Key Strategic Directions for 2005-06
Enhanced Access to Culturally Appropriate Hearing Services for Aboriginal and Torres Strait Islander Peoples
Eligibility for access to hearing services was expanded by the Australian Government on 1 December 2005 to include all Aboriginal and Torres Strait Islander people aged 50 years and over, and those who participate in the Community Development Employment Program. The Department is administering access for this group through the Community Service Obligations component of the Hearing Services Program. Australian Hearing, the Government-owned hearing service provider, is responsible for delivering these services.
The Department worked with Australian Hearing in 2005-06 to supplement their awareness raising activities about the Australian Government’s initiative to improve access to the Hearing Services Program for Aboriginal and Torres Strait Islander people. The Department initiated consultations with key government and Indigenous agencies in the Northern Territory, Western Australia and New South Wales throughout 2005-06. The consultations increased awareness of the new eligibility criteria and established links that will assist in the implementation of the measure in the various jurisdictions.
Australian Hearing commenced an extensive marketing campaign in October 2005 which targeted Indigenous media and agencies providing services to Aboriginal and Torres Strait Islander people. Despite this campaign, initial uptake of the services by the target group was slower than expected. A total of 501 Aboriginal and Torres Strait Islander people had received services under the new measure by 30 June 2006, compared with a provisional target of 2,050. Uptake of the measure is expected to increase in line with expanding awareness of the measure and increasing acceptance of hearing services amongst Indigenous communities.
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Improved Performance and Quality of Hearing Devices
In October 2005, a new Deed of Standing Offer between the Department and suppliers of hearing devices came into effect. The Deed sets out conditions of device supply between suppliers and accredited hearing service providers of the Hearing Services Program. A total of 13 suppliers signed the new Deed.
As part of the conditions of device supply set out in the Deed, the Department introduced new minimum device specifications for the supply of hearing devices under the Hearing Services Program. These new specifications were phased in from October 2005 and fully implemented by December 2005. The new arrangements mean that devices supplied as ‘free-to-client’ now have higher minimum specifications. In addition, ‘behind-the-ear’ devices supplied under the Hearing Services Program now must have additional features, including directional microphones and noise suppression.
As a result of these changes, the proportion of devices that were provided as ‘free-to-client’ devices increased from 58 per cent in 2004-05 to 74 per cent in the second half of 2005-06.
Improved Access to Community Service Obligations Services and Improved Reporting and Costing of Community Service Obligations Arrangements
The Department ensures access to Community Service Obligations through a Memorandum of Understanding (MoU) with Australian Hearing. In 2005-06, 37,021 clients received services under the Community Service Obligations component of the Hearing Services Program, compared with 36,407 clients in 2004-05. Improved funding reporting and cost attributions, particularly for services provided to Aboriginal and Torres Strait Islander people, are now in place and monitored by the Department through the MoU.
Streamlined Contractual Arrangements
The Service Provider Contract incorporates Clinical Standards for Government-funded hearing services. Early in 2006, the Department commenced the implementation of new standards, known as Hearing Rehabilitation Outcomes for Voucher Clients, which focus on the rehabilitation outcomes to be achieved for clients. These Outcomes are quite different to the current focus on processes to be undertaken by clinicians, and remove a significant amount of prescriptive detail from the existing contractual requirements.
Although the new Outcomes will not formally be incorporated as a contractual requirement until July 2007, a phase-in period was commenced to allow the industry time to become familiar with the new standards and, if appropriate, to make modifications to their service delivery. The Department conducted Industry Information Forums in capital cities during May and June 2006.
In late 2005, the Department contracted an external consultant to undertake a review of its role in regulating the professional qualifications of practitioners who provide services under the Hearing Services Program. The review will be finalised in the second half of 2006 and recommendations will be formalised in 2007.
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Quality Assurance of Service Provision
For the first time since the Hearing Services Program's inception in 1997, the number of service providers contracted to provide services to voucher clients reached 200, with services delivered through a national network of 1,713 permanent, visiting and remote sites.
The quality of service provision is monitored by the Department through a range of quality assurance measures. The Department regularly conducts audits of contracted service providers to assess compliance with their contractual obligations and with the Clinical Standards for hearing services. During 2005-06, the Department conducted a record number of 49 site visits and reviewed the files of 218 practitioners (which represented a 24 per cent sample of all practitioners).
A small percentage of audit outcomes result in compliance action being initiated against the contracted service provider. During 2005-06, one compliance notice was issued to a contracted service provider for alleged contraventions of the conditions of its accreditation under the Hearing Service Providers Accreditation Scheme 1997.
In addition, for the first time, the delegate of the Minister revoked the approval of one practitioner for long-term and systematic non-compliance with the Clinical Standards. This revocation was made under Rule 34 (2) (d) and Rule 34 (2) (e) of the Hearing Services Rules of Conduct 2000 and means that the practitioner is no longer able to provide any services to voucher clients.
During 2005-06, the Department reviewed its audit processes, resulting in the development and trial of new audit processes. These new processes are consistent with the change to outcome-based standards and are designed to give improved recognition to the level of professional expertise and judgement demonstrated by the hearing services industry.
In conjunction with the new audit processes, the Department contracted an external provider to design and conduct auditor training for 19 staff who were involved in a range of audit processes. This is the first time that formal auditor training was conducted for all staff.