Agency Outline

The Department of Health and Human Services is responsible for purchasing and delivering integrated services that maintain and improve the health and wellbeing of Tasmanians.

The Department coordinates the delivery of its services across Tasmania through a network of facilities, community services and home‑based care; it reports to the Minister for Health, Hon Michael Ferguson MP, and the Minister for Human Services, Hon Jacquie Petrusma MP.

Service delivery is achieved through direct provision of services by the Department or through service agreements or contracts with provider organisations. From 1 July 2015, the newly formed Tasmanian Health Service (THS) will have responsibility for the provision of public hospital services and a broad range of health services. The Department, on behalf of the Minister for Health, will enter into a Service Agreement for 2015‑16 with the THS and monitor performance against this agreement.

The principal responsibilities of the Department include:

·       planning and purchasing high quality, safe and efficient health services through the public hospital system; primary and community health services, including mental health, oral health and correctional health services; and ambulance services;

·       delivering health promotion and protection through emergency management, public health and related preventative health services;

·       funding care for older Tasmanians, as well as support and assistance to enable them to remain living independently in their own homes;

·       funding a network of alcohol and drug abuse prevention and treatment services;

·       funding a range of accommodation and support services aimed at enhancing the quality of life for people with a disability;

·       statutory responsibilities for vulnerable children and young people in relation to child protection and juvenile justice;

·       funding a wide range of community services for children and their families, including early intervention, family support services and child health services; and

·       delivering secure, affordable housing and support to low income Tasmanians, as well as accommodation and support for people experiencing homelessness.

This chapter provides the Department's financial information for 2015‑16 and over the Forward Estimates period (2016‑17 to 2018‑19). Further information about the Department is provided at www.dhhs.tas.gov.au.

One State, One Health System, Better Outcomes ‑ Rebuilding Tasmania's Health System

The Tasmanian Government is reforming the health system to make it focus more on the needs of patients.

The Government's vision is for Tasmania to strive to have the healthiest population in Australia by 2025 and a world-class health care system.

The goal is to give Tasmanians a better health system: a complete, statewide system that places the interests of patients at the forefront of every decision.

Redesign of the health system will ensure that we spend the existing health dollar more efficiently. This will free up existing funds that will allow the Government to:

·       address gaps in health services in our local communities;

·       enable the treatment of more people, meaning reduced waiting times for access to treatment and reduced waiting lists; and

·       direct health spending and activity towards the interventions that are shown by evidence to provide the greatest benefit to patients and the community.

This stage of the reform process focuses heavily on the four major acute hospitals and ensuring that each facility is working to its defined role in the system. This does not discount the role and importance of the other parts of the health system, rather it is an acknowledgement of the persistent issues that Tasmania has faced in the delivery of acute hospital services and in developing and maintaining strong linkages with primary and community care.

It is clear that the division of Tasmania's acute health service into three distinct management structures has been a barrier to our hospitals working effectively together to deliver optimal care for all Tasmanians. This has led to safety and quality issues in some areas, duplication of services resulting in inefficiencies, identifiable service gaps and higher costs that limit the Government's ability to deliver the range and volume of services that Tasmanians need.

Through the One State, One Health System, Better Outcomes reforms, a single statewide Tasmanian health service will provide leadership and stewardship of the health system and break down the existing barriers to provide better health services for all Tasmanians. It will have greater accountability for its effectiveness and efficiency and, importantly, be engaged with the Tasmanian community.

Further information on the reforms is available at: http://www.dhhs.tas.gov.au/onehealthsystem.

 

Key Deliverables

Table 4.1 provides a summary of the Budget and Forward Estimate allocations for key deliverables within the Department.

Table 4.1:          Key Deliverables Statement

	2015-16   Budget	2016-17 Forward Estimate	2017-18 Forward Estimate	2018-19 Forward Estimate
	$'000	$'000	$'000	$'000
Minister for Health
Additional Funding to Frontline Health1	25 000	25 000	25 000	25 000
Children and Adolescent Mental Health Service	600	600	600	600
Hospital Alternative Program2	750	750	1 000	….
Ice and Other Drugs Strategy3	1 350	1 150	1 150	1 150
Mental Health Policy - Implementation	675	175	175	….
North West Regional Cancer Centre1	2 500	3 000	4 500	4 500
Nurses Graduates - Additional Transition to Practice Placements1	1 246	1 260	2 610	….
Patient Transport to Support One Health1	2 000	4 000	4 000	4 000
Rebuilding Health Services - Elective Surgery Program1	20 000	20 000	20 000	….
Southern Midlands Paramedics4	500	500	500	500
Suicide Prevention Strategies	1 434	1 227	….	….
Major Capital Infrastructure
Health Transport and Coordination Infrastructure	….	5 000	5 000	….
Hospital and Health Centre Maintenance	3 290	4 260	790	….
Launceston General Hospital Allied Health Clinics	3 000	….	….	….
Royal Hobart Hospital
Hospital Capital Fund	16 197	….	….	….
Redevelopment Project	11 991	173 825	176 576	74 508
Women's and Children's Precinct	42 501	….	….	….
Statewide Cancer Centres	9 625	….	….	….
St Helens Hospital Redevelopment	….	250	2 750	4 000

 

Table 4.1:          Key Deliverables Statement (continued)

	2015-16   Budget	2016-17 Forward Estimate	2017-18 Forward Estimate	2018-19 Forward Estimate
	$'000	$'000	$'000	$'000
Minister for Human Services
Autism Continuum of Care	250	250	300	….
Building a Joined Up Human Services Support System	600	600	….	….
Children, Young People and Families Investment	220	220	….	….
Community Sector Organisations - Additional Funding	2 000	2 500	2 500	….
Disability - Additional Support	500	500	500	….
Elder Abuse	150	150	….	….
Equal Remuneration Order (ERO) Costs5	16 276	21 248	24 180	31 786
Establishing Food Co‑operatives	100	….	….	….
National Disability Insurance Scheme (NDIS)	2 000	11 600	39 600	39 600
NDIS Job Ready Workforce	125	125	….	….
Neighbourhood Houses	850	….	….	….
Sheffield Family Support Centre	125	125	125	63
TasCOSS	63	63	63	….
Youth Justice - Save the Children Bail Program and Post-Detention Transition Program	421	600	….	….
Major Capital Infrastructure
North West Youth Accommodation and Training Facility	….	1 500	4 500	….
Northern Suburbs Community Centre	83	900	677	….

Notes:

1.   The THS will play a central role in the delivery of these initiatives, and an outline of each is provided in the THS chapter, chapter 25 of Government Services Budget Paper No 2. While funding for these initiatives has been transferred to the THS, the Department will retain responsibility for the management and control of the implementation of these Key Deliverables.

2.   The THS will play a central role in the delivery of this initiative, as indicated in chapter 25 of Government Services Budget Paper No 2. Funding for this initiative has been retained by the Department and the Department will retain responsibility for the management and control of the implementation of this Key Deliverable.

3.   This key deliverable is funded from both the Department's existing Budget and Forward Estimates and additional funding provided in this Budget ($1 million in 2015‑16; $800 000 from 2016‑17 and thereafter).

4.   This key deliverable is funded from the Department's existing Budget and Forward Estimates.

5.   Of the $31.786 million in 2018‑19, additional funding of $7.606 million has been allocated in the 2015‑16 Budget, with the remaining $24.18 million entered in prior years.

 

Minister for Health

Additional Funding to Frontline Health

Additional funding of $100 million will be provided over four years to invest in frontline health services provided by the THS, which will be established on 1 July 2015 through the merger of the three existing THOs.

The establishment of the THS is a key component of the One State, One Health System, Better Outcomes reforms and is designed to improve the coordination of services and reduce duplication and inefficiencies within the health system.

The THS is required to manage its funding to ensure the efficient operation of the facilities and services under its control, and the efficient use of its resources and delivery of services purchased by the Government.

Children and Adolescent Mental Health Service

Additional funding of $600 000 per annum from 2015‑16 will increase staffing levels at Children and Adolescent Mental Health Services (CAMHS). CAMHS is a specialist service that provides treatment and support to young Tasmanians (under 18) with serious mental illness, and their families. The additional resources will help to address long standing under‑resourcing of this service, to help improve outcomes for young Tasmanians with serious mental illness by increasing the capacity of CAMHS to provide greater equity of access to mental health care across age groups.

Hospital Alternative Program

This 2014 election commitment provided $3 million over four years to help keep people with chronic illness out of hospital, by providing them with quality care in the home or community, including restoring the Hospital in the Home program. Initiatives under this program will be implemented as part of the One State, One Health System, Better Outcomes reforms.

Ice and Other Drugs Strategy

Over four years, $4.8 million will be invested to tackle the problem of Ice and other drugs in Tasmania. This funding will be used to implement recommendations from the review into drug use in the North West, which was released in November 2014.

Specific initiatives include:

·       the opening of 12 new residential rehabilitation beds available for clients across the State with a priority of establishing a residential rehabilitation program for clients based in the North West;

·       employment of new specialist consultation liaison staff within Alcohol and Drug Services (ADS) based in Launceston and Ulverstone to work across the North and North West. These staff will work with the broader health system and community services;

·       new transport options to improve access for North and North West clients to the southern specialist Inpatient Withdrawal Unit when appropriate; and

·       supporting communities and current service providers, including assistance for health promotion, prevention and early intervention strategies, such as raising community awareness and improving health and health policy literacy.

Additional funding of $3.4 million over four years has been provided in this Budget, with $1.4 million over four years being prioritised from the Department's existing Budget and Forward Estimate allocation.

Mental Health Policy - Implementation

This 2014 election commitment provided additional investment in mental health for the development of an integrated system that provides support in the right place at the right time, with clear signposts about where to get help and how. Additional funding is provided for:

·       Rural Alive and Well - a further $500 000 in 2015‑16, in addition to $500 000 provided in 2014‑15;

·       mental health outreach services through the Neighbourhood House network - with a further investment of $225 000 over the next three years. This is in addition to the $75 000 provided in 2014‑15; and

·       additional advocacy for people with mental illness and people living with a disability - with $300 000 provided over three years. This is in addition to the $100 000 provided in 2014‑15.

North West Regional Cancer Centre

The North West Regional Cancer Centre is currently under construction as part of the Statewide Cancer Project. Construction is due to be completed at the end of 2015. Additional funding of $2.5 million in 2015‑16, $3.0 million in 2016‑17, and $4.5 million per annum from 2017‑18 has been allocated for the operating costs associated with the North West component of the Northern Integrated Cancer Service.

Under the Northern Integrated Cancer Service, the North West Regional Cancer Centre in Burnie and Holman Clinic in Launceston will work closely together to provide better services across the North and North West of the State. Through the development of a critical mass of specialists, the new linear accelerator will be opened and operated at the North West Regional Hospital to provide vital radiation oncology treatment to cancer sufferers.

Nurse Graduates - Additional Transition to Practice Placements

This 2014 election commitment provided $5.4 million over four years for additional Transition to Practice Placement for nursing graduates. This will enable the employment of up to 85 additional graduate nurses across the State over four years.

Patient Transport to Support One Health

The Government is investing an additional $24 million over the next four years, including $10 million for capital upgrades (refer to Key Deliverable - Health Transport and Coordination Infrastructure), to provide improved patient transport and coordination under the Government's One State, One Health System, Better Outcomes reforms.

Under the reforms, the health system will operate as a single statewide system, with each hospital having an important but different role to play. Hospitals will specialise in the procedures they are best suited to provide and patients will be treated at the hospital best suited to the patient's needs.

Additional funding of $14 million over the Budget and Forward Estimates period will be used to improve emergency patient transport by streamlining patient transport between facilities, providing transport for people to access non-urgent medical appointments as well as financial support for private travel and accommodation where required.

Priorities for investment in improved patient transport services will be identified as part of the implementation planning to be undertaken during and post the finalisation of the One Health System White Paper.

Rebuilding Health Services - Elective Surgery Program

This 2014 election commitment provided $76 million over four years for additional elective surgery with a focus on the reduction of waiting lists. This commitment will deliver up to 15 000 extra elective surgeries, addressing backlogs and improving the quality of life for thousands of Tasmanians by ensuring patients get their operations sooner.

Southern Midlands Paramedics

The Government is investing approximately $500 000 per annum to base paramedics at Oatlands. These funds will support services staffed 24/7 by a paramedic and volunteers. Through servicing the Oatlands and Central Highlands areas, this service will also help to ease pressure on ambulance stations in surrounding areas such as Campbell Town and the East Coast. The cost of this initiative will be met within existing resources.

Suicide Prevention Strategies

This 2014 election commitment provided $3 million over three years for targeted and proactive suicide prevention strategies.

The funding is prioritised into the following areas:

·       assisting communities with the implementation of their Suicide Prevention Community Action Plans;

·       establishing early intervention referral pathways, especially following a suicide attempt or self‑harming;

·       delivering suicide prevention awareness training to persons in key occupations to recognise and respond to the signs;

·       ensuring Tasmanian researchers can access information needed to allow in‑depth analysis of Tasmanian suicides, to better target prevention strategies;

·       developing a targeted Youth Suicide Strategy for Tasmania in consultation with the Youth Network of Tasmania; and

·       undertaking analysis of suicide 'hotspots' to mitigate risks if places are known for repeat suicides.

Health Transport and Coordination Infrastructure

Commencing in 2016‑17, a funding allocation of $10 million will be provided over two years for health transport infrastructure. These funds will be used for investment in improved infrastructure associated with changes to patient coordination, transport and accommodation arising from the One State, One Health System, Better Outcomes reforms.

Investment will target capital upgrades to support patients that need to travel for services, staff that may need to travel to provide outreach services to patients or strategies that limit the need for patients or staff to travel in order to provide or receive services under a single state wide Tasmanian health system.

Priorities for investment in improved infrastructure will be identified as part of the implementation planning to be undertaken during and post the finalisation of the One Health System White Paper.

Hospital and Health Centre Maintenance

Funding of $8.3 million over three years is allocated from 2015‑16 for hospital and health centre infrastructure maintenance. This funding will support the sustainable delivery of safe and efficient health care services across the State and will be used to fund the maintenance, replacement or upgrade of existing hospital and health centre infrastructure across the State, including at the Hobart Private Hospital, Launceston General Hospital, Flinders Island Hospital, Launceston Ambulance Station and at rural hospital locations.

Launceston General Hospital Allied Health Clinics

Funding of $3.0 million has been provided in 2015‑16 to expand and refurbish the existing Specialist Clinic at the Launceston General Hospital (LGH), and for additional minor works in LGH Allied Health Outpatient Services. The redevelopment of the existing Specialist Clinic will focus on the redesign of the existing space to support the current model of care and to improve patient experience by ensuring patient confidentiality and privacy. The redesign of the space into a modular/pod configuration will support an efficient and comfortable experience for patients from presentation to completion of visit.

Royal Hobart Hospital Redevelopment

The $657 million Royal Hobart Hospital Redevelopment is Tasmania's largest ever health infrastructure project and will deliver a modern health facility for generations of Tasmanians to come.

The $657 million Project includes $20.1 million for the RHH Cancer Centre upgrade, detailed as a separate key deliverable under Statewide Cancer Centres.

Following the Royal Hobart Hospital Rescue Taskforce Review, work has recommenced on the project, with an additional $71.9 million invested in the Project to deliver the following significant improvements:

·       a safer construction methodology allowing key acute services to continue to be provided on site but away from the day to day disruption of construction. This means that acute care patients still have access to critical medical facilities and security;

·       a fully costed decanting and refurbishment plan including the construction of the temporary facility in Liverpool Street which better provides for the care of patients who require access to the broader facilities for their quality of care;

·       an improved design which will increase the floor area of levels two and three by an additional 1400m². This will allow increased space for mental health services including more outdoor recreational space;

·       an improved design for the maternity ward that will increase the number of single bedrooms for women who have caesarean or complex births;

·       the addition of a helipad for emergency aeromedical retrievals, that facilitates better linkages to other hospital sites; and

·       the accelerated replacement of the hyperbaric chamber which was identified as a construction risk.

Works on the new redevelopment have now commenced and the new Inpatient Precinct, the final element of the Project, will be completed in the 2018‑19 financial year.

Statewide Cancer Services

Funding is provided to build specialist Cancer Centres within the hospital precincts of the Royal Hobart Hospital, the Launceston General Hospital and the North West Regional Hospital.

The total commitment for the project is $63 million, with $23.9 million from the State, $36.3 million from the Australian Government, and notable donated contributions from the Elphinstone Group of Companies ($1.6 million), the Menzies Centre ($600 000) and the Cancer Council ($600 000).

Construction of the Cancer Centres at the Royal Hobart Hospital and Launceston General Hospital has been completed.

At the North West Regional Hospital, $9.1 million will be utilised in 2015‑16 on infrastructure for medical oncology and radiation therapy services, as well as associated education and support facilities. The development of supporting information technology for the Cancer Centres will receive $483 000 in 2015‑16. It is anticipated that all projects under the Statewide Cancer Services program will be completed in 2015‑16.

St Helens Hospital Redevelopment

Following the initial funding allocation of $3 million over two years for the planning and commencement of this project, a further $4 million is allocated in 2018‑19 for construction of the St Helens Hospital Redevelopment. The construction of a new hospital will achieve a safe, accessible, pleasant and efficient environment for facility patients/clients, staff and community members. It is anticipated that the total cost of the redevelopment will be $12.1 million.

Preliminary consultation with the Break O'Day Council is underway to plan for the Redevelopment.

Minister for Human Services

Autism Continuum of Care

This 2014 election commitment provided $1 million over four years to kick‑start a longer‑term strategy to provide best practice autism care to Tasmanians.

Building a Joined Up Human Services Support System

The Government's election commitment A Hand-up for Vulnerable Tasmanians, articulated the need to work on a long‑term plan in partnership with the community sector to deliver a more joined up human services system that provides:

·       a shared entry point and assessment for Government and community-delivered services;

·       a lead worker for complex cases, dedicated to building a network of support around individuals and families; and

·       an outcomes-based focus, working with individuals and families on their strengths and goals.

The aim of joined up human services is to improve outcomes for Tasmanians and to provide a hand-up for the most vulnerable within the Tasmanian community.

Additional funding of $1.2 million is provided over two years to progress this commitment through the establishment of a dedicated project team that will further the implementation, and then evaluate, five priority initiatives under the Building a Joined Up Human Services Support System project. This initial work will help formulate the future roll-out of the Building a Joined Up Human Services Support System initiative.

Children, Young People and Families Investment (365 Day Plan)

Children and Youth Services (CYS) is progressing a number of actions including:

·       input into the Safe at Home internal performance review being managed by the Department of Justice, which aims to improve the effectiveness of responses to family violence;

·       commencement of Stage 2 of the Out of Home Care System review;

·       establishing an independent process to review child death and serious injury, as well as a vulnerable infants and babies strategy;

·       establishing a statewide Reviewable Events Unit and an Out of Home Care Operations and Carer Support Unit; and

·       drafting of Commissioner for Children legislation.

The 2014 election commitment includes the investment of $300 000 (over three years) into short‑term preventative support care, to help keep families together and the investment of $360 000 (over three years) into a pre‑placement process.

Action being taken by the Government under this initiative is in addition to the new funding of $800 000 provided in the 2015-16 Budget for additional support for the prevention of family violence through Our Watch (see chapter 8 Department of Premier and Cabinet) and Safe-at-Home (see chapter 5 Department of Justice). The Government is strongly committed to addressing family violence and providing support to those that it impacts. The Government currently provides estimated direct expenditure of over $16 million annually across the Departments of Health and Human Services; Police and Emergency Management; Justice; Education; and Premier and Cabinet to provide services directly aimed at dealing with family violence. Furthermore, estimated annual funding in excess of $24 million across the Departments of Health and Human Services and Education is made available to provide services that deal with family violence, such as social worker support in schools, the sexual assault service and family support services.

Community Sector Organisations ‑ Additional Funding

This 2014 election commitment provided additional funding of $9 million to the community sector over four years. This additional funding will be used to support increasing costs and sector capacity building.

Disability ‑ Additional Support

This 2014 election commitment provided additional funding of $2 million over four years for disability services to assist those on waiting lists, who are outside of the NDIS trial cohort. This funding will provide approximately 12 000 additional hours of support.

Elder Abuse

This 2014 election commitment provided funding of $450 000 over three years to support the Elder Abuse Strategy including the helpline, peer education and awareness.

Equal Remuneration Order (ERO) Costs

Additional funding of $7.6 million is provided in 2018‑19, bringing the total ERO supplementation in 2018‑19 to $31.8 million. The ERO is being implemented in nine instalments over eight years; 2018‑19 will be year seven of the ERO. This funding will enable community sector organisations to fully meet their obligations and requirements under the Fair Work Australia ERO.

The funding supplementation included in this Budget is in addition to the $82.5 million reported in the 2014‑15 Budget for the first six years of the ERO. In total, the Tasmanian Government has committed $114.3 million to funding the first seven years of the ERO. This funding represents the total cost of the ERO in Tasmania, less an anticipated contribution by the Australian Government of $23.8 million for the same period. The Australian Government commitment is split across payments made to the State and paid directly to the National Disability Insurance Agency (NDIA).

Establishing Food Co-operatives

This 2014 election commitment provided $100 000 in 2015‑16 to resource start up food co‑operatives. This funding will help families and individuals access low cost, healthy, fresh and nutritious food by establishing partnerships between community, local food producers, Neighbourhood and Community Houses and food relief organisations.

National Disability Insurance Scheme (NDIS)

The Tasmanian Government is strongly committed to the full implementation of the National Disability Insurance Scheme (NDIS).

Funding of $39.6 million is provided in 2018‑19 to meet additional costs associated with the transition to the full NDIS. Over the next four years, $92.8 million of funding will be provided to assist with the introduction of the NDIS in Tasmania.

Tasmania was chosen as a launch site for the NDIS, which commenced in July 2013. This first stage will provide support to approximately 1 000 young people aged 15‑24 with disability, who are assessed as eligible. Tasmania has established an implementation team to work in collaboration with the Australian Government's National Disability Insurance Agency (NDIA), the disability sector, clients, their families and carers to ensure Tasmania's successful launch and readiness for the full scheme.

This first stage of the NDIS is being undertaken during the period to 2015‑16, with transition to the full scheme occurring from 2016‑17 to 2018‑19. Around 10 600 Tasmanians with a disability are expected to benefit from the NDIS when fully implemented in July 2019. During 2015-16, all States and Territories will finalise the timing of payments, as well as cash and in-kind contribution requirements, for full implementation of the NDIS. The contribution required by Tasmania will be adjusted in the 2016-17 Budget once agreements are finalised.

NDIS Job Ready Workforce

This 2014 election commitment provided funding of $250 000 over two years for National Disability Services (Tasmania) for the development of a job‑ready workforce to meet the new jobs required in Tasmania for the NDIS.

Neighbourhood Houses

This 2014 election commitment provided $1.7 million over two years for Neighbourhood and Community Houses. This initiative will provide each house with an additional one‑off injection of $50 000 over the two year period from 2014‑15 to 2015‑16.

Sheffield Family Support Centre

This 2014 election commitment provided $500 000 for the Family Support Centre in Sheffield. The Centre is managed by Glenhaven Family Care, a Community Sector Organisation in partnership with the Kentish Council and the community.

TasCOSS

This 2014 election commitment provided $250 000 over four years to TasCOSS to assist in building a joined‑up human services support system in partnership with the Government. This will include the development of shared tools to oversee, measure and monitor outcomes and assist community sector organisations to position themselves under the Government's new 'hand‑up approach'. This approach is designed to help vulnerable Tasmanians to move out of disadvantage.

Youth Justice ‑ Save the Children Bail Program and Post‑Detention Transition Program

This 2014 election commitment provided one‑on‑one support through both the Supporting Young People on Bail Program and the Post‑Detention Transition Program. Additional funding for these initiatives is supported by approximately $360 000 provided from the Solicitors' Guarantee Fund.

North West Youth Accommodation and Training Facility

Additional funding of $6 million is allocated over two years to build a supported accommodation facility in Devonport with specialist support services for youth. The Youth Accommodation and Training Facility will deliver around 25 units of accommodation for low income young people in the Devonport area, who are homeless, or at risk of homelessness. The facility will also include safe and secure accommodation options and support services suitable for young people living with disability. Planning for this project will commence in 2015‑16 and it is expected to be completed in 2017.

Northern Suburbs Community Centre

Additional funding of $1.7 million has been provided for the Northern Suburbs Community Centre (including Rocherlea Neighbourhood House). This project will replace the existing Northern Suburbs Community Centre in Rocherlea with a new purpose built facility situated in a more appropriate location to enable easier community access.

 

Output Restructure

A restructure of Output Group 2 has occurred since the publication of the 2014-15 Budget. Previously Output Group 2 Tasmanian Health Organisations consisted of:

·       Output 2.1 ‑ Tasmanian Health Organisation ‑ South;

·       Output 2.2 ‑ Tasmanian Health Organisation ‑ North; and

·       Output 2.3 ‑ Tasmanian Health Organisation ‑ North West.

The new title Output Group 2 Tasmanian Health Service consists of a single Output, Output 2.1 Tasmanian Health Service.

In addition, Cancer Screening Services has been transferred from Output Group 3 Statewide Services to the Tasmanian Health Service. This transfer relates to a proportion of funding within Output 3.2 Public Health Services.

Output 3.2 has been renamed Public Health Services following the restructure of the service. The Output was previously named Population Health.

Output Information

Outputs of the Department of Health and Human Services are provided under the following Output Groups:

·       Output Group 1 ‑ Health Services System Management;

·       Output Group 2 ‑ Tasmanian Health Service;

·       Output Group 3 ‑ Statewide Services;

·       Output Group 4 ‑ Human Services System Management;

·       Output Group 5 ‑ Human Services;

·       Output Group 6 ‑ Children Services System Management;

·       Output Group 7 ‑ Children Services; and

·       Output Group 8 ‑ Independent Children's Review Service.

Table 4.2 provides an Output Group Expense Summary for the Department.

 

Table 4.2:          Output Group Expense Summary

	2014-15)   Budget)	2015-16)   Budget)	2016-17) Forward) Estimate)	2017-18) Forward) Estimate)	2018-19) Forward) Estimate)
	$'000)	$'000)	$'000)	$'000)	$'000)
Minister for Health
Output Group 1 - Health Services System Management
1.1  Health Services System Management1	144 745)	119 695)	108 751)	104 991)	110 847)
	144 745)	119 695)	108 751)	104 991)	110 847)
Output Group 2 - Tasmanian Health Service
2.1  Tasmanian Health Service2	590 110)	650 128)	665 390)	685 223)	679 140)
	590 110)	650 128)	665 390)	685 223)	679 140)
Output Group 3 - Statewide Services
3.1  Ambulance Services3	62 097)	65 899)	67 371)	66 501)	66 575)
3.2  Public Health Services4	40 582)	32 647)	30 546)	25 788)	26 415)
	102 679)	98 546)	97 917)	92 289)	92 990)
Capital Investment Program5	72 096)	173 820)	3 000)	6 000)	439 900)
Special Capital Investment Funds5	112 102)	165 691)	27 575)	....)	....)
Minister for Human Services
Output Group 4 - Human Services System Management
4.1  Human Services System Management6	2 768)	3 379)	3 543)	2 941)	2 759)
	2 768)	3 379)	3 543)	2 941)	2 759)
Output Group 5 - Human Services
5.1  Community Services7	21 061)	22 649)	23 423)	25 066)	21 806)
5.2  Disability Services8	214 066)	217 778)	240 160)	281 077)	289 001)
5.3  Housing Services9	261 046)	127 730)	130 691)	132 157)	133 895)
	496 173)	368 157)	394 274)	438 300)	444 702)
Output Group 6 - Children Services System Management
6.1  Children Services System Management	4 897)	5 124)	5 279)	5 315)	5 341)
	4 897)	5 124)	5 279)	5 315)	5 341)

 

Table 4.2:          Output Group Expense Summary (continued)

	2014-15)   Budget)	2015-16)   Budget)	2016-17) Forward) Estimate)	2017-18) Forward) Estimate)	2018-19) Forward) Estimate)
	$'000)	$'000)	$'000)	$'000)	$'000)
Output Group 7 - Children Services
7.1  Children Services	108 599)	108 935)	112 545)	113 220)	115 973)
	108 599)	108 935)	112 545)	113 220)	115 973)
Output Group 8 - Independent Children's Review Service
8.1  Office of the Commissioner for Children	892)	922)	944)	948)	962)
	892)	922)	944)	948)	962)
Capital Investment Program	4 283)	143)	....)	....)	....)
Special Capital Investment Funds	477)	1 089)	1 157)	1 236)	1 278)
TOTAL	1 639 821)	1 695 629)	1 420 375)	1 450 463)	1 893 892)

Notes:

1.   The decreases in Health Services System Management primarily reflect the transfer of responsibility for the election commitments relating to Elective Surgery and Nurse Graduates ‑ Additional Transition to Practice Placements from the Department to the THS; the cessation of NPA funds and Commonwealth Own Purpose Expenditure Agreements; and Australian Government funding for eHealth projects ceasing in 2014‑15. These decreases are partly offset by additional funding relating to the Ice and Other Drugs Strategy.

2.   The increase in Tasmanian Health Service in 2015-16 primarily reflects: the transfer of responsibility for the election commitments relating to Elective Surgery and Nurse Graduates ‑ Additional Transition to Practice Placements from the Department to the THS; additional funding for initiatives including Additional Funding to Frontline Health, North West Regional Cancer Centre, Patient Transport to Support One Health, and Children and Adolescent Mental Health Services; and the transfer of Cancer Screening Services from the Department to the THS. The decrease from 2017‑18 to 2018‑19 reflects the cessation of funding for election commitments.

3.   The increase in Ambulance Services in 2015‑16 and 2016‑17 reflects a more accurate Budget estimate of revenue and expenditure, primarily relating to Ambulance Fees. The decrease in the outyears is due to a reduction in depreciation expense associated with motor vehicles from 2016‑17, based on the depreciation schedules of the existing Ambulance fleet.

4.   The decrease in Public Health Services reflects the transfer of Cancer Screening Services from the Department to the THS in 2015‑16, the expiry of NPAs including Preventive Health, and revised arrangements for the Essential Vaccines program.

5.   The movements in Capital Investment Program (CIP) and Special Capital Investment Funds (SCIF) primarily reflect the transfer of completed infrastructure assets to the THS. The Department undertakes capital works on behalf of the THS and transfers the resulting assets to the THS once completed. This transfer appears as an accrual expense within the Department and as accrual revenue within the THS.

6.   The increase in Human Services System Management in 2015‑16 and 2016‑17 reflects additional funding provided for the Building of the Joined Up Human Services Support System.

7.   The decrease in Community Services in 2018‑19 primarily reflects the expiry of the National Partnership Agreement on Pay Equity for the Social and Community Services Sector. A new agreement is expected to be negotiated with the Australian Government.

8.   The increase in Disability Services primarily reflects additional funding for NDIS and ERO, and election commitments, including Community Sector Organisations ‑ Additional Funding and Disability ‑ Additional Support.

9.   The decrease in Housing Services in 2015‑16 primarily reflects the transfer of Housing Tasmania stock to the Non‑Government Sector as part of the Better Housing Futures Program Stage 2 which occurred during 2014‑15.

Output Group 1:   Health Services System Management

1.1 Health Services System Management

This Output performs a number of functions including the provision of support for corporate services, policy, planning, regulation, funding, monitoring and service improvement across health services. This Output also provides support to the Secretary in establishing output priorities, including service improvement and supporting the Tasmanian Health Service to develop consistent, collaborative models of care particularly for chronic and complex conditions.

This Output includes:

·       grants provided to non‑government organisations in relation to mental health services, home and community health services, population health and alcohol and drugs;

·       funding held centrally in relation to health related expenses including payments to nationally funded centres, the National Blood Authority and the Post Graduate Medical Council;

·       the Department's contribution to the Australian Government for older people receiving basic community care as part of cross‑billing arrangements under the National Partnership Agreement on Transitioning Responsibilities for Aged Care and Disability Services; and

·       centralised functions in relation to the delivery of Statewide Mental Health Services.

Table 4.3:          Performance Information ‑ Output Group 1

Performance Measure	Unit of Measure	2012‑13 Actual	2013‑14 Actual	2014‑15 Target	2015‑16 Target
Implementation of Government reform agenda goals achieved within published timeframe1	%	na	na	100	100
Priority activities in the Statewide Clinical Governance Framework Action Plan undertaken1,2	%	na	na	100	na
Service Agreements developed and administered in accordance with the THO Act, and policy settings endorsed by the Minister for Health3,4	Number	3	3	3	1

Notes:

1.   These performance measures were introduced in the 2014‑15 Budget and, as such, prior year actuals are not available for all measures.

2.   Performance measures for the implementation of the Statewide Clinical Governance Framework Action Plan are no longer applicable. The Clinical Governance Framework has been under active review as a project under the One Health System Reform program, with progress against project milestones occurring as part of the Program's governance model.

3.   In 2014‑15, all three THO service agreements were finalised within the required legislative timeframe. The performance of all THOs against the requirements of the agreements was monitored and managed in accordance with the processes outlined in the 2014‑15 THO Service Agreement Performance Framework.

4.   A single Service Agreement will be required in 2015‑16 due to the establishment of the THS on 1 July 2015.

 

 

Output Group 2:   Tasmanian Health Service

2.1 Tasmanian Health Service

This Output provides admitted acute, non‑admitted acute, emergency department, forensic medicine, community and aged care, oral health and mental health services to patients through Tasmania's major public and rural hospitals, residential aged care and community health based services. The State contribution to the THS is included in this Output.

Performance Information Comments

On 1 July 2015, a single Tasmanian Health Organisation (the Tasmanian Health Service) will commence operation, replacing the current three THOs. Performance information relating to the THS is provided in chapter 25 of Government Services Budget Paper No 2.

Output Group 3:   Statewide Services

3.1 Ambulance Services

This Output provides integrated pre‑hospital emergency and medical services, health transport, aero‑medical and medical retrieval services to the Tasmanian community. It provides these services through a system of paramedics, doctors, patient transport officers, volunteer officers and the support and partnership of independent non‑government services around the State.

3.2 Public Health Services

This Output provides two service streams: Public and Environmental Health Services, which monitors the health of the Tasmanian population and implements programs to protect and promote health; and Population and Health Priorities, which implements programs to prevent or reduce risk factors that lead to chronic conditions.

Table 4.4:          Performance Information ‑ Output Group 3

Performance Measure	Unit of Measure	2012‑13 Actual	2013‑14 Actual	2014‑15 Target	2015‑16 Target
Ambulance Services1
Total Ambulance Responses2	Number	76 395	78 944	na	na
Emergency Ambulance Responses3	Number	47 315	48 607	na	na
Satisfaction with Ambulance Services	%	98	98	98	98
Median Emergency Response Times (Statewide)4	Mins	11.0	11.4	11.8	11.8
Median Emergency Response Times (Hobart)4	Mins	10.1	10.4	10.8	10.8
Median Emergency Response Times (Launceston)4	Mins	9.7	10.1	10.5	10.5
Median Emergency Response Times (Devonport)4	Mins	8.9	9.6	10.0	10.0
Median Emergency Response Times (Burnie)4	Mins	9.1	9.5	10.0	10.0
Ambulance Services expenditure per person5	$	119.8	127.6	na	na
Public Health Services
Vaccine coverage in children aged 12‑15 months	%	92.7	89.8	90.4	92.5
Vaccine coverage in children aged 24‑27 months	%	94.0	93.5	88.7	92.5

Notes:

1.   In 2012, the Ambulance Service refined its case load and response time reporting to exclude vehicle movements that did not involve patients ‑ such as the movement of a vehicle to a repairer or driving between stations when not on cases. Excluding these vehicle movements provides a more accurate reflection of actual patient related ambulance responses. To enable comparison across years, all demand and response time figures reported in this Table have been calculated using the latest data refinements.

2.   The number of vehicles dispatched (responses) is one measure of the Ambulance Service's workload and an indicator of the demand for ambulance services in Tasmania. This measure includes emergency, urgent and non‑urgent responses (cases managed by Ambulance Tasmania's Health Transport Service are excluded ‑ these include scheduled bookings for Non‑Emergency Patient Transport Service patients). This indicator is a measure of demand rather than performance. As such, the figure presented here is the actual figure for 2012‑13 and 2013‑14 and target figures for 2014‑15 and 2015‑16 are not presented.

3.   This measure is a subset of the figure reported as Total Ambulance Responses but for emergency incidents only.

4.   The ambulance emergency response time is the difference in time between an emergency 000 call being received at the Ambulance Tasmania Communications Centre and the first vehicle arriving at the location to treat the sick or injured patient. The Median Emergency Response Time (MERT) is the middle time value when all the response times are ordered from the shortest to the longest. The MERT can be broadly interpreted as the time within which approximately 50 per cent of the first responding ambulance resources arrive at the scene of an emergency. However, this is not always the case.

5.   The figures here are as published in the annual Report on Government Services, and may differ from those in previous reports due to statistical parameter adjustments. This indicator is a measure of cost, rather than performance, and as such it is not possible to set targets for 2014‑15 and 2015‑16.

Performance Information Comments

Ambulance Services

There is a direct correlation between increased calls for help and slower ambulance response times as the same number of vehicles become busier.

There are a variety of factors which affect ambulance response times in Tasmania including:

·       demand for service against the available resource base;

·       the ageing population as a primary driver of demand;

·       a relatively high proportion of the population living in rural and remote areas;

·       hilly terrain, ribbon urban development along the Derwent and Tamar rivers; and

·       a high reliance on Volunteer Ambulance Officers.

According to the Rural, Remote and Metropolitan Areas Index, Tasmania has almost twice the national average population in rural and remote areas than all other jurisdictions. Tasmania also has the lowest proportion of its population living in highly accessible locations.

Ambulance Tasmania experienced an increase in caseload during 2013‑14 compared with the previous year. The demand for services has increased by 3.3 per cent from the previous year. The daily average number of Emergency Dispatches increased from 129 in 2012‑13 to 133 during 2013‑14.

Some impact on response performance has been noted as a result of this increased demand. The Ambulance Service is starting to see the benefits of a number of operational and clinical initiatives aimed at improving patient outcomes, which have been implemented over the past 12 months. These include:

·       launch of the Early Access to Defibrillation Program (EADP);

·       commencement of the Aeromedical and Medical Retrieval Road Retrieval Unit;

·       approval and release of Intensive Care Flight Paramedic Clinical Field Protocols;

·       completion of the In‑Vehicle Information System pilot;

·       amendments to the Ambulance Service Act 1982 came into effect on 1 July 2014 significantly improving protections for Volunteer Ambulance Officers (VAOs) and Paramedics and improving patient safety;

·       launch of the 'Join, Learn, Be Ready' Volunteer Recruitment campaign;

·       completion of the Computer Aided Dispatch (CAD) Server hardware upgrade; and

·       introduction of Air Maestro aeromedical scheduling and clinical management software in line with other states and territories.

Public Health Services

The definition for 'fully immunised' changed during 2013‑14 with pneumococcal, meningococcal C and varicella vaccines being included. Children are now considered fully immunised if they have received vaccines for diphtheria, tetanus and pertussis (DTPa), polio, Haemophilus influenza type b, hepatitis B and pneumococcal for 12‑15 month and 24‑27 month age groups; and meningococcal C and measles, mumps, rubella and varicella (MMRV) for the 24‑27 month age group.

Tasmania's 12‑15 month age cohort rate reduced during 2013 and is now below the national average for this group. The change in the definition of fully immunised, cessation of the General Practice Immunisation Incentive Program and modified Australian Childhood Immunisation Register support during 2013 influenced this reduction, in combination with the fluctuating rates that can be experienced with small population numbers. There has been a slight decrease in the 24‑27 month cohort, however, the rate remains above the national average. The primary reason for the drop in reported coverage for the 24‑27 month age cohort is due to the inclusion of additional vaccines on to the National Immunisation Program. It is expected that these children will catch-up by their fourth birthday when they present for their next scheduled vaccination, if not before.

Output Group 4:   Human Services System Management

4.1 Human Services System Management

This Output performs a number of complementary functions including the provision of support for corporate services, policy, planning, regulation, funding, monitoring and service improvement across human services. This Output also provides support to the Secretary in establishing Output priorities.

Table 4.5           Performance Information ‑ Output Group 4

Performance Measure	Unit of Measure	2012-13 Actual	2013‑14 Actual	2014‑15 Target	2015‑16 Target
Organisations receiving a Quality and Safety Review within relevant timeframes1	%	na	60	42.5	60
Target Population transferred to NDIS trial within agreed timeframes2	%	na	81.1	93.5	100.0
Social Housing owned and/or managed by the Community Sector3	%	17.0	34.0	35.0	35.0

Notes:

1.   The 2014‑15 Target has been revised to 42.5 due to short‑term resource constraints in this area during 2014‑15.

2.   The 2013‑14 Actual has been revised from 80.1 to 81.1 to align with NDIA published figures due to the inclusion of both active and inactive participants. These data have been sourced from National Disability Insurance Agency (NDIA) data, 30 June 2014 and Appendix C Planned Intake of Participants.

3.   In Tasmania, there has been a significant transfer of management of 34 per cent of housing stock in 2013‑14 to community organisations under the Better Housing Futures initiative.

Performance Information Comments

The program of Department led quality and safety audits of community sector organisations is still relatively new, with a pilot being undertaken in 2013 and formal targets first set in 2013‑14.

As Tasmania has already undertaken significant reform of the specialist disability service system, the State submitted a proposal, which was accepted, to be included as a trial site for the National Disability Insurance Scheme (NDIS). The cohort of young people aged 15‑24 was chosen for the trial, as this was considered an opportunity to address some of the long standing transitional issues for young people moving from school to employment or vocational options and for those young people moving out of State care.

The first year of the NDIS trial, in 2013‑14, resulted in 786 young people benefiting from becoming participants in the Scheme, which was within one per cent of the expected Bilateral target of 792 participants in the first year.

The full transition to the NDIS trial for this cohort will see around 1 000 young people supported by the NDIS by mid‑2016 and is progressing in accordance with agreed targets.

 

In 2009, all Housing Ministers agreed to the large scale transfer of up to 35 per cent of social housing stock to be managed by the community sector by 2014. Housing Tasmania commenced a program of stock transfer involving the management of around 3 900 properties by community housing providers under the Better Housing Futures Program. The properties, in high density public housing areas, have been progressively transferred to organisations from 2012‑13, with the final transfer taking place in July 2014. The national target of 35 per cent will be exceeded by Tasmania in 2014‑15, with 42.7 per cent of social housing stock under community management as at 31 March 2015.

The management of housing by community organisations will improve outcomes for Tasmanians who need housing assistance. Community organisations are able to access Australian Government Rent Assistance and other benefits, which enable them to fund an increased level of maintenance and other services, including a range of community initiatives.

Output Group 5:   Human Services

5.1 Community Services

This Output provides services relating to planning, developing and managing family and community support services throughout the State. This includes funding for the neighbourhood house program, integrated family support services, gambling support program and a range of other counselling and support services. All of these services are provided by community sector organisations.

5.2 Disability Services

This Output provides services relating to planning, developing and managing disability services throughout the State. Services include disability policy and program, disability assessment and advisory services, individual support packages and community partnerships.

5.3 Housing Services

This Output provides services relating to planning, developing and managing affordable housing and homelessness programs throughout the State. This includes all functions relating to the delivery and management of public housing, capital development, housing reform, community housing, specialist homelessness services, new homelessness initiatives, private rental assistance and the management of community sector organisations providing outsourced services.

 

Table 4.6:          Performance Information ‑ Output Group 5

Performance Measure	Unit of Measure	2012‑13 Actual	2013‑14 Actual	2014‑15 Target	2015‑16 Target
Disability Services
Accommodation support clients1,2	Number	1 326	1 346	1 167	1 095
Community access clients1,3	Number	1 567	1 419	1 281	1 021
Supported accommodation waiting list4	Number	142	111	90	90
Community access waiting list4	Number	176	82	83	83
Housing Tasmania
Public Housing occupancy rate5	%	97.1	98.1	98.0	98.0
Applicants housed6	Number	1 011	1 066	1 000	1 000
New allocations to those in greatest need5	%	89.3	85.3	80.0	80.0
Households assisted through Private Rental Assistance	Number	4 128	4 100	4 000	4 000
Applicants on wait list	Number	2 310	2 465	2 700	2 700
Average wait time for people who are housed	Weeks	37.9	35.7	41.5	41.5
Average time to house Category 1 applicants	Weeks	16.2	20.7	20.0	20.0
Net recurrent cost per dwelling5,7	$	8 015	10 644	8 800	8 500
Turnaround time8	Days	27.9	28.9	28.0	28.0

Notes:

1.   The 2013‑14 actuals have been revised due to NDIS transition processes.

2.   The 2014‑15 target is based upon 2013‑14 threshold less 133 clients expected to transition to the NDIS. The 2015‑16 target is based upon 2014‑15 target less 72 clients expected to transition to the NDIS.

3.   The 2014‑15 target is based upon 2013‑14 threshold less 219 clients expected to transition to the NDIS. The 2015‑16 target is based upon the 2014‑15 target less 260 people estimated to be diverted directly to the NDIS.

4.   The target for 2014‑15 and 2015‑16 is based upon the March 2015 waiting list figure.

5.   Housing Tasmania data is provided from the Report on Government Services (ROGS) where appropriate. For 2013‑14, actual data was previously not available from ROGS. This has now been updated to reflect published ROGS data.

6.   This includes applicants housed into public or community housing from the common wait list.

7.   This is updated annually to reflect the current year dollar value, with 2012‑13 figures updated to reflect 2013‑14 dollars.

8.   A national review of turnaround time is taking place due to discrepancies in jurisdictions' reporting of ROGS data. Turnaround time data for 2012‑13 has been updated to reflect Housing Tasmania's data definitions.

 

Performance Information Comments

Disability Services

Disability Services continues to operate in an environment where demand for services outstrips supply. Whilst an increase in demand for services is consistent with national trends, implementation of the NDIS in 2013‑14 and 2014-15 has begun to address the issue.

In terms of services delivered, there was a decrease in the number of clients receiving accommodation support and community access, reflecting the age cohort transition to the NDIS during 2014‑15.

 

Housing Tasmania

Public housing occupancy rates remain high at 98.1 per cent for 2013‑14. There are efficient assessment processes through the new Housing Connect model and timely allocations to housing. Demand for public housing remains high and turnover is low as people remain in safe, affordable and stable housing. This level of occupancy is expected to continue.

There is a range of affordable housing options available to people in housing need. The number of applicants housed in both public housing and non‑government housing increased slightly with 1 066 people housed in 2013‑14. Activity has continued at these levels in 2014‑15.

Housing Tasmania continues to perform extremely well in housing people most in need compared to other jurisdictions. In 2013‑14, the national average was that 74.1 per cent of allocations were to people in greatest need, whereas Tasmania achieved 85.3 per cent of allocations to people in greatest need. Trends show that new allocations to people in greatest need have reduced slightly; this may continue to decline due to the transfer of management of properties to the community sector and the reduced range of properties to match to the needs of applicants.

In 2013‑14, there were 4 100 households assisted by Private Rental Assistance. In 2014‑15, the number of households supported has remained steady. Occupancy rates within the private rental market remain high.

The wait list is trending upwards. In 2013, the Housing Connect model came into operation and a broader common wait list commenced. The wait list trend may reflect the success that Housing Connect is having in encouraging more people to seek assistance. It may also be the result of the wait list expanding from public to community housing and applicants having a greater range of housing choices. The implementation of the Government's Affordable Housing Strategy from 2015‑16 will assist in addressing the current upward trend.

On average, people are waiting shorter times to be housed. The average wait time has declined slightly from 37.9 weeks in 2012‑13 to 35.7 weeks in 2013‑14. This is well below the target of 41.5 weeks. The time to house Category 1 applicants in 2013‑14 was an average of 20.7 weeks. This is slightly above the target and reflects the high occupancy rates and high demand for public housing.

Net recurrent costs per dwelling increased from $8 015 in 2012‑13 to $10 644 in 2013‑14. This was a result of the management transfer of Better Housing Futures dwellings to community housing organisations during the year. The increase in the 2013‑14 figure reflects the fact that stock transfers were affected in June, with the reduced year end stock numbers compared to full year costs. If adjusted to reflect the transferred stock, then the true net recurrent cost per unit for retained Housing Tasmania properties would be around $8 600. Savings associated with the Better Housing Futures stock transfer initiative will be better reflected in 2014‑15, which will see a reduction in this measure.

Turnaround times from when public housing properties become vacant to the time the property is let remain stable. A significant review of this performance indicator is being undertaken nationally to ensure that there is consistent and comparable data across jurisdictions.

 

Output Group 6:   Children Services System Management

6.1 Children Services System Management

This Output performs a number of complementary functions including the provision of support for corporate services, policy, planning, regulation, funding, monitoring and service improvement across children services. This Output also provides support to the Secretary in establishing Output priorities.

Table 4.7:          Performance Information ‑ Output Group 6

Performance Measure	Unit of Measure	2012‑13 Actual	2013‑14 Actual	2014‑15 Target	2015‑16 Target
Planned strategic projects with milestones achieved	%	na	65	100	100
Planned regular operational performance reviews completed addressing key issues within the remit of Children's Services	%	100	100	100	100
Planned quality appraisals completed within relevant timeframes	%	100	100	100	100

Performance Information Comments

Strategic projects are undertaken by the Planning, Program Development and Legislation, Out of Home Care Reform, and Information Management units. In 2013‑14, 15 of 23 strategic projects were either completed or scheduled milestones were achieved. Children Services launched a series of extensive reforms to the Out of Home Care (OOHC) service system during this period. Based on a framework that takes into account the impacts of trauma on children, the OOHC service system is being progressively redesigned to provide intervention options that effectively respond to the needs of children who have experienced trauma.

Performance information dashboards are updated daily by the Performance and Evaluation Unit and are routinely accessed throughout Children Services. In addition, formal processes for review of performance were undertaken on a quarterly basis. This involved managers from all programs in Children Services meeting to review performance information, nominate priorities for future performance analysis as well as identify and agree upon responses to emerging issues. During 2013‑14, four such reviews were scheduled and completed.

Quality appraisals are undertaken by staff in the Quality Improvement and Workforce Development Unit for practice issues arising in relation to Child Protection Services, Youth Justice Services and the Ashley Youth Detention Centre. Key drivers for service quality are determined by applying a combined understanding of research techniques, performance information, and practice knowledge to identify issues to be addressed through workforce development strategies. For 2013‑14, this included embedding of the Signs of Safety approach, which focuses on less adversarial and more inclusive engagement practices when working with children, families and other stakeholders. During 2013‑14, there were three quality appraisals completed within the allocated timeframe and three appraisals were commenced with completion dates in 2014‑15, all of which are on schedule.

 

Output Group 7: Children Services

7.1 Children Services

This Output provides services to children, young people and their families through a range of programs including the child health and parenting service, child protection, out of home care, adoptions and permanency planning, family violence counselling and support and community and custodial youth justice.

During 2014‑15, Children and Youth Services has focused on the consolidation and strengthening of services through a range of priorities focused on:

·       Practice Development, comprising the development of a service delivery framework and online manuals; embedding the Signs of Safety approach in all programs, commencing with child protection; modernising the child health system; and building practice leadership skills in managers;

·       Leadership, Workforce Development and Accountability, including collaborating with staff to develop a shared set of service values and principles; working in partnership with Human Resources to develop a DHHS human services capability framework; strengthening the learning and development framework; building improved recruitment, selection and induction processes; and providing support and skills development for the foster carer network; and

·       Reform of the Out of Home Care system to provide a needs-led, quality assured, financially viable, safe and outcomes‑focused response to children who cannot live at home.

 

Table 4.8:          Performance Information ‑ Output Group 7

Performance Measure		Unit of Measure		2012‑13 Actual		2013‑14 Actual		2014‑15 Target		2015‑16 Target
Children Services
Mothers attending the eight week Child Health Assessment1		%		85.0		87.6		88.0		88.0
Children in notifications (per 1 000 of population)1,2		Rate		68.5		71.0		73.5		76.0
Average daily children in active transition at Response3		Number		8.9		24.7		13.0		10.0
Investigation outcome determined within 28 days2,4		%		48.5		31.9		45.0		60.0
Children who were the subject of a substantiation during the previous year, who were the subject of a subsequent substantiation within 12 months2		%		17.7		21.5		15.0		17.0
Average daily children in out of home care1,5		Number		1 034.0		1 064.9		1 045.0		1 045.0
Children with approved case and care plans2		%		68.6		72.6		80.0		80.0
Foster care households with five or more foster children2		%		7.6		5.1		5.0		3.8
Children in out of home care who had 3+ non-respite placements in the last 12 months		%		3.8		3.2		3.0		4.0
Children actively managed while waiting for therapeutic family violence counselling services		Number		69		112		80		65
Custodial Youth Justice
Average daily young people in Youth Justice detention1,5	Number		18.4		11.6		9.9		7.5
Distinct number of young people in Youth Justice detention1	Number		72		56		52		40
Community Youth Justice
Average daily young people in Community Youth Justice1,5	Number		389.7		309.2		236.0		190.0
Distinct number of young people in Community Youth Justice1	Number		811		643		505		400
Community Service Orders completed before the statutory expiry date	%		83.8		92.0		90.0		90.0
Youth Justice Community conferences held within six weeks of receipt of referral for conference	%		86.1		81.7		82.0		85.0

Notes:

1.   The 2014‑15 and 2015‑16 targets are projections rather than targets, reflecting the different processes used to produce this value.

2.   The 2013-14 actuals are preliminary and may differ from figures published in publications such as Report on Government Services 2015 or Child Protection Australia 2013-14.

3.   This average daily measure is being reported in this chapter for the first time in place of the snapshot measure 'Unallocated child protection investigations'. Children in active transition at Response are provisionally allocated to a team leader while awaiting the allocation of a child protection worker. The Team Leader will respond to critical case requirements if they emerge prior to allocation.

4.   The title of this indicator has been changed to reflect the greater importance of substantiation of investigations compared to finalisation.

5.   The titles of these indicators have been subject to minor changes.

Performance Information Comments

Child Health and Parenting Services (CHAPS) maintained a consistently high level of engagement with parents of newborn children, with at least 96 per cent of parents enrolling their newborn children in 2013‑14. CHAPS provide a range of health checks and, during 2013‑14, the proportion of parents attending at eight weeks improved across Tasmania. This figure is projected to remain stable during 2014‑15 and 2015‑16.

Child Protection Services (CPS) aims to finalise investigations of child abuse or neglect within 28 days of receipt of notification. The proportion of investigation outcomes determined within 28 days decreased from 48.5 per cent during 2012‑13 to 31.9 per cent during 2013‑14 due to increasing complexity of cases and implementation of Signs and Safety. A refocus on performance should see an improvement in results from 2014‑15. The rate of re-substantiations has increased during 2013‑14. Effort continues to be directed to addressing cumulative harm and linking children and their families to support services that work collaboratively to meet client needs.

During 2013‑14, a daily average number of 24.7 children were in active transition from the functional area of Intake to Response. CPS remains committed to keeping the number of children in active transition low and an overall reduction was achieved in past years following the introduction of new models of care as well as information systems and tools to support operational staff.

Out of Home Care services provide care for children placed away from their parents for protective or other reasons related to safety and wellbeing. The daily average number of children in Out of Home Care in Tasmania increased to 1 064.9 during 2013‑14. However, an annual decline in the number of children being admitted to care has occurred since 2008‑09.

A decline in the daily average number of children in care is anticipated during 2014‑15 as the number of children being admitted to care continues to decrease. Ongoing refinement of the Out of Home Care system will seek to deliver improved support for the increasing proportion of children in care with complex needs due to prior trauma.

During 2013‑14, 3.2 per cent of children in care had three or more non-respite placements and the number of foster care households with five or more children declined to 5.1 per cent. Carer availability is a critical factor for improving the stability and quality of care and an increase in the number of available carers is likely to be required to reduce the impact of unnecessary multiple placement changes.

At 30 June 2014, there were 112 children on the waiting list for counselling and support service from the Children and Young Person's Program. All families on this list receive interim support depending upon need via phone or face‑to‑face contact on a weekly, fortnightly, or monthly basis. Where needed, families may also be referred to external services.

A continuing decline in the reported number of Custodial Youth Justice clients has been observed in recent years. The daily average number of young people in detention decreased to 11.6 during 2013‑14, from 18.4 reported in 2012‑13. The total number of custodial clients has also decreased. During 2013‑14 there were 56 distinct young people in detention compared to 72 during the previous year.

Similarly, the daily average number of young people in Community Youth Justice decreased during the same period, from 389.7 in 2012‑13 to 309.2 in 2013‑14. There was also a reduction in the total number of community clients, from 811 distinct young people during 2012‑13 to 643 during 2013‑14.

The number of young people engaged with Community or Custodial Youth Justice Services is predominantly influenced by external services. The factors affecting activity levels include referral practices and diversionary programs implemented by Tasmania Police as well as the number of successful prosecutions and sentencing options selected by the Courts.

Output Group 8:   Independent Children's Review Service

8.1 Office of the Commissioner for Children

Activities provided in this Output include promoting the rights and wellbeing of children and examining the policies, practices and services provided for children and any law affecting the health, welfare, care, protection and development of children.

Performance Information Comments

The Office of the Commissioner for Children is an independent, statutory office responsible to the Parliament of Tasmania. Details of the Commissioner for Children's activities are available in the Commissioner's Annual Reports, which can be accessed from its website at www.childcomm.tas.gov.au.

Special Capital Investment Funds

Table 4.9 identifies expenditure by the Department from the Government's Special Capital Investment Funds.

Table 4.9:          Special Capital Investment Fund (SCIF) Allocations

	Estimated Total) Cost	2015‑16 ) Budget	2016‑17 Forward Estimate	2017‑18 Forward Estimate	2018‑19 Forward Estimate
	$'000	$'000	$'000	$'000	$'000
Minister for Health
Hospitals Capital Fund
Mersey Hospital Upgrade	1 900	1 400	.…	.…	.…
Royal Hobart Hospital	100 000	16 197	.…	.…	.…
		17 597	.…	.…	.…
Infrastructure Tasmania Fund
Flinders Island Multi Purpose Centre Upgrade	6 000	138	.…	.…	.…
Glenorchy - Tier Three Community Health Services Facility	21 000	10 693	6 416	.…	.…
King Island Hospital and Health Centre Upgrade	5 000	112	…	.…	.…
Kingston - Tier Three Community Health Services Facility	6 500	2 000	4 443	.…	.…
		12 943	10 859	.…	.…
Royal Hobart Hospital Redevelopment Fund
Royal Hobart Hospital Redevelopment Fund	35 000	649	….	….	….
Minister for Human Services
Housing Fund
Housing Fund	60 000	1 554	1 157	1 236	1 278
Total SCIF Allocations	)	32 743	12 016	1 236	1 278

 

Hospitals Capital Fund

The Hospitals Capital Fund (HCF) was established in 2007‑08 to provide capital funding for hospitals around the State. In 2015‑16, $17.6 million has been allocated from the HCF for the upgrade of the Mersey Community Hospital ($1.4 million) and the redevelopment of the Royal Hobart Hospital ($16.2 million). These are anticipated to be the final allocations from this Fund.

Infrastructure Tasmania Fund ‑ Health Infrastructure

The Infrastructure Tasmania Fund ‑ Health Infrastructure was established in 2008‑09, to implement a series of capital investment projects. Expenditure in 2015‑16 of $12.9 million will include redevelopment of the Glenorchy Community Health Centre ($10.7 million); and redevelopment of the Kingston Community Health Centre ($2 million).

Royal Hobart Hospital Redevelopment Fund

The Royal Hobart Hospital Redevelopment Fund was established in 2004‑05 for capital redevelopment of the Royal Hobart Hospital site. Expenditure in 2015‑16 of $649 000 is anticipated which will be utilised to purchase a Clinical Information System. This is the final allocation from this Fund. This Fund was established prior to the major Royal Hobart Hospital Redevelopment that is currently underway, and is therefore not included as part of the calculation for the total cost of that project.

Housing Fund

The Housing Fund was established in 2007‑08 with an allocation of $60 million for the purpose of increasing the supply of affordable housing. In 2015‑16, it is anticipated that $1.6 million will be spent from the Housing Fund on projects, which include the:

·       continuation of support for the National Rental Affordability Scheme (NRAS), with funding towards the development of up to 1 400 properties under NRAS Stage 4 ($1.1 million); and

·       acquisition of suitable land for the development of affordable housing sites ($465 000).

 

Capital Investment Program

Table 4.10 provides financial information for the Department's Capital Investment Program. More information on the Capital Investment Program is provided in chapter 6 of The Budget Budget Paper No 1.

Table 4.10:        Capital Investment Program

	Estimated) Total) Cost)	2015-16)   Budget)	2016-17) Forward) Estimate)	2017-18) Forward) Estimate)	2018-19) Forward) Estimate)
	$'000)	$'000)	$'000)	$'000)	$'000)
Minister for Health
Health Transport and Coordination Infrastructure	10 000	....)	5 000)	5 000)	....)
Hospital and Health Centre Maintenance	8 340	3 290)	4 260)	790)	....)
Launceston General Hospital Allied Health Clinics	3 000	3 000)	....)	....)	....)
National Health and Hospitals Network Reforms: Emergency Department1	9 340	828)	....)	....)	....)
RHH Redevelopment2,3	436 900	11 991)	173 825)	176 576)	74 508)
RHH Women's and Children's Hospital	100 000	42 501)	....)	....)	....)
Redevelopment of Ravenswood Community Health Centre	2 373	840)	....)	....)	....)
Rural Breast Screening Clinics - Establishment and Upgrade	1 268	1 204)	....)	....)	....)
St Helens Hospital Redevelopment Project	12 100	....)	250)	2 750)	4 000)
Statewide Cancer Services	63 000	9 625)	....)	....)	....)
Minister for Human Services
Church Street Youth Accommodation and Training Project	11 400	3 333)	....)	....)	....)
Housing - New Projects	Ongoing	9 291)	6 649)	6 488)	6 298)
Neighbourhood House Program Capital Investment	4 000	1 245)	....)	....)	....)
Non-Works Housing	Ongoing	7 454)	7 616)	7 776)	7 915)
North West Youth Accommodation and Training Facility	6 000	....)	1 500)	4 500)	....)
Northern Suburbs Community Centre	1 660	83)	900)	677)	....)
Total CIP Allocations		94 685)	200 000)	204 557)	92 721)

Notes:

1.   Total funding of $30.7 million was originally provided for National Health and Hospital Network (NHHN) Reforms. The Elective Surgery and Sub Acute Area components of the NHHN are now complete and the Emergency Department component will be completed in 2015‑16. The estimated total cost for the NHHN Emergency Department has reduced since the publishing of the 2014‑15 Budget Papers, as $360 000 of unspent capital funding was redirected to employ 1.2 FTE Emergency Department Senior Physiotherapists for three years. Of the completed NHHN Elective Surgery component, $740 000 was also redirected for a trial of a new extended recovery model of care in 2014‑15.

2.   The estimated total cost for the RHH Redevelopment has increased since the publishing of the 2014‑15 Budget Papers as an additional State Government contribution of $71.9 million was approved in December 2014 following the Royal Hobart Hospital Rescue Taskforce Review.

3.   With respect to the RHH Redevelopment Project, funding of $100 million was allocated from the Special Capital Investment Fund (SCIF) Hospitals Capital Fund, $436.9 million under the RHH Redevelopment CIP Project, and $100 million under the CIP RHH Women's and Children's Hospital. This $636.9 million, with the additional $20.1 million for the RHH Cancer Centre upgrade, completes the total allocation of $657 million referenced throughout this chapter.

Health Transport and Coordination Infrastructure

See the Key Deliverables section at the commencement of this chapter.

Hospital and Health Centre Maintenance

See the Key Deliverables section at the commencement of this chapter.

Launceston General Hospital Allied Health Clinics

See the Key Deliverables section at the commencement of this chapter.

National Health and Hospitals Network Reforms

Funding of $30.7 million was originally allocated in 2010‑11, over four years, for capital improvements relating to the National Health Reform initiatives: Elective Surgery, Emergency Department and Sub‑Acute under the National Partnership Agreement on Improving Public Hospital Services. In 2014‑15, $1.1 million was redirected to recurrent Emergency Department and Elective surgery projects. As a result, the available funding for National Health and Hospital Network Reforms has been reduced to $29.6 million. In 2015‑16, $828 000 is allocated for Emergency Departments. This will be the final allocation under these reforms.

Royal Hobart Hospital Redevelopment and the Royal Hobart Hospital Women's and Children's Precinct

See the Key Deliverables section at the commencement of this chapter.

Redevelopment of Ravenswood Community Health Centre

Funding of $2.4 million was allocated in 2013‑14, over three years, for the refurbishment of the existing Ravenswood Community Health Centre Facility. It is estimated that $840 000 will be spent during 2015‑16.

Rural Breast Screening Clinics ‑ Establishment and Upgrade

Funding of $1.3 million was allocated in 2013‑14, over two years, to: establish a new mobile breast screening clinic dedicated to North West Tasmania; refurbish the existing mobile screening clinic; establish a new clinic site; and upgrade existing sites. It is estimated that $1.2 million will be spent during 2015‑16 to complete the Project.

St Helens Hospital Redevelopment Project

See the Key Deliverables section at the commencement of this chapter.

Statewide Cancer Services

See the Key Deliverables section at the commencement of this chapter.

Church Street Youth Accommodation and Training Project

The construction of the Church Street Youth Accommodation and Training Facility has a total project budget of $11.4 million, with $10.4 million provided by the State Government and $1 million provided by the Australian Government. The Australian Government component was agreed after the publication of the 2014-15 Budget and has been fully expended. The project will deliver a mixed accommodation facility that will provide tenants with stable, supported, long‑term accommodation, which will enable them to access key services, to reconnect with their family and community and to focus on employment, education and training opportunities. Construction works are well advanced, with construction anticipated to be completed in 2015‑16.

Housing ‑ New Projects

Funding of $9.3 million is provided in 2015‑16 for Housing Tasmania's capital program, including the purchase and construction of public housing. Further details of the Housing capital program are provided in chapter 6 of The Budget Budget Paper No 1.

Neighbourhood House Program

Funding of $4 million is provided over three years to expand the current capital and maintenance program across the State. These funds will facilitate capital works that improve the suitability and sustainability of neighbourhood houses to meet current, contemporary community activities and programs. In 2015‑16, $1.2 million will be expended from the Neighbourhood House Program.

Non‑Works Housing

A Non‑Works Housing allocation of $7.5 million is allocated in 2015‑16. This is for the repayment of loans from the Australian Government under the former Commonwealth‑State Housing Agreement.

North West Youth Accommodation and Training Facility

See the Key Deliverables section at the commencement of this chapter.

Northern Suburbs Community Centre

See the Key Deliverables section at the commencement of this chapter.

 

Detailed Budget Statements

Table 4.11:        Statement of Comprehensive Income

	2014-15)   Budget)	2015-16)   Budget)	2016-17) Forward) Estimate)	2017-18) Forward) Estimate)	2018-19) Forward) Estimate)
	$'000)	$'000)	$'000)	$'000)	$'000)
Revenue and other income from transactions
Appropriation revenue - recurrent1	1 108 668)	1 164 964)	1 210 034)	1 269 649)	1 281 232)
Appropriation revenue - works & services2	7 915)	11 142)	11 910)	186 109)	28 508)
Other revenue from government3	16 784)	1 603)	....)	....)	....)
Revenue from Special Capital Investment Funds2	38 055)	32 739)	12 016)	1 236)	1 278)
Grants2,4	117 766)	113 186)	208 380)	34 892)	77 228)
Sales of goods and services5	103 207)	98 725)	97 887)	99 088)	100 317)
Interest	275)	245)	239)	232)	256)
Other revenue	18 891)	20 624)	21 008)	20 623)	19 222)
Total revenue and other income from transactions	1 411 561)	1 443 228)	1 561 474)	1 611 829)	1 508 041)
Expenses from transactions
Employee benefits6	192 578)	184 710)	188 473)	182 887)	188 722)
Depreciation and amortisation7	29 659)	28 743)	28 743)	26 166)	25 740)
Supplies and consumables8	184 350)	173 360)	177 826)	178 471)	181 662)
Grants and subsidies9	1 087 285)	1 295 443)	1 013 167)	1 050 994)	1 486 279)
Borrowing costs	8 713)	8 584)	8 156)	7 762)	7 386)
Contributions provided10	131 975)	....)	....)	....)	....)
Other expenses	5 261)	4 789)	4 010)	4 183)	4 103)
Total expenses from transactions	1 639 821)	1 695 629)	1 420 375)	1 450 463)	1 893 892)
Net result from transactions (net operating balance)	(228 260)	(252 401)	141 099)	161 366)	(385 851)
Other economic flows included in net result
Net gain/(loss) on non-financial assets	13 080)	12 347)	11 951)	11 986)	11 986)
Total other economic flows included in net result	13 080)	12 347)	11 951)	11 986)	11 986)
Net result	(215 180)	(240 054)	153 050)	173 352)	(373 865)

 

 

 

Table 4.11:        Statement of Comprehensive Income (continued)

	2014-15)   Budget)	2015-16)   Budget)	2016-17) Forward) Estimate)	2017-18) Forward) Estimate)	2018-19) Forward) Estimate)
	$'000)	$'000)	$'000)	$'000)	$'000)
Other economic flows - other non-owner changes in equity
Changes in physical asset revaluation reserve	66 828)	26 296)	26 388)	26 485)	26 590)
Total other economic flows - other non-owner changes in equity	66 828)	26 296)	26 388)	26 485)	26 590)
Comprehensive result	(148 352)	(213 758)	179 438)	199 837)	(347 275)

Notes:

1.   The increase in Appropriation revenue ‑ recurrent in 2015‑16 reflects additional funding provided in the 2015‑16 Budget for Health and Human Services initiatives.

2.   The movement in Appropriation revenue - works & services, Revenue from Special Capital Investment Funds and Grants primarily reflects movements in funding from CIP and SCIF, including those components of CIP that are funded by the Australian Government.

3.   Other revenue from Government in 2014‑15 and 2015‑16 reflects the utilisation of funds carried forward under Section 8A(2) of the Public Account Act 1986.

4.   The significant decrease in Grants in 2017‑18 reflects the limited drawdown in Australian Government capital funding in this year for the RHH Redevelopment Project. In 2017‑18, the majority of Project funding will be sourced from Appropriation revenue ‑ works & services.

5.   The decrease in Sales of goods and services in 2015‑16 primarily reflects the finalisation of receipts from the Australian Government for the Tasmania eHealth project.

6.   The movement in Employee benefits primarily reflects the impact of the 2014‑15 Budget Savings Strategies and the transfer of Cancer Screening Services from the Department to the THS.

7.   The decrease in Depreciation and amortisation reflects a more accurate estimate of depreciation and amortisation profiles. The decrease from 2016‑17 primarily reflects Ambulance Tasmania motor vehicles, based on the current depreciation schedule of the existing Ambulance fleet.

8.   The decrease in Supplies and consumables in 2015‑16 primarily reflects the reclassification of expenditure relating to the Royal Hobart Hospital Redevelopment asset purchases, and the transfer of Cancer Screening Services from the Department to the THS.

9.   The increase in Grants and subsidies in 2015‑16 primarily reflects additional funding for the THS for initiatives including Additional Funding to Frontline Health, North West Regional Cancer Centre, Patient Transport to Support One Health, and Children and Adolescent Mental Health Services. Other movements reflect the transfers of assets to the THS, as the Department undertakes capital works on behalf of the THS and transfers these assets to the THS once completed.

10. The balance against Contributions provided in 2014‑15 reflects the transfer of the Housing Tasmania stock to the Non‑Government Sector entities as part of the Better Housing Futures Program Stage 2.

 

Table 4.12:        Revenue from Appropriation by Output

	2014-15)   Budget)	2015-16)   Budget)	2016-17) Forward) Estimate)	2017-18) Forward) Estimate)	2018-19) Forward) Estimate)
	$'000)	$'000)	$'000)	$'000)	$'000)
Minister for Health
Output Group 1 - Health Services System Management
1.1  Health Services System Management1	102 827)	95 540)	97 903)	95 175)	102 302)
	102 827)	95 540)	97 903)	95 175)	102 302)
Output Group 2 - Tasmanian Health Service
2.1  Tasmanian Health Service2	590 110)	649 936)	665 299)	685 191)	679 140)
	590 110)	649 936)	665 299)	685 191)	679 140)
Output Group 3 - Statewide Services
3.1  Ambulance Services	50 726)	51 096)	52 699)	53 456)	54 131)
3.2  Public Health Services3	19 102)	13 743)	14 209)	14 296)	14 555)
	69 828)	64 839)	66 908)	67 752)	68 686)
Capital Investment Program	1 980)	7 994)	9 510)	180 932)	28 508)
Recurrent Services	762 765)	810 315)	830 110)	848 118)	850 128)
Works and Services	1 980)	7 994)	9 510)	180 932)	28 508)
	764 745)	818 309)	839 620)	1 029 050)	878 636)
Minister for Human Services
Output Group 4 - Human Services System Management
4.1  Human Services System Management4	2 640)	2 964)	3 061)	2 501)	2 523)
	2 640)	2 964)	3 061)	2 501)	2 523)
Output Group 5 - Human Services
5.1  Community Services	18 346)	18 358)	18 254)	18 960)	19 170)
5.2  Disability Services5	178 854)	187 263)	209 105)	249 229)	256 068)
5.3  Housing Services6	39 656	38 000	38 616	38 637	38 716
	236 856	243 621	265 975	306 826	313 954

 

Table 4.12:        Revenue from Appropriation by Output (continued)

	2014-15)   Budget)	2015-16)   Budget)	2016-17) Forward) Estimate)	2017-18) Forward) Estimate)	2018-19) Forward) Estimate)
	$'000)	$'000)	$'000)	$'000)	$'000)
Output Group 6 - Children Services System Management
6.1  Children Services System Management	4 565)	4 682)	4 761)	4 837)	4 968)
	4 565)	4 682)	4 761)	4 837)	4 968)
Output Group 7 - Children Services
7.1  Children Services	100 990)	102 492)	105 228)	106 460)	108 743)
	100 990)	102 492)	105 228)	106 460)	108 743)
Output Group 8 - Independent Children's Review Service
8.1  Office of the Commissioner for Children	852)	890)	899)	907)	916)
	852)	890)	899)	907)	916)
Capital Investment Program	5 935)	3 148)	2 400)	5 177)	....)
Recurrent Services	345 903)	354 649)	379 924)	421 531)	431 104)
Works and Services	5 935)	3 148)	2 400)	5 177)	....)
	351 838)	357 797)	382 324)	426 708)	431 104)
Department of Health and Human Services
Total Recurrent Services	1 108 668)	1 164 964)	1 210 034)	1 269 649)	1 281 232)
Total Works and Services	7 915)	11 142)	11 910)	186 109)	28 508)
	1 116 583)	1 176 106)	1 221 944)	1 455 758)	1 309 740)
Appropriation Carried Forward	16 784)	1 603)	....)	....)	....)
Total Revenue from Appropriation	1 133 367)	1 177 709)	1 221 944)	1 455 758)	1 309 740)
Controlled Revenue from Appropriation	1 133 367)	1 177 709)	1 221 944)	1 455 758)	1 309 740)
Administered Revenue from Appropriation	....)	....)	....)	....)	....)
	1 133 367)	1 177 709)	1 221 944)	1 455 758)	1 309 740)

Notes:

1.   The decrease in Health Services System Management primarily reflects the transfer of responsibility for the election commitments relating to Elective Surgery and Nurse Graduates ‑ Additional Transition to Practice Placements from the Department to the THS. This is partly offset by additional funding relating to the Ice and Other Drugs Strategy Budget initiative.

2.   The increase in Tasmanian Health Service primarily reflects: the transfer of responsibility for the election commitments relating to Elective Surgery and Nurse Graduates ‑ Additional Transition to Practice Placements from the Department to the THS; additional funding for initiatives including Additional Funding to Frontline Health, North West Regional Cancer Centre, Patient Transport to Support One Health, and Children and Adolescent Mental Health Services; and the transfer of Cancer Screening Services from the Department to the THS. The decrease from 2017‑18 to 2018‑19 reflects the cessation of funding for 2014 election commitments.

3.   The decrease in Public Health Services in 2015‑16 reflects the transfer of Cancer Screening Services from the Department to the THS.

4.   The increase in Human Services System Management in 2015‑16 and 2016‑17 reflects additional funding for the Building a Joined Up Human Services Support System.

5.   The increase in Disability Services primarily reflects additional funding for NDIS and ERO, and 2014 election commitments, including Community Sector Organisations - Additional Funding and Disability - Additional Support.

6.   The decrease in Housing Services in 2015‑16 primarily reflects the implementation of savings initiatives associated with the outsourcing of housing stock through the Better Housing Futures initiative and DHHS corporate review.

 

 

Table 4.13:        Statement of Financial Position as at 30 June

	2015)   Budget)	2016)   Budget)	2017) Forward) Estimate)	2018) Forward) Estimate)	2019) Forward) Estimate)
	$'000)	$'000)	$'000)	$'000)	$'000)
Assets
Financial assets
Cash and deposits	47 720)	42 253)	42 319)	41 994)	41 597)
Investments1	2 706)	6 968)	6 497)	6 058)	5 805)
Receivables2	4 467)	7 170)	7 014)	7 122)	7 272)
Equity investments3	13 029)	18 573)	19 014)	19 410)	19 763)
Other financial assets2	4 909)	6 357)	6 247)	6 320)	6 424)
	72 831)	81 321)	81 091)	80 904)	80 861)
Non-financial assets
Inventories4	6 287)	2 711)	2 911)	910)	929)
Property, plant and equipment5	1 812 781)	1 353 650)	1 521 514)	1 709 686)	1 357 251)
Infrastructure6	....)	....)	5 000)	10 000)	10 000)
Heritage and cultural assets	442)	475)	480)	486)	492)
Intangibles4	14 642)	12 446)	11 352)	10 351)	9 665)
Other assets2	4 516)	5 730)	5 830)	5 628)	5 786)
	1 838 668)	1 375 012)	1 547 087)	1 737 061)	1 384 123)
Total assets	1 911 499)	1 456 333)	1 628 178)	1 817 965)	1 464 984)
Liabilities
Payables	16 398)	16 690)	16 947)	16 425)	16 834)
Interest bearing liabilities7	188 365)	184 244)	174 961)	165 519)	157 604)
Employee benefits4	62 286)	42 028)	43 635)	43 716)	45 109)
Superannuation4	20 698)	16 433)	16 469)	16 280)	16 678)
Other liabilities4	29 533)	15 272)	15 062)	15 084)	15 093)
Total liabilities	317 280)	274 667)	267 074)	257 024)	251 318)
Net assets (liabilities)	1 594 219)	1 181 666)	1 361 104)	1 560 941)	1 213 666)
Equity
Reserves	2 007 078)	1 915 818)	1 942 206)	1 968 691)	1 995 281)
Accumulated funds	(418 953)	(740 246)	(587 196)	(413 844)	(787 709)
Other equity	6 094)	6 094)	6 094)	6 094)	6 094)
Total equity	1 594 219)	1 181 666)	1 361 104)	1 560 941)	1 213 666)

Notes:

1.   The movement in Investments primarily reflects the effect of borrowings of $5 million by the Department to fund the cost of staff separations in the THOs in 2014‑15. These borrowings are passed through the Department to the THS.

2.   The increases in Receivables, Other financial assets and Other assets in 2016 reflect a more accurate estimate based on the 30 June 2014 outcome.

3.   The increase in Equity investments in 2016 reflects an increase in activity and payments through the HomeShare Program following the Government's decision to change the eligibility criteria to make the program more accessible to more Tasmanians.

4.   The decrease in Inventories, Intangibles, Employee benefits, Superannuation and Other liabilities in 2016 reflects a more accurate estimate based on the 30 June 2014 outcome.

5.   The movement in Property, plant and equipment in 2016 reflects: a more accurate estimate based on the 30 June 2014 outcome; changes to the timing of the Royal Hobart Hospital Redevelopment following the Royal Hobart Hospital Rescue Taskforce Review; the transfer of completed assets to the THS; and the transfer of properties to the Non-Government Sector under the Better Housing Futures Program Stage 2 in 2014‑15.

6.   The increase in Infrastructure in 2017 reflects additional funding provided under Health Transport and Coordination Infrastructure.

7.   The decrease in Interest Bearing Liabilities reflects the repayment of borrowings under the Commonwealth-State Housing Agreement.

 

 

Table 4.14:        Statement of Cash Flows

	2014-15)   Budget)	2015-16)   Budget)	2016-17) Forward) Estimate)	2017-18) Forward) Estimate)	2018-19) Forward) Estimate)
	$'000)	$'000)	$'000)	$'000)	$'000)
Cash flows from operating activities
Cash inflows
Appropriation receipts - recurrent	1 108 668)	1 164 964)	1 210 034)	1 269 649)	1 281 232)
Appropriation receipts - capital1	7 915)	11 142)	11 910)	186 109)	28 508)
Receipts from Special Capital Investment Funds1	38 055)	32 739)	12 016)	1 236)	1 278)
Grants1	117 766)	113 186)	208 380)	34 892)	77 228)
Sales of goods and services2	104 195)	100 072)	98 117)	98 927)	100 097)
GST receipts	46 098)	47 253)	48 431)	49 644)	50 894)
Interest received	276)	245)	239)	232)	256)
Other cash receipts	18 921)	20 624)	21 008)	20 623)	19 222)
Total cash inflows	1 441 894)	1 490 225)	1 610 135)	1 661 312)	1 558 715)
Cash outflows
Employee benefits3	(170 150)	(166 057)	(164 648)	(161 040)	(164 857)
Superannuation3	(21 731)	(21 237)	(22 183)	(21 954)	(22 071)
Borrowing costs	(8 713)	(8 584)	(8 156)	(7 762)	(7 386)
GST payments	(46 100)	(47 255)	(48 433)	(49 646)	(50 896)
Grants and subsidies4	(913 097)	(959 242)	(985 667)	(1 047 994)	(1 049 379)
Supplies and consumables5	(186 755)	(172 890)	(177 861)	(176 786)	(181 432)
Other cash payments6	(3 381)	(4 791)	(4 188)	(4 183)	(4 126)
Total cash outflows	(1 349 927)	(1 380 056)	(1 411 136)	(1 469 365)	(1 480 147)
Net cash from (used by) operating activities	91 967)	110 169)	198 999)	191 947)	78 568)
Cash flows from investing activities
Payments for acquisition of non-financial assets7	(127 069)	(116 095)	(201 631)	(194 859)	(82 936)
Proceeds from the disposal of non-financial assets	13 080)	12 347)	11 951)	11 986)	11 986)
Equity injections and cash flows from restructuring8	(3 000)	(2 191)	(441)	(396)	(353)
Net advances paid	509)	458)	471)	439)	253)
Net cash from (used by) investing activities	(116 480)	(105 481)	(189 650)	(182 830)	(71 050)

 

 

Table 4.14:        Statement of Cash Flows (continued)

	2014-15)   Budget)	2015-16)   Budget)	2016-17) Forward) Estimate)	2017-18) Forward) Estimate)	2018-19) Forward) Estimate)
	$'000)	$'000)	$'000)	$'000)	$'000)
Cash flows from financing activities
Net borrowings9	(7 328)	(9 121)	(9 283)	(9 442)	(7 915)
Net cash from (used by) financing activities	(7 328)	(9 121)	(9 283)	(9 442)	(7 915)
Net increase (decrease) in cash and cash equivalents held	(31 841)	(4 433)	66)	(325)	(397)
Cash and deposits at the beginning of the reporting period	79 561)	46 686)	42 253)	42 319)	41 994)
Cash and deposits at the end of the reporting period	47 720)	42 253)	42 319)	41 994)	41 597)

Notes:

1.   The movement in Appropriation receipts - capital, Receipts from Special Capital Investment Funds and Grants primarily reflects movement in funding from CIP and SCIF, including those components of CIP that are funded by the Australian Government.

2.   The decrease in Sales of goods and services in 2015‑16 primarily reflects the finalisation of receipts from the Australian Government for the Tasmania eHealth project in 2014‑15. The decrease in 2016‑17 reflects one-off receipt of Department of Veterans Affairs fees by Ambulance Tasmania as a result of a reconciliation of prior year data, and the finalisation of payments under the current agreement from the Royal Flying Doctor Services for medical services on the Bass Strait Islands in 2015‑16.

3.   The movement in Employee benefits and Superannuation primarily reflects the effect of the 2014‑15 Budget Savings Strategies and the transfer of Cancer Screening Services from the Department to the THS in 2015‑16.

4.   The increase in Grants and subsidies in 2015‑16 primarily reflects additional funding for initiatives that will be undertaken by the THS including: Additional Funding to Frontline Health, North West Regional Cancer Centre, Patient Transport to Support One Health, and Children and Adolescent Mental Health Services; and additional funding for the Department for the Ice and Other Drugs Strategy.

5.   The decrease in Supplies and consumables in 2015‑16 primarily reflects the reclassification of expenditure relating to the Royal Hobart Hospital Redevelopment to payments for the acquisition of non-financial assets, and the transfer of Cancer Screening Services from the Department to the THS.

6.   The increase in Other cash payments in 2015‑16 primarily reflects an increase in workers compensation payable by the Department.

7.   The movement in Payments for the acquisition of non-financial assets primarily reflects movement in funding from CIP and SCIF, including those components of CIP that are funded by the Australian Government.

8.   The movement in Equity injections and cash flows from restructuring reflects an increase in activity and payments through the HomeShare Program in 2014‑15 following the Government's decision to change the eligibility criteria to make the program more accessible to more Tasmanians.

9.   The movement in Net borrowings reflects the repayment of borrowings of $5 million by the Department to fund the cost of staff separations in the THOs in 2014‑15. This funding is passed through the Department to the THS.