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WORKING COLLABORATIVELY IN ESTABLISHING A CASE MANAGEMENT SERVICE AFTER THE RECENT VICTORIAN BUSHFIRES Working collaboratively in establishing a case management service after the recent Victorian bushfires Desley Hargreaves, National Manager Social Work Services Centrelink Colleen Clark, Assistant Director Victorian Bushfire Case Management Service AASW Conference 6-8 November 2009 Map of affected areas Black Saturday February 2009-The consequences 173 people lost their lives Over 2000 homes lost & 78 towns impacted 3 schools destroyed and 47 damaged 55 Business destroyed Destroyed: 430,000 Hectares burnt 11,000 stock 10,000 km fencing 1,000,000 wildlife Over 3550 agricultural facilities destroyed The ask – set up a case management service! The Victorian Premier John Brumby and the Federal Minister for Community Services Jenny Macklin announced the establishment of the VBCMS on 10 February 2009: “Each affected family will be given a name and phone number of a person they can call who can give them the help they need to get their lives back on track.” Building the Service from scratchjust three days..the challenges Negotiating and building a working relationship between State and Commonwealth public servants Managing the P(p)olitics – understanding who is in charge here!! Sharing knowledge to develop and articulate the framework and service offer Finding staff – meeting expectations about quality while finding quantity – the surge capability and the negotiated relationships Building the Service from scratchjust three days… Call Centre established and operational Operational guidelines and instructions drafted Recruitment Strategy commenced Funding secured from Government Needs Assessment Developed Advertising distributed across all Recovery and Relief Centres …and by end of the first week Client Data base developed & deployed 2428 Registrations received 100 Case Managers employed 1207 cases assigned Resource Kit developed Core training developed and being implemented Social The Four dimensions of recovery Case Management Community Development Program Psycho-Social Support Women Men Youth Children Family CRC Neighbourhood CSH Community Economic Individual CDO Natural Industry (including primary producers) Employment Business/ Government Tourism Commerce Services Water Quality Land degradation and contamination Flora and Fauna Natural Environment Natural Environment (parks and public lands) Built Air Quality Agriculture Marine Environment Electricity Transport Gas Water Telecommunications Roads Community essential infrastructure Other essential services (eg, schools, hospitals etc) Recovery System - Social Community Development Program Case Management Psycho-Social Support Women Community Development Officers Community Recovery Committee Community Service Hub Men Outreach Community Info Community Engagement Youth Children Individual Family Neighbourhood Community Leadership • DHS and Commonwealth deployed 3 Executive Officers to lead the development of the VBCMS • Executives remained fully involved for 2 months before starting to hand over responsibility • Convincing Arguments- many meetings with Regional Executives and Emergency Recovery Groups and CSOs • Early establishment of governance structures; VBCMS Coordination Committee • Daily staff meetings held jointly with Commonwealth Convincing key stakeholdersgame of catch up for first two months • Daily meetings and report to Minister for Bushfire Recovery-moved to weekly in May and continue today • Briefings shared between State and Commonwealth Ministers • Joint Bushfire Recovery subcommittee of Cabinet (Vic) • Winning over Bill Shorten Parliamentary Secretary for Bushfire Recovery and Christine Nixon Chair Victorian Bushfire Reconstruction and Recovery Committee • Focus on local and federal members of Parliament • Broad information sharing Branding of the Service • Case Managers were identified as delivering case management as part of the VBCMS • Commonwealth part of VBCMS not separate to it. • Other agencies identified staff as agency staff working as part of the VBCMS Elements of the Commonwealth’s contribution to the Partnership • Program Development-sharing of expertise in emergency recovery case management delivery. • Partnership Skills Expertise- in partnering with other organisations both within Australia and Internationally helped the relationships get off to a good start Elements of the Commonwealth’s contribution to the Partnership • Call centre-25 Social Workers staffing the Registration line offering 24 hour coverage • 105 case managers- 25% of the total staffing • Interstate clients all case managed by 24 social workers in the Centrelink network. • Centrelink’s Interpreter Service Elements of the Commonwealth’s contribution to the Partnership • Establishment of the Commonwealth Professional Services • Professional staff from Centrelink,CRS Australia, Defence Community Organisation, Family Court of Australia and Dept of Immigration and Citizenship • Logisitical challenges re professional supervision and support, training, conditions of service, 110 cars, laptops and mobile phones +accomm for Interstate staff and office space!! Growth in cases VBCMS today – a statewide effort Region Active Closed CMs Agencies BSW 18 15 1 1 East 429 387 31.3 7 Gipps 403 374 33.1 5 Gramp 83 44 5 3 Hume 1183 419 97.9 6 Loddon 212 97 14.8 5 NWMR 965 523 87.4 15 Sthn 136 98 8.9 3 18 14 Interstate Cwlth Features of the Model • Clients self identify they are bushfire affected- no other eligibility criteria. • No service fees • Open length of service provision up to 2 years • Qualified and non Qualified Case Managers • Initial practice approach was problem and task centred moving into client centred practice as the urgency of immediate needs met. • Out reach home based service available on continuum of intensive to less intensive service provision with the flexibility to move back and forth. • Bushfire and non bushfire related needs all in scope-nothing out of scope • Provision of practical assistance, personal support, information, advocacy and referrals Summary of WHO predictions of the prevalence of psychosocial problems after an emergency Before emergency-12 months prevalence After emergency-12 month prevelance Severe mental disorder (such as psychosis, severe depression, severe disabling anxiety disorder) 2-3% 3-4% Mild or moderate mental disorder (such as mild and moderate depressions or anxiety) 10% 20% (reduces to 15% with natural recovery) Moderate or severed psychological/social distress (no formal disorder) No estimate Large percentage, reduces due to natural recovery Mild psychological/social distress No estimate Small percentage (increases over time) Five essential elements of Immediate and mid term trauma intervention (Hobfoll, Friedman, Gerson, deJong) • Safety • Calming • Self and Collective Efficacy • Connectedness • Hope Discussion Points • • • • • • • • • • • Who was attracted to these positions? Professional vs volunteerism, working in EM context Joining up individual case work with community development Emphasis of the case work role within Case management Working with clients who have never received a ‘helping’ service before activism vs advocacy Client data for planning purposes CM filled service gaps CM fill informal support gaps Role boundaries in relationship based practice Need to market CM at intake and initial engagement (should this include CM turnover) • Whose goals? • Differing agency context/culture influence on service model lead to clients ‘shopping around’ What Worked Well • • • • • • • • Highly valued by clients Easy Access to the Service Simple data base Communications: Bulletin, Resource and Grants Kit, 1800 CM help line Adequate funding Inclusive focus of service 1800 client feedback line CM reduced demand on other services What Did We Learn • 24 hour commitment impossible to achieve • Open access meant most in need were not identified early enough and limited resources not effectively deployed. • Triage helped once it started • Tensions with Municipal Recovery work • Local services needed guarantees of funding and durationslowed things down • Perception that VBCMS gateway to other services such as Appeal Fund, donated goods and other VBRRA initiatives • Professional case manager qualifications vs volunteerism. • Data sharing and privacy/consent issues emerged almost immediately • Recruitment of case managers impacted services’ ability to maintain core service delivery • Case managers as advocates caused concern amongst some The changing nature of recovery New events and recovery activities: • Much higher expectations upon ‘government’ to provide well coordinated assistance & to do it correctly. • How to incorporate a highly specialised case management service into an integrated recovery team • Plus – Royal Commission scrutiny Client Feedback We would like to express our gratitude to our Case manager. He has gone well beyond the call of duty to provide guidance and support both material and emotional. I cannot speak more highly of the service/friendship he has given us. His approach was non-intrusive and always respectful of our emotional instability in the early stages. He has been able to slowly step back when we were ready to stand on our own although we are not quite ready to let go of the apron strings yet, we will be fine by the time he goes home to his family. A kind and generous Soul who’s mission was to find ways to help others in need. Mission Accomplished. Where to from here • • • • • • • • • Commonwealth transition Integration with Community Recovery Planning for future role of CM in Recovery CM Alumni Program Consolidating the case management model Staff support strategies The first anniversary Evaluation Exit strategy Questions?