Final Report on RREF 2001 - Department of Health

Executive Summary
Beyond the detailed consideration that was given to how the Koori population should be scaled
as a need variable, it was recognised that including the Koori population as a need variable in
the RREF did not guarantee that the goal of better access or more appropriate services would
automatically result, and that other complementary strategies would be required by way of
continuing Service Development Grants.
The particular problems faced by agencies serving Koori populations included the need to
operate across LGA and even regional boundaries in some cases. Similarly, recognition of
cultural and linguistic diversity as a need variable in the RREF could add to the level of
resources allocated to regions with large numbers in these populations, but did not address the
nature of services required or the additional costs of service delivery associated with use of
interpreter services. Again, Service Development Grants were seen as a means of addressing
these issues.
5. The most effective approach to recognising the needs of rural LGAs
The needs of rural areas were raised at all stages of the Review and are considered throughout
the <strong>Final</strong> <strong>Report</strong>.
Under the options developed for a revised RREF, with all LGAs weighted on the same need
variables, need weightings show a wide range of need across both rural and metropolitan LGAs
rather than a simple rural-urban divide. While rural regions still achieved weightings of at least
30%, the relativity of these weightings has changed as metropolitan regions also receive need
weightings. The need weightings apply to only small populations in some rural LGAs and other
population trends also affect the outcomes of the RREF.
At an early stage in the Review, it was widely argued that other measures needed to be taken to
address the higher costs of service delivery in rural areas as performance targets attached to
current RREF allocations failed to do so, and rather increased the performance targets that had
to be reached. The detailed analysis of need factors across all regions has provided a sounder
basis for need weightings in the RREF, and any revision of the unit cost structure in HACC and
development of related pricing mechanisms needs to be informed by a similarly detailed
investigation of the factors contributing to cost variations, and the extent of those variations
across all LGAs.
Within rural areas differences between the cost of serving clients living in major rural centres
and towns compared to those who were more distant were recognised, and
mechanismsaddressing the cost of travel in rural areas need to be specifically targeted to these
“distant” clients. The need for any measures taken to address rural needs in HACC to be
consistent with approaches to rural services taken in other DHS programs was also emphasised.
Uneven access to services that were funded on a region-wide basis also need to be addressed
through planning measures as well as through resource allocation.
6. The impact of capacity to raise fees on regional resource allocation
There was unanimous agreement from the beginning of the Review that the RREF should not
attempt to take direct account of capacity to raise fees for HACC services. Rather, it was
considered that this factor should be dealt with indirectly through inclusion of a socio-economic
status variable in the RREF.
<strong>Final</strong> <strong>Report</strong> July 2001
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