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Overview of the Initiative

Table of Contents

Background

Phase one of the Responding to People with Multiple and Complex Needs Project was conducted in 2002-2003. It involved consultation with key stakeholders from a range of government and non-government organisations and other significant bodies.

The project findings suggested that an innovative response was required to build a more effective response to people with multiple and complex needs.

The service response targets individuals 16 years and older with multiple and complex needs. It is centred on a time-limited specialist intervention that aims to:

  • stabilise housing, health, social connection and safety
  • pursue planned and consistent therapeutic goals for each individual
  • provide a platform for long term engagement in the service system.

In 2004, the Multiple and Complex Needs Initiative (MACNI) was implemented. Its elements included a statutory panel, two state wide services to provide assessment and intensive case management and legislation.

On 1 June 2009, new legislation came into effect that altered the MACNI model. The legislation, the Human Services (Complex Needs) Act 2009 and accompanying practice guidelines saw the devolution of decision making powers to the DHS regions, the cessation of the MACN Panel, the emergence of a Central Eligibility and Review Group and the amalgamation of the two statewide services into one - Indigo Care Plan Development and Coordination Service. The aim has been to improve the timeliness and flexibility of the MACNI service response.

What are the key elements of the Multiple and Complex Needs Initiative?

  • The Human Services (Complex Needs) Act 2009
  • Regional gateway and regional coordination
  • The Central Eligibility and Review Group (CERG)
  • Care Plan Coordinaton
  • Indigo Care Plan Development and Coordination Service

The legislation - Human Services (Complex Needs) Act 2009

MACNI is underpinned by the Human Services (Complex Needs) Act 2009. This Act establishes powers for a new approach to planning service delivery for some of Victoria's most vulnerable community members.

The Act allows service providers to exchange information in the best interests of the individual and advises that an individual may refuse participation at any point of the MACNI process.

For more information please visit the Legislation page.

Eligibility for the Multiple and Complex Needs Initiative

For an individual to be eligible for MACNI they must meet the eligibility criteria outlined in the Act.

An eligible person is a person who:

  • has attained 16 years of age: and
  • appears to satisfy two or more of the following criteria:
    • has a mental disorder within the meaning of the Mental Health Act 1986;
    • has an acquired brain injury;
    • has an intellectual impairment;
    • is an alcoholic or drug-dependent person within the meaning of the Alcoholics and Drug-dependent Persons Act 1968; and
  • has exhibited violent and dangerous behaviour that has caused serious harm to himself or herself or some other person or is exhibiting behaviour which is reasonably likely to place himself or herself or some other person at risk of serious harm; and
  • is in need of intensive supervision and support and would derive benefit from receiving coordinated services in accordance with a care plan under this Act that may include welfare services, health services, mental health services, disability services, drug and alcohol treatment services or housing and support services.

How do people access the Multiple and Complex Needs Initiative?

Who can make referrals?

Referrals to MACNI may come from any source including the following:

  • existing service providers working with the individual
  • self referrals
  • family members or significant others
  • court support services  or
  • Correctional Services 

             A diagram of the MACNI Service Model can be viewed on the following link:

MACNI SERVICE MODEL

Regional Gateway

The Department of Human Services has eight geographic regions. A Regional Gateway to MACNI has been established in each region and is managed by a Regional Coordinator.

The Regional Coordinator is the first point of contact for service providers and other bodies or individuals seeking information about MACNI or wishing to discuss a potential referral.

Regional Coordinators will provide preliminary advice regarding an individual's likely eligibility and, where appropriate, will participate in case discussions/problem solving meetings.

In addition to the input of the Regional Coordinator, each region has established its own local or regional panel to provide co-ordinated, cross program consideration of all potential referrals to CERG for MACNI eligibility. These panels comprise senior program managers and regional funded sector representatives and the regional coordinator.

Improved cross program coordination and collaboration at the regional gateway level is contributing to a reasonable proportion of matters being resolved locally without having to be referred to CERG for MACNI eligibility.

Where a region determines that a matter should be referred to the CERG, this will occur only after:

  • every reasonable effort has been made to problem-solve locally
  • the individual has been notified of the region's intention to refer their case to MACNI and they have not refused to participate (this is a requirement under the Act)
  • the Regional Director has endorsed the referral.

What is the Central Eligibility and Review Group?

The Central Eligibility and Review Group (CERG) is comprised of senior Department of Human Services, Department of Health and Department of Justice program managers and clinical advisers. In addition the CERG has access to independent expert advisers for advice and expertise. The CERG is chaired by the Executive Director of Operations Division DHS.

The CERG has a number of responsibilities including:

  • Determining eligibility for clients referred to MACNI from the DHS regions
  • Reviewing care plans
    • on request from regions or other stakeholders, for practice advice or support
    • when access to the central pool of funds on behalf of a MACNI client is sought
    • as a quality assurance mechanism
  • Reviewing and approving requests for brokerage for individual MACNI clients, and monitoring overall spending of MACNI brokerage
  • Contributing to evaluation and program review
  • Providing advice to the Steering Committee, DHS Executive and Department of Justice on systemic and specific issues concerning complex clients.  

How is information provided to the CERG?

Information is provided to the CERG via the Multiple and Complex Needs referral form.

What happens if the CERG decides that the individual is eligible for MACNI?

If the CERG decides that the individual is eligible for MACNI, it will inform the relevant region who will, in negotiation with Indigo and other service providers as required, begin the process of care plan development. 

More information about the CERG can be found in the Service Components section.

What happens once an individual is determined eligible by the CERG?

Once an individual is determined eligible by the CERG, the matter is returned to the region for action. At this stage the region will negotiate with Indigo Care Plan Development and Coordination Service and other relevant service providers, the development of a care plan. This care plan will be based on an assessment of the individual's needs. The regional panel approves the care plan and care plan coordinator, approves the allocation of regional brokerage funds and reviews the care plan. They can request additional funds by applying to the CERG. They can also seek advice and guidance from the CERG about the care plan as required.

What is a MACNI Care Plan?

The care plan outlines the following:

  • areas of the individual's life which have been identified as a priority

  • priority goals of the individual

  • strategies to engage the individual

  • further assessment priorities

  • identification of the services and supports and their roles and responsibilities

  • a crisis intervention plan specific to the individual

  • when and how the care plan will be monitored and reviewed.

A care plan lasts the duration of 12 months. There is opportunity to extend a care plan if it is in the best interests of the individual for up to a total of 36 months.

The care plan will also identify a Care Plan Coordinator either from the existing service system or, in some cases, from Indigo Assessment and Care Plan Coordination Service.

Who is Indigo Care Plan Development and Coordination Service?

Indigo Care Plan Development and Coordination Service (Indigo) is a funded state wide service established under MACNI. The service provides a range of services and supports to MACNI clients and MACNI service providers. Indigo works in partnership with regions to achieve the most sustainable and appropriate outcome possible for the individual. Indigo is funded to provide assessments, care plan development, care plan coordination, secondary consultation, mentoring, co-work and  training.

More information is on the Indigo Care Plan Development and Coordination Service Components page.

What is the role of the Care Plan Coordinator?

The Care Plan Coordinator works in partnership with the care plan team and the region to facilitate coordination and implementation of the care plan.

Download the Care Plan Coordination Booklet 2009 - Red Book  

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