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Darrundaygu
Becoming good for a purpose!
CONTENTS Chairperson Message 4 Board of Directors 6 Building Sustainability 8 Clinical Excellence 10 Health & Wellness 14 Business Excellence 18 Financial Audit 24
Chairperson Message
GIINAGAY NGUJAWINY
We are proud to present Galambila's Annual
Report for the 2015 Financial Year and the
achievements relating to this years theme
'Yidaagay Darrundaygu: Becoming good for a
purpose!'.
The continual improvements that have been made
throughout the year have resulted in a record
amount of Medicare Earnings on an ongoing
monthly basis, as well as a noticeable increase in
active clients and the number of visiting specialist
services.
All of which have contributed to greater enhanced
services for our community and further
complimenting Galambila’s overall Vision for
“Greater Choices for Our Mob to Improve Health for
All Stages of Life”.
Financial Highlights
This is the first General Purpose Annual Financial
Report aligned with the Australian Accounting
Standards and has been a result of improvements
in our Financial Management System to increase
financial accountability reporting to the Board and
its members. Highlights this year include:
7% increase in Medicare and Practice Incentive
Income
3.5% of income in retained earnings
Higher security in relation to the payment of
accounts
We are making major improvements toward
ensuring we achieve the outcomes as envisioned in
our “Towards 2017 Strategic Plan”, an in particular,
that “We Will be a Sustainable Business,
Maintaining Cultural Integrity Throughout”.
Focusing on the Future
At Galambila there has been a shift to focus on
young people. More and more of our activities are
within the schools and we will be establishing a
Youth Reference Group. To ensure a successful
future, we need to provide opportunities for Youth to
be engaged and valued within our Organisational
frameworks toward future growth. Currently 48% of
Our Clients are Youth (Aged 0-24), and our future
succession strategy will actively ensure that young
people will be actively engaged and working to help
shape the future of Galambila for Our Mob and
Community.
Investing in Growth
Although our major priority is on treatment and
primary health care, we are making major strides
toward a focus an intervention and prevention
processes (ie. Comprehensive Care).
Galambila is fast becoming recognized as a major
Regional Support for other AMS’ based on ‘Best
Practice’ throughout the Region. We currently
provide outreach support and associated program
service deliver to; Durri AMS @ Kempsey, Werrin
AMS @ Port Macquarie, Tobwabba @ Forster,
Darrimba Maarra @ Nambucca Heads and Birpai
AMS (Town Clinic – Port Macquarie).
All of which have expanded Galambila’s Footprint,
and has further highlighted how we have
strategically diversified and improved our services,
not only to our Mob here in Coffs Harbour, but has
been recognized and promoted across the Region.
Reuben Robinson, Chairperson
These include:
IT @ RAMS (Implementing, maintaining and
enhancing our IT Computer services to
Galambila AHSI and all of the above mentioned
Aboriginal Medical Services).
Regional Tackling Smoking & Healthy Lifestyles
Local Decision Making: (NSW Aboriginal Affairs
Strategy)
Mid North Coast Aboriginal Health Accord
(Ongoing Collaboration) in partnership with Mid
North Coast Local Health District.
Mid North Coast Regional AMS Alliance
(Ongoing Collaboration) in partnership with other
AMS’ (Ballina – Forster).
NDIS: The National Disability Scheme is a major
reform that is due to commence in Coffs Harbour
in 2017. We have decided invest in
enhancements to provide future services to our
clients that have a disability or a severe mental
illness. This is a major reform and Galambila are
fully committed to implementing a process
toward NDIS Accreditation and are working
diligently toward becoming a service provider for
our Mob.
To accommodate for increased services and
increased Staff, we are fast outgrowing our current
premises. We have finalised our design plans to
extend the reception area and anticipate that
constructions will commence in February 2017.
The new design will will accommodate for more
comfortable seating arrangements, tea/coffee
serving facilities and a designated play area for the
children. The new extensions will also increase our
general consultation rooms and potentially the
number of visiting specialists, and will greatly
contribute toward a more comfortable experience
when visiting Galambila for your health service
needs.
Recognition
Overall, it has been a very successful and busy 12
months with a substantial amount of work
undertaken by Galambila. All achievements
throughout the year would not have been possible
without good governance practices, strong
leadership between the Board of Directors and the
Executive Team, but most Importantly, the Very
Deadly and Dedicated Team of Health
Professionals and Administrative Staff that are
continually working toward maintaining and
enhancing our Aboriginal Medical Service, for All of
Our Community. Too Deadly!
“We Will Survive, We Will Thrive, We Will
Prosper -
Toward A Healthy And Empowered Mob”
Yaarri Yarraang
Reuben Robinson
Chairperson
Board of
Directors
Clark Webb Deputy Chairperson
Christian Lugnan Treasurer
Aunty Kerrie Burnet
Jen Cook Secretary
Christine Robinson
Diane Anthony
Julie Carey
Angela Cowan
Reuben
Robinson
$1,193
Julie
Carey
$477
Diane
Anthony
$404
Christian
Lugnan
$186
Christine
Robinson
$477
Kerrie
Burnet
$404
Building
At Galambila sustainable development relates
to our capacity to uphold our organisational
identity as being Aboriginal Community
Control that specialises in meeting the needs
of Aboriginal people and their families now and
into the future. It takes into account our social
responsibility, the community and political
landscape and the financial impact.
We have a long-term agenda to undertake a
journey of continuous improvements to
empower our mob, including staff, increase
community participation and strengthen our
organisational structures. It recognises that
uncertainties exists, and that we need to be
flexible and that change is an ongoing
process. It also supports diversity and
differences within our community and
Galambila's workforce. Sustainable
development requires looking at the broader
picture and constantly thinking critically about
the fine tuning of the many parts of Galambila's
relationships and service components to
ultimately share these with our community.
At times we have to balance tensions between
identifying needs, developing strategy to
address these needs with scarce
resources. Our overall intent is to improve the
quality of life of our mob. We are constantly
thinking critically about fine tuning our practices
and relationship to meet the health and cultural
need of our clients and community.
Our Value Proposition
Operationally we have been striving to
demonstrate our capacity and capability to
provide the best possible service to our clients
and community. Areas we have been focusing
on include:
Excellence in Clinical and Business Practice
Culturally Appropriate Comprehensive Care
Building Sustainability
Towards Excellence
The Corporate Service Unit has achieved a
milestone and introduced a new financial
system allowing improved Budget Planning
processes and financial reporting. These
changes have allowed the Executive Team to
make informed decisions to the financial
Karl Briscoe Clinical Services
Manager
Paul Fernon Community Health
Manager
Peter McFadyen Corporate Services
Manager
Jon Rolph Regional IT
Manager
Sustainability
impact on any changes that are occurring to program and service
delivery.
It has been a year since the Clinical Service Unit introduced our new
practice model whereby the Aboriginal Health Worker Workforce
provide frontline services. Over the last twelve (12) months we have
seen the benefits of this practice in the increased Medicare revenue
and much improved quality of data.
The redesign of our Tacking Indigenous Smoking Initiative by the
Community Health Services Unit has had an immediate impact through
providing Smoking Cessation advice on a one-to-one basis and
increased focus toward young people with the Health Promotion
activities being well received in Schools from Coffs Harbour to Port
Macquarie. Mental Health Services maintains its stability even though
we recognise it is under resourced.
Our journey towards excellence continues through a systems approach
to provide improved healthcare to our clients and community.
Kristine Garrett
Chief Executive Officer
Clinical
Excellence
Throughout 2015/2016 year Clinical services have
ceased the Statistics indicate that there has been a
great deal of need for this service not only to assist
our GP with the treatment of clients by undertaking
Clinical checks with an added bonus of generation
of Medicare income which was reinvewsted back
into the organisation.
Evidence indicated that there was a great deal of
need for this service not only to assist the GP with
the Clinical checks, however to assist clients with a
more comprenhensive approach to their care whilst
accessing health care at Galambila. Work continues
to refine the process with constent evaluations
being undertaken by:
Aborignal Health Practitioners/Workers
General Practitioners (GP’s)
Nurses
Pharmasist
Receptionist
Cultural Integrity Throughout this year we have been focused on the
delivery of high quality health care for our clients
with respect being given to the cultural integrity of
the organisation.
The clinic ensures local customs and protocols of
the Gumbaynggirr nation are respected and abided
by the organisation. Some of the many ways in
which clinical services have implemented strategies
within our work environment include:
Conducting language classes/questionnaires as
part of staff development days
Signage on the front clinic door along with
telephone message
Undertaking a Smoking ceremony with all staff
and buildings within the organisation.
All new General Practitioners Registrars who come
and work for Galambila undertake a localised
cultural orientation in order to provide a more
comprehensive cultural understanding of the
community’s history. opportunities to further
enhance and refine our client’s health journey
through the clinic. With the main objectives of the
Clinical team in providing ‘Excellence in Clinical and
Business Service’ for clients. We continue to
evaluate our progress in order to provide the highest
possible level of Clinical care for our community.
Galambila staff involved in providing Clinical
services included: Doctors, Nurses, Pharmacist,
Aboriginal Health Practitioners/Workers and
Receptionists.
Our Community and Clients Aboriginal and Torres Strait Islanders people make
up 4.1 % of the population within Coffs Harbour and
surrounding areas, equating to 2,820 of the total
population of 68,415. Galambila’s reputation
through clients narrative as the preferred service
provider for Aboriginal and Torres Strait Islander
people, with 85% of the total client population
accessing the service more than 3 times over the
past 12 months.
During the 2015/2016 year a total of 3,117 clients
accessed Galambila staff for Health care. There
was around 31,400 Episodes of care provided to our
clients throughout 2015/2016. Figure 1 breaks down
our male and female clients being distributed across
the age groups with the largest being the 0-14 age
bracket.
Figure 1 Client Age Distribution
Client Arrival and Departure Time Averages Over the 2015/2016 year we have seen client
average wait times increase and decrease
throughout the year. Figure 2 outlines the monthly
wait time fluctuations, what the data is suggesting
the highest wait times is in the months August and
February. The major factor behind these months is
the commencement of new GP Registrars with
Galambila and them coming up to speed. As Figure
2 also illustrates the average wait times is lower in
the afternoon which is when we have booked
appointment for our clients
Figure 2 - Average Arrival / Departure Waiting times
Introduction of New Practice Model Major focus areas for this year include the
introduction of a new Practice Model with the first
point of clinical care for clients in seeing an
Aboriginal and/or Torres Strait Islander Health
Practitioner / Health Worker. Clients have
commented on how good it is to have an Aboriginal
Health Worker as their first point of clinical contact.
The standout of achievements during the 2015/2016
year in comparison to the 2014/2015 achievements
was the lifestyle health information that was
captured. The screening of clients for Smoking,
Alcohol and Physical Activity status meant referrals for brief intervention
were able to be arranged. This approach allowed Galambila staff to
address the unhealthy lifestyle conditions in order to prevent chronic
related conditions.
Figure 3: Lifestyle Factor Comparisons
Building Clinical Competency Galambila consistently abides by the clinical standards which are set
through the RACGP and accredited through AGPAL. By undertaking a
continually quality improvement approach to the way in which we
undertake our clinical business we consider our practice to be evidence
based best practice standards. All Clinical staff at Galambila abide by
the Chronic Conditions Manual 1st Ed 2015 which sets standards of care
which are evidence base best practice.
Operational Excellence Throughout this year we have completed a total of 1107 Health
Assessments in comparison to 960 in the 2014/2015 year (see figure 6).
By undertaking Health Assessments allows a comprehensive approach
in order to address identified health needs of our clients.
This was coupled with 1391 GP Management Plans/Team Care
Arrangements and Reviews activities being undertaken throughout the
year (see figure 6)
Figure 4: Yearly 715 Health Assessment Comparison
Figure 6: Yearly GP Management Plans and Team Care Arrangements and Reviews, Numbers and Income
Our Staff and Workplace Clinic staff employed at Galambila in a Fulltime
Equivalent capacity includes:
1 x Principal General Practitioner (GP)
3 x General Practitioners (GP’s)
2 x Registered Nurses
1 x Allied Health Practitioner (Pharmacist)
5 x Aboriginal Health Workers
1 x Aboriginal and Torres Strait Islander Health
Practitioners
4 x Reception staff (Including trainee
receptionist)
University student placements Galambila continues to host Medical students from
the University of Western Sydney with 5 students
attending placement at Galambila throughout the
year. This experience enables them to gain a
greater insight into the working environment of an
Aboriginal Medical Service with the hope of enticing
them to work in Aboriginal Health post completion of
their studies.
Outreach Services Galambila has now completed 12 months of
managing the Rural Doctors Network (RDN)
contracts which provides our clients access to
Specialist and Allied Health services in order to
assist in addressing the identified Health needs.
Services Provided through RDN Include:
Asthma Educator
Cardiac Educator
Child and Adolescent Psychologist
Dietitian
Endocrinologist
Exercise Psychologist
Fitness Instructor
Podiatrist
Psychiatry
Psychology
Group Social Worker
Gunnumba Consulting
Nurse
Aboriginal Health Worker
Health and
Galambila’s community health programs contribute
to the prevention, early detection and self-
management of illness and disease. The
Community Health team delivers:
Social and emotional wellbeing, mental health
and substance misuse programs
Preventative programs for smoking, nutrition,
physical activity, Elders health and chronic
disease
Programs for the early detection of kidney
disease, ear health, hearing and vision problems
The third year of operation for Galambila’s
Community Health Team was a very successful
year. Highlights included:
Successfully tendering to continue to deliver the
Tackling Indigenous Smoking program until 2018.
This program now only focuses on smoking as
the Commonwealth Government decided to
discontinue the healthy lifestyle component of the
previous program.
Commencing a drug and Alcohol support
program (2 days a week) with new funding
through the Commonwealth Medical Outreach
Program.
Expanding the spring into shape chronic disease
prevention and management program to 5 days a
week for 20 weeks. The program now includes 3
exercise sessions, nutrition and cooking and the
weekly Guunumba Support Group.
Successfully developing proposals to deliver two
mental health system’s improvement projects for
the North Coast Partners in Recovery program.
Social emotional wellbeing
The Community Health team deliver an integrated
primary mental health care service that provides
clinical interventions, community-based recovery
support, care co-ordination, employment services
(provided by CHESS), and comprehensive physical
healthcare and preventative health programs.
Services provided in 2015/16 included:
A total of 1963 clients contacts by our
Aboriginal Mental support Health Workers
180 Psychiatry consultations
680 psychology sessions
168 Drug and alcohol counselling sessions
75 employment and vocational support
consultations
Wellness
The Mental Health Support, Drug and Alcohol
Support and Partners in Recovery programs
provide intensive mentoring, support and care co
-ordination to approximately 40 clients. As clients
graduate from the programs, new clients can
come on.
The System’s Improvement Project team
developed a Coffs Aboriginal Mental Health
System improvement plan that was provided to
the Mid North Coast’s IMHpact service delivery
group for consideration. To develop this plan, the
project team conducted an Action Learning
project with Ontrack Community Programs, and
completed narrative enquiry sessions with 9
organisations involved in mental health service
delivery.
The team also conducted narrative enquiry
sessions with 38 community members about
their experiences, and consulted with 9 youth
organisations and schools and 72 youth about
youth service delivery issues.
Tackling Indigenous Smoking Program
READY MOB successfully tendered to continue
delivering until 2018 and have set an ambitious
target to work with the community and
stakeholders to achieve a 15% reduction in
Aboriginal smoking rates in the Mid North Coast
by June 2018.
The 2015/16 program outcomes included:
Provided smoking cessation education and
brief interventions at 55 community and school
events across the region. 6792 community
members (client contacts) received brief
interventions or participated in education at
these activities.
The team conducted 292 Get Fit and Quit
Program sessions across five locations (Coffs
Harbour, Port Macquarie, Nambucca,
Kempsey and Port Macquarie) during the
reporting period. There was a total of 3936 client
contacts through these sessions.
On 12 December 2015 the Ready Mob team
delivered a fantastic event called the READY
MOB fitness challenge. Five teams and over
120 people from across the Mid North Coast met
in Scott’s Head to participate in a gruelling
regional fitness challenge and to celebrate
healthy lifestyles.
A total of 140 people received smoking cessation
support through Stop the Juums program. 99
smokers registered with the smoking cessation
clinic at Galambila and attended appointments
between February and June 2016. This is about
10% of all current smokers at Galambila.
Designed and selected service providers to assist
the team to implement two community based
social marketing campaigns: 1) youth tobacco
prevention and 2) Second-hand smoke. These
campaigns will be integral to our program
implementation over 2016-2018.
Developed and delivered a campaign about
Nicotine Replacement Therapy (NRT). This
included providing free NRT to all adult smokers
on request and creating three short films with local community
members that had over 7000 views on Facebook.
Health education and interventions
Community Health deliver priority clinics and programs that contribute to
early detection and self-management of illness and disease.
Health education, intervention and education programs included:
Spring into Shape (including fitness, cooking, nutrition and Guunumba
Group Support) and Elders Health Days
Ears and Eyes School Program
Ear Health and Hearing Clinics and Audiometry
Kidney Health and Nutrition clinics
One Deadly Step
The program outcomes included:
172 Spring into Shape Program session were conducted with a total
of 48 program participants. There was a total of 1687 client contacts
over the program.
13 Ear Health and Hearing screening clinic were conducted including
4 outreach clinics held at local schools. 145 children had hearing and
ear health screening tests as a part of these activities. 89 clients were
also seen by an Audiologist for follow-up.
4 Kidney health screening clinics held over the year. A total of 36
clients attended these clinics.
12 Elder’s health day activities were held over the year. An average
participation of 16 Elders attending each session. In June 2016 day a
very successful day with 50 Elders from Yaegel, Bundjalung and
Gumbaynggirr country attending.
Over 400 people attended
the One Deadly Step event
which included 125 people
completing the
comprehensive health
screening activities on the
day. 87% of people that
completed the screening
activities were Aboriginal
and 72% of those screened
choose Galambila as their
preferred health provider for
any follow up.
Business
Excellence
The Corporate Services Team performs a variety of roles including
Finance, Human Resources, Industrial Relations, Workplace health and
Safety, Transport, cleaning and maintenance.
Following are the major goals we have achieved this year:
Skilled and deeply knowledgeable workforce
Improved and facilitated the Annual Performance Assessment’s used to
better capture performance requirements and development
opportunities for staff.
Presented the new EA to staff and initialised staff committee to help
develop knowledge of the process among staff and to produce a better
outcome on the EA
An Empowered Mob
During the year our trainee cleaner successfully applied for a full time
position at Galambila. We will now engaged a new trainee to again
provide employment opportunities for our mob.
Excellence in business and clinical practices
Reconfigured general ledger to match our financial system to our
business needs and allow more meaningful reporting.
Developed monthly internal reporting and
forecasting to management and Board, which
provides monthly information on our financial
performance to date and for the rest of the year.
(Our auditor stated that this was by far the most
advanced and informative reporting she has seen
in any AMS)
Finalised our conversion to a general purpose
financial reporting format for our Annual Financial
Statements to allow consistency or presentation
and inter-year comparison
Digitised the HR records to enable better tracking
and improve confidentiality
Worked with the Clinical Services team to make
our transport more responsive to client needs
Extended GPS coverage to the rest of our fleet to
improve the safety of our staff
Embedded the new AGPAL compliant cleaning
methodology to meet infection control
requirements
Best use of resources
Our new Telstra set-up is working well and has
reduced our call costs.
Our new electricity deal is working well and is
saving us money on electricity.
Development Application approved for the
building extension
Growth at a glance for the 2012 to the 2015 financial years Income (in $Millions)
Staff Numbers (as at end of fin year)
Some statistics from the Corporate
services area
Transport - In 2015/2016 our drivers assisted
7,297 clients with their travel to and from our
clinic, specialists and the hospital.
Cleaning – In 2015/2016 our cleaners have
provided over 58,000 scheduled cleaning items.
Finance – during the year we processed over
$2,056,000 worth of payments and paid out over
$4,592,000 in staff costs.
Human Resources – During the year we
recruited 22 people to full time, part time, fixed
term and casual positions and our overall
numbers grew to 50.
Key Performance Indicators
Percentage of revenue sources
Number of IT staff
IT@RAMS is a regional service based at Galambila. It works with a consortium of Services made up of Durri, Biripi, Werin, Tobwabba and Galambila. It provides the following:
IT Support
Provision of a dedicated IT Helpdesk
Monitoring and maintenance of IT hardware and software
Replacing hardware on a scheduled, regular, basis
Upgrading and implementing new hardware and software
Reporting on service levels
Information Management Support
Providing clinical and operational reports
Assisting in the analysis, documentation and improvement of clinical and operational processes
Providing training in priority areas (e.g.
induction)
IT/IM Management
Contract manage IT/IM vendors
Manage IT/IM project
Develop and maintain IT/IM governance processes
Provide advice and guidance in relation IT/IM matters
The services provided by IT@RAMS are governed by a Memorandum of Understanding between the consortium members.
Financial Stewardship
Resources were managed to ensure the maximum benefit to the region within the budgetary constraints set by the Department of Health and IT@RAMS Memorandum of Understanding.
This included:
Implementation of Office 365, providing a more flexible platform for communicating within and between Services
Development of Intranet sites for all Service and deployment to two, with the other Services preparing to deploy
Upgrade and improvement to the technology that delivers access to applications
Upgrading the operating systems on all computers including PCs, Notebooks and Servers
Deployment of new backup software to local and remote backups
Figure 1: Staff Inductions
Enhancing the capabilities of the Business Continuity solution
Create a new Disaster Recovery capability to provide a fully redundant capability
Provided a secure file storage area where files can be shared with third parties
Upgrade the Tele-Health system
IT@RAMS retained a small surplus at the end of the financial year to be available to support services in 2016/17.
Staff & Workplace
Training developed and delivered 12 new user guides and procedures were developed and published. Their subject areas included:
Office 365
Medical Director
Pracsoft
Pen CAT
Vidyo
32 staff inductions performed. This is consistent with the previous year but incorporated a wider
range of roles. (Figure 1) 43 other staff training sessions were provided, again to a wider range of staff and subjects (Figure2)
Out of hours’ support
The implementation of 24x7x365 monitoring of the
IT environment was introduced at the start of the
year. It has been responsible for the resolution of
incidents overnight or at weekends, resulting in
avoidance of outages impacting staff and clients.
Focus on data quality
During the year there has been a greater focus on
data quality with the initiation of quarterly quality
reviews with key clinical staff.
Challenges
The bi-annual reporting for the Department of
Health underwent some major changes during the
year that resulted in considerable additional time
and effort on behalf of IT@RAMS and the wider
organisation. Warranty
Figure 2: Staff Training Sessions
Community & Clients
Through the IT@RAMS managed service a total of
4,455 instances of support were provided. These
was spread across the sites within the IT@RAMS
region
The support are further broken down by month and category below
The priority of each incident, with 1 as the highest,
represents the impact and scale of issues
encountered. Below is a breakdown of incidents
by month and priority.
You will see that there is a peak of incidents
between November and March. This was the
period of highest project activity, causing some
additional disruption for users.
* Galambila includes all tickets that impacted more than one site
Vision for the next year
Keep Galambila and IT@RAMS at the forefront of clinical and technical
best practice within the Community Controlled Health Sector and to
support innovation in health care. In particular:
Deploy an on-line training service
Embrace the opportunities created by MyHealth
Look at new ways of engaging with, and supporting, our Clients
Galambila Aboriginal Health Service Inc.
Clinic: (02) 66520800
Cnr Harbour Drive & Boambee StreetCoffs Harbour, NSW 2450
PO Box 4186Coffs Harbour, NSW 2450
www.galmbila.org
www.justgiving.com/galambila
Opening TimesMonday to Friday8:30am to 5:00pm