The Council of Australian Governments (COAG) pledged to develop and implement strategies to address Indigenous disadvantage and has agreed six high level targets for closing the gap between Indigenous and non Indigenous Australians.
The targets are to:
- close the gap in life expectancy within a generation
- halve the gap in mortality rates for Indigenous children under five within a decade
- ensure all Indigenous four years olds in remote communities have access to early childhood education within five years
- halve the gap in reading, writing and numeracy achievements for Indigenous children within a decade
- halve the gap for Indigenous students in year 12 attainment or equivalent attainment rates by 2020
- halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade.
Aim
The package provides a strong focus on initiatives to tackle the key risk factors for chronic disease in Indigenous communities, such as smoking and other lifestyle factors.
- Community events and local education campaigns which will provide opportunities for local Indigenous leaders and others to promote and reinforce healthy lifestyle choices.
- National and local Indigenous anti-smoking campaigns will be conducted. Additionally a new regional tobacco control workforce will be trained to support Indigenous people to quit smoking
- Training will be provided to existing health professionals and others so that they have the skills to encourage and assist people to quit.
- Healthy Lifestyle Workers will be trained and employed to reinforce local community campaigns and provide targeted education, support and guidance for families and individuals with or at risk of chronic illness to adopt healthier lifestyles eg healthy diets and exercise and added support to quit smoking.
Improving chronic disease management and follow–up care
A key focus of the package is on improving the detection and management of chronic disease and addressing known barriers to access to health care. This will be achieved through an integrated suite of reforms to existing programs, supported by new initiatives, as outlined below.
- New financial incentives via the Practice Incentive Program (PIP) will encourage General Practices and Aboriginal Medical Services (AMS) to focus on improving detection and management of chronic disease for Indigenous patients.
The PIP Indigenous Health Incentive will include:- A one-off payment to practices that agree to undertake certain activities to improve the provision of care to their Indigenous patients
- An annual payment to practices for each Indigenous patient* registered with the practice for chronic disease management for a 12 month period
- An annual payment to practices for each registered patient for whom a target level of care is provided by the practice in a 12 month period.
Practices participating in this incentive will be able to refer those Indigenous patients identified as needing more complex chronic disease management to the Chronic Disease Management Program. They will also be able to access the new PBS arrangement.
- Flexible funding will be provided through the new Chronic Disease Management Program to:
- Provide care coordination to support individual patients∗ to access follow services consistent with their care plan
- Overcome barriers that could reduce access to follow up care provided by allied health professionals and specialists.
- Indigenous patients* of general practices participating in the PIP Indigenous Health Incentive, and Indigenous health services, will be provided with financial assistance to reduce or eliminate co-payments when purchasing PBS medicines at community pharmacies.
- The Medicare Benefits Schedule (MBS) will be revised to allow Practice Nurses and Aboriginal Health Workers to provide additional follow up care – from 5 to 10 MBS billable care items per year, per Indigenous client. This will take effect from 1 November 2009.
- The Medical Specialist Outreach Assistance Program (MSOAP) will be expanded to provide multidisciplinary teams comprising specialists, GPs, and/or allied health professionals. These teams will specifically target rural and remote Indigenous communities, contributing to the better management of chronic and complex health conditions in these areas.
- Access to specialist care will be further boosted by funding to support private specialists to provide outreach services in urban areas.
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