Community Health in Victoria
Background
Community Health Services (CHS) deliver a wide range of services addressing primary health care needs generally operating within a framework based on the social model of health.
One of the strengths of community based health services is the consumer-focused model of care that can be provided across the acute and community settings. This model enhances the capacity for partnerships with other sectors that influence the health of individuals and populations. The type and scope of services managed and delivered by CHS vary depending on local needs.
Although there are significant differences in the range of services and programmes within community health settings, common features exist. A common focus of community health services is having a defined, local population and a multidisciplinary approach.
Community based services respond both to the needs of the local community and to the emerging population health data. The community health sector recognises the benefits of multidisciplinary, multifaceted approaches at the population and individual health level.
There are approximately 100 CHS in Victoria, operating from over 400 sites. CHS deliver a range primary health and support services to meet local needs. There are two organisational types. There are 40 CHS that are managed by independent Boards of Management and the remainder are integrated with larger health services, such as Metropolitan or Rural Health Services and hospitals.
Further information about Community Health Services can be found at the Victorian Government website..
Philosophy of Community Health
The community health sector directly contributes to improved health status, reduced inequalities and lower health costs. A strong community health care system is built on four key pillars:
Healthy Living
Focus on social connectedness, prevention of illness and injury, managing chronic conditions, and self-care that helps individuals remain well, rather than treatment after becoming sick - as apposed to providing it after they become sick.
Community Participation and Access
Services are customised to ensure disadvantaged groups are able to access services and participate in all aspects of their care.
Professional Health Care Teams
Teams of multidisciplinary health care professionals work together and across the broad health sector to improve health outcomes and reduce duplication.
Connection to Local Communities
Community health is community managed or connected to local communities; this means knowing the community, its needs and working with communities on solutions. When communities work together they gain strength from one another, develop their own solutions and sustain improvements
Services provided by Community Health
CHS provide universal, community based health promotion, prevention and curative services, based on collaborative, multisectoral activities (Keleher 2006).
Community Health Program funded services include:
- Health promotion and disease prevention
- Early identification and intervention
- Assessment and treatment (e.g. allied health services such as audiology, dietetics, occupational therapy, physiotherapy, podiatry, speech therapy, community nursing, counselling/casework)
- Coordinated care with GPs, other primary providers, the acute, aged care and mental health sectors
CHS also provide a platform for the delivery of a range of other primary health services. Programmes and services vary according to local needs and funding arrangements and include: dental, social support and volunteer coordination, drug and alcohol treatment, mental health, youth services, disability services, rehabilitation services, medical, post acute care, home and community care, community rehabilitation and day centres. 
The size of individual CHS varies, with some operating from only one or two sites while others provide services from up to fifteen physical locations within a geographical area. The number and range of services and programs is also diverse and linked to specific community needs and expectations. Many CHS make available outreach programs where practitioners give care in the clients' home. The number of staff and the range of health and allied health professionals employed at each health service fluctuate between individual organisations.
The DHS Community Health Directory provides further information and contact details.
Clients
CHS aim to provide universal services while also targeting services to particularly disadvantaged populations with the poorest health outcomes and greatest economic and social needs. The majority of clients accessing CHS will be:
- Health Care Card holders
- People on low incomes
- Older persons
- Children
- Refugees and new arrivals
A high proportion of clients experience or are at risk of, chronic and complex conditions.
A high proportion of CHS clients compared to the population are Aboriginal and/or Torres Strait islander.
Funding
The Primary Health Funding Approach is the model used to fund service delivery organisations to provide allied health, counselling, nursing and health promotion services. The current funding model was revised in July 2007 to ensure in part that the funding allocation process is more transparent and equitable and to simplify administration. 
CHS have an annual total of approximately $400 million from multiple program areas. The Department of Human Services Community Health Program funds approximately 25 percent ($100 million) of the services provided by CHS: about $75million for direct services (counselling, allied health and nursing) and $30 million for health promotion. Other major sources of DHS funding include Home and Community Care (HACC), Dental Health, Disability Services, Drug Treatment Services, Mental Health, Primary Care Partnerships (PCP), Office of Children and Aged Care.
Useful information can be located at the following websites:
Home and Community Care
Primary Care Partnerships
