Robyn Marven Project Coordinator Aboriginal Health Project Ph: 02 6049 1900 Email: rmarven@bordergp.org.au

Valda Murray Outreach Officer Aboriginal Health Project Ph: 02 6049 1900 Email: vmurray@bordergp.org.au

  

What is the Closing the Gap Project?

The Council of Australian Governments (COAG) has pledged to develop and implement coordinated strategies to address the key causes and determinants of Indigenous disadvantage, and has agreed six high level targets for closing the gap between Aboriginal and or Torres Strait Islander people and those people not of this descent. These targets are:

• to close the gap in life expectancy within a generation;
• to halve the gap in mortality rates for Aboriginal and or Torres Strait Islander children under five within a decade;
• to ensure all Aboriginal and or Torres Strait Islander four year olds in remote communities have access to early childhood education within five years;
• to halve the gap in reading, writing and numeracy achievements for Aboriginal and or Torres Strait Islander children within a decade;
• to halve the gap for Aboriginal and or Torres Strait Islander students in year 12 attainment or equivalent attainment rates by 2020; and
• to halve the gap in employment outcomes between Aboriginal and or Torres Strait Islander and non-Aboriginal and or Torres Strait Islander Australians within a decade.

What are the aims of the Aboriginal Health Project?

The aim of the Closing the Gap - Improving Aboriginal and or Torres Strait Islander people Access to Mainstream Primary Care Program is to contribute to closing the gap in life expectancy by improving access to culturally sensitive primary care services for Aboriginal Australians.

The objectives of the Program are to:

• increase access to mainstream primary care services by Aboriginal Australians
• improve the capacity of general practice to deliver culturally sensitive primary care services
• increase the uptake of Aboriginal and or Torres Strait Islander specific MBS items including Aboriginal  Health checks and follow up items
• support mainstream primary care services to encourage Aboriginal and or Torres Strait Islander Australians to self-identify
• increase awareness and understanding of Closing the Gap measures relevant to mainstream primary care
• foster collaboration and support between the mainstream primary care and the Aboriginal and or Torres Strait Islander health sectors

Aboriginal Health Project Coordinator, Robyn Marven pictured with Liz Hetta,  VChair of Mungabareena Aboriginal Corporation at the "Who's Ya' Mob" family day.

 Overview and local context

 An estimated *3500 Aboriginal and/or Torres Strait Islander people reside in the Albury Wodonga region.  This is broken down to approximately 500 people resident in Wodonga and 3000 in Albury.

The statistical information provided via link below gives a comprehensive breakdown of Aboriginal and Torres Strait Islander people in the region although the overall numbers are somewhat less than currently registered with Albury Wodonga Aboriginal Health Service and key Aboriginal organisations in the area: http://www.id.com.au/profile/alburywodonga

The Albury Wodonga Regional GP Network is actively involved in supporting improvements in Aboriginal and Torres Strait Islander health with the recent appointment of Robyn Marven as the Coordinator of the Aboriginal Health Project. The focus of the project is to develop strategies to increase access for Aboriginal and Torres Strait Island people into mainstream primary care services. 

The GP Network is a member of the Albury Wodonga Aboriginal Health Reference Group which is comprised of Albury Wodonga Aboriginal Health Service; Albury Community Health; Albury Wodonga Health, Gateway Community Health, Mungabareena Aboriginal Corporation. 

How can the Aboriginal Health Project help you?

The PIP Aboriginal and or Torres Strait Islander Health Incentive

As part of the Australian Government’s commitment to Closing the Gap, a new Practice Incentive Payment (PIP) Aboriginal and or Torres Strait Islander Health Incentive was introduced on 1 May 2010.

The PIP aims to support general practices and Aboriginal Medical Services to provide best practice chronic disease management to Aboriginal and Torres Strait Islander patients.

The PIP is based around three key components a sign-on payment, a payment linked to registration of each eligible patient and an outcomes payment associated with the cycle of care provided to the patient by the practice. The PIP is a key element of the Australian Government's Closing the Gap package and is expected to act as a 'gateway' through which patients can access other programs under the package.

The guidelines for this PIP have now been released and are available, alongside other relevant documents, from the Medicare Australia website at www.medicareaustralia.gov.au/pip Medicare Australia has recently written to all PIP practices advising the release of the guidelines and inviting them to participate in this PIP.

Access to Pharmaceutical Benefits Scheme (PBS) medicines

General practices participating in the PIP Aboriginal and or Torres Strait Islander  Health Incentive, and all non-remote Aboriginal and or Torres Strait Islander health services, will be able to register Aboriginal and Torres Strait Islander clients for assistance with the cost of PBS medicines.
This initiative will allow many more Aboriginal and Torres Strait Islander people throughout Australia, particularly those in metropolitan and regional centres, to access cheap – and in some instances free – PBS medicines. Such assistance is already available through remote Indigenous health services. 

The PBS co-payment measure:

• This measure will be available to Aboriginal and Torres Strait Islander clients attending Aboriginal Community Controlled health services, as well as general practices participating in the PIP Aboriginal and Torres Strait Islander  Health Incentive. Assistance will be targeted to those with chronic disease risk factors or established chronic disease. Co-payment assistance began operation on 1 July 2010.
• Clients will need to be registered by their ACCHO health service or general practice.
• Clients’ prescriptions will be processed in the usual way.
• Clients who would normally pay full price will pay only the concessional rate per prescription – $5.40 as at 30 September 2009.
• Clients who would normally pay the concessional rate will receive their medicines free of charge.

 Mandatory patient premiums for some brands of medicines will still apply.

Achievements of the Aboriginal Health Project

• Research, review and present Albury Wodonga contact list of agencies and personnel working with Aboriginal and Torres Strait Islander people.
• Participate in the Local Indigenous Network Meetings, the Koori Interagency Network Meetings and the Community Working Party Meetings. All these meetings are monthly.
• Contribute to Closing the Gap day, titled ‘Who’s Ya’ Mob’ in conjunction with Albury Wodonga Aboriginal Health Service .  
• Meetings with the State Based Office have occurred via telephone hook up and the IHPO attend  SBO meetings.
• The Project Officer completed the Needs Assessment and contributed Interim Work Plan to the AWRGPN PCRIS Report
• Research initiated regarding the Patient Incentive Payment Scheme for Aboriginal patients. As and when more information is made available from Government sources then the information can be re interpreted for both Aboriginal community members and GP’s. This is also relevant to the PBS directives that will impact on Aboriginal community members who suffer chronic illness.
• Review literature to develop Policy and Procedure document for use by General Practice when determining Aboriginal and Torres Strait Islander origin
• Contact Network Practice Managers to gauge interest in PIP and PBS - 19 eligible  Practices in total.
• Identify a General Practice that can be a pilot study for the implementation of Closing the Gap objectives. Initial discussion has occurred and a draft strategy is being developed. 
• Engage GP’s and Aboriginal and Torres Strait Health Service in discussions relating to AWRGPN application for innovative/pilot funding for prevention of Type 2 Diabetes.   Prepare in consultation with key stakeholders application for funding via LMP Pilot project guidelines
• Developing Website material for inclusion in AWRGP Network site

 "Dhurany" is a double page insert for the local free News Weekly paper that is circulated throughout Albury Wodonga.  It is envisaged that information focusing on Aboriginal people from the district, including stories, information and cultural insights will be regularly coordinated by the GP Network's Aboriginal Health Project Coordinator.  THe inaugural printing occured in December 2010 and many people have commented positively on this intitiative.

Appointment of Aboriginal Outreach Officer.   The division has appointed Valda Murray to this new position.  Valda has extensive experience working in health throughout the region and is a welcome addition to the Aboriginal Health Program.  The objectives of the program are to:

• Establish links with Aboriginal communities and individuals in the Network area to encourage and support the increased use of primary and allied health services
• Identify barriers for local Aboriginal people and communities that may be restricting access to health services and advise the Network about ways to lessen these
• Encourage and support Aboriginal people to access health and related services, through approaches focused at both individual and community levels
• Support health progessionals and health services to develop culturally appropriate and safe policies and practices.

 Care Coordination and Supplementary Services Program

The Division has received funds for the above program.  A partnership between the Division and Albury Wodonga Aboriginal Health Service has been formed where the Chronic Care Nurse will operate from AWAHS.  The program will contribute to improved health outcomes for Aboriginal people in the region who are suffering from chronic health conditions.  At this local level, many GP's and Practice Nurses are time poor and may not be able to provide the degree of holistic care and support that would be ideal to assist patients.  The Care Coordinator may be able to assist the patient access a range of services such as allied health professional appointments, home help and other forms of support. Information on the services the patient has been connected with will then be fed back to the GP for inclusion in the patient's car plan so that it can be considered in future reviews of the plan.