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History

About the Initiative

Between January 2002 and August 2003 the Department of Human Services undertook a project to develop and implement strategies to respond to people with multiple and complex needs.

The target population comprised a small number of individuals who have multiple and complex needs, that require a service response that is unable to be met or sustained within existing service frameworks. While there are many individuals with complex needs requiring improved service responses, this initiative focuses on only those people at the extreme end of the continuum of complexity.

Phase 1 of the project involved the identification and profiling of the individuals with multiple and complex needs.

This phase was finalised in May 2003, culminating in the release of two reports on 26 August 2003 by the Minister for Health, the Hon Bronwyn Pike MP and the Minister for Community Services, the then Hon Sherryl Garbutt MP.

*The current contact details for further information regarding the Multiple and Complex Needs Initiative is 9096 7995, previous contact details outlined in these reports are no longer current*

The two reports are:

Background

Over many years concerns have been raised by service providers, clinicians, carers, Office of Public Advocate, police, magistrates and others on the difficulty of providing services to a group of people who have multiple and complex needs. The group of people often considered to have complex needs includes those individuals who may experience various combinations of mental illness, intellectual disability, acquired brain injury, physical disability, behavioural difficulties, social isolation, family dysfunction, and drug and/or alcohol misuse. They are often unable to sustain appropriate accommodation and/or require a level of support the current design of services does not readily allow. Services are often unable to maintain involvement over time with individuals with extremely difficult behaviours. Many of these individuals are homeless or at risk of homelessness.

These individuals may become involved with a wide range of services without clear case management and funding responsibility being established or may be referred from service to service as they do not meet legislative requirements for eligibility. Services may include mental health, disability, child protection, juvenile justice, drug treatment, housing and support programs and aged care.

This group of people needs an individualised and tailored service response to assist in managing their complex needs. Service responses are currently provided on a case by case basis and at high cost. Responses are often reactive and provided during a crisis rather than being fully planned and coordinated to achieve the best outcome for the individual

Terms of reference - Phase 1

The projects terms of reference included:

to identify, quantify and develop a comprehensive profile of the types of individuals with complex needs (the target group) and the costs/resources associated with service provision to these individuals
to identify strengths and weaknesses of current legislative frameworks that define the provision of services to the target group
to identify strengths and weaknesses of policy frameworks, service responses and any gaps in services
to identify examples of best practice (including anecdotal) and evidence-based research, both locally and internationally, regarding service provision
to develop a service framework and strategic plan for improving responses to the target group taking into account current resource usage, potential resource demands and future workforce requirements
to define appropriate service responses and propose reconfiguration of resource allocations to provide these
to develop recommendations on how service solutions may be supported by legislative change.

Project organisation

Committees and reference groups

The Steering Committee includes senior Department of Human Services and Department of Justice executives with the ability to determine future cross department policy frameworks and resource allocations. The Steering Committee meet on a regular basis to provide guidance to the project team in implementing project objectives.

The Reference Group was established to provide expert opinion and advice.

The Reference Group and Steering Committee were brought together with other key stakeholders at two forums during Phase 1. The first forum considered initiatives from other jurisdictions, key service delivery issues and innovative and effective practice models. The second forum provided an opportunity for project directions to be presented and discussed with the Reference Group and Steering Committee.

Steering Committee

Executive Director, Operations (chair)
Executive Director, Disability Services
Executive Director, Mental Health and Drugs Division
Director, Mental Health
Director, Regional Operations Performance
Regional Director representative DHS
Director, Housing Services
General Manager, Clinical Services (DoJ)
Manager, Statewide Clinical Services (Prisons) (DoJ)
Manager, Child Protection

This steering committee continues to meet on a regular basis to provide advice to the Central team

Project Sponsor

Executive Director, Operations Division, Department Human Service

Period 2004 - 31 May 2009

In 2004 the Multiple and Complex Needs Initiative was implemented. As its key components it included:

The Human Services (Complex Needs) Act 2003
Regional Gateway
Multiple and Complex Needs Panel
Multidisciplinary Assessment and Care Planning Service
Care Plan Coordinaton
Intensive Case Management Service

Link to the MACNI model as it was Pre 31 May 2009

Human Service (Complex Needs) Act 2003

From 2004 until 31 May 2009, MACNI was underpinned by the Human Services (Complex Needs) Act 2003. The Act established powers for an approach to planning and service delivery for some of Victoria's most vulnerable community members.

The Human Services (Complex Needs) (Amendment) Act 2006 extended the sunset provisions of the original legislation by a further two years (to 31 May 2009) and increased the pool of members of the Multiple and Complex Needs Panel.

You can link to the Human Service (Complex Needs) Act 2003 (external link) on the Parliamentary document website (www.legislation.vic.gov.au) - Summary Notes below.

Downloads

Human Service (Complex Needs) Act 2003 - Summary Notes [PDF, 81kb]

Evaluation and changes

During this period of time KPMG conducted an evaluation of MACNI (Refer to References and Reports). In addition, a series of consultations and forums were held during 2008 to reflect on the benefits and limitations of MACNI and consider any changes that might enhance the work being conducted.

The evaluation, internal studies and the consultation process noted concerns about the administrative burden imposed by a very linear process that was the MACNI model. Concerns about delays in the development of care plans and the lack of flexiblity for regions led to a comprehensive rethink about the MACNI model and how it can be improved. On 1 June 2009 new leigislation came into effect - Human Services (Complex Needs) Act 2009. Along with this legislation came a significant change to the MACNI model including:

greater devolution of decision making to the DHS regions,
cessation of the MACN Panel
introduction of a Central Eligibility and Review Group
amalgamation of the assessment and intensive case management services to form Indigo Care Plan Development and Coordination Service
greater flexiblity with regard to planning for the individual client.

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