture cross sector referral and integration within CSAPHN MHAOD comorbidity reform agenda.

Support Access to Care - Health Services

Increase individual and community access to health care services.

Targeted co-planning and co-design with ADAC and ACCHOs to realign currently funded and new activity within CSAPHN AOD scope and funding.

Commission brief intervention, withdrawal management and counselling with alcohol and amphetamines focus.

Facilitate establishment of long term rehabilitation programs in country regions.

Improve the Health System - System Integration & Coordination

Support Access to Care - Health Services

Support Health Services - Workforce Training & Development

Support Health Services - Workforce Training & Development

Improve integration of systems and coordination of care across health services for improved individual health outcomes and experience of health care.

Increase individual and community access to health care services.

Health professionals are supported to increase skills, knowledge and capability, and improve workforce sustainability.

Health professionals are supported to increase skills, knowledge and capability, and improve workforce sustainability.

Facilitate cross sector referral and integration within CSAPHN MHAOD comorbidity reform agenda.

Co-design and commission AOD services responsive to community need.

Facilitate drug and alcohol upskilling across existing mental health programs and funded activity.

Facilitate drug and alcohol upskilling across existing mental health programs and funded activity.

Alcohol & Other Drugs

Identified Need Sub-Priority Opportunity

Community appropriate MHAOD rehabilitation services

Access Improve the Health System - System Integration & Coordination

Support Access to Care - Health Services

Expected Outcome Options

Advocate for community health and wellbeing needs and primary health care at a local, state and national level.

Increase individual and community access to health care services.

Facilitate cross sector referral and integration within CSAPHN MHAOD comorbidity reform agenda.

Explore required support measures to address lack of residential services in rural areas.

Potential Lead

CSAPHN ADAC

Integrated and coordinated care across the health system

Potentially Preventable Hospitalisations (PPH)

Improve the Health System - System Integration & Coordination

Improve integration of systems and coordination of care across health services for improved individual health outcomes and experience of health care.

Investigate continuity of care with discharge from acute care to inform commissioning and system improvement activity. Inclusive of medication management, risk assessment and diagnosis post admission, identification and integration of drug and alcohol needs.

CSAPHN Regional LHNs Private Sector

CSAPHN Regional LHNs Hospitals

Mental Health

Access to low intensity MH services

Access Support Access to Care - Health Services

Increase individual and community access to health care services.

Care Coordination Support Access to Care - Health Services

Improve the Health System - Advocacy

Improve the Health System - System Integration & Coordination

Support Access to Care - Health Services

Workforce Support Health Services - Mental Health and AOD

System Integration Improve the Health System - System Integration & Coordination

Increase individual and community access to health care services.

Advocate for community health and wellbeing needs and primary health care at a local, state and national level.

Improve integration of systems and coordination of care across health services for improved individual health outcomes and experience of health care.

Increase individual and community access to health care services.

Health Service providers are supported to improve individual and community health outcomes and experience of health care.

Improve integration of systems and coordination of care across health services for improved individual health outcomes and experience of health care.

Access to Mental Health services in rural and remote areas

Access Improve the Health System - System Integration & Coordination

Improve integration of systems and coordination of care across health services for improved individual health outcomes and experience of health care.

Access to specialist MH services for young people

Early Intervention Prevention / Social Determinants

Support Access to Care - Health Services

Increase individual and community access to health care services.

Improve the Health System - System Integration & Coordination

Improve integration of systems and coordination of care across health services for improved individual health outcomes and experience of health care.

Support region-specific, cross sectoral approaches for children and young people with, or at risk of, mental illness. CSAPHN SA Health LHNs APHN

Facilitate extensive service mapping of the sectors to ascertain service distribution and workforce gaps.

Improved demand management strategies.

More focus on low intensity intervention through the implementation of a stepped care model through mental health and alcohol and other drugs reform.

Review feasibility and efficiency of centralised regional triage and intake.

CSAPHN SA Health Regional LHNs

Support region-specific, cross-sectoral approaches for people with, or at risk of, mental illness.

Work with identified service providers and sector representative bodies to facilitate improved clinical governance practices.

Implementation of a stepped care model through mental health and alcohol and other drugs reform.

Investigate discharge planning processes across the acute sector and research best practice models to inform project design enabling improvements in the continuity of care including medication management, assessment and diagnosis post admission, identification and integration of drug and alcohol needs.

Address service gaps in the provision of psychological therapies for people in rural and remote areas and other under-serviced and/or hard to reach populations. Facilitate comprehensive service mapping of the sectors to ascertain service distribution and workforce gaps.

Explore effective early intervention models and linkage into youth health services.

CSAPHN SA Health Regional LHNs Headspace

CSAPHN SA Health Regional LHNs RFDS

Mental Health

Identified

Access Support Access to Care - Health Services

Increase individual and community access to health care services.

Work in partnership to support organisations that provide family and community programs in the target regions.

Headspace

Access to suicide prevention and services

Access Improve the Health System - Health Technology

Increase individual and community access to health care services.

Increase individual and community access to health care services.

Increase health service implementation and application of technical solutions to improve integration of systems and coordination of care across health services.

Commission youth focussed MHAOD services in communities of need including engagement with the RFDS and Headspace sites for improved outreach services.

Promote better mental health for youth through support to Headspace and community programs and education and youth support and counselling activities.

Facilitate telehealth options for increased access to psychiatry services.

Implementation of a stepped care model through mental health and alcohol and other drugs reform. Targeted commissioning to meet areas of need. Co-design activity through flexible funds.

CSAPHN SA Health

Regional LHNs

Black Dog Institute

Commonwealth

Support Access to Care - Prevention Activities

Care Coordination Improve the Health System - System Integration & Coordination

Increase individual and community access to preventative health care services.

Improve integration of systems and coordination of care across health services for improved individual health outcomes and experience of health care.

Plan, develop and implement National Suicide Prevention Trial in the Country North region.

Facilitate implementation of a stepped care model through mental health and alcohol and other drugs reform. Investigate discharge planning processes across the acute sector and research best practice models to inform project design enabling continuity of care, risk assessment and diagnosis post admission, identification and integration of drug and alcohol needs.

Suicide Prevention Networks

Community led suicide prevention approaches

Access Support Access to Care - Health Services

Increase individual and community access to health care services.

Co-design activity through flexible funds.

Commission Aboriginal and Torres Strait Islander suicide prevention through psychological therapy for underserviced groups.

Plan, develop and implement National Suicide Prevention Trial in the Country North region.

CSAPHN SA Health Regional LHNs

Black Dog Institute

After Hours Engage with StakeholdersCommunity

Improve the Health System - System

Increase knowledge and understanding of community health and wellbeing needs to support CSAPHN with effective commissioning of activity and advocacy for communities.

Improve integration of systems and coordination of care across health services for

Develop partnerships within local communities to implement community-specific response and support models to address episodic mental health occurrences in the after-hours period through the delivery of suicide prevention trainings.

Work in partnership with Aboriginal communities to implement community-specific response and support models

Commonwealth Suicide Prevention Networks