National Rural Health Conference 2017 Cairns

Delivering culturally appropriate aged care and palliative care in Cape York: the

Apunipima and Catholic Health Australia Partnership

Mark Wenitong and Annette Panzera

• Health improvements through: - Community Governance of health services - Provision of community-specific primary health care services in all communities - Reciprocal Accountability Framework to hold all health providers accountable

• Stop children being taken from communities• Create safe communities

• Healthy children who are being educated • Health information in the schools• Career pathways to VET and tertiary sectors• Families taking responsibility for children

• Culture is included in the health service• Health services reflect the community’s

cultural constructs

• Jobs match people wanting jobs• Provide jobs for local people• Creating & supporting local business opportunities

• Home ownership• Community leading solutions• Creation of business opportunities• Environmentally safe communities• Increased infrastructure• Access to basic services • Funding investments being

aligned to community priorities• Community values are naturally

being taught & passed to the next generation

Heart of Apunipima Way

Less than 10% of the Qld Indigenous population are aged >60

Things to know about Cape York • 17 Aboriginal Communities

• Communities range from 60 to 1,400 residents

• Approximately 14,000 people with 8,000 being Indigenous

• Wet season cuts off Communities for about six months of the year

• Majority are welfare dependent - low income

• Not enough houses so often have 12+ people in a 3 bedroom house

• Food costs are high when there is food in the Community Stores

• High rates of chronic disease

• Apunipima established in 1994 as the only solution to better health

Apunipima means “United All In One”

Apunipima / CHA Partnership April 2015 to present

• 2015 – Apunipima delegation visit Canberra and CHA • August 2015 – Apunipima are keynote speakers at CHA National Conference –

majority of members show interest in partnering with Apunipima to close the gap

• Late 2015 St Vincents health Australia agree to fund a palliative care scoping project in Northern peninsula Council (Apunipima partner)

• March 2016 Mercy Health assist Apunipima with a clinical governance review • July 2016 group of CHA members, HESTA representatives and other local

stakeholders led by a team from Apunipima visit Aurukun, followed by a day workshop in Cairns to discuss partnering possibilities

• November 2016 – As an initial outcome of the workshop funding is secured to initiate a workforce exchange project

• November 2016 – Allied Health staff from Cabrini assist Apunipima to respond to a trauma event in Kowinyama

• March/April 2015 – A project officer is recruited to the workforce exchange project and an ACU student intern begins the evaluation framework

Statement of Strategic Intent 2016

Apunipima Cape York Health Council (Apunipima) is the largest community controlled health organisation in Queensland and delivers a comprehensive

primary health care service to 11 Cape York communities. Apunipima adheres to a family centred model of comprehensive primary health care. Catholic

Health Australia (CHA) represents Australia’s largest non-government grouping of hospitals, aged and community care services in both metropolitan

and regional locations in fulfilment of the healing ministry of Christ. Apunipima and CHA have begun a journey of collaborating together towards achieving the goal of closing the substantial gaps in health outcomes between

Aboriginal people in Cape York and other non-Indigenous Australians. This Statement of Strategic Partnership formalises that relationship and sets out the

intent of both parties to work together over the coming years.

Palliative Care – Project outline • Developing a palliative care service needs a long term strategy • It is about changing both community and clinical staff attitudes • Funded a project officer in the first year to establish project • Focusing on PEPA training as a first step both in Cairns and NPA • Engaging local Palliative Care service (Gordanvale) – keen to assist • NPA leading with assistance from SVHA – developing PD, interview

panel etc • Responding to a request – Apunipima presented at CHA Conf • Focusing on a specific need – Palliative care at NPA • Started conversation - building a partnership • Bringing cultural and clinical expertise together • Funding is only part of the solution

• Established Aged Care Ministry in Far North Queensland (Cairns) June 2015

• Recognition of cultural diversity and community partnerships

• ACYHC and Mercy Health Board linkage in 2015

• Commitment to ACYHC announced at CHA Conference 2015

• June 2016 – Supported Apunipima in a clinical governance review

Mercy Health - Our journey with ACYHC began in 2015

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Emergency response to an incident in Kowinyama

• In October 2016 Apunipima contacted CHA regarding a serious incident in Kowinyama which led to 15 people being evacuated to Cairns and Townsville hospitals

• Allied health support (physios and OT) were needed to assist those injured in the community who had remained as well as those returning from attending the ED

• Cabrini Health were able to assist with equipment and 2 staff who came to Apunipima offices in cairns, received cultural awareness training and then travelled to the community with the Apunipima team

• This resulted in the identification of some serious gaps in allied health support • The workforce exchange program is now looking to fill some of those gaps

Next steps for 2017 • Analysis of aged care services in the Cape • Roll-out of workforce exchange program • Interview respondees to the EOI • Develop evaluation framework to assure continuous evaluation through lifetime

span of project so that incremental changes can be made where required • Possible reestablishment of an echocardiography service (under discussion with

QH) • Organise a visit to a Cape community (Kpwinyama or Coen) • 2nd workshop in July • Funding applications as required

Big Thank you! Apunipima staff that looked after us:

Renee Williams, Paula Arnol and Mark Wenitong and many others…..

And of course our sponsors for the Aurukun visit and Cairns workshop:

HESTA in particular Kylie Woolcock and Bart Moyes