1. HACC Diversity Planning Forum
This project is supported with funding under the Home and Community Care Program by the Commonwealth Government and the Victorian Government.
HDG Consulting Group
February - March 2011

2. Welcome
Acknowledgement of Traditional Custodians

3. Session overview In this session we will:
explain the policy context and requirements for diversity planning
talk about what diversity planning is and what it means for HACC funded agencies
share ideas about diversity planning approaches
provide an opportunity to discuss practical examples.

4. Policy context

5. Background Building on access and equity work
Moving from cultural to diversity planning
Continuous Quality Improvement
The department has implemented various strategies and projects aimed at improving access to HACC services. Most of the initiatives implemented have been directed towards improving access for people from CALD and Aboriginal backgrounds, such as the Culturally Equitable Gateways Strategy, Strengthening HACC in Aboriginal Communities and the Cultural Planning Strategy.
The Cultural Planning Strategy was established in 1997 to support the HACC service system to increase access to and better meet the needs of HACC eligible people from CALD backgrounds. Under the CPS, agencies were required to develop and submit a HACC Cultural Action Plan to their respective regions on an annual basis. Evaluation of the Cultural Planning Strategy (CPS) from 2007 to 2009 recommended that the Department focus on diversity in a broad sense.
Diversity Planning and Practice will build upon this work and support agencies to continue to improve service access by a range of groups who are disadvantaged and experience difficulty in accessing services.
It is an action planning process that compliments a range of HACC quality improvement initiatives including the Active Service Model and Assessment Framework as well as service coordination practice.

6. Diversity planning and practice
A strategic population planning initiative that supports and encourages a holistic, person-centred approach to HACC service delivery.
Underlying principles:
equitable access to HACC services
a sensitive and responsive approach to planning services
consideration of diversity as core business.
Does not mean that any one group will be prioritised for services over another. It is to ensure that people have access based upon assessed relative need.
Diversity planning is underpinned by principles that seek to achieve:
equitable access to HACC services by those eligible, regardless of their diversity or disadvantage, based upon assessed relative need
a sensitive and responsive approach to planning services that acknowledges a community, group and/or individual’s uniqueness and complexity of need
consideration of diversity as core business and central to strategic planning and leadership
Diversity Planning will assist the department to determine growth in services in future years. Agencies are not required to increase their client population or provide extra service hours, but ensure that they do not exclude HACC eligible people from services, due to their diverse and complex needs.

7. Continuous Quality Improvement
The Active Service Model, the Assessment Framework and Diversity Planning and Practice share a key aim:
strengthening person-centred care.
The future:
ASM approach as core business
Diversity Planning encompassed within broader quality improvement planning.
Considering and planning for diversity will lead to actions in the way that we deliver services. It will assist agencies to respond to clients with diverse needs when adopting an active service model approach to service delivery and support HACC Assessment Services to practice assessment that is sensitive and inclusive to diversity.
There is significant overlap between the three initiatives, and progress in each area will support achievements in the others. The Department is working to ensure that the activities required by funded agencies in delivering these initiatives are as streamlined as possible.  
Over time, it is expected that agencies will adopt an ASM approach as core business and that planning will be incorporated into a broader quality improvement plan that will also encompass diversity planning.
As such, planning requirements related to these initiatives will be merged in future to simplify planning processes.

8. HACC Quality Improvement
Diversity Planning and Practice
HACC Assessment Framework
Active Service Model
Outcomes
All of this is designed to result in quality services for diverse communities and to achieve positive outcomes for HACC clients.
Person-centred care 8

9. Key requirements
Diversity planning requires all HACC funded agencies to:
demonstrate an understanding of their catchment’s HACC target population
identify groups or individuals who may not be accessing services
identify barriers to service access for these groups or individuals
develop and implement an action plan to improve access to your services with achievable and measurable outcomes in accordance with Regional Diversity Plan
monitor the action plan against outcomes
review the plan and use what is relevant to develop the next plan.
Monitoring will be on an annual basis by Regions and triennially through quality review processes.
HACC funded agencies will be required to demonstrate diversity planning processes, goals, priorities, strategies and most importantly OUTCOMES.

10. Implementation Action Timeline Diversity Planning Forums
February to March 2011
Finalisation of statewide diversity priorities
mid 2011
Development of Regional Diversity Plans
1 July to 31 December
First Common Community Care Quality Framework reviews
commencing mid 2011
Development of Agency Diversity Plans
1 January to 30 June
Implementation of Regional and Agency Diversity Plans for
Commencing 30 June
Diversity planning and practice will be informed by high level statewide priorities and directions reflected in HACC Triennial Plans. Regions will prepare Regional Diversity Plans which will reflect statewide priorities and take account of region wide issues identified through data analysis and community and agency consultation processes. Each agency will prioritise HACC diversity planning strategies to reflect relevant aspects of the Regional Diversity Plan to their local catchment.
Implementation of diversity plans will commence in the next HACC Triennium (July 2012 to June 2015). The Department of Health will provide supplementary information during 2011 outlining a staged approach to implementation.

11. Benefits of diversity planning
It will increase your agency’s capability to respond to diversity within your local community.
It will assist to inform planning and resource allocation decisions.
It will support a diversity responsive workforce.
It will improve equitable access to services by diverse and disadvantage groups.
It will enable HACC services to better understand and measure diversity within their communities.
You may be wondering what the benefits of diversity planning are – both for your agency and for your clients.
For agencies:
It is central to quality service planning and delivery.
It will enable HACC services to capture, enumerate and measure diversity within their communities
It will assist to inform planning and resource allocation decisions
It will support a diversity responsive workforce.
It will support your agency to meet quality standards.
For clients:
It will increase your agency’s capability to respond to diversity within your local community
It will improve equitable access to services by diverse and disadvantage groups.

12. A guide for HACC services in Victoria
Strengthening diversity planning and practice:
A guide for HACC services in Victoria
These Diversity Planning Forums are an opportunity to inform HACC funded agencies about Diversity planning and practice and their requirements.
A practice guide has been drafted, to support agencies to implement diversity planning and practice. The contents of this guide is being presented to you today. As you may imagine, a guide such as this requires research and consultation with key stakeholders. Many groups and individuals played a key role in assisting in the development, structure and content of the guide.
We would particularly like to acknowledge those who contributed to the development process:
Department of Health Regions and the HACC Diversity Working Group
Victorian Committee for Aboriginal Aged Care and Disability
Ethnic Communities’ Council of Victoria
Municipal Association of Victoria
Gay and Lesbian Health Victoria
HACC Equity and Access Program
Alzheimer’s Australia Vic
Community Connections Program
Health Services
Primary Health
Royal District Nursing Service
If you have any feedback you would like to provide regarding the contents of the guide and the clarity of the information presented today, please do so on the feedback sheets provided.
A final version of the guide is not yet available. Following these forums, the guide will be finalised and published, with the final version made available to HACC agencies in the latter part of 2011.

13. Why is a guide needed?
A new concept – shared understanding and expectations.
To support agencies to implement Diversity planning and practice.
The guide will support agencies to implement Diversity planning and practice by outlining key concepts, reflective questions, information, resources and tools.
It is intended for use by HACC funded agencies and those staff responsible for implementing Diversity planning and practice.

14. What is in the guide? Introduction to diversity planning
Outline of key requirements
Information and tools to :
understand diversity
apply diversity lenses to your services
set priorities
review your progress.
The guide is in seven sections - these are:
Introduction.
Key requirements.
Understanding diversity: covers the concept of diversity, diversity considerations and reflection on diversity issues.
Applying diversity lenses to special needs groups: covers Aboriginal people, culturally and linguistic diverse people, people who are homeless or at risk of homelessness, people with dementia and gender identity and sexual orientation.
Planning for your community: covers planning processes, data sources, measureable goals and objectives and examples of planning tools and templates.
Quality improvement: covers Community Care Common Standards and diversity planning relevant items and examples.
7. Examples of tools in the guide to:
Assess your diversity planning process
Document objectives and actions
Measure and report achievements
Review Diversity Plans.
Sections are divided into information, reflective questions and resources.

15. What is diversity?

16. What do we mean by diversity?
Diversity is recognising that people are individuals and have unique needs and preferences.
People may also belong to, or identify with a community or group who have different needs and expectations.
Diversity planning embraces and reflects cultural differences.
Culture is self-ascribed and defines who we are, how we think, what we value and what is important.
We should keep in mind first and foremost that people are individuals with their own history, experiences, needs and expectations. However individuals may also have shared histories, experiences, needs and expectations with other individuals and this may see them identify with a specific group or community.
In recent years HACC services have specifically targeted access and equity initiatives to CALD and Aboriginal groups, but there are many more groupings that people are categorised into as you can see from this list.
Culture: Aboriginality, ethnicity, language differences, new communities, homelessness
Age: children, older adults
Geographical locality: regional/rural/remote/urban
Sexual orientation: gay, lesbian, bisexual, transgender and intersex
Health status: diabetes, cancer, HIV, mental illness
Socio-economic status: education, occupation, income, housing conditions
Gender: male or female issues
Faith: religious beliefs and practices
Migration/refugee status: history and experiences
Disability: cognitive, physical, sensory

17. Diversity
Age, for example
Children
Young people
Older adults
Health status, for example
Disability
HIV/AIDS
Mental health
Cognitive issues
Dementia
Drug and alcohol dependency
Culture, for example
Aboriginality
Ethnicity
Language differences
New and emerging communities
Refugee status
Migration history
Faith and sprirituality
Gender identify and sexual orientation, for example
Women's health
Men's health
Gay, lesbian, bi-sexual, transgender, intersex
Socio-economic status, for example
Education
Occupational status
Financial disadvantage
Insecure housing
Homelessness
Literature
This is an example of the diverse groups that are frequently mentioned in literature when we were researching information for the guide.
The list is not exhaustive.
Note also there are likely to be overlaps between these examples.

18. HACC special needs groups
people from Aboriginal and Torres Strait Islander backgrounds
people from CALD backgrounds
people with dementia
people living in rural and remote areas
people experiencing financial disadvantage (including people who are homeless or at risk of homelessness).
Diversity Planning and Practice asks us to consider a range of special needs and other diverse and disadvantaged groups in our local area, and consider how their diversity impacts on service access.
Diversity planning is designed to enhance the HACC Program’s responsiveness to all HACC eligible people, paying special attention to communities, groups and individuals who experience disadvantage in accessing services due to their diverse circumstances and needs.
These diverse groups include the five HACC special needs groups.

19. Understanding diversity
‘Know the community – know what works’
(NHMRC, 2006)

20. Diversity planning

21. Planning processes
Diversity planning focuses on understanding the needs of your existing and potential clients and developing actions to improve your service delivery to meet those needs.
For many HACC services it will not be necessary to establish new plans.
Where planning already occurs, existing planning processes and plans may be extended to include HACC diversity planning requirements and demonstrate specific outcomes for HACC clients.

22. Options
Option 1: Include HACC diversity planning within existing organisational and/or service planning processes. Ensure HACC diversity considerations are effectively considered and priorities, objectives and actions documented. Ensure outcomes are specified for HACC clients.
Option 2: Participate in a local area planning process to develop an integrated HACC Diversity Plan with other local agencies. Develop shared goals and priorities. Ensure specific objectives, actions and performance measures are noted for each agency.
Option 3: Develop a stand-alone HACC Diversity Plan for your agency. Specify goals, priorities, actions and performance measures.
Three options.
The key aspect is that for whichever option you choose to use, diversity planning results in specified outcomes for HACC clients.

23. Example: Extending existing processes
Local government with a large and culturally diverse aged population.
Council prepared an overarching Later Years Strategy to provide a framework to address the needs of its older citizens and to improve social conditions.
Used existing planning process and extended it to incorporate HACC specific diversity actions.
This required analysis of HACC MDS data and additional actions and performance measures.
Summarise text below (from the guide).
One local government area has a large and culturally diverse aged population, with 17 per cent or 20,000 people aged 65 years or over. The council prepared an overarching Later Years Strategy to provide a framework to address the needs of its older citizens and to improve social conditions.
The Later Years Strategy was developed using a broad range of information sources. These included a review of Commonwealth and State policy directions in aged care and healthy ageing; socioeconomic data and projections from ABS Census data; a review of the council’s Residential Aged Care Strategy; and a literature review about attitudes of older people. In addition to these information sources, consultation was held with various cultural groups and networks, such as the Inter Faith Committee, Neighbourhood Houses Coordinators’ group, and Aged and Disability Service Providers Network. The Strategy Plan included multiple objectives, one of which was to ‘engage with primary care and community health services in an integrated approach to health promotion for older people, with a focus on self management and prevention.’
With the introduction of HACC diversity planning, the council decided to use their existing planning process and update their board, overarching Later Years Strategy to incorporate HACC specific diversity actions. To do so, further analysis was undertaken of HACC MDS data, some additional focus groups were held with diverse groups that had not previously been considered in any detail (including people with early onset dementia; and people identifying as GBLTI). Additional actions and performance measures were added to the existing plan.
Because the Later Years Strategy was focussed on older people, the council also updated their Disability Action Plan to better incorporate HACC diversity consideration for younger people with a disability. A similar process was used. Further analysis was undertaken of HACC MDS data, additional focus groups were held with diverse groups that had not previously been considered in any detail (young people with a disability who were homeless or in insecure housing; young people with a disability identifying as GBLTI; young people with a disability). Specific actions and performance measures were added to the existing plan.

24. Example: interagency approach
Interagency approach by three HACC funded agencies in catchment.
Shared data and jointly discussed interpretation.
Agreed on improving access for CALD people with dementia as a shared priority.
Documented a simple, shared plan.
Outlined roles, responsibilities and actions.
Agreed to review progress quarterly through telephone meetings.
Three HACC funded agencies in a catchment area met to discuss their service delivery to people living both permanently and temporarily in their catchment.

25. Example: agency specific plan
HACC funded Aboriginal Community Controlled Organisation
MDS data showed 90% PAG participants were female.
Engaged a respected male Elder to consult with male community members.
Priority to establish a separate PAG for men.
Worked with the local TAFE and Men’s Shed program to do so.
A HACC funded Aboriginal Community Controlled Organisation (ACCO) ran planned activity groups twice a week at their local gathering place. They looked at their HACC MDS data for the previous twelve month period, which showed that 90% of participants were female. Although there were registered HACC male clients, they did not attend the groups. The agency engaged a respected male Elder from the ACCO Board to contact the men to discuss their past experiences of the groups, why they were no longer attending, and the types of activities that would interest them. The men consistently fed back their preference for a meeting place separate from the women. The agency developed a diversity plan with a priority to focus on establishing a separate planned activity group for HACC eligible males. The plan listed a number of actions in partnership with the local council, the local TAFE and the men’s shed program. These included to: allocate a space one day per week, train male volunteers to assist with the program, allocate staff with the appropriate skills, and seek funding for program implementation. Timelines, responsibilities and measures were listed in the plan for each stage.

26. What planning processes does your agency currently have in place?
Can diversity planning be included in this process?
Are there partner agencies which could work with yours to develop a plan?
Which options are you likely to choose?
Discuss questions on slide.
Some ideas about partnerships:
Ethno-specific or multicultural organisations
Aboriginal Community Controlled Organisations
Housing support networks or services
Primary Care Partnerships
HACC Assessment and ASM networks or alliances

27. Governance and leadership
Effective diversity planning and implementation requires leadership by agency management.
Ensure that people with the capacity to make decisions about service development, use of resources and human resource development are engaged in the planning stage.
Who should be involved?
 Who will lead your planning?

28. DH Regional Diversity Plan
Board
CEO
Management
HACC Manager
Coordinator
Staff
Vision, Mission, Values
Strategic planning
DH Regional Diversity Plan
HACC planning
Diversity Plan
ASM Plan
Other programs and service plans
Leadership is essential.
Consider who may be involved in the diversity planning process in your agency.

29. Key components These are typical for many planning processes
1. Agree on the process and who should be involved
Who needs to be involved in the planning process? Consider CEO, Board members, community advisory groups, representatives of special needs groups or agencies.
Who should be responsible for developing, approving and implementing the plan?
What resources are available for developing and implementing the plan?
Is it better to develop a joint plan with other agencies or a plan for your own agency only? When does the plan need to be completed?
OUTCOMES: Person responsible, participants in planning, resources available, timeline.
2. Gather information
Who do you provide services to? What diverse needs do they have?
What sources of data can be used and what do they indicate? Are there people missing out on your service because of gender, religion, distance, dementia, culture, language? Are there people who stop using the service/s? If so why? Have there been any complaints about discrimination, lack of understanding or respect?
Is there another agency or person that can provide useful data or information?
OUTCOMES: Profile of service users, service gaps, complaints data, other feedback.
3. Understand the needs
Talk to people who represent those missing out on services. Find out what they need or why they do not access the service. Do they need better information? Are they worried about discrimination or privacy? Is there something about the location of the service, the timing or the way it is provided that does not suit them? Are there diversity issues or behaviours that your staff find difficult to understand or manage?
OUTCOMES: Access barriers, suggestions for practice responses.
4. Meet with other service providers
Are there local agencies that could work with your service to provide more suitable options? Consider religious organisations, ACCOs, Housing Services, Neighbourhood Houses, Migrant Resource Centres, volunteer programs, leisure centres, men’s sheds and so forth.
 OUTCOMES : Shared understanding; collaboration and/or partnership opportunities.
5. Priorities and actions
6. Measures

30. Gathering information
Gather information on the diversity of existing or potential client groups.
Population and service usage data.
Complaints records or service refusal records.
Surveying and consultation with:
consumer representatives
special interest groups and liaison officers
community leaders.
Mapping current client profile against demographics of your catchment.
Gathering accurate information on the diversity of the client group is the key to effective planning. Mapping your current client profile against the demographics of your catchment can indicate under - or over -representation of particular diverse groups. Thus you will be able to evaluate the effectiveness of your your agency’s responsiveness to local diverse groups, improve where necessary and plan for the future. This should be an ongoing process, documented in a diversity plan that is a living document.
When starting to plan ask yourself:
Are there peak body representatives who can provide data or add to our interpretation?
Do we have a shared understanding of the analysis? Do other local service providers confirm our interpretation? Are the priorities clear?
What is evidence, rationale and logic underpinning our decisions?
It may be possible to identify issues relevant to particular diverse groups.
Sources of information and data:
Australian Bureau of Statistics, Australian Institute of Health and Welfare, Victorian Department of Health and Local Government planning units (for detailed community profile data at the local government area level)
Demographic data relevant to the HACC special needs groups is available through your Regional Office
Service usage data and client profiles are available in the funded agency channel
Information may be available in recent and existing research reports, evaluations and studies
Links to key data sources provided in the guide.
Mapping your current client profile against the demographics of your catchment can indicate under - or over -representation of particular diverse groups. Thus you will be able to evaluate the effectiveness of your currently service delivery, improve where necessary and plan for the future.

31. Understand the barriers
Why are people not accessing services?
Do they want HACC?
Do they know about the services?
Are the services provided in a way or place that doesn’t suit them?
What would be more suitable?
Do they live far away from town?

32. Priority setting considerations
Based on relative assessed need.
Aligned to Regional Diversity Plan
Number of HACC eligible people wthin a diverse group affected
What is already being done by others.
Capacity of your agency and of partner agencies
Most efficient use of resources and greatest impact
Achievable within the timeframe and resources available

33. Setting objectives S M A R T Specific Measurable Achievable
Example: To develop a team of home care providers with specific skills and knowledge to provide services to clients in local caravan parks/boarding houses/temporary accommodation sites M
Measurable
Example: 4EFT home care providers complete xx training; develop link with 10 accommodation providers A
Achievable
Example: Develop and conduct training sessions by working in partnership with other xxx HACC services, xxx community health and HACC training coordinator. R
Realistic/ resources
Example: using combined resources of partnership and workforce development funds T
Time orientated
Example: by 31 December 2012
Many of you will probably already be using SMART objectives to enhance planning.
By setting SMART goals, you will be able to evaluate the effectiveness of your service, identify what does and does not work and revise programs and services accordingly.

34. Tips for effective planning
Diversity planning is about evidence and quality of outcomes, not quantity.
Be realistic, keep it simple, set priorities and make sure objectives are measureable and achievable.
Be inclusive and responsive, collaborate with other agencies, consumers and other key stakeholder groups.
Try not to be over ambitious, particularly when you first start to contact and reach out to diverse groups that may not have been specifically targeted for your services before. Keep your plans simple. By using SMART objectives you will be able to anticipate whether your diversity planning is becoming too complex to be achieved within your resources.

35. Case Study Metropolitan council.
Feedback received about need to make services more responsive to older GLBTI.
Met with Gay and Lesbian Health Victoria staff members and developed an action plan.
Workshops on how to create a GLBTI inclusive service and staff training.
A statement of commitment to GLBTI people.
A self evaluation using Val’s Café audit tool.
Preparation to for the Rainbow tick.
Issue: accessible and responsive services for people who are gay, lesbian, bisexual, transgender or intersex (GBLTI)
An inner city HACC local government provider has a diverse population including a large GLBTI community.
Council had received feedback about HACC services to make them more accessible and responsive to older GLBTI people.
Council’s Aged Services staff met with Gay and Lesbian Health Victoria staff members and developed an action plan. The action plan, supported by council’s senior management team, included:
enrolment and participation in the workshops conducted by Gay and Lesbian Health Victoria on: How to create a GLBTI inclusive service
conducting the Val’s Café audit of services to clarify existing practice
a consultation strategy including inviting GLBTI people accessing HACC services to participate in a consumer focus group, and consulting the GLBTI community to inform service planning
a statement of commitment to GLBTI people
a training program to skill staff to work effectively with GLBTI clients
reviewing assessment processes, tools and care plans
implementing reviewed documentation with assessment team
a communications strategy including to promote GLBTI inclusive practices in the GLBTI media and local papers
an evaluation of the action plan
a self evaluation audit in preparation for a Rainbow Tick
undertaking the Rainbow Tick processes

36. Success Successful diversity planning means:
adapting and enhancing existing planning processes where appropriate
understanding your local community and their needs
where appropriate, working collaboratively on how to best respond to increasing needs in your community
setting clear, measurable and achievable goals and objectives
meeting quality standards.

37. Questions?

38. Group activity

39. Group activity Form small groups and introduce group members..
Choose a speaker and note taker.
Share examples of service planning to meet diverse needs of HACC clients.
What do you already know about population groups who are not accessing HACC services?
What data sources do you use to analyse and understand the diversity within your community?
What partnerships or collaborations will be helpful?.

40. Key points from each group
Population groups? Using data? Partnerships for diversity planning? Examples of diversity planning?

41. Feedback and discussion

42.  natasha.kukanja@health.vic.gov.au  03 9096 9959
For further information please contact:
Natasha Kukanja
HACC Service Development  
Or your Department of Health Regional Office