Public reporting on the Victorian Ombudsman investigation into the lockdown of 33 Alfred Street

Identify all sensitive and high-risk accommodation settings administered by the Victorian Government and invest in them to ensure appropriate COVID-19 outbreak prevention, preparation and response measures are in place.

The Victorian Government has provided significant resources and focus to the management of sensitive residential locations where the risk of COVID-19 transmission is considered to be higher due to shared facilities. 

The High-Risk Accommodation Response (HRAR) is the Department of Families, Fairness and Housing’s primary program to support sensitive residential locations where the risk of COVID-19 transmission is considered higher, including public housing estates. As at June 2021, this encompasses almost 30,000 properties, including 57 high-rise public housing towers, over 1,400 other public housing locations and 120 Supported Residential Services, as well as community housing residences, rooming houses, disability residential settings and caravan parks with long term residents.     

Prevention and preparation

The 2020-21 Victorian State Budget allocated more than $155 million for COVID-19 preparation and prevention measures, including through the HRAR program which is delivered in partnership with 24 community health providers across 31 local area catchments state-wide. 

The Department of Families, Fairness and Housing works directly with a Lead Provider in each catchment area to ensure that appropriate public health measures are in place at all times to protect the safety and wellbeing of residents across all in-scope settings, and that timely, culturally appropriate and accessible services are available to residents and facility managers. This includes access to health and social services, infection prevention control, cleaning, testing, food and essential supplies, and community engagement strategies. The Victorian Government’s continued commitment to this important work was demonstrated through an additional allocation of up to $152.9 million through the recent 2021-22 Victorian State Budget. 

The HRAR program is premised on genuine community engagement, working with residents who are best placed to identify, communicate, and manage the risks associated with the transmission of COVID-19 in their community. The approach seeks to empower residents to make informed public health-related decisions based on clear, accessible, culturally, linguistically, and religiously appropriate and authoritative public health and support service information.

Case Study: Public Housing High-Rise Estates

Prior to the community outbreak in North and West Melbourne in May 2021, the HRAR program was already working with residents and community groups to accelerate vaccination rates and boost the health of the broader tower communities. Residents and staff of high-rise and low-rise public housing, some community housing, sensitive accommodation settings with shared facilities (such as Supported Residential Services, rooming houses and crisis accommodation) are eligible for the COVID-19 vaccine. The availability of the COVID-19 vaccine is being promoted at public housing high-rise towers and connected estates across Melbourne, including information on the 49 open access state vaccination centres.

To support engagement, a tailored and inclusive approach is being taken to reach as many individuals and families in the most culturally appropriate way. This includes an on-site Health Concierge service (staffed to support a number of languages), resident forums (including language-based forums), dedicated communication channels established via WhatsApp, designated bi-cultural liaison officers, doorknocking, care pack distribution, community health nurses, text messages, supported vaccine bookings and translated public health information in relevant languages to top identified community languages at each estate.

In June 2021, vaccination clinics have been operating across the Fitzroy, North Melbourne, Flemington, Collingwood, Richmond, St Kilda, Carlton, Albert Park, Prahran, Kensington, South Melbourne and South Yarra estates, and follow up visits will occur at the appropriate time for second doses of vaccinations.

The HRAR program is premised on five key service pillars to support prevention, preparation and response across all 30,000 in-scope settings:

• Catchment planning: local area approaches to the planning, delivery and coordination of services
• Community engagement: engagement strategies to provide information about infection prevention and control, and to promote local social recovery activities
• Prevention and preparedness (including vaccination support): COVID-19 prevention and preparedness activities that align with Public Health messages (such as on-site vaccination programs) and implementation of “COVID safe” plans
• Active linkage to health and social supports: supporting access for residents to culturally appropriate support services (including health and social services, food and essential supplies) to meet their needs
• Outbreak support: public health care and outbreak response activities to protect health and wellbeing

Outbreak response measures

The Victorian Government has provided significant resources to support residents during an outbreak in residential locations where the risk of COVID-19 transmission is considered higher. This includes well developed emergency management structures and plans to manage a response should an outbreak occur. During the May 2021 Victorian community outbreak, which included exposure sites near to the Flemington and North Melbourne estates, the Department of Families, Fairness and Housing were able to put this planning in to place. The plans included:

• A coordinated multi-agency response 
• A focus on mitigating the risk of community transmission through targeted case management and contact tracing for residents who were close contacts and had visited exposure sites
• Supporting the provision of accessible testing being made widely available 
• Providing timely, relevant and accurate public information for residents, including community forums  
• Increasing engagement and supports for residents
• Providing access to supports people may need to isolate safely, such as food and material aid
• Increasing access to vaccinations. 

Although we recognise that each outbreak is different and requires a tailored approach, we are now able to leverage structures across public health, housing, community health, local government, and other partners to respond quickly to concerns about COVID-19 transmission.  For example, in the event of an outbreak, our HRAR Lead Providers work with Local Public Health Units (LPHUs) to deliver targeted in-reach and on-site testing, vaccination and ongoing prevention, preparedness and public health promotion activities. The LPHUs have been created to provide significant additional capacity in the event of health emergencies to strengthen the public health response and help the Department of Health engage with the community, enable better integration of care provision and public health functions, and improve the ability to respond to future public health needs.

Establish processes to regularly evaluate implementation and impact of these measures for the duration of the COVID-19 pandemic.

The Department of Families, Fairness and Housing is committed to continuous improvement and embedding lessons learnt into program design and enhancement. The High-Risk Accommodation Response (HRAR) program was developed based on lessons learnt from operations during the first and second wave of COVID-19 in 2020. The HRAR program adopts a service model that enables the rapid delivery of prevention, preparedness and outbreak response activities which continues to be refined based on achievements and lessons, community engagement and feedback, emerging priorities (including the COVID-19 vaccination roll-out) and an appreciation for the need to coordinate and consolidate approaches across a variety of settings.

Examples of improvements and developments include:

• A community engagement toolkit that was developed based on feedback from residents from North Melbourne and Flemington which is used by HRAR Lead Providers and built into the service specifications for HRAR (the service specifications are available at High-risk Accommodation Response Extension (Word)
• A robust governance structure, data and reporting framework is built into the service specifications for HRAR and this will provide an important input for future evaluations 
• Employment of health concierge services at high-rise towers to be on hand to respond to requests for at-home testing, support pop-up testing at public housing sites, and help disseminate key public health messages in a variety of community languages. The health concierges provide local intelligence and feedback to HRAR Lead Providers to allow local services to be continually improved
• The Victorian Healthcare Association (VHA) has been funded to facilitate a community of practice for the HRAR program lead providers. This enables lead providers to identify opportunities for collaboration and consistent implementation and sharing of best practice. The VHA has convened regular meetings that bring the Victorian Government and the sector together to share information and gain a collective understanding of project implementation, as well as providing an open forum to discuss and clarify key issues.

At 30 June 2021, there had not been any positive cases of COVID-19 in public housing high-rise since 27 October 2020, down from a peak of 326 cases on 18 July 2020. This is a remarkable achievement by residents and the community, supported by community healthcare providers and other services.  

In early 2021, a rapid review of the HRAR program was undertaken. The purpose of this review was to provide insight into the lessons learned, including successes, challenges and what could be improved. The rapid review included engagement with representatives from community health providers, local councils, Supported Residential Service proprietors and peak bodies. The review confirmed the value of the program, especially the focus on partnerships, engagement, and locating the strategy in a local community health context.

A formal evaluation of the HRAR program will be completed by the end of 2021. The evaluation will be further supported by independent research and will capture resident experience and views in the next phase of work. The Department of Families, Fairness and Housing will publicly release key findings from this evaluation by June 2022.

The following case study provides an example of how the HRAR program has worked effectively to manage outbreaks and prevent transmission of COVID-19:

Case Study

There were several positive outcomes and key lessons that resulted from supporting residents during a COVID-19 outbreak in late 2020 at a medium density community housing site. The site houses approximately 250 people, where many residents speak languages other than English.

92 per cent of these residents were tested over a four-day period. The approach included twice daily (10am and 3pm) visits to every household to encourage residents to access the supports that were available to enable them to stay safe and remain in place whilst testing was occurring across the site.

These visits focused on building trust and confidence with residents, the provision of information and support, the identification of needs and consistent messaging and communication about the outbreak. Integral to the success was ensuring that practical support was readily available to allow people to remain in place including culturally appropriate meals, fresh fruit and vegetables, nappies and formula and COVID-19 care packages.

Examples of continual improvements includes the focus on effective governance. A Strategic Advisory Group to inform ongoing monitoring and improvement has been established for the HRAR program. The group includes key HRAR provider representatives and connected agencies, such as Access Health, cohealth, Scope and the Victorian Multicultural Commission. Work is also underway to form representative groups of residents to provide valuable ongoing feedback and local intelligence.

As part of the HRAR program, Lead Providers (community health providers) are required to report monthly on program objectives and the impact of activities undertaken, as well as reporting on catchment planning and overall risk ratings for locations within a catchment area.

Post-outbreak reviews and debriefs also occur following any community outbreaks and/or outbreaks in HRAR settings to identify lessons and areas for improvement.

Develop and implement local guidelines, procedures and training relating to exercise of the emergency detention power identified in section 200(1)(a) of the Public Health and Wellbeing Act 2008 (Vic) in response to an outbreak of an infectious disease, addressing, at a minimum:

1. the circumstances in which it may be appropriate to detain a person during a public health emergency 
2. considerations informing use of the power, including the need to respect and protect the health and wellbeing of those being detained 
3. legislative safeguards relating to use of the power, specifying, wherever possible, measures to be adopted to ensure compliance with these safeguards 
4. obligations arising under the Charter of Human Rights and Responsibilities Act 2006 (Vic). 

Department of Health Authorised Officers undertake a mandatory training program prior to being placed in accommodation settings that includes detention powers under the Public Health and Wellbeing Act 2008 (Vic) and the obligations under the Charter of Human Rights and Responsibilities Act 2006 (Vic). This training is regularly reviewed to ensure alignment with current operational procedures. The Legal Services Branch has supported this work by preparing guidance materials for Authorised Officers to refer to in considering the obligations arising under the Charter of Human Rights and Responsibilities Act 2006 (Vic).

An updated Guidance Note has been developed by the Department of Health to support Authorised Officers in making a decision to detain (under s 200(1)(a) of the Public Health and Wellbeing Act 2008 (Vic)) and issuing Detention Notices, which includes legal, public health and Charter of Human Rights advice. The Guidance Note also provides advice on several other possible ‘decisions’ under the Detention Notice.

This Guidance Note has been shared with the COVID-19 Quarantine Victoria (CQV) for development of similar Guidance Notes for CQV Authorised Officers.

The Department of Health is also responsible for administering the legislated detention review scheme for the review of Authorised Officers’ decisions to detain. A Guidance Note has also been developed to support detention reviews. This Guidance Note also includes legal, public health and Human Rights Charter advice and is provided to detention review officers in addition to training.

Consider measures to improve DHHS’s capability to perform health emergency management functions, including by: 

1. appointing or investing in staff with relevant emergency management expertise 
2. clarifying and enhancing surge capacity arrangements for health emergencies 
3. reinforcing partnerships with relevant service providers in support of emergency preparedness, response and recovery activities.

The Department of Health has developed new guidelines, training and procedures to support and incorporate emergency management expertise into staff training modules.

A comprehensive training program has been implemented for the upskilling of departmental staff and external staff employed in a temporary capacity. The program features foundational training in emergency management, advanced emergency leadership training, emergency exercise development principles and quality debriefing and learning processes. This program was delivered in a rapidly evolving emergency response and relief environment (including adjusting to virtual events and associated training).
 
Since the Machinery of Government change in February 2021, both the Department of Health and the Department of Families, Fairness and Housing have revised procedures and associated training and exercises to reflect the focus of each department.

The Department of Health has also increased its COVID-19 public communications and engagement capability to engage directly with the community, including culturally and linguistically diverse communities. Campaigns through media, social media and other digital channels have included promoting worker support payments, testing, vaccines, and essential public health messaging.

Surge capacity for health emergencies has increased significantly by the introduction of Local Public Health Units (LPHUs). The LPHUs strengthen the public health response to COVID-19 by engaging directly with the community, enabling better integration of care provision and public health functions, and improving the ability to respond to future public health needs.

The Department of Families, Fairness and Housing has reinforced partnerships with relevant service providers in support of emergency preparedness, response and recovery activity. As part of the High Risk Accommodation Response (HRAR) program, the Department of Families, Fairness and Housing established Catchment Leadership Groups across the state to provide a local area approach for the delivery of services, with delineated roles and responsibilities between agencies and government bodies involved in service delivery and governance of the HRAR program.

Catchment Leadership Groups consist of a range of stakeholders, including:

• Lead Community Health Providers
• Victorian Government representatives
• LPHUs and associated health partnerships
• Identified community leaders
• Local Government
• Local health and community services
• Disability providers and local Commonwealth Disability Liaison Officers
• Culturally and Linguistically Diverse (CALD) representative organisations
• Aboriginal and Torres Strait Islander representative organisations.

Additionally, Health Concierge teams have been established at most high-rise towers. They assist residents in accessing information in many languages, linking them to community-based health professionals and providing support services if needed. Residents and community members have been hired as part of Health Concierge and community engagement.

The Department of Families, Fairness and Housing continues to engage with key peak bodies to assist with preparedness, engagement, sharing of critical information and compliance activities. These bodies include National Disability Services (NDS), Community Housing Industry Association (CHIA), Consumer Affairs Victoria (CAV) and Municipal Association of Victoria (MAV) among others.

Dedicated funding has been provided for local government and community organisations to support people to isolate safely when they test positive to COVID-19, are close contacts or are awaiting test results and are required to isolate (in the community) until the results are known.

This includes:

• Emergency relief packs provided by Australian Red Cross     
• Funding for councils to provide enhanced COVID-19 isolation support which can include coordinating the provision of culturally appropriate food and other supports
• Funding via the Urgent Response Community Engagement Brokerage Fund for Outbreak Response to assist local health organisations, community organisations and local leaders in delivering an effective COVID-19 response during an outbreak, including increased testing and effective isolation supports
• Grants funded via the CALD Communities Taskforce for community organisations to deliver critical supports for Victoria’s multicultural communities (including emergency relief and outreach supports)
• Support to culturally and linguistically diverse families through the Family Recovery Program which provides case management support to overcome COVID-19 related interruptions to employment, education, and mental health.

The Department of Families, Fairness and Housing is also committed to developing a Shared Responsibility Framework in response to previous reviews undertaken by the Inspector-General for Emergency Management. The Framework will provide guiding principles and outline shared responsibilities to support people most at risk in emergencies in Victoria and identify future priority areas of effort.

Develop and publish information clarifying the process for making complaints under section 185(1) of the Public Health and Wellbeing Act 2008 (Vic), including specific information for people seeking to complain about the exercise of emergency powers during the COVID-19 pandemic.

As of 26 April 2021, the Department of Health has appointed Detention Review Officers, to coincide with the commencement of recent amendments to the Public Health and Wellbeing Act 2008 (Vic) (PHW Act) that introduced a new Detention Review process.

This process ensures that people who have been detained under COVID-19 emergency powers can seek a formal review from an experienced lawyer as to whether the Authorised Officer has appropriately issued a detention notice under the PHW Act or whether the Chief Health Officer should consider the Authorised Officer's decision further.

In accordance with the legislation, the process aims to provide timely and accountable outcomes for the applicant. The process is designed to ensure applicants have an initial decision within 24 hours if the Authorised Officer's decision is affirmed or up to 48 hours if the Chief Health Officer must consider the matter further. Reasons for the decision are provided to the Applicant in either case.

The Detention Review process is now live and can be accessed at the coronavirus website.

The Department of Health Detention Notices have been updated and now contain specific reference to the ability to make a complaint to the Secretary to the Department of Health under section 185 of the PHW Act in relation to an Authorised Officer’s exercise of health emergency powers and the process for doing so, and the Detention Review process as described above.

In consultation with the Victoria Multicultural Commission, work with community leaders and public housing residents to strengthen trust and engagement, and develop and implement measures to: 

1. establish avenues for improving the accuracy of public housing records maintained by the Housing Division, including primary/ preferred language and country of-origin data 
2. improve understanding of the needs and preferences of culturally and linguistically diverse people living in public housing 
3. establish and maintain partnerships with community leaders and residents to support timely communication with people living in public housing
4. increase participation of multicultural communities in policy, planning and project activities relating to public housing.

We are listening to public and social housing residents across the state to implement new initiatives and programs in response to feedback, but we acknowledge that ongoing work and engagement is critical to sustain trust and engagement.

An immediate step to improve accuracy of resident information held by the Department of Families, Fairness and Housing is the enhanced Housing Victoria Online Services (HVOS) platform which allows residents to update their own personal details (including primary language, country of origin, preferred contact methods, interpreter needs and Aboriginal or Torres Strait Islander identification).

Any changes made by public housing residents via HVOS directly updates the Department of Families, Fairness and Housing’s housing database that is used by departmental staff to inform services and operations. Departmental staff working with residents are also able to update details in response to engagements with residents and will undertake a ‘blitz’ in July 2021 to update records and inform residents of the ability to manage their own records.

The Victorian Government invested $7.5 million in 2020-21 and a further $6.5 million in the 2021-2022 Victorian State Budget to fund the Paving the Way Forward program to improve health and safety outcomes and increased local employment and training opportunities for residents. New ways of working with residents are being developed, drawing on the intensive engagement with the North Melbourne and Flemington communities from July 2020, as well as new initiatives currently being trialled at South Melbourne and North Richmond estates with residents working alongside the Department of Families, Fairness and Housing and community stakeholders. The ‘My Home, My Neighbourhood and My Services’ objectives of the trial are focused on:

• Building the structures and opportunities for residents to have a voice about issues that matter to them
• Working with residents, services and organisations to improve community connection, health, wellbeing, education, employment and justice outcomes
• Working with tenancy and property services to better respond to resident, property and community needs.

This enhanced foundation of community engagement provides a unique opportunity to address the broader systemic issues that communities in these estates experience and build lasting change across the public housing system. Paving the Way Forward was a specific program launched at the North Melbourne and Flemington estates as part of the recovery from the 2020 pandemic. Lessons are being shared and, where relevant, implemented in all estates across Victoria.  The team continues to work with the North Melbourne and Flemington residents on the preferred communication channels, ensuring mediums are appropriate. This has also included a series of tailored conversations with a focus on a range of resident groups, including cultural groups such as Vietnamese speakers at both estates.

Through the Paving the Way Forward program, the Department of Families, Fairness and Housing has built on the strong relationships developed with community leaders and residents to ensure timely communication around the latest COVID-19 health advice and housing issues. 

The Paving the Way Forward program produces a fortnightly newsletter for residents to keep them informed of program developments. This newsletter was first produced and distributed to residents during the July 2020 COVID-19 lockdown. During the recent May-June 2021 COVID-19 restrictions, the newsletter was produced daily (Monday to Friday) and a series of resident focused virtual conversations occurred, centred on COVID-19 safety and vaccination.

Regular virtual conversations with community leaders are also held to communicate the latest health advice and collect feedback from residents about their concerns, including a recent forum at the North Melbourne and Flemington estates to discuss the status of cleaning. The Department of Families, Fairness and Housing is actively monitoring standards and quality of cleaning in all public housing buildings and providing transparency to residents through cleaning logs in tower foyers so they can monitor when cleaning has taken place. 

In August 2020, the Victorian Government created the Culturally and Linguistically Diverse (CALD) Communities Taskforce, which has progressed work to enhance engagement with CALD communities, as well as partnering with community organisations to provide direct support to community members. The Taskforce has included consideration of the unique needs of Victorians in public housing, and how they can be supported in the COVID-19 pandemic and recovery. The CALD Communities Taskforce Priority Response for Multicultural Communities (PRMC) grants program has also been established to fund community organisations to deliver critical supports for Victoria’s multicultural communities including emergency relief, outreach supports, health literacy and education activities, delivery of vaccination-related activities and information, and projects supporting social and economic recovery. While this grants program is not specifically targeted to public housing communities, community organisations working in areas where there are CALD communities in public housing may have provided support.

Consider other measures to improve relationships between DHHS and residents of the Flemington and North Melbourne public housing estates, including:

1. forming one or more tenant representative bodies
2. further opportunities for remunerated employment or workplace learning within the Victorian Government that could be made available to residents during and beyond the COVID-19 pandemic
3. identifying opportunities to expand the community engagement model adopted during the lockdown to broader departmental activities.

The decision to place these estates into lockdown was a difficult one and we recognise that it was a very challenging time for residents. The Department of Families, Fairness and Housing was - and is - listening and acting on resident feedback on the ground. The Paving the Way Forward program builds on the Department of Families, Fairness and Housing’s intensive engagement with residents during the COVID-19 emergency at the North Melbourne and Flemington public housing estates in 2020 and expands this engagement across all estates to drive system wide future reform.

Residents’ voice and experiences, as identified through community engagement and formal governance mechanisms, are a central tenet of the Paving the Way Forward program. To date, community engagement activities at North Melbourne and Flemington have included fortnightly community pop-up conversations at each tower, themed ‘deep dives’ with residents around issues such as mental health, amenity, employment, health and security, and co-design workshops.

Residents are also kept informed of program developments through a fortnightly newsletter (established during the hard lockdown) which is being maintained, as well as dedicated WhatsApp channels that have been established for more immediate information sharing and in preparation for situations requiring time-critical updates such as during a community outbreak.

Most recently, a virtual Community Forum was held on 6 June 2021 with interested residents of the Flemington and North Melbourne estates to discuss a range of issues related to COVID-19 including current community outbreaks, resident safety and measures put into place under the HRAR program to support prevention, and outbreak preparedness and response.

As part of the $6.5 million investment into the Paving the Way Forward program in the 2021-22 Victorian State Budget, $2.4 million of this investment will be focused on supporting the residents of the North Melbourne and Flemington estates through enhanced engagement and partnerships to improve health, social and economic outcomes.

New representative bodies will be set up to support enhanced housing services that meet resident needs and improve outcomes. Resident action groups will work with the on-site Paving the Way Forward team and design and implement Local Action Plans for each estate focused on community capacity building activities and housing amenity. Residents will be invited to participate in the action groups via an expression of interest in late June 2021.

The resident advisory committee will help with the design and establishment of a new residents committee in late 2021 that will provide input into decision making on the estate with representation for each tower.

A focus on improved training and local employment opportunities has already seen over 40 jobs created for public housing residents since the COVID-19 emergency. Residents have been employed through the COVID-19 Rent Relief Grant Program, the cohealth Concierge Program and directly through the Department of Families, Fairness and Housing’s Youth Employment Program and the Paving the Way Forward program. The Paving the Way Forward program is currently finalising an expression of interest process for a community partner to work in the team. As part of this process community partners are strongly encouraged to consider employment opportunities for residents in their own teams.

The Paving the Way Forward program is also working closely with the Department of Jobs, Precincts and Regions to ensure funded employment programs support residents to become job ready and are targeted to residents’ needs, and is considering other approaches to improving outcomes from the Public Tenant Employment Program.