Service Coordination for
Aboriginal Clients
Graeme Fletcher – Team Leader, Supporting Primary Health
Public Health & Research Unit
VACCHO
Victorian Aboriginal Community Controlled Health Organisation
VACCHO
Who are we?
• VACCHO represents a collective of 24 Aboriginal
Community Controlled Health Organisations (ACCHOs)
around Victoria.
ACCHOs
• Multi-functional community organisations with health
as a key part of their responsibility; some members are
groups that offer full health services.
National representation
• Every state and territory has a similar representative
and advocacy organisation; and together we form the
National Aboriginal Community Controlled Health
Organisation (NACCHO).
What we do for our Members:
• Develop policy
• Provide support and advice
• Education & training
• Assist with strategic planning
What we do on behalf of our Members:
• Identify state wide health needs
• Advocacy
• Auspice state wide health projects
• Initiate approaches to government and mainstream
agencies around Aboriginal health issues
• Negotiate with the State and Federal governments
• Put together responses to issues and write submissions
Myths about VACCHO
VACCHO is a funding body
VACCHO runs health services
VACCHO gets involved in internal politics
Some current initiatives
designed to improve or
enhance service coordination:
• Aboriginal Health Promotion & Chronic
Conditions Program (AHPACC) – DoH
• Strengthening Primary Health Care (SPHC)
– DoH
• Improving Care for Aboriginal Patients
(ICAP) – DoH
• Other initiatives aimed at improving
linkages: AHWs, IOWs, etc (State and
Federal funding)
AHPACC Program
Aboriginal Health Promotion & Chronic Care
AHPACC involves Aboriginal Community Controlled
Health Organisations & Community Health Services
working in partnership to:
• Strengthen relationships between ACCHO's & CHS’s
• Increase access to health promotion and chronic disease
management services
• Increase capacity of the Aboriginal workforce
• Improve health outcomes and prevent hospital
admissions
AHPACC in Yarra
North Yarra Community Health Service
(from report presented at VACCHO AHPACC Forum in April 2010:
NYCH AHPACC activities include:
•
A drop in clinic (9-12 am on Monday morning except public holidays)
•
Programs related to homelessness, drug and alcohol and working in with the
Department of Justice
•
The Billabong BBQ every Tuesday morning provides an opportunity to offer a range
of outreach services and a large proportion of the attendees have chronic illness
(e.g. VAHS GP attends to give flu shots, optometrist)
•
Dental service at NYCH
•
Theatre performances with health promotion messages
•
Acknowledgement signs have been installed at NYCH sites
•
A memorial breakfast is held each 2nd Tuesday in November, commemorating
“Parkies” who have passed away
•
Successful Cultural Awareness training completed at North Yarra
•
Completed the entire cultural audit – invited Team Leaders and CEO to lead the
process (currently doing a review)
•
Close links have been established with MAYSAR (Melbourne Aboriginal Youth Sport
and Recreation), Maya Healing Centre, Collingwood Football Club.
•
Dental van goes to Swan Hill
AHPACC Challenges
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Accountability
Workforce issues
Community engagement
Integration
Measuring Outcomes
 AHPACC program review
Strengthening Primary Health
Care (VAHS pilot)
Objectives
•
Increase the use of Medicare items for health assessments and
chronic disease management
•
Increase the use of standardised chronic disease management
best practice guidelines for Aboriginal clients
•
Increase integrated care across services and providers, through
increased use of coordinated care plans
•
Increase recalls/reminders for Aboriginal clients for health
assessments, screening, and ongoing care
•
Increase appropriate referral of Aboriginal clients across primary
and specialist health care services
•
Increase processes to support coordinated discharge planning
for Aboriginal clients
•
Increase access to culturally safe primary and specialist health
care services for Aboriginal client
ICAP
Why AHLOs? - The role of AHLOs
“Aboriginal health workers are so important because a blackfella will go to a
blackfella when they won’t go to a whitefella”
NHHRC, 2009
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Cultural interface
Social and cultural support
Cultural education
Relationship building
Links to resources, networks and events
Over 70% of Aboriginal patient admissions
occur at hospitals with AHLOs
ICAP
• Improving identification (signage, posters,
brochures)
• Discharge planning tool(s)
• Environment and access – artwork etc
• Establishing Aboriginal Advisory
Committees
• Community engagement
ICAP Challenges
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•
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Accountability
Workforce issues
Community engagement
Integration
Measuring Outcomes
 ICAP/KMHLO program review
Close the Gap
• Closing the Health Gap Regional
Advisory Committees established
• Regional Closing the Gap
Implementation Plans
PRIORITIES:
• Tackling smoking
• Primary health care services that can deliver
• Fixing the gaps and improving the patient journey
• Healthy transition to adulthood
• Making Indigenous health everyone’s business
Closing the Gap
• Healthy Lifestyle Workers will be
trained and employed to reinforce
local community campaigns and
provide targeted education, support
and guidance for families and
individuals with or at risk of chronic
illness to adopt healthier lifestyles
eg healthy diets and exercise and
added support to quit smoking.
Closing the Gap
Improving chronic disease management and follow-up care
A key focus of the package is on improving the detection and
management of chronic disease and addressing known barriers to
accessing health care. This will be achieved through an integrated
suite of reforms to existing programs, supported by new initiatives, as
outlined below.
New financial incentives
- via the Practice Incentives Program (PIP)
- will support accredited general practices and Aboriginal Medical
Services to provide better health care for Indigenous
Australians, including best practice management of chronic
disease.
Closing the Gap
• The PIP Indigenous Health Incentive will include:
-
A one-off payment to practices that agree to undertake
certain activities to improve the provision of care to their
Indigenous patients;
An annual payment to practices for each Indigenous
patient registered with the practice for chronic disease
management for a 12 month period; and
An annual payment to practices for each registered
patient for whom a target level of care is provided by the
practice in a 12 month period.
Practices participating in this incentive will be able to refer
those Indigenous patients identified as needing more
complex chronic disease management for care
coordination. They will also be able to access
Pharmaceutical Benefit Scheme (PBS) co-payment relief
for their Indigenous patients through the package.
Aboriginal Outreach Workers
• The Government is funding local Indigenous people to work
as Aboriginal and Torres Strait Islander Outreach Workers in
Indigenous health organisations. Aboriginal and Torres Strait
Islander Outreach Workers will encourage and support
Indigenous people to access primary healthcare services
and to ensure follow-up treatment is accessed. This may
include assisting people to travel to and from appointments.
• Aboriginal and Torres Strait Islander Outreach Workers will
be employed through selected Indigenous health
organisations to help Aboriginal and Torres Strait Islander
Australians who do not currently access health care, to do
so.
• Aboriginal and Torres Strait Islander Outreach Workers will
also help with access to follow-up treatment.