High Needs One-off Discretionary Funding Service Specification

H High Needs One-off Discretionary Funding Service description WBOP PHO One-off funding is for vulnerable patients, especially Māori and High Needs*. This additional funding is to support responsive and proactive engagement with patients identified as being vulnerable to a poorer health outcome during this time of COVID-19. It is at the discretion of the practice to utilise the funding to subsidise those who need it most.

100% of this payment is to be used to reduce patient co-payments or other barriers to patients accessing general practice services: 1. Patient Services: Covering or reducing the cost for any normally invoiced patient service e.g. co-payments, prescription charges or extended consultations 2. Discretionary: To support other needs of the patient e.g. food, heating, transport, or pharmacy costs Please note: Paying off existing patient debt to the practice can be considered only in special circumstances where the debt poses a significant barrier to patient engagement. This use must be pre-approved by the PHO and applications to forgive debt will be assessed on a case by case basis. Send requests with supporting information by email to the GPL Team Lead debbieb@wboppho.org.nz .

Mandatory Requirements Practice plan:  Reflects how the practice would employ a proactive approach to engage with and support their vulnerable populations, especially Maori and High Needs* patients more likely to experience poorer health outcomes at this time.  Consideration given to the economic impact likely to occur because of COVID-19  Co Design informed by engagement with eligible individuals, their whanau and Iwi community agencies.

A plan template is available, your General Practice Liaison Team can assist with developing your plan and additional support is available from Kiri Peita, PHO Director of Māori Health.

Eligibility criteria Any person enrolled and funded with a WBOP PHO general practice who is:  Māori, Pacific ethnicity, or Quintile 5 deprivation level OR

*High Needs Definition is Māori, Pacific or Quintile 5

Updated 26 May 2020



Other ethnicity patients identified as being vulnerable to poorer health outcomes or affordability issues.

Vulnerability can be related to.

Personal factors: Age, chronic health conditions including mental health and physical health, language barriers, high health requirements Socio-economic factors: High quintile, unemployment, dependency on benefit, housing issues, transportation, debt at practice System and social factors of vulnerability: Where ethnicity becomes a factor knowing that our health care system does not deliver equitably across all ethnic groups Vulnerability may also include the wider impacts of COVID-19

Reporting Utilisation of the funding will be fully auditable General practice is required to report to the WBOP PHO at the end of the usual PHO six monthly reporting cycle identifying how the funds were spent.

Reporting Requirements Patients Demographics of: Age, gender, ethnicity, quintile What the funds were used for?  In practice cost of patient services  identify what the fund was used for, e.g. Co-payment, ECG etc  Support to access an external agency, e.g. pharmacy costs, radiology  Other referrals made as part of the consultation  Discretionary support, e.g. food, heating etc

Payment     

Discretionary Funding for Vulnerable patients was a one-off payment to practice on 7 May 2020 Payment is per enrolled and funded patient, equal to $2.00 for total population plus $5.00 per High Need defined patient (Māori, Pacific or Quintile 5) Payment is calculated using the patient register on 1 April 2020 Funding is not time-limited and should be treated as income in advance This fund is separate and additional to the existing High Needs Discretionary Fund

Contact details: Your General Practice Liaison Or email your enquiry to the General Practice Services Email: GPSadmin@wboppho.org.nz *High Needs Definition is Māori, Pacific or Quintile 5

Updated 26 May 2020