NACCHO Aboriginal Health News: Unique funding enables First Nations-led COVID-19 research

feature tile - older Aboriginal man with Aboriginal flag sweatband & ceremonial paint on face waving to camera

First Nations-led COVID-19 research funding

A unique $2 million funding round has privileged First Nations voices and resulted in high-quality COVID-19 research projects that will result in better outcomes for First Nations communities. The 11 projects from across Australia were awarded funding from the Australian Partnership for Preparedness Research on Infectious Disease Emergencies (APPRISE) Centre of Research Excellence, based on a $2 million donation from the Paul Ramsay Foundation to support the development of effective responses to COVID-19 for First Nations communities. Townsville-based APPRISE investigator Professor Adrian Miller of the Jirrbal people of North Queensland and Director of the Centre for Indigenous Health Equity Research at CQ University says APPRISE gave the space for a First Nations-led process that began with the creation of the APPRISE First Nations Council to advise on all aspects of  the grant process from research priorities to evaluation criteria.

To view the APPRISE media release click here.

Two Aboriginal women & 3 Aboriginal children walking on Country away from the camera

Image source: Standford News, Standford University website.

Start evaluating for impact

How do you know if your programs are making a difference?

Interplay works with communities to design evaluations that measure the things that communities value. The Interplay Project is designed to bring the voice of Aboriginal and Torres Strait Islander community members into research and evaluation with a vision that all people are empowered to experience optimal wellbeing from the safety and strength of their own culture. Interplay work towards this by collaboratively building science around different ways of knowing and being. To view the Interplay Project’s new website click here.

The Interplay Project also recently launched a mobile app, Disability in the Bush on behalf of the NDIS. You can check out the mobile app, available in five different Aboriginal languages by clicking here.

Five Aboriginal women, two Aboriginal children & a terrier dog sitting on bare weathered red rocks

Image source: The Interplay Project website.

WA Connecting to Country grant program

The Connecting to Country grant program supports projects that enable Western Australian Aboriginal people and organisations to undertake on Country trips to renew links between community, Country and culture. Grants up to $25,000 are available for a wide range of activities that foster the transfer of knowledge between generations, preservation of culture and strengthening of communities. Activities may include those that improve understanding of Country, ancestry and kinship and promote positive mental health, wellbeing and resilience through community-led cultural healing projects.

For further information about the Connecting to Country grant program click here. Grant applications close on 10 November 2020.

Aboriginal elder of Nyikina country, John Watson show grandchildren his special lands in WA's Kimberley area

Aboriginal elder of Nyikina country, John Watson show grandchildren his special lands in WA’s Kimberley area. Image source: St Stephen’s School website.

Free palliative care online training program

The Australian Healthcare and Hospitals Association (AHHA) has developed a free online training program to help aged and community care workers, carers, volunteers, family members and health professionals who provide palliative care to aged persons in the community. Every person’s needs are unique and sorting your way through the emotional and social stresses faced by a dying person and their family can be difficult. The modules will help those involved in providing end of life care develop skills and confidence in that role.

To find out more about the AHHA palliative care training program and to register click here.

Aboriginal hand held within two other Aboriginal hands

Image source: Aged Care Guide website.

Fierce Girls wellbeing resources

An ABC podcast Fierce Girls tells the stories of Australian girls who dare to do things differently, adventurous girls, girls with guts and spirit. Among the inspiring tales of some of Australia’s most extraordinary women are those of Ash Barty and Nova Peris.

For more information about the ABC Fierce Girls podcast click here.

snapshot of cartoon drawing of Ash Barty from ABC Fierce Girls podcast webpage

Image source: ABC website.

University fee hikes put CtG targets at risk

The Federal Government’s “job-ready” university reforms will dramatically increase the cost of courses in the social sciences, a consistently popular discipline amongst Indigenous students. According to the latest national data, 33 per cent of Indigenous students chose to enrol in social science degrees compared to 19 per cent of the general cohort. Experts are concerned the changes will disproportionately disadvantage Aboriginal and Torres Strait Islander students, by lumping them with more debt or deterring them from study altogether — scenarios which both stand to jeopardise national higher education targets agreed to just months ago. Wiradjuri man Lachlan McDaniel believes his arts degree was “probably the best thing that ever happened” to him, but fears new laws passed this week will make it much tougher for other Indigenous students to get the same opportunities.

To view the full article click here.

Wiradjuri man Lachlan McDaniel graduating from arts/law degree

Wiradjuri man Lachlan McDaniel graduating from an Arts/Law degree. Image source: ABC website.

NSW – Casino – Bulgarr Ngaru Medical Aboriginal Corporation

FT/PT Practice Nurse

Bulgarr Ngaru Medical Aboriginal Corporation (BNMAC) Richmond Valley is looking for a motivated Practice Nurse to join our team in Casino NSW with part time and full time work options available. The Registered Nurse will take a proactive role to assist clients to address health issues in a holistic way at BNMAC’s Aboriginal Community Controlled Health Service. BNAMC endeavors to take a proactive approach working with local communities to raise awareness of health issues and to develop and implement intervention strategies in the treatment of chronic conditions.

To view the job description click here. Applications close Saturday 14 November 2020.Bulgarr Ngaru Medical Aboriginal Corporation logo

VIC – Shepparton – Rumbalara Aboriginal Co-operative Ltd.

FT Aboriginal Family Violence Practice Leader

Rumbalara Aboriginal Co-operative has a vacancy for a full-time Aboriginal Family Violence Practice Leader. This is a leadership position co-located in The Orange Door site and will have a significant role to work closely with services to lead high quality, culturally safe and effective responses to Aboriginal and Torres Strait Islander people seeking support and safety. The Orange Door is a free service for adults, children and young people who are experiencing or have experienced family violence and families who need extra support with the care of children.

To view the position description click here. Applications close 4.00 pm Monday 2 November 2020.Rumbalara clinic & logo

Working from home, any location – Hearing Australia

FT Manager of Aboriginal Engagement and Awareness for HAPEE

Hearing Australia is currently recruiting for a Manager of Aboriginal Engagement and Awareness for the Hearing Assessment Program – Early Ears (HAPEE). This is a national team of 11 Community Engagement Officers that among many things establish and facilitate free hearing assessments primarily in Aboriginal Medical Services, Childcare Centres and CP clinics nationally. This role is responsible for: ensuring that the Community Engagement Officers can effectively engage with primary health and early education services in their locations; ensuring targets for number of locations that Hearing Assessment Program – Early Ears (HAPEE) operates in are met; working with marketing on the development and delivery of culturally appropriate awareness campaigns; expanding HAPEE so that families who use private medical services are aware of and can access the program; providing high quality advice and support to senior management of Australian Hearing.

To view the job description click here. Applications close as as soon as a pool of suitable applicants are identified.Hearing Australia logo - outline of Australia using soundwaves

Across Australia (except Vic & Tas) – Australian Bureau of Statistics (ABS)

2021 Census Engagement Manager x 35 (25 in remote areas, 10 in urban/regional locations)

The ABS is recruiting Census Engagement Managers for the 2021 Census. Due to the close working relationship with the community, 35 Census Engagement Manager positions will be only open to Aboriginal or Torres Strait Islander applicants. Census Engagement Managers are specialised roles requiring a high degree of community interaction. They will be working within communities telling people about the Census and ensuring everyone can take part and get the help they need. Where possible, Census Engagement Managers will be recruited locally. To view a recruitment poster click here.

For further information on the roles and to apply click here.

Applications for Census Engagement Manager roles are open now and close Thursday 5 November 2020. ABS 2021 Census Engagement Manager banner

older Aboriginal man looking directly at camera with Aboriginal male youth in background - image from Diabetes Australia website

NACCHO Aboriginal Health News: First Nations People should not pay price for Australia’s economic recovery

First Nations people should not pay price for economic recovery

The Edmund Rice Centre today expressed serious concern at the disregard for the needs of First Nations Peoples and Refugees in the 2020–21 Federal Budget. “It has been said that the Federal Budget is statement on the nation’s priorities. Clearly if that is the case, judging by this Budget, First Nations Peoples, refugees and people seeking asylum – some of the most vulnerable people to the pandemic – are very low priorities for this Government”, Phil Glendenning, Director of the Edmund Rice Centre and President of the Refugee Council of Australia said. Two months ago the Prime Minister signed a new Closing the Gap Agreement committing Federal and State Governments to a long-term program to finally reduce the huge disparities in life expectancy, health, incarceration, education and employment between First Nations peoples and other Australians. “Prime Minister Morrison’s signing of the new Closing the Gap Agreement just two months ago was a welcome step, but in last night’s Budget the Government provided no resources to make it happen”, Mr Glendenning said. 

To view the Edmund Rice Centre media release click here.

Victorian Aboriginal Community Controlled Health Organisation (VACCHO) CEO, Jill Gallagher agreed, saying a lack of Federal Government support towards Closing the Gap targets was a major omission in a Budget that would provide some hip pocket relief and new jobs for young people but delivered “nothing of substance” for Victorian Aboriginal and Torres Strait Islander communities.

Ms Gallagher said Treasurer Josh Frydenberg mentioned Aboriginal and Torres Strait Islanders just once in his speech. She described the lack of money for new Closing the Gap measures as “dispiriting”. “There are a number of targets which all levels of Government have committed too but where is the investment?”, she asked.

To view the article about the VACCHO comments click here.

Funding to improve health of First Nations families

A program that is already showing unprecedented success in improving the health and employment outcomes of First Nations families has been awarded $2.5 million in funding through the National Health and Medical Research Council. Led by the team at Charles Darwin University’s Molly Wardaguga Research Centre at the College of Nursing and Midwifery, the project is focused on providing the Best Start to Life for First Nations women, babies and families and has been awarded a Centres of Research Excellence (CRE) grant. Co-director of the Molly Wardaguga Research Centre Associate Professor Yvette Roe said the funding would allow the centre to expand and build on a current program that had resulted in a 50% reduction in preterm birth and 600% increase in First Nations employment.

To read the full article click here.

Women and researchers during the Caring for Mum on Country project, Galiwinku, Northern Territory. (L-R)-Yvette Roe, Dhurruurawuy, wurrpa Maypilama, Sarah Ireland, Wagarr and Sue Kildea

Women and researchers during the Caring for Mum on Country project, Galiwinku, Northern Territory. (L-R)-Yvette Roe, Dhurruurawuy, wurrpa Maypilama, Sarah Ireland, Wagarr and Sue Kildea. Image source: Katherine Times.

Palawa man heads mainstream health peak body

The Australian Physiotherapy Association (APA) has announced the appointment of Palawa man Scott Willis as its 22nd national president, the first Indigenous president of a mainstream health peak body in Australia. Scott, who commences his two year term on 1 January 2021, said “Aboriginal and Torres Strait Islander peoples’ health remains a priority area for our profession. We’re going to ensure not only that we are a culturally safe, engaged profession by listening to, learning from and working with First Nations peoples, but we’re going to make physio a known, viable and aspirational professional choice for young Aboriginals coming through the education system. I want them to know they can and should aspire to strong and respected leadership roles in the community.”

To view the APA media release click here.

portrait photo of APA President Scott Willis

APA president-elect Scott Willis. Image source: Australian Physiotherapy Association.

Cashless Debit Card expansion opposed

The Aboriginal Peak Organisation of the Northern Territory (APO NT) have called on all members of parliament to strongly oppose the legislation that would make the Cashless Debit Card (CDC) permanent in the current trial sites and expand it to the NT and Cape York, despite there being no proof that compulsory income management works. APO NT spokesperson John Paterson said, “Support for the bill would directly contradict the recent National Agreement on Closing the Gap that was supported by all levels of government including the Commonwealth. It is not in keeping with the spirit of the agreement and its emphasis on Aboriginal and Torres Strait Islander self-determination.” Mr Paterson added, ”We did not ask for the card, yet 22,000 of us will be affected if the card is imposed on NT income recipients.”

To view the APO NT’s media release click here.

Aboriginal man under tree holding Cashless Debit Card to camera

Image source: Gove Online.

Restricting high-sugar food promotion helps diet

Restricting the promotion and merchandising of unhealthy foods and beverages leads to a reduction in their sales, presenting an opportunity to improve people’s diets, according to a randomised controlled trial of 20 stores in remote regions of Australia. Julie Brimblecombe, of Monash University, Australia, co-joint first author of the study, said: “Price promotions and marketing tactics, such as where products are placed on shelves, are frequently used to stimulate sales. Our novel study is the first to show that limiting these activities can also have an effect on sales, in particular, of unhealthy food and drinks. This strategy has important health implications and is an opportunity to improve diets and reduce associated non-communicable diseases. It also offers a way for supermarkets to position themselves as responsible retailers, which could potentially strengthen customers loyalty without damaging business performance.” 

To read the full article published in The Lancet click here.

hands of Aboriginal person pushing trolley or health foods in outback store

Image source: Adult Learning Australia website.

New research supports self-care

Federal Health Minister Greg Hunt is set to launch a new policy blueprint that calls for policy reform to improve population health and reduce health service demand through effective self-care. Released by the Mitchell Institute, the document notes a range of environmental, economic and social factors drive self-care capability. It says governments can play a major role in creating environments that either inhibit or enable self-care. The importance of self-care to good health has also been highlighted by COVID-19, according to the Mitchell Institute’s Professor of Health Policy, Rosemary Calder. “Now is the time for a systematic approach, led by a national agenda to enable shared responsibility between government organisations and health care professionals to tackle health inequity and support self-care for all Australians,” she says.

To view the full article click here.

man's hand holding baby's hand both cradled in woman's hand against blurred grass background

Image source: Emerging Minds, Australia website.

Funding for healthy ageing research

Professor Dawn Bessarab from the University of WA’s Centre for Aboriginal Medical and Dental Health and her team will lead the Centre for Research Excellence on the Good Spirit Good Life: Better health and wellbeing for older Aboriginal and Torres Strait Islander Australians. The first Centre for Research Excellence in Australia to explore Indigenous ageing, Professor Bessarab and her team were awarded $2.5 million in NHMRC funding. They will develop their research with and from the perspective of Aboriginal people, to better understand healthy ageing in older Aboriginal people and inform culturally secure and effective service provision.

To view the full article click here.

elderly Aboriginal woman in hospital bed looking up to nurse

Indigenous elder Mildred Numamurdirdi. Image source: The Guardian.

Cost of hygienic products linked to high disease rates

A Senate committee investigating the over-pricing of items in remote Aboriginal communities has heard from Melbourne University Indigenous Eye Health Institute’s senior engagement officer Karl Hampton, who said the price-gouging of items like soap and towels is a key factor to Indigenous youth holding “the heavy burden” of serious trachoma infections.

To view the full Global Citizen article click here.

supermarket shelves showing high cost of soap

Image source: The Guardian Australian edition.

Keeping our sector strong discussion

Indigenous Business Australia (IBA) is hosting a virtual forum from 12.00–1.00 pm (AEDT) Monday 12 October 2020 with the Minister for Indigenous Australians, The Hon Ken Wyatt, AM, MP, to discuss the changes made by Indigenous businesses adapting to survive and thrive in the current climate.

To find out more and register your attendance click here.

Spaces are limited for this opportunity so be sure to register today!

Learning from each other webinar series

The Sydney Institute for Psychoanalysis invites you to join them as they bring together First Nations’ thinkers with psychoanalysts and psychotherapists in a series of six webinars in the spirit of Two Way – working together and learning from each other.

All profits will go to CASSE’s Shields for Living, Tools for Life, a dual cultural and therapeutic program, based in the Alice Springs region for ‘at-risk’ youth, providing an alternative to detention and reducing the likelihood of offending or reoffending.

The Two-Way: Learning from each other webinar series will stream 8.00–9.30 pm AEST each Tuesday from 13 October to 17 November 2020.

Click here for the webinar program and registration.

Queenie McKenzie Dreaming Place - Gija country 1995

Queenie McKenzie, Dreaming Place – Gija Country, 1995.
Image source: Australian Psychoanalytical Society,

Range of health scholarships available

The following scholarship programs, aimed at increasing Aboriginal and Torres Strait lslander participation in the health workforce and improving access to culturally appropriate health services, are seeking applications.

Indigenous Health Scholarships – Australian Rotary Health administer these scholarships on behalf of the Department of Health, providing a one off grant of $5,000 to assist students with their day to day expenses and provide mentoring support while they undertake a course in a wide range of health related professions. For further information click here.

Nursing Scholarships – the Australian College of Nursing are currently offering nursing scholarship opportunities for study in 2021 with undergraduate and postgraduate scholarships of up to $15,000 per year of full time study being available for eligible courses. Further information is available here. Applications close from 25 October 2020.

Puggy Hunter Memorial Scholarship Scheme – provides financial assistance to Aboriginal and Torres Strait Islander undergraduate students for entry level studies that lead or are a direct pathway to registration or practice as a health professional.  Further information is available here. Applications close on 8 November 2020 for studies in 2021.

portrait of Indigenous Health Scholarship 2020 recipient Marlee Paterson, UNSW, Doctor of Medicine.

Indigenous Health Scholarship 2020 recipient Marlee Paterson, UNSW, Doctor of Medicine. Image source: Australian Rotary Health website.

NSW – Taree – Biripi Aboriginal Corporation Medical Centre

Aboriginal Health Worker – Drug & Alcohol/Sexual Health – Identified x 2 (male and female)

Human Resources Officer x 1

Maintenance Officer x 1

Biripi Aboriginal Corporation Medical Centre (Biripi ACMC), a community controlled health service providing a wide range of culturally appropriate health and well-being services covering communities across the Mid-Northern NSW Region, is looking to fill a number of vacant positions.

To view the job descriptions for each position click on the name of the position above.

Applications for all positions close 5.00 pm Sunday 18 October 2020.Biripi Aboriginal Corporation Medical Centre logo silhouette of two black hand overlapping inside yellow circle inside border top half black, bottom half red with words Our Health In Our Hands

VIC – Shepparton – Rumbalara Aboriginal Co-operative Ltd.

PT Case Manager (Re-advertised)

FT Cradle to Kinder Worker

FT Family Preservation Worker 

Kinship Care Case Management

FT Practice Manager

Rumbalara Aboriginal Co-operative Ltd. has a number of vacancies within its Health & Wellbeing, Engagement & Family and Positive Ageing & Disability services areas.

Applications for the Case Manager position close 4.00 pm Tuesday 13 October 2020.

Applications for the Cradle to Kinder Worker, Family Preservation Worker and Kinship Care Case Manager positions close 4.00 pm Wednesday 14 October 2020.

Applications for the Practice Manager position close 4.00 pm Friday 23 October 2020.

NSW – Sydney – The George Institute for Global Health

FT Research Associate (project Manager)

The George Institute for Global Health has a very exciting opportunity for a Research Associate (project Manager) to join its ‘Safe Pathways’ team that will work in partnership with families to focus on developing a discharge planning and delivery model of care that will: address institutionalised racism; facilitate access to ongoing specialist burn care; and enhance communication, coordination and care integration between families, local primary health services and the burns service at Westmead. 

The George Institute’s Aboriginal and Torres Strait Islander Health Program cuts across content areas and is conducted within Aboriginal and Torres Strait Islander ways of knowing, being and doing, with a focus on social determinants of health, health systems and healthcare delivery, and maintains an Aboriginal and Torres Strait Islander paradigm of health and healing (physical, emotional, social, cultural and spiritual) and a commitment to making impact through translation that influences policy.

For further details about the position click here. Applications close on 30 October 2020 or sooner if a suitable candidate is found.The George Institute for Global Health banner, words and purple tick with dot in shape of flame

World Evidence-Based Healthcare Day

World Evidence-Based Healthcare Day is a global initiative that raises awareness of the need for better evidence to inform healthcare policy, practice and decision making in order to improve health outcomes globally. It is an opportunity to participate in a debate about global trends and challenges, but also to celebrate the impact of individuals and organisations worldwide, recognising the work of dedicated researchers, policymakers and health professionals in improving health outcomes. World Evidence-Based Health Day is on Tuesday 20 October 2020 and has the 2020 theme is ‘Evidence to Impact’. For further information click here.logo with words World Evidinece-Based Healthcare Day 2020 ebhc 20 October 2020 light blue & navy

White Ribbon Day

Together, we really can end men’s violence against women in our communities and in our workplaces. But it starts with us turning awareness into sustained, collaborative action and it needs to start now. This year White Ribbon Day is on Friday 20 November. White Ribbon Australia are asking you to hold an event – online or as a group (following local COVID-safe guidelines) – to bring your community together as a catalyst for ongoing action. Download a Community Action Kit here to access ideas and resources to bring your community together on White Ribbon Day, get involved on social media, and to kick-start a Community Action Group that will continue to create impact long after the event is over.White Ribbon Australia banner - black bacground words White Ribbon Australia & white ribbon icon

Feature Image - Aboriginal boy head in hands

NACCHO Aboriginal Health News: Survey to review mental health youth services

Mental health youth services survey

If you work or volunteer with an Aboriginal Community Controlled Organisation or other Aboriginal or Torres Strait Islander organisations you are invited to participate in a short headspace online survey and share your views on issues of access, engagement and cultural safety of mental health supports for young Aboriginal and Torres Strait Islander people. All participants go into the draw to win a $100 voucher!

To view a survey flyer click here and to access the survey click here.

Young Aboriginal girl crying

Image source: newsinmind.com

NT outreach services improve hearing impairment

Ear and hearing health is vital for overall health and quality of life. Ear disease and associated hearing loss can have long-lasting impacts on education, wellbeing and employment. Aboriginal and Torres Strait Islander children are more likely than non-Indigenous children to experience ear and hearing problems.

An Australian Institute of Health and Welfare report has shown positive results are being achieved by hearing health outreach services provided to Aboriginal and Torres Strait Islander children and young people in the NT. The report shows that in 2019, 2,156 audiology; 770 ear, nose and throat teleotology; and 1,119 Clinical Nurse Specialist services were provided. Among children and young people who received treatment, 61% had improved hearing loss and 71% had improved hearing impairment.

To access a more detailed summary of the report click here.

Health professional checking ear of Aboriginal boy

Image source: Menzies School of Health Research website.

National cancer screening health worker engagement project

The University of Melbourne is undertaking a project to understand how the primary healthcare workforce engages with the national cancer screening program (bowel, breast and cervical). Findings from the study will lead to the development of materials and initiatives to assist in boosting cancer screening participation.

During the first phase of the project the researchers are interested in interviewing nurses, GPs and Practice Managers to understand more about their role, their go-to-resources when they need more information about the screening programs and resources they would like to have access to.

Everyone that will be interviewed will be reimbursed with a $50 Gift Card. We intend to carry out interviews during the month of September. The interviews will be recorded with your permission.

For information about how to become involved in the project please contact Ebony Verbunt, Research Assistant, University of Melbourne email ebony.verbunt@unimelb.edu.au or phone 0429 928 039.

Aboriginal male & female cartoon figures with ages for breast, bowel, cervical cancer screening tests

Image source: Cancer Council Victoria website.

COVID-19 information to Aboriginal and Torres Strait Islander communities survey

Since the coronavirus outbreak began, it has been extremely important to make sure health information about the virus reaches people in Aboriginal and Torres Strait Islander communities. The Australian Government Department of Health has worked with Indigenous communications agencies to produce a range of communications materials to help share information about the virus and inform communities about how they can stay safe.

You can provide feedback on how effective these campaign materials have been in reaching Aboriginal and Torres Strait Islander communities by taking this survey.

7 Keep Our Mob Safe resource images e.g. posters

Image source: Australian Government Department of Health.

Residential aged care risk assessment urgently required

The AMA has warned urgent improvements in aged care and a coordinated response from all levels of government are needed to prevent the pandemic outbreak in Victorian aged care homes spreading into residential aged care nationwide. The AMA has called for every residential aged care home in Australia to be urgently and comprehensively assessed for its ability to safely care for residents during the COVID-19 pandemic.

To view the AMA’s media release click here.

Elders hands in carer's hand

Image source: Aged Care Guide.

ACT paves way for raising incarceration age

The Australian Capital Territory’s Legislative Assembly has voted to raise the age of criminal responsibility from 10 to 14, paving the way for other jurisdictions to reform an outmoded law which disproportionately affects Aboriginal and Torres Strait Islander children.

To read the related Amnesty International Australia media release click here.

Aboriginal child's hands on jail barred overlaid with Aboriginal flag.

Image source: Amnesty International Australia.

COVID-19 vaccine will not be compulsory

Health Minister, Greg Hunt has confirmed that although any potential coronavirus vaccine will be strongly encouraged, it will not be made compulsory.

To read a transcript of Minister Hunt’s interview with David Koch on the Sunrise program click here.

QLD – Cairns or ACT – Canberra

PT Cultural Lead x 1 (Identified Position)

CRANAplus, the peak professional body for health professionals working in remote and isolated areas across Australia, has a vacancy for a Cultural Lead. This identified position, available to Aboriginal, First Nations, and Torres Strait Island people, will collaborate closely with internal and external stakeholders to develop and drive priorities supporting CRANAplus’ Organisational Strategic Plan.

You can view the CRANAplus website here and find details of the Cultural Lead position here.

CRANAplus logo & image of 4-wheel drive in outback

ACT – Canberra

FT Flexible Education Classroom Teacher  x 1 (Identified Position) – 6 months with the possibility of permanency

The ACT Education Directorate is seeking a reflective practitioner who: is able to create dynamic learning environments and authentically personalised education programs for Aboriginal and Torres Strait Islander students; has a demonstrated understanding of trauma and neuroscience informed education practices; and is passionate about inclusion, social justice, innovation and equity. Flexible Education is a community of schools/settings for students with complex and challenging needs including Murrumbidgee Education and Training Centre, Muliyan, Boomanulla, the Hospital School, the education program at The Cottage and Distance Education.

For more details about the position click here.

Aboriginal youth and teacher against graffitied wall

Image source: School News Australia.

NACCHO Aboriginal and Torres Strait Islander Health Research News : New look @HealthInfoNet Community Portal – expanded content and focus better supports Elders and community members working to reduce harms from #AOD use in their communities.

The Community Portal on the Australian Indigenous HealthInfoNet Alcohol and Other Drugs Knowledge Centre has recently been updated to better meet the information needs of Elders and community members working to reduce harms from alcohol and other drug (AOD) use in their communities.

The redevelopment of the Community Portal was guided by focus groups in Perth and Adelaide as well as feedback from a national user survey which found that people wanted to see a web resource that was strength-based, easy to use, and had a more visual format.

The portal has refreshed its content with a focus on strength-based resources, information on healing and trauma and up front, factual information on mental health and addiction.

The collection of health promotion resources for each topic has a visual format which is easy to use and navigate.

The refreshed portal also now features the artwork of Aboriginal artist Melanie Robinson with a vibrant piece about families coming together on the land (pictured above).

Family, friends and community members are often the first to respond to people who may be in crisis or distressed. The expanded content on the Community Portal includes more information on events, courses, funding and programs to support community members who may be seeking training, resources, or services to address AOD issues in their community.

short webinar has been recorded to provide an overview of the process and results to update the Community Portal.

It also describes the changes that have been made based on the feedback we received from stakeholders.

This is followed by a tour of the Community Portal, including information on:

  • the new subsections, including Healing
  • how to navigate around the portal
  • the new search and filter features
  • factsheets subsection.

The webinar can be viewed here.The AOD Knowledge Centre would like to acknowledge and thank the community members and Aboriginal and Torres Strait Islander AOD workers from Whadjuk Country (Perth) and Kaurna Country (Adelaide) who participated in the focus groups and those who responded to the user survey for their ideas and advice on the redevelopment of the Community Portal.

Find out more, visit the Community Portal on the AOD Knowledge Centre

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