Question 1 – How have you adapted service delivery in response to the bushfires, floods and Coronavirus pandemic? When has it worked and when hasn’t it worked? How will this affect how you deliver services in the future? Have your service adaptations included better integration with other initiatives?

In response to recent crises, breakthru has adapted its Family Mental Health Support Services
(FMHSS) service delivery. These changes have been tailored to the unique issues faced by customers and staff in their respective geographies of operation. Ways breakthru has adapted its service delivery include:
• increased use of telehealth servicing;
• transiting group-based programs to online; and,
• implementing a comprehensive crisis management plan to ensure service continuity.
Challenges faced by breakthru during this time include:
• decreases servicing resulting from the closure of schools;
• the demand for services by customers has increased exponentially, resulting in a large waitlist;
• though experiencing increased customer demand, there is less ability to deliver services due to internet lines and phone access becoming disconnected;
• more group-based works in schools to triage the growing customer waitlist; and,
• children entering into care with a lack of internal strategies to cope with a sudden and unexpected event.
Lessons learnt by breakthru:
• domestic violence in the home has escalated. This was reflected in the mandatory reporting we undertook.
• many of the target cohorts breakthru services are skilled in using technology. This has allowed breakthru to reach an audience that were previously difficult to reach. For example, engaging with school via a telehealth model has given breakthru the opportunity to reach larger Local Government Areas. This provides better value-for-money because there are minimal to no travel costs;
• Mixed form service delivery has become more prominent.
• the service disruptions breakthru encountered were negligible. This is because we achieved the same outcomes through modifying our service delivery;
• Maintained integration with other services through online models but found this less effective than a traditional face to face meeting
• linking with local community partners helped to achieve better outcomes for young people.

Question 2 – Are the proposed key outcomes for the families and children programs the right ones? Are there any major outcomes missing? How can we include strengths-based outcomes that focus on family or child safety?

Breakthru agree with the key outcomes proposed. It aligns with the outcome-based tool we have incorporated across our FMHSS program to measure client journey’s.

Question 3 – What tools or training would support you to effectively measure and report outcomes through the Data Exchange Partnership Approach?

Training would support breakthru to effectively measure and report outcomes through the Data Exchange (DEX) Partnership Approach. This is because training around the timelines of the three domains (circumstances, goals and satisfaction) reported on would increase understanding into how to use the DEX portal effectively. For instance, this includes learning at what interval to report each score and demonstrate the outcomes achieved by customers in FMHSS servicing.

breakthru believes that using the DEX portal should become compulsory. This will increase its benefit to the Department of Social Services (DSS) because service providers will be more accountable for implementing the contract to the needed. Moreover, making its usage obligatory will minimise the inconsistencies in how the guidelines are interpreted and standardise how providers implement the program.
Lastly, to improve for DSS, breakthru believes that DEX should provide users with greater access to statistics and consider introducing a rating system for providers to help breakthru benchmark against providers with similar cohorts.

Question 4 – Do you already have a program logic or theory of change outlined for your program? Did you find the process useful? If you do not have one, what has stopped you from developing one? What capacity building support would assist service providers to develop program logics and theories of change?

breakthru has not incorporated a program logic or theory of change into its FMHSS program. Implementing these modifications would be economically unviable for breakthru because external facilitation would be required.

However, to successfully introduce a program logic or theory of change for FMHSS programs, breakthru views the following as requirements:
• training;
• subsidised and/or low-cost options; and,
• a longer and more in-depth consultation process by government with service providers.

breakthru have opted to use an evidence-based tool instead to track the journey of change for the customers who enter FMHSS.

Should program logic or theory of change be made compulsory breakthru suggests that the DSS provide guidelines or a template to help with the transition.

Question 5 – If longer-term agreements are implemented, how can the department work with you to develop criteria to measure and demonstrate performance? How can the Data Exchange better support this?

Funding certainty and accountability have allowed breakthru to retain staff and provide better services. This is because we have been able to plan for a longer period.

breakthru believes that outcomes should be measured consistently during the customer’s time in the FMHSS program. Should the department make score reporting mandatory there should be set guidelines on what intervals to report.

Greater accountability is needed within funding programs to ensure the delivery of FMHSS contracts are universally strong. To resolve this issue, breakthru believes that providing organisations with incremental increases over time would create more accountability within the DEX portal to record and track customer outcomes.

Furthermore, clear targets and Key Performance Indicators (KPIs) should be outlined by DSS. This would likely allow service providers to achieve better outcome for FMHSS customers.

Providers should be able to use the DEX portal to benchmark against each other anonymously and drive organisations to reach greater outcomes for participants

Question 6 – What does success look like for your service, and how do you assess the overall success of your service?

From breakthru’s perspective, the mental health outcomes of customers are mutable, fluctuating throughout their life or during the period of treatment. Client progression to mental health is not linear and breakthru are able to be reactive to customer needs throughout their journey FMHSS servicing.

breakthru assesses success through measuring the amount of community capacity that is built by its services. We aim to demonstrate tangible long-term benefits to customers that enter a breakthru FMHSS and this is achieved through using the Outcome Star. This allows customers to make informed choices around their received supports, helping breakthru to track their person-centred care journey.

Successful service delivery incorporates a model of utilisation for staff. In this model staff are required to account for 80% of their time. This benefits breakthru’s customers because support workers are required to increase efficiency and creatively support the community. breakthru actively sources feedback from customers to improve services.

Question 7 – Do you currently service cohorts experiencing vulnerability, including those at risk of engaging with the child protection system? If not, how does service delivery need to adapt to provide support to these cohorts?

breakthru has five contracts for FMHSS servicing within both New South Wales and Victoria. Across these five sites we have encountered vulnerable cohorts, including:

• Aboriginal and Torres Strait Islander (ATSI) peoples
• Culturally and linguistically diverse (CALD)
• Domestic and Family Violence
• Humanitarian entrants
• Young people transitioning from the child protection system
• People with disability

A few examples of how we achieve this are as follows:
• Using identified workers
• Using interpreter services
• Facilitate local initiatives that service these communities such as drop-in services, interagency meetings and events.

The FMHSS servicing model is flexible and responsive to community needs, allowing breakthru to adapt its service delivery to these vulnerable cohorts.

Question 8 – If you are a Children and Parenting Support or Budget Based Funded service provider, do you currently link with a Communities for Children Facilitating Partner or other regional planning mechanism to understand what other services are provided in the community and what the community identifies as their needs? How does this work in practice? Would you value the increased support of being attached to a local Facilitating Partner?

breakthru encourages collaboration within the DSS funded services. However, we have experienced difficulties identifying what services are offered within each local government area or region. To resolve this situation, breakthru has engaged non-DSS funded services within the regions to better understand the local community’s needs and collaborate to achieve stronger outcomes. This provides holistic coordination of support, including financial, mental health, general health, allied health and housing. Some examples of the services breakthru engages to address local area needs are:
• high schools;
• youth interagency meetings;
• hospitals;
• Primary Health Networks;
• National Disability Insurance Agency (NDIS). This includes Local Area Coordinators (LACs), support coordinators and Ability Linkers
• Department of Education (NSW/VIC)

breakthru believes an accessible database of DSS funded services within each LGA would help to address the local needs of FMHSS funded cohorts. This will facilitate the building of local relationships and enhance the ability of community organisations to collaborate in DSS funded programs.

Question 10 – The capability building support offered under Families and Children Activity programs has gone through several iterations. What works well? What do you think should change?

breakthru has held its current five contracts for over five years. During this time, breakthru believes the introduction of the activity work plan represents a positive shift. Although recently added to the FMHSS contracts, the change has helped track and plan breakthru’s intention in implementing the contracts across the five sites. Other capability building supports breakthru have initiated include:
• The measurable change that we are making to families through using breakthru’s outcome tracking model
• Innovative service delivery resulting from the pandemic and bush fires
• facilitating subcommittees in local agencies

breakthru believes that minimal changes are needed in capability building , the gaps breakthru have identified include:
• Poor integration of families into the NDIS;
• A non-streamlined referral process;
• Lack of services for people aged 12 years and under;
• Lack of understanding of the benefits of other DSS funded program; and,
• Little to no facilitation of how funded providers can collaborate better.

Question 11 – Aside from additional funding, how can the department best work with you to support innovation in your services while maintaining a commitment to existing service delivery?

Although the DSS has stated that no additional funding will be provided to organisations, breakthru believes that providing organisations with the ability to use funding more flexibly would create additional benefits to both customers and the community. This would mean being more responsive to community need across different sites. Breakthru also believes there needs to be greater accountability towards targets and KPIs. We would also like to have the opportunity to be measured against other providers and could test and learn different approaches to implementing the contracts across different LGA’s in which we operate. Breakthru would take this opportunity to report back to the department around any learnings.