Resource allocation for community-based therapy

Adequate and equitable resourcing of services for children with disabilities and their families is a challenge that is faced by agencies as the growth in client numbers outstrips any increase in available funding. While funding models have been developed within the acute health care and education sectors, there have been few attempts to develop funding models for therapy (occupational therapy, physiotherapy, psychology, and speech pathology) provided within community-based, paediatric disability services. This paper outlines a model for allocating staff resources to provide therapy services for children with physical disabilities based on a project conducted by Novita Children's Services (formerly the Crippled Children's Association of South Australia, Inc.).

Services were mapped using a framework based on the International Classification of Function developed by the World Health Organization and adopted by the Australian Institute of Health and Welfare. An action research methodology was employed that included focus groups held with staff to identify potential resource drivers; collection of travel time data, client caseload numbers; and developing profiles of services and client groups. A model for allocating staff time was developed to reflect the differing service demands, travel time, leave allowances and time for activities to develop the social environment for individuals with disabilities.

Analysis indicated that the drivers of staff resources were the type of service delivery (early intervention versus school aged services), model specific (e.g., time required to provide community-based services and work within multi-disciplinary teams), and specific client (need for complex technology or equipment; school/preschool transition times; high health care needs due to dysphagia, deteriorating conditions with changing needs, or post surgery/medication rehabilitation) and family well-being issues. While further data collection and refinement of the model is needed, it provides the organization with more objective and equitable resource allocation and enables improved advocacy for client needs.