Thanks for your email - you will hear formally from us - cheers diana

Diana Marriott
Communications Manager

Bay of Plenty District Health Board
DDI: 07 579 8029
[mobile number]
www.bopdhb.govt.nz

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On behalf of Debbie Brown, Senior Advisor Governance & Quality

 

Dear Marie,

 

Please find below response to your OIA request dated 27 February 2019.

 

1.               For each of the past three years ending June 2016, June
2017 and June 2018 what was the DHBs Rural Adjuster funding component of
the PBFF funding pool?

The rural adjuster is as follows:

2015-16: $2,366,000

2016-17: $10,420,000

2017-18: $10,803,000

 

Please note that the rural adjuster contributes to the Population Based
Funding Formula rather than being a specific funding line.  The rural
adjuster is an input and DHBs role is to allocate resources that provide
the best possible outcomes for their communities in accordance with their
legislative role.  DHB allocation of resource is articulated in their
annual plan.

Funding of the rural adjustor changed from 2015-16 to 2016-17 due to the
Ministry of Health using a new funding model that used weighted rural
population index-reflecting  rural population and geography. The main
advantage of the weighted rural population index model is that funding is
more closely aligned with DHBs that have the most rural residents.

 

2.               Does the DHB fund and provide rural hospital services? 

BOPDHB does not fund a rural hospital or rural hospital services.
Whakatane Hospital is not designated rural. We have a health centre in
Opotiki but this does not constitute a rural hospital.

 

If yes, continue to answer questions 2.1, 2.2 and 2.3. If no, go to
question 3.

 

2.1         Provide the following information about the rural hospitals in
your DHB.  

If there are none, please report this.

·      Name or location of hospital

·      List of services the hospital provides

·      The business structure of the hospital eg DHB owned and operated /
NGO or Iwi owned and operated

·      Annual Budget

 

Not applicable as we do not fund a rural hospital or rural hospital
services.

 

2.2         How is the annual budget for each of the rural hospitals
listed in the table in 2.1 set?

Not applicable as we do not fund a rural hospital or rural hospital
services.

 

2.3         How does the DHB apply the annual rural adjuster funding to
the benefit of each of the rural hospitals listed in the table in question
2.1.

               Not applicable as we do not fund a rural hospital or rural
hospital services.

 

3.               Does the DHB fund and provide rural community services?

The DHB funds the following rural community services:

·      Rotorua Area Primary Health Services Limited (RAPHS)-Long term
conditions for the Murupara General Practice being $19,806 per annum,
Rural Primary Health Care Premium to Murupara General practice of $164,667
per annum, Rheumatic Fever services via Murupara GP practice at $14,517
per annum, Rural After Hours service for Murupara GP practice at $62,700
per annum, Rural Locum Support for Murupara GP practice as a  one off for
2019-20 at $5,000 for the year (this is derived from the Rural SLAT
initiative).  RAPHS is a PHO situated in Rotorua and services Murupara due
to its closer location even though Murupara is in the BOPDHB geographical
location.  Murupara GP practice is a privately owned business.

·      Midlands Regional Health Network Charitable Trust-Rural Primary
Health Care Premiums for the Waihi Beach GP practice being a total of
$97,501 per annum made up of Rural Workforce retention $50,763; Rural
reasonable Rostering $16,913 and Rural Bonus $29,825, Long Term Conditions
being $14,326 per annum, under 14s being $1,964 per annum and Rural Locum
Support being a one off for 2019-20 being $5,000 for the year.  We also
fund the Otawhiwhi Marae outreach clinics undertaken by the Waihi Beach GP
practice.   Midlands Regional Health Network Charitable Trust is a PHO
which services several DHBs.  Waihi Beach Practice is situated in the
BOPDHB geographical location but is owned by Midlands.

·      Rural Pharmacy Services-We fund two Opotiki pharmacies which are
privately owned to provide Rural and isolated Pharmacy Initiatives and
Afterhours both $110,053 each per annum, Rural Ranking at $1,012 each per
annum, one of the pharmacies undertakes Outreach and Depot services for
the DHB owned Tekaha GP practice being $33,009 per annum, under 14s being
$2,171 each.  We also fund Adamson’s Pharmacy which is privately owned and
located in Whakatane to provide Rural and Isolated Pharmacy Initiatives to
Tuhoe at Taneatua, Waimana, Ruatoki and Ruatahuna being $23,706 per
annum.  We also fund a Rotorua based privately owned pharmacy $31,356 per
annum to provider outreach and depot services to the Murupara GP practice.

·      We fund two Primary care inpatient beds to be utilised by the
Katikati Medical Centre for patients requiring additional care who are not
unwell enough to require hospital care; this is funded via a Community
Trust being two beds (one capacity and one utilisatoin) at $192,939 per
annum-this also includes a sum of $60,706 specifically for GP services for
patients occupying the beds.   The Community Trust subcontracts with a
privately owned aged care facility for the beds.

·      The DHB owns and operates a small GP practice in Te Kaha where
patients are seen free of charge.  The practice does not sit under a
PHO-please see funding in 3.2.

·      The DHB funds a community nursing service in Opotiki called
OPINS-see funding details in 3.2.  This is owned and operated by a
non-government organisation (NGO).

·      The DHB funds the Western Bay PHO who then provides rural services
to Katikati.  These include-podiatry services, skin lesion removal via
Katikati Medical Centre-routine wound care-cervical screening-Care Plus,
opioid substitution-free afterhours care for youth under 14 and diabetes
management.  The cost is difficult to quantify as it comes out of a
general budget associated with the services for the whole of Western Bay.

·      Wester Bay of Plenty PHO funds Katikati Medical Centre $35,863 per
annum to address needs of high needs enrolees and palliative care visits.

·      The BOPDHB funds Katikati Medical Centre via the Western Bay of
Plenty PHO the following Rural Premiums-Rural Bonus $60,837 per annum,
Rural Workforce, Recruitment and Retention $142,737 per annum and
Reasonable Roster $8,987 per annum.

·      Western Bay of Plenty PHO funds GP and nurse led clinic visits on
Matakana Island via Ngati Kahu Hauora GP practice at an annual cost of
$50,855.

·      Eastern Bay PHO provides a number of services to rural areas in the
Eastern Bay of Plenty which are part of whole contracts which is difficult
to quantify value. These rural community services include-cervical
screening, breast screening, smoking cessation support, healthy heart and
diabetes services,  podiatry services, dietician advice, minor skin
surgeries, Green Prescription, continuing medical and nursing education,
radiology, primary mental health, sexual education nd health services,
childhood immunisation, rheumatic fever and cellulitis prevention
services, and opioid substitution.

·      Afterhours services are available for people living rurally which
are provided at Whakatane Hospital (this is not a rural hospital) via a GP
services in weekends and week nights.

·      More specifically there is dedicated funding of $81,824 per annum
to support the Opotiki Medical Centre.

·      EBPHA also pass on 100% of rural premium funding to rural GP
practices registered with them being $328,797 per annum for Opotiki and
Kawerau practices.

·      EBPHA also fund a BeeFound NZ Locum pilot at $10,400 per annum and
locum support of $22,180 per annum to assist rural practices find locum
GPs.

 

Maori Health and Kaupapa rural services

The total spend of Hauora Māori within the rural Eastern Bay of Plenty
community is as indicated in the below table  Majority of these services
are Non-Governmental Organisations and have similar governance and
operational structures with kaupapa māori advice, delivery and guidance
implemented at various levels.  All of these services have links with Iwi
with 3 being owned by Iwi.  Due to the confidentiality of these services,
some of the key information has been withheld.

 

Provider Profile
# Agreement Name Key area
of
delivery 16/17 17/18 18/19
1.                Suicide Based in
  Intervention and Whakatane
Prevention by services $                       $        $         
Maori for Maori rurally -   72512.52 72,512.45
2.                Kaupapa Maori Ruatahuna
  Rural Community  $       $       
Nursing Service $      101,599.18 102,615.22 104,657.28
3.                Well Child Ruatahuna
  Tamariki Ora  $         $         
Service $        70,157.28 70,157.28 70,157.28
4.                Koroua & Kuia Ruatahuna
  Early
Intervention  $         $         
Services $        93,089.40 94,020.50 94,020.50
5.                Community Ruatahuna
  Transport  $         $         
Services $        23,176.24 23,176.24 24,473.60
6.                Whanau Ora Opotiki $         $         
  94877.4 95,826.13 97,733.07
7.                Asthma Management Based in
  - Maori Whakatane
services  $         $         
rurally $        94,304.13 95,247.17 95,247.17
8.                Nurse Led Kaupapa Based in
  Maori Community Whakatane
Based Services services  $       $       
rurally $      263,253.00 265,885.53 271,176.65
9.                Well Child Based in
  Tamariki Ora Whakatane
Service services  $       $       
rurally $      249,231.40 249,231.40 249,231.40
10.               Kaupapa Maori Based in
Antenatal and Whakatane
Parenting services  $         $         
Programme rurally $        10,099.85 24,239.64 24,722.01
11.               Koroua and Kuia  Based in
Early Whakatane
Intervention services  $  $       
Services rurally $      145,970.26      147,429.94 150,364.20
12.               W/U Mental Health Based in
co-existing Whakatane
(Mental Health services  $       $       
and addiction) rurally $      104,979.00 106,029.00 108,139.00
13.               W/U Kaupapa Maori Based in
Community Whakatane
Clinical Support services  $       $       
Service rurally $      104,979.00 106,029.00 108,139.00
14.               Rheumatic Fever Based in
Prevention Whakatane
Services - services  $       
Whakatane area rurally $        50,328.00 50,838.36 0
15.               Koroua & Kuia - Taneatua
Early
Intervention  $         $         
Services $        94,359.72 95,303.28 95,303.28
16.               Community Taneatua
Transport  $         $         
Services $          4,442.22 26,921.28 22,434.40
17.               Kaupapa Maori Taneatua
Social Work  $         $         
Support Services $        87,879.53 88,758.29 90,524.57
18.               POC. Adult Taneatua
Community
Residential
Services -
Package of Care  $       $       
NHI: GAS9019 $        57,567.38 113,843.08 118,116.93
19.               W/U Kaupapa Maori Taneatua
Adult Mental  $       $       
Health Services $      599,137.08 605,127.01 628,624.29
20.               W/U Kaupapa Maori Taneatua
Infant, Child and
Youth Mental  $       $       
Health Services $      396,137.00 461,606.38 476,799.01
21.               Whanau Ora Taneatua  $       $       
$      114,321.05 115,464.30 117,762.04
22.               Rheumatic Fever Taneatua  $       $       
$      130,000.00 131,299.94 131,299.92
23.               Kaupapa Maori Opotiki
Antenatal and  $         $         
Parenting $        35,685.95 24,482.04 24,847.44
24.               Rheumatic Fever Murupara
Prevention
Services -  $         $         
Murupara $        44,943.20 45,392.64 45,392.64
25.               Well Child Opotiki
Tamariki Ora
Service $132,471.03 $132,471.03 $132,471.03
26.               Community Opotiki
Transport  $       $         
Services $        19,140.68 115,998.72 96,665.47
27.               W/U Infant, Opotiki
Child, Adolescent
and Youth Mental  $     $       
Health Services $      104,848.50 106,028.64 107,083.13
28.               W/U Rangatahi Opotiki
Kaupapa Maori
Mental Health
Peer Support $         
Service $        81,200.00 $82,012.00 84,934.08
29.               Kaupapa Maori Opotiki
Adult Mental  $       $       
Health Services $      663,516.00 663,516.00 677,748.04
30.               W/U Specialist Opotiki $       
Youth AOD Service $106,029.00 106,029.00
31.               Whanau Ora Opotiki
Community Health
Service $        89,292.24 $90,185.14
32.               Acute Rheumatic Opotiki
Fever - Community
based services $      126,287.00 $127,549.87 $127,549.87
33.               Koroua and Kuia Opotiki
Early
Intervention  $         $         
Services $        95,228.40 96,180.72 98,094.72
34.               Community Opotiki
Transport  $         $         
Services $          2,244.02 11,333.00 13,599.00
35.               W/U Kaupapa Maori Opotiki
Child Adolescent
and Youth  $       $       
Community AOD $      140,637.12 145,759.26 147,170.83
36.               W/U Kaupapa Maori Opotiki
Community
Services for  $       $       
Maori $      291,158.04 294,068.80 301,850.04
37.               Well Child Kawerau
Tamariki Ora  $         $         
Service $        90,128.08 90,128.08 90,128.08
38.               Sexual Health and Kawerau
School Based  $         $         
Clinics $        51,049.48 51,559.92 38,669.94
39.               Support Services Kawerau  $         $         
For Mama and Pepi $        63,016.29 63,646.41 64,912.97
40.               Childrens Team Kawerau  $         $       
- 84,019.33 128,139.00
41.               Kaupapa Maori Kawerau
Antenatal and  $         $         
Parenting $        10,099.85 24,239.64 24,239.64
42.               Koroua and Kuia Kawerau
Early
Intervention  $         $         
Service $        95,228.55 96,180.87 95,228.55
43.               W/U Kaupapa Maori Kawerau
Infant Child
Adolescent and  $       $       
Youth Service $      104,979.00 106,028.79 108,139.00
44.               W/U Kaupapa Maori Kawerau
Early
Intervention
Alcohol & Other  $       $  
Drug Services $      104,979.03 106,028.79      108,139.00
45.               W/U AOD Kawerau
Triage/Assessment  $       $       
Service $      107,152.00 107,152.00 107,152.00
46.               Whanau Ora - Kawerau
Maori Community  $       $       
Health Service $      127,624.20 128,900.45 128,900.40
TOTAL  $   $   
$  5,470,796.78 6,040,452.63 6,008,521.92

If yes, continue to answer questions 3.1, 3.2 and 3.3. If no, go to
question 3

 

3.1       Provide the following information about the rural community
services in your DHB.

If there are none, please report this.

·     Location of services

·     List of Community services in each location

·     The business structure of the service provider eg DHB owned and
operated / NGO or Iwi owned and operated

·     Annual Budget.

 

Assume this is the list covered in 3.     

 

Please see full details under number three and below in 3.2.

 

3.2       How is the annual budget for the community services listed in
the table in 3.1 set?

 

The annual budget for community services in Te Kaha and Opotiki is agreed
with the provider Arm for Te Kaha and NGO for Opotiki.  The BOPDHB
provider arm is funded to deliver community based services, School Dental
service, Public Health Nursing service and District Nursing services.
These services operate across the BOPDHB region including urban and rural
areas.  For the rural services these are delivered in Te Kaha, Opotiki,
Kawerau, Murupara  in the Eastern Bay and Katikati in the Western Bay. The
total funding for these services is set regionally and is not budgeted
separately for the rural areas.

 

3.3         How does the DHB apply the annual rural adjuster funding to
the benefit of each of the rural community listed in the table in question
3.1?

Funding is allocated either by the Ministry of Health through an agreed
funding formula such as for rural roster funding or by the DHB based on
the assessed need of the population e.g. in the case of Opotiki rural
funding which provides 24/7 nursing cover for the Opotiki Health Centre.

4.               For each of the past three years, under each of the
components of the Rural Adjuster, quantify the allocation of Rural
Adjuster funding through the DHBs contracts with its contracted providers
or Service Level Alliance Teams.

Small hospital facilities                              

·      Community services                                   

·      Offshore Islands                                              

·      Travel and Accommodation                                        

·      Inter hospital transfers- not applicable.
                              

·      Governance 

                             

Rural GP/PHO payments-the rural GP payments are via the five PHOs which
service out BOP geographical location.  The total annual amount passed
through the PHOs is $783,426 per annum plus $97,000 per annum
discretionary rural support funding. 

Governance for rural premiums only is in the form of the Bay of Plenty
Alliance Leadership Team (BOPALT) to which the Rural SLAT reports.  There
is no allocated rural adjustor funding for supporting BOPALT.

 

5.          i. Does the DHB include reporting requirements specific to the
use of rural adjuster funding in its contracts with service providers
whose contract includes rural adjuster funding.  

Yes reporting is required on a three monthly for under 14s, long term
conditions and PHO report activity against Rural Premiums in their three
monthly reports. We do not require reporting for pharmacy outreach
services due to the complexity of the services and the potential
administrative burden.

 

ii. If yes, provide a list of the reporting requirements included in the
DHB contracts with these providers. 

General reporting requirements involve volumes where applicable, activity
and initiatives related to Rural Premiums e.g. locum cover, housing,
transport etc.

 

Kind regards,

 

Karina Thomson

Executive Assistant

to Helen Mason, Chief Executive

 

Bay of Plenty District Health Board | Tauranga Hospital | Cameron Road |
Private Bag 12024 | Tauranga 3143 

T: 07 579 8363 | E: [1][email address] | W:
[2]www.bopdhb.govt.nz 

 

[3]CARE email signature 3

 

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I am on leave until Tuesday 16th April.  My emails are being monitored but
it your email is urgent please contact Maxine Griffiths at
[email address]

 

Kind regards,

 

Karina Thomson

Executive Assistant

to Helen Mason, Chief Executive

 

Bay of Plenty District Health Board | Tauranga Hospital | Cameron Road |
Private Bag 12024 | Tauranga 3143 

T: 07 579 8363 | E: [1][email address] | W:
[2]www.bopdhb.govt.nz 

 

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