Aboriginal health and wellbeing strategic plan. Discussion guide

Transcription

1 Aboriginal health and wellbeing strategic plan Discussion guide

2 Aboriginal health and wellbeing strategic plan Discussion guide

3 Cover image Vicki Couzens (ngootyoong ngarrakeetoong) Healthy communities 2010 Medium: line drawing, digital enhancement (Photoshop file) ngootyoong ngarrakeetoong is an abstract visual depiction of the principles that underpin healthy Victorian Aboriginal communities. The work is styled in the form of a possum-skin cloak. These cloaks were worn by Aboriginal Victorians prior to colonisation and have come to symbolise Victorian Aboriginal culture. The cloak represents Country and culture. The concept of belonging to Country is implied by the idea of being enfolded in your cloak/country/culture. Across the panels is a stylised river representing water: the lifeblood of the land and a fundamental part of a healthy lifestyle. The panels reference all aspects of a healthy lifestyle and demonstrate a living and diverse culture. The symbols depict: men and women; men and women s business; spirituality and ceremony; healthy foods and diet; children and communities; and Ancestors. To receive this publication in an accessible format phone using the National Relay Service if required, or aboriginal.policy@dhhs.vic.gov.au Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne. State of Victoria, February, 2016 Throughout this document, the term Aboriginal is used to refer to both Aboriginal and Torres Strait Islander peoples. Use of the terms Koori, Koorie, and Indigenous are retained in the names of programs and initiatives, and, unless noted otherwise, are inclusive of both Aboriginal and Torres Strait Islander peoples. ISBN (pdf/online) Available at www2.health.vic.gov.au ( ) ii

4 Contents Background 1 Purpose of this guide 1 Consultation 2 The strategic plan: Vision, priorities and building blocks 2 Why we need a new strategic plan 4 What we know now 4 Snapshot 5 A new approach to Aboriginal health and wellbeing in Victoria 7 Co-designed policy 7 Making self-determination real 7 Life course approach 7 A better coordinated system 8 New Aboriginal community engagement framework 8 Invitation to contribute 9 Contact details 9 Appendix: Reform agenda 10 iii

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6 Background The Victorian Government is committed to improving Aboriginal health and wellbeing and is determined to overcome the unacceptable health disparity and health outcomes for Aboriginal and Torres Strait Islander Victorians. 1 To achieve this, the government has outlined a number of priority areas and initiatives. These include: closing the life expectancy gap within a decade and reducing the mortality rate of children under five offering birthing services for mums and bubs providing better health education around prevention and health outcomes for the Aboriginal community to address inequities in health, particularly focussing on diabetes, kidney disease, asthma and cardio-vascular disease ensuring better access to mental health and drug and alcohol services promoting self-determination by increasing community ownership and participation by the Victorian Aboriginal community in the health services they use strengthening the capacity of the health system by developing cultural protocols. 2 On 1 January 2015, the former Department of Health and the former Department of Human Services merged to become the Department of Health and Human Services. Our goal is to develop and deliver policies, programs and services that support and enhance the wellbeing of all Victorians. To do this, we have to understand the different factors that contribute to people s health and wellbeing. We look at the causes of ill health, the drivers of good health and the social and economic environment in which people live. We also pay attention to vulnerable groups in our community and identify the barriers they can face in their day-to-day lives. Our approach puts people at the heart of policy-making, service design and delivery. We are currently developing a new Aboriginal Health and Wellbeing Strategic plan (the Strategic plan). We want all Aboriginal Victorians to be able to get the services and support they need, when they need them, so they can enjoy better outcomes in every part of their lives. To achieve this, the Strategic plan will consider all aspects of Aboriginal health and wellbeing. It will also set out an integrated approach that will see us develop and deliver programs and services from all parts of the department. Purpose of this guide The Strategic plan will only be effective if it meets the needs and aspirations of Victoria s Aboriginal peoples. That s why we want to hear directly from Aboriginal people across Victoria and those working to improve their health and wellbeing. We are committed to developing this Strategic plan in genuine partnership with the Aboriginal community and community sector organisations. This guide provides information about our commitment to Aboriginal Victorians, our new approach to advancing Aboriginal health and wellbeing and how you can contribute to the development of the Strategic plan. 1. Victorian Labor Platform 2014, Ibid. 1

7 Consultation You can participate in the design of the Strategic plan in the following ways: 1. Attend a symposium Thursday 25 February 2016, 10am to 4pm Thursday 19 May 2016, 10am to 4pm Richmond Football Club Punt Road, East Melbourne 2. Attend an Aboriginal community consultation These sessions will be held in rural and regional Victoria. Dates and location TBC. 3. Provide a written response See the discussion questions on page 9 4. Meet with our Aboriginal Health and Wellbeing Branch Contact us to arrange a meeting, either with you or your community group or network. We will also work with an Expert Panel to co-design the Strategic plan. The panel includes individuals who have a strong record in promoting Aboriginal health and wellbeing. They will provide independent and specialist advice so that we develop policy priorities that meet the needs and aspirations of the Victorian Aboriginal community. Within the department, the Aboriginal Outcomes Committee will oversee the development of the Strategic plan. This group is a sub-committee of the department s Executive Board. 2

8 The Strategic plan: Vision, priorities and building blocks We developed the following proposal as a starting point for our community consultations on the Strategic plan. No elements of the proposal are fixed. Our aim is to have a wide-ranging discussion about how best to improve the health and wellbeing of Aboriginal Victorians. Our vision In partnership with Aboriginal people, we will promote and deliver lasting health and wellbeing outcomes that enable Aboriginal people and communities to thrive. Our approach The Strategic plan will take a life course approach, with priorities that align with the different stages of life: 1. Start to life 2. Childhood 3. Transition to adulthood 4. Adulthood 5. Older people. An integrated life course approach recognises the many supporting foundations that exist in a person s life such as family, community, opportunities and place and the positive contribution they can make to a person s overall health and wellbeing. In addition, the Strategic plan will focus on priorities that are relevant in different stages of life, such as: 1. Chronic disease 2. Aboriginal social and emotional wellbeing 3. Disability 4. Homelessness and housing 5. Family violence. The Strategic plan will also reflect the following building blocks that help strengthen Aboriginal communities. Integrating these principles into the Strategic plan will be essential to deliver better health and wellbeing outcomes for individuals and communities: 1. Self-determination: We will promote greater engagement, participation and empowerment of Aboriginal communities. 2. Aboriginal culture and identity as a protective factor: We will develop cultural protocols between Aboriginal people and non-aboriginal people and their related organisations. 3. Information sharing: We will collect better data and build strong evidence in order to provide innovative and responsive services to the Aboriginal community. 3

9 Why we need a new Strategic plan On 1 January 2015, the former Department of Health and the former Department of Human Services merged to become the Department of Health and Human Services. The new department inherited two policy documents on the health and wellbeing of Aboriginal people in Victoria: Koolin Balit Victorian Government Strategic Directions for Aboriginal Health and the Human Services Aboriginal Strategic Framework The former is focused on health and the latter, focused on human services, is now out of date. We do not currently have a single policy approach to promote Aboriginal health and wellbeing in Victoria. However, our commitment to improving Aboriginal health and wellbeing is embedded in a broad range of existing policy initiatives and reforms (see Appendix: Reform Agenda). The Aboriginal Health and Wellbeing Branch is leading the development of a new Strategic plan, we expect that the Strategic plan will be finalised by the end of September We anticipate that a series of action plans will be developed to ensure that the outcomes in the Strategic plan can be achieved. Monitoring and evaluation will occur during the project cycle and after the policy is implemented. Performance indicators will be developed to track progress over time. This will help build our evidence base and guide our efforts to improve the health and wellbeing outcomes for Aboriginal people and communities across Victoria. What we know now The Australian Bureau of Statistics (ABS) estimated that Aboriginal Victorians made up 0.9 per cent (51,000) of the total Victorian population in Just over half of Victoria s Aboriginal people live in regional and rural areas and just under half in metropolitan areas. 51% 36% 15% <21 yrs yrs >49 yrs 4

10 Victoria s Aboriginal population is growing at a much faster rate than the non-aboriginal population. The Victorian Government Aboriginal Affairs Report highlighted that the Victorian Aboriginal population increased 41 per cent between the 2006 and 2011 Census. It noted that this increase was due to higher birth rates and more people identifying as Aboriginal. The Victorian Aboriginal population is young: 60 per cent are aged 25 years or under, compared to 32 percent of other Victorians. The average age of Aboriginal Victorians is 22 years, compared to 37 years for non-aboriginal Victorians. Victorian Aboriginal culture is rich, strong and alive. Resilience and cultural identity will continue to provide a solid foundation for a positive future as the Aboriginal population grows. However, in all social indicators including education, employment, health, housing, justice, child protection, disability and family violence Aboriginal people experience greater challenges than non-aboriginal people. Snapshot Key indicators from Koolin Balit 2012 provide an overview of the current status of Aboriginal health and wellbeing. While life expectancy figures are not currently available for Victoria, Aboriginal people across Australia live shorter lives than non-aboriginal Australians: the life expectancy gap is 9.7 years for women and 11.5 years for men. The perinatal mortality rate of babies of Aboriginal mothers in Victoria is approximately twice that of babies of non-aboriginal mothers. The rate of low-birthweight babies born to Aboriginal mothers in Victoria is approximately twice that of non-aboriginal mothers. Child mortality in Victoria for Aboriginal children under five years is more than double the rate for non-aboriginal babies. Mental health-related admissions are significantly higher than non-aboriginal admission rates in Victoria. Aboriginal people are 2.4 times more likely to have a disability than non-aboriginal people. Hospitalisation rates for most causes are higher for Aboriginal people in Victoria. Overall rates are one and a half times those for non-aboriginal people. Rates are more than double for several clinical specialities, including dental, dialysis, psychiatry, neonatology and antenatal care. Potentially preventable hospitalisations of Aboriginal people in Victoria are more than three times higher than for non-aboriginal people. Presentations to hospital emergency departments for Aboriginal people in Victoria are double the rate for non-aboriginal people. Tobacco use by Aboriginal people in Victoria aged over 18 years is more than one and a half times the rate for non-aboriginal people. Rates of alcohol-related harm are higher for Aboriginal Victorians than the general population, as evidenced in both emergency department and hospital admission data. 5

11 We also know that: Between 2001 and 2011, the number of Aboriginal children and young people in out-of-home care increased by over 80 per cent. While Aboriginal children make up only about 1.2 per cent of the general population, they account for 16 per cent of children on care and protection orders and are over 11 times more likely to be in out-of-home care than non-aboriginal children. 3 Current information on the incidence of family violence against Aboriginal women is limited but is estimated to be significantly higher than the general population. 4 Aboriginal people are significantly more likely to stay in improvised dwellings, tents or sleep rough than other Australians Final Report of the Protecting Victoria s Vulnerable Children Inquiry, p International Violence Against Women Survey. 5. Australian Bureau of Statistics 2011 Census. 6

12 A new approach to Aboriginal health and wellbeing in Victoria Co-designed policy The Victorian Government is committed to strengthening the role and influence of Aboriginal people, communities, and organisations, particularly in their relationships with government. In keeping with this commitment, we will work in partnership with Victorian Aboriginal communities, the funded sector, community organisations and others to co-design the Strategic plan. We will do this by reaching out to communities and listening to what they tell us; by seeking advice from experts in the field; by drawing on the latest evidence and best practice approaches; and by being transparent in how we work. By hearing directly from Victorian Aboriginal communities about their priorities and aspirations, we will be able to develop realistic and meaningful goals to promote their health and wellbeing. We will also be able to identify approaches that build on the strengths, capacity and commitment of Aboriginal communities in order to achieve these goals. Making self-determination real Implementing the government s commitment to self-determination requires a shared understanding of Aboriginal people s own perspective on self-determination and how the government can support and promote it. The department is carefully considering how to do this in a number of contexts, including co-designing a new engagement approach (see below), preparing this Strategic plan, and developing different ways to deliver health and human services in Victoria. This includes the direct delivery of statutory services by Aboriginal organisations and co-designing services delivered in mainstream settings. We will play an active role in the whole-of-government process, led by the Office of Aboriginal Affairs Victoria, to define self-determination. These discussions will directly influence how we work and do things. We want to make self-determination real in the everyday work of our department. Life course approach Inequalities in health can lead to, or result from, inequalities in other parts of life access to housing, education, work and transport, among others. The link between poor health and poverty is clear: those with the least resources suffer more from avoidable illness and reduced life expectancy, often across generations. These inequalities are particularly evident for Aboriginal Victorians. An integrated life course approach recognises the many supporting foundations that exist in a person s life such as family, community, opportunities and place and the positive contribution they can make to a person s overall health and wellbeing. Building stronger partnerships with Aboriginal communities is another important factor that can improve health and wellbeing outcomes for individuals, families and communities. 7

13 A better coordinated system Targeted, coordinated and joined up effort by all levels of government, delivered in partnership with Aboriginal communities, is central to achieving better health and wellbeing outcomes for Aboriginal peoples in Victoria. Given the mix of Commonwealth, state and local government-funded programs, cooperation is essential to minimise service gaps and improve the accessibility and availability of services for Aboriginal Victorians. The Commonwealth Government s policies and services heavily influence outcomes for many Aboriginal Victorians, including through: the Indigenous Advancement Strategy primary health care (through management of the Medical Benefits Scheme and payments to Aboriginal Community Controlled Health Organisations) investment in early childhood initiatives income support and employment services. Local government plays a significant role in driving positive outcomes for Aboriginal Victorians by providing essential services for people at all stages of life. In addition, local government has established strong partnerships with organisations in their communities including with Aboriginal Community Controlled Health Organisations to deliver innovative solutions that address local needs and promote better health and wellbeing. New Aboriginal community engagement framework Our department has committed to co-designing a new engagement framework with Aboriginal people. This engagement framework will seek to clarify and embody the principle of Aboriginal self-determination. The former Departments of Health and the former Departments of Human Services each had their own Aboriginal engagement mechanisms. There is a need to align both in order to create a new framework that will allow the Victorian Aboriginal community to determine their own health and wellbeing priorities and inform our policies. To develop the new engagement framework, we will review our internal and external engagement and partnership platforms. This will ensure that our new approach is inclusive and includes mechanisms that promote good communication and build effective partnerships between the department and the Victorian Aboriginal community. The framework will help us foster engagement, partnerships and co-design between communities, government and sector agencies so that Victorian Aboriginal communities have a genuine say in policy direction and program development. It will also help us develop a transparent approach to program monitoring and implementation, as well as promote accountability for outcomes for Aboriginal Victorians. 8

14 Invitation to contribute To develop a Strategic plan that will meet the needs and aspirations of the Victorian Aboriginal community, we need to understand the experiences of the Victorian Aboriginal community, community organisations, the funding sector and government. We invite you to be part of this process and help shape the Strategic plan. We are particularly interested to hear from Aboriginal Victorians and service providers working with the Victorian Aboriginal community. Some of our questions are: 1. What are your priorities for Aboriginal health and wellbeing? Why? a. Priorities for now? b. Priorities for the future? 2. What should happen? Why? 3. What needs to change? Why? We look forward to meeting you at a symposium or a community meeting. Alternatively, you can share your views in a written response or by arranging a meeting with a representative from our Aboriginal Health and Wellbeing Branch. Contact details For further information about the project please contact: Taryn Lee, Principal Policy Officer Aboriginal Health and Wellbeing Branch, Department of Health and Human Services Phone: taryn.lee@dhhs.vic.gov.au Enquires: aboriginal.policy@dhhs.vic.gov.au Aaron Duff, Policy Officer Aboriginal Health and Wellbeing Branch, Department of Health and Human Services Phone: aaron.duff@dhhs.vic.gov.au Enquires: aboriginal.policy@dhhs.vic.gov.au 9

15 Appendix: Reform agenda The department continues to focus on prioritising Aboriginal people, families and communities within all its policies. This includes a number of policies currently under development, including: Victorian public health and wellbeing plan , outlines the government s key priorities over the next four years to improve the health and wellbeing of Victorians. the Victorian 10 Year Mental Health Plan, which incorporates the development of an Aboriginal Social and Emotional Wellbeing Framework. the Victorian Cancer Plan , which will have specific actions targeted at the Victorian Aboriginal community. the health sector s new Equity in Participation strategy, to be developed alongside a new implementation plan for Delivering for All, the human services access and equity framework, which will take a whole of department approach, inclusive of Aboriginal people. Aboriginal Recruitment and Retention Strategy, to focus on innovation and efforts in recruitment Other key existing policy frameworks and initiatives include the following: Koolin Balit: Victorian Government strategic directions in Aboriginal health Koolin Balit was developed alongside the Victorian Aboriginal Affairs Framework in It sets out what the department, together with Aboriginal communities, other parts of government and service providers, will do to achieve the government s commitment to improve Aboriginal health. As its implementation continues, the department will strengthen its focus across the social determinants of health and reflect the Victorian Government s commitment to Aboriginal self determination. A $61.7 million investment over four years from supports the implementation of Koolin Balit. A range of projects and programs are being implemented across the state. Many of these have built on initiatives first developed under Closing the Health Gap. The development of the new Framework will replace the Koolin Balit. The roadmap for reform: Strong families, safe children project The Roadmap for Reform: Strong Families, Safe Children project (the Roadmap) will set the directions and practical steps for long term reform of the Victorian child and family services system. This includes child protection, early intervention services and out-of-home care. The Roadmap will set out how the Victorian child and family service system can be improved to help prevent neglect and abuse, intervene early, keep more families together through crises, and secure better futures for children who cannot live at home. This reform will be an important area for alignment in the development of the Framework. Taskforce 1000 Taskforce 1000 was set up as a response to an unacceptably high number of Aboriginal children in out of-home care. The Commissioner for Aboriginal Children and Young People and the Secretary of Department of Health and Human Services co-chair the taskforce. In 2015, the taskforce reviewed the circumstances of approximately 1,000 Aboriginal children and young people in out-of-home care. The case file reviews result in the development of individual remedial case management practices and separate local area plans to improve practice. A statewide report will be tabled by the Commissioner following finalisation of the area reviews in early

16 Aboriginal children s forum In 2015, Minister for Families and Children, Jenny Mikakos, announced that she will chair a regular Aboriginal Children s Forum (the Forum) that will shape policies and practices to reduce the number of Aboriginal children in out-of-home care. The Forum meets quarterly at different locations across Victoria and is co-chaired by the chief executive officer of a local Aboriginal Community Controlled Organisation. The forum is attended by Aboriginal Community Controlled Organisations, the community sector, and government to lead strategies for the safety and wellbeing of Aboriginal children and young people in, or at risk of entering, out of home care. A key focus area for the Forum is to lead the development of innovative, best practice approaches to reduce Aboriginal overrepresentation. This includes delivering on the priorities outlined in Koorie Kids: Growing Strong in their Culture. Family violence Strong Culture, Strong Peoples, Strong Families, Towards a safer future for Indigenous families and communities - 10 year plan continues to progress the objectives and actions that guide, inform and direct joint efforts of the Aboriginal community and the Victorian Government to reduce Aboriginal family violence in the short, medium and long term. In addition, the department will ensure connections and alignment between the departmental response to the recommendations of the Royal Commission into Family Violence and the development of the Framework. The Commission is due to provide its report and recommendations to the Governor of Victoria by 29 March Youth justice The department is committed to working collaboratively with Victorian Aboriginal community representatives and other government departments to deliver on the actions of the Aboriginal Justice Agreement to reduce the number of Aboriginal young people in the justice system. In 2014 the third phase of the Agreement was released with a focus on outcomes for Aboriginal young people. Key departmental priorities include: reducing the number of Aboriginal young people being remanded to custody focusing on ensuring young Aboriginal people engage with school, training or employment developing the early intervention and cultural strengthening focus of the Koori Youth Justice Program. Aboriginal inclusion action plan: Moondani The department s first inclusion action plan Moondani (which means embrace in the Woiwurrung language) was launched in July Moondani builds on the former Health, Human Services and Sport and Recreation action plans to commit to placing inclusion at the heart of our work. It includes almost 50 actions which engage all parts of the department to guide our efforts towards more inclusive policies and practices across the health and human services systems. 11

17 Social housing and homelessness The government made an election commitment to review the status of Director of Housing owned properties currently managed by Aboriginal Housing Victoria with a view to transferring the title of the property from the Director to the organisation. The department is currently considering a statewide housing register to simplify access to social housing, and improve the transparency and accountability of allocations. It should also provide a better understanding of true demand from Aboriginal households, as there is likely to be a high number of applicants in common across the public housing and Aboriginal Housing Victoria waiting lists The department is developing options to improve the service response to people experiencing homelessness and housing need. The department has provided $16.8 million available under the National Partnership Agreement on Remote Indigenous Housing to Aboriginal Community Controlled Organisations to deliver new capital, upgrades, repairs and maintenance as well as build organisational capacity to manage their housing portfolio. Disability The department has been contributing to the development of the Aboriginal and Torres Strait Islander Engagement Plan for the National Disability Insurance Scheme (NDIS). In the Barwon NDIS trial site two projects are supporting Aboriginal people and families to improve knowledge about and participation in the NDIS, and to enhance capacity of organisations to provide culturally safe services. Balit Narrum an Aboriginal disability network provides collective planning across the disability sector, Aboriginal home and community care service, education, local and state government. The network also works with and representatives from the Aboriginal community to improve access and participation of Aboriginal community members. A range of engagement strategies has seen an increase in uptake of disability services by Aboriginal people. The department is ensuring that key Aboriginal stakeholders are informants on consultations for the new Victorian state disability plan. Health 2040 Health 2040: a discussion paper on the future of healthcare in Victoria was released in September 2015 to stimulate discussion on the direction for health reform in Victoria. The paper framed discussion at the Victorian Health Minister s Health Reform Summit held on 18 September The Summit identified ten key principles to guide future reform. The Health 2040 discussion paper identified that Aboriginal people continue to experience unacceptable disparities and inequalities in health outcomes. The discussion paper highlighted the need to develop ways to ensure that the needs of the most vulnerable members of the Victorian community, including Aboriginal people, have access to the kinds of services they need. The summit and submissions to the Health 2040 discussion paper will inform a detailed government response later this year. The final Health 2040 reform will be a plan to rebuild and reshape Victoria s health system to achieve a better balance between community-based and hospital-based care over the next 20 years. 12

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