We support local areas to deliver innovative and timely support for people with complex support and coordination needs.
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People with complex needs often experience challenges having their needs met. They may benefit from support across multiple, interconnected services. The people who need this support may live with a combination of:
- mental health challenges
- harmful substance use
- behaviour that can lead to risk to self and others
- homelessness
- trauma
- disability.
About complex needs teams
There are 17 local areas in Victoria. Each local area has a complex needs coordinator. The coordinators are a single point of contact for anyone seeking information about complex needs responses.
A complex needs coordinator can:
- provide information and advice on how to support a person in a complex service situation
- explore other support options, including referrals for extra assessments or services
- help with case direction and decision making to deliver holistic care
- help to improve coordination of supports and services alongside National Disability Insurance Scheme (NDIS) funded support coordinators.
Complex needs coordinators provide time-limited services.
Alongside the coordinators, each local area has a collaborative, multi-disciplinary complex needs panel. The panels meet regularly to consider, and seek to resolve, individual client needs and systemic barriers to accessing services.
When to contact
Reach out to your local area complex needs team for:
- general information about complex needs services
- advice on eligibility criteria or to discuss a potential referral.
Find details for the central team and all local areas in the contact section.
Scope of services
The department’s complex needs response focuses on coordinating supports for people with complex needs. The responses and are not designed to replace existing supports.
Please contact other services for help with:
- direct client contact
- emergency or crisis support
- housing
- case management
- client debts.
Service provision framework
The Service Provision Framework: Complex Needs (August 2023) guides complex needs coordinators. The framework ensures consistent, current and high-quality delivery of complex needs services.
There are forms and templates that support the framework. Complex needs coordinators can provide these.
To learn more, download the Service Provision Framework: Complex Needs.
Complex needs responses
The department delivers several complex needs responses. These are:
- Complex needs consultation
- Support for High Risk Tenancies (SfHRT) program
- Multiple and Complex Needs Initiative (MACNI)
- Assertive Outreach and Support (AOS)
- broader complex needs responses.
Complex needs consultation
Care teams and professionals supporting people with complex support needs can use our consultation services. This service aims to enhance existing service systems and help people access support.
Around 90% of complex needs response clients per year receive consultation support.
Complex needs response consultations:
- facilitate assessments. For example, diagnoses to assist with access to or entry into service systems, or deliver risk assessment and management plans
- provide information and practice advice, system navigation and problem-solving support
- build capacity within existing service system
- time-limited coordination (under 4 hours per week).
Support for High Risk Tenancies
The Support for High Risk Tenancies (SfHRT) program strengthens the service system response to public housing tenants with complex needs.
Care teams and professionals supporting tenants in community housing can also access SfHRT consultation.
The program integrates and coordinates services needed to sustain at-risk tenancies. This includes providing advocacy, brokerage and consultation for clients via referrers. Brokerage is only available to public housing tenants.
SfHRT aims to:
- stabilise housing, health, social connection and safety issues
- provide a platform for long-term engagement in the service system
- develop a greater understanding of what high-risk tenants need
- explore service response options to promote learning and develop good practices
- identify gaps and service development opportunities
- develop strategic approaches to address gaps and improve service responses to tenants’ need.
For more information, download the Support for high risk tenancies fact sheet.
Multiple and Complex Needs Initiative
The Multiple and Complex Needs Initiative (MACNI) is a time-limited, specialist service for people 16 years and older who have multiple and complex needs.
This includes people with combinations of:
- mental illness
- substance abuse issues
- intellectual impairment
- acquired brain injury.
These individuals may pose a risk to either themselves, the community or both. Participating in MACNI is voluntary.
MACNI aims to improve coordination of supports and services to deliver a holistic response. This approach seeks to prevent further escalation of people’s needs. The program uses a person-centred, local solution approach for people with complex needs. External agencies deliver the care plan coordination of a MACNI response.
A complex needs coordinator can only consider MACNI after all other service options have been exhausted.
The MACNI is underpinned by the Human Services (Complex Needs) Act 2009. It's a shared service between the:
- Department of Families, Fairness and Housing
- Department of Justice and Community Safety.
For more information, download the Getting it together - A guide for individuals, carers and services on accessing the Multiple and Complex Needs Initiative (MACNI).
Assertive Outreach and Support
The Assertive Outreach and Support (AOS) program is for people with complex needs who experience significant service barriers and pose an unacceptable risk of harm to others.
After referral, the program links people to relevant support services as soon as possible. The AOS program is a short to medium-term response. It focuses on:
- assertive outreach delivery
- case management support.
Eligibility
A person needs to meet all criteria to be eligible for the AOS program. The person must:
- be 16 years and over
- appear to have complex functional needs. The source of these needs must link to mental illness, psychological distress, cognitive impairment, neurodiversity, substance use or trauma
- appear to pose an unacceptable risk of harm to others
- be experiencing significant service gaps. The current service system is not addressing their needs or reducing risk to community safety.
The program is not designed to replace existing mainstream or specialist supports. This includes services from the department or National Disability Insurance Scheme.
Please contact your local complex needs team for further information.