This presentation by Craig Cooper (NAPWA) explores a client-centred service delivery approach in the context of mainstreaming HIV care. It also looks at the inhibiting and driving factors that activate or derail service delivery collaboration for HIV services. This presentation was given at the AFAO Positive Services Forum 2012.

1. HIV Community and Health
Service Collaboration
Craig Cooper
Secretary / Treasurer

2. Presentation
• Populations and Positions
• Stories about People
• Collaborative Service Delivery
• Key Strategies
• How to make it work?

3. Populations
• Young People
• Sex Workers
• People who Inject Drugs, and have a suspected or confirmed
substance dependence disorder
• Children and Families, under investigation or court orders
• Aboriginal and Torres Strait Islander people and communities
• Gay, Lesbian, Transgender and Queer
• People engaged in the Criminal Justice System, and recidivist
offenders
• People with diagnosed co-morbidities
• Homeless People
• People with a profound Disability
• People that are immigrating and have been refugees

4. Positions
• Youth Worker - NGOs
• A&OD Family Therapist - NGO
• Youth Health A&OD Counsellor – Community
Health
• A&OD Counsellor – Hospital Campus
• Management – A&OD, Criminal Justice System
• Management – Hospital and Health based HIV &
Hepatitis Services
• HIV Service Management - NGOs

5. Stories about People
• A Mother – 1992
• A Son – 2002
• A Dealer – 2004
• A Homeless Man - 2007

6. A Mother – 1992
• A 32 year old sex working Mother of 2
children under 5 years of age, from Western
Sydney. Substance dependant; traumatic
childhood; monitored by child and family
services and the criminal justice system; self
mutilating; working from home and the Great
Western Highway; with multiple sexually
transmitted infections and HCV positive

7. A Son – 2002
• A 24 year old young man from the Inner-West
of Sydney. Living and partying with mates;
unemployed and attending an illicit drug court
diversion program. Arrested for possession;
blasting Tina; on PEP

8. A Dealer – 2004
• A 38 year HIV positive Gay Man living in the
Inner-West of Sydney. Attending a court
ordered illicit drug diversion program for
dealing large quantities of a range of
substances. Only other service contact was an
S100 prescribing GP on Oxford Street. Hosting
bareback seeding and breeding parties for
guys with an unknown HIV status

9. A Homeless Man - 2007
• A 48 year old CALD Man confirmed HIV and
HCV co-infection from South-East and Inner-
West of Sydney. Acutely and severely
psychotic; no permanent or fixed address for
more than 10 years; multiple incarcerations;
known to HIV services and the criminal justice
system, but not in treatment or engaged in
any services before Hospital admission

10. Collaborative Service Delivery
Themes from the engagement with and in response to
the before mentioned people (stories):
• Person or client centred strengths based approach
• Developing and maintaining relationships
• Duty of Care; Infection Control; Access to and
Retention with Multiple-Services, Harm Reduction
• Care co-ordination and treatment adherence
• Accountable and responsible caring professionals
• Evaluation, review and client involvement in service
design, delivery, and representations
• Mainstream and specialist service compatibility

11. Drivers
Drivers & Inhibitors
• Client rights and community need
• Well written and designed service delivery model
• Staff and service agency
Inhibitors
• Doing what is comfortable and keeping busy
• Fear and disagreement (excuses)
• Power and Control, acting territorial
• Lack of structural, policy or management support
• Apathy, complacency and complicitness

12. Key Strategies
Client Service Delivery:
• Consult, listen and respond to the needs of the
people you’re working with and caring for
• Always treat people with Dignity and Respect
• Acknowledge the persons culture and resilience
• Approach the treatment and care relationship
with humour and positive regard
• Maintain privacy and confidentiality (use of client
release of information)

13. Key Strategies
Service Delivery Management:
• Ensure you’re mindful of and complying with
legislation
• Implement and be informed by best practice
guidelines, research and findings
• Understand and appreciate the role of service
partners and their criteria for action

14. How to make it work?
The Client:
• Always have the person (instead of the
presenting issue, service context or
therapeutic construct) in the forefront of
everything you do. This can be achieved by
asking the person, what do you want and
what can I do for you?
• Ensure the service model is client or person
centred, flexible and adaptive

15. How to make it work?
Service Delivery Practice:
• Informally and formally consult with partners and
stakeholders
• Formalise MOUs, Service Level Agreements, fee
for service arrangements, and collaborative care
coordination plans
• Understand the agencies you and your clients are
working with, including language, legislation,
policy etc.
• Evaluate and build a body of evidence and use
this to improve service delivery and the
partnership arrangement

16. In Closing
1. The options and ways to collaborate between
mainstream and specialist services are endless
2. We need to build on an evidence base
3. The range of service models and options need
to be consistently synergistic
4. The work needs to be expansive, instead of
limited
5. Specialist and mainstream services both have a
place and need to be maintained
Thank You