ahcsa our health, our choice, our way · 2020. 7. 9. · in may 1992, paul ashe was appointed...

Aboriginal Health Councilof South Australia Ltd.

AHCSA OUR HEALTH, OUR CHOICE, OUR WAY

ANNUAL REPORT 2018-2019

Pipalyatjara Amata

Umuwa

FregonMimili

Ernabella

Indulkana

Nganampa Health Council

Oodnadatta

Coober Pedy

Oak Valley Health Service

Yalata

Tullawon Health Service Inc.

Oak Valley

Koonibba

Ceduna Koonibba Aboriginal HealthService Aboriginal Corporation

Ceduna

Port Augusta

Port Lincoln

Pika Wiya Health ServiceAboriginal Corporation

WhyallaNunyara Aboriginal Health Service Inc.

Quorn

Hawker

Copley

Marree

NepabunnaUmoona Tjutagku Health Service

Aboriginal Corporation

Port Lincoln Aboriginal Health Service Inc.

Aboriginal Sobriety Group Indigenous Corporation

Nunkuwarrin Yunti of South Australia Inc.

Mount Gambier

Murray Bridge

Meningie

RaukkanVictor Harbor

Loxton

RenmarkBarmera

GerardBerri

Pangula Mannamurna Aboriginal Corporation

Point Pearce

Adelaide

South Australia

Moorundi Aboriginal Community Controlled

Health Service Inc.

OUR MEMBERSAboriginalHealthCouncilofSouthAustraliaLtd.

Key

AboriginalCommunityControlledSubstanceMisuseServiceAboriginalCommunityControlledHealthService

ANNUAL REPORT CONTENTS 2018-2019

CHAIRPERSON’S REPORT 2

CHIEF EXECUTIVE OFFICER’S REPORT 4

DEPUTY CHIEF EXECUTIVE 6 OFFICER’S REPORT

STRATEGIC DIRECTION 8 OFFICIAL LAUNCH

AHCSA 2018 NAIDOC OPEN DAY SHED PARTY 10

AHCSA STRATEGIC DIRECTIONS 12

ORGANISATIONAL STRUCTURE 14

PROGRAM REPORTS

Constitutional Objective 1 15

QUALITY, ACCREDITATION 15 AND COMPLIANCE

EXECUTIVE 18

HumanResources 18


PUBLIC HEALTH AND PRIMARY HEALTH CARE 20

PublicHealth 20

BloodBorneVirus 22

SexualHealth 23

DeadlySounds 26

DeadlySights 27

TrachomaElimination 29

AboriginalDental 30

TACKLING INDIGENOUS SMOKING 31

MaternalHealthTacklingSmoking 32


RESEARCH 36

AboriginalHealthResearchEthicsCommittee 36

AboriginalGender 38

SheddingtheSmokes 40

StrongDadsStrongFutures 41

UnderstandingStressandStayingStrong 43

AlcoholManagement 46

QUALITY SYSTEMS 47

DigitalHealth 49


CHRONIC DISEASE 50


EDUCATION, TRAINING 51 AND WORKFORCE

RegisteredTrainingOrganisation 51

RuralAboriginalHealthWorker 56

FINANCIAL REPORT 57

BoardofDirectors’Report 58

StatementofProfitorLossandComprehensiveIncome 60

StatementofFinancialPosition 61

StatementofChangesinEquity 62

StatementofCashFlows 63

NotestotheFinancialStatements 64

StatementbytheBoardofDirectors 77

IndependentAuditor’sReport 78

our health, our choice, our way | www.ahcsa.org.au

Throughoutthisdocument,theterms‘program’and‘programme’areused.‘Program’relatestoState-fundedinitiatives,while‘programme’referstoCommonwealth-fundedinitiatives.

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ABOUT AHCSAAboriginalHealthCouncilofSouthAustraliaLimited(AHCSA)isthepeakbodyrepresentingAboriginalcommunitycontrolledhealthandsubstancemisuseservicesinSouthAustraliaatastateandnationallevel.

Ourprimaryroleistobethe‘healthvoice’forallAboriginalpeopleinSouthAustralia.WeachievethisbyadvocatingforthecommunityandsupportingworkerswithappropriateAboriginalhealthprogramsbasedonaholisticperspectiveofhealth.

AHCSAisamembership-basedpeakbodywithaleadership,watchdog,advocacyandsectorsupportrole,andacommitmenttoAboriginalself-determination.

TheBoardofDirectorsandtheSecretariatcollectivelyformAHCSA.TheroleoftheSecretariatistoundertakeworkdirectedbytheCouncilonwhichallMemberorganisationsarerepresented.

AHCSA’s 38 year history includes:

1981 IncorporatedhealthunitundertheSouthAustralianHealthCommissionAct.

1999 CommissionedareviewthatrecommendedreincorporationundertheAssociationsIncorporationAct,SA1985,toincreaseeffectivenessandrepresentation.

2001 ReincorporatedinOctoberasanAboriginalcommunitycontrolledorganisation,governedbyaBoardofDirectorswhosemembersrepresentAboriginalCommunityControlledHealthandSubstanceMisuseServicesandAboriginalHealthAdvisoryCommittees/Groups(AHACs/AHAGs)throughoutSouthAustralia.

2011 AHCSAcelebratedits10thanniversaryasanindependentAboriginalCommunityControlledHealthOrganisation.

2014 AHCSAInc.purchaseslandandbuildingat220FranklinStreet,Adelaide,SouthAustralia.

2015 AHCSAInc.submitsanapplicationforexemptiontoincorporateundertheCorporations(AboriginalandTorresStraitIslander)Act2006withtheMinisterforIndigenousAffairs,theHonourableNigelScullion.

2016 ExemptionisgrantedinFebruary,andpaperworkiscompletedforAHCSAtoincorporateundertheAustralianSecuritiesandInvestmentsCommission(ASIC).AHCSA’sBoardofDirectorsupdateditsConstitutiontomeetASICrequirements.InAugust,aSpecialGeneralMeetingwasheldwithAHCSAMemberstoendorsetherevisedConstitutionforAHCSALimited.PaperworkwassubmittedtoASICtoregisterasacompany.

2017 InJanuary,theAboriginalHealthCouncilofSouthAustraliaIncorporatedbecametheAboriginalHealthCouncilofSouthAustraliaLimited.Assuch,itbecamearegisteredcompanyundertheCorporationsAct2001andisacompanylimitedbyguarantee.ThisisanexcitingnewphasefortheAboriginalHealthOrganisationandweworktowardsbecomingasustainableorganisationforAboriginalpeopleacrossSouthAustraliaintothefuture.

AHCSA MEMBERSAboriginalHealthCouncilofSouthAustraliaLtd.

PIKA WIYA HEALTH SERVICE ABORIGINAL CORPORATIONEstablishedasPikaWiyaHealthServicesInc.intheearly1970stoprovideamedicalservicetotheAboriginalpopulationinPortAugustaandDavenport,theorganisationwasincorporatedin1984undertheSAHealthCommission(nowCountryHealthSALocalHealthNetworkInc.).On1July2011,theservicetransitionedtoAboriginalcommunitycontrolundertheCATSIAct.

NowknownasPikaWiyaHealthServiceAboriginalCorporation,theorganisationoperatesfrompremisesinPortAugustaandalsohasclinicsatDavenport,CopleyandNepabunnacommunitiesaswellasprovidesservicestothecommunitiesofQuorn,Hawker,Marree,LyndhurstandBeltana.

NGANAMPA HEALTH COUNCILNganampaHealthCouncil(NHC)isanAboriginalCommunityControlledHealthOrganisationoperatingontheAnanguPitjantjatjaraYankunytjatjara(APY)LandsinthefarnorthwestofSouthAustralia,whichishometoalmost3,000residents.TheAnangucultureisstillstrong,andPitjantjatjara/Yankunytjatjaraisthefirstlanguage.NHCprogramsincludeagedcare,sexualhealth,environmentalhealth(UPK),dental,women’shealth,malehealth,children’shealth,immunisation,eyehealthandmentalhealth.

Theyhaveanationalreputationforbestpracticeclinicalservices,collaborativeprogramresearchanddevelopment,andcollectionofdataforongoingevaluation.TheirsuccessesincludethereductionofSTIsbyover50%since1996andconsistentchildimmunisationofatleast90%.Completedhealthcheckshaveincreasedfrom84in2003/04toover1,400in2016/17.Antenatalvisitsinthefirsttrimesterhaveincreasedby50%since1992.PublicationoftheinternationallyrecognizedUPKreportin1987andtheUPKprogram,whichestablishedninehealthylivingpracticesthatledtotheprovisionofhealthhardwarewhichhasreducedrheumaticheartdiseaseandscabies,whichleadstokidneyfailurelaterinlife.Improvementsinthenumberofwellwomen’schecksandthedentalhealthofchildrenarecomparablewiththerestofSouthAustralia.Theyhavealsodevelopedthe‘MaiWiruStorepolicy’andstorecouncilstomaintainthepolicy.Theseachievementshavebeenwidelyrecognised.

NHCisawellutilisedservice,withover60,000patientcontactsperyear.TheirclinicsareAGPALaccreditedwithmodernequipmentandsophisticatedITsystems,includingCommunicare,telemedicinefacilitiesandanintranetsite.ThemainclinicsarelocatedatIwantja(Indulkana),Mimili,Fregon,Pukatja(Ernabella),Amata,andPipalyatjara,withasmallerclinicatNyapari.TheTjilpiPampakuNguraAgedCarefacilityislocatedatPukatja,withadminofficesatUmuwaandAliceSprings.

PORT LINCOLN ABORIGINAL HEALTH SERVICE INC.TheAboriginalcommunitywasintegraltotheestablishmentofthePortLincolnAboriginalHealthService(PLAHS).ItdevelopedasaresultofReportsandSubmissionsputtotheCommonwealthandStateGovernmentsfromthemid1980’sonwards.InMay1992,PaulAshewasappointedHealthServiceCo-ordinatortooverseeitsearlyestablishmentphase.

ByJune,theAboriginalandTorresStraitIslanderCommission(ATSIC)issuedagrantforbuildingrenovations,furniture,fittingsandmedicalequipment,aswellasrecurrentfundsforrecruitmentofstaff.TheSAHealthCommissionalsomadeanareaavailablewithintheHealthandWelfareComplexonOxfordTerrace.PLAHSwasofficiallyopenedinSeptember1993byLowitjaO’Donoghue,ChairpersonofATSIC,andIrisBurgoynewaselectedastheInauguralChairperson.In2013,PLAHScelebratedits20thAnniversarywithanOpenDayandCommunityBBQ.

2018-2019 ANNUAL REPORT


NUNKUWARRIN YUNTI OF SOUTH AUSTRALIA INC.NunkuwarrinYuntiofSouthAustraliawasinitiatedinthe1960sbyMrsGladysElphick,whofoundedtheCouncilofAboriginalWomenofSA,oneofthefirstAboriginalorganisationsinthestate.Incorporatedin1971,NunkuwarrinYuntievolvedfromtheAboriginalCulturalCentre,theAboriginalCommunityCentreofSA,andtheAboriginalCommunityRecreationandHealthServicesCentreofSA.

Theirfirstprogrammewasestablishedwiththeaidofdonations,somegovernmentfundingandtheservicesofadedicateddoctor.TheyalsoaccommodatedtheAboriginalLegalRightsMovement,AboriginalChildCareAgency,AboriginalSobrietyGroupInc.,NationalAboriginalCongress,AboriginalHostelsLtd,TrachomaandEyeHealthProgramme,WOMA,AboriginalHousingBoard,AboriginalHomeCare,andKumangkaAboriginalYouthService.TheyalsoassistedwiththeestablishmentoftheEldersVillage.TheybecameknownasNunkuwarrinYuntiofSouthAustraliaInc.in1994.ItiscommunitycontrolledandgovernedbyanallAboriginalandTorresStraitIslanderBoard.

ThisensuresthedeliveryofculturallyappropriateservicestoAboriginalandTorresStraitIslanderpeoplebyAboriginalandTorresStraitIslanderpeople.Ithasgrownfromawelfareagencywiththreeemployeestoamulti-facetedorganisationwithover130staff,whodeliveradiverserangeofhealthcareandcommunitysupportservicesandisaregisteredtrainingorganisation.

NUNYARA ABORIGINAL HEALTH SERVICE INC.AccessandequityissuesraisedbytheCommunityin1996,andtheoverallappallingstateofhealthinthebroaderAboriginalCommunity,weretheconduittotheestablishmentofNunyaraWellbeingCentreinWhyallain2003.ThiswasapartnershipbetweenHealth,Housing,theAboriginalCommunityandtheCommonwealth.However,the‘in-reach’modelwherebymainstreamserviceprovidersvisitedNunyaradidnotmeetCommunityexpectationsordeliverimprovedhealthoutcomes.

AfterthegrantingofCommonwealthHealthyforLifefundingin2008,NunyarawasabletoindependentlydelivercomprehensiveprimaryhealthcaretotheCommunity.By2012,NunyaratransitionedtofullAboriginalCommunityControlandbecameNunyaraAboriginalHealthServiceInc.TodayNunyaradeliversservicestoover1,100AboriginalpeopleinWhyalla.

TULLAWON HEALTH SERVICE INC.Establishedin1982astheYalataMaralingaHealthServiceInc.(YMHS)followingcommunityinitiativeandlobbying,thehealthservicewasnotonlyconcernedwithlookingafterpeoplelivinginYalatabutalsoolderpeoplewhohadreturnedtotheirtraditionallandsinthenorthandatOakValley,northwestofMaralinga.

Bythelate1990s,OakValleywasreadytoestablishitsownhealthservicecalledOakValley(Maralinga)HealthService(OV(M))basedontwoprinciplesthattheAnangupeopleofYalataandOakValleyareonepeople,andbothYMHSandOV(M)shouldhavecooperativeand‘seamless’arrangementsforAnangubetweentheservices.On31May2001,theYMHSConstitutionwasamendedandthenameoftheorganisationchangedtoTullawonHealthServiceInc.withtheimportanceofthetwoprinciplesremainingintheConstitution.

UMOONA TJUTAGKU HEALTH SERVICE ABORIGINAL CORPORATIONUmoonaTjutagkuHealthServiceAboriginalCorporation(UTHSAC)providesprimaryhealthcareservicestoAboriginalpeopleinandaroundCooberPedyandalsoauspicestheDunjibaSubstanceMisusePrograminOodnadatta.Establishedin2005,UTHSAChasexpandedsteadilyoverthepast10yearstoprovideacomprehensiverangeofhighqualityservicesincludingmedical,dentalandsocialservicesforthecommunityaswellasanincreasingnumberoftransientclients.

OAK VALLEY HEALTH SERVICEOakValleyHealthServicewasestablishedin1985asacommunityoutstationforAnangupeopledisplacedfromtheMaralingaLandsfortheBritishatomictests.OakValley(Maralinga)Inc.managedtheestablishmentofthecommunityincludinghousing,roadsandotherinfrastructure.Nowservicedwithastore,mechanicsgarage,healthclinic,agedcarecentre,anewschoolandanairstrip,aCDEPprogramandartsworkshopisalsoavailable.

Thehealthclinicprovidesprimaryhealthcaretothecommunity,monitoringongoinghealthissuessuchasdiabetes,hypertension,antenatalandpost-natalcare,childandschoolhealth.Theirmainroleishealtheducation,hostingvisitingspecialistsandreferralsfortheRoyalFlyingDoctorService(RFDS).

PANGULA MANNAMURNA ABORIGINAL CORPORATIONPangulaMannamurnawasestablishedfromtheSouthEastAboriginalPartnership,whichcomprisedofmembersfromtheSENungasClubandcommunitymemberswhosefocuswastoforma‘onestopshop’forAboriginalpeopleinthesoutheast.ThisvisionofthefoundingfamilieswhosetupPangulaMannamurnawasbasedonAboriginalandTorresStraitIslanderpeoplehavingaccesstohealthandwellbeingserviceseitheronsite,orthrougheffectivereferrals.Thevisionalsoincludedasafeplaceforcommunitytovisitandstayconnectedtoothers.Thevisionisstillalivetodayandwillcontinueonwellintothefuture.

ABORIGINAL SOBRIETY GROUP INDIGENOUS CORPORATIONTheAboriginalSobrietyGroupIndigenousCorporation(ASG)hasbeenoperatingsince1973,asavoluntaryself-helpgroupforpeoplewantingtoregaintheirsobriety.ASGprovidescompletealcoholanddrugsubstancemisuserecoverypathway.ThisincludesCrisisInterventionwithaMobileAssistancePatrol.TheSubstanceMisuseTeamestablishesindividual’sneedsandprovidesreferralsforrehabilitationandhealth.Rehabilitation(Monarto)providesaholisticprogramformenatLakalinjeriTumbetinWaal(LTW),andLeilaRankineHouseofHopeforwomen,andTheHomelessnessProgram(WoodvilleGardens)isatCyrilLindsayHouseformenandAnnieKoolmatrieHouseforwomen.TheDisabilityProgram(Ottoway)isatArkaringaHouseforwomen.

ASGisalsobasedatBerri,whichalsoincludeaMobileAssistancePatrol,SubstanceMisuseTeam,SocialandEmotionalWellBeingandMentalHealthSupportTeam.Theirpurposeistoprovideholistichealingpathwaysawayfromgrief,loss,trauma,andabusivelives.TheirvaluesincludepracticingAboriginalculture,custom,tradition,andspiritualityforasoberandhealthylifestyle.

CEDUNA KOONIBBA ABORIGINAL HEALTH SERVICE ABORIGINAL CORPORATIONFirstestablishedastheCedunaKoonibbaAboriginalHealthService,theorganisationwasdesignedtomeetthehealthneedsofAboriginalpeoplewithintheCedunadistrictofSouthAustraliaincludingScotdesco,Koonibba,TiaTuckia,MundaandWannaMarhomelands.

Incorporatedin1986undertheSAHCAct,on1July2011theorganisationtransitionedfromtheSAGovernmenttoAboriginalcommunitycontrolandbecameknownasCedunaKoonibbaAboriginalHealthServiceAboriginalCorporation.

MOORUNDI ABORIGINAL COMMUNITY CONTROLLED HEALTH SERVICE INC.Thishealthservicewasestablishedin2017todeliveracomprehensiverangeofprimaryhealthcareservicestotheircommunities.Atthecoreoftheseservices,MoorundiACCHSInc.deliversaholisticmodelofhealthcare,whichincludesclinicalservicesandwellbeingprograms.

InNgarrindjeri,theword‘Moorundi’meansriverandrefersdirectlytotheMurray.ForthepeopleoftheNgarrindjerination,theriveriswherealllifebeginsandtheconnectionbetweenhealthandwaterisintricatelylinkedtothecultureoftheNgarrindjericommunity.


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InJuly2018,weheldourfirstNAIDOCOpenDayShedPartyintheAHCSAcarpark.Manypeopleattended,includingtheMinisterforHealthandWellbeingtheHonStephenWade.Itwasamazingtoseethecarparktransformedintoafuncommunityhub,filledwithsoftfurnishings,partylights,astageandlivemusic.Itwasawelcomingfamilygathering.

ThankyoutoAHCSAstaffwhoplannedtheeventandmadethedaypossible,andtothewonderfulsponsors:Bunnings,thePrimaryHealthNetworks,CoLLECTDesign,theRuralDoctorsWorkforceAgency,andtheDepartmentofPrimeMinisterandCabinet.WehavealottoliveuptoforournextNAIDOCOpenDay.

AlongwithotherDirectorsandAHCSAstaff,IhadtheopportunitytoattendourpeakbodyconferencewiththeNationalAboriginalCommunityControlledHealthOrganisation(NACCHO),heldinBrisbaneinNovemberlastyear.ThethemefortheconferencewasInvestinginWhatWorks,whichsawmanyinspirationalspeakersfromtheAboriginalCommunityControlledHealthSector,includingDrPaulTorzillo,whopresentedtheHousingforHealthinitiativeattheNganampaHealthCouncilthroughtheirUPKEnvironmentalHealthProgram.Thereweremanysuchspeakersoverthetwodays,endingonthethirddaywiththeNACCHOAnnualGeneralMeeting.PriortotheNACCHOAGM,theYouthConferencewasheld.AHCSAlooksforwardtoattendingthe2019conferenceinDarwin:BecauseofThem,WeMust!Improvinghealthoutcomesfor0-to-29-year-olds.

Completedduringthisreportingperiod,wewerefortunatetoreceivefundingthroughtheLowitjaInstituteforthreeprojects,includingtheAboriginalGenderStudy.ThisinvolvedAHCSAbeingapartoftheAdvisoryGroup,whichwasveryrewarding.Particularlysincewewereabletoprovidesupportfrombeginningtoend.

Theteamhasdoneamazingwork,whichinvolvedthemmeetingwithkeypeopleinanumberofcommunitiestogatherinformationonwhatisanunder-researchedareaofAboriginalhealth.Thestudypresentedgreatoutcomes,whichwasdocumentedinaFinalReport,aswellasinaCommunityReport.Thankyoutoallwhohavebeeninvolved,totheresearchteamandtoallcommunityparticipants.

InDecember2018,IfeltveryprivilegedtoattendtheAHCSARegisteredTrainingOrganisation(RTO)Graduation.Thatnightalsomarked35yearssincethefirstAboriginalHealthWorkergraduationin1983,throughourpredecessor,theAboriginalHealthOrganisation.ItwasamazingtoseethelevelofprofessionalismwithinthisimportantindustryandhowAHCSAhasplayedsuchanintegralroleinelevatingtheleveloftrainingsincewebecameanRTOin2005.CongratulationsagaintothestudentsandstaffintheEducation,TrainingandWorkforceteamforthisachievement.

TheBoardhasbeenworkingveryhardoverthepast12monthstodevelopthenewAHCSAStrategicDirection2019-2024,holdingseveralworkshopsthroughoutthistimetoplanforthefutureandreflectonourlastStrategicDirectiondocument.OurfiveConstitutionalObjectivesformthefoundationofourorganisationandplayamajorroleinhowwedirectthebusinessofAHCSA.Thisfoundationcontinuestoprovidestabilityforournewdocument,StrategicDirection2019-2024,withtheadditionofournewConstitutionalObjective4:Provideanddeliverchronicdiseasecareservicesandprograms.ThisimportantdocumentwaslaunchedinMarch2019,withthecommissionedcoverartworkcreatedbyrenownedAboriginalartistAnnaDowling,hangingproudlyinourbuildingforalltosee.

AstheClosingTheGaprefreshoccursatnationallevel,IhaveattendedmeetingsofthenewlyformedSouthAustralianAboriginal

CHAIRPERSON’S REPORT 2018-2019

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Welcome to our 2018-2019

Annual Report. It has been a

whirlwind 12 months with

many exciting and rewarding

achievements by both the

AHCSA Board and Secretariat.

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CommunityControlOrganisationsNetwork(SAACCON),whichistheSouthAustralianpeakbodythroughwhichtheCoalitionofPeakswillshareandseekinformationunderaClosingtheGapPartnershipAgreement.

TheCoalitionofPeaksismadeupofnearly40membersofnational,stateandterritoryAboriginalandTorresStraitIslanderpeakbodieswithinvarioussectorsacrossthecountry.IthascometogethertobeaformalpartnerwiththeCouncilofAustralianGovernments(COAG)inthenextphaseofClosingtheGap.ThewayweworktogetherissetoutinthePartnershipAgreementonClosingtheGap(PartnershipAgreement)ofMarch2019.ThenewNationalAgreementwillsetouthowgovernmentsandtheCoalitionofPeakswillworktogetheroverthenext10yearstoimprovethelivesofAboriginalandTorresStraitIslanderpeopleacrossAustralia.

HereinSouthAustralia,meetingsonthenewNationalAgreementwillbeheldacrossthestate.SouthAustralia,throughtheAboriginalLegalRightsMovement,istheleadconvenerofthesemeetingsandistheCoalitionofPeaksrepresentativeonJointCouncilforClosingtheGap.TheCEOandIrepresentAHCSAonthisbodyandaninvitationhasbeenextendedtoalloftheAHCSAMembersandotherAboriginalpeaksacrossSouthAustraliatobecomeinvolved.

TheAHCSASecretariathashadanextremelybusyyearsupportingourMembersandrepresentingAHCSAatastateandnationallevel.OnbehalfoftheBoardofDirectorsIwouldliketoexpressourgratitudeandappreciationforyourcontinuedhardworkanddedicationtoAHCSA.TherearemanyexcitingprojectsscheduledfortheupcomingfinancialyearandwelookforwardtohearingtheupdatesatournextBoardmeeting.

The Board has been working very hard over the past 12 months to develop the new AHCSA Strategic Direction 2019-2024, holding several workshops throughout this time to plan for the future and reflect on our last Strategic Direction document

Thankyouonceagaintoourfunders:SAHealth;theDrugandAlcoholServicesofSouthAustralia;DepartmentofHealth;theLowitjaInstitute;UniversityofSydney;theBrienHoldenInstitute;theRuralDoctorsWorkforceAgency;andtheDepartmentofPrimeMinisterandCabinet.

Finally,toourBoardofDirectors,Iextendabigandheartfeltthankyouforyourparticipation,inputandguidance.ToourChiefExecutiveOfficer,TeamLeaders,andAHCSAstaff,withoutwhosecontribution,valuableinputandfacilitationwouldmaketheoperationalsuccessofourorganisationimpossibleandunachievable,thankyouforallthatyoudo.

Polly Sumner-DoddChairperson


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BeingthepeakbodyforAboriginalhealthinSouthAustralia,AHCSAasanorganisationhasparticipatedinawiderangeofmeetings,forumsandconferencestoprovideinputandadvocateonbehalfofourMembersandAboriginalcommunities.Thishasincludedstronglyadvocatingonanumberofkeylegislativematters,includingtheControlledSubstances(YouthTreatmentOrders)AmendmentBill2018andHealthPractitionerRegulationNationalLawSouthAustraliaRemoteAreaAttendance(Gayle’sLaw).

AHCSAcontinuestohavestrongworkingrelationshipswithourfunders,partnersandstakeholdersasweworktogethertoimprovethehealthoutcomesofAboriginalpeopleinSouthAustralia.

Overthelasttwelvemonths,theAHCSABoardandstaffhavebeendevelopingourstrategicdirectionforthenextfiveyears.IwouldliketothanktheBoardfortheircommitmentandcontributiontothisimportantdocument,whichwillguidetheworkofAHCSAoverthenextfiveyears.

OurAHCSAStrategicDirection2019-2024waslaunchedinMarchthisyearandthisresourcecanbefoundonAHCSA’swebsite.WelookforwardtoworkingwithourMembersonimplementingnewinitiativesaspartofourStrategicDirection,includingeightkeystrategiesthatwillsupportAHCSA’sOrganisationPlan,CommunityEngagementPlanandPartnershipPlan.WewillensurethattheoutcomesofourkeystrategiesandinitiativesaresharedwithourstakeholdersviafutureAHCSApublications.

CHIEF EXECUTIVE OFFICER’S REPORT 2018-2019

InDecember2018,wecelebratedthegraduationofover50students,throughourRegisteredTrainingOrganisation,witharangeofqualifications.ThiswascoupledwithanAHCSAHealthAwardsceremony.BoththestudentsandthehealthawardwinnersshouldbeveryproudoftheirachievementsandthecontributiontheyhavealreadymadeandwillcontinuetomakeinAboriginalhealth.

OurresearchprogramsandpartnershipshaveexpandedinrecentyearsanditispleasingthatAboriginalresearchisbeingdriven,ownedandleadbyAboriginalresearchersandtheAboriginalcommunity,forthebenefitoftheAboriginalcommunity.WelookforwardtocontinuingtostronglycontributetothiskeyareaofAboriginalhealth.

AHCSArecentlywentthroughourQualityInnovationPerformanceLtd(QIP)AccreditationprocessagainsttheQICHealthandCommunityServicesStandards7thEditionandwewouldliketothankourMemberrepresentatives,keystakeholdersandallstaffwhocontributedtotheauditprocess.Yourparticipationandinputisgreatlyvalued.

Inclosing,IwouldliketothankyouforyourinterestinourAnnualReportandhopeyouenjoyreviewingtheupdatesregardingourkeyprojectsandactivitiesforthe2018-2019financialyear.IwouldliketosincerelythanktheAHCSABoard,staffandMembersfortheircontinuedsupportandcommitmenttoAHCSA,whichensuresthatourorganisationcancontinuetofulfiltheroleofpeakbodyforAboriginalhealthinSouthAustralia.

Shane Mohor ChiefExecutiveOfficer

We have once again experienced

a very busy, challenging and

rewarding year. I would firstly

like to acknowledge our staff

who have continued in their

commitment to our Members

through many and varied programs

and support mechanisms. I would

also like to thank AHCSA’s Board

for their on-going guidance,

direction and support.

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AHCSA as an organisation has participated in a wide range of meetings, forums and conferences to provide input and advocate on behalf of our Members and Aboriginal communities


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DEPUTY CHIEF EXECUTIVE OFFICER’S REPORT 2018-2019

ResearchcontinuestobehighonAHCSA’sagendaandbyJunethisyear,wewillhavefourprojectscomingtoanend.ThethreestudiesfundedbytheLowitjaInstitute:AboriginalGenderStudy;StrongDadsStrongFutures;andUnderstandingStressintheWorkforce.TheSheddingtheSmokesProgrammewasfundedbytheDepartmentofHealth.Allwerehighlybeneficialprojects,whichinvolvedworkingwithourMembersandcommunities.TheyalsostrengthenedourpartnershipsandrelationshipswiththeTullawonHealthServiceandUmoonaTjutagkuHealthServiceAboriginalCorporation,theUniversityofCanberra,UniversityofSouthAustralia,WardliparinggaAboriginalHealthUnit,aswellastheSouthAustralianHealthandMedicalResearchInstitute(SAHMRI).

Thisyear,theQualitySystemsteamheldtheirfirstQualityForumwithourMembers,whichincludedguestsfromAboriginalHealthCouncilofWesternAustralia(AHCWA)andVictorianAboriginalCommunityControlledHealthOrganisation(VACCHO).Overthetwodays,theteamshowcasedwhattheSectorhasbeendoingwithclinicalgovernance,chronicdiseasesystems,MyHealthRecord,accreditationandCommunicare.TheForumalsoshowcasedcasestudiesfromtheMembersandvisitors.Itwasahugesuccess,withanotherForumplannedfor2020.TheteamengagedadigitalstorytellertocapturethetwodaysinavisualformatandaCaseStudyReportisamongsttheprojectstheteamwillbeworkingonlaterintheyear.

IwouldliketoacknowledgethehardworkofourAccreditationWorkingGroupthroughourAHCSAAccreditationandComplianceOfficer.Allinvolvedhavebeenworkingtirelesslyoverthepastfewyearstoenableustomeetouraccreditationrequirementsandachievereaccreditation.Throughregularmeetings,includingseparateworkinggroupmeetingsonriskandcompliance,andpolicydevelopmentand

updates,ithasenabledAHCSAtomeetalloftheaccreditationstandards,demonstratebestpracticeandcontinuousqualityimprovement.

TheTackingIndigenousSmokingteamcontinuestosupportourMemberswhodon’treceivefundingforthisProgramme,aswellasAboriginalcommunitiesintheRiverland,YorkePeninsulaandOodnadatta.Thefocusforthisfinancialyearhasbeenprovidingtrainingandawarenessforsmokingcessationthroughthehealthworkforce,visitstoschoolsandwithexistingmale/femalesupportgroups,communityeventsandplanningcolourfunrunsincommunities.Theteamcontinuestobeverypopularandinhighdemandamongstthecommunity,andinpartnershipwiththeMaternalHealthTacklingSmokingProgram,theyaretargetingallAboriginalpeoplefromthegrowthofthebabythroughtoEldercare.

ThestudentgraduationinDecemberwasdefinitelyahighlightfortheyear.ItwasgreattowitnesssomanypeoplewhowehaveseenpassthroughthedoorsatAHCSAovertheyears,andwhoweseeoutonthegroundintheservicesandinthehospitals,walkonstagetoreceivetheirgraduationcertificates.Itwasanextravaganzafromtheminuteattendeeswalkedintotheroom,fromthevenue,therobes,thefamilyandfriendstotheentertainment.TheEducation,TrainingandWorkforceteamdidanamazingjobinplanningandfacilitatingtheevent.

Itwasalsoatremendoushonourtoseethegraduatesfromtheclassof1983,whowereabletoattendonthenight.ThiswasthefirstgroupofgraduateAboriginalHealthWorkers,whoarenowstrongAboriginalleadersandEldersinourcommunities.IwouldliketoacknowledgemyAunty,OliveGlinkwhowasoneofthesefirstAHWswhowentontobecomeaRegisteredNurseandworkatthePikaWiyaHeathService

The AHCSA Secretariat has been

working tirelessly over the past

year, continuing to produce high

quality work and resources to

support our Members and the

Sector, as well as continuing to

provide training, advice and visits

to the communities for capacity-

building and hands-on support.

C

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formanyyearsuntilherretirement.WehavesincelostAuntyOllie,however,manypeopleinPortAugustarememberandvalidatetheworkshedidthroughoutherlife,aswellasothersfromthisfirstgroupofAboriginalHeathWorkers,whohavesincepassed.

ThePublicHealthandPrimaryHealthCareteamcontinuestoprovidesupporttotheServicesfromtheEar,EyeandTrachomaProgramstotheSexualHealthandBloodBorneVirusPrograms.Buildingthecapacityofthehealthservicestoenablethemtodelivercomprehensiveprimaryhealthcareaswellastheconnectiontoalliedhealthandkeystakeholdershasalwaysbeenahighpriorityfortheteam.

TheSexualHealthteamcontinuedtosupportourMemberswitheducationandtraining,andasexuallytransmittedinfectionscreeningperiod.Thisyearincludedtheintroductionoftheenhancedsyphilisoutreachprogram,providingsupportacross

keyregions,aswellasliaisingwiththeKirbyInstitutewithpoint-of-caremachinetestingandtraining.

TheBloodBorneVirusProgramCoordinatorhasbeenworkingwithMembersandthePatientInformationManagementSystems(PIMS)Officeronaviralhepatitiscontinuousqualityimprovementproject.Thissupportsserviceswithscreeningandmanagementofviralhepatitisthroughstrengtheningpatientinformationmanagementsystems,andtheundertakingofclinicalaudits.Whilethishasbeengruellingwork,theresultsandimprovementswillbeveryrewardingforthehealthservicesandtheProgram,aswellasthereceiversoftheProgram–thecommunity.

Thankstoallofourpartners,keystakeholdersandfundersforyouron-goingsupport,whichenablesustodotheworkwedo.

AHCSA and Hepatitis SA were successful in securing a grant from the Department for Correctional Services to bring to South Australia Ilbijerri Theatre Company’s production VIRAL – Are you the cure?

Finally,thankyoutotheAHCSABoardofDirectors,staffandMembersforyourcontinuedcommitmenttoAHCSAandtheworkwedoasacollective.Ilookforwardtoworkingwithyoualloverthenextfinancialyear.WeexisttosupportourMembersandAboriginalcommunitiesacrossthestate,becauseatAHCSA,weareourMembers.

Amanda Mitchell DeputyChiefExecutiveOfficer


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Theeightmechanismsforchangestrategiestosupporttheimplementationofthisworkareasfollows:

1. TheAHCSAResearchStrategy

2. TheAHCSAPathwaytoAboriginalCommunityControlStrategy

3. TheAHCSAEducationHubStrategy

4. TheAHCSACommunicationStrategy

5. TheAHCSAWorkforceStrategy

6. TheAHCSABusinessDevelopmentandWealthCreationStrategy

7. TheAHCSAYouthStrategy

8. TheAHCSAHealthLeadershipStrategy

WecommissionedartistAnnaDowlingtoproduceanartworkthatwouldreflectthevisionoftheBoardandAHCSAthatwouldsitproudlyonthefrontcover.Annaproducedthebeautifulredgumtree‘inkonpaper’thatadornsthefrontcover,withtheoriginalillustrationhangingproudlyinourbuilding.ThankyoutoAnnaforcapturingtheessenceofAHCSAinyourbeautifulartwork.

TheAHCSAStrategicDirection2019-2024buildsonthethemesofthepreviousStrategicDirectiondocument,maintainingtheAHCSAConstitutionasthefoundationoftheorganisation.ThenewdocumentnowincludesanupdatedConstitutionalObjectivefromtheConstitutionrevisedin2017:‘Provideanddeliverchronicdiseasecareservicesandprograms’.ThisbecomesthefourthConstitutionalObjective,with:‘Contributetothedevelopmentofawell-qualified,andtrainedAboriginalhealthsectorworkforce’,becomingthefifth.

OurConsultant,DanaShenguidedtheBoard,CEOandseniorstafftoupdateanddevelopthe23keydirectionsthatwilldrivetheactionofthefiveConstitutionalObjectives.Anewinitiativefortheorganisationtoprogressthestrategicdirection,willbethedevelopmentandimplementationofTheAHCSAOrganisationalPlan,withthesupportanddirectionofTheAHCSACommunityEngagementPlanandTheAHCSAPartnershipPlan.

STRATEGIC DIRECTION OFFICIAL LAUNCH

ThankyoutoCoLLECTDesignforshapingtheartwork,thewordsandvisionintothisuniquedocument.Welookforwardtoworkingwithyoutodeveloptheeightmechanismsforchangestrategiesandthreekeyplansmentionedabove.

AHCSAexiststosupportourMembersandAboriginalcommunitiesacrosstheState.Together,weaimtobethe‘differencemakers’.Weareoneandthesame.AHCSAisitsMembersandwehavehighaspirationsforourCommunitiesasoutlinedinthisdocument.

‘AHCSA has great ambitions for our Community and we will aim high in order to achieve these through working to improve the health of Aboriginal people holistically.’

AHCSA Strategic Direction 2019-2024. 2019

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In March this year, our Board of

Directors launched the AHCSA Strategic Direction 2019-2024. After a number of workshops undertaken

from March 2018 through to this

financial year, the Board were very

happy to share the final document

with AHCSA staff, Members, key

partners and stakeholders.

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The NAIDOC Open Day was

themed ‘Because of Her We Can’.

We wanted to do something different

and exciting, so we held a Shed

Party in our Franklin Street car park.

Thespacewastransformedfromaconcreteshell,toacosycarnivalwithrugs,lights,livemusic,facepainting,basketweaving,artistsinresidence,stalls,showbagsandminihealthchecksonofferinourclinicalrooms.

ThefestivitieskickedoffwithaWelcometoCountrybyUncleLewisO’Brien,whosharedwithusastoryaboutaveryspecialAuntyinhislifeandreflectedonhowimportantshehadbeentohimandhisfamilythroughouttheirlives.Thankyou,UncleLewis.

AHCSAChairperson,AuntyPollySumner-Doddwelcomedeveryonetoourspecialdayofcelebrationandacknowledgementtoallofthespecialwomeninourlives.Sheespeciallyacknowledgedthecontributiontheyhavemadetoourcommunitiesandourfamilies.Thosewhohaveenabledustogrow,learnandbecomethepeoplewearetoday.

AuntyPollyalsodeliveredaspecialtributetoourformerCEO,MrsMaryBuckskin,honouringherworkanddedicationtoAHCSAandhercommitmenttoachievingwhatwehavetodate–‘BecauseofHerWeCan’.

WewerefortunatetohaveNatashaWanganeenasourMC,andasalways,Natashabroughtfunandlaughtertotheoccasion,assheintroducedandthanked

allofourmusicians,guestsandcontributorsthroughouttheday.MinisterforHealthandWellbeingHon.StephenWadewasabletoattendandvisitedtheclinicroomstohaveaminihealthcheckwithourAboriginalHealthPractitionerstudents,whichwasahighlightforthem.ItwasgreattoseetheMinisterparticipateinourevent,meetingwithstaff,studentsandcommunitymembers.

Ourline-upofmusiciansincludedEddiePeters,KatieAspel,EllieLovegrove,andCoreyandGemma.Inbetweenthemusic,facepaintingandbasketweaving,staffandguestswereabletoenjoyabeautifulhotroastfromtheteamatTexasBullMachine,withtakehomepacksavailableforourcommunitymembersattending.

ThankyoutoAuntyJaniceRigneyandtheSouthernEldersWeavingGroupandAudreyBrumbyforyourattendanceandsharingyourweavingandpaintingexperienceswithusall.

Ahugethankyoutooureventsponsorswhomadethedaypossible:

• DepartmentofPrimeMinisterandCabinet

• RuralDoctorsWorkforceAgency

• AdelaidePrimaryHealthNetwork

• CountrySAPrimaryHealthNetwork

• CoLLECTDesign

• CommonwealthBankofAustralia

• BunningsWarehouse

ThankyoutoalloftheAHCSAstafffortheircontributionovermonthsofplanning,throughtosupportleadinguptotheeventandofcoursefortheirattendanceontheday.Itisyourteamwork,dedicationandprideinAHCSAthatmakestheseeventsaworthwhileandwonderfulexperience.

AHCSA 2018 NAIDOC OPEN DAY SHED PARTY

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OUR VISIONOurvisionisthatallAboriginalpeoplewillthrive,behealthyandculturallystrong.

OUR MISSIONTheAboriginalHealthCouncilofSouthAustraliaLtd.willworkinwaysthatmaximisethecapacityoftheAboriginalCommunityindeterminingtheirhealthandwellbeingbyensuring:

•Communityparticipation

•Communityownership

• Communityempowerment

OUR VALUESWewilldothisinwaysthatensuretheAboriginalHealthCouncilofSouthAustraliaLtd.values:

• Culturaldiversity

•Communityhistoryandknowledge

•Communitystrength

AHCSA STRATEGIC DIRECTIONS 2018-2019

AHCSA’S CONSTITUTIONAL OBJECTIVESWewillachieveourvisionthroughtheobjectivessetforthintheAHCSAConstitutionasthefoundationdocumentoftheCompany.

TheseobjectivessupporttheactivitiesoftheAHCSABoardandSecretariat:

1. OperateasthepeakbodyforAboriginalhealthinSouthAustralia,includingby:

i. BeingthepeakorganisationconsultedbyGovernmentsinrelationtoissuesofAboriginalHealth;

ii. ProvidingleadershipinthedevelopmentofpolicyaffectingAboriginalCommunitiesandtheirhealthneeds;

iii. AdvocatingonbehalfofMembersandthoseCommunitieswithoutrepresentation;

iv.ProvidingregulatoryassistanceandenforcementforMembers;and

v. DevelopingleadershipwithintheSouthAustralianAboriginalCommunity,includingdevelopingyouthleaders;

2. ProvidesupporttoMemberstoimprovehealthoutcomesforallAboriginalpeopleofSouthAustralia,promotingandadvancingtheCommunity’scommitmenttophysical,socialandemotionalwellbeingandqualityoflife;

3. ProvidesupporttoMemberstobuildtheircapacitytocreateastrongandenduringAboriginalCommunityControlledHealthSectorandcontributetoimprovingthecapacityofmainstreamhealthservicestorespondappropriatelytothehealthneedsoftheAboriginalCommunitywithinSouthAustralia;

4. Provideanddeliverchronicdiseasecareservicesandprograms;and

5. Contributetothedevelopmentofawellqualified,andtrainedAboriginalhealthsectorworkforce.

We want to be clear about the way we move forward because we love and have a deep respect for our Communities and our work


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our health, our choice, our way | www.ahcsa.org.auour health our choice our way | www.ahcsa.org.au

For tens of thousands of years, the Red Gum has provided physical and spiritual sustenance to Aboriginal people. We see this tree as a representation of AHCSA, and everything that we stand for

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PUBLIC HEALTH AND PRIMARY HEALTH CARE

David JohnsonTeam Leader, Public Health Medical Officer (NACCHO)

Raz Abdul-RahimPublic Health Medical Support Officer (NACCHO)

Sarah BettsProgram Coordinator, Sexual Health (DHW)

Catherine CarrollClinical Support Officer, Sexual Health (DHW)

Josh RiessenJunior Project Officer, Sexual Health (DHW)

Michael LarkinProgram Coordinator, Blood Borne Virus Program (DHW)

Leanne QuirinoProject Officer, Ear Health (DoH)

Robyn CooperProject Officer, Trachoma Elimination Program (CHSALHN)

Chris RektsinisProject Officer, Eye Health (NACCHO)

TACKLING INDIGENOUS SMOKING PROGRAMME

Ngara KeelerTeam Leader, Coordinator (DoH)

Trent WingardYouth Project Officer (DoH)

Jessica StevensEvaluation and Communication Project Officer (DoH)

Trevor WingardProject Officer (DoH)

Grant DayProject Officer (DoH)

Tim LawrenceProject Officer (DoH)

Jenaya HallProject Officer (DoH)

Mary-Anne WilliamsMaternal Health Tackling Smoking Project Officer (DASSA)

RESEARCH

Gokhan AyturkTeam Leader, Senior Research and Ethics Coordinator (C)

Beth HummerstonResearch Officer, Alcohol Management Project (Uni Of Sydney)

QUALITY SYSTEMS

Polly PaerataStatewide CQI Coordinator (NACCHO)

Isaac HillHealth Informatics Coordinator (NACCHO)

Sarah FraserPractice Managers’ Support Officer (NACCHO)

Nick WilliamsGP Supervisor (GPEx)

Lana DydaPIMS Officer (NACCHO)

Beth HummerstonPIMS Officer (NACCHO)

Carly ClyantDigital Health Coordinator (ADHA)

EDUCATION, TRAINING AND WORKFORCE

Annie-Rose ThurnwaldTeam Leader, Accreditation and Compliance Officer (DPM&C)

Christine FraserSenior Clinical Educator (DPM&C)

Annabella MarshallClinical Educator

James BissetEducator (DPM&C)

Dominic GuerreraEducator Assistant (DPM&C)

Hannah KeainCompliance and Material Support Officer (DPM&C)

Tallulah BilneyStudent Travel and Administration Officer (DPM&C)

Alfred LoweStudent Travel and Administration Officer (DPM&C)

AHCSA BOARD OF DIRECTORS

SHANE MOHORChief Executive Officer (C)

AMANDA MITCHELLDeputy Chief Executive Officer (C)

Aboriginal Health Research and Ethics Committee (AHREC)

EXECUTIVE

Mandy GreenExecutive Assistant (C)

Laura AzarHuman Resources Business Partner (C)

Debra SteadSenior Finance Officer (C)

Angela BroughamStrategic and Business Executive (C)

Marjo StroudAccreditation and Compliance Officer (AHCSA OP)

Belinda LockAdministration and Finance Support Officer (AHCSA OP)

Angel WoolseyReception and Travel Officer (AHCSA OP)

Louise HickfordReception and Travel Officer (AHCSA OP)

Kaylene O’TooleTrainee Reception Officer (AHCSA OP)

KEY

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DHW Department for Health and Wellbeing

DoH Department of Health

DPM&C Department of Prime Minister and Cabinet

NACCHO National Aboriginal Community Controlled Health Organisation

CHSALHN Country Health SA Local Health Network

DASSA Drug and Alcohol Services of South Australia

AHCSA AHCSA OperationalOP

ADHA Australian Digital Health Agency

ORGANISATIONAL STRUCTURE 2018-2019

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QUALITY, ACCREDITATION AND COMPLIANCEInJunethisyear,AHCSAunderwentthefinalstagetobecomeQualityInnovationPerformanceLtd(QIP)accreditedagainsttheQICHealthandCommunityServicesStandard7thEdition.Thisstageinvolvedatwo-dayon-siteassessmentbyQIPassessors.Aswithanearlierdocumentsubmissionstage,thisassessmentwasagainst93indicatorsofthefollowingstandards:

• Governance

• Managementsystems

• Consumerandcommunityengagement

• Diversityandculturalappropriateness

• Servicedelivery

ThefinalaccreditationreporthasnowbeenissuedwithAHCSA’stotalcompliancewithallrequirements.AHCSAisnowQIPaccreditedforthenextthreeyearsuntil15June2022.ThisaccreditationwillassurefundersandconsumersthatAHCSAiscommittedtosafetyandsystematicallyensuresthehighestqualityofserviceandperformance.

Summary of QIP Quality Innovation and Accreditation Report 2019

Governance

TheAHCSABoardofDirectorsiscommittedtoensuringAboriginalpeopleacrossthestatehaveaccesstohighqualityhealthservicesthroughtheirlocalAboriginalCommunityControlledHealthService(ACCHS)inaculturallysafeenvironment,andthatanyunmetneedsareidentifiedandaddressed.Thevisionandvaluesoftheorganisationprovidethebasisforalldecisionsandstrategicdevelopment.

Thegovernancesystemissupportedbydelegationsofauthority,policies,procedures,andreviewprocesses.TheBoard,CEO,managers,andstaffworkdiligentlyonbehalfoftheAHCSAMemberstoimplementtheobjectivesoftheorganisation.

Human Resources

Theorganisationhaseffectivesystemsforhumanresourcemanagement.StafftravelacrossthestateaswellasprovidingMember-basedservicesandtrainingoutoftheAdelaideoffice.AHCSAendeavourstoemployAboriginalstafftoprovidevaluableculturalexperienceandskillsinworkingwithMembersandotherservices.Staffareencouragedandactivelysupportedtodeveloptheirprofessionalskillsandknowledgeonanon-goingbasis.

Finance

ThereareeffectiveprocessesforbudgetplanningandreviewofexpenditureandvariancestoensureAHCSAmeetstherequirementsofthefundingbodiesandisfinanciallysound.AHCSAhascomprehensivesystemsforrecordsmanagement,andthecollectionandanalysisofdatatoinformservicedevelopment.

Culture

EnsuringculturalsafetyiscentraltothedevelopmentofallsystemsandprocessesatAHCSA,whichhasenabledtheachievementofoutstandinghealthoutcomes.TheAssessmentTeamwereveryimpressedwithhowtheorganisationseesitselfasservingandsupportingtheMembersineachregiontoexcelanddevelophealthservicesandpromotion.ThiswasalsoreflectedinMember’sfeedbacktotheAssessment

team,whichexpressedtheirappreciationofthissupportiverole.TheCEOForumswereespeciallyviewedasaveryvaluableopportunitytolearnandnetworkbytheMembers.

Collaboration

TheAssessmentteamnotedstrengthsinthewayAHCSAcollaborateswithotherservices;advocatesonbehalfofAboriginalhealthissues;strategicallypositionsitselftoensureviability;incorporatesbetterpracticeintoservicedevelopmentandHR;andcontributestosectordevelopmentthroughcollaborativecapacitybuildinginitiatives.

Training

Thetrainingfacilitiesareimpressiveandtherearesufficientresourcestoprovidehighlyprofessionaltrainingandlearningexperienceswiththelatestequipmentavailableinhealthpracticeandpromotion.

Feedback from the Report

Commendations

• AHCSA’suniqueunderstandingoflocalculturalandsocialcontextsoftobaccouseandthemajormotivatorsforchangingsmokingbehavioursiscriticaltothesuccessoftheTacklingIndigenousSmoking(TIS)Programme.TheAssessmentteamwouldliketorecognisetheenthusiasmandcommitmentoftheTISteamandtheimportanceofthisProgrammeinreducingtheharmsrelatedtosmokingandenvironmentalsmoke.

CONSTITUTIONAL OBJECTIVE 1

Operate as the peak body for Aboriginal Health in South Australia

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• TheregularCEOForumprovidesanopportunityforMemberstomeetinarelaxedandinformalsettingtoexchangeideasanddiscussissuesandrelevanttopicswithpeers.Theseforumswereconsideredtobeveryimportanttoconnect,informandenableleaderstobuildmoresuccessfulhealthservices.

• Interviewswithstaff,ExecutiveManagementandtheBoardofDirectorsfoundthattheorganisationhasbeensuccessfulinre-establishingapositiveworkplaceculture.TheExecutiveManagementhasworkedhardtobuildatrustingenvironmentinwhichthequalificationandexperienceofthestaffisrecognisedandproperdelegationoftasksoccurs.Theintroductionofteamleadershashelpedtofacilitateon-goingandopencommunicationbetweenmanagersandemployees.Staffreportthatknowledgeandexperienceissharedandindividualsarerecognisedandvaluedfortheirexpertiseindifferentareas.Employeeachievementsandmilestonesarecelebrated,whichhashelpedtostrengthenrelationshipsandencourageemployeeengagement.

• TheCEOdemonstratesawillingnesstoaccommodateeachemployee’sfamilyresponsibilitiesandtoexplorealternativestrategiestomeetbusinessobjectives,whererequired.Thereisaclearunderstandingthatwhathappensinanindividual’shomelifewillaffecthowtheyactandinteractatwork.Theorganisationhasmadesignificantinvestmentintotheiremployeewellbeingprogramtoprotectandimprovethephysical,socialandemotionalwellbeingoftheirstaff.BothAboriginalandnon-Aboriginalstaffreportthattheorganisationhasa‘family’approachtobusinessthathashelpedtobridgeorganisationalandinterpersonaldifferences.

General Comments

• ConsiderableefforthasbeenmadebytheorganisationinrecentyearstofocusonsupportingeachMemberorganisationtoachievetheirownvisionandmission,whilstsupportingthevaluesofAHCSA,whichareculturaldiversity,communityhistoryandknowledge,andcommunitystrength.

• Reviewoftheorganisation’sserviceandprogramplansandrelevantdocumentsandrecordsshowsthatplansaredocumented,implemented,communicated,reviewedandreportedon.Theseplansincludeperformancemeasuresandarelinkedtothestrategicplan.TheEarHealthProjectissuchanexampleamongmanyothers.StakeholdersspokehighlyoftheprofessionalanddiligentapproachtoprogramplanningbyAHCSA.

• ReviewofMoUs/serviceand/orpartnershipagreementsshowsthattheorganisationnegotiatesagreementsand/orpartnershipsthatarefair,legal,alignedwithstrategicdirectionsandhavemechanismsinplacetoresolvedisputes.TheAboriginalViralHepatitisProgramAgreementisanexampleoftheseprocessesbeingeffectivelydemonstrated.

• Theorganisationisawareofthehighdependenceongovernmentfundingandisexploringwaystoincreaserevenuefromothersources.

• Reviewofhumanresourcedocumentsandrecords,andstafffileauditresultsshowsthatallstaffareappropriatelyqualified,demonstratedcompetencyintheirrolesandhaveclearlydefinedrolesandresponsibilitiesthatarereviewedandevaluated.

• TheNetSuitesoftwarehasenabledtheorganisationtostoreallkeydocumentsinoneplace.StaffreportedpositivelyontheirexperiencewithNetSuite.

• Reviewofrecordsmanagementpolicies,procedures,accessprotocolsandMemberorganisationinformationdemonstratesthatAHCSAmaintainsappropriaterecordsfortheroleofapeakbody.

• AHCSAhasmadeconsiderableefforttoprovideMemberswithrelevantinformationontheiroperationsandlegislativechanges.TheMemberportalisanexampleofthisandvaluedbyMemberorganisations.

• Siteinspectionshowsthattheworkhealthandsafetyprocessesareimplemented,communicatedandreviewed,andmeetregulatoryrequirements.

• AreviewofthepartnershipagreementbetweenAHCSAandstate-basedprimaryhealthnetworksfindsthatthekeyobjectiveofthispartnershipistoadoptasharedandcoordinatedapproachinseekingtoaddressthehealthneedsoftheAboriginalandTorresStraitIslanderpeopleandtheirCommunitiesinthemostefficientandeffectivemannerpossible.

• AHCSAiscommittedtoworkingwitheachofitsMemberorganisationstostrengthenthecapacityoftheAboriginalCommunityControlledhealthsectorandmainstreamhealthservicestorespondtothehealthneedsoftheAboriginalCommunityofSouthAustralia.

• Reviewofdatacollectionandanalysisprocesses,andserviceandprogramplansdemonstratestheorganisation’ssystematicdatacollectioninforms


QUALITY, ACCREDITATION AND COMPLIANCE

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The Assessment team noted strengths in the way AHCSA collaborates with other services, advocates on behalf of Aboriginal health issues and strategically positions itself to ensure viability

needsassessment,analysisandplanning.Forexample,theserviceagreementfortheProvisionofAboriginalBloodBorneVirus(BBV)PreventionProjectsetsoutthereportingrequirementsforprojectoutcomes,outputsandkeyperformanceindicatorstotheSexuallyTransmittedInfection(STI)andBBVSectionofSAHealth.

• Reviewofconsumerfeedbackdocumentsandrecordsshowsthatneedsassessmentandplanningprocessandoutcomesareevaluated.Forexample,consumerfeedbackwassoughtfollowingthepilotworkshopoftheMedicareAccessImprovementProgram,designedtoassistMemberstoincreaseMedicarerevenue.ThedatawascollatedandanalysedandtheresultspresentedattheNACCHO2018MembersConference.Thefeedbackfromthepilotprogramwasverypositiveandfurthersessionsareplanned.

• Reviewofconsumerandcommunityengagementdocumentsandrecordsdemonstratesthattheorganisationhasconsumerandcommunityengagementprocessesthataredocumented,implemented,communicatedandreviewed.

Forexample,thepartnershipagreementbetweenAHCSA,theAdelaidePrimaryHealthNetwork(APHN)andtheCountrySouthAustraliaPrimaryHealthNetwork(CSAPHN)requiresallpartiestoprioritiseandcommittocommunityandstakeholderengagementmechanismsandtoshareand/orjointlyparticipateinthesemechanisms.

Recommendations for Improvement

TheQIPAssessmentteamalsoidentifiedanumberofopportunitiesforimprovementatAHCSA.Theseopportunitiesincludesuggestions,whichtheAHCSAQualityandAccreditationWorkingGroupwillembedinaQualityImprovementPlantobesubmittedtoQIPsixmonthsafterachievingaccreditation.ThiswillassistAHCSAwiththeon-goingdevelopmentofitsqualityandmanagementprocesses.

Recommendations

• RegulartestingandimprovingoftheBusinessContinuityPlanisrecommended.

• SetatimeframeandactionplantocompletealloutstandingpolicyreviewsbyDecember2019.

• Improvesystemforcapturingfeedbackintheformofverbalexchanges.

• Seekbestpracticeguidanceforapplyingversioncontroltodifferenttypesofdocuments,includingcommunityengagementplansandrecords,andensureconsumerreviewresultsarenoted.

• FinaliseandimplementaCulturalSafetyPolicyandDiversityPolicywithinputfromconsumers.Instatementsregardingdiversity,ensurespecificreferencetohowAHCSAsupportsLGBTIworkplaceinclusion.

• ReviewandendorseAccessandEquityPolicy.

• UpdateRegisteredTrainingOrganisation(RTO)TrainingProgramInformationBookletwithinformationabouthowpeoplewithdisabilitycanaccesstheRTOandparticipateonanequalbasis.

• ReviewandupdatetheRTOComplaints,ComplimentsandAppealsPolicyaswellastheRTOStakeholderConsultationandFeedbackPolicy.

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EXECUTIVE

HUMAN RESOURCESAfterahandovertransitionplanandatemporaryjobsharingarrangementwithJeffMountford(formerHumanResourcesOfficer),LauraAzarhasnowfullytakenontheHumanResourcesroleasaHumanResourcesBusinessPartner.

TheHumanResourcesplanfortheupcomingyearistopromoteAHCSAasanemployerofchoicebyensuringthatthebenefitsofbeingemployedatAHCSAarewellcommunicatedinourrecruitmentadvertisementsandon-boardingofnewstaff.

WeplantoimproveefficiencywithintheorganisationbyintroducingmoreflexibilityandautomationintoHRprocesses,particularlywithrelationtorecruitment,staffon-boarding,inductionandperformancereviews.AllHRfoldersandformswillbeconvertedintoelectronicfilesforeaseofaccessandimprovedsecurity.

Furthertothat,wewillensurethatstaffarereceivingappropriatetraininginworkplace-relatedmattersandbehaviours,aswellasprovideday-to-daysupportandadvicetostaffandManagers/TeamLeaderstokeepAHCSAabreastofchangesinemploymentlegislationandindustrialrelations.

22%

67%

2%

76%

33%

Total AHCSA Employees – 42 Staff Asat30June2019

Full time Part time Casual

Gender

Male Female

Positionsadvertisedsincethelastreportingperiodasat30June2019were:

2018 STAFF RECRUITMENTS

ReceptionandTravelOfficersx2(JobShareArrangement)

EarHealthProjectOfficer

DigitalHealthCoordinator

AHCSAAccreditationandComplianceOfficer

HumanResourcesBusinessPartner(OutsourcedRecruitment)

StrategicandBusinessExecutive(OutsourcedRecruitment)

2019 STAFF RECRUITMENTS

StudentTravelandAdministrationOfficer

TISEvaluationandCommunicationProjectOfficer

TISProjectOfficer(Internal)

Improving efficiency within the organisation by introducing more flexibility and automation into our human resources processes

Recruitment Metrics

FromJanuarythisyear,AHCSAadvertisedstaffvacanciesviaSeek,LinkedInandAHCSA’snetworks.Theaveragetimetofill,whichisthetimeneededtofillthepositionsfromthedatetheywereadvertisedtothedateanofferofemploymentwasaccepted,hasbeen33days.Thisisasignificantachievementcomparedtotheaveragetimetofillof42days,andcomparedtothe53.67daysreportedinthelastAnnualReport.

ThisresultismainlyduetothenatureoftheadvertisedpositionsandtothefactthatalltherecruitmentssofarhavebeenmanageddirectlybyAHCSAratherthanbeingoutsourced,whichmakestherecruitmentprocessmoreefficientandcosteffective.

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62%

38%

Aboriginal or non-Aboriginal

Non-Aboriginal Aboriginal

Staff Metrics

Asat30June2019,AHCSA’sworkforcecomprisedof32full-timeemployees,ninepart-timeandonecasual.Ofthoseemployees,28arefemaleand14male.Part-timestatushasincreasedsincethelastreportingperiodduetomorestaffrequestingflexibleworkarrangementsandAHCSAapprovingtheirrequests.OfthetotalnumberofemployeesatAHCSA,16areAboriginal,and26arenon-Aboriginal.

Staff Turnover

Staffturnoverisataround16.67%withsevenstaffdepartinginthelast12monthsoutofatotalaverageof42staffacrosstheyear.Theturnoverratiohasdecreasedcomparedtothatofthepreviousreportingperiod(18.69%).Departuresweremainlyduetofundingcomingtoanendon30June2019andotherreasonspersonaltodepartingstaff,suchasmovinginterstateoroverseas.

Staff Turnover – 16.67%July2018–June2019

Average number of staff for period

Staff who left during period

86%14%

Current Projects

AHCSAhasimplementedi-induct,whichisanonlineinductionsystemthatHumanResourceswillbeusingasatooltowelcomenewrecruits.ItwillprovidethemwithanoverviewofAHCSA’smission,values,mainpoliciesandprocesses.

Thepurposeofthesystemistoimprovestaffon-boardingexperienceandassistwithretentionandengagement,particularlywithinthefirstsixmonths.Thefirstdraftoftheonlinecontentiscurrentlybeingreviewedandshouldbereadytogolivesoon.

Staff Training

AHCSAstaffattendedtrainingonDe-escalatingChallengingSituationsandAlcohol&OtherDrugsintheWorkplacetoprovidethemwithtoolstomanagechallengingsituationsandavoidescalation.TheywerealsogivenanoverviewofAHCSA’spolicyonalcoholandotherdrugs,whichisnowincludedintheHRinductionofnewstarters.AHCSAstaffalsoattendedtheChildSafeEnvironmentstraining,whichiscompulsorytoallAHCSAstaff.

AHCSA has implemented i-induct, which is an online induction system that Human Resources will be using as a tool to welcome new recruits

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Provide support to Members to improve health outcomes for all Aboriginal people of South Australia, promoting and advancing the Community’s commitment to physical, social and emotional wellbeing and quality of life


PUBLIC HEALTHTheobjectiveofthePublicHealthProgramistoprovidepublichealthadviceandsupporttoAHCSAanditsMembers.TheroleofthePublicHealthMedicalOfficer(PHMO)continuestoprovidepublichealthadviceandsupporttoAHCSAanditsMembers,withinvolvementinawiderangeofactivitiesandinitiatives.

Sector Advocacy

ThePHMOplayedakeyroleinestablishingtherecentlyformedSAAboriginalEnvironmentalHealthWorkingGroup,whichbringstogetherkeystategovernmentdepartments,NGOsandAboriginalCommunityControlledHealthServices(ACCHSs)toidentify,developandadvocateforresponsestothepoorenvironmentallivingconditionsexperiencedbymanyAboriginalpeopleinSouthAustralia.

Addressingtheseissuesiscriticaltoachievingthesustainableeliminationoftrachoma,alongwithreducingtheimpactofarangeofotherinfectiousdiseases.

ThegroupisprogressingthedevelopmentofastatewideAboriginalEnvironmentalHealthFrameworkaswellasadvocatingforresourcingofanAboriginalenvironmentalhealthworkforce,withafocusonenablinghome-basedhealthhygienepracticesandfacilitatingtherepairandmaintenanceofhealthhardwareinhomes.

ThePHMOwaspartofthewritinggroupfortheNationalEndRheumaticHeartDisease(RHD)Roadmap,whichwasendorsedattheCouncilofAustralianGovernments(COAG)HealthCouncilmeetinginMarch2019.

Importantly,theRoadmaphighlightstheneedtoaddressthecultural,socialandenvironmentaldeterminantsofAboriginalandTorresStraitIslanderhealth,whichwillbringbenefitsbeyondRHD.ItalsorecognisesthecrucialroleofACCHSsandthedeliveryofcomprehensive,responsiveprimaryhealthcare.

LedbythePHMO,AHCSAhascontinuedtoadvocateforAboriginalHealthPractitioners(AHPs)tobeabletoindependentlyvaccinateundertheSAVaccineAdministrationCode(SAControlledSubstanceslegislation),withadditionaltrainingandappropriatesupervision.

Overthepast12months,thePHMOhasbeenworkingcloselywiththeSAHealthimmunisationsectiontomakethischangetotheCode,andAHCSAhasnowsignedanagreementtodevelopanddeliveratrainingprogramforAHPstoenablethemtomeetthecompetencystandardstovaccinateundertheCode.Thisisapilot,whichwillbeevaluatedwiththeaimofprovidingthecourseoverthenextfiveyears.

Public Health Coordination

ThePHMOcontinuestoconveneamonthlyAHCSAPublicHealthNetworkteleconferencebetweenallACCHSsinSAandAHCSA.Thesemeetings,chairedbytheAHCSAPHMO,enablecommunicationbetweenAHCSAandACCHSstafftostrengthenprimaryhealthcaresystemsandsupportafocusonpreventionandpublichealthactivitiesinACCHSs.

Overthepastyear,thePHMOhasbeenworkingtoenhancetheSAresponsetothelargemulti-jurisdictionalinfectioussyphilisoutbreak,whichhasincludedSouthAustraliasince2017.IncollaborationwithSAACCHSs,NACCHOandtheDepartmentofHealthEnhancedSyphilisResponseUnit,AHCSAcoordinatedthedevelopmentofasuccessfulstatewideproposaltofundasexualhealthworkforceresponseinACCHSs.ThishasincludedtheexpansionoftheAHCSASexualHealthProgramcapacitybuildingandcoordinationrole.

AHCSAhasbeenworkingcloselywiththeCommonwealthDepartmentofHealthtosupporttheimplementationofanewHearingAssessmentProgram(HAP)deliveredbyHearingAustraliainSA.

ThisProgramaimstoimprovetheearlydetectionandtreatmentofhearinglossforAboriginalandTorresStraitIslanderchildrenaged0to5yearsthroughbetteraccesstocomprehensivehearingassessmentsandfollow-uptreatment.

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TheAHCSAPHMOandEarHealthProjectOfficerhavebeenconsultingwithtwoACCHSstoensurethatSAisinvolvedinthefirstphaseoftheProgramimplementation.

Support for AHCSA Programs

ThePHMOoversawamajorrewriteandupdateoftheAHCSASexuallyTransmittedInfection&Blood-BorneViruseshandbook,whichhasnowbeendistributedtoallACCHSs.Thisresourcefacilitatesastandardisedevidence-basedapproachforlocalSTIandBBVcontrolprograms.DrRazlynAbdulRahimablysupportedthisupdate.

AHCSA’sSTIDataProgramhasbeenoperatingfornearlyfiveyears,andinvolvesAHCSAreceivingde-identifiedSTIdatafromSAPathologyonbehalfofACCHSsinSA.ThisdataisthenanalysedandreportspreparedtobefedbacktoACCHSsforqualityimprovementactivitiesandhealthserviceplanning.

SAPathologymovedtoanewdataplatformmid-2018andthishasresultedintheneedforAHCSAtoundertakealargepieceofworktomigratetheAHCSAreporttothenewplatform.ThenewsystemhasbeenextensivelytestedandvalidatedandSTIreportingtoACCHSshasrecommencedinanewformatfor

easierinterpretation.Theabilitytoprovidemoretimelyreportsonsyphilistestingratesisalsoclosetobeingfinalised.

ThePHMOoversawthedevelopmentoftheDeadlySightsCommunicareandMBSGuideincollaborationwiththeAHCSAQualitySystemsteamandtheEyeHealthProjectOfficer.

TheaimoftheGuideistosupportstrengtheninglocalACCHSs’capacitytoidentifyeyeconditionsearly,havereferralpathwaysinplaceforthosewhoneedspecialistcareaswellassupportingeyespecialistvisitstoACCHSs.ItwillalsosupporttherolloutofnewretinalcamerasinSAACCHSs.

ThePHMOcontinuestoprovideteamleadershipandsupporttotheAHCSASexualHealthProgram,BloodBorneVirusProgram,theEyeHealthProgramme,TrachomaControlProgram,EarHealthProgrammeandtheRheumaticHeartDiseaseProgram.

The PHMO oversaw the development the Deadly Sights Communicare and MBS Guide in collaboration with the AHCSA Quality Systems team and the Eye Health Project Officer

Medicine Registrar Supervision

ThePHMOsupervisesaPublicHealthMedicineRegistrar,whichisadoctorundertakingspecialtytraininginpublichealth.RegistrarDrSonaliMeenaiscurrentlyworkingonaprojectdetailingthebarriersandenablersforpeopleundertakinghealthhygienepractices,aswellaswhatcanbelearntfrompreviousprogramstoaddressthesebarriers.

Thisinformationwillbeusedtosupportevidence-basedinterventionsaimedatreducingtheprevalenceofconditionssuchastrachoma,rheumaticheartdisease,middleeardisease,skininfections,gastrointestinalinfectionandrespiratoryinfections,allofwhichimpactonthegrowthanddevelopmentofchildreninadditiontohavinglonger-termimpacts.

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BLOOD BORNE VIRUS TheAHCSABloodBorneVirus(BBV)ProgramworkswithAboriginalhealthservicesandthebroaderhealthsectoracrossSouthAustralia,supportingthepreventionandtreatmentofviralhepatitis.

Continuous Quality Improvement

Programactivityoverthe2018-2019periodhasincludedaviralhepatitiscontinuousqualityimprovementprojectworkingwitheightAboriginalCommunityControlledHealthServices(ACCHSs).TheBBVProgramCoordinatorandPatientInformationManagementSystems(PIMS)Officerareundertakingthisproject,whichsupportsserviceswithscreeningandmanagementofviralhepatitisthroughstrengtheningpatientinformationmanagementsystems,andundertakingclinicalaudits.

AcrosstheeightparticipatingACCHSs,892clinicalrecordswereaudited,with503recommendationsprovidedbacktoservices.

Committee Representation

Overthepastfinancialyear,theBBVProgramhashadrepresentationonthefollowingcommittees:

• SAAboriginalSexuallyTransmittedInfection(STI)andBBVActionPlanProjectSteeringGroup(Co-chair)

• HepatitisBActionPlanImplementationGroup

• HepatitisCActionPlanImplementationGroup

• PeerSupportedCleanNeedleProgram–PostReleasePrisoners

Achievements

ThepastyearhasseentheBBVteamsupportingviralresearchthroughtheSouthAustralianHealthandMedicalResearchInstitute(SAHMRI)CentreforResearchExcellenceinAboriginalSexualHealthandBloodBorneViruses.TheyhavealsosupportedtheestablishmentofnewcleanneedleprogramsatregionalACCHSs.

ThesuccessfulsecuringofagrantwithHepatitisSAfromtheDepartmentforCorrectionalServiceshasbeenanothersignificantcoupfortheteam.ThegrantprovidedtheopportunitytobringtoSouthAustraliaILBIJERRITheatreCompany’sproductionVIRAL–Areyouthecure?ILBIJERRIisoneofAustralia’sleadingtheatrecompaniescreatinginnovativeworksbyFirstNationartists.TheperformancefocusedonincreasingawarenessofhepatitisCtreatment.Thetourincludedsixshowsattheyouthtrainingcentre,YatalaLabourPrison,MobilongPrison,andaperformanceatTauondiAboriginalCollege.

ViralhepatitisandharmreductioneducationwasdeliveredtoAHCSACertificateIIIandCertificateIVstudentsstudyingAboriginalandTorresStraitIslanderPrimaryHealthCare.SimilareducationhasbeendevelopedforACCHSsanddeliveredateventssuchastheAHCSASHINESAFRESHXTABOOworkshop,andtheAHCSAQualityForum.

TheteamhasalsodevelopedapresentationonviralhepatitisandtheAboriginalcommunity,whichtheyhavebeeninvitedtodeliverattheclosingplenaryofthe11thAustralasianViralHepatitisConference,tobeheldinAdelaideinAugustthisyear.

Partnerships

AHCSAwouldliketoacknowledgetheirpartnerswhohavesupportedtheobjectivesoftheBBVprogramover2018-2019.Theseinclude:SAACCHSs,KakarraraWilurraraHealthAlliance,SAHealthCommunicableDiseaseBranchandViralHepatitisNursingWorkforce,DrugandAlcoholServicesSA,HepatitisSA,HepatitisAustralia,AboriginalDrugandAlcoholCouncil,RelationshipsAustraliaSouthAustralia,SAHMRI,SHINESA,DepartmentforCorrectionalServices,andtheAustralasianSocietyforHIVMedicine,ViralHepatitisandSexualHealthMedicine.

Across the eight participating Aboriginal Community Controlled Health Services, 892 clinical records were audited, with 503 recommendations provided back to services

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Grant Support

CommunityEngagementHealthPromotionGrantsawardedtoAHCSAMembersandassistedwithavarietyofactivitiesandincentiveprogramstoincreaseyoungpeople’sparticipationintheAnnualSTIScreening.

ThegrantssupportedWomen’sPamperDaysatthePikaWiyaHealthServiceAboriginalCorporationinPortAugustaandUmoonaTjutagkuHealthServiceAboriginalCorporation(UTHSAC)inCooberPedy.UTHSACalsoorganisedaMen’sBushTripandPikaWiyaorganisedaMen’sHealthDayatDavenportCommunityOutreachClinic,whichalsoincludedsupportfromAboriginalDrugandAlcoholCouncil(ADAC)andmaleworkersfromAHCSA’sTacklingIndigenousSmokingteam.

SomeACCHSsorganisedrafflesforthosewhoparticipatedinscreening,withprizesdrawnattheendofthescreeningperiod,whileotherACCHSsofferedgiftsorvouchersforyoungpeopleparticipating.PortLincolnAboriginalHealthServicerananupdatedcommercialforlocaltelevisiontopromotetheenhancedSTIscreeningperiod.

Updated Resource

ThisyearalsosawthepublicationofanupdatedSexuallyTransmissibleInfections&Blood-BorneVirusesHandbookforSAACCHSsincollaborationwithAHCSA’sQualitySystemsteam,BBVProgramandotherpartnersincludingAdelaideSexualHealthCentre.HardcopieshavebeendistributedtoallACCHSsandarealsoavailableelectronicallyonAHCSA’sSHPwebpage:https://ahcsa.org.au/app/uploads/mp/files/resources/files/ahcsa-sti-bbv-handbook-2019-online-version.pdf

SEXUAL HEALTH AHCSA’sSexualHealthProgram(SHP)supportsACCHSsandotherservicesworkingwithyoungAboriginalpeopleinthepromotionofandimprovedaccesstoopportunisticandvoluntarysexuallytransmittedinfection(STI)screeningforpeopleagedbetween16and35years.

ToensurethattheACCHSworkforceinSAispreparedtodeliverSTIandBloodBorneVirus(BBV)screening,theteamworksinpartnershipwithProgrampartnerstoprovideeducationalupdatesandskillsdevelopmentthroughanannualtwo-dayworkshopheldinAdelaide.SHINESAandAHCSAcollaboratedthisyeartopresentFRESHXTABOO,atwo-dayworkshopfor20AboriginalHealthWorkersinMay2019.

Workforce Development

ThisremainsapriorityfortheProgram,includingthedeliveryoftheSexualHealthModule,whichhasbeenintroducedasanelectiveintoAHCSA’sRegisteredTrainingOrganisation(RTO)CertificateIVAboriginalHealthWorkerandPractitionersprogram.

InSeptember2018andFebruary2019,theSHPteamcoordinatedthedeliveryoftheSexualHealthModuleto26AboriginalHealthWorkerandPractitionerStudentsincollaborationwithAHCSA’sRTOandprogrampartnerorganisations.TheseincludetheAdelaideSexualHealthCentre,SHINESAandSAMESH,YarrowPlace,SASexIndustryNetwork(SIN),HepatitisSAandDASSA.

The Handbook has been developed by AHCSA to facilitate a standardised evidence-based approach to control programs for STIs and BBVs at the comprehensive primary health care level within ACCHSs in SA

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AHCSA’s Public Health Medical Officer, David Johnson has been advocating for Aboriginal Health Practitioners to be able to independently vaccinate under the SA Vaccine Administration Code (SA Controlled Substances legislation). These practitioners would be given additional training and appropriate supervision if the legislation allows for it.

Inthemeantime,AHCSAdoctorsandnurseshavebeentravellingtoMemberstoadministervaccinationsperiodically.OnesuchoccasionwaswhenAHCSA’sTacklingIndigenousSmokingMaternalHealthProjectOfficer,Mary-AnneWilliamstravelledtoNunyaraHealthServiceinWhyallatoadministerMeningococcalW(Menveo)vaccinations.

ThesevaccinationdayswereorganisedinresponsetorecentoutbreaksofMeningococcalacrossSouthAustralia,withtheAboriginalCommunitybeingathigherriskoftheillness.Thedayfocusedontheimmunisationofchildrenandyoungadultsbetweentheagesof12monthsand19years.

Oneofthechildrenwhoattendedwasnine-year-oldJoyisha,whowascomfortedbyhermum,MelissaStewartontheday.MelissaexplainsthatJoyishadidn’tknowthatshewasgoingforherneedles,‘soshewasveryshockedwhenwetoldher.’Sheaddsthat,‘shedoesn’tlikeneedles…likeme’.

PROTECTING OUR COMMUNITY

VACCINATING OUR CHILDREN

Beforetheneedlewasgiven,MelissaexplainedtoherdaughterwhyitwasimportantforthemtocometotheclinicandalthoughJoyishakeptsayingthatshedidn’twanttogoin,fromtheinformationprovidedbytheclinic,Melissawasabletoreassureherthateventhoughitwasscary,itwastoprotecther.‘Iexplainedtoherthatitwasforherhealthandthattherearenastydiseasesintheworld.Shecriedabit,butshewasfineoncetheyweredone.’

Melissasaysthat,‘thepeopleatNunyarahadexplainedthatitwasgoodtogetitdoneforthekids,andtokeeptheCommunitysafe.’Sheaddedthattherearealwaysdifferentpeoplewhocomeouttodotheneedles,butthatMary-Annewasreallygood.‘Iknowtheclinicwell,becauseIgrewupinthearea,andmychildrenknowit.’Melissasaid,adding,‘It’sreallygoodthatthey’reexpanding.It’sgoodthatwehaveourownHealthCentre.’

Alarge-scaleletterdropwasdonepriortotheevent,togetasmanychildrenaspossibletoattend.Overthetwodays,about40peoplewerevaccinated,withmorerespondingtothelettersandbookingtheirappointmentstoensurethattheygettheirimmunisationscompleted.

‘I know the clinic well, because I grew up in the area, and my children know it.’ Melissa said, adding, ‘It’s really good that they’re expanding. It’s good that we have our own Health Centre.’

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SQIDCyclesarestate-based,three-monthly,interactiveclinicalqualityimprovementcyclesthatfocusononeareaofhealth.Itinvolvesthecollectionofde-identifiedbaselinehealthdata,followedbywebinarpresentationstohealthservicesthatexploretheprocessesanddataentrymethodsassociatedwiththecycletopic.De-identifiedhealthdataiscollectedagainafterthreemonthsandcomparedwiththebaselinedatatoassesshealthserviceimprovement.

SQIDCycle2focusedonimprovingotoscopyscreeningratesinAboriginalchildrenunderfiveyearsofage.NineAHCSAMembersparticipatedinthisCycle.DataextractedatthebeginningoftheCycle(June2018)showedthatSAACCHSshadanaveragescreeningrateof39.4%.AttheendoftheCycle,thesectorachievedanaverageincreaseof7.9%withtheaveragechildotoscopyscreeningrateat47.3%.Overthepast12months,MembersthatparticipatedintheProgramdocumentedanearexaminationfor378children.

Workshops

Thisyear,theACCHSsandGovernmentorganisationshavebeeninvolvedintrainingsessionsandworkshopsatAHCSAandwithintheirorganisations.AHCSAhaspartneredwiththeRuralDoctorsWorkforceAgency(RDWA)andBenchmarqueTrainingGrouptofacilitatetrainingworkshopsinearhealthandhearing.ThetwotrainingsessionsareaccreditedcoursesinOtitisMediaManagementandTympanometry.Uptotheendofthereportingperiod,fourtrainingsessionswereheld,withfourmoretobeheldbySeptember2019.

March 2019

• Two-dayworkshopatAHCSA:OtitisMediaTrainingandSystems

– 17attendeesfromgovernmentandnon-governmentorganisations

June 2019

• RoyalAdelaideHospital(RAH)AboriginalHealthUnit:OtitisMediaManagement


• MunaPaiendiAboriginalHealthService:OtitisMediaManagement


• CedunaKoonibbaAboriginalHealthServiceAboriginalCorporation:TympanometryTraining

– 10attendeesfromtheACCHSs

Stakeholder Relationships

TheEarHealthProjectOfficercontinuestobuildandstrengthenrelationshipswithkeystakeholderstobeabletoprovidecomprehensiveearhealthandhearingmodelsofcareinACCHSs.

ThishasincludedworkingwiththeRDWAtostrengthenthecapacityofACCHSstosupportandutilisevisitingspecialistandalliedearhealthservices.

TheteamhasworkedwithBenchmarqueTrainingGroupandtheiradvisoryteam,andsoughttheinvolvementoftheDepartmentofHealthintheworkshops,toassistwithpriority-settingforthenewHearingAssessmentProgramandresearch.

Members that participated in the SQID Cycle 2 Program documented an ear examination for 378 children

DEADLY SOUNDS TheDeadlySoundsProgrammecontinuestosupportACCHSsinSouthAustralia.Itsmainfocusistodevelopclinicsystemsandearhealthmodelsofcare.Thiswillstrengthenactivitydirectedattheearlyidentificationandmanagementofyoungpeoplewithmiddleeardisease.

Early Detection

ResearchshowsthattheclinicalpresentationofotitismediainfectionsdiffersbetweenIndigenousandnon-Indigenouschildren.OtitismediaischaracterisedinIndigenouschildrenbyayoungerageatfirstepisode,higherfrequencyofinfection,greaterseverityandgreaterpersistencethaninnon-Indigenouschildren.

Repeatedearinfections,whichareoftenundiagnosedanduntreated,aresubstantiallyandsignificantlyassociatedwithhearingproblemsatalaterstage.Betweentheagesoftwoand20,anIndigenouschildoryoungpersonislikelytoexperiencehearinglossfrommiddleearinfectionsforatleast32months,comparedwiththreemonthsfornon-Indigenouschildrenoryoungpeople.

WhiletheProgrammecontinuestoincludeyoungpeopleaged0to21years,therehasnowbeenaparticularfocusonchildrenaged0tofouryears,recognisingtheneedforidentificationandmanagementofeardiseaseandassociatedhearinglossatthisage.

Data Collection and Continuous Quality Improvement

AHCSA’sSouthAustralianQualityImprovementData(SQID)CyclesProgramsupportedtheimplementationoftheDeadlySoundsGuide,whichlooksatimprovingCommunicaredocumentationofclinicalinformationandreferralpathways.



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DEADLY SIGHTS Despitebeingbornwithon-averagebettervision,AboriginalAustraliansovertheageof40haveapproximatelythreetimestherateofblindnessthanthatofnon-AboriginalAustralians.Yetapproximately94%ofvisionlossinAboriginalpeoplecaneitherbepreventedortreated.

ThroughtheEyeHealthProjectOfficer(EHPO),AHCSA’sEyeHealthProgramme,DeadlySights,continuesitsaimtoimproveandsustaineyehealthoutcomesfortheAboriginalcommunitycontrolledhealthsectoracrossthestate.

EffortsarelargelyfocusedoncontinualsupportandcapacitybuildingofAHCSAMemberhealthservices,andfrontlinesupporttooutreacheyehealthpractitionercommunityvisits.

Capacity Building

ThisisaboutstrengtheningPrimaryHealthCare(PHC)workforceskillssetsandknowledgeineyehealthandvision,betterincorporatingeyehealthintostandardworkpractice,andactivelyengagingineyehealthpractitionervisitsandresultingpatientpathways.

TheEHPOisworkingwithAHCSAMembers,theAboriginalCommunityControlledHealthServices(ACCHSs)by:

• Deliveringperiodicstafftrainingandmentoringinprimaryeyehealthcare,visiontesting,andscreeningfordiabeticretinopathy.

• HelpingcombatdiabeticretinopathyfromwithinthePHCinterfacesincetheprovisionofretinalcamerasandoperatortraining.

• Providingon-goingmentorshipandsupportforACCHSstoembedin-houseretinalscreeningintoroutinecarepracticeforpatientswithdiabetes.

Support Remote Community Visits

TheEHPOhasfrontlineinvolvementindeliveryofvisitingeyehealthservices,whichincludesscheduling,coordinating,andfacilitatingoptometristandophthalmologistvisits.Communityconsultation,andlocallevelsupporttoPHCstaffbefore,during,andaftervisitshasalsobeengiven.

Monitoringandassistingpatientpathwaysfromprimarytosecondaryandtertiaryeyehealthcare,includingaccesstolowcostprescriptionglasses,hasbeenintegraltothesupportprovided.

Thethreemostcommoneyeconditionsfoundwere:

Refractive Error

• Blurredvision,whentheshapeoftheeyedoesn’tbendlightcorrectly

• Treatment/Action:Correctiveeyewear(glassesorcontactlenses)

Cataracts

• Cloudingoftheeyelenswhichinhibitsorreducesclearvision

• Treatment/Action:Daysurgeryprocedure,withlocalanaesthetic

Diabetic Retinopathy

• Adiabetescomplication,causingreducedbloodsupplyanddeteriorationtotheretina,causingpreventablevisionloss

• Treatment/Action:Retinallasering,intravitrealinjections,vitrectomysurgery

Remote Visit Service Delivery

ThismodeliscurrentlyunderreviewforchangethroughthecollaborativeeffortsofAHCSAanditsMembers,theRuralDoctorsWorkforceAgencyandrelevantvisitingpractitioners.

Proposedchangesincludeuncouplingoptometristfromophthalmologistvisits,increasedfrequencyofoptometristvisits,andtheintroductionoffixedophthalmologytreatmenthubsinuptothreeruralorremoteSAlocations.

Theaimsofthesechangesaretoimprovethetimelydetectionanddiagnosisofeyeandvisionissuesthroughincreasingthepercentageofin-needclientsthatattendoptometristvisits,andoptimisevisitingophthalmologist’stimetodelivertherequiredtreatments,onsitewhereverpossible,orreferexternally.

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Remote Area Optometrist/ Ophthalmologist Visits

Thesevisitscurrentlyruntwiceyearlyto12communitiesincludingCeduna,Yalata,OakValley,Tjunjtuntjara(WA),CooberPedy,andsevencommunitieswithintheAPYLands.

New Eye Health Resource Deadly Sights

FundedthroughRDWA,andcollaborativelydevelopedbytheAHCSAEyeHeathProgrammeandQualitySystemsteam,DeadlySightsisacomprehensiveCommunicareandMedicareBenefitsSchedule(MBS)GuideforeyehealthinthePHCsetting.ItiswrittenspecificallyforACCHSsontheCommunicarepatientrecordsystem,andalsoforvisitingeyehealthpractitionerstothoseACCHSs.

ItcontainsinformationonallthingseyehealthatthePHClevel,andproceedstoguidestaffthroughtheeyecomponentofhealthchecks,includingvisualacuity,trichiasis,retinalphotographyfordiabeticretinopathy,andtherestoftheretinalscreeningprocess.

ThesearecomplementedwherepossiblewithscreenshotsfromCommunicareandflowchartsfordiabeticpatientcareandMBSclaimingforretinalscreening.

REMOTE AREA VISITS 2018-2019

Community Totalclients

seen

Clientsseen

Aboriginal

Clientsseennew

Clientsseen

diabetic

Retinalphotos

taken

Referralsforsurgery

orfurthertreatment

Onsitetreatments:

eg:laserforretinopathy

Readingglasses

issuedonsameday

Prescriptionglasses

arranged

Fregon 31 31 2 18 19 9 1 22 4

Mimili 37 37 6 21 20 3 3 18 11

Iwantja 49 49 9 31 21 9 4 32 6

Pipalyatjara 41 36 3 26 24 4 3 17 16

Nyapari 15 15 1 10 11 4 2 9 7

Pukatja 97 92 11 64 27 13 5 48 21

Amata 84 84 8 62 36 12 4 40 29

CooberPedy 69 52 25 34 16 12 4 15 30

Yalata 46 41 11 21 21 5 1 22 9

OakValley 24 24 3 18 0 4 1 13 2

Tjuntjuntjara 52 47 10 28 6 7 2 27 4

Ceduna 65 62 18 38 14 8 5 13 11

TOTAL 610 570 107 371 196 90 35 276 150

The Eye Health Programme continues its aim to improve and sustain eye health outcomes for the Aboriginal community-controlled health sector of SA

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TRACHOMA ELIMINATIONAHCSA’sTrachomaEliminationProgram(TEP)continuestostrivetowardseliminatingblindingtrachomainSouthAustraliaby2020.Workingwiththehealthservices,schoolsandcommunitiesinCeduna,Copley,Koonibba,LeighCreek,Nepabunna,OakValley,Oodnadatta,PortAugustaandYalata,theteamisontracktoachievethisgoal.ThegoodnewsisthattheoverallprevalenceofactivetrachomainSAhasdecreasedfrom17%in2010to1.6%in2017.

Clean Faces, Strong Eyes

Trachomaiscausedbybacteriaandiscompletelypreventable.Iteasilyspreadsfromonepersontoanotherthroughinfectedeyeandnosesecretions.Tostopthetransmissionoftrachoma,facialcleanlinessisessential.

ThereforeanimportantpartoftheProgramisprovidingcomprehensivehygienehealthpromotion.TheTEPpromotedthecleanfaces,strongeyesmessagewithresourcescreatedandprovidedbytheIndigenousEyeHealthUnit,MelbourneUniversity.

SpotlessLinendonatedtowels,facewashersandblankets,whichweredistributedtothoseremotecommunitieswithlessaccesstoaffordablelinen.TheSADentalAboriginalOralHealthProgram,whosuppliedtoothbrushesandtoothpaste,alsosupportedtheProgram.

Thehealthpromotionactivitiesundertakentoencouragefacialcleanlinessandgoodgeneralhygieneseemtobeeffectivewiththecleanfacerateimprovingfrom51%in2010to88%in2017acrossSouthAustralia.

Advocacy Workshop

TheTEPcontinuestoadvocateforenvironmentalhealthimprovementsthatwillbecriticaltosustainedtrachomaelimination.AnenvironmentalhealthworkshopwasorganisedandhostedbyAHCSAinOctober,incollaborationwiththeDepartmentofPrimeMinisterandCabinet,IndigenousEyeHealthUnit,CountryHealthSALocalHealthNetwork,EnvironmentalHealthDirectorateSA,SAHousingAuthorityandNganampaHealthCouncil.

Over50peopleattendedfromAHCSA’sMembers,NGOs,variousgovernmentdepartmentsandkeyagencies.Theworkshopresultedinacross-sectoralSouthAustralianAboriginalEnvironmentalHealthWorkingGroup(SAAEHWG)beingestablished,withAHCSAasanactivemember.TheSAAEHWGisnowworkingonanAboriginalEnvironmentalHealthFrameworkthatwilldescribekeypriorities,actionareastoaddressthesepriorities,anddescriptionsofwhoisresponsibleforaddressingeachactionarea.

The overall prevalence of active trachoma in SA has decreased from 17% in 2010 to 1.6% in 2017. This a reduction of 15.4% in seven years

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ABORIGINAL DENTAL AHCSAreceivesfundingfromtheDepartmentofHealthfortheAboriginalDentalProgrammethroughtheNationalAboriginalCommunityControlledHealthOrganisation(NACCHO)onefundingagreement.

AHCSAadministersthisfundingtotheSouthAustralianDentalServicethroughamemorandumofadministrativearrangement,whichassistsintheprovisionoforalhealthprogrammesforAboriginalandTorresStraitIslanderchildrenandeligibleadults.

Anadultiseligibleforgovernment-fundeddentalservicesifheorsheisaholderoradultdependentofaholderofacurrentCentrelinkPensionerConcessionCardorHealthCareCard.AHCSAprovidesthefundingwithanemphasisontheprovisionoforalhealthprogrammesaspartofawhole-of-health,primaryhealthcareapproachforAboriginalandTorresStraitIslanderpeople.

TheAboriginalDentalProgrammeprovidesgeneralemergencyandcourseofcaretoAboriginalpeople,whichcanincludeextractions,restorativework,denturesandotherservicesneeded.

TheAboriginalOralHealthProgramprovidedthroughtheSADentalServicehasbothincreasedtheservicestoAboriginalpeopleinSouthAustraliaandalleviatedthedemandandresourcesontheAboriginalDentalProgram.

Key Features

• TheAboriginalDentalProgrammeonlyoperateswhereclientscannotaccesstheAboriginalLiaisonProgram(ALP)throughalocalSADentalServiceClinicinruralandremoteareas.

• ThishasresultedinreduceddemandforAboriginalDentalSchemefundedcareoverrecentyears,whilethetotalnumberofAboriginalclientstreatedcontinuestorise.

• ThereisnowaittimeforcareundertheAboriginalDentalScheme.

Benefits of Care Under ADS or ALP

• Immediateaccesstoemergencycare

• Priority(ie:nowaitinglistorwaitingtime)accesstogeneraldentalcare

• Priorityaccesstodentures

• PathwayfacilitatedthroughthelocalACCHS/AHWinsomecases

• Noclientfees



The Programme provides general emergency and course of care to Aboriginal people, which can include extractions, restorative work, dentures and other services needed

Areas Covered• Balaklava

• BarossaValley

• Ceduna

• CooberPedy

• FleurieuPeninsula

• LeighCreek

• Meningie

• MurrayBridge

• PortAugusta

• PortLincoln

• PortPirie

• Riverland

• SouthEast

• StreakyBay

• Whyalla

• YorkePeninsula

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TACKLING INDIGENOUS SMOKING

AHCSA’sTacklingIndigenousSmoking(TIS)ProgrammeissupportedbyfundingfromtheAustralianGovernmentundertheIndigenousAustralians’HealthProgramme.Itisadynamiccommunity-drivenProgrammeprovidingactivitiesandsupporttoAboriginalpopulationsinAHCSA’sregionalcatchmentareatoreducethegapintheprevalenceofsmokingamongAboriginalandTorresStraitIslandercommunities.

TheTISteamachievesthisbyreducingtheuptakeofsmoking,increasingsmokingcessationandreducingexposuretosecond-handsmoke.

AHCSA’sTISProgrammecatchmentregionsincludetheCeduna,CooberPedy,MurrayBridge,PortLincoln,theRiverland,PortAugusta,Whyalla,YorkPeninsulaandsurroundingareas.

Partnerships

RelationshipsandpartnershipswithAboriginalcommunitiesarevitaltothesuccessofAHCSA’sTacklingIndigenousSmokingProgramme.Thesepositiverelationshipsdirecttheprovisionofsupportandactivitiestomeetlocalneeds.TheTISProgrammeobjectivesaretoconnectwith,inspireandempowerregionalandremotecommunitiestotackletobaccointheirownways.

KeypartnershipsandcollaborationswithAHCSAMembersandprogramsincludingtheSheddingtheSmokes,MaternalHealthTacklingSmoking,EducationandWorkforce,SexualHealthandQualitySystemsteamsensurethattheTISteamprovidesaholisticapproachtotacklingsmoking.

Theteamhasalsoformedstrongrelationshipsandpartnershipswithregionalhealthservicesandagenciestofacilitatesupportfortobaccocontrolandincreaseaccesstoquitsmoking

supports.TISProgrammesupportisalsoprovidedbypartner,NunyaraAboriginalHealthServiceInc.

WithinputfromCommunityleaders,AHCSAcontinuestofocusonprovidingleadershiptoorganisationsintheirinvolvementintobaccoreduction,supportingcommunitymemberstostartandcontinuetheirquitsmokingjourney,celebratesmoke-freelifestyles,buildcapacitytosupportquittingandreduceexposuretosecond-handsmokeincommunitieswithinAHCSA’sTISProgrammeregionalcatchmentareas.

TheteamhasbeenfortunatetopartnerwiththeAboriginalBasketballAcademy,AdelaideFootballClub–AboriginalPrograms,PortAdelaideFootballClub–AboriginalCommunityPrograms,SouthAustralianAboriginalSportsTrainingAcademyandmanyregionalschoolsandyouthhubs.Theseyoungpeoplearestrivingforsuccessforthemselves,theirfamiliesandcommunities.

Brighter Outlook

Indigenousyouthcontinuetoleadthewayinstayingsmoke-freeandareinfluentialintheirowncommunities,sharingthesmoke-freelifestylemessagesaboutthepositivebenefitsofquittingsmokingandstayingsmoke-free.TheTISteamisproudtoencourageAboriginalyouthtostayinschoolandmakethemostofthemanypositiveeducational,trainingpathwaysandopportunitiesavailable,whileprovidingeducationonhealthyandsmoke-freelifestyles.

Community Reach

TheTISteamhasextendedthegeographicalreachoftheProgrammethroughsocialmarketingcampaigns,developmentanddistributionofresources.Communityeducationsessionshaveincludedschoolandyouthactivities,capacitybuildingworkshopsandin-servicetraining.Theyhavealsoincludedcommunityengagements,populationhealthpromotionactivitiesandsmoke-freeevents.

Quit Support Referrals

Increasedaccesstoquitsupportshavebeenfacilitatedthroughcapacity-building,communityeducation,communityeventsanddirectreferralstotheQuitline,healthservicesandotherTISregionalprograms.

Reduced Exposure to Second-hand Smoke

TheTISProgrammecontinuestoprovidesupportandadvicetodeveloporstre

ahcsa our health, our choice, our way · 2020. 7. 9. · in may 1992, paul ashe was appointed...

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