NACCHO Aboriginal Health and #ClosingtheGap : Should the government lower retirement age thresholds for Indigenous Australians, as lower life expectancy means our mob not getting fair access to the pension and super ?

” The Indigenous population is more likely not to reach preservation age, so question whether the system is fit for purpose for this cohort.

This has a significant effect on the relevance of preservation age for these members who are overwhelmingly more likely to take their accrued super under permanent incapacity and other early release provisions than at retirement age.”

Indigenous Australians were much more likely to receive a disability support pension than the age pension but in the total population this was not the case, the Australian Institute of Superannuation Trustees said, suggesting Indigenous people were more likely to become disabled before retirement.

Read all NACCHO Aboriginal Health and Elder Articles HERE 

Read AIHW Report on disability support for Indigenous Australians 

What is First Nations Foundation?


We are a national Indigenous financial foundation, led by an Indigenous board, striving to achieve economic freedom for First Nations.

​We operate on a national basis and offer programs in financial literacy, research and superannuation outreach to Aboriginal and Torres Strait Islander people. WEBSITE

Media Coverage

Superannuation funds are agitating for lower retirement age thresholds for Indigenous Australians, warning lower life expectancy means they’re not getting fair access to the pension and super.

Major fund AustralianSuper, consulting firm PricewaterhouseCoopers, the Australian Institute of Superannuation Trustees and the Australian Council of Trade Unions all raised concerns about Indigenous access to funds in retirement as part of submissions to a government review.

Australian Bureau of Statistics data shows for the Aboriginal and Torres Strait Islander population born between 2015 and 2017 the life expectancy for men was 71.6 years and for women was 75.6 years. Non-Indigenous men and women have a life expectancy of 80.2 years and 83.4 years respectively.

Gap between Indigenous and non-Indigenous life expectancy (Close the Gap Report, 2019) ANTAR

In the past decade there has been a small narrowing in this life expectancy gap. The federal government has committed $4.1 billion for Indigenous health initiatives for four years from 2019-20.

AustralianSuper’s submission to the retirement income review this week specifically pointed to this gap as a concern for the superannuation system.

The preservation age, which is when someone can access their super, is currently between 55 and 60 depending on date of birth.

The pension age is 66 for those born from 1954 to June 1955, rising to 67 years for those born after 1957.

Treasurer Josh Frydenberg last year ruled out raising the pension age to 70 as part of the first retirement income review since the 1990s. But reducing the superannuation age for specific groups of people is unlikely to be a popular proposal.

The Department of Prime Minister and Cabinet in a 2018 submission to the Banking Royal Commission said current legislation allows the early release of superannuation funds to pay for medical treatment and did not support changing the age requirements as it would run counter to the “universal aspect” of the superannuation system.

The AIST, which is part of the cross-industry Indigenous Superannuation Working Group, said that the retirement system was too often based on assessments about “full-time, male, continuously-employed, higher income earners”.

The ACTU, which has pushed for a raft of changes including increasing the super guarantee for women, wants immediate reform to lower the age pension eligibility and preservation age for Aboriginal and Torres Strait

The submission also recommends superannuation funds and relevant government services are offered in Indigenous languages and a reduction in the paperwork needed to prove ancestry.

Consulting firm PwC also flagged “unique challenges in retirement” for Aboriginal and Torres Strait islanders.

A spokesman for Minister for Indigenous Australians Ken Wyatt said that while the life expectancy gap needed to be considered there were “systemic and structural transformations required to achieve better life outcomes for Aboriginal and Torres Strait Islander people in older age”.

He said a government strategy to close the gap was focused on economic development to help intergenerational change for longer term wellbeing.

NACCHO Aboriginal Healthy Ageing News : The @georgeinstitute is looking to partner with ACCHO services in NSW, WA and SA to deliver a healthy ageing research project, called the #Ironbark project

The George Institute for Global Health is looking to work with Aboriginal communities on a healthy ageing research project, called the Ironbark project.

They are ready to partner with ACCHO services in NSW and SA to deliver either the Ironbark: Standing Strong and Tall program (weekly exercise group and yarning circle), and the Ironbark: Healthy Community program (a weekly social program).

Services are funded and trained to deliver one of the programs for 12 months with groups of Aboriginal men and women 45 years and older.” 

What is the study about?

The Ironbark Study is comparing two different programs aimed at improving health and wellbeing of older Aboriginal people. Both involve an ongoing program delivered weekly by a local person, in a community setting. The Ironbark: Standing Strong program is a weekly exercise and discussion program, and the Ironbark: Healthy Community program is a weekly program that involves discussions and social activities.

Who is conducting the research?

The study is being conducted by researchers from The George Institute for Global Health, The University of NSW, The University of Sydney, Flinders University, Wollongong University and Curtin University.

What does the study involve?

Services participating in the study are randomly assigned to either receiving the Ironbark: Standing Strong program or the Ironbark: Healthy Community program. Both programs aim to improve the health and wellbeing of older Aboriginal people.

At the end of the trial, sites that delivered the Ironbark: Healthy Community program will have the opportunity to deliver the Ironbark: Standing Strong program for a further 6 months, including all resources and equipment needed.

Being a site in the study involves recruiting 10 – 15 eligible Aboriginal people aged 45 years or older to participate in a weekly facilitated meetings at a culturally appropriate and accessible venue.

Participants

Participants must be: of Aboriginal and/or Torres Strait Islander descent; aged 45 years or older; living independently; prepared to attend the program weekly.

People cannot participate if: they have not gone outside without physical assistance from another person in the past month; they have been diagnosed with dementia; they have a medical condition precluding exercise (e.g., unstable cardiac disease).

People who do not fit the criteria, including non-Aboriginal family and community, will be able to attend classes but data collected will not be included in the trial.

What data will be collected?

A health assessment will be conducted with all participants by the study research assistants. This includes an interview where they will be asked about health and wellbeing, including questions about medication, sleep, physical activity and diet. Participants will also be asked to do some simple tests to measure their health, including strength and balance, and waist circumference. The interview and tests will take around one hour to complete.

Participants will be asked a few questions each week about their health, sleep, falls and physical activity.

These will take only 1-2 minutes to complete.

Every three months they will be asked some questions about their health, lifestyle and enjoyment of the program, and asked to complete some simple tests to measure strength and balance. These tests and questions will take about 30 minutes to complete.

At the end of the program participants will repeat the health assessment. This will include an interview where they will also be asked about quality of life and physical activity.

Ironbark: Standing Strong program

Sites allocated the Standing Strong program will be supported to deliver a weekly class that runs for around 1.5 hours – about 30 – 45 minutes is exercises, and 30 – 45 minutes will be a yarning circle facilitated by a trained worker. The program will run for the whole year, with additional weekly home exercise recommended.

Participants will be required to provide a form from their doctor indicating they are physically fit enough to do the class.

Ironbark: Healthy Community program

Sites allocated the Healthy Community program will be supported to deliver weekly yarning circles. The yarning circles will include discussions and activities that are important to community wellbeing and possibly social activities. Guest speakers may attend the program on request of the group.

How will the study benefit Aboriginal communities?

Being involved in the study will benefit participants directly by creating additional opportunities for them to meet with family and community, discuss topics important to older Aboriginal people, and have their experiences included in the findings.

The study will also contribute to employment opportunities for local Aboriginal people to participate as site managers and/or program facilitators.

It is also expected that the findings of the study will build on the evidence base around appropriate wellbeing programs for older Aboriginal people, and inform national policy development in this area.

What is needed from participating services?

We plan to recruit 60 Aboriginal community or health services in NSW, Western Australia and South Australia into the Ironbark Trial.

We are ready to work with services in NSW and SA : Services need to;

  • Be well established within their local Aboriginal community, and have existing relationships
  • Be able to offer programs or services specifically for older Aboriginal people, and can recruit 10 – 15 eligible participants. Groups should not already be doing a regular exercise

Ironbark – overview

  • Have existing Aboriginal staff working at the service who are willing to oversee program delivery on a weekly basis over the duration of the trial
  • Utilise a culturally appropriate venue that is accessible to participants
  • Be willing to actively participate in both the program delivery and research components of this

How will our service be supported to participate in the study?

The Study team will provide sites:

  • Funding to employ locally based staff on a casual basis
  • Weekly stipend to cover cost of morning/afternoon tea for group meetings
  • Ironbark: Standing Strong program sites will receive training and ongoing support on delivering the program, the Ironbark: Standing Strong and Tall Manual and handouts, all equipment needed to deliver the exercise program
  • Ironbark: Healthy Community program sites will receive training and ongoing support to deliver the program, resources to facilitate discussions and organise activities.
  • At the end of the trial, sites that delivered the Ironbark: Healthy Community program will have the opportunity to deliver the Ironbark: Standing Strong program, including all resources and equipment needed
  • All sites will receive site specific data from the study, as well as information about the results of the research

What will happen to the results?

All participating sites will receive copies of the findings of the study, in a format that is accessible to staff and community. Sites will also receive site specific information about the findings.

To inform program and policy development, we will also be disseminating the findings through peer review publications, reports to the funding body, presentations and reports to policy makers and to key stakeholders such as peak Aboriginal health and other organisations.

The findings will be presented in a non-identifying way, to maintain confidentiality of sites and individuals involved. Only the site managers will have access to non identifying information on participants, for emergency purposes and for accurate data collection.

Consent

Participation in this study is entirely voluntary – sites and services can stop at any time. All participants (sites and individuals), will be required to sign a consent form, prior to participation.

Contact check out their website:

www.ironbarkproject.org.au

The project is a collaboration between The George Institute for Global Health, University of NSW, Flinders University, University of Wollongong, Curtin University and University of Sydney.

NACCHO Aboriginal Health and the @HealingOurWay #StolenGeneration : Fact sheets launched by Minister @KenWyattMP have been guided by survivors: they identified the key issues for them with #GPs, #dentists and #agedcare providers, what is helpful and what should be avoided.

“Many Stolen Generations survivors experienced childhood trauma as a result of their forced removal from family, community, culture and language, and sometimes also as a result of abuse and racism experienced after their removal.

Every day events can trigger the original trauma, particularly if a situation brings back the lack of control Stolen Generations survivors experienced when they were taken from their families.”

Interacting with aged care staff, GPs, dentists and other services is often difficult for Stolen Generations survivors said The Healing Foundation’s Chair Professor Steve Larkin

‘General practice is often the first and only point of contact with the healthcare system for many patients. The RACGP has a strong interest in ensuring that general practice services and healthcare in general are safe and responsive to people who experienced the devastating impacts of forced removal,’ he said.

‘This new resource provides essential context and useful tools to assist GPs to identify and understand the impacts of trauma for their patients.

These are principles of good clinical practice, which is beneficial for all patients.’

Associate Professor Peter O’Mara, Chair of RACGP Aboriginal and Torres Strait Islander Health, said the factsheet is a vital resource for GPs.

Download 

Working-with-Stolen-Generations-GP-fact-sheet

Working-with-Stolen-Generations-GP-snapshot

General practitioners, dentists and the aged care sector will be better placed to support Stolen Generations survivors following the launch of new resources at Parliament House .

Download all new resources HERE 

The resources, launched by the Minister for Indigenous Australians The Hon Ken Wyatt AM MP, were developed by The Healing Foundation in collaboration with Stolen Generations survivors and peak bodies including the Royal Australian College of General Practitioners, the Australian Dental Association, Aged & Community Services Australia and the Aged Care Industry Association.

Stolen Generations survivor and member of The Healing Foundation’s Stolen Generations Reference Group Geoff Cooper said he hoped the fact sheets would create greater awareness about the best ways to provide services to the Stolen Generations without triggering trauma.

“Little changes can make a big difference to how we feel when we walk in to a service. Things like not making us talk about bad stuff that’s happened to us if we don’t want to, and explaining what you’re going to do before you do it so we aren’t caught off guard.”

The resources are part of The Healing Foundation’s Action Plan for Healing project, funded by the Department of Prime Minister and Cabinet in 2017 following the 20th anniversary of the 1997 Bringing them Home report, which highlighted the contemporary needs of the Stolen Generations and their descendants.

An Australian Institute of Health and Welfare analysis conducted as part of the Action Plan for Healing project found there are over 17,000 Stolen Generations survivors in Australia today, and by 2023 will all be aged over 50 and eligible for aged care.

“The development of the fact sheets has been guided by Stolen Generations survivors: they identified the key issues encountered when dealing with GPs, dentists and aged care providers, what is helpful and what should be avoided,” Professor Larkin said.

“We’ve been delighted with the level of interest the resources are already receiving from the target sectors, and are excited to see the materials taken up at the practice and provider level nationally.”

Australian Dental Association CEO Damian Mitsch said the organisation was proud to have supported the creation of the dental resource.

“This resource will go a long way in providing education and helpful tips to guide dental practitioners in providing effective dental care to Stolen Generations survivors,” Mr Mitsch said.

Download 

Working-with-Stolen-Generations-Dental-fact-sheet

The CEO of Aged & Community Services Australia (ACSA), Patricia Sparrow, said the organisation and its members were pleased to have contributed to the aged care resource.

“We believe the work of The Healing Foundation in providing information about how aged care services acknowledge the needs, and care for Stolen Generations survivors is critical.

“Through these resources, providers of aged care are able to better understand some of the trauma and triggers as well as the diversity of needs for Stolen Generations survivors, which must be considered in delivering the best quality care for all people,” Ms Sparrow said.

Download

Working-with-Stolen-Generations-Aged-Care-fact-sheet

Resources will now be developed for hospitals, allied health professionals and disability services.

The fact sheets provide practical tips, tailored for each profession, on how staff and management can improve services to Stolen Generations survivors. The suite of fact sheets can be downloaded here.

The Healing Foundation is a national Aboriginal and Torres Strait Islander organisation that partners with communities to address the ongoing trauma caused by actions like the forced removal of children from their families.

Aboriginal and Torres Strait Islander Elder Care News : Read or download both NACCHO’s 15 Recommendations and @AMAPresident 42 Recommendations in submissions to the Royal Commission into Aged Care Quality and Safety

” Older Aboriginal and Torres Strait Islander people are being let down by the aged care system.

 They are significantly underrepresented in residential aged care services, at under one per cent, and their uptake of dementia services is very poor.

Yet older Aboriginal and Torres Strait Islander peoples experience at least 2.3 times the burden of disease as other Australians and are also 3-5 times more likely to experience dementia.i

 It is a sad indictment of the system that the care needs of our ageing First Peoples are not being met.

The needs of older Aboriginal and Torres Strait Islander peoples require urgent attention by the Australian Government and the health and aged care systems.

NACCHO Submission to the Royal Commission into Aged Care Quality and Safety 30 September 

Download the full NACCHO Submission HERE

NACCHO submission_Royal Commission Aged Care Quality and Safety_September 2019_FINAL (1)

Read previous NACCHO Aboriginal and Torres Strait Islander Elder Care articles

 ” The Royal Commission, we know, has been extended to 2020, November 2020.

And they’re having to encounter and deal with an enormous number of submissions, of stories that we see making the front pages of our papers and the headlines on our evening news day after day after day.

They’re stories of neglect, they’re stories of lack of care, of stories of lack of access at the appropriate and necessary time of their life.

The Aged Care Commission will deliver its findings in November 2020 and they need that additional time – it’s just been announced that their findings will be delayed another six months, because they’ve got to deal with all the necessary work and all the submissions they’re receiving.

But the message I want to leave with you today is that we can’t wait for the findings of the Royal Commission to start investing in aged care.

AMA President, Dr Tony Bartone, and ANMF President, Annie Butler, Doorstop, Parliament House, Monday, 30 September 2019 Pictured above :

Aboriginal and Torres Strait Islander people living in regional, rural and remote Australia experience particular challenges in accessing culturally and linguistically appropriate aged care services and supports.

Ongoing investment into programs such as the National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP) is essential in supporting the growth and development of aged care services for Indigenous Australians. ” 

AMA Recommendation 40 of 42 see in full Part 2 below or Download 

As the Commissioners will be aware, the population of First Peoples aged 65 and over is projected to grow by 200 per cent between 2011 -2031.ii

This unprecedented population growth combined with the complex health issues that our people experience as they age presents major challenges for providers of both aged care and primary health care to respond to increased service needs from Aboriginal and Torres Strait Islander elders.

We believe it is imperative that the Australian Government commits to resourcing more innovative, efficient and effective solutions that address the barriers to accessing aged care solutions for older Aboriginal and Torres Strait Islander peoples.

NACCHO welcomes the opportunity to provide this submission to the Royal Commission into Aged Care Quality and Safety.

We wish to acknowledge the comprehensive nature of this inquiry, including the different ways in which members of the public, aged care providers and other interested agencies have been invited to contribute.

The Royal Commission hearings have provided ample evidence of the key components and conditions that make up best practice aged care for older Aboriginal and Torres Strait Islander peoples.

They have also provided evidence of systemic failures to provide culturally safe, accessible care. It is also evident from the hearings, however, that there is a genuine interest among all participants to better understand the needs of older Aboriginal and Torres Strait Islander people in order to inform recommendations on how to improve their health and aged care outcomes.

NACCHO’s vision is that all Aboriginal and Torres Strait Islander peoples be able to enjoy quality of life through whole-of-community self-determination and individual spiritual, cultural, physical, social and emotional well-being.

To enable this vision, our people must be granted agency in the development and implementation of policies and programs that impact on their lives, as enshrined in the Aboriginal and Torres Strait Islander Act 2005 (Cth) and the UN Declaration on the Rights of Indigenous Peoples 2007.iii

We believe the next step forward in addressing the needs of older Aboriginal and Torres Strait Islander peoples as outlined in this submission, is a genuine commitment from the Australian Government to work in partnership with Aboriginal and Torres Strait Islander peoples and their representatives to develop solutions and oversee their implementation in services on the ground.

This submission addresses the Royal Commission’s Terms of Reference in relation to the criteria of:

  • Person-centred aged care;
  • Challenges and opportunities for delivering accessible, affordable and high quality aged care services; and
  • How best to deliver aged care services in a sustainable way, including through innovative models of care and investment in the aged care

NACCHO’s response to the Terms of Reference includes feedback received from our member services, Aboriginal Community Controlled Health Organisations (ACCHOs), who deliver a range of services in urban, rural and remote communities across Australia.

NACCHO Concluding comments and recommendations

It is imperative that, given the population projections of older Aboriginal and Torres Strait Islander peoples, the burden of disease they carry, and their underrepresentation in the aged care system, that their needs and preferences are given urgent priority.

NACCHO believes the next step forward is for the Australian Government and providers to deliver on what works, in genuine consultation with Aboriginal and Torres Strait Islander peoples and their representatives.

Aboriginal and Torres Strait Islander peoples need to be decision makers on what a culturally safe aged care system looks like.

NACCHO is strongly committed to and interested in being part of the solutions to address the care needs of our people and is confident that, with adequate resourcing, the Aboriginal community controlled health sector has the knowledge and experience to make a positive difference to older First Peoples’ health and aged care outcomes.

The following list of recommendations are based on our consultations with Aboriginal and Torres Strait Islander representatives, including our member services.

NACCHO recommends that:

  1. Cultural safety be embedded across all areas of aged care services, compliant with what is outlined in the Aged Care Diversity Framework and Action xxxvi
  2. Cultural safety be a mandatory part of accreditation
  3. As part of their accreditation requirements, mainstream aged care services commit to work collaboratively with local ACCHOs, including seeking their advice on issues relating to cultural safety and trauma-informed
  4. Aboriginal community controlled organisations be funded to deliver regular cultural competency training, tailored to local protocol, to mainstream aged care
  5. Regular cultural safety training be mandatory for all aged care assessors and call centre staff.
  6. There must be a concerted effort to increase the numbers of Aboriginal and Torres Strait Islander peoples who receive higher levels of package care (levels 3 and 4).
  7. That the Australian Government commit to undertaking feasibility studies on the need for additional residential aged care services in remote and very remote locations in close consultation with Aboriginal local communities, including exploring options for:
    1. additional National Aboriginal and Torres Strait Islander Flexible Aged Care Services; and
    2. establishing Aboriginal and Torres Strait Islander specific, community-based, small scale hostels with formal ties to local ACCHOs and/or residential aged care services.
  8. Funding for interpreters be available for Aboriginal and Torres Strait Islander language speakers as it is for other
  9. Aboriginal and Torres Strait Islander run aged care services become eligible to access block
  10. Aboriginal Community Controlled Health Organisations receive an increase in their baseline funding in recognition of:
    1. the vital roles they play in keeping older Aboriginal and Torres Strait Islander peoples healthy and well in community and residential aged care settings;
    2. the projected population growth of this age group; and
    3. the significant burden of disease and complex health conditions experienced by older Aboriginal and Torres Strait Islander
  11. ACCHOs are designated as preferred providers of aged care navigation services for older Aboriginal and Torres Strait Islander peoples, through the aged care application and assessment
  12. ACCHOs are designated as preferred providers of primary health care for all Aboriginal and Torres Strait Islander residents of aged care
  13. The Australian Government increase its investment in integrated primary health and aged care exemplified by
  14. The Australian Government, at a minimum, reinstate aged care workforce funding to the same level prior to the 2015
  15. Aged care services are funded to employ Aboriginal liaison

PART 2 The AMA makes the following recommendations to the Royal Commission and looks forward to further working with the Royal Commission and the Australian Government to further improve the aged and health care systems.

Aged care workforce

Recommendation 1: Retaining and increasing the number of doctors interested in working in the aged care space should be the focus of any future reforms in aged care if appropriate clinical care is to be provided. Investing in primary care particularly for patients in aged care settings will save on public hospital expenditures.

Recommendation 2: Further investigation and research is needed into the demographics and movements of GPs in the aged care sector due to the decreasing trend in GP aged care visits and an ageing medical workforce. The research needs to take into consideration the forward-looking trends of expenditures related to Australia’s ageing population and the projected need for the medical workforce.

Recommendation 3: Medicare rebates need to increase in excess of 50 per cent to begin to adequately compensate for the additional time and complexity involved in comparison to a GP attendance in their own consulting rooms.

Recommendation 4: Introduce an MBS telehealth item for phone calls between the GP, RACF staff and relatives. This may reduce some barriers to accessing medical services after hours. The Government should consider introducing telehealth for RACFs for afterhours consultations as a pilot. Outcomes of such a pilot program will help inform government policy and provide an evidence base for informed decision making.

Recommendation 5: The Royal Commission should investigate the absence of routine roles for geriatricians and psychogeriatricians and how this should be addressed to better support GPs.

Recommendation 6: Further research is needed into improved funding and workforce models for medical care of older people.

Recommendation 7: Aged care providers need to provide basic equipment and facilities to support doctors to carry out their services in aged care settings. This includes access to a consulting room, a computer and appropriate clinical software.

Recommendation 8: Education and training for Doctors in Training and medical students on caring for older people should be increased.

Recommendation 9: Registered nurses should be available on site, 24 hours a day in RACFs to ensure older peoples’ medical needs are adequately met, including the appropriate administration of medicines.

Recommendation 10: There should be a mandatory minimum qualification for personal care attendants that includes basic health care.

Recommendation 11: Government should provide additional funding for specialised training of the aged care workforce, primarily personal care attendants. This should include a professional development leave option for those wanting to further develop their skills.

Recommendation 12: Implement a streamlined process to improve access to respite care for people who have not yet been assessed by an ACAT/RAS or who have not yet entered the aged care system.

Recommendation 13: Minimum mandatory staff-resident ratios should be researched and then introduced in RACFs that reflect the level of care need of older people and ensure 24 hour on site registered nurse availability.

Recommendation 14: The Aged Care Safety and Quality Commission should investigate staff turnover when assessing and auditing aged care providers.

Recommendation 15: The effectiveness of the aged care assessment process should be improve by including the patient’s usual doctor in the assessment arrangements.

Fragmentation between health and aged care systems

Recommendation 16: Communication between doctors, hospitals and aged care providers must be improved through minimum standards and guidelines.

Recommendation 17: Government must make more home care packages available to older people to address their care needs and to prevent the need for more complex care in RACFs and hospitals.

Aged care regulation

Recommendation 18: More specific Aged Care Quality Standards, including a Medical Access Standard should be developed for RACFs that helps to facilitate access to doctor services and high-quality clinical care.

Recommendation 19: Quality Indicator data should be made an integral part of the accreditation/audit reports conducted by the Aged Care Quality and Safety Commission.

Quality of care in aged care settings

Recommendation 20: Palliative care must be built into any aged care model, by defining the skills and staff requirements and recognising that palliative management is a basic RACF service. The funding model must be flexible enough to account for increased needs at the end of life and be responsive enough to allow for reassessment when required.

Recommendation 21: AMA members support mandating the requirement that all RACFs residents should have a current up to date ACD. AMA members also contend that there should be an MBS item/fee available for GPs to complete ACDs with their patients living in RACFs or their SDMs.

Recommendation 22: Further work is needed to raise awareness among aged care service providers on advance care planning, the role of aged care providers in ensuring the development and implementation of advance care plans, directives and communication around hospital transfers and the person’s usual GP, the need for caring staff to be aware of existence of ACDs, My Health Record and advance care planning, as well as the role of ACDs in clinical care.

Recommendation 23: Expand the Better Access to Mental Health Initiative to ensure older people living in RACFs receive the same access to mental health services as the rest of the population.

Recommendation 24: Improve dementia management and behavioural training for nursing and personal care staff attendants to reduce prescription of antipsychotic medication.

Recommendation 25: Doctors must be able to maintain clinical independence in order to make the best treatment recommendations for patients, based on current evidence, preserving their own clinical judgments regarding treatment recommendations.

Recommendation 26: Medication reviews should occur annually, and when there is a significant change in an older person’s medication and/or medical condition.

Recommendation 27: A National strategy on polypharmacy should be developed, along with evidence-based guidelines for prescribing to the elderly. Having a strategy and guidelines may reduce adverse events, hospitalisation and PBS costs.

Recommendation 28: Develop and implement national nutrition standards for aged care facilities, ensuring menus are varied and food is appealing and palatable.

Recommendation 29: Continuing education on elder abuse and neglect of the profession, including doctors, nursing aged care staff and personal care staff is essential to evaluate and mitigate medical and psychiatric consequences for the victims.

Recommendation 30: Introduce relevant safeguards for whistle-blowers in aged care, along with regulation for urgent mandatory investigations into their revelations.

Recommendation 31: Older people should maintain the choice of their preferred medical practitioner in residential care.

Recommendation 32: Simplify the aged care navigation process and ensure access to more information on aged care provider performance against the Aged Care Quality Standards.

The use of technology in aged care

Recommendation 33: Greater transparency for GPs and patients to be able view the progress of aged care assessments. This will provide GPs with confidence that their patients are being provided with the necessary care in a reasonable timeframe, as well as enable GPs to take action if this is not occurring.

Recommendation 34: More investment in innovation, digital technologies and telehealth in aged care.

Recommendation 35: Use of digital technologies in aged care in the future should be planned now by the Government and in coordination with relevant stakeholders.

Aged care in regional, rural, and remote Australia

Recommendation 36: Government needs to develop comprehensive plans to better support the provision of health and aged care in regional, rural, and remote Australia, and to commit to significant funding increases to bridge the gap between city and country.

Recommendation 37: Multi-purpose model of services for rural and remote communities should be further supported by the Government, particularly with the implementation of new Aged Care Quality Standards and accreditation under those standards for multi-purpose providers.

Young people living in residential aged care facilities

Recommendation 38: Options other than residential aged care facilities should be explored and implemented by the Government for younger people with disabilities who are currently serviced by residential aged care facilities.

Recommendation 39: Better coordination between disability and aged care systems is required to enable seamless transition between different services for people living with disability. Coordination with primary care in the process is crucial as well as other service sectors including allied health.

Aged care for special needs groups

Recommendation 40: The AMA calls for more research into health and aged care needs of special needs groups, including but not limited to CALD, ATSI and LGBTQI. These groups have particular needs around culturally appropriate and culturally safe services, which should be further documented and enable equity in accessing services and service provision.

The need for research on the care of older people

Recommendation 41: More research into care of older people in the future, including appropriate aged care and health care data collection to inform future policy and regulation.

Recommendation 42: Conduct a scientific evaluation of the impact of government policies on the wellbeing of older Australians. This will lead to proper policy adjustments and revisions as needed.

Have your say about Elder Care what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

 

NACCHO Aboriginal Health and #ElderCare : Broome hearing of the Royal Commission focuses on the ability of our mob to gain access to aged care services as well as the extent to which #remote areas are included in the availability of aged care services

 “Could I then turn to what is a good news story, and if we could go back to Bidyadanga. 

You will shortly hear from three people who deliver care in the Aboriginal community of Bidyadanga.  The community council there comprises two members of each of the five language groups.

 Primary medical care is delivered by the Kimberley Aboriginal Medical Service, KAMS, through the Bidyadanga Health Centre.  On Wednesday, you will hear from the general practitioner who works for both KAMS and the Broome Regional Aboriginal Medical Service. 

That’s BRAMS, and travels to Bidyadanga for two days on a weekly basis to work at the clinic.  Another doctor is also present for a number of other days during the week. 

The centre has four remote area nurses and one or two Aboriginal health workers.  One senior Aboriginal health worker, who is a senior community member, has worked at the facility for well over 10 years.

There are also currently three Aboriginal liaison officers who work part-time for the clinic and two full-time administration staff. 

KAMS also trains general practice registrars who come up on six to 12 month blocks to provide primary care and emergency services to the community.

 Through the prism of Bidyadanga, the Commission can see firsthand the critical intersection between primary health and aged care in a location where there is no residential care in the traditional sense “

Extract from Monday 17 June transcript for The Royal Commission into Aged Care Quality and Safety that is holding a public hearing in Broome this week .

See SMH media Coverage : Indigenous people believe aged care isn’t ‘culturally safe’, and ageing earlier

The Broome hearing of the Royal Commission focused on the ability of Aboriginal and Torres Strait Islander people to gain access to aged care services as well as the extent to which remote areas are included in the availability of aged care services.

Specifically, the Broome hearing inquired into:

  • the unique needs of Aboriginal and Torres Strait Islander people when it comes to aged care services
  • the perspective and experience of people who access aged care in remote areas including family members and carers
  • the nature and scope of aged care services for Aboriginal and Torres Strait Islander people living in remote areas
  • the barriers to accessing aged care services for people living in remote areas
  • the challenges of maintaining an adequately skilled and culturally appropriate workforce in remote areas
  • good practice care models for people living in remote areas

The Royal Commission heard evidence from witnesses from the local community and surrounding areas as to their experiences of aged care services.

For more information about the hearing consult the Hearings page on the website and more information about the community forum can be found on the Engagement page.

Proceedings can be viewed or listened to using the webcast on the Royal Commission website. Hearing transcripts will also be available at the end of each hearing day.

Public submissions

The Royal Commission into Aged Care Quality and Safety invites interested members of the public and institutions to make submissions to the Royal Commission using an online form (the link to the form is below). The Royal Commission will continue to accept submissions until at least the end of September 2019. A date for the closing of submissions will be announced in the second half of 2019.

The online form is designed to capture information that is relevant to the work of the Royal Commission and consistent with the areas of inquiry set out in the Royal Commission’s Terms of Reference

Online Form HERE

Download the full transcript-17-june-2019

Read all the NACCHO Aboriginal Health and Elder Care articles

Location of Indigenous-focused aged care programs See ANAO 2017 Report

”  Commissioners in this fourth substantive public hearing, the focus of the evidence will be on aged care in remote areas of Australia and the related issues of access and inclusion with specific attention being directed to Aboriginal and Torres Strait Islander people.  People who identify as being Aboriginal and Torres Strait Islander comprise 16 per cent of the remote population and 46 per cent of the very remote population.”

Mr Bolster Counsel Assisting

For this reason, it is important that the Royal Commission when inquiring into aged care in remote areas, consider aged care services for people who identify as Aboriginal and Torres Strait Islander.

It would, however, be a mistake to conflate Aboriginal and Torres Strait Islander people and life with regional and remote locations, remembering that over 60 per cent of Aboriginal and Torres Strait Islander people live in major cities or inner regional areas.

With that in mind, and while it will receive some attention in this hearing, the particular needs of Aboriginal and Torres Strait Islander people living in urban areas will be explored further in later hearings, including the Perth hearing next week.

What is remote aged care?

We commence the answer to the question by identifying examples that frame the experience of delivering aged care in some of the most remote locations imaginable.

At Docker River in the Northern Territory, close to its south-western corner, is a facility known as Tjilpi Pampaku Ngura Flexible Aged Care Service.  It services a population of 394 with a median age of 31 of whom 74 per cent are Aboriginal.

It is funded to provide care for 19 residential care places and 22 home care packages.  Tjilpi Pampaku Ngura is in the traditional lands of the Anangu people and the predominant language is Pitjantjatjara, English being spoken at home in only 14 per cent of households.

Alice Springs is nearly 700 kilometres to the east on principally dirt roads and involves an eight to nine hour drive or a chartered plane.  There are no regular airline services.  Diesel is the only fuel available.  The median annual income is $15,000, just over a quarter of what it is in Darwin.  We will be talking about Docker River shortly.

On the other side of the border in the Anangu Pitjantjatjara Yankunytjatjara or APY Lands in remote South Australia, 217 elders receive aged care services through Aboriginal Community Services SA from whom you will hear evidence, predominantly via the Commonwealth Home Support Programme as well as a limited number of home care packages.

Balgo, or Wirrimanu in the eastern Kimberley is a 250 kilometre trip south of Halls Creek and over 10 hours from Kununurra.  The drive is mainly on dirt roads that are often impassable in the wet season.

A population of between 500 and 600 is serviced by a health centre run by the Aboriginal Community Controlled Health Service with visits by doctors of the Kimberley Aboriginal Medical Service.  Aged care services, predominantly home care packages and CHSP, are delivered by Kimberley Aged and Community Services, an arm of the WA Country Health Service known as WACHS.

That’s in partnership with the local Aboriginal Corporation.  At Balgo, a loaf of bread and long-life milk cost around three times the price that you will pay for them in Kununurra.

Balgo is one of a  number of remote communities in the Kimberley where care is delivered through a place-based partnership model where there is a relationship with the local Aboriginal community corporation.  KACS, that is Kimberley Aged and Community Services,  also delivers home care packages directly at a number of other remote locations as well as undertaking client case management reviews, referrals to specialists, recruiting and training remote workers as well as quality monitoring at smaller locations.

On Thursday Island there is a 40 bed residential aged care facility known as the Star of the Sea where 80 per cent of the staff identify as Aboriginal or Torres Strait Islander.  Star of the Sea is the only residential aged care facility in the Torres Strait.  It contains a central meeting room known as the Ocean Room that overlooks the Torres Strait, thereby providing resident with a connection to the ocean to which that unique culture is inextricably attached.  As the High Court observed in Mabo v Queensland (No 2), “the Meriam people of the Torres Strait retain a strong sense of affiliation with their forebears and with the society and culture of earlier times.  They have a strong sense of identity with their islands.”  In the case of the Torres Strait, the geography is such that many of the islands are small and spread over a vast area as the map, which should be on display, identifies.

Finally, 200 kilometres south of Broome is Bidyadanga, one of the largest remote Aboriginal communities in Western Australia with a population of 700 to 1000 people.  It is home to five language groups, Karajarri, Juwalinny, Mangala, Nyungamarta and Yulpartja.  Bidyadanga has a dedicated aged care service with a CHSP-funded HACC centre, HACC being a reference to the former Western Australian Home and Community Care Program.  People in Bidyadanga have high care needs;  there are no residential care options available other than a move far away from country to Broome.  Consistent with what this Royal Commission has been told in earlier hearings, people in Bidyadanga have a strong preference for being able to stay in their own home.  Just as importantly, they want to stay on country for as long as possible.  Bidyadanga has a health centre, general store, and outposts of government agencies including Australia Post and Centrelink.  The local fishing is good.  I’m told the blue nose thread fin salmon cooked on coals is a good reason to stay there.

These are just a few practical examples of the remote places where aged care is delivered;  each will be the subject of evidence at this hearing.

Madeleine Jadai brought photos to emphasize the importance of family to Indigenous people requiring aged care. CREDIT:ROYAL COMMISSION ON AGED CARE QUALITY AND SAFETY

I turn now to the question of what “remote” means.

For the purpose of delivering services in remote Australia, the Commonwealth relies on at least two methods of classifying regions as remote or very remote.  The first of these, known as the Modified Monash Model is used for service delivery purposes by the Department of Health.  It has seven levels ranging from level 1 which represents major cities through to level 6 and 7 for remote and very remote.

It’s best explained by a chart that is – it should be coming up on the screen now.  The yellow portions are the very remote portions.  They’re MMM7.  And the MMM6 portions are the lilac colour slightly closer to the coast on the east coast.  And in the case of Tasmania, there’s another graph which we attach and the Commission will see that both in the case of King Island and the Flinders Island group, they are very remote.  There is a comparable ABS remoteness classification which is largely to the same effect and the relevant charts for that purpose will be in the evidence.  Any consideration though of remote aged care needs must extend beyond the States and the internal Territories and address the external Territories as well.

Of the seven external Territories only three support a permanent population, Christmas Island, the Cocos (Keeling) Islands and Norfolk Island.  All three are classified as very remote under the Modified Monash Model and the Commonwealth Department of Infrastructure, Regional Development and Cities has responsibility for health care on both Christmas Island and Cocos (Keeling) Island.  That is delivered through a standalone Indian Ocean Territories Health Service.  A recent March 2019 report by PricewaterhouseCoopers, prepared for the Commonwealth, noted that although each has a strong and easily accessible primary health care service, which is known as the Indian Ocean Territories Health Service, there is no aged care – residential aged care in either Territory.  Complex procedures are delivered in Western Australia.

The PwC report is currently with government and community consultations were commenced on Christmas Island in May and there will be future consultations on Cocos (Keeling) Island in June.  This is a significant issue and one that will be explored in further hearings.  The Norfolk Island situation is slightly different.  Norfolk is categorised as RA5 under the ABS remoteness classification.  It is not classified under the Modified Monash Model.  It is located within the South-East Sydney Aged Care Planning Region and the Central and Eastern Sydney Public Health Network.  Norfolk Island Health and Residential Aged Care Services is an integrated multipurpose service, and I will be talking more about multipurpose services later;  it provides 14 high-care residential aged care places on the island.

Can we turn now to the Kimberley.  The Kimberley Aged Care Planning Region is one of 73 planning regions across Australia and you’ve already heard evidence about the significance of such regions for aged care planning and funding purposes.  The Kimberley region provides a useful snapshot of the features of aged care in remote and very remote Australia.

Although it must be acknowledged that there are many differences between regions across the country, including cultural and geographic differences.  According to ABS census data from 2016 published by the Australian Institute of Health and Welfare on the generation aged care website, just over 31 and a half per cent of the region’s population aged 50 or over identifies as an Aboriginal or Torres Strait Islander person.  That’s to be contrasted with the national or state average of about one and a half per cent.  23 – 21.3 per cent of the population over 65 was born overseas as opposed to around 36 per cent nationally.  But there is a higher proportion of people over 65 for whom English is not their preferred language.

In terms of service delivery there are a number of features that stand out.  Although there are more residential aged care places per 1000 people than the state and national average, the vast majority of residential care places are provided by not for profit providers.  This equates to around 83 places per 1000 people over 70.  At this hearing you will hear evidence from and about providers that operate in Western Australia, particularly in the Kimberley, the Northern Territory, South Australia and Far North Queensland, servicing the Torres Strait.  Whilst a number of places are provided by government providers, roughly six per 1000, there are no residential aged care places provided by for profit organisations in the Kimberley, whereas on average there are 30 places per 1000 people aged 70 or over nationally and around 22 per 1000 in Western Australia provided by for profits.

In the Kimberley, unlike the position nationally, slightly more males use permanent residential aged care than females.  Similarly, unlike the position nationally and in the rest of the State, the majority of residents in the Kimberley are Aboriginal and/or Torres Strait Islander.  There is also a markedly higher proportion of people whose preferred language is not English, even though such residents were born in Australia or another English speaking country.  Perhaps the most significant comparison between the Kimberley and urban Australia is to be seen in the age profiles of those that use aged care and there’s a graph that should be coming up on the screen now.

Focusing for the moment on those that use residential aged care, it can be seen that as of 30 June 2017, the demand by Aboriginal and Torres Strait Islander males presents at a much earlier age than is the case in the typical urban cohort.  The graphs that follow provide a comparison between the demand for residential care and home care in the Kimberley, Alice Springs and inner west Sydney regions.  It gives much the same impression establishing that the largest cohort of men in the city is likely to be between 80 and 90 years old, whereas in the Alice Springs and the Kimberley the corresponding cohort is much young, spanning the years 65 to 79.  The position is roughly comparable in the case of women, although the gap would seem to be slightly smaller given that Aboriginal women tend to enter aged care later than males.

I turn now to the question of culturally safe care. 

There are also particular important considerations that arise in relation to the provision of aged care for Aboriginal and Torres Strait Islander people which will be explored at this hearing.  It’s important to note the diversity of Aboriginal and Torres Strait Islander cultures and language.  There are over 500 indigenous nations and over 250 different language groups across Australia.  An approach that works for one particular cultural group may not be appropriate in another setting.  At the forefront of these challenges, whether care is delivered in the city, rural or remote Australia, it needs to be culturally safe and culturally appropriate.  Whilst this encompasses many things and will hold different meanings for different cultural groups, for Aboriginal and Torres Strait Islander people we will hear that at its centre is the acknowledgement of the identity of the person and their connection to community and country, their community and their country.

One witness will tell you that this may mean different things in different parts of the country, and in that sense it has aspects that are location based and dependent on the particular cultural practices of the region.  It also has an individual element that depends upon the personal history of the person and in this respect, the perspective of people in the Stolen Generation comes to mind.  The following are common themes that the evidence is likely to demonstrate.

The first, as I’ve said, is connection to country.

We will hear about the importance of having connection with country and staying on country as people age.  For people who are no longer living in their country, having the opportunity to return to country is important.

You will hear how in Derby and in other places, the Juniper facilities, like other facilities across the country, arrange to transfer residents to country with support staff.  You will hear of the challenges for older people who may be forced with having to go off country to access health and aged care services, in particular when it comes to residential care.

 Secondly, there is the connection to family and community.

In this respect, we will explore the unique role of the elder in traditional Aboriginal and Torres Strait Islander communities and how the important cultural responsibilities associated with that role need to be understood when attempts are made to provide care.  We expect that you will hear evidence about a collectivist culture where there is a sharing of resources and the challenges in delivering home care to an older person in that setting.

Thirdly, there is language.

Language plays an important role for many Aboriginal and Torres Strait Islander people in their connection to culture, kinship, land and family.  And languages are the foundation upon which the capacity to learn, interact and to shape identity is built.  Fourthly, there are important cultural requirements in the lead-up to and immediately following the passing of an Aboriginal person.  You will hear evidence about how for some cultures a smoking ceremony is conducted in the deceased’s living space for religious and cultural purposes, together with ceremonies after death that may involve keeping the body in place for a period of time before burial in country.

In some cultures it may be appropriate for attendance by kin or community members at ceremonies associated with an impending death.  It would appear that there may be a need to provide notice that a person is dying so that arrangements can be made for necessary attendances for sorry time or sorry business.  Singing ceremonies before and after death need to be understood and respected.  You will hear of one service that has sought to have a separate palliative care residence where there is space for family and community to spend time with the older person.  At the same time, it needs to be borne in mind that some Aboriginal and Torres Strait Islander people have cultural reservations about discussing these matters.  We seek to approach this matter respectfully and in good faith so that these matters can ensure better delivery of culturally safe care.

Food, of course, plays an important role in culture.

You will hear evidence that delivery of cultural food at least once a week in a residential facility will enhance the experience of Aboriginal and Torres Strait Islander Elders.  Awareness of these relationships and a commitment to embrace them is critical to delivering culturally safe care and obtaining the trust of the resident and their community.  We will also explore what is culturally safe palliative care, an issue that can be complicated by some traditional approaches to death.

On another level, the everyday delivery of care may involve attention to significant male and female roles and kinship relationships.  Gender, clan and kinship can impact on whether it is appropriate for a particular person to provide care to another person.  This can present challenges in terms of workforce and recruitment.  Overall, the delivery of cultural safe care is based on trust on the part of the care recipient and this is an issue that will be considered by a number of the witnesses.  One witness is likely to tell you that it is best where care is provided as close as possible to home, by people who are sensitive to the history and culture and needs of that resident, and you will hear from some of those witnesses today.

Another witness will talk about place-based models of care.  You will also hear about the time that it takes to develop trusted relationships that are required to deliver care.  Ruth Crawford, a nurse for 45 years, is the manager of the Kimberley Aged and Community Services and she will give evidence tomorrow about the partnership model of care that operates in places such as Balgo, Bidyadanga and a number of other remote communities within the Kimberley.  You will hear that where care is not culturally safe, Aboriginal and Torres Strait Islander people are not likely to access services.  You will also hear about the challenges that Aboriginal and Torres Strait Islander people face in navigating My Aged Care.

The barriers that prevent access to the aged care system or getting the types of level of assistance they need come in many forms.  The aged care assessment process requires a person to talk about their intimate and personal health, their domestic situation;  all of this with a complete stranger.  That stranger may be of the opposite sex and may not have had any cultural awareness training.  You will hear that this framework leads to Aboriginal and Torres Strait Islander people avoiding the aged care system, withdrawing from the ACAT discussion.

You will also hear how My Aged Care assumes a level of literacy and good access to postal services as well as e-literacy and connection that is not a reality in some parts of Australia.  You will hear about the services that work to get around these barriers by wrapping around the older Aboriginal or Torres Strait Islander person.  They use their pre-existing relationship of trust to get the person to an ACAT assessment and support them through it.  Much of this work is done without aged care funding and depends upon the goodwill and flexibility of committed services and staff and members of the local community.  Language is also a barrier.  When an Aboriginal or Torres Strait Islander interpreter is required, in the limited circumstances that there is a professional interpreting service available, the person can be required to pay for this out of their home care package.

Can I turn then to funding structures.

Commissioners, you have already heard evidence about how aged care is predominantly delivered through residential aged care, home care packages, as well as the Commonwealth Home Support Program.  Some providers of residential and home care are also eligible for viability supplements in recognition of the additional costs of delivering care in remote settings or to people defined as special needs groups under the Aged Care Act, and that includes Aboriginal and Torres Strait Islander people.  While each of these programs operate in the context of remote and very remote Australia, there are additional programs that is will be under examination in this hearing which we would like to outline briefly.

The first and largest of those is the National Aboriginal and Torres Strait Islander Flexible Aged Care Program known as NATSIFACP or sometimes NATSIFlex which I will use because I think it’s easier.  The stated objects of that program are to deliver a range of services to meet the changing aged care needs of the community, to provide aged care services to Aboriginal and Torres Strait Islander people close to home and community, to improve access to aged care services for Aboriginal and Torres Strait Island people, to improve the quality of culturally appropriate aged care services for Aboriginal and Torres Strait Islander people and to develop financially viable cost effective and coordinated services outside of the existing mainstream programs.

NATSIFlex operates, as I said, outside of the Aged Care Act and providers are block funded based on an agreed allocation of aged care places and the types of places.  Unlike ACFI funding, there are two levels of residential care and two levels of home care, one high and one low.  The intention is to provide stability of funding and flexibility.  Nationally, the program funds 453 residential aged care beds, 11 respite places and 396 home care services in 30 organisations delivered through 35 services.  Currently the Commonwealth is prioritising the conversion to NATSIFlex status for which there are only limited opportunities, and this is to a very small number of services, those that are likely to struggle under mainstream funding arrangements.

Debate surrounds whether this is the right criteria or whether there should be any restriction on conversion of mainstream services to NATSIFlex status.  You will hear from the provider Juniper about how their 40 bed facility at Kununurra, built with a Commonwealth grant, is precluded from NATSIFlex funding by reason of these criteria.  There may, however, be reasons to prefer services that operate in the mainstream wherever possible and that they only – the conversion to NATSIFlex only be allowed if it’s necessary to ensure ongoing viability.

To put the matter in perspective, the Commonwealth projects that by 2029 the use of ACFI-funded residential care in remote and very remote Australia will have increased by nearly 700 places or 63 per cent on current levels.  Similarly the use of NATSIFlex-funded places will have increased by 227 or 61 per cent.  Resident pathways into NATSIFlex care are broader and more flexible than the pathways under the Aged Care Act.  ACAT assessment is not required and referral can be from a range of sources, including My Aged Care, CHSP assessors, GPs, social workers, etcetera.  Residential care can be either permanent or short term and you will hear evidence that in some locations residents take up the care, particularly during the wet season when travel is difficult.

At least one witness is likely to criticise the program on the basis that the flexibility of the system means that admission to residential care is often premature, expressing the view that care at home, funded by other programs, including the NDIS, would suffice and that such a result may be driven by providers looking to increase occupancy rates so as to increase their funding.

Witnesses are also likely to consider whether the number of Aboriginal and Torres Strait Islander people receiving aged care at an earlier age reflects gaps, whether current or historical, in primary health care and disability services, rather than premature ageing.  There is a real issue as to whether NATSIFlex funding enables service providers to respond to the pressures associated with the remote delivery of care, particularly having regard to the challenges of providing culturally appropriate care.  Grants only operate for periods of between two or three years and seem geared to provide the revenue associated with providing care to residents, not providing the basis for any capital development or improvement.  There are other avenues through which support, including for capital grants, is provided by the government, including the Aboriginal and Torres Strait Islander Aged Care Service Development Assistance Panel, the SDAP.

This program provides funding to enable providers to obtain specialist advice and assistance in a range of areas, including service delivery, sector support and financial and project management.

Australian Regional and Remote Community Services, or ARRCS as we will refer to it, is the largest NATSIFlex provider in the country, operating the facility at Docker River, previously referred to, and facilities at Mutitjulu, Tennant Creek in the Northern Territory.  Its related organisation, Pinangba, which operates in Queensland, is the operator of the Star of the Sea facility on Thursday Island.  ARRCS is one of the two providers through whom UnitingCare Queensland delivers aged care services to Aboriginal and Torres Strait Islanders.  You will hear from the group general manager of that organisation responsible for the regional and remote community services, along with the CEO of UnitingCare Queensland, the parent company.

A second relevant program is the funding of Multi-Purpose Services or MPS which are partnerships between the Commonwealth and State and Territory Governments to deliver integrated health and aged care services in very small communities, particularly in regions where it is not viable to operate a standalone hospital or a standalone aged care service.  Mention also needs to be made of the Aged Care Regional, Rural and Remote Infrastructure Grants funding round which provide support to regional, rural and remote aged care service providers to undertake infrastructure works.

Could I then turn to the issue of home care packages in this region.

Waiting times for the delivery of remote home care packages are a matter of concern and largely mirror the position in the rest of Australia.  Evidence from the Commonwealth is to the effect that in remote and very remote Australia there were 1480 approvals for home care packages in calendar year 2018.  Of those living in remote or very remote regions who were assigned their first package, regardless of level, in that period, only 38.8 per cent, that is 608 people, received that assignment within nine months.  For most people, the time between approval and assignment exceeds nine months.  There were significant numbers who had not been assigned a provider after 18 months:  218.

At the two year and beyond period, the figure was 68 and at the three year period, there were 28 people.  Evidence from the Commonwealth is that in the case of Aboriginal and Torres Strait Islander people they represent 3.1 per cent of participants, although it is not at all clear the extent to which they are required to wait for packages.

There is also a viability supplement paid to all of the providers referred to above, including NATSIFlex and MPS to recognise the higher costs of providing care due to the location, size and client mix of a service.  Despite all of this, the Aged Care Financing Authority warned in September of last year that there were a number of facilities in regional and remote areas that were experiencing significant financial difficulties and were likely to be forced to merge with or sell to a larger provider.

Could I then turn to what is a good news story, and if we could go back to Bidyadanga.

You will shortly hear from three people who deliver care in the Aboriginal community of Bidyadanga.  The community council there comprises two members of each of the five language groups.  Primary medical care is delivered by the Kimberley Aboriginal Medical Service, KAMS, through the Bidyadanga Health Centre.  On Wednesday, you will hear from the general practitioner who works for both KAMS and the Broome Regional Aboriginal Medical Service.

That’s BRAMS, and travels to Bidyadanga for two days on a weekly basis to work at the clinic.  Another doctor is also present for a number of other days during the week.

The centre has four remote area nurses and one or two Aboriginal health workers.  One senior Aboriginal health worker, who is a senior community member, has worked at the facility for well over 10 years.

There are also currently three Aboriginal liaison officers who work part-time for the clinic and two full-time administration staff.  KAMS also trains general practice registrars who come up on six to 12 month blocks to provide primary care and emergency services to the community.  Through the prism of Bidyadanga, the Commission can see firsthand the critical intersection between primary health and aged care in a location where there is no residential care in the traditional sense.

You will hear from Dr Martin Laverty, the CEO of the Royal Flying Doctor Service, on the importance of that sort of primary health care as a means of avoiding admissions to hospital, often far away, and unwanted entry into residential aged care, also far away from that country.

Tomorrow, you will hear from representatives of two providers from the eastern part of the Kimberley.  The first provider is Uniting Church who provide aged care services under the name of Juniper.  It operates the Juniper Ngamang Bawoona and Juniper Numbala Nunga facilities in Derby.  Juniper, from whom you heard evidence at the first Adelaide hearing, cross-subsidises its remote residential facilities with revenue from its more traditional aged care operations in Perth.  The second provider, Southern Cross Care, operates the Germanus Kent House here in Broome, and the associated Bran Nue Dae Day Centre.

We also expect that you will hear evidence from an Aboriginal enrolled nurse who has worked at Germanus Kent House, and that should occur within the next hour or so.

See full transcript to continue transcript-17-june-2019

 

 

 

 

 

 

 

 

 

 

 

NACCHO Aboriginal #Agedcare Health : Minister @KenWyattMP Download : The Aboriginal and Torres Strait Islander Aged Care #Consumer and Provider Action Plans to support the distinctive needs of our mob

” The Aboriginal and Torres Strait Islander Aged Care Action Plan Actions to support older Aboriginal and Torres Strait Islander people, to be launched today, addresses the distinctive support needs of older Aboriginal and Torres Strait Islander peoples and represents the first such aged care strategy since 1994. 

It is one of three aged care action plans being released under the Commonwealth’s Aged Care Diversity Framework, with the other two encompassing the needs of CALD communities and LGBTI people.( see below )

The action plan provides specific guidance to aged care providers on how to address the needs of Aboriginal peoples in enacting the overarching principles of the Aged Care Diversity Framework, which takes a human rights approach to driving cultural and systemic change in the aged care system, and to ensure that all Australians access safe, equitable and high-quality aged care services regardless of their ethnicity, culture, sexuality and life experiences.

Implementation of the plan will increase the accessibility of culturally safe aged care support and services to older Aboriginal and Torres Strait Islander peoples, and provide guidance to mainstream service providers seeking to increase the cultural safety and appropriateness of the services they offer to Aboriginal people.

In particular this plan emphasises the need for mainstream service providers to collaborate and/or co-design services with Aboriginal community-controlled organisations.

Noeleen Tunny is manager of VACCHO’s Policy and Advocacy Unit

Originally published in Croakey

Read all NACCHO Aboriginal Health and Elder care Articles HERE

Download the Action Plans HERE

actions-to-support-older-aboriginal-and-torres-strait-islander-people-a-guide-for-consumers

actions-to-support-older-aboriginal-and-torres-strait-islander-people-a-guide-for-aged-care-providers

Minister Wyatt honoured to join Elders & such an amazing group of dedicated and talented advocates for Aboriginal & Torres Strait Islander Aged Care, launching Australia’s first Aged Care Diversity Action Plan for First Nations people. Thanks – at Parliament House

Part 1 : Aged Care Diversity Framework

From Here

The Hon Ken Wyatt AM MP, Minister for Senior Australians and Aged Care and Minister for Indigenous Health, established an Aged Care Sector Committee Diversity Sub-Group to advise the Government on the development of an Aged Care Diversity Framework and action plans.

The Aged Care Diversity Framework (the Framework) was launched on 6 December 2017.

The Framework is an overarching set of principles designed to ensure an accessible aged care system where people, regardless of their individual social, cultural, linguistic, religious, spiritual, psychological, medical and care needs are able to access respectful and inclusive aged care services. The Framework takes a human-rights based approach in line with the World Health Organization principles of:

  • non-discrimination
  • availability
  • accessibility
  • acceptability
  • quality
  • accountability

Development of the Framework was informed through:

Action plans

Three action plans have been developed under the Framework to assist aged care service providers and government to address specific barriers and challenges faced by:

  • Older Aboriginal and Torres Strait Islander peoples
  • Older people from Culturally and Linguistically Diverse Backgrounds
  • Older lesbian, gay, bisexual, trans and gender diverse, and intersex peoples

In addition there is a shared action plan and government action plan to support all diverse older people.

The action plans are informed by extensive public and aged care sector consultations.

An action plan for older people who are homeless, or at risk of homelessness, is currently being developed.

Part 2 : Actions to support older Aboriginal and Torres Strait Islander people in aged care

Originally published in Croakey

While the gap in life expectancy for Aboriginal and Torres Strait Islander peoples is still significant, there are people living into their older years who require aged care support that meets their diverse needs.

The 65 and over Aboriginal population is projected to grow by 200 per cent by 2031, making it critical for us to get aged care right now.

Aboriginal Australians are affected by chronic disease more frequently and at a younger age than non-Indigenous people. In some areas the prevalence of dementia is almost five times that of non-Indigenous Australians, with higher rates of self-reported falls, incontinence and pain. Yet despite these statistics, Aboriginal and Torres Strait Islander peoples are less likely than the general population to access aged care.

Successive iterations of the Productivity Commission’s Report on Government Services indicate that Aboriginal and Torres Strait Islander peoples who are eligible to receive an aged care assessment are less likely to be assessed than their counterparts in both the general population and in culturally and linguistically diverse (CALD) communities. This disparity was evident both at a national level and in each Australian jurisdiction and suggests a need to support better engagement of older Aboriginal people within the aged care system.

Stolen Generations

Adding further complexity to the space is the fact that 100% of the Stolen Generation will be at least 50 years old by 2023, i.e. eligible for aged care as Aboriginal people can access these services earlier due to their broader lower life expectancy. This group will require sensitive, trauma-informed care that does not re-traumatise them.

The Aboriginal and Torres Strait Islander Aged Care Action Plan Actions to support older Aboriginal and Torres Strait Islander people, to be launched tomorrow, addresses the distinctive support needs of older Aboriginal and Torres Strait Islander peoples and represents the first such aged care strategy since 1994.  It is one of three aged care action plans being released under the Commonwealth’s Aged Care Diversity Framework, with the other two encompassing the needs of CALD communities and LGBTI people.

The action plan provides specific guidance to aged care providers on how to address the needs of Aboriginal peoples in enacting the overarching principles of the Aged Care Diversity Framework, which takes a human rights approach to driving cultural and systemic change in the aged care system, and to ensure that all Australians access safe, equitable and high-quality aged care services regardless of their ethnicity, culture, sexuality and life experiences.

Collaboration

The Institute of Urban Indigenous Health (based in Brisbane) and the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) collaborated in the development of the plan. VACCHO coordinated the consultation process in NSW, Victoria, Tasmania and SA.

Consultations with Aboriginal and Torres Strait Islander people, and aged care providers included:

  • 629 completed surveys
  • 51 individual consultations carried out by the project team and members of the working group = these complemented the survey data and explored in more detail issues being raised in the survey responses and views expressed by members of the Working Group; and
  • a written submission from the Healing Foundation in recognition of the specific issues related to ageing and the needs of the Stolen Generations.

Implementation of the plan will increase the accessibility of culturally safe aged care support and services to older Aboriginal and Torres Strait Islander peoples, and provide guidance to mainstream service providers seeking to increase the cultural safety and appropriateness of the services they offer to Aboriginal people. In particular this plan emphasises the need for mainstream service providers to collaborate and/or co-design services with Aboriginal community-controlled organisations.

To quote the plan: “The plan can assist providers to identify actions they could take to deliver more inclusive and culturally appropriate services for consumers. It acknowledges that there is no ‘one-size-fits-all’ approach to diversity, and that each provider will be starting from a different place and operating in a different context.”

VACCHO and its members, including those members who themselves provide aged care supports,  look forward to working with aged care providers to ensure the best, culturally appropriate care is provided to older Aboriginal people; they are the keepers of culture, and deserve to be respected and valued.

Noeleen Tunny is manager of VACCHO’s Policy and Advocacy Unit

NACCHO Aboriginal #Eldercare Health #Apology11 and #CaringForOurStolenGenerations How you can get involved ? : Stolen Generations want a commitment on aged care @KenWyattMP

Even compared to their Aboriginal and Torres Strait Islanders contemporaries, who are already at a disadvantage in Australia, Stolen Generations members aged 50 and over are suffering more – financially, socially and in areas of health and wellbeing,

Aboriginal and Torres Strait Islander people who were removed from their families are two times as likely to have been incarcerated and almost three times as likely to rely on government payments, compared to those who were not removed as children.

We’ve just been scratching the surface. We need government and service providers to commit to long term and widespread healing programs, trauma informed resources and culturally appropriate care.”

Chair of The Healing Foundation’s Stolen Generations Reference Group Ian Hamm said the data draws a clear distinction in the health and welfare outcomes between ageing Stolen Generations and the general Indigenous population.

Read NACCHO Elder Care Articles HERE 

Read NACCHO Stolen Generation Articles HERE

This year we will commemorate the National Apology to the Stolen Generations by sharing stories that have been shared with us over the years.

Witnessing the stories of Stolen Generation members who were removed from their homes, families and communities allows all Australians to join in on the healing journey and be part of the solution moving forward. This is the spirit of commemorating the National Apology.

We are sharing Stolen Generations stories via Facebook. Tune in on 13 February at 2pm and 6pm (AEST)

Share the Facebook event: http://bit.ly/2WUynLv

Eleven years on from the National Apology, members of the Stolen Generations are calling on governments to ensure aged care services are sensitive to their needs and support publicly funded alternatives to residential care that deal with trauma related issues arising from re-institutionalisation.

Hope Beyond the Window by Jacqui Stewart. The painting represents children from a Stolen Generation. The church symbolises religion and the window represents ‘hope’ looking through to the sky. The children are portraying despair but also at the same time hopefulness and belief for a better future. The old tree beside the church symbolises an Aboriginal Elder who is protecting and watching the children while the leaves illustrate “free spirits” flying through the wind. The painting was influenced by photographs of the Moore River Native Settlement in WA and the movie Rabbit Proof Fence. Image reproduced with kind permission from the artist.

Source: Stolen Generations stories – Creative Spirits, retrieved from 

It follows the release of data from the Australian Institute of Health and Welfare that uncovers alarming and disproportionate levels of disadvantage for Stolen Generations aged 50 and over.

The AIHW report forecasts that by 2023 all remaining Stolen Generations survivors will be eligible for aged care. The data shows that 89 per cent of those aged 50 and over were not in good health and 76 per cent relied on government payments as their main source of income.

The Healing Foundation CEO Richard Weston said the report provides a clear evidence base to the complex needs of Stolen Generations aged 50 and over who suffered profound childhood trauma when they were forcibly removed from their homes, isolated from family and culture and often institutionalised, abused and assaulted.

“While appalling, this level of disadvantage should not come as a surprise. If people don’t have an opportunity to heal from trauma, it continues to impact on the way they think and behave, leading to a range of negative outcomes including poor health and isolation, which in turn leads to social and economic disadvantage,” Mr Weston said.

“The Aged Care Royal Commission has been running for less than a week and we’re already hearing about the profound trauma experienced by those in care. Clearly, the Stolen Generations need and deserve assistance in their aging years, but given their past experiences with institutionalisation, it’s vital that we find public funded alternatives that respond to trauma related issues.”

How you can get involved

-Share the Facebook event: http://bit.ly/2WUynLv
-Share the Stolen Generations stories via YouTube
-Visit our webpage to learn more about Apology11
-Share the factsheet: http://bit.ly/2I7xjk4
-Talk about the recent findings in the Australian Institute of Health and Welfare’s Aboriginal and Torres Strait Islander Stolen Generations aged 50 and over report.

Tag us on Facebook: @Healing Foundation and Twitter: @healingourway using #Apology11 and#CaringForOurStolenGenerations

Read more: https://healingfoundation.org.au/app/uploads/2019/02/190212-Apology11-Caring-for-Stolen-Generations-InformationSheet.pdf

NACCHO Aboriginal Health #NACCHOagm2018 Report 4 of 5 : Minister @KenWyattMP full text keynote speech launching @AIHW  report report solely focusing on the health and wellbeing of young Indigenous people aged 10–24

” Culturally-appropriate care and safety has a vast role to play in improving the health and wellbeing of our people. In this respect, I want to make special mention of the proven record of the Aboriginal Community Health Organisations in increasing the health and wellbeing of First Peoples by delivering culturally competent care.

I’m pleased to be here at this conference, which aims to make a difference with a simple but sentinel theme of investing in what works, surely a guiding principle for all that we do

Providing strong pointers for this is a new youth report from the Australian Institute of Health and Welfare.

Equipped with this information, we can connect the dots – what is working well and where we need to focus our energies, invest our expertise, so our young people can reap the benefits of better health and wellbeing “

Minister Ken Wyatt launching AIHW Aboriginal and Torres Strait Islander Adolescent and Youth Health and Wellbeing 2018 report at NACCHO Conference 31 October attended by over 500 ACCHO delegates 

In Noongar language I say, kaya wangju. I acknowledge the traditional custodians on the land on which we meet and join together in acknowledging this fellowship and sharing of ideas.

I acknowledge Elders, past and present and I also want to acknowledge some individuals who have done an outstanding job in the work that you all do and I thank you for the impact that you have at the local community level: John Singer, chair of NACCHO; Pat Turner AM, CEO of NACCHO; Donnella Mills; Dr Dawn Casey; Dr Fadwa Al-Yaman; Professor Sandra Eades; Donna Ah Chee; LaVerne Bellear; Chris Bin Kali; Adrian Carson – and I’m sorry to hear that Adrian’s not with us because of a family loss – Kieran Chilcott; Raylene Foster; Rod Jackson; Vicki Holmes; John Mitchell; Scott Monaghan; Lesley Nelson; Julie Tongs; Olga Havnen.

All of you I have known over a long period of time and the work and commitment that you have made to the pathways that you have taken has been outstanding. I’d also like to acknowledge Dr Tim Howle, Prajali Dangol, and Helen Johnstone, the report authors.

I’m pleased to be here at this conference, which aims to make a difference with a simple but sentinel theme of investing in what works, surely a guiding principle for all that we do.

Providing strong pointers for this is a new report from the Australian Institute of Health and Welfare.

I understand this is the very first study by the Institute that focuses solely on First Nations people aged 10 to 24.

Download a copy of report aihw-ihw-198

As such, it is a critical document.

Firstly because it puts at your fingertips high quality, targeted research about our young people.

Secondly, it gives us a clear understanding of where they are doing well, but also the challenges young people still face.

And thirdly, equipped with this information, we can connect the dots – what is working well and where we need to focus our energies, invest our expertise, so our young people can reap the benefits of better health and wellbeing.

I’m always passionate about all young people having the best start in life and marshalling the human resources necessary so that this care extends right through to early adulthood, laying strong foundations for the rest of their lives.

I want to run through some of the key findings of this report and then talk about Closing the Gap Refresh in our Government’s commitment to and support for our young people. I’m pleased some real positives have been identified.

The report found a majority of the 242,000 young First Australians, or 63 per cent, assessed their health as either excellent or very good. Further, 61 per cent of young people had a connection to country and 69 per cent were involved in cultural events in the previous 12 months.

As the oldest continuous culture, we know that maintaining our connections to country and our cultural traditions is a key to our health and wellbeing. Education is another important factor in our ability to live well and reach our full potential.

In the 20 to 24 age group, the number of young people who have completed Year 12 or the equivalent has increased from 47 per cent in 2006 to 65 per cent in 2016. Smoking rates have declined and there is also an increase in the number of young people who have never taken up smoking in the first place.

Eighty-three per cent of respondents reported they had access to a GP and between 2010 and 2016, the proportion of young people aged 15 to 24 who had an Indigenous health check – that’s the MBS Item 715 – almost quadrupled from 6 per cent to 22 per cent. These are some of the encouraging results, but challenges remain.

In 2016, 42 per cent of young First Australians were not engaged in education, employment or training. Although there has been a decline in smoking rates for young people, one in three aged between 15 and 24 was still smoking daily.

Sixty-two per cent of our young people aged 10 to 24 had a longer-term health challenge such as respiratory disease, eye and vision problems, or mental health conditions. These statistics inform us, and, critically in the work we are doing, point to an evidence-based pathway forward.

I know you’ll be interested to know that the Prime Minister has now confirmed the refresh of the Closing the Gap will be considered at the next COAG meeting on 12 December.

Closing the Gap requires us to raise our sights from a focus on problems and deficits to actively supporting the full participation of Aboriginal and Torres Strait Islander people in the social and economic life of the nation. There is a need to focus on the long term and on future generations to strengthen prevention and early intervention initiatives that help build strong families and communities.

The Government has hosted 29 national roundtables from November 2017 to August 2018 in each state and territory capital city and major regional centres. We’ve also met with a significant number of stakeholders. In total, we reached more than 1200 participants. More than 170 written submissions were also received on the public discussion paper about Refresh.

The Refresh is expected to settle on 10 to 15 targets. These targets are aimed at building our strengths and successes to support intergenerational change. Existing targets on life expectancy, Year 12 enrolment, and early childhood will continue.

Action plans will set out the concrete steps each government will take to achieve the new Closing the Gap targets, and we have to hold state and territory governments to account. The plans to be developed in the first half of 2019 will be informed by the lived experience of Aboriginal and Torres Strait Islander people, community leaders, service providers, and peak bodies.

Dedicated and continuous dialogue along with meaningful engagement with Aboriginal and Torres Strait Islander people and communities is fundamental to ensuring the refreshed agenda and revised targets meets the expectations and aspirations of First Australians and the nation as a whole.

These actions will be backed by positive policy changes in both prevention and treatment, such as the introduction from tomorrow of the new Medicare Benefits Schedule item to fund delivery of remote kidney dialysis by nurses and Aboriginal and Torres Strait Islander health workers and practitioners, further improving access to dialysis on country.

The COAG health ministers in Alice Springs just recently on 3 August met with Indigenous leaders and asked for their views on a range of issues, and all of the leaders in attendance had an incredible impact on each state and territory Minister.

I know that because I attended the Ministers’ dinner later in which the discussion came to the very issues that were raised by our leaders from all over the nation.

And COAG, the next morning, made the decision that Aboriginal health will be a priority on the COAG agenda for all future meetings, and that whoever the Minister for Indigenous Health is will be ex officio on the Health Ministers’ Forum to inform and to engage in a dialogue around the key issues that were identified, not only by the leadership, but by the evidence of the work that we do; and there are six national priorities now that COAG will turn its mind to, the COAG health ministers.

Over the next decade, the Australian Government has committed $10 billion to improve the health of First Australians.

This is a substantial sum of money, but we are only going to achieve better health and wellbeing outcomes if we work and walk together. We have to build mutual trust and respect in all that we do, and I include in this every state and territory system.

We have to increase cultural capability and responsibility in all health settings and services. We must support and encourage the development of local and family-based approaches for health. As I’ve said before, we need every one of our men and women to take the lead and perpetuate our proud traditions that have kept us healthy for 65,000 years.

Culturally-appropriate care and safety has a vast role to play in improving the health and wellbeing of our people. In this respect, I want to make special mention of the proven record of the Aboriginal Community Health Organisations in increasing the health and wellbeing of First Peoples by delivering culturally competent care.

And while they’re widely canvassing the importance of supporting the growth and potential of children and young adults, I would like to make special mention of the support required for our senior people as well, our Elders.

We must ensure that all older First Nations Australians who are eligible for age or disability support can access the care they deserve; either through the My Aged Care System or the National Disability Insurance Scheme. With a holistic grassroots approach of the Aboriginal Community Controlled Health Organisations, I believe ACCHOs should work to ensure that our older, Indigenous leaders receive assessments and support options that are available.

In August, as I indicated, I met with Indigenous leaders as part of the COAG Health Council Roundtable. Coming out of this was not only a resolution to make First Peoples health a continuing council priority, but a commitment to develop a National Aboriginal and Torres Strait Islander Health and Medical Workforce plan. I see this as being more about Aboriginal doctors, nurses and health workers working on country and in our towns and cities. It’s also about building capacity of health professionals across the entire health system to provide culturally safe services.

I was talking with Shelly Strickland some time ago, and she asked me a couple of questions, and I said to her: watch the movie Hidden Figures.

And at the time, I know she left me thinking what the hell is he talking about and why would you recommend a movie? When you look at that movie, it was about Afro-American women who put man on the moon.

The movie is based on the work of the women who gave the scientists the solutions to putting a rocket into space, landing man on the moon, and bringing them back; it was an untold story. And there are multiple layers when you look at that movie of overt racism. They were not allowed to use the same toilets as their white counterparts, they had to run two car parks away in any condition to use a toilet.

When something went wrong, people looked at them and saw them as the fault. But what they did very superbly was take their knowledge, apply science, apply the thinking that was needed, and demonstrated mathematically that man could land on the moon.

Not one NASA, non-Indigenous or non-American Afro-American had reached that solution. Those four women – I think it was four – provided the solution, but their story was never told. And they were the true leaders of space adventure and discovery. If they had not done the thinking and the tackling of the issue, then the solution would never have been reached. There are parallels in Aboriginal health.

We think of GP super clinics – they were modelled on our AMSs, about a holistic approach. There are other elements of what you do, and what we as a people do, that health systems have taken note of. But what we have to be better at is sharing where we have leadership.

I look at the work that Donna Murray is doing with Allied Health Staff – the outcomes that she achieves, they are stunning.

The work which she puts into helping make the journey a positive journey achieves outcomes that are disproportional to the work that we do as a government in many other areas in mainstream.

And we do lead – and if you haven’t seen that movie, you have to look at it and think of the parallels that our people went through. But, I think the other most salient point is, is that it was the Afro-American women who were the backbone of the space and science discovery program of America.

And I would like to acknowledge our women as well. I think the NAIDOC theme is one of the best themes I have seen in a long time; and I’ve been around a while. And I see it in health where our women play a very pivotal role and are the backbone of the frontline services that are delivered. Men always gravitate to the top; we tend to do that.

But, I do see that the actual hands-on work is done by our women, and so I thank you for that, because the progress we’ve made is because of the way in which you, like those Afro-American women, have helped shape the destiny and future. And I think of some of the people that I’ve known over the years who would be in a similar category.

And certainly, I’ll single out one because she was a great friend and taught me a lot, was Naomi Myers, whose leadership and dedication was parallel to that of the women in that movie Hidden Figures.

While the Medical Health Workforce Plan will be positive for Aboriginal Torres Islander jobs across Australia, it has particular potential for tackling chronic disease and improving the lives of our people in remote communities.

We are all well aware of the importance of health and wellbeing of our young children. There is ample evidence that investment in child and family health supports the health and development of children in the first five years; setting strong foundations for life.

And Kerry Arabena’s work certainly epitomises that along with many others. Good health and learning behaviours set in the early years continue throughout a young person’s life. Young people are more likely to remain engaged in education and make healthy choices when they’re happy, healthy and resilient, and supported by strong families and communities that have access to services and support their needs.

Connected Beginnings program is using a collective impact placed based approach to prepare children for the transition to school so they are able to learn and thrive. The program is providing children and their families with access to cohesive and coordinated support and services in their communities.

The Australian Nurse Family Partnership Program targets mothers from early pregnancy through to the child’s second birthday, and aims to improve pregnancy outcomes by helping women engage in good preventive health practices, supporting parents to improve their child’s health and development, and helping parents develop a vision for their own child’s future; including continuing education and work. Increasingly, research is also highlighting the long term value of investing in youth.

This investment benefits young people now as they become adults, and as they then have children of their own.

So I want to focus on some of the things that we are doing that is important, the take up of MBS 175, access to MBS items.

We’re improving the Practice Incentives Program, Indigenous Health Incentive which promotes best practice and culturally safe chronic disease care. We are reducing preventable chronic disease caused by poor nutrition through the EON Thriving Community programs in remote communities.

We’re tackling smoking rates through the Tackling Indigenous Smoking Program; and encouragingly, youth had the biggest drop. And we’re prioritising Aboriginal and Torres Strait Islander mental health in the first round of funding under the Million Minds Research Mission.

More broadly, for our First Australians and the wider population, we are investing in services for the one in four who experience mental illness each year.

And this also includes through Minister Hunt funding to headspace Centres, Orygen, beyondblue’s new school-based initiative BU, Digital Mental Health child, and youth mental health research and working alongside Greg has been a tremendous opportunity, because I’ve been able to get into his ear about the need for him also to consider our people in key initiatives that he launches, and he’s been a great ally.

And our work on the 10-year National Action Plan for Children’s Health continues. I want to continue setting strong foundations for making sure our people have access to culturally safe and appropriate health services.

Let me also just go quickly to the report. I had a look at the report online, and I was impressed with the way in which the writers – and FAD were in AIHW and have pulled together this one and have taken elements out of the two major better health reports.

And it was great to see our profiling, in some cases being better, in some cases being challenging. But this is a good guide for all of us to use and I commend everybody who’s been involved, and it gives me great pleasure to launch the Aboriginal and Torres Strait Islander Adolescent and Youth Health and Wellbeing 2018 report.

So, congratulations to all of those involved and congratulations to each and every one of you who have contributed to this report in the data that you provide, the work that you do but your commitment to our people. Thank you.

NACCHO Aboriginal Health and #ElderCare funding up to $46 million : Applications close on 26 Nov 2018: Donna Ah Chee CEO @CAACongress welcomes @KenWyattMP announcement of increased funding to assist Aboriginal people growing old with their families in their own communities


Improvements in Aboriginal health have more of our people living into old age than there were even a decade ago and necessitates a need to meet the increasing demand for these types of services.

Being on country as you grow old is a very strong cultural obligation for Aboriginal people and for too long our people have had to move into population centres to access services.

We now have two major recent initiatives that will help our older people stay on country. Firstly, the announcement of the new Medicare item for nurse assisted dialysis on country and now this announcement from Minister Wyatt.

This continuing connection to country is vital for the spiritual foundation and quality of life of Aboriginal people.

It is a key part of keeping our older people healthy and happy.

Our people have a very strong desire to be on country when they die and announcements like this will help to make sure that people grow old and die on country and with family. We know that social isolation is very damaging to older people’s health and this will ensure people remain socially and culturally connected.

While keeping people at home with aged care packages is a key goal there are some very successful aged care facilities on country at places like Mutitjulu. This also is important for people who need this level of care

Central Australian Aboriginal Congress (Congress) Chief Executive Officer, Donna Ah Chee, welcomes the announcement of increased funding to assist Aboriginal people growing old in a well-supported way, with their families in their own communities

Originally published Talking Aged Care 

Photos above Ken Wyatt meeting with the elders from the Yindjibarndi Aboriginal Corporation in Roebourne WA 2017

Read NACCHO Aboriginal Health and Elder Care Articles HERE

Ageing First Australians living remotely will now have increased access to residential and home aged care services close to family, home or country following an announcement by Federal Government to expand their Budget initiative – the National Aboriginal and Torres Strait Islander Flexible Aged Care (NATSIFAC) program

The $105.7 million Government commitment, which will benefit more than 900 additional First Australians, is set to be expanded progressively over the next four years.

Federal Minister for Senior Australians, Aged Care and Indigenous Health Ken Wyatt announced the first round of expansion funding under the program – up to $46 million – to increase the number of home care places delivered through NATSIFAC program in remote and very remote areas.

“Aged care providers are invited to apply for funding under the expanded NATSIFAC program’s first grants round, which is designed to improve access to culturally-safe aged services in remote Aboriginal and Torres Strait Islander communities,” the Minister explains.

“The program funds service providers to provide flexible, culturally-appropriate aged care to older Aboriginal and Torres Strait Islander people close to home and community.

“Service providers can deliver a mix of residential and home care services in accordance with the needs of the community.”

Minister Wyatt reiterates the importance of home care in enabling senior Australians to receive aged care to live independently in their own homes and familiar surroundings for as long as possible, and says the initiative is all about “flexibility and stability”.

“It is improving access to aged care for older people living in remote and very remote locations, and enables more Aboriginal and Torres Strait Islander people to receive culturally-safe aged  care services close to family, home or country, rather than having to relocate hundreds of kilometres away,” he says.

“At the same time, it helps build the viability of remote aged care providers through funding certainty.”

Applicants can apply for new or additional home care places under the NATSIFAC program or approved providers can apply to convert their existing Home Care Packages, administered under the Aged Care Act 1997, to home care places under the NATSIFAC program.

Applications close on 26 November 2018 with more details about the expansion round available online.

GO ID: GO1606
Agency:Department of Health

Close Date & Time:

26-Nov-2018 2:00 pm (ACT Local Time)
Primary Category:
101001 – Aged Care

Publish Date:

4-Oct-2018

Location:

ACT, NSW, VIC, SA, WA, QLD, NT, TAS

Selection Process:

Targeted or Restricted Competitive

Description:

This Grant Opportunity is to increase the number of home care places under the NATSIFAC Program in remote and very remote Australia (geographical locations defined as Modified Monash Model (MMM) 6 and 7).

Eligibility:

To be eligible you must be one of the following:

Type A:

Existing NATSIFAC Program providers delivering services in geographical locations MMM 6-7

Type B:

Approved providers currently delivering Commonwealth funded home care services (administered under the Aged Care Act 1997) to Aboriginal and Torres Strait Islander people in geographical locations MMM 6-7, with up to 50 home care recipients per service, for conversion to the NATSIFAC Program

Type C:

Organisations not currently delivering aged care services in geographical locations MMM 6-7, however but existing infrastructure and the capability to deliver aged care services to Aboriginal and Torres Strait Islander people

Total Amount Available (AUD):

$46,000,000.00

Instructions for Lodgement:

Applications must be submitted to the Department of Health by the closing date and time.

Other Instructions:

$46 million (GST exclusive) over 4 years, 2018-2022.

 

 

NACCHO Aboriginal #Mentalhealth #SuicidePrevention and #RUOKday : If you ask #RUOK ? What do you do if someone says ‘no’? Plus Sponsorships for 10 #Indigenous young people to take participate #chatsafe campaign

R U OK Day today encouraging all of us to check in with others to see if they’re OK.

But what if someone says “no”? What should you say or do? Should you tell someone else?

What resources can you point to, and what help is available?

Read NACCHO Aboriginal Health articles over the past 6 Years

Mental Health 189 posts 

Suicide Prevention 124 Posts

Here is a guide 

Stop and listen, with curiosity and compassion

We underestimate the power of simply listening to someone else when they’re going through a rough time. You don’t need to be an expert with ten years of study in psychology to be a good listener. Here are some tips:

Listen actively. Pay attention, be present and allow the person time to speak.

Be curious. Ask about the person’s experience using open questions such as

what’s been going on lately?

you don’t seem your usual self, how are you doing/feeling?

Validate their concerns. See the situation from the person’s perspective and try not to dismiss their problems or feelings as unimportant or stupid. You can say things like

I can see you’re going through a tough time

it’s understandable to feel that way given everything you’ve been going through.

There are more examples of good phrases to use here.

Don’t try to fix the problem right now

Often our first instinct is wanting to fix the person’s problems. It hurts to see others in pain, and we can feel awkward or helpless not knowing how to help. But you don’t have to have all of the answers.

Instead of jumping into “fix it” mode right away, accept the conversation may be uncomfortable and allow the person to speak about their difficulties and experiences.

Sometimes it’s not the actual suggestion or practical help that’s most useful but giving the person a chance to talk openly about their struggles. Also, the more we understand the person’s experience, the more likely we are to be able to offer the right type of help.

Encourage them to seek help.

Ask:

how can I help?

is there something I can do for you right now?

Sometimes it’s about keeping them company (making plans to do a pleasant activity together), providing practical support (help minding their kids to give them time out), or linking them in with other health professionals.

Check whether they need urgent help

It’s possible this person is suffering more than you realise: they may be contemplating suicide or self-harm. Asking about suicidal thoughts does not worsen those thoughts, but instead can help ease distress.

It’s OK to ask them if they’re thinking about suicide, but try not to be judgemental (“you’re not thinking of doing anything stupid, are you?”). Listen to their responses without judgement, and let them know you care and you’d like to help.

Read more: How to ask someone you’re worried about if they’re thinking of suicide

There are resources and programs to help you learn how to support suicidal loved ones, and crisis support lines to call:

  • Contact the Social and Emotional team at your nearest ACCHO
  • Lifeline (24-hour crisis telephone counselling) 13 11 14
  • Suicide Callback Service 1300 659 467
  • Mental health crisis lines

If it is an emergency, or the person is at immediate risk of harm to themselves or others, call 000.

Encourage them to seek professional help

We’re fortunate to be living in Australia, with access to high quality mental health care, resources and support services. But it can be overwhelming to know what and where to seek help. You can help by pointing the person in the right direction.

The first place to seek help is the general practitioner (GP). The GP can discuss treatment options (psychological support and/or medication), provide referrals to a mental health professional or arrange access to local support groups. You can help by encouraging your friend to make an appointment with their GP.

There are great evidence-based online courses and self-help programseducational resources and free self-help workbooks that can be accessed at any time.

There are also online tools to check emotional health. These tools help indicate if a person’s stress, anxiety and depression levels are healthy or elevated.

What if they don’t want help?

People with mental health difficulties sometimes take years between first noticing the problem and seeking professional help. Research shows approximately one in three people experiencing mental health problems accesses treatment.

So even if they don’t want help now, your conversation may have started them thinking about getting help. You can try understanding what’s stopping them from seeking help and see if there’s anything you can do to help connect them to a professional. You don’t need to push this, but simply inviting the person to keep the options in mind and offering your ongoing support can be useful in the long run.

Follow up. If appropriate, organise a time to check in with the person again to see how they’re doing after your conversation. You can also let the person know you’re around and they are always welcome to have a chat with you. Knowing someone is there for you can itself be a great source of emotional support.

Read more: Five types of food to increase your psychological well-being

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.).

The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

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Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.). The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at jo.robinson@orygen.org.au. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

Anyone seeking support and information about mental health can contact beyondblue on 1300 22 46 36. For information about suicide and crisis support, contact Lifeline on 13 11 14 or the Suicide Callback Service on 1300 659 467