Building an eye care program with Aboriginal communities in Victoria a partnership approach

Transcription

1 Building an eye care program with Aboriginal communities in Victoria a partnership approach Genevieve Napper 1 and Cheryl Vickery 1 Kulan Barney 2, Jimi Peters 2, Mitchell Anjou 3, Tim Fricke 1,4, Jonathan Jackson 1,4, Indigenous Allied Health Alliance Annual Conference November 2013 Adelaide 1. Australian College of Optometry, 2. Victorian Aboriginal Community Controlled Health Organisation (VACCHO), 3 Indigenous Eye Health Unit, Melbourne School of Population Health, University of Melbourne, 4. Department of Optometry and Vision Sciences, University of Melbourne

2 Partners

3 Eye Health in Aboriginal communities Blindness and vision impairment are 6.2 times and 2.8 times, respectively, more prevalent in adult Aboriginal Australians than in the non-aboriginal Australians 35% of adult Aboriginal people have never had an eye examination Main causes of vision loss in Aboriginal Australians are refractive error and presbyopia, cataract, and diabetic eye disease 39% of Aboriginal adults can not see normal sized print 94% of vision loss is preventable or treatable Taylor HR et al (2009) National Indigenous Eye Health Survey, Minum Barreng (Tracking Eyes). Melbourne, Indigenous Eye Health Unit, Melbourne School of Population Health in collaboration with CERA and Vision CRC (ISBN ) Australian Institute of Health and Welfare Eye health in Aboriginal and Torres Strait Islander people. Cat. no. IHW 49. Canberra: AIHW Holden BA et al (2008) Global vision impairment due to uncorrected presbyopia. Archives of Ophthalmology 126(12):1731-9

4 Building an eye care program strategies Aim to reduce avoidable blindness and vision loss for Aboriginal communities Reducing barriers to accessing eye care services that Aboriginal communities experience (geographic access difficulties, lack of culturally appropriate services, costs) accessible, available, affordable, acceptable services Increasing locations and settings for optometry services for Aboriginal communities across Victoria urban and rural Increased number of eye examinations linked with the introduction of the Victorian Aboriginal Spectacle Subsidy Scheme (VASSS) Partnerships with other organisations working with Aboriginal Community Controlled Health Organisations (ACCHOs), Government, Eye Health Organisations, Community (Aboriginal Liaison Officer) Developing a workforce of optometrists current and future

5 Developing an optometry workforce 17 optometrists at the ACO work regularly with Aboriginal Communities -Victorian Aboriginal Health Service (VAHS) Fitzroy outer suburban Aboriginal Health Services (Bunurong Dandenong and Western Suburbs Indigenous Gathering Place Maidstone) -Indigenous access programs at Braybrook, East Preston and Frankston -Visiting Optometry Scheme in rural Victoria 13 ACCHOs -Community work at schools and community health promotion events -Northern Territory work with Brien Holden Vision Institute clinical skills in a range of community settings, specialist skills in paediatrics, ocular disease/therapeutics, low vision, education. Experienced and younger optometrists cultural training, peer support and education, community interaction and learning/exchange

6 The Victorian Aboriginal Eye Health Committee Victorian statewide Aboriginal eye health committee established 2010 drawing together key government and non-government stakeholders key stakeholders: Vic Govt Department of Health Aust Govt Department of Health VACCHO Australian College of Optometry (ACO) Indigenous Eye Health Unit Uni of Melb Vision 2020 Australia Royal Victorian Eye and Ear Hospital (RVEEH) Victorian Aboriginal Health Service (VAHS) RANZCO Vision Australia

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8 VACKH Aboriginal Eye Health Strategy Koolin Balit the Victorian Government Strategic Directions for Aboriginal Health projects VACCHO Eye Health Project Officer -Patient pathway co-ordinator Eye and Ear Hospital -Funding to ACO to run the Victorian Aboriginal Spectacle Subsidy Scheme (VASSS); appointment ACO ALO Nov 2012 Eye Health initiatives within Koolin Balit VACCHO Eye Health Project Officer -Victorian Aboriginal Spectacle Subsidy Scheme and ACO ALO -additional support to regions for eye health projects, including increased support for co-ordination and patient pathway support

9 Planning and Projected Needs for eye care services - Victoria Optometry days per year Victoria (all regions) 801 Glasses required per year Victoria (all regions) 2412 Also: ophthalmology services for cataract and diabetic retinopathy, hospital services, co-ordination time (bookings, patient pathway support, transport) IEHU September 2012

10 Closing the Eye Health Gap in Victoria In 2010 the VACKH introduced a spectacle subsidy scheme, continued for 2013 Victorian Aboriginal Spectacle Subsidy Scheme (VASSS) makes glasses available for all members of Victorian Aboriginal communities for $10 (once every two years). Includes an expanded range of frames endorsed by Aboriginal community elders pairs of glasses prescribed under the subsidy in aiming to provide 1425 pairs of glasses each year (5700 over 4 years) Evaluation of VASSS conducted by DH Vic in 2012 indicated positive impact Eye Health section included in Koolin Balit Strategic Directions for Aboriginal Health

11 Optometry service locations in Victoria ACCHO locations only (GOAL IS TO HAVE NONE OF THESE) ACCHO locations with VOS/ACO services ACCHO locations with VOS and local practices offering scheme ACCHO locations with local practices offering scheme Practice offering scheme with no local ACCHO

12 ACCHO locations with optometry services In 2012 eye care services are available at 19 (of 26) ACCHO sites and via VES practitioners offering the VASSS at 22 mainstream sites Victorian Aboriginal Health Services (Fitzroy) optometry clinic opened 1998 Mildura Aboriginal Health Service local VES optometrist visits since 1998 Rumbalara (Shepparton) local VES optometrist visits since mid 90s Expanded metropolitan services ACO 2010 Bunurong; Western Suburbs Indigenous Gathering Place; Billabong BBQ; community events, youth services and schools Visiting Optometry Scheme (VOS) 2009 Lake Tyers, Orbost 2011 Mildura, Robinvale, Dareton (NSW), Swan Hill, Echuca 2012 Bairnsdale, Sale, Morwell, Heywood, Framlingham/Wangoom, Halls Gap, Wodonga Local optometry networks Portland, Warrnambool, Horsham Inner regional -Bendigo, Ballarat, Geelong -Healesville

13 Eye examinations at Aboriginal Health Services showing an increase with introduction of spectacle subsidy VOS funding from July 2009 VASSS funding from July 2010

14 Partners ACO has focused on developing partnerships and collaborations in building services: Victorian Aboriginal Community Controlled Health Organisation (VACCHO) Aboriginal Health Services across Melbourne and Victoria; including elders and community members; Victorian Aboriginal Childcare Agency Department of Health Victoria Aged Care and Aboriginal Health Branch Victorian Advisory Council on Koori Health (VACKH) Eye Health committee Visiting Optometry Scheme (VOS) funded by Commonwealth Department of Health Medicare Australia Royal Victorian Eye and Ear Hospital (RVEEH) Vision 2020Australia Aboriginal Eye Health committee Participating private optometrists in rural Victoria; Victorian Eyecare Service (VES) Optometrists Association Australia (OAA) ATSI Eye Health and Vision Care working group Indigenous Eye Health Unit (IEHU) University of Melbourne; Optometry Department Brien Holden Vision Institute (formerly ICEE) NT Memberships: Indigenous Allied Health Alliance, Weenthunga Health Network (Vic)

15 Continuing Challenges and Future Directions Identify gaps in services for metropolitan and rural Aboriginal communities and expand services to meet population needs address funding gaps Improve co-ordination of eye care services along patient pathway Identify and implement strategies to ensure timely attendance for surgical and laser treatment of eye diseases Achieve greater integration with local ophthalmology and hospital services Achieve greater integration with primary health services and health workers at ACCHOs and greater integration with diabetes/chronic disease programs; Medicare Locals and Department of Health Regions Continue to diversify service sites and settings to improve access Increase community and health worker education about eye care Enhance existing partnerships and establish new partnerships Increase community participation in service development and service delivery Close the Gap for Vision

16 Meeting the needs of communities

17 Working towards more Indigenous Optometrists

18 Thank you Genevieve Napper Cheryl Vickery