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• Indigenous Chronic
  Disease Package
• Tackling Chronic Disease
  Risk Factors
  • National action to reduce Indigenous smoking rate
  • Helping Indigenous Australians to reduce their risk of chronic disease
  • Local Indigenous community campaigns to promote better health
• Improving Chronic Disease
  Management and Follow up
  • Subsidising PBS medicine co-payments
  • Higher utilisation costs for MBS and PBS
  • Supporting primary care providers to coordinate chronic disease management
  • Improving Indigenous participation in health care through chronic disease self management
  • Increasing specialist and allied health follow up care
  • Monitoring and evaluation
• Workforce Expansion,
  Training and Support
  • Workforce education and training
  • Expanding the outreach and service capacity of Indigenous health services
  • Engaging Divisions of General Practice to improve Indigenous Access to mainstream primary care
  • Attracting more people to work in Indigenous Health
  • Clinical practice and decision support

eNewsletter

Indigenous Chronic Disease – eNewsletter

Third Edition, October 2010

• Welcome
• All in a Day's Work
• Training the Workforce
  • National Network of Tackling Smoking and Healthy Lifestyle Workers
  • Aboriginal and Torres Strait Islander Outreach Worker Orientation and Training
  • Accessing orientation and training for Aboriginal and Torres Strait Islander Outreach Workers
  • Nurse Continuing Professional Development (CPD) and Clinical Placement Scholarships in Aboriginal Medical Services (AMS)
  • Additional GP Registrar Training Posts in Aboriginal Medical Services
• National Updates
  • Closing the Gap – PBS Co-payment Measure
  • Medical Specialists
  • Practice Incentives Program (PIP) Indigenous Health Incentive
• Regional Updates
  • Divisions of General Practice improving access to mainstream primary care for Aboriginal and Torres Strait Islander people
  • Increasing specialist follow-up care - MSOAP
• Key Contacts

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Welcome

Welcome to the third edition of the Indigenous Chronic Disease Package (ICDP) e-newsletter.

As you will see, there’s a lot happening in this second year of the ICDP’s implementation. This edition updates you on a range of initiatives aimed at improving primary care that are being rolled out. There’s further important information about the PBS Co-Payment Measure and the PIP Indigenous Health Incentive. Several development, training and scholarship initiatives are being provided. A national effort to cut smoking is under way. And teams of specialists are starting to move out into the regions.

This year the new workforce will start to be trained – and you can get more information in the ‘Training the Workforce’ section in this edition.

In addition, increasingly there’ll be further support in chronic disease management through a number of programs – the Medical Specialist Outreach Assistance Program-Indigenous Chronic Disease, the Urban Specialist Outreach Assistance Program and the Care Coordination and Supplementary Services.

Department of Health and Ageing staff and film crew Practices at a pharmacy in Rockingham Kwinana.

Guidelines for these programs are available on the ICDP website: www.health.gov.au/tackling-chronic-disease - and your Division of General Practice or National Aboriginal Community Controlled Health Organisation (NACCHO) affiliate will be able to let you know when these are available in your area.

It is good to share stories of how the ICDP is working at the service and community level – and the feature on the next page about Clement Jetta, from the South West Aboriginal Medical Centre in Bunbury, Western Australia, is one such story.

Our thanks also to the Indigenous Health Services and Divisions of General Practice in Western Australia and South Australia who helped the Department of Health and Ageing gather stories about the implementation of the ICDP. An Aboriginal film group with extensive media experience filmed, interviewed and photographed staff at participating Indigenous Health Services and Divisions of General Practices.

These video clips and photos are featured in this e-newsletter and will be used in other ICDP publications and on the website.

If you have a story for the e-newsletter, please send an email to ICDP@health.gov.au and we can talk with you about it.
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All in a Day's Work

It is not unusual for Clement Jetta to be running around in his community helping people.

It’s all part of a day’s work as an Aboriginal Health Worker at the South West Aboriginal Medical Centre in Bunbury, Western Australia.

"We help our clients with their health, from home visits, delivering medication, going to their specialist appointments, visiting the doctor or booking transport to get to their appointments.

"I feel like an advocate between my people and the health services so it’s a very important role to me.

Clement Jetta, Aboriginal Health Worker at the South West Aboriginal Medical Centre in Bunbury, Western Australia.

“Sometime I feel like the middle person where clients will come and talk to me about their situations and I’ll give their feedback to the doctor.”

Community role models like Clement are key players in tackling Indigenous chronic disease and raising awareness of the risks.

“I’m well known and respected in my community. My mother is an elder and we know the families well here so people know they can talk to me confidentially and that I will help them.”

Clement has a family history of diabetes and knows how important it is to encourage people to live a healthy lifestyle.

“Since I started in the medical centre I have seen a lot of families suffering from chronic diseases. You see television shows that promote the five serves of vegetables and two serves of fruit kind of stuff.

“We don’t push people or pressure them to eat properly but we encourage them to do it and will always ask how their diet is going.

“A lot of clients want me to bring them kangaroo meat because my family goes hunting all the time and it’s a good source of meat that’s not very fatty. Basically with healthy foods, we promote it every chance we get.

“Sometimes my clients joke and call me Dr Clem, even though they know I’m a health worker and not a doctor. That’s why I’m furthering myself and trying to be a role model in the community, so hopefully I will help my people follow and achieve their goals as well.”

To further his career in health, Clement has nearly completed his Certificate IV Aboriginal and Torres Strait Islander Primary Health Care.
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Training the Workforce

To implement the ICDP, we need an appropriately trained workforce – the right people in the right places.

The ICDP is providing significant funding to build the capacity of the workforce to better prevent and manage chronic disease in Aboriginal and Torres Strait Islander people. With the start of the Regional Tackling Smoking and Healthy Lifestyle Teams in 20 regions and the ACT, along with the ongoing recruitment of Aboriginal and Torres Strait Islander Outreach Workers, the Department of Health and Ageing is providing orientation and training for these workers. In addition, health professionals are also being encouraged to expand their knowledge and skills.

National Network of Tackling Smoking and Healthy Lifestyle Workers

As part of the COAG National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes, the Government is funding a major Australia-wide initiative to reduce Indigenous smoking rates. The Tackling Smoking initiative is complemented by funding to employ and train Healthy Lifestyle Workers to support and promote lifestyle changes by Indigenous Australians who are at risk of developing preventable chronic diseases.

Over the next three years, Regional Tobacco Coordinators and Tobacco Action Workers in 57 regions will conduct local anti-smoking campaigns in Indigenous communities. They will work with regional communities on developing locally and culturally appropriate quit smoking services and education programs. They will work alongside Healthy Lifestyle Workers in each region.

These workers will work in regional teams - a national network of Regional Tackling Smoking and Healthy Lifestyle Teams. Importantly, wherever possible these regional teams are being employed by Aboriginal Community Controlled Health Services.

As you know, Chair of the Close the Gap Campaign and former Social Justice Commissioner, Dr Tom Calma has been engaged as the National Coordinator – Tackling Indigenous Smoking. Dr Calma is leading the rollout of this national network.

The Tackling Smoking measure also includes:

• regional social marketing activity, local anti-smoking campaigns and events;
• increased access to smoking cessation support;
• enhancement of Quitline services to make them more culturally appropriate and accessible for Aboriginal and Torres Strait Islander people;
• regional/local role models and ambassadors;
• training of existing workers to deliver brief interventions; and
• funding for the Centre for Excellence in Indigenous Tobacco Control.

An induction training workshop for this new national network is planned for the week beginning 6 December 2010 in Canberra. The workshop will include an overview of why this work is so important and why it needs to involve communities in a partnership approach. Dr Calma will be the keynote speaker to open this event.

Training for the Tackling Smoking workers will be provided by the Centre for Excellence in Indigenous Tobacco Control. This will draw on the centre’s resource ‘Talking Up Good Air’ as well as specific modules developed about how to be a Tackling Smoking worker.

The training for Healthy Lifestyle Workers is being developed by a team from Indigenous HealthInfoNet at Edith Cowan University. It will include guidance and pointers on healthy lifestyles, chronic disease prevention and health promotion strategies. The training will bring together information about how to promote healthy shopping and eating, increased physical activity, and community gardens and healthy lifestyles. It will also help workers to better understand related issues such as problems caused by alcohol. The Healthy Lifestyle Workers will work through case studies and be guided on how to undertake similar tasks or initiatives.

In addition to the induction training, workers will be encouraged to undertake formal Vocational Education and Training (VET) sector training. This way, if they do not already have relevant qualifications, they can become formally qualified at the Certificate III (Tobacco Action Workers and Healthy Lifestyle Workers) or IV (Regional Tobacco Coordinators) level. This will also enable their experience and skills to be formally recognised.

Aboriginal and Torres Strait Islander Outreach Worker Orientation and Training

The Government is funding orientation for all Aboriginal and Torres Strait Islander Outreach Workers employed in Aboriginal community controlled health services and Divisions of General Practice, and for those without formal qualifications, accredited training will be available to the Certificate II level.

Workshops were held in states and territories in 2009/10 to advise on the orientation and training requirements for this new workforce, and involved the Aboriginal community controlled health sector training providers, Divisions of General Practice, the state government, Community Services and Health Industry Skills Council and other VET sector orientation and training experts. It is anticipated another workshop will be held in the ACT in the near future. Tasmania will be asked to provide feedback to the national report, which will be provided by the National Aboriginal Community Controlled Health Organisation (NACCHO) as an outcome of the workshops.

Accessing orientation and training for Aboriginal and Torres Strait Islander Outreach Workers

To access orientation for Aboriginal and Torres Strait Outreach Workers, employing organisations need to contact the NACCHO affiliate in their state or territory. The NACCHO affiliate will liaise with the relevant Registered Training Organisation (RTO) for the region and arrange for the orientation training to be delivered. This will be in accordance with the agreed orientation strategy in each jurisdiction, and may include face-to-face training or block release. There will be no cost to the Outreach Worker or the employing organisation for the orientation training; including costs associated with travel and accommodation.

Many Aboriginal and Torres Strait Islander Outreach Workers employed to date have qualifications above the Certificate II level. However, for those who do not, accredited training is available to the Certificate II level. As with orientation training, the first step is for the employing organisation to contact the NACCHO affiliate, which will then contact the relevant RTO. The RTO will arrange to meet with the Outreach Worker to undertake a learning assessment, develop an individualised learning pathway and provide advice on training. Training will then be provided according to the outcomes of the learning assessment. As with the orientation, there will be no cost to the Outreach Worker or the organisation for accredited training provided up to the Certificate II level; including costs associated with travel and accommodation.

If you wish to contact the NACCHO Affiliate,in your state or territory, please contact the NACCHO National Secretariat on (02) 6248 0644 or email Elaine@naccho.org.au for contact details.

Nurse Continuing Professional Development (CPD) and Clinical Placement Scholarships in Aboriginal Medical Services (AMS)

The Continuing Professional Development (CPD) Scholarships for nurses working in an AMS were not fully subscribed in the May/June round. Applications for the second round of CPD scholarships closed on 1 October 2010. The Royal College of Nursing Australia is currently assessing those applications.

Information on the CPD scholarships can be found on the Royal College of Nursing Australia website at http://www.rcna.org.au/scholarships/scholarships or by phone on 1800 117 262.

The Clinical Placement Scholarships were advertised in May/June this year, with all places allocated to nursing students.

If you are interested in becoming a nurse, contact:

The Congress of Aboriginal and Torres Strait Islander Nurses http://www.indiginet.com.au/catsin/
or
The Royal College of Nursing Australia http://www.rcna.org.au

Other health workforce programs specifically assisting Aboriginal and Torres Strait Islander people can be obtained from http://www.health.gov.au/internet/main/publishing.nsf/Content/work-ab

Additional GP Registrar Training Posts in Aboriginal Medical Services

ICDP funding allows GP Registrars to work in accredited Aboriginal Medical Services for six months. This forms part of the Registrar’s formal three to four year training to become a GP. Registrars gain invaluable experience working to improve the health of Aboriginal and Torres Strait Islander people. Up to 38 posts are provided each year. The training posts are coordinated by General Practice Education and Training Limited (GPET). For more information, visit the GPET website at: http://www.agpt.com.au/
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National Updates

Closing the Gap – PBS Co-payment Measure

Do you require more information about the Closing the Gap (CTG) Pharmaceutical Benefits Scheme (PBS) Co-payment Measure?

In the second edition (June 2010) of the ICDP e-newsletter, we introduced you to the measure, which started on 1 July 2010. The measure aims to reduce the cost of PBS medicines for eligible Indigenous Australians. Many Aboriginal and Torres Strait Islander patients living with, or at risk of, chronic disease will be eligible under the new arrangements.

In this edition, we look at the circumstances in which medical specialists may annotate ‘CTG’ prescriptions for eligible Aboriginal and Torres Strait Islander patients under the measure.

To find out more about the PBS Co-payment Measure, including how to register, please click here

Medical Specialists

The PBS Co-payment Measure recognises that medical specialists are key members of multi disciplinary teams necessary for effective chronic disease care. Medical specialists to whom a registered patient has been referred may annotate ‘CTG’ prescriptions under the PBS Co-payment Measure. They may do this by writing ‘CTG’ at the top of the prescription followed by their initials or signature.

It is important to remember that:

• if you are an eligible patient, you are entitled to receive access to more affordable PBS medicines including medicines prescribed by a medical specialist;
• if you are a GP, you need to inform the medical specialist of the measure for your referred patient. You may wish to include the following words or similar in your referral:
  "John Citizen is eligible for extra assistance with the cost of medicines. To ensure he is able to access this, please annotate the top of any prescriptions with the letters ‘CTG’ and initial."
• as a medical specialist, you must correctly annotate the PBS prescription for the eligible patient referred to you in order for them to benefit from the program; and
• as a pharmacist, you must process correctly annotated ‘CTG’ prescriptions presented to your pharmacy.

Practice Incentives Program (PIP) Indigenous Health Incentive

One of the practice sign-on requirements of the PIP Indigenous Health Incentive is that at least two practice members (one of whom must be a GP) must undertake cultural awareness training within 12 months of joining the incentive.

The Department of Health and Ageing has funded the Royal Australian College of General Practitioners (RACGP) to develop online cultural awareness training. The training was introduced at GP10 – the RACGP’s annual conference – in October this year, with the training becoming available in early 2011.

Access to the online training will be via the RACGP’s gplearning portal and will be available free of charge to RACGP members and general practice teams. GPs and practice staff completing the online training will satisfy the cultural awareness requirement of the PIP Indigenous Health Incentive.

For more information, refer to the RACGP media release at www.racgp.org.au/media2010/38483

Practices under the management of an Aboriginal Board of Directors, or the committee comprising predominately Aboriginal community representatives, are exempt from cultural awareness training requirement.

The PIP Indigenous Health Incentive application forms and other information can be found on the Medicare Australia website: www.medicareaustralia.gov.au/provider/incentives/pip/forms-guides.jsp

Further information, including the PIP Indigenous Health Incentive Frequently Asked Questions (FAQs) is also available from the Indigenous Chronic Disease Package website.

Medicare Australia can assist with more specific enquiries, please email pip@Medicareaustralia.gov.au or call the PIP enquiry line on 1800 222 032 (call charges may apply)
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Regional Updates

Divisions of General Practice improving access to mainstream primary care for Aboriginal and Torres Strait Islander people

On 17 August 2010, the WA GP Network (WAGPN) hosted a meeting in Perth for the WA Divisions of General Practice Network Closing the Gap (CTG) Indigenous Health Project Officers and Indigenous Outreach Workers, referred to as the Aboriginal Health Network (the Network).

The meeting focused on reviewing the CTG mechanisms for increasing the uptake of MBS items and coordinated care incentives. Participants discussed building the capacity of practices, and Melanie Robinson, of Marr Mooditj, a Registered Training Organisation, talked about how to improve workforce development and cultural safety.

The WAGPN also announced a range of CTG resources developed by a sub-committee of the Network to target general practice. Mass media strategies for information and awareness-raising, such as local print media and radio, were also discussed.

As well, the Network discussed strategies and opportunities for working together, expanding the workforce and state-based COAG CTG activity. The Network is looking forward to a possible two day event in February 2011.

In addition to regular teleconferences, face-to-face meetings take place twice a year to maintain an effective network across WA Divisions of General Practice to implement the Closing the Gap: Improving Indigenous Access to Mainstream Primary Care measure.

Increasing specialist follow-up care - MSOAP

Two teams providing greater access to specialist and allied health professional follow-up care have been granted approval in WA. They are a renal team for the Kimberley region and a general medicine team for the Ngaanyatjarra Lands. The teams started services in June 2010.

The Ngaanyatjarra team will target renal care and diabetes management. It consists of a GP, a registered nurse and an Aboriginal Health Worker who will conduct six visits per year, each visit for four days.

The Kimberley team consists of a nephrologist, a GP specialising in renal health, a registered nurse (pre-dialysis speciality) and Aboriginal Health Workers visiting the communities of Broome, Derby, Fitzroy Crossing, Halls Creek and Kununurra.

The team will undertake four visits per year, each visit for five days. Back to Top

Key contacts

For more information about the Indigenous Chronic Disease Package, please visit www.health.gov.au/tackling-chronic-disease

Requests for specific information about the package can be emailed to ICDP@health.gov.au Back to Top

Page currency, Latest update: 22 October, 2010

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