AHCSA Board of Directors
Pika Wiya Health Service Aboriginal The organisation has grown from a welfare agency with three employees to a multi-faceted community controlled Corporation organisation with over 70 staff who deliver a diverse range Established as Pika Wiya Health Services Inc. in the of health care and community support services. early 1970s to provide a medical service to the Aboriginal population in Port Augusta and Davenport, the organisation Nunyara Aboriginal Health Service Inc. was incorporated in 1984 under the SA Health Commission Prior to 2003, there were only two Aboriginal Health Workers (now Country Health SA Local Health Network Inc.). in Whyalla. Due to access and equity issues raised in 1996 On 1 July 2011, the service transitioned to Aboriginal and the overall appalling state of health in the broader community control under the CATSI Act. Aboriginal community, Nunyara Wellbeing Centre was established. Now known as Pika Wiya Health Service Aboriginal Corporation, the organisation operates from premises Nunyara integrates Indigenous holistic models of health in Port Augusta and also has clinics at Davenport, Copley care with western models, so that the benefits of both may and Nepabunna communities as well as provides services assist the community. The organisation recognises the wide to the communities of Quorn, Hawker, Marree, Lyndhurst range of factors that impact on wellbeing including poverty, and Beltana. relationships and the environment, and is working to strengthen the community’s capacity to manage their Nganampa Health Council health and wellbeing more effectively.
Established in 1983, Nganampa Health Council is an The Nunyara Wellbeing Centre Inc. changed their name Aboriginal owned and controlled health service operating to the Nunyara Aboriginal Health Service in this financial on the Anangu Pitjantjatjara Yankunytjatjara Lands in the year. far north west of South Australia. Covering more than 105,000 square kilometres, Nganampa Health operates nine clinics, a 16 bed aged care respite facility and assorted Tullawon Health Service Inc. health related programs including aged care, sexual health, Established in 1982 as the Yalata Maralinga Health Service environmental health, health worker training, dental, women’s Inc. (YMHS) following community initiative and lobbying, health, male health, children’s health and substance abuse the health service was not only concerned with looking prevention. after people living in Yalata but also older people who had The main clinics are located at Iwantja (Indulkana), Mimili, returned to their traditional lands in the north and at Oak Fregon, Pukatja (Ernabella), Amata, and Pipalyatjara while Valley, north west of Maralinga. smaller clinics are located at Yunyarinyi (Kenmore Park), By the late 1990s, Oak Valley was ready to establish its Nyapari and Watarru. The aged care respite facility is own health service called Oak Valley (Maralinga) Health located at Pukatja and administration offices at Umuwa Service (OV(M)) based on two principles that the Anangu and Alice Springs. people of Yalata and Oak Valley are one people, and both YMHS and OV(M) should have cooperative and ‘seamless’ Port Lincoln Aboriginal Health Service Inc. arrangements for Anangu between the services.
The Port Lincoln Aboriginal Health Service (PLAHS) was On 31 May 2001, the YMHS Constitution was amended founded by the local Aboriginal community in 1992, with and the name of the organisation changed to Tullawon the assistance of the Aboriginal and Torres Strait Islander Health Service Inc. with the importance of the two Commission and the South Australian Health Commission principles remaining in the Constitution. through the National Aboriginal Health Strategy. The establishment of the service resulted from a number of reports and submissions put to both the Commonwealth Umoona Tjutagku Health Service Aboriginal and State Government from the mid 1980s onwards. Corporation Nunkuwarrin Yunti of South Australia Inc. Umoona Tjutagku Health Service Aboriginal Corporation (UTHSAC) provides primary health care services to Nunkuwarrin Yunti was initiated in the 1960s by the late Aboriginal people in and around Coober Pedy and also Mrs Gladys Elphick, who founded the Council of Aboriginal auspices the Dunjiba Substance Misuse Program in Women of SA, one of the first Aboriginal organisations in Oodnadatta. South Australia. Established in 2005, UTHSAC has expanded steadily over Incorporated in 1971, Nunkuwarrin Yunti evolved from the past seven and a half years to provide a comprehensive the Aboriginal Cultural Centre, the Aboriginal Community range of high quality services including medical, dental and Centre of South Australia, and the Aboriginal Community social services for the community as well as an increasing Recreation and Health Services Centre of South Australia, number of transient clients. and became known as Nunkuwarrin Yunti of South Australia Inc. in 1994. In 1998, Nunkuwarrin Yunti was awarded NAIDOC Organisation of the Year in South Australia.
Pg 3 Aboriginal Sobriety Group Inc. Pangula Mannamurna Inc. The Aboriginal Sobriety Group Inc. (ASG) has been operating Pangula Mannamurna was established from the South since 1973 when it commenced as a voluntary self-help East Aboriginal Partnership which comprised members group for people wanting to regain their sobriety. from the SE Nungas Club and community members whose focus was to form a ‘one stop shop’ for Aboriginal people Today, ASG provides a complete alcohol and drug in the south east. substance misuse recovery pathway including Crisis Intervention - Mobile Assistance Patrol; Substance Misuse The organisation strives to build on the vision of the Team - establishes clients’ needs and provides referrals; founding members who wanted to create a place for Stabilisation - short-term assistance through hostels and Aboriginal people to access health and wellbeing services, the Health and Fitness Centre and referrals for rehabilitation; gather to discuss and address community identified issues, and Rehabilitation - long-term holistic program provided and to be a place to celebrate achievements and culture. by Lakalinjeri Tumbetin Waal. Ceduna Koonibba Aboriginal Health Service Kalparrin Community Inc. Aboriginal Corporation Kalparrin is a Ngarrindjeri word meaning ‘helping with a First established as the Ceduna Koonibba Aboriginal heavy load’. The organisation was established in 1975 by Health Service, the organisation was designed to meet a group of Elders who were looking for something better the health needs of Aboriginal people within the Ceduna in their lives besides alcohol and other drugs. district of South Australia including Scotdesco, Koonibba, Situated on a property 8kms east of Murray Bridge, some Tia Tuckia, Munda and Wanna Mar homelands. of the programs and services offered are Substance Use Incorporated in 1986 under the SAHC Act, on 1 July 2011 Recovery Program, Bringing Them Home Program, Mobile the organisation transitioned from the SA Government Assistance Patrol, Spirited Men’s Program, and Community to Aboriginal community control and became known as & Housing Services. Ceduna Koonibba Aboriginal Health Service Aboriginal Corporation. Oak Valley Health Service Oak Valley Health Service was established in 1985 as Aboriginal Health Advisory Committees a community outstation for Anangu people displaced • South East AHAC from the Maralinga Lands for the British atomic tests. Oak Valley (Maralinga) Inc. managed the establishment • Riverland AHAIG of the community including housing, roads and other infrastructure. Now serviced with a store, mechanics • Mid North AHAC garage, health clinic, aged care centre, a new school and an airstrip, a CDEP program and arts workshop • Wakefield AHAC is also available. • Eyre AHAC The health clinic provides primary health care to the community, monitoring ongoing health issues such as • Northern AHAC diabetes, hypertension, ante-natal and post-natal care, • Moorundie AHAC child and school health. Their main role is health education, hosting visiting specialists and referrals for the Royal Flying Doctor Service (RFDS).
Annual Report 2012-2013 | Pg 4 Chairperson’s Report
The Aboriginal Health Council of SA Inc. (AHCSA) was At an organisational level, I was involved with development fortunate to have had two Chairpersons in the 2012-2013 of the AHCSA Strategic Plan; undertook training with financial year, both of whom brought leadership and AHCSA’s Registered Training Organisation (RTO); consulted guidance to the organisation whilst continuing to support with RTO Manager Stan Butler; continued the relationship the communities and organisations they represent. between AHCSA and the Aboriginal and Torres Strait Islander Health Registered Training Organisation National Yvonne Buza Network (ATSIHRTONN); and held discussions with various 1 July 2012 to December 2012 positions such as the Workforce Issues Project Officer. The business of Aboriginal health continues to thrive and There were two highlights early in the financial year. grow for South Australia and it has been very important The first being the inaugural AHCSA NAIDOC Open for AHCSA to be driving this agenda, both in planning Day for which I was on the Organising Committee and and discussions, to ensure our sector and members are participated in the program. Many people attended the included in the process of meaningful engagement. event at which the proposed NAIDOC Awards for future NAIDOC Open Days was announced. The second Through the Board, we advocated at the national, state highlight was the inaugural NAIDOC celebrations in my and community levels on a regular basis. As AHCSA own community at Roxby Downs. Chairperson and Board Member of the National Aboriginal Community Controlled Health Organisation (NACCHO), As this is my final report as Chairperson, I would like to I attended various forums including the NACCHO Board particularly acknowledge my fellow Board Members, key of Management Anti-Tobacco Focus and the Governance stakeholders and funding bodies for the support provided Sector Network meetings. to AHCSA. In handing over, I wish the new Chairperson every success with continuing AHCSA’s business as the At a state level, I attended regular meetings with the state peak body for Aboriginal health. Minister for Health and Ageing John Hill along with AHCSA Chief Executive Officer Mary Buckskin, Deputy Chief Executive Officer Shane Mohor and Public Health Medical Officer David Scrimgeour. These meetings have always provided an opportunity to raise issues and ask the difficult questions that affect our communities as the Chief Executives of the Department for Health and Ageing and Country Health SA Local Health Network Inc. attend as well. AHCSA valued these meetings and the relationship with Minister Hill, and wish him the best of luck with his future endeavours. We hope to continue to build a strong relationship with the new Minister for Health and Ageing Jack Snelling.
I provided advocacy and support to our members at various levels with key stakeholders and partners such as the SA Aboriginal Health Partnership (SAAHP) and the SA Council of Social Services (SACOSS) – Grief and Loss. I also provided support to Kalparrin; attended SA State Safety and Quality Commission meetings; participated on the Country Health SA Local Health Network Inc. (CHSALHN) Aboriginal Health Forum as well as the SA Ethics Committee; and continued discussions with Medicare Locals, CHSALHN regarding AHAC Incorporations, and CEA about corporate governance.
Pg 5 John Singer the pleasure of having our full Board of Management meeting in Port Lincoln to coincide with the community’s December 2012 to 30 June 2013 celebrations. Since the Annual General Meeting (AGM) in December, AHCSA had a quiet period over January and February, Also congratulations to Nganampa Health Council. We will however, the next eight months were very busy whilst we celebrate our 30 year anniversary in the first half of next reacquainted to the important and urgent priorities around year and will acknowledge the work done over many years Aboriginal health in South Australia. The upcoming federal by our staff across our region. election also made this year busy at the NACCHO level At the national level, NACCHO and its members, with the with three major events planned. support of Affiliates, have organised a Chief Executive Uncertainty around the future of Aboriginal Health Advisory Officer breakfast at Parliament House and workshop, the Committee (AHAC) members was a priority this year. Whilst inaugural Ochre Day Male Health Day, and the Health the focus on internal governance for our members is new, Summit in Adelaide. These three initiatives, leading into with long term support hopefully we can provide governance the federal election, will put NACCHO and its members on tools that assist our boards and senior management to make the ‘front foot’ in putting a positive plan on the table and sure we are at the cutting edge of health in this state. providing effective policy advice on how our members can and are already running high quality health programs. Members and AHCSA also completed risk assessment and compliance requirements this year which involved A lot of our focus in South Australia next year will be the additional work for staff but now allows us to put pressure state election which will be held in early March. We will be on other non-government organisations and mainstream talking with all sides of politics to make sure we are telling services around accountability and to question government government that we are the key independent organisation whether it’s a better choice to invest their dollars in to provide direction on Aboriginal health. Aboriginal Community Controlled Health Organisations I look forward to raising issues on behalf of members (ACCHOs). when requested and will hopefully have the opportunity ACCHOs in South Australia employ the right staff with the to visit all member services to hear what is happening on skills to make sure all requirements are met and combine the ground and get direction and innovative ways to tackle clinical knowledge along with senior administration our health issues. experience to keep lobbying and making sure we develop In closing, I wish to thank all our board members, their our organisations and build on current and long term staff and the staff at AHCSA. With our key partners, we successes. can continue to improve Aboriginal health across South Congratulations to the Port Lincoln Aboriginal Health Australia and lead the way around how we deliver Service (PLAHS) which will celebrate 20 years of service culturally appropriate programs which provide evidence early in the new year. We have always had a strong that we are ‘closing the gap’ and challenge mainstream presence and representation from PLAHS and will have or other non-government organisations to do better!
Annual Report 2012-2013 | Pg 6 Chief Executive Officer’s Report
This year has been very busy and I’d like to acknowledge Governance support and capacity development continues the hard work and commitment of AHCSA staff and the to be a major focus for both AHCSA and our members Board whose commitment and passion never ceases to with the AHCSA Board undertaking some training during amaze me. The program reports will again provide just the year. We also supported a number of services with a small snapshot of the range of work we are involved in. their AGMs and this was well received by our members.
We started this financial year with the inaugural AHCSA AHCSA is well into the accreditation process and has NAIDOC Open Day welcoming family, friends and partners successfully completed the Risk Assessment for the Office into the organisation to celebrate NAIDOC Week 2012 - for Aboriginal and Torres Strait Islander Health (OATSIH) Spirit of the Tent Embassy: 40 years on. Over 100 people with the combined effort of both Board and staff. toured AHCSA’s premises starting with the training room where they had a blood sugar and blood pressure check We continue to meet regularly with funding bodies and other and ending in the meeting room where they marked their partners including universities and a range of non-government visit with a hand print. The inaugural NAIDOC Week AHCSA organisations. Establishing relationships and partnerships Awards to be held in 2013 was announced at the event. with the five Medicare Locals has been a priority and will These awards will recognise the vital achievements of continue to be so. individual Aboriginal Health Workers and others working in The Board endorsed our Strategic Directions Plan which AHCSA’s member services. will inform the Strategic Plan scheduled for completion in We welcomed in a new Board Executive for a two-year December 2013. Both plans link directly with AHCSA’s term following the AGM in December led by Mr John Constitution and objectives. Singer from Nganampa Health Council. We have continued with the Council of Australian I’d like to acknowledge and thank Mrs Yvonne Buza Governments (COAG) Close the Gap strategies with key as outgoing Chairperson for her six years of service. partners to ensure maximum benefit for our communities. She remains on the Board as the representative of the As we approach the final year of these strategies, work is Northern AHAC. being focused on evaluation of the programs. We want to be in a better position to advocate for the continuation of The AHCSA Secretariat continues to fluctuate in numbers Close the Gap priorities and to get resources directed to the and programs as we draw close to the end of June each Aboriginal community controlled health sector. year and enter a new financial year. This is an ongoing challenge as we work to build the capacity of our sector. Thank you again to the Board and staff for their continued support, and to our members for their confidence in AHCSA. We also prepared ourselves for some possible changes due It has been a busy and challenging year. to the federal election as well as changes in the National Congress as the term of the first elected Board comes to Mary Buckskin an end. AHCSA’s two Congress representatives this year were Vicki Holmes and Bill Wilson. Chief Executive Officer
Two AHCSA members will celebrate significant milestones late this year. Nganampa Health Council will celebrate 30 years since they were established in 1983, and Port Lincoln Aboriginal Health Service will celebrate 20 years. These are great achievements and show that hard work and commitment pay dividends.
Work is continuing on the development of the new Aboriginal Community Controlled Health Service (ACCHS) for the Hills Mallee Southern Region. We are aiming for a July 2014 establishment date.
AHCSA’s RTO work continues to grow. There will be a major focus on our compliance with the new national system under the Australian Quality Skills Authority (AQSA) and the implementation of the new qualifications for Aboriginal Primary Health Care.
Pg 7 Deputy Chief Executive Officer’s Report
As we finish our 11th year as an Aboriginal Community On a national level there has been important liaison Controlled Health Organisation, I reflect on another and discussions with key stakeholders and partners extremely busy year both in the organisation and the to generate and build stronger partnerships for future membership. This position continues to provide ongoing business. Importantly, we have supported the eHealth day to day support to the Chief Executive Officer (CEO) project both at a staff level and also through the NACCHO regarding all AHCSA operational activities including eHealth Advisory Group. It has been a good opportunity individual support to the executive leadership staff, to work closely with the Aboriginal Medical Services in particular relating to their program areas such as Alliance of the Northern Territory (AMSANT) and AHCSA Education and Training, Workforce, Public Health and staff have enjoyed this close connection. This has also Primary Health Care, and Strategic Planning. extended to the Good Medicine Better Health program and AHCSA will support AMSANT, Northern Territory Consistent and ongoing support with information technology Health, and Queensland Aboriginal and Islander Health was also provided both internally and within our member Council (QAIHC) with training and delivery through the services. This has played an important role in continuous NACCHO funded program over the next two years. quality improvement and the growth of the organisation. Netsuite and other software has been installed and investment The Trachoma, Eye Health and Ear Health Programs made in staff training on these new programs. have needed continual support to secure further funding. Unfortunately, funding for the Trachoma Elimination There have been many things happening internally this Program ceased by 30 June although trachoma hasn’t financial year which needed guidance and support for the been eliminated and Australia remains the only country CEO and other staff members. One of the most significant in the world with this disease. was the OATSIH Risk Assessment which involved a lot of preparation from staff with a very successful outcome for AHCSA continues to strive toward maintaining the current the organisation. All of this has assisted AHCSA with its direction for the organisation and its membership. To subsequent preparation for accreditation with many of the support this, the Deputy CEO proactively provides the systems and evidence required from the Risk Assessment CEO, Board and ACCHS CEOs with advice relating to the flowing into the requirements. We will know the outcomes National Health Reform Agenda initiatives and changing later in 2013. political environment. Support and guidance is also provided at each AHCSA Full Board and Executive meetings Another crucial piece of work since January was throughout the year, and the AGM. negotiating the extension of four positions through the Close the Gap Program for GP Workforce and The Strategic Direction for the organisation has been Administration, Patient Information Management Support, cemented from its foundation document - the Constitution. and Education and Training. These have been crucial The Board of Management lead the way with developing positions that have supported members, however, with the Strategic Directions document early in the financial the current financial climate there is no guarantee of year as phase one of the new Strategic Plan development continued funding except on a year by year basis even and it was launched at the AHCSA AGM in December. with countless reports and Key Performance Indicators This has paved the way for phase two where staff will (KPIs) being met. develop the next steps of the organisational plan which will involve linking the programs and daily functions Quarterly meetings with the Minister for Health and Ageing of the organisation to the constitutional objectives and and the SA Health Chief Executives continues to provide strategic directions. This is a great development for the an opportunity for AHCSA to advocate for continual support organisation and continues to be a majority priority and for the sector and from mainstream services in metropolitan, focus for AHCSA Board and staff. rural and remote regions where ACCHSs are based. Accreditation provides a focus to develop policies, Through the NACCHO Governance Project there has been business rules, and procedures to key areas of an high level support to the ACCHS CEOs as well as to organisation through a set of 18 Standards designed Chairpersons with the establishment of a CEO Forum. specifically for the delivery of health services. Importantly, This has provided the opportunity for CEOs to network achieving accreditation through meeting the Standards and link in with the CEOs from Medicare Locals which has requires demonstration that the organisation has quality generated good discussions with workshops planned later systems in place and that all of these systems work in 2013. Some other activities for discussion have together to meet the organisations stated objectives, included OATSIH Risk Assessment preparation, key in AHCSA’s case the Constitutional Objectives. This requirements, advice, funding models, operational advice, results in meeting the Constitutional Objectives by design and support which are different to the Chairpersons support. rather than by chance and that the embedded application of Continuous Quality Improvement principles ensures the perpetual ability to review and improve all aspects of the organisation.
Annual Report 2012-2013 | Pg 8 Deputy Chief Executive Officer’s Report
Some of the goals for the next financial year include:
• Strengthening our position financially to look at a building of our own in the upcoming years.
• Securing further funding for AHCSA and its programs.
• Securing COAG funding beyond 2014.
• Recruitment and retention based on secure funding to maintain effectiveness as the peak body representing our members.
• Models of best practice with continuous quality improvement.
• Supporting the east west alliance.
• Increasing the Business Model for AHCSA such as systems and operational support including legal protection and scope.
I would like to thank our key partners and stakeholders for their continual support as well as staff for all their hard work, and the Board and members for their dedication and commitment to AHCSA.
Shane Mohor Deputy Chief Executive Officer
Pg 9
Manager Administration and Facilities’ Report
Every year continues to get busier for AHCSA, particularly (in progress), implementation of Phase 2 of Netsuite, QMS in relation to the administrative support and tasks required Audit, develop/review physical resource policies, develop/ by the organisation. Assistance is provided to each team review Human Resource policies, assist Finance Team with a dedicated administration position allocated to with preparation of the financial audit, coordinate office ensure resources are available and support is provided move to the second Unley office, office repairs for the with various meetings and minutes, and the many Wayville office, develop an Administration Team Work workshops required throughout the year, as well as the Plan and Action Plan, and participate in WH&S committee monitoring and maintenance needed for the organisation meetings. to keep it functioning every day. Executive Management is currently exploring alternate The Administration Team: accommodation to meet AHCSA’s business activities and organisational growth. A working group has been • Contributes to the achievement and objectives and established to work on this project with the AHCSA policies of AHCSA by managing a professional and Council to be kept updated on a regular basis. confidential administration and executive support service for the organisation. The lease agreement for office space at Level 1, 50 Greenhill Road, Wayville expired on 30 June 2013 and was • Ensures that AHCSA’s internal and external customers not renewed. Additional office space has been secured receive a high standard of customer service. at Suite 3, 13-15 King William Road, Unley which is adjacent to the main Unley office. This office is occupied by staff of • Is responsible for the management of physical the Education and Training and ATSHIRTONN teams and resources. includes a training room for students. The lease is for two • Contributes to AHCSA’s Continuous Quality years until June 2015 with a right to renew for a further Improvement. three years if needed.
• Contributes to AHCSA’s Workplace Health and Safety The five year lease for the main Unley office expires in (WH&S) practices. September 2013. In order to coincide with the duration of the 13-15 King William Road lease, the lease for the main In October 2013, a new position, Administration Assistant, Unley office has been extended for two years with a right Education and Training Team, will be advertised to help to renew for a further three years if needed. manage student activities in 2013. In addition, all employment contracts for members of the Administration An alternative property to house all staff and to include larger Team will be reviewed and extended to meet organisational meeting and training rooms, car parking and storage space needs including the Performance and Development review continues to be explored with a view to purchase. and Performance Appraisals. Other reviews undertaken include vehicles, ipad internet The team coordinated and supported many meetings and dongle plans, cleaning services, insurance policies, workshops throughout the year as well as prepared for archiving, and newsletter mailout database. various reviews and processes including the AGM and I would like to thank all members of the Administration Council Meeting on 5-6 December 2012, AHAC Forum Team for their continued dedication, hard work and the meeting on 12-13 December 2012 in Mt Gambier, monthly contribution they make to the success of AHCSA. I’d also AHREC meetings, AHCSA Full Board and Executive like to thank the CEO and Deputy CEO for their support to meetings, AHCSA’s RTO Student Induction Day, Aboriginal the Administration Team. Hospital Liaison Officers (AHLO) Network meetings, ATSIHRTONN members meetings, AHCSA Constitutional Working Group meetings, monthly Administration Team Angela Francisco meetings, bi-monthly staff meetings, and recruitment Manager, Administration and Facilities processes. In addition, various workshops and events were coordinated including the RTO Graduation on 7 December 2012, GP Forum, registrations and travel for upcoming NACCHO meetings in November 2012, and preparations for the AHCSA Strategic Planning Retreat.
Assistance was provided with internal reviews in preparation for accreditation and the OATSIH Risk Assessment including the implementation of the Records Management system, review of the Administration Handbook, review of AHCSA forms, implementation of a Business Classification Scheme
Pg 11 Manager Finance Report
2012-13 has been an incredibly busy year for the Finance As part of continuous quality improvement, AHCSA reviewed Team. Contributing to this was an increase in programs, its systems and anticipated that it would require more staff, student numbers, the implementation of NetSuite sophisticated tools to manage its business. Considerable and the preparation work for the OATSIH Risk Assessment longer-term benefits were identified by investing in new and AHCSA’s subsequent accreditation review held in June. technologies that embrace the whole organisation. In November 2012, AHCSA commenced live use of NetSuite The Finance Team comprises: with the implementation of the Finance, Human Resources and Asset Management modules. The selected software • Natalia Bzikadze - Finance Assistant system is subscription based and hosted by the supplier. • Suzanne Wood - Finance Officer Further implementation across the organisation is required • Melissa Connolly - Manager, Finance and will be conducted in a structured approach utilising business process analysis and change management The team continued to provide a range of services to methodologies. support the AHCSA Secretariat and Board of Management including: I would like to thank team members for their ongoing contribution and dedication as well as the Administration • Accounts Payable Team for their continuing support. • Accounts Receivable Melissa Connolly • Delivery of financial reports and end of year financial Manager, Finance statements
• Cash management
• Resource allocation and delivery of information and advice to facilitate informed decision making
Annual Report 2012-2013 | Pg 12
AHCSA Organisation Structure Board of Directors
CEO (C) Mary Buckskin
ATSIHRTONN Executive Services
National Coordinator Deputy CEO (C) Darrien Bromley Shane Mohor
Exec Assistant (C) Project Officer Alison Hambour(.8) Karen Wyld
Exec Assistant (C) Admin Officer Mandy Green Rachel Telfer
Strategic Planning Education & Training Team Workforce
Health Development Manager, E-Health Program Manager Manager Workforce Coordinator (C) Sarah Ahmed Stan Butler Ann Newchurch Amanda Mitchell
eHealth Strategic Solutions Senior Research Community Care Educator Workforce Issues Policy Architect & Ethics Officer (C) Karen Bates Officer Dan Kyr Rosie King (.8) Vacant (O) Educator Admin Assistant Research Coordinator Christine Fraser Workforce Development Adam Stewart Grief & Loss Officer (C) Merridy Malin (.8) Robert Dann Educator Wendy Lawrie Research Officer, Next Steps GPET Project Officer Janet Stajic (.6) Carmen Dadleh Educator John McKiernan Hills Mallee Southern Region GP Supervisor Project Manager Nick Williams John Evans AMIC Trainer Mary-Anne Williams Tackling Smoking Coordinator Quality Standards and Training Resource Education Ruth Miller Accreditation Officer (O) Consultant Paul Ryan Graham Williams Maternal Tackling Smoking Project Officer ICT/IM Officer (O) Training Resource & Education Mary-Anne Williams Ian Thurnwald Project Officer Vacant COAG Workforce Liaison Officer Accreditation & Governance Michele Robinson (O) Project Officer (O) GMBH Project Officer Bradley Nott Darryl Cameron Health Check & Communicare Research Training Educator Support Officer Aboriginal Social Marketing Vacant Lana Dyda Officer Andrea Murphy (.8) Admin Assistant Clinical Educator Lena Bridgland (.8) Kathryn Dunn Admin Assistant Belinda Lock Student Support Officer Mathew Campbell
Admin Assistant Leanne Ritossa (.9)
Admin Assistant Jason Wauchope (.8)
Admin Assistant Annie-Rose Thurnwald Pg 15 Board
Executive Management
Aboriginal Health Research & Ethics Committee (AHREC) Teams
RTC Steering Committee Program Management
Aboriginal Primary Health Care Staff Workers Forum (APHCWF)
Admin Support
Deputy CEO Shane Mohor
Admin & Facilities Finance Public Health & Primary Health Care
Manager, Trachoma Manager, Admin & Facilities (C) Manager, Finance Public Health Medical Officer (O) Elimination Program Angela Francisco Melissa Connolly David Scrimgeour Desley Culpin
Executive Assistant Finance Officer (C) Manager, Sexual Health Admin Assistant Alison Hambour (.8) Suzanne Wood Sarah Betts Chris Rektsinis (.8)
Executive Assistant Finance Assistant (C) Sexual Health Project Officer Mandy Green Natlia Bzikadke John Solar
Executive Assistant Executive Assistant Coordinator, Blood Borne Virus Kerrin Florance (.8) Alison Hambour (.8) Program Michael Larkin Executive Assistant Admin Assistant Mandy Green Leanne Ritossa (.9) Coordinator, EH&CDSSP (O) Christina Whap Executive Assistant Admin Officer Kerrin Florance (.8) Alcohol and Other Drugs Rachel Telfer Prevention Coordinator Paul Elliott Admin Assistant Jayson Wauchope (.8) PIMS Coordinator Beth Hummerston Admin Assistant Mathew Campbell Ear Health Project Officer Garry Goldsmith Admin Assistant Belinda Lock (.8) Admin Assistant Chris Rektsinis (.8) Admin Assistant Lena Bridgland (.8)
Human Resource Officer Jeff Mountford
Receptionist (C) Lois Multa
Admin Assistant Christ Rektsinis
Admin Assistant Adam Stewart
Admin Assistant Annie-Rose Thurnwald Annual Report 2012-2013 | Pg 16
Education and Training
AHCSA’s Registered Training Organisation (RTO) aims Certificate IV in Aboriginal and/or Torres 36 to build the capacity of members to create strong and Strait Islander Primary Health - enduring ACCHOs and contribute to improving the Community Care capacity of mainstream health services to respond appropriately to the health needs of the Aboriginal Aboriginal Maternal and Infant Care 12 community in South Australia. (Certificate IV Practice)
In 2012-13, the national and state Vocational Education Certificate IV Indigenous Research 13 and Training (VET) sector reform continued to underpin the Capacity Building direction of the Education and Training Team (ETT). The VET Good Medicines Better Health 60 reforms directly led to the establishment of the Australian Skills Quality Authority (ASQA) in 2012 and ASQA’s focus has Total students 269 been on RTO audit, regulation and compliance. The RTO is currently focused on preparing for audit and will continue Training Partners until February 2014. The ETT would like to acknowledge its training partners on behalf of AHCSA: The Australian Health Practitioner Regulation Agency (AHPRA) through the Aboriginal and Torres Strait Islander • QuitSA Health Practitioner Board finalised its registration standards • Alzheimer’s Australia (SA) ‘Aboriginal Health Practitioner (AHP)’ by 1 July 2012. The AHPRA registration requirement for AHP within South • James Cook University Australia has created a significant demand from AHWs to • Country Health SA Local Health Network Inc. AMIC undertake clinical practice training. It is predicted this will Program continue to be a dominant factor for student placement into the future. • Metro Health SA AMIC Program
Scope of Training • Cancer Council of South Australia • Kumangka Aboriginal Youth Service AHCSA’s scope of practice is detailed on training.gov.au under ‘Organisation 40142, Aboriginal Health Council of • Pika Wiya Aboriginal Health Service South Australia’. • NACCHO Good Medicines Better Health and Ear and During the year, the RTO directly delivered the following Hearing Health accredited training courses: • Central Australian Aboriginal Congress • Certificate III in Aboriginal and/or Torres Strait Islander • Aboriginal Medical Services Alliance Northern Territory Primary Health Care (HLT33212) • Julian Burton Burns Trust • Certificate IV in Aboriginal and/or Torres Strait Islander Future Activities Primary Health Care - Practice (HLT43907) Next year, the RTO will focus on: • Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health - Community Care (HLT44007) • Meeting the administrative demands commensurate of increased student enrolments and regulatory compliance. • Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care - Practice (HLT52107) • Ensuring the ongoing availability of high quality training venues to meet the created training demand. • Diploma of Aboriginal and/or Torres Strait Islander Primary Health - Community Care (HLT52207) • Maintaining the training and infrastructure resources that are congruent with expanded student and training • Certificate IV in Training and Assessment (TAE40110) demands. • Certificate IV in Indigenous Research Capacity • Responding to the regulatory needs of the ASQA as Building (31001QLD) a RTO beyond 2013. From 1 July 2012 to 30 June 2013, enrolments across all • Supporting the registration compliance of the Aboriginal categories of study were: and Torres Strait Islander Health Practitioner.
Certificate No. of Enrolments Certificate III in Aboriginal and/or Torres 90 Strait Islander Primary Health Care Certificate IV in Aboriginal and/or Torres 58 Strait Islander Primary Health Care - Practice
Annual Report 2012-2013 | Pg 18
Primary Health Care
Audit and Best Practice in Chronic Disease From these early experiences, the local research project ‘Investigating the barriers and enablers to CQI within (ABCD) Research Project Aboriginal primary health care services’ was developed. The ABCD National Research Partnership aims to build Whilst it will not be completed until late 2013, the findings capacity for Continuous Quality Improvement (CQI) within will support the identification of strategies to strengthen South Australian Aboriginal primary health care services CQI effectiveness in varied workplaces including rural, and to negotiate and complete a relevant research program remote, metropolitan, community controlled, government, around this. etc. Disseminating the research outcomes will be the focus of 2013-14 to guide the final year of the project. Targeted training and ongoing support is provided for participating ACCHS staff to implement One21seventy In acknowledging the barriers, the local research team - a CQI program. This includes stakeholder workshops worked with other AHCSA teams to offer a coordinated and practical visits to sites when requested as well as approach and increase service delivery to member coordinated support with other AHCSA teams including services. The recent development of an AHCSA CQI Team Communicare and accreditation support. which meets monthly has already identified areas for future collaboration to support member service staff. CQI aims to improve health outcomes by assisting Aboriginal Initially this will target data collection and information primary health care services to improve their systems for systems topics with Communicare support staff as well delivery of best practice care. This sector is a complex as ongoing accreditation support as these key activities service system and there are many barriers to mplementing are directly linked. quality improvement processes, not all of which can be directly addressed by individual services. Promoting quality Recent experience has demonstrated that offering member improvement, therefore, requires a systems approach and service staff an opportunity to see the ‘bigger picture’ of CQI strong organisation-wide commitment which is the ongoing and how often disparate programs and activities are linked focus for the local ABCD project. encourages an organisational approach to planning and activities. An AHCSA two-day governance workshop in May Adopting a CQI approach can support improvements in as well as other AHCSA led events such as CEO Forums and health outcomes for Aboriginal people. Services are able Board member training support supported understanding of to take control of the quality agenda and build upon local CQI activities and the ABCD project to new members self-determination. By using local data to guide program and demonstrated the linkages between accreditation, direction and placing focus on creating quality care, One21seventy, Communicare and broader organisational services can control the amount of quality data available. planning activities. This can then be used as evidence to influence decisions about the health needs of their local community. The SA Research Officer is closely supported by the project partners such as AMSANT and their CQI team Clinical staff including AHWs have an opportunity to and the national Menzies/ABCD project coordinating reflect on current practices and procedures as well as centre. Links with Flinders University’s public health refresh (or introduce) knowledge and skills in a particular team has also supported local research activities and subject area. Whilst conducting a clinical audit and connected other local projects such as ‘Managing Two associated CQI activities, clinical staff can self-identify Worlds Together’. Barriers to project success are usually areas for improvement. This is an empowering and similar and collaboration can often support identification inclusive approach to broad improvement activities whilst of enablers which support meeting project aims. increasing capacity and often the morale of staff. The ABCD National Research Project participating members Quality improvement initiatives in health care have meet every six months to discuss CQI implementation illustrated that strong leadership and management experiences and present research activity within the project. support are vital elements for success in addition This promotes opportunities to share positive experiences as to access to appropriate support. In 2012-13, most well as barriers. A collaborative approach that includes active participating health services remained engaged in the involvement of health services throughout the process, from project through the One21seventy CQI program and local identification of research topics to implementation, is used research activities. Many health services continued to to continue development and implementation of research conduct various quality improvement activities within their projects to address identified priorities. current setting; however, these were usually ad-hoc and dependent upon individuals. CQI training is delivered as requested with participating member services. As 2013 is the third program year, The continuing challenge is to build capacity of the established working relationships support the ad-hoc whole health service and develop the systems to support nature of training. The Research Officer acts as CQI ongoing and systematic CQI activity. Many services implementation support and visits services to deliver have found it challenging to focus on CQI for a range either training and/or hands on support to conduct of reasons including workforce issues and competing One21seventy activities. The local research project has priorities. This year, more than 60% of key contacts shown that health service staff consider this to be the changed which made continuity difficult. most important enabler to implementation.
Pg 21 The focus for next year will be to ensure key research Meetings were attended with the Coroner about deaths in project findings are well disseminated in a variety of Ceduna to improve outreach services and possible ways methods to all participating services and used to inform to prevent further deaths. As a member of the Kakarrara and plan for the final phase of the national project. The Wilurrara Health Alliance, discussions were held around Research Officer will continue to work closely with key what may improve the situation. The Ceduna community clinical staff and GPs in participating health services to services are looking to control the amount of alcohol for support systematic cyclical review, analysis of clinical sale per person or ban sale altogether to people who have data and action planning for improvement following the been deemed by police or a magistrate that they should One21seventy CQI program. be prevented and barred from purchasing and consuming alcohol. Alcohol Prevention Other meetings attended were: The Project Officer has been working closely with stakeholders for two years in program planning, support, • Police Illicit Drug Diversion Meetings at DASSA - state and education and training. A number of camps and town reference committee to deal with issues of consumption, meetings have been attended in addition to travelling with violence and death associated with use and abuse of local staff on client visits to talk about the role and to offer alcohol. Items discussed included ID cards, restricting support. This includes working with men’s groups, youth sales, dry areas, fines for causing problems in and groups, and presenting at schools about the issues with around public drinking venues, 3pm lock out, etc. alcohol and other drugs in their life, family, and community. • Alcohol Management Group meetings in Port Augusta regarding building a local rehabilitation service. As the program was affected by funding limitations, costs were shared where possible with other agencies travelling • KWY men’s health service that works with services to communities at the same time. The Project Officer worked providing cross cultural training. with Korna Winmil Yunti (KWY) and men’s groups around • Alcohol Management Reference Group that meets the state whilst travelling with Aboriginal Drug and Alcohol at DASSA. Council (ADAC) staff. • Board examining comorbidity in the North and how A state Male Gathering Camp was held at Tumby Bay Aboriginal people’s mental health and alcohol during the year. Over three days, nearly a hundred men treatment is addressed/responded to in the North shared their stories and concerns, and built some great Playford Council area. friendships and networks. DVDs were developed of the workshops and shared stories. Aboriginal Family Support Services (AFSS) assisted to deliver a program in remote areas which addressed grief A survey was developed to assist member services and loss. Presentations were also given at schools, learn more about the program and assistance available. remote male camps, and men’s groups to help males It also provided a record of what is required by member to share their stories and begin healing by supporting organisations and assisted with reporting. The survey each other. recorded the number of local alcohol and other drug services, qualifications of the workers, interest in training, The Project Officer visited services around the state to talk programs or projects, substance misuse issues, and the about training needs and how to respond to issues. number of youth workers. Programs were examined to assess whether they addressed issues such as underage drinking, family/ Support was provided to Aboriginal organisations to lobby domestic violence, gambling, alcohol related brain for regulations and agreements to reduce alcohol supply as damage, supported accommodation, and guardianship. a member of the Alcohol Management Group Reference committee. Members of the committee represent Liquor In the next year, the Project Officer will focus more on Licensing, Liquor and Gambling, Liquor Stores Association alcohol related brain damage and how to send a clear Board, Drug and Alcohol Policy - SA Police (SAPol), message to the young. Support may be sought from Licensing Enforcement SAPol, Office of the Liquor magistrates to include education and training with and Gambling Commissioner (OLGC), DASSA, South community service orders and meetings with brain Australian Network for Drug and Alcohol Services damaged people requiring supervised accommodation (SANDAS), City of Charles Sturt; LCASA, Restaurant and under guardianship orders. and Catering Association of South Australia (RCSA), Department for Education and Child Development (DECD), and AHCSA. The decisions and strategies agreed can affect alcohol supply to Aboriginal people where appropriate and necessary.
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Blood Borne Virus Program CNP site investigations and CNP service discussions were held at Coober Pedy, Mount Gambier, Port Augusta, and The objectives of the Blood Borne Virus (BBV) Program are: Whyalla, and Viral Hepatitis Health Promotion Resources were provided to AHCSA member services. • Liaise with Viral Hepatitis Clinical Practice Consultant nurses and ACCHSs to increase knowledge of viral An Aboriginal BBV Steering Committee advised the hepatitis treatment and increase access to viral program. The committee comprised representatives from hepatitis treatment in Aboriginal communities. SA Health (Sexually Transmissible Infection and Blood Borne Virus Section, and Communicable Disease Control • Promote the BBV Program through face to face Branch), DASSA, Nunkuwarrin Yunti, Hepatitis SA, AIDS meetings, participation at relevant forums and Council SA, and Shine SA, along with a Hepatitis SA workshops, and articles in newsletters. Consultant Nurse representative. • Respond to requests from other agencies working in Various meetings and conferences were attended as follows: viral hepatitis prevention, testing and management to enable provision of culturally appropriate services for • Hepatitis Network Aboriginal people. • BBV Program Coordinator Reference Group • Support DASSA to expand the number of CNP sites in specific regional and metropolitan locations. • Public Health Network
• Support DASSA to increase cultural appropriateness • National Hepatitis C Education Committee (NHCEC) of CNP service delivery. • Government advisory structure by SA Health (as This year, the program organised a ‘Keeping Safe required) Reducing Harms Workshop – Providing Sexual Health and Blood Borne Virus education for Aboriginal Health • BBV Partnership Structures Meeting Workers from across South Australia’ as well as BBV • Hepatitis Nurse Educators Network Education Sessions at Port Lincoln Aboriginal Health Service, Pika Wiya Health Service Aboriginal Corporation, • HIV Code Factsheet reference group meeting Nunyara Aboriginal Health Service, and Umoona Tjutagku Health Service Aboriginal Corporation. Assistance was • Aboriginal Sexual Health Program Advisory Group also provided with two-day Personal Digital Assistant (ASHPAG) (PDA) data collection in July and October 2012. Next year the program will focus on: In July 2012, Hepatitis SA and AHCSA facilitated a performance-based health promotion project featuring • Member service education and training of BBV Australia’s premier Aboriginal Theatre Company, ILBIJERRI. management and prevention. The key aspect of the project was the performance of ILBIJERRI’s latest production, Body Armour, to eight • Working with clean needle programs to increase secondary schools throughout South Australia (four in cultural appropriateness of services for Aboriginal metropolitan areas and four in regional areas). This was clients. inspired by the success of Chopped Liver, a previous • Exploring options for increasing the number of CNPs ILBIJERRI production, in South Australia in 2007 and 2009. particularly in regional locations. Schools were selected based on their high proportion • Strengthening linkages between Hepatitis C of students who identify as Aboriginal or their association Consultation Nurses and AHCSA member services with Aboriginal communities. Body Armour addresses the to increase access to treatment for Hepatitis C. issue of hepatitis C prevention and body art/modification with a particular focus on body piercing and tattooing, and • Resource development for Hepatitis B pre and post specifically targets young Aboriginal people. Following the test discussion. tour, the Hepatitis SA Education Team and AHCSA revisited the schools to conduct 1.5 hour education sessions on body art, hepatitis C prevention and blood awareness with students selected by school staff. The intention was to educate these students and enable them to make healthy decisions surrounding body art, particularly in relation to hepatitis C prevention.
Pg 23 eHealth A primary health care model has been used in working with communities and ACCHSs as evidenced by our The objectives of the eHealth Program are to enable policy of funding registration officers at the local level and ACCHSs to access national eHealth initiatives, provide via the local ACCHSs achieving program goals. We have funding support for fostering community development via fostered discussion at ACCHSs around continuity and eHealth programs, provide IT infrastructure support to quality of care provision and aided them to access and ACCHSs, and inform and advise ACCHSs about pertinent utilise instruments to improve these. national eHealth developments. The program has also been proactive in commenting on All AHCSA member services have now been set up with and providing feedback on national eHealth policies to IT infrastructure to access eHealth initiatives and Pangula ensure our sector’s needs are recognised and protected. Mannamurna was the first ACCHS in Australia to go live We have built a new and close relationship with SA on the Personally Controlled Electronic Health Record Health’s eHealth team to ensure they are aware of our (PCEHR). Over 45,000 patients around the state are now sector’s needs, and negotiations around how we can meet registered for the national eHealth record including these clinical needs are culminating in the joint Point to Aboriginal patients. Point messaging project.
AHCSA has funded ACCHSs to employ and upskill local ACCHSs have been assisted with the completion of staff to do patient registration. We continue to work closely documentation and deploying infrastructure which allows with SA Health towards obtaining hospital discharge them to access national eHealth and telehealth initiatives. summaries electronically via the PCEHR. This is already We have enabled registration of community members to happening from metropolitan Adelaide hospitals and we a record which improves their clinical experience and are entering into a national project to enable discharge improves clinician access to accurate medical information. summaries to be securely emailed directly into Communicare. The registration function has been completely decentralised The following table summarises the status of each service: and takes place wholly within communities by locally employed registration staff managed by the local health Name PCEHR PCEHR in Use service. Capability Some major achievements this year were: Pangula Yes Yes Mannamurna • All ACCHSs signed up to the PCEHR.
Ceduna Yes Scheduled 2014 • All ACCHSs on at least Communicare v12.5. Koonibba • Argus messaging system installed in all ACCHSs and Pika Wiya Yes No the National Health Services Directory (NHSD) updated. Nganampa Yes No All services have been funded for provision of an extra server for their systems. Nunyara Yes Yes Oak Valley Yes No • Implementation of the ROSIE infrastructure project for Tullawon, Tjuntjuntjara and Oak Valley to improve their PLAHS Yes Scheduled 2014 internet connectivity in association with Kimberley- Pilbara Medicare Local (KPML) and Country North SA Tullawon Yes Yes Medicare Local (CNSAML). Commitment from SA Health Umoona Yes Yes to trial sending electronic discharge summaries directly Tjutagku to Communicare from 2014.
Tjuntjuntjara Yes No Interagency relationships continued to be formed and Nunkuwarrin Scheduled Scheduled 2014 maintained with: Yunti • SA Health eHealth Systems Unit to keep abreast Team members have become the first point of call for of state developments and work towards obtaining eHealth related requests and queries from AHCSA electronic discharge summaries. member services. We provide guidance through the changing eHealth and IT infrastructure landscape. • NT, WA Country Health Service (WACHS) and DoHA for ongoing eHealth funding and opportunities to The eHealth program has enabled ACCHSs to access participate in initiatives. funding, infrastructure and training to improve continuity of clinical care to their patients. It has also enabled them • CHSALHN to aid the IT component of the transition to be one step ahead as they are amongst the first in process in Ceduna, Port Augusta and Whyalla. Australia to exploit the increasing and evolving initiatives. • Communicare to ensure their developments mirror ACCHS needs.
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• Healthdirect Australia to ensure the NHSD is updated The EH&CDSSP visits the following Aboriginal communities with member services’ details. at least twice a year. All plans and logistics are approved by the Aboriginal communities beforehand. • NACCHO eHealth expert group. • Port Augusta - Optometrist Monthly meetings continue with consortium partners in Darwin (ie DoH NT, General Practice Network NT • Whyalla - Optometrist (GPNNT), AMSANT, WACHS, National E-Health Transition Authority (NeHTA) and DoHA. These meetings track • Murray Bridge and Raukkan - Optometrist project problems, deal with issues, measure gains, plan • Ceduna - Ophthalmologist and Optometrist transition to a national eHealth system, offer policy and provide legislation feedback. • Yalata - Ophthalmologist and Optometrist
eHealth training is delivered to health service staff on • Oak Valley - Ophthalmologist and Optometrist an ongoing basis either individually or in small groups. Community Liaison Officers are trained on employment • Tjuntjunjarra - Ophthalmologist and Optometrist and ongoing support is provided. • Coober Pedy - Ophthalmologist and Optometrist Eye Health and Chronic Disease Specialist • Iwantja, Fregon, Mimili, Pipalyatjara, Nyapari, Amata, Support and Pukatja - Ophthalmologist and Optometrist The Eye Health & Chronic Disease Specialist Support The program ensures that there is a strong focus on Program (EH&CDSSP) is a Commonwealth Government offering a best practice service which is appropriate, funded program auspiced through AHCSA which is flexible and culturally safe for all participants. There are focused on providing Aboriginal communities in rural and strong links with the major hospitals in Alice Springs and remote South Australia with access to medical specialists Adelaide aligned with associated Aboriginal partners such such as Ophthalmologists and Optometrists as well as as logistics, housing and social wellbeing. education and health promotion. The team’s professional and cultural understanding of The EH&CDSSP operates in partnership with rural and chronic disease and its sustained duration and complexity remote communities and maintains strong alliances with including the causes and extent of their impact on the State Affiliates including the Royal Society for the Blind community ensures Aboriginal people are provided with (RSB), Rural Doctors Workforce Agency (RDWA), Can a holistic approach to their health and wellbeing. The Do For Kids, Crows Football Club, and the Sight For All program travels to the people who live in the remote and Foundation. very remote communities with high level eye health Chairperson of the Sight For All Foundation, Dr James equipment and offers a welcoming and positive approach. Meucke, an Ophthalmologist, has for several years The EH&CDSSP plays a pivotal role in representing ACCHSs provided advice in regard to eye health and diabetes as at a state and national level on many committees, working well as professional and commercial support to make parties, agencies and boards both within government and available eye health DVDs covering ‘real’ and animated non-government eye health and chronic disease forums. On stories. The films cover rural and remote health promotion, most occasions, AHCSA is the only representative from healthy living and eye surgery, and can be viewed via the South Australia and, therefore, ensures that a two way Sight For All website. Where possible, they are used during communication strategy is in place and Aboriginal community visits or health promotion and education communities are heard. activities. Tackling the burden of chronic disease caused by obesity, Dr James consults on a regular basis with senior AHCSA tobacco, and alcohol is included in the training and is Aboriginal staff and community members to gain directed at primary prevention. Within AHCSA, the health appropriate cultural and language guidance. Feedback project teams work closely together to ensure up to date has been extremely positive and AHCSA looks forward information is shared so that high level training and to a long and healthy relationship and strongly recognises education can be offered to the Aboriginal health sector the work and support of Dr James and the Sight For All workforce. Foundation. The EH&CDSSP is working in partnership with the Trachoma On a national level, the EH&CDSSP has further enhanced Elimination Program to ensure communities are provided relationships with NACCHO, Vision 2020, the Medical with an up to date, informative and strong health promotion Specialist Outreach Assistance Program (MSOAP), and focus in regard to eye disease and other chronic health Visiting Optometrists Support Service (VOSS). In particular, conditions. As both programs continue to be poorly we wish to acknowledge the strong support, both advisory funded and work under pressure of unstable contracts and economically, through lobbying the Commonwealth and unclear financial projections, several areas of health Government, from the Indigenous & Remote Eye Health promotion and logistics have been delayed until a clear Service (IRIS) and the Australian Society of Ophthalmologists pathway is offered. On a more positive note, amalgamating (ASO). the programs has enabled sharing of resources in
Pg 25 partnership with schools and the ACCHSs in rural and • Advising ACCHSs on programs for no cost or low cost remote communities providing a holistic approach to child spectacle purchase. health checks. • Continuing to work closely with ACCHS management, Family Health Checks with a focus on the reason to see majors and staff to investigate and discuss new and an ‘Eye’ doctor if you have a chronic disease and Child constructive ways to deliver services from specialists. Health Checks with a focus on ‘Clean Faces - Clean Hands - Strong Eyes’ were held at schools in Coober Patient Information Management System Pedy, Whyalla, Oodnadatta, Oak Valley, Yalata, and Ceduna. The health checks were a great success bringing The Patient Information Management System (PIMS) aims Aboriginal Community Education Workers, Environmental to enhance information management in South Australian Health Workers, Clinic Health Workers and AHCSA staff ACCHSs. The objectives of the program are to: together for a day with healthy eating, healthy entertainment, • Develop a set of PIMS procedures and templates promotion, and discos whist collecting data and providing across ACCHSs to achieve standardisation and referrals to specialists and GPs. Feedback from the schools, consistency of data. clinics and communities was outstanding and more are planned for the next 12 months. • Investigate methods for cross sectoral data sharing between the Aboriginal community controlled health During the year, the EH&CDSSP attended: sector and DoHA. • Vision 2020 conferences in Brisbane, Sydney and • Provide leadership and advocacy in the participation Canberra. of data sharing with DoHA to assist with the evaluation • Rural Health West, Perth - Understanding the of benchmarks in the SA Implementation Plan of the Aboriginal rural and remote eye health services in COAG National Partnership on Closing the Gap in far north west of Western Australia. Indigenous Health Outcomes.
• Royal Australian and New Zealand College of • Provide orientation/training sessions for ACCHS staff Ophthalmologists (RANZCO), Hobart - State regarding PIMS. presentation, AHCSA & Eye Health Programs This year, PIMS undertook the following activities: in South Australia. • Maintained linkages with member services to establish Eye Health and Trachoma Awareness training was Communicare training requirements. provided to AHWs and other health professionals in Port Augusta, Ceduna, Whyalla, Coober Pedy, Adelaide, • Delivered Communicare orientation/training to AHCSA Yalata, Oak Valley, and Oodnadatta. In training and staff, member services, and mainstream agencies. development, the EH&CDSSP ensures: • Identified how Communicare can best support clinical • ACCHSs are supportive of the training requirements processes/procedures by improving patient data quality. for their AHWs in the broad areas of chronic disease, in particular, the relationship between diabetes and • Investigated how Communicare can best be used to eye health checks. support organisational reporting requirements to reduce the burden. • AHWs are encouraged and supported to become more involved in using eye health equipment and understand The Pangula Mannamurna Communicare Project has been the relationship between diabetes, eye health, and completed and has: chronic disease. • Eased the burden of internal and external organisation • Aboriginal health professionals continue to be offered reporting requirements. the opportunity to attend training at the Royal Adelaide Hospital (RAH) and Flinders Medical Centre (FMC) to • Supported CQI initiatives. understand the dynamics and management of eye • Supported improved patient management. health equipment, operations, and screening. • Met numerous accreditation requirements. Next year, the EH&CDSSP will continue to focus on: • Improved access to Medicare Benefits Schedule • Coordinating specialist visits and providing culturally incentives. sensitive advice to specialists to ensure they provide culturally appropriate services according to community • Focused on sustainability of the project’s benefits on its protocols. completion by increasing the organisation’s workforce capacity. • Consultation to provide a minimum of two visits a year or as requested by the ACCHSs. This project can be replicated at other services.
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Use of Go To Meetings and remote access to Communicare Public Health at member services has enabled the delivery of more appropriate and effective training to more staff and visiting The Public Health Medical Officer (PHMO) provides public staff providing services to Aboriginal clients. health advice and support to AHCSA and member services.
PIMS maintained relationships with Menzies and Rheumatic Regular visits were made to member services and a wide Heart Disease (RHD) Australia staff and provided support range of activities and initiatives implemented. Whilst the with the generation of reports in the management of RHD at core activity is providing public health advice and support member services. With the One21Seventy program, PIMS to AHCSA’s member services, at any one time there may provided support to the ABCD researcher regarding audit be one or two which require more sustained support. tools. This year, particular attention was provided to Umoona Tjutagku Health Service Aboriginal Corporation over four Various presentations were given including the CEOs Forum days a month. regarding the Pangula Mannamurna Communicare Project. For the past few years, AHCSA has supported the use of Training provided included: ABCD (One21seventy) CQI program in most ACCHSs. As the funding is now coming to an end, options for the best • AHCSA’s Public Health Medical Officer, Public Health way to support CQI into the future are being considered. Registrar, HERO Team, Blood Borne Virus Coordinator, AHCSA believes we now have the opportunity for a EH&CDSSP, Trachoma Elimination Team, Ear Health more sophisticated approach. There have been major Program Coordinator, Workforce Development Team, developments in the use of health information systems and eHealth Team. with ACCHSs which has led to opportunities to collect data which can be used by health services for planning, • Eight member services and Spinifex Health Service evaluation, and quality improvement. More recently, at Tjuntjuntjara, WA. infrastructure has been introduced to allow data to be • 164 Communicare orientation/training sessions with reported electronically eg OSR and nKPI. However, from 185 staff attending. the health service perspective, these data disappear into a virtual black hole ie it is not being analysed and fed back • Phone/remote access to Pangula Mannamurna, Ceduna to health services in a way which can help them improve Koonibba Aboriginal Health Service, Umoona Tjutagku the quality of care. Health Service Aboriginal Corporation, Oak Valley Health Service, Tullawon Health Service, Pika Wiya Aboriginal QAIHC has been working on this issue and has developed Health Service, Nunyara Aboriginal Health Service Inc, systems which allow data to be extracted from health and Spinifex Health Service. information systems within health services which is held in a secure database and then analysed and sent back to Team members attended Practice Health Atlas and Map each health service. While each health service only sees Information training which covered a decision support tool their own data, they are able to compare the performance enabling report generation that have the potential to further with aggregated de-identified data from other services. guide services with data quality and management, pro-active Over time, health services are also able to see if their practice population health care, clinical performance performance is improving or not. monitoring, business systems development, and accreditation. In South Australia, we have been looking at the possibility of providing a similar function to enhance data management In the next year, PIMS will continue to: and CQI in ACCHSs. Given the considerable work and costs which have gone into developing the system • Support member services via onsite/phone/remote in Queensland, it makes sense to work with QAIHC. access training to optimise the use of Communicare Therefore, we have had discussions facilitated by the Centre with the aim of improving data management patient of Research Excellence in Primary Health Care (CRE) with care. the University of SA and James Cook University of which QAIHC and AHCSA are both members. The resources • Support agencies delivering programs focusing on available through the CRE have helped move our plans client health care to enable existing patient information along. management systems to be used optimally. QAIHC and AHCSA are now working together to develop • Develop collaborative linkages with key agencies. systems for improved data management at the health service level. Currently, this is called the AHCSA/QAIHC Quality Improvement Project (AQQIP).
Pg 27 Since February 2013 and until January 2014, Kushani The HERO Team was involved in a range of other activities Marshall has been AHCSA’s public health registrar under to support health services and other agencies in sexual the supervision of the PHMO. Her activities include: health activities throughout the year including:
• Developing a system for collecting data on STI control • Ceduna Youth Week activities to be used for CQI activities within health services. • Yalata Footy Carnival Collaboration
• Working with Umoona Tjutagku Health Service • Mt Gambier Young Women’s Camp and Young Men’s Aboriginal Corporation to help develop clinical Trip to Dreamtime at the G systems within their drug and alcohol service. • Port Augusta Women’s Health Day • Developing a paper outlining options for CQI in • Coober Pedy Youth Health Expo ACCHSs in the future. Throughout the year, the HERO Team worked closely with • Undertaking exploratory work on the impact of patient the AHCSA BBV Project Coordinator, AHCSA Statewide mobility on the provision of Aboriginal primary health Alcohol Prevention Program Coordinator, and PHMO. care. The team continues to consult with the AHCSA ETT As team leader of the Public Health and Primary Health to include sexual health indepth in the Certificate III Care team at AHCSA, the PHMO provides supervision Aboriginal Health Worker training course. and support to the Sexual Health team, BBV Project Coordinator, Eye Health Program Manager, PIMS This year has also seen a close association with AHCSA’s Coordinator, Ear Health Project Officer, and the Statewide Workforce Development team’s ‘Keepin’ it Corka’ and Alcohol and Drugs Prevention Coordinator. other health promotion and community development events including Blak Nite and NAIDOC Week. Sexual Health The HERO Team organised the AHCSA Sexual Health The Sexual Health Program commenced in early 2010 Program Advisory Group (ASHPAG) to provide input into with the aim of building capacity within ACCHSs to activities. A meeting was held in April and two more improve sexual health services for Aboriginal people in meetings were planned for August and November 2013. South Australia. The program in 2012-13 was funded by two separate sources within SA Health, the Sexual Health Closer links have been developed with the AIDS Council Services for Aboriginal and Torres Strait Islander Young of SA, Nunkuwarrin Yunti, Moolagoo Mob and Sexual Women and their Partners Program (funded through Health Information Networking and Education SA the Indigenous Early Childhood Development National (SHineSA), leading to a range of shared activities. The Partnership Agreement) and the Indigenous HIV/STI team worked closely with SHine SA ‘s Yarnin’ On team Prevention Program. including delivering a joint presentation at Coober Pedy Youth Expo that was developed in collaboration with The review of AHCSA’s statewide Sexual Health Program, Country Health SA Local Health Network Inc. and Coober HERO (Health Education Respecting Others), conducted Pedy Area High School. by James Ward was completed in November 2012. The recommendations incorporated member services feedback The Sexual Health Team coordinated the South Australian and served as the framework for the current Action Plan for section of an Australian Research Council funded project 2013 which focuses on: ‘Sexual health and relationships in young Indigenous people: The first Australian national study assessing • Community engagement with young people. knowledge, risk practices and health service access in • Developing clinical capacity to address the issues relation to sexually transmissible infections and blood of sexually transmitted infections and blood borne borne viruses among young Aboriginal and Torres Strait viruses within the South Australian Aboriginal Islander people’ or with the short title ‘the GOANNA community. survey’. The overall goal of this project is to develop and conduct the first Australia-wide study describing levels of A new Sexual Health Manager commenced in January knowledge, risk practices and access to health services in 2013 and the Project Officer continued until June 2013 relation to sexually transmitted infections (STIs) and blood and the project continued to employ a Registered Nurse borne viral infections (BBVs) among young Aboriginal and (RN) support and advisor in a part time capacity since Torres Strait Islander people aged 16 to 29 years. October 2012. Prior to the 2013 STI screening period, the HERO Team In collaboration with AHCSA’s BBV and Drug and Alcohol visited most ACCHSs with the exception of Nganampa Projects, a two-day workshop, ’Keeping Safe, Reducing Health Council which has its own sexual health program. Harm’ was organised for AHWs at Tandanya on 14-15 A powerpoint was presented to staff that describes the February 2013. history and scope of the project’s annual six-week STI screening period. This provided an opportunity for education, discussion and questions relevant to
Annual Report 2012-2013 | Pg 28 Primary Health Care
implementation of sexual health programs at a local level. Trachoma Elimination The HERO Team visits support culturally appropriate sexual health services including promotion of local Trachoma, an eye infection which can cause blindness, activities aimed at reducing the risk of STIs and clinical continues to be endemic in Aboriginal and Torres Strait activities including screening and management of STIs. Islander populations in some parts of the Northern Territory, Opportunistic screening of all people at risk of STIs has South Australia and Western Australia. Major improvements been encouraged and supported but there has also been in environmental conditions in Aboriginal and Torres Strait an emphasis on a community-wide screening program Islander communities in Australia are a core requirement particularly aimed at people aged 16-30 years for the for trachoma elimination. six-week period. The aim of the six-week community In line with its Vision 2020 initiative, the World Health STI screening every year is three-fold: Organisation (WHO) has adopted a resolution to eliminate 1. There is evidence that if enough people in the target blinding trachoma by 2020. The AHCSA Trachoma group are screened and if necessary treated within Elimination Program is responsible for establishing the a finite time period that this can have a significant geographic extent of endemic trachoma in South Australia impact on transmission of STIs within the community through screening in communities in all areas. CHSALHN and hence lead to a reduced prevalence. will also contribute to this activity.
2. Opportunistic screening only reaches those people The program’s aim is to reduce the prevalence and who access health services for other reasons, whereas transmission of active trachoma by undertaking community screening casts a wider net and has the comprehensive screening in all children aged 1-14 potential to diagnose STIs in people who do not access annually in communities where trachoma is endemic, health services (which is reasonably common in the and ensure that all individuals and families requiring age group at highest risk of STIs). treatment are treated according to the ‘Guidelines for the public health management of trachoma in Australia’. The 3. It ensures that for a six-week period every year that program also supports ACCHSs and health professionals there is a greater emphasis on sexual health which to develop processes to ensure that adults aged over 40 helps to ensure that it does not get submerged in the are screened for trichiasis. many other competing issues in primary health care for Aboriginal people. Appropriate and culturally safe consultation and engagement is provided to rural and remote Aboriginal communities of ACCHSs participating in the 2013 screening from 29 April South Australia including education and health promotion to 7 June included: in reference to Trachoma (and Trichiasis) and eye health awareness. • Nunkuwarrin Yunti Inc, Adelaide Services provided by AHCSA, specifically in the communities • Pika Wiya Health Service Aboriginal Corporation, Port of Coober Pedy, Oodnadatta, Yalata and Oak Valley are: Augusta • 50% of adults aged 40 and over are screened for • Nunyara Aboriginal Health Service Inc., Whyalla trichiasis.
• Pangula Mannamurna inc., Mt Gambier • 100% of adults diagnosed with trichiasis are referred to an Ophthalmologist for treatment. • Ceduna Koonibba Aboriginal Health Service Aboriginal Corporation • 90% of adults with diagnosed trichiasis are encouraged and supported to be re-examined • Port Lincoln Aboriginal Health Service annually by health care staff. • Umoona Tjutagku Health Service Aboriginal • 80% of 5-9 year old Aboriginal children are screened Corporation, Coober Pedy for trachoma. • Tullawon, Yalata • 100% of children screened for trachoma are also • Oak Valley Health Service screened for clean faces and 70% of these have clean faces. • Spinifex Health Service, Tjuntjuntjara • Promotion of the clean faces messages, as part of a holistic personal hygiene program, as described on section 12 ‘Guidelines for the public health management of trachoma in Australia’.
• A minimum of eight sessions of trachoma training.
Pg 29 In the past, particularly due to the work of many AHWs, Feedback indicated that the ‘days’ were extremely trachoma control activities were carried out by ACCHSs successful and positive not only in checking children’s with no support or involvement of SA Health. However, health in areas of hair, skin, teeth, BSL, ears, eyes there had not been a coordinated public health response (trachoma and vision) but in maintaining community links to trachoma control in South Australia. From 2009, AHCSA’s and child health sharing along with data collection and Trachoma Elimination Program has provided education, recording. Feedback from families and children was very health promotion support, and awareness training for all positive and there was strong support from the school Aboriginal people in South Australia. principals and Aboriginal Community Education Department staff. We are looking forward to conducting these ‘days’ The program ensures continued relationships and awareness again with these schools and others in Whyalla which of appropriate linkages and partnerships with all established have indicated they would like to participate. or visiting Aboriginal health programs. Many of the activities and services provided have been suggested by AHWs and held in conjunction with school and community sports days or community health activities, and they were successful.
Engagement and consultation continues with all health professionals and agencies in rural and remote communities including the Royal Flying Doctor Service (RFDS), visiting allied health professionals eg podiatrists, dentists, local community hospitals, aged care, and all levels of education.
Ongoing trachoma and trichiasis awareness training is provided to all AHWs and other health professionals who work for and with ACCHSs in line with the ‘Guidelines for the public health management of trachoma in Australia’. The program aims to continue to educate the health workforce by establishing and maintaining knowledge, skills and experience in trachoma control. Challenges to achieving this include the turnover of health professionals in rural and remote ACCHSs.
In ensuring ongoing appropriate engagement and community consultation, the program travels to and supports rural and remote communities with eye health awareness training and education, health promotion, and screening over extended appropriate periods. This year, the program consisting of one Manager, one part time Administration Officer and one part time contract RN undertook comprehensive screening for active trachoma in all Aboriginal children aged 1-14 in Coober Pedy, Oodnadatta, Yalata, Whyalla, and Oak Valley.
Major trachoma health campaigns were promoted for rural and remote communities and the program continued to support Ceduna Koonibba and Pika Wiya health services who signed contracts with CHSALHN. All contractible requirements were completed and KPIs met albeit major obstacles from floods, wind/dust storms, sorry business, and pre-planned community events.
Annual Report 2012-2013 | Pg 30