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                                 NATIONAL INDIGENOUS HEALTH EQUALITY SUMMIT OUTCOMES

   The Council of Australian Governments has agreed to a partnership between all levels of government and Indigenous Australian communities to
      achieve the target of closing the gap on Indigenous disadvantage. In relation to Indigenous Australians’ health, COAG has committed to:
                            closing the Aboriginal and Torres Strait Islander life expectancy gap within a generation; and
                       halving the mortality gap for Aboriginal and Torres Strait Islander children under five within a decade.

                   PROPOSED SET OF CLOSE THE GAP TARGETS TO ACHIEVE THE COAG COMMITMENTS
1. PARTNERSHIP TARGETS

GOAL: To enhance Aboriginal and Torres Strait Islander community engagement, control and participation in Indigenous health policy and program
development, implementation and monitoring.

TARGET                       PROCESS            INDICATORS/TIME               INDICATORS/TIME              INDICATORS/TIME   COMMENTS,
                                                FRAME by 2013                 FRAME by 2018                FRAME by 2028     REFERENCES,
                                                                                                                             RESOURCES

Within 2 years:                                 Within 4 years:               Within 8 years:

* Establish a national                          * 60% of communities and      * 100% of communities
framework agreement to                          representative bodies are     and representative bodies
secure the appropriate                          active partners in regional   are active partners in
engagement of Aboriginal                        planning of primary health    regional planning of
people and their                                care at the State/Territory   primary health care at the
representative bodies in                        level. (Within 4 years.)      State/Territory level.
the design and delivery of
accessible, culturally
appropriate and quality
primary health care
services

* Ensure that nationally                        * 50% of hospitals have       * The 100% of hospitals
agreed frameworks exist                         appropriate mechanisms        have appropriate
to secure the appropriate                       to engage Aboriginal          mechanisms that engage
engagement of Aboriginal                        people in the design and      Aboriginal people in the
people in the design and                        delivery of secondary care    design and delivery of
delivery of secondary care                      services.                     secondary care services.
services
2. HEALTH STATUS TARGETS
GOALS: To close the Aboriginal and Torres Strait Islander life expectancy gap within a generation and halve the mortality gap for Aboriginal and
Torres Strait Islander children under five within a decade
2.1 MATERNAL AND CHILD HEALTH
GOAL: To achieve comparable rates in perinatal and infant mortality

 TARGET                         PROCESS                     INDICATORS/TIME             INDICATORS/TIME             INDICATORS/TIME   COMMENTS,
                                                            FRAME by 2013               FRAME by 2018               FRAME by 2028     REFERENCES,
                                                                                                                                      RESOURCES.

 All Indigenous women and       Access                      5-10 yrs                    5-10 yrs
 children have access to
 appropriate mother and
 baby programs

 50% reduction in the           Antenatal                   Premature birth and LBW     Premature birth and LBW
 difference between             Care                        rates                       rates
 Indigenous and non-                                        5-10 yrs                    5-10 yrs
 Indigenous Australian’s
 rates of premature birth
 and LBW
 75% of all pregnant
 women present for first
 antenatal assessment
 within the first trimester

 50% reduction in the           ARI prevention through      ARI hospitalisation rates   ARI hospitalisation rates
 difference in hospital rates   Immunisation, nutrition,    5-10 yrs                    5-10 yrs
 of acute respiratory           SDIH
 infections

 >90% of children               ARI
 diagnosed with ARI             Treatment
 receive full treatment and
 appropriate follow-up


 20% reduction in rates of      Gastro prevention through   gastroenteritis             gastroenteritis
 hospitalisation for            immunisation, nutrition,    hospitalisation rates 5-    hospitalisation rates 5-
 gastroenteritis                SDIH                        10yrs                       10yrs
The establishment of a     5 yrs
national database on
childhood hospital
presentations for Injury
2. HEALTH STATUS TARGETS (cont.)
2.2 CHRONIC DISEASE
(a) Primary prevention

GOAL: To reduce the level of absolute risk of vascular events among Aboriginal and Torres Strait Islander Australians by 2.5% within 10 years

TARGET                       PROCESS                       INDICATORS/TIME   INDICATORS/TIME              INDICATORS/TIME   COMMENTS,
                                                           FRAME by 2013     FRAME by 2018                FRAME by 2028     REFERENCES,
                                                                                                                            RESOURCES

Reduction in smoking         Smoking rates                                   Reduce per capital                             Requires multi-layered
rates to parity with non-                                                    consumptions rates to the                      approach to smoking
Indigenous Australians                                                       national average rates (by                     cessation. (See also
2% annual reduction –                                                        2020).                                         Primary Health Care and
population                                                                                                                  Health Related Services
4% annual reduction –                                                                                                       Targets, table 3(d)).
pregnant women.

> 90% of Aboriginal and      Nutrition and Food security                     By 2018                                        Significant reform beyond
Torres Strait Islander                                                                                                      health sector.
families can access a                                                                                                       (See also Primary Health
standard healthy food                                                                                                       Care and Health Related
basket (or supply) for a                                                                                                    Services Targets, table
cost of less than 25% of                                                                                                    3(d)).
their available income.

>80% of eligible             Population                                      Absolute risk of vascular
Indigenous Australian        Risk Assessment                                 events reduced by 2.5% in
adults having at least one                                                   10 years
risk assessment within
each 2 year period

Improve access to and        Population                    5 years                                                          (See also Primary Health
receipt of medicine and      Risk                                                                                           Care and Health Related
non-medicine                                                                                                                Services Targets, table
management of elevated                                                                                                      2.1).
vascular risk among all
Aboriginal people
2. HEALTH STATUS TARGETS (cont.)
2.2 CHRONIC DISEASE (cont.)

(b) Secondary prevention
(i)     General
GOAL: To improve the management and reduce adverse outcomes in chronic disease

TARGET                        PROCESS                    INDICATORS/TIME   INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                         FRAME by 2013     FRAME by 2018     FRAME by 2028     REFERENCES, RES.

Increase coverage and         Specialist outreach                                                              (See also Infrastructure
availability of specialists                                                                                    Targets, table 4(a)).
services including
outreach to Aboriginal and
TSI clients in ACCHOs and
other urban, rural and
remote settings

> 80% of patients requiring   Rheumatic fever/           5 years                                               (See also Primary Health
routine prophylaxis receive   rheumatic heart disease/                                                         Care and Health Related
greater than 80% of yearly    prophylaxis                                                                      Services Targets, table
scheduled injections                                                                                           3(d)).

Ensure all patients with      Assessment and             2-5 years
CHD, CKD and DM               management
undergo regular review of
HbA1c, lipids, BP, renal
function, proteinuria,
weight, visual acuity and
absolute cardiovasc. risk

Ensure all patients with      Assessment and             2-5 years
CHD, CKD and DM               management
undergo regular
assessment of
psychological distress and
psychosocial risk
(ii) Chronic Heart Disease
GOAL: To improve the management and reduce adverse outcomes in chronic disease

TARGET                       PROCESS                      INDICATORS/TIME   INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                          FRAME by 2013     FRAME by 2018     FRAME by 2028     REFERENCES, ETC.

>80% of all patients         Reducing time to Care        5-10 years        5-10 years                          Requires multiple systems
experiencing Acute                                                                                              improvements and raised
Coronary Syndrome (ACS)                                                                                         patient awareness
present for and receive
appropriate and timely
care

>80% of all high-risk* ACS   In Hospital Management       5-10 yrs          5-10 yrs                            Coronary angiography as
patients have access to                                                                                         a minimum
and receive appropriate
management and care

Reduce excess case           Will require improved in-    Case fatality
fatality (compared to non-   hospital treatment;          3-5 yrs
Aboriginal patients) at 12   appropriate discharge
months from acute CHD        evidence based care; long
from 30% to 10%              term management of CVD
                             and improved continuity of
                             care across the sectors



(iii) Type 2 DM and CKD
GOAL: To improve the management and reduce adverse outcomes in chronic disease

TARGET                       PROCESS                      INDICATORS/TIME   INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                          FRAME by 2013     FRAME by 2018     FRAME by 2028     REFERENCES, ETC.

Ensure >75% all T2DM                                      5 yrs                                                 Reduce complications
patients have BP
<130/80mmHg
Ensure all patients with      Scheduled Care   2-5 yrs
T2DM undergo regular
review of HbA1c, lipid
profile, BP, renal function
and visual acuity

50% of known patients         DM Control       5 yrs
with T2DM have an HbA1c
less than 7%

All patients with T2DM are    Treatment        2-5 yrs
receiving appropriate
medicine and non-
medicine management.

Stabilize all-cause           Incidence                  10 yrs
incidence of end-stage
kidney disease within 5 -10
years
2. HEALTH STATUS TARGETS (cont.)

2.2 CHRONIC DISEASE (cont.)

(c) Tertiary prevention
GOAL: To improve the management and reduce adverse outcomes in chronic disease

TARGET                        PROCESS             INDICATORS/TIME   INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                  FRAME by 2013     FRAME by 2018     FRAME by 2028     REFERENCES,
                                                                                                        RESOURCES

>50% eligible patients        CR                                    10 years                            Aboriginal CR
surviving ACS have                                                                                      $20m / 4 yrs
access to and receive                                                                                   Must consider alternate
appropriate cardiac                                                                                     models of CR
rehabilitation

Increase the proportion of    ESKD                5 yrs
Indigenous Australian         Referral / Access
patients with ESKD who
receive appropriately timed
and managed access to
dialysis

All CKD patients complete     Transplant Access   5 yrs
assessment and work-up
for transplantation within
12 m, then parity in
transplant rates

Increase the proportion of    Rehab
Aboriginal and Torres
Strait Islander people
accessing appropriate
rehabilitation and respite
care following stroke
2. HEALTH STATUS TARGETS (cont.)

2.3 MENTAL HEALTH AND EMOTIONAL AND SOCIAL WELL BEING

GOAL: To improve the mental health and SEWB of Indigenous Australians to the same standards enjoyed by the majority of the Australian population
and reduce the impact of mental disorders on patients and their families.

TARGET                       PROCESS                        INDICATORS/TIME   INDICATORS/TIME   INDICATORS/TIME         COMMENTS,
                                                            FRAME by 2013     FRAME by 2018     FRAME by 2028           REFERENCES,
                                                                                                                        RESOURCES

Reduce the impact of loss,   Resource appropriate           2-5 years                                                   Chronic stress in childhood
grief and trauma on mental   mental health education,                                                                   linked to poor adult
health across the lifespan   support and intervention                                                                   outcomes including
                             services                                                                                   diabetes, cardiovascular
                                                                                                                        disease and depression

Reduce the disparity in      Support and resource           5 years                                                     Baseline Indigenous
suicide rates and mental     appropriate mental health                                                                  mental health services are
health disorders including   service provision across all                                                               grossly inadequate in rural
depression, and psychosis    areas of remoteness                                                                        and remote areas,
across the lifespan                                                                                                     particularly in regard to
                                                                                                                        children and youth

Improve mental health        Implement a national           2 years                                                     Little data available on
outcomes and reduce          policy framework for                                                                       interventions and
adverse events for           Indigenous mental health                                                                   outcomes of mental health
Indigenous patients                                                                                                     care, especially follow up
including Indigenous         Support appropriate            5 years                                                     for suicide attempts or
people with chronic          monitoring and standards                                                                   hospital admissions. Most
disease, substance abuse     of care for Indigenous                                                                     National data relates to
or in custody                mental health patients                                                                     hospital admissions and
                                                                                                                        diagnosis. Very little data
                             Ensure availability of         2-5 years                                                   related to the impact of
                             effective treatments for all                                                               mental health problems
                             Indigenous patients                                                                        and chronic disease
                             especially those in rural                                                                  despite international
                             and remote areas                                                                           evidence
2. HEALTH STATUS TARGETS (cont.)

2.4 DATA
GOAL: Achieve specified levels of completeness of identification in health records

 TARGET                         PROCESS           INDICATORS/TIME              INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                  FRAME By 2013                FRAME By 2018     FRAME By 2028     REFERENCE,
                                                                                                                   RESOURCES

 Recording of Indigenous                          Indigenous Australians                                           (See also Infrastructure
 status in every jurisdiction                     Identification in National                                       Targets, table 4(d)).
 to achieve 80% accuracy                          Datasets
                                                  2-5 years
3. PRIMARY HEALTH CARE AND OTHER HEALTH SERVICE TARGETS
(a) Aboriginal and Torres Strait Islander primary health care services
GOAL: To increase access to culturally appropriate primary health care to bridge the gap in health standards

TARGET                   PROCESS                        INDICATORS/TIME              INDICATORS/TIME              INDICATORS/TIME             COMMENTS,
                                                        FRAME by 2013                FRAME by 2018                FRAME by 2028               REFERENCES,
                                                                                                                                              RESOURCES

Access to culturally     1.1 A 5 year Capacity          1.1.1 Services are funded    Reduced hospital             Aboriginal and non-         Additional grants to
appropriate              Building Plan for Aboriginal   by a single core of pooled   admission rates for          Aboriginal hospital         Aboriginal primary health
comprehensive PHC        and Torres Strait Islander     funds for a minimum of 3     ambulatory conditions.       admission rates for         care services of $150m,
services, at a level     primary health care            years at a time, and at                                   ambulatory conditions are   $250m, $350m, $400m,
commensurate with need   services is developed          least three times the per    The disparity in vaccine     equivalent.                 $500m per annum over 5
                         (including governance,         capita MBS utilisation by    preventable disease rates                                years with the $500m
                         capital works and recurrent    non-Indigenous               is eliminated.                                           sustained in real terms
                         support) to provide            Australians (with a rural    Reduced prevalence of                                    thereafter until the
                         comprehensive primary          and remote loading of up     chronic disease risk                                     Indigenous Australian health
                         health care to an              to an additional three       factors.                                                 gap closes.
                         accredited standard and to     times).
                         meet the level of need.                                     Decreased childhood                                      The proposed expenditure
                                                        1.1.2 To complement          mortality rates.                                         provides for staff salaries
                                                        uptake of PBS and MBS                                                                 (doctors, nurses, Aboriginal
                                                        by Aboriginal peoples and    Increased life expectancy.                               Health Workers, allied
                                                        Torres Strait Islanders                                                               health, dental,
                                                        increased to at least 1.2                                                             administrative/management
                                                        times the per capita                                                                  and support staff) including
                                                        utilisation for the non-                                                              training, transport provision,
                                                        Indigenous Australian                                                                 and ancillary programs and
                                                        population.                                                                           all other operational costs
                                                                                                                                              including the annualised cost
                                                        1.1.3 All ACCHSs have                                                                 of infrastructure. This also
                                                        access to pharmaceuticals                                                             includes housing for staff in
                                                        through Section 100 or its                                                            remote areas.
                                                        equivalent.
                                                                                                                                              In some areas, the required
                                                        1.1.3 Capital works                                                                   infrastructure will not be
                                                        programs to assist                                                                    readily available and capital
                                                        Aboriginal communities                                                                works programs will be
                                                        wishing to develop a new                                                              required by one or all levels
                                                        ACCHS are established.                                                                of government.

                                                        1.1.4 80% of ACCHSs are                                                               This is consistent with the
                                                        accredited in the new                                                                 Rudd Governments Super
                                                        accreditation framework                                                               Clinics pledge for
which includes                 mainstream services.
governance, capital works,
and service delivery and
maintained to accreditation
status.

1.1.5 80% of ACCHS
provide home visiting
services and have facilities
for provision of visiting
allied health and specialist
services.

1.1.6 Established
mechanisms for
community engagement
initiatives.

1.1.7 Resources are in
place for NACCHO
Affiliates and Torres Strait
Islanders CCHS to support
every Aboriginal and
Torres Strait Islander
community that wishes to
develop their Aboriginal
&Torres Strait Islander
primary health services
into legally incorporated
community-controlled
services.
3. PRIMARY HEALTH CARE AND OTHER HEALTH SERVICE TARGETS (cont.)
(b) Mainstream primary health care services
GOAL: Improve the responsiveness of mainstream health services and programs to Aboriginal and Torres Strait Islander peoples health needs


TARGET                       PROCESS                        INDICATORS/TIME               INDICATORS/          INDICATORS/          COMMENTS,
                                                            FRAME by 2013                 TIME FRAME by 2018   TIME FRAME by 2028   REFERENCES,
                                                                                                                                    RESOURCES

Mainstream services          2.1 Increase Aboriginal        2.1.1 Uptake of PBS by                                                  $80m per annum.
provided to Aboriginal and   people’s access to             Aboriginal peoples and                                                  Implementation of Goal 1
Torres Strait Islander       medicines and services.        Torres Strait Islanders                                                 will enhance the success
people in a culturally                                      increased to at least 1.2                                               of and complement this
sensitive way and at a                                      times the per capita                                                    initiative.
level commensurate with                                     utilisation for the non-
need.                                                       Indigenous Australian
                                                            population.

                                                            2.1.2 An established
                                                            quality use of medicines
                                                            scheme for Aboriginal
                                                            primary health care
                                                            services in non-remote
                                                            areas that also increases
                                                            access to medicines.

                                                            2.1.3 The S100 remote
                                                            area PBS access scheme
                                                            has an incorporated quality
                                                            use of medicines
                                                            component.

                             2.2 Develop national           2.2.1 Outcomes-based                                                    $30m over 5 years
                             strategies to enhance the      incentives are introduced
                             utilisation and relevance of   for increased use of
                             the Medicare Benefits          Indigenous specific health
                             Schedule (MBS). (ie            assessments.
                             Increase Aboriginal
                             peoples and Torres Strait      2.2.2 Uptake of MBS by
                             Islander access to             Aboriginal peoples and
                             Australia’s universal health   Torres Strait Islanders
                             scheme)                        increased to at least 1.2
                                                            times the per capita
                          utilisation for the non-
                          Indigenous Australian
                          population.

                          2.2.3 All jurisdictions have
                          a registration process in
                          place for AHWs.

2.3 State and federal     2.3.1 Australian Health        Under the Australian
bilateral financing       Care Agreements commit         Health Care Agreements.
agreements to commit to   to monitor and report on
health equity within      access to health programs
mainstream programs,      by Aboriginal peoples and
such as through public    Torres Strait Islanders.
health or health care
agreements.               2.3.2 Performance
                          indicators are agreed for
                          which funding is
                          contingent, that pertains to
                          meeting targets that
                          improve Aboriginal peoples
                          and Torres Strait Islanders
                          access to hospital and
                          other services.

                          2.3.3 Targets are
                          developed and agreed to
                          under the Health Care
                          Agreements including for
                          kidney dialysis; population
                          health programs (such as
                          sexual health, cervical
                          screening, Breastscreen);
                          rehabilitation services (eg
                          cardiac rehabilitation,
                          Commonwealth Hearing
                          Services Program);
                          residential aged care
                          services, and
                          immunisation.

                          2.3.4 Commonwealth and
                          State/Territory health
                          programs agree to health
                          impact assessments of
                            policies relevant to
                            Aboriginal and Torres
                            Strait Islanders in order to
                            ensure their accessibility.

                            2.3.5 Equity audits for
                            access to essential
                            mainstream services are
                            undertaken.

2.4 Systems for programs    2.4.1 The Multi- Program
delivered through private   Funding Agreement
general practices commit    between the Department of
to health equity.           Health and Ageing with
                            Divisions of General
                            Practice in Australia have a
                            set of performance
                            expectations pertaining to
                            delivery of services to
                            Aboriginal peoples and
                            Torres Strait Islanders.
                            2.4.2 All Australian
                            Governments commit to
                            make it part of the
                            accreditation process that
                            all government funded and
                            private general practices
                            provide culturally sensitive
                            services to Aboriginal and
                            Torres Strait Islander
                            people.

                            2.4.3 All health care
                            providers to commit to a
                            Charter detailing the level
                            of service an Aboriginal
                            and Torres Strait Islander
                            patient will receive,
                            including arrangements to
                            ensure cultural issues are
                            recognised and addressed
                            within each service, [and] a
                            system to provide
                            interpretation and cultural
                            support where necessary
for patients.
3. PRIMARY HEALTH CARE AND OTHER HEALTH SERVICE TARGETS (cont.)
(c) Maternal and child health services
GOAL: National coverage of child and maternal health services is provided

TARGET                        PROCESS                       INDICATORS/TIME                INDICATORS/TIME              INDICATORS/TIME   COMMENTS,
                                                            FRAME by 2013                  FRAME by 2018                FRAME by 2028     REFERENCES,
                                                                                                                                          RESOURCES

National coverage of          3.1 Increase the Aboriginal   3.1.1 A national health        Halve the gap in mortality                     $92.2m over 4 years
culturally appropriate        and Torres Strait Islander    plan for Aboriginal and        rates between Indigenous                       (Labor Pledge)
maternal and child health     populations’ access to        Torres Strait Islander         and non Indigenous
services for Aboriginal and   culturally appropriate        mothers and babies is          Australian                                     $37.4 m for home visiting
Torres Strait Islander        maternal and child health     developed, costed, and         children under the age of                      provided in the 2007-08
people                        care services.                implemented.                   five within a decade.                          federal Budget.

                                                            3.1.2 Aboriginal and Torres    70% of Aboriginal and                          See also Goal 1 which
                                                            Strait Islander primary        Torres Strait Islander                         enables this. (Goal 3
                                                            health care services are       children have a child                          cannot succeed without
                                                            supported to deliver child     health assessment by                           Goal 1).
                                                            and maternal health            aged 2 years.
                                                            services as core activity.                                                    Nutrition is an integral part
                                                            These services act as                                                         of MCH.
                                                                                           90% of Aboriginal and
                                                            hubs for parenting support     Torres Strait Islander
                                                            referrals.                     children have a hearing
                                                                                           assessment prior to school
                                                            3.1.3 Aboriginal and Torres    entry.
                                                            Strait Islander primary
                                                            health care services are
                                                            supported to deliver           Immunisation rates
                                                            culturally appropriate home    sufficient to achieve herd
                                                            visiting programs as core      immunity and achieve
                                                            activity, and there is         national targets
                                                            integration in this activity
                                                            with other home visiting
                                                            service providers.

                                                            3.1.4 Incentive programs
                                                            for the immunization of the
                                                            Aboriginal and Torres
                                                            Strait Islander population,
                                                            including development of
                                                            an Aboriginal and Torres
                                                            Strait Islander
                                                            immunisation workforce to
                                address continuing high
                                rates of vaccine
                                preventable diseases.

                                3.1.5 Performance
                                indicators for hearing
                                service providers under the
                                Commonwealth Hearing
                                Services Program are
                                developed to improve
                                hearing services provision
                                and rehabilitation services.

                                3.1.6 All State and
                                Territory health services
                                capacity to monitor ear
                                disease and allow the
                                hearing ability of
                                Indigenous Australian
                                children to be tested by
                                3years of age, forms part
                                of the criteria for service
                                accreditation.

3.2. Develop a national         3.2.1 Scheme developed.        Reduced incidence and      $50m over 4 years
‘nutritional risk’ scheme for                                  prevalence of under        Target 3.1 Mother and
at-risk mothers, infants and    3.2.2 Eligibility for such a   nutrition.                 Child Health teams would
children.                       scheme includes a low                                     intersect with and refer
                                household income,              Reduced low birth weight   clients to this program.
                                pregnancy, postpartum, or      rates to levels of non-
                                breast-feeding, or a child     Aboriginal and Torres      $20m over four years.* As
                                under the age of five          Strait Islander people.    above
                                years, in the presence of                                 * Heart Foundation, Close The
                                                                                          Gap: Improving Chronic Disease
                                nutritional risk assessed by                              Prevention and Cardiovascular
                                a health professional. This                               Disease Outcomes for Aboriginal
                                risk may include:                                         and Torres Strait Islander
                                inadequate diet; abnormal                                 Peoples 2008.
                                weight gain during
                                pregnancy; a history of
                                high-risk pregnancy; child
                                growth problems such as
                                stunting, underweight, or
                                anaemia; and
                                homelessness.
                         3.2.3 Nutritionists are
                         partnered with Indigenous
                         Health/Nutrition Workers to
                         support the maternal and
                         child health nurse home
                         visiting teams.




3.3. Develop health      3.3.1 Effective programs      4% annual reduction of
promotion programs       developed.                    smoking in pregnant
targeting smoking and                                  women.
alcohol consumption in   3.3.2 Incentive programs
pregnancy.               for Aboriginal and Torres     Reduce foetal alcohol
                         Strait Islander primary       syndrome rates.
                         health care services to       Reduce per capita
                         meet patient population       consumptions rates in
                         targets.                      pregnancy to the national
                                                       average rates.
3. PRIMARY HEALTH CARE AND OTHER HEALTH SERVICE TARGETS (cont.)
(d) Indigenous-specific population programs for chronic and communicable disease
GOAL: Enhance indigenous-specific population programs for chronic and communicable disease

TARGET                         PROCESS                        INDICATORS/TIME                 INDICATORS/TIME              INDICATORS/TIME   COMMENTS,
                                                              FRAME by 2013                   FRAME by 2018                FRAME by 2028     REFERENCES,
                                                                                                                                             RESOURCES

National coverage of           4.1 Develop and implement      4.1.1 The                                                                      $20m over 4 years
Aboriginal and Torres Strait   a national chronic disease     recommendations of the
Islander peoples for funded    strategy which ‘close the      National Chronic Disease
and effective programs for     gap’ in excess disease.        Strategy and National
chronic and communicable                                      Service Improvement
disease.                                                      Frameworks for national
                                                              health priority areas
                                                              (pertaining to Indigenous
                                                              Australians) are
                                                              incorporated within a Plan
                                                              funded and implemented.

                                                              4.1.2. Cardiac rehabilitation
                                                              programs for Aboriginal
                                                              and Torres Strait Islander
                                                              peoples are developed.

Minimise the harm              4.2 Fund coordinated           4.2.1 A National Tobacco        Reduce per capital                             Requires multi- layered
associated with the use        Aboriginal and Torres Strait   control campaign is             consumptions rates to the                      approach to smoking
and misuse of alcohol,         Islander peoples’ Programs     developed.                      national average rates (by                     cessation
tobacco and other drugs        for tobacco control, alcohol                                   2020).                                         $24m over 4 years for
                               and substance misuse,          4.2.2 Population-based                                                         Tobacco. Cost to be
                               nutrition and physical         smoking cessation                                                              determined for other
                               activity.                      programs (including                                                            substances.
                                                              components assisting                                                           Implementation of
                                                              pregnant women to quit)                                                        programs run and
                                                              are developed and                                                              integrated through
                                                              implemented.                                                                   NACCHO affiliates where
                                                                                                                                             possible and where
                                                                                                                                             preferred. As a link to the
                                                              4.2.3 The Complementary
                                                                                                                                             uptake of health checks
                                                              Drug and Alcohol Action
                                                                                                                                             through the promotion of
                                                              Plan is implemented.
                                                                                                                                             physical activity in PHC.
                                                              Programs targeting: control                                                    (See also Health Status
                                                              of supply; harm reduction;                                                     Targets, table 2.2(a))
                                                           harm minimisation;
                                                           intervention; early
                                                           intervention implemented

                                                           Reduced hospitalisation
                                                           rates of Indigenous people
                                                           with alcohol and other drug
                                                           related morbidity and
                                                           mortality.

                                                           4.2.4 Culturally appropriate
                                                           and accessible alcohol and
                                                           other drugs services [which
                                                           involve] partnerships
                                                           between Aboriginal and
                                                           mainstream health services
                                                           at a regional level, are
                                                           provided including the
                                                           provision of patient
                                                           assisted transport
                                                           schemes.

                                                           4.2.5 An Aboriginal and
                                                           Torres Strait Islander
                                                           National Physical Activity


GOAL: National nutrition plan, developed, funded and implemented

TARGET                     PROCESS                         INDICATORS/TIME                INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                           FRAME by 2013                  FRAME by 2018     FRAME by 2028     REFERENCES,
                                                                                                                              RESOURCES

> 90% of Aboriginal and    Food Security                   National nutrition plan,                                           Resource requirements to
Torres Strait Islander     Focus on affordability and      developed, costed, funded                                          be determined
families can access a      accessibility of healthy food   and implemented
standard healthy food      choices.
basket (or supply) for a
cost of less than 25% of
their available income.    Nutrition interventions for                                                                        Heart Foundation,
(See also Health Status    at-risk communities –                                                                              “Everyday Foods” of Heart
Targets, table 2.2(a))     recognizing the link                                                                               Foundation Buyer’s Guide
                           between poverty and poor                                                                           for managers of remote
                           quality diets                                                                                      Indigenous community
                              stores and takeaways 2008
Community stores to
commit to healthy nutrition
goals and targets as well
as financial goals and
targets
3. PRIMARY HEALTH CARE AND OTHER HEALTH SERVICE TARGETS (cont.)

(d) Indigenous-specific population programs for chronic and communicable disease (cont).

GOAL: Comprehensive and culturally appropriate oral health care services organised and coordinated on a regional basis.

TARGET                         PROCESS                       INDICATORS/TIME                 INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                             FRAME by 2013                   FRAME by 2018     FRAME by 2028     REFERENCES, RES.

By 2020 high quality,          4.3. Develop and              The Federal Govt. to                                                $290 million for a
comprehensive and              implement an oral health      coordinate a National                                               Commonwealth Dental
culturally appropriate oral    program as an integral        Indigenous Australians’                                             Health Program over three
health care services will be   component of                  Oral Health Care Program                                            years (Labor pledge).
organised and coordinated      comprehensive primary         which allocates resources                                           Proposed that the Federal
on a regional basis.           health care including:        and responsibilities for the                                        Government initiate a
                               -Community water              provision of clinical care by                                       small community water
All Indigenous                 fluoridation                  State/Territory public                                              fluoridation program,
communities with a             -A coherent oral health       dental providers and                                                suitable for remote and
population of more than        promotion strategy            NACCHO on a regional                                                rural locations, and work
1000 will have a               - High quality,               basis                                                               with State/Territory
fluoridated water supply by    comprehensive and                                                                                 Governments, local water
2015.                                                        4.3.1 Culturally appropriate                                        authorities and
                               culturally appropriate oral
                                                             and accessible oral health                                          communities to implement
                               health care services
All Indigenous                                               services [which involve]                                            the program; and
                               organised and coordinated
communities with a                                           partnerships between                                                resource the Australian
                               on a regional basis
population of more than                                      Aboriginal and Torres                                               Research Centre for
500 will have a fluoridated                                  Strait Islander and                                                 Population and Oral Health
water supply by 2020.                                        mainstream health                                                   to develop an oral health
Implementation of a                                          services at a regional                                              promotion strategy with
coherent national oral                                       level, are provided                                                 NACCHO, Indigenous
health promotion strategy                                    including the provision of                                          Dentists’ Association of
by 2010.                                                     patient assisted transport                                          Australia, RCADS,
                                                             schemes.                                                            professional representative
                                                                                                                                 organisations and
                                                             4.3.2. An oral health                                               State/Territory health
                                                             promotion campaign is                                               promotion agencies
                                                             supported for Aboriginal
                                                             peoples and Torres Strait
                                                             Islander (stand alone
                                                             and/or integral to chronic
                                                             disease programs).
                                                             4.3.3. Access to oral
                                                             hygiene materials is
                                                             increased.
GOAL: To be developed (adolescent and youth health)

TARGET                      PROCESS                     INDICATORS/TIME   INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                        FRAME by 2013     FRAME by 2018     FRAME by 2028     REFERENCES,
                                                                                                              RESOURCES

4.4 A national Indigenous   4.4.1 Strategy developed.
adolescents or youth
health strategy is
developed to make health
services more accessible
and appropriate to them.


GOAL: To be developed (men’s health)

TARGET                      PROCESS                     INDICATORS/TIME   INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                        FRAME by 2013     FRAME by 2018     FRAME by 2028     REFERENCES,
                                                                                                              RESOURCES

4.5 A national Indigenous   4.5.1 Strategy developed.
men’s health strategy is
developed to make health
services more accessible
and appropriate to
Indigenous men.
3. PRIMARY HEALTH CARE AND OTHER HEALTH SERVICE TARGETS (cont.)

(d) Indigenous-specific population programs for chronic and communicable disease (cont).

GOAL: Communicable disease programs implemented

TARGET                  PROCESS                       INDICATORS/TIME              INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                      FRAME by 2013                FRAME by 2018     FRAME by 2028     REFERENCES,
                                                                                                                       RESOURCES

                        4.6.1 A National Aboriginal   Reduced rates of invasive                                        Also depends on Goal 1.
                        and Torres Strait Islander    pneumococcal disease.
                        Sexual Health and Blood       Etc.                                                             $10.3 million pledge for
                        Borne Virus Strategy is                                                                        Rheumatic fever and heart
                        funded to reduce STI and                                                                       disease control.
                        HIV/Hepatitis C rates.
                                                                                                                       $X for STI strategy,
                        4.6.2 The National Flu and    >80% of patients requiring                                       trachoma control, Flu and
                        Pneumococcal vaccine          routine prophylaxis                                              Pneumo. (See also Health
                        program is expanded to        receiving greater than 80%                                       Status Targets, table 2 (b)
                        increase vaccine              of yearly scheduled                                              (1)).
                        coverage.                     injections

                        4.5.3 A national rheumatic
                        fever/heart disease
                        strategy for increased                                                                         $10m?
                        coordination between
                        primary health care
                        services and population
                        health programs is
                        developed to improve
                        preventive interventions
                        and access to surgery.

                        4.5.4 Trachoma control
                        programs are expanded
                        through implementation of
                        SAFE strategy.
3. PRIMARY HEALTH CARE AND OTHER HEALTH SERVICE TARGETS (cont.)

(e) Mental health/ social and emotional well being

GOAL: Improve access to timely and appropriate mental health care in PHCS and specialised mental health care services across the lifespan

TARGET                      PROCESS                      INDICATORS/ By 2013          INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                                                      FRAME by 2018     FRAME by 2028     RESOURCES,
                                                                                                                          REFERENCE

Completed service plans     Implement in consultation    5 years                                                          Comment: Emphasis on
and partnerships            a service plan to respond    Yearly evaluation of                                             specialist mainstream
                            to the mental health needs   service agreements.                                              services being responsible
                            of PHC services and                                                                           for supporting PHCS
                            Indigenous communities.      Evaluate mainstream
                            Implement National           services appropriateness
                            Cultural Respect             and responsiveness in line
                            Framework for mainstream     with National Cultural
                            services.                    Respect Framework


Increase access to and      Build and strengthen         Benchmark Baseline data                                          Ref: Bringing Them Home
total number of mental      capacity in PHC services     Audit of policy                                                  Report, National Strategic
health professionals        to respond to mental         frameworks, service                                              Framework for Aboriginal
working in PHCS             health needs across the      provision and programs                                           and Torres Strait Islander
                            lifespan including access                                                                     mental health and SEWB
Increased screening for     to SEWB centres and          Training data for mental
risk factors for mental     Bringing them home (BTH)     health courses for PHCS
health in general health    counselling                  staff
checks
                            Implement screening tools    Mental Health Staff
                            and protocols for            numbers
                            identifying and managing     5 years
                            psychosocial risk
                                                         Increased referral to
                            Comprehensive health         support programs
                            checks and Chronic           2 years to develop
                            Disease management           protocols
                            plans to include mental
                            health concerns

Protocols for identifying   Mental health                Protocols and guidelines                                         Identifying and managing
and managing                management plans             implemented                                                      mental health problems
psychological or             initiated and completed    2 years                        early in their course will
behavioural distress and     Develop ‘Best Practice’    Mental health patient          improve overall mental
mental illness across the    guidelines.                contacts in PHCS data          health and SEWB
lifespan in PHCS including                              base ongoing                   outcomes, especially in the
custodial populations and                                                              youth population.
homeless with                                           Decrease Deliberate Self       Managing ‘stress’ will also
priority given to children                              Harm and suicide rates         improve general health
and youth, and children in                              2-5 years                      outcomes
out of home care
implemented                                             Decrease acuity, ED
                                                        contacts and hospital
                                                        admissions/readmissions

                                                        Decrease prevalence of
                                                        common disorders such as
                                                        Depression and Anxiety
                                                        10 years

Standardised referral        Referrals to specialised   Decreased delay in time of
pathways to specialised      services developed and     referral to specialised care
services such as drug and    standardised
alcohol, family violence,                               Increased Indigenous
trauma and grief                                        patient mental health
counselling, Psychiatric                                services contacts
services and suicide
prevention programmes                                   2 years to implement
implemented.                                            protocols


                             Improved outcomes for      Decrease incarceration
                             mental health care for     rates for mental health
                             Indigenous Australians     patients
                             including co-morbidity     Monitor referrals under the
                             issues of substance use    Mental Health Act ongoing
                                                        Reduced DSH and
                                                        mortality rates
                                                        Reduced rates of
                                                        substance use in mental
                                                        health patients
                                                        Improved Outcome and
                                                        follow up data including
                                                        access to medications and
                                                        specialists
                                                        Decrease prevalence of
                                                        severe mental illness
                                                            5-10 years

All Indigenous women to       Support development and       5-10 years                Known association with
have access to culturally     resourcing of                                           poorer birth, physical and
appropriate maternal and      maternal/infant mental                                  mental health and life
infant mental health          health services alongside                               outcomes for infants born
services                      antenatal services across                               to mothers with antenatal
                              all communities                                         and postnatal mental
                                                                                      health disorders and
                                                                                      exposure to chronic stress
                                                                                      in utero

All Indigenous women          Support the cultural          5 years                   Current evidence of
have access to mental         adaptation of the                                       efficacy of the EPDS and
health screening              Edinburgh post-natal                                    intervention in mainstream
perinatally                   depression scale (EPDS)                                 populations
                              and other culturally
                              relevant instruments
                              Identify and manage at risk
                              Indigenous mothers
                              through appropriate mental
                              health screening tools
                              perinatally

All Indigenous children and   Support resources for         5-10 years   5-10 years   WAACHS Vol 2 found 24%
youth to have access to       identifying children and                                of Indigenous children
appropriate mental health     youth at risk through                                   aged 4-17 years at high
screening and referral        community, health and                                   risk of clinically significant
pathways to mental health     education services                                      emotional or behavioural
services as appropriate       Identify and reduce the                                 difficulties compared to
Reduce the disparity for      impact of negative life                                 15% of non-indigenous
Indigenous children at risk   stress events on child                                  children
by 50%                        development                                             Multiple negative life stress
                                                                                      events was the strongest
                                                                                      predictor
Improve access and base       Support and resource           2-5 years   Few rehabilitation and
level rehabilitation and      rehabilitation,                            support services exist in
support services for          accommodation,                             for Indigenous mental
chronic mental health         educational, life skills and               health patients in remote
problems and disorders        recreational services for                  locations
throughout the lifespan for   patients with chronic                      Children of parents with
all Indigenous patients and   illness and their families,                chronic disease and/or
their families                especially in rural and                    mental disorders are at
                              remote areas.                              high risk of poor life, health
                              Support adequate data                      and wellbeing outcomes
                              collection on Indigenous                   placing the next generation
                              patients under the Mental                  at risk.
                              Health Act, compulsory
                              treatment orders and their
                              outcomes
3. PRIMARY HEALTH CARE AND OTHER HEALTH SERVICE TARGETS (cont.)
(e) Mental health/ social and emotional well being (cont.)
GOAL: Build community capacity in understanding, promoting wellbeing and responding to mental health issues

TARGET                   PROCESS                     INDICATORS/ TIME              INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                     FRAME by 2013                 FRAME by 2018     FRAME by 2028     RESOURCES,
                                                                                                                       REFERENCE

                         Develop mental health       Number of communities
                         Promotion, Prevention and   and people accessing
                         Early Intervention (PPEI)   programs
                         programs through the PHC    2 years
                         sector
                                                     Number and review of
                                                     community action plans
                                                     2-5 years

                                                     Number and evaluation of
                                                     PPEI programs operating
                                                     Decrease in observable
                                                     risk factors, eg, substance
                                                     use
                                                     Increase in observable
                                                     protective factors, eg,
                                                     family functioning
                                                     Increased family and
                                                     community wellbeing
                                                     Measures for cultural
                                                     recovery and continuity 2-
                                                     5 years
3. PRIMARY HEALTH CARE AND OTHER HEALTH SERVICE TARGETS (cont.)
(e) Mental health/ social and emotional well being (cont.)

GOAL: Promoting mental health recovery across the lifespan

TARGET                         PROCESS                       INDICATORS/ TIME          INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                             FRAME by 2013             FRAME by 2018     FRAME by 2028     RESOURCES,
                                                                                                                           REFERENCE

Increased access to            Develop targeted              Number of patients in
education,                     accommodation,                employment, education
accommodation and              recreational, life skills,    and training programs.
employment programs for        employment and                Number of patients in
mental health patients         education programs for        supported accommodation
Increased access to            patients with mental health   and number of people
recreation, social, cultural   problems                      accessing support
and family support                                           programs 2-5 years
programs
4. INFRASTRUCTURE TARGETS
(a) The size and quality of the health workforce

GOAL: Provide an adequate workforce to meet Aboriginal and Torres Strait Islander health needs by increasing the recruitment, retention,
effectiveness & training of health practitioners working within Aboriginal and Torres Strait Islander health settings and build the capacity of the
Indigenous health workforce

TARGET                          PROCESS                       INDICATORS/TIME              INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                              FRAME By 2013                FRAME By 2018     FRAME By 2028     REFERENCE,
                                                                                                                               RESOURCES

Develop a funded National       Aboriginal and Torres         Specify numbers to be                                            Specify shortfall in each
Training Plan for               Strait Islander student       trained in each discipline                                       discipline
                                                                                                                                st
Indigenous doctors,             recruitment and support                                                                        1 level competence
nurses, dentists, allied        units in selected
health workers, AHWs            universities in every State                                                                    CDAMS
                                and Territory                                                                                  – ref AMA $36.5m pa
Design, fund and
implement a recruitment
and retention strategy to
provide the required
numbers for each
discipline (medical, dental,
nursing and allied health
workers that include
AHWs)

Design, fund and
implement a career
pathway for AHWs

Increase the number of
health practitioners
working by 430 within
Aboriginal (and Torres
Strait Islander) health
settings* of whom 270 are
primary care doctors.
Build capacity of the
Indigenous health
workforce
* AMA Discussion Paper 2004 –
Update
                              A financial and non-         GP workforce salaries are      See above. Locations
                              financial incentive scheme   on a par with mainstream       based on need.
                              for health staff to work     primary health care
                              within Aboriginal and        services.                      Other strategies include
                              Torres Strait Islander                                      HECS reimbursements.
                              primary health care          Disparities in recruitment     Retention packages
                              services and to retain and   and retention of GPs,          needed as well.
                              expand the workforce pool    nurses, AHWs and allied
                              to meet specified service    health within Aboriginal
                              requirements.                and Torres Strait Islander
                                                           PHC services are
                                                           reduced.

                                                           Non-financial incentives
                                                           include regulatory
                                                           mechanisms which include
                                                           geographic restriction of
                                                           provider numbers based
                                                           on population and with
                                                           preferential access to the
                                                           most popular locations
                                                           based on length of
                                                           services in areas of need.

                                                           The National Aboriginal
                                                           and Torres Strait Islander
                                                           Workforce framework has
                                                           been funded and
                                                           implemented.

Increase coverage and          Increase the Aboriginal     Agreed benchmarks in           $12m over 4 years
availability of specialists   and Torres Strait Islander   rural and remote areas
services including            populations’ access to       developed regarding            This includes referrals.
outreach to Aboriginal and    specialist Services in       specialist to population
Torres Strait Islander        accordance with need.        ratio’s so as to ensure that   (See also Health Status
clients in Aboriginal and                                  Aboriginal peoples and         Targets, table 2 (b) (1)).
Torres Strait Islander                                     Torres Strait Islanders
primary health care                                        have access at least to the
services and hospitals and                                 same level as other
rural and remote settings                                  Australians.

                                                           The Medical Specialists
                                                           Outreach Assistance
                                                           Program is funded to a
                                                           level where all Aboriginal
                                                          peoples and Torres Strait
                                                          Islanders can get access
                                                          to specialists services as
                                                          close to their community
                                                          as possible.

Provide an additional 1500   Introduce a national         $20m over 5 years.                                        Link in with
AHWs                         program to fully implement                                                             Vocational, educational
                             the national Aboriginal                                                                and training Programs
                             Health Worker                                                                          (VET)
                             Qualifications within the
                             Aboriginal Community
                             Controlled health services
                             sector including career
                             structure, pay equity and
                             professional development.

Develop a skilled alcohol    Number of alcohol and
& drug workforce.            drug workers.


Develop a skilled oral       The Federal Government                                    100 Indigenous dentists,
health workforce.            to coordinate a focused                                   dental therapists and
                             process with the Dental                                   dental hygienists by 2020.
                             Schools, the Australian                                   300 dentists, dental
                             Dental Council, RCADS,                                    therapists and dental
                             the Indigenous Dentists’                                  hygienists,
                             Association of Australia                                  30 specialist dentists
                             and the professional                                      10 dental educators by
                             representative                                            2030
                             organisations to promote
                             careers in oral health and
                             support students and
                             practitioners
4. INFRASTRUCTURE TARGETS (cont.)
(a) The size and quality of the health workforce (cont.)
GOAL: Increase the quality of the health services and the workforce

TARGET                         PROCESS             INDICATORS/TIME             INDICATORS/TIME    INDICATORS/TIME   COMMENTS,
                                                   FRAME By 2013               FRAME By 2018      FRAME By 2028     REFERENCE,
                                                                                                                    RESOURCES

Develop a National                                 Establish and cost pilot    National network                     $10m seed funds in year 1
Network of Centres of                              centres
Teaching Excellence in
every State and Territory                          Cultural safety training
to deliver high quality                            programs are delivered in
health services, providing                         partnership with and
multidisciplinary teaching                         recognised by ACCHSs
and conduct applied                                and their representative
research on improved                               bodies.
methods of health service
delivery

Ensure implementation of                                                                                            Entry level
appropriate training on                                                                                             Step back training
Aboriginal and Torres                                                                                               programs before ITAS
Strait Islander health
including cultural issues in
all relevant undergraduate                                                                                          $5m over 5 years.
curricula.

Ensure that all new staff
and existing staff providing
services to Aboriginal
peoples and Torres Strait
Islanders complete a
relevant cultural safety
training/security
programme

Implement a program of
work place and work force
reform that implements a
model that is based on
care at the first level of
competence
Establish programmes that
increase the availability of
a multi disciplinary and
trans disciplinary
workforce at the local level
in Aboriginal and Torres
Strait Islander health




(b) Mental health/ social and emotional wellbeing workforce

Goal: Build an effective MH/SEWB workforce

TARGET                         PROCESS                       INDICATORS/TIME         INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                             FRAME By 2013           FRAME By 2018     FRAME By 2028     REFERENCE,
                                                                                                                         RESOURCES

Increase Indigenous            Promote parity for            Baseline measure                                            Ref: Ways Forward Report
mental health                  Indigenous mental health
professionals to 1:500         professionals across all      Yearly increments to
population                     mental health professional    profession/population
                               groups                        ratios to
                                                             50% by 10 years

                                                             Intake of students
                                                             Retention rates
                                                             Graduates
                                                             10-20 years


                               Establish recognition and     Baseline data
                               registration for Aboriginal   Agreed competencies
                               Mental Health Workers         Registration numbers
                               (AMHW’s)                      5 years
Increase competency of       Improve competency of        University curriculum       Ref: CDAMS Indigenous
mental health                the non-Indigenous mental    development in Indigenous   health curriculum
professionals working with   health workforce (students   mental health (IMH)         framework
Indigenous peoples           and staff) through           Agreed standards of
                             education and training.      competency in IMH
                                                          Cultural safety training
                                                          completed by all staff
                                                          5 years
INFRASTRUCTURE TARGETS (cont.)

(c) Housing, environmental health and health services capital works
GOAL: To immediately commence improvement of the most basic facilities within all existing Indigenous Australians’ houses to ensure safety and
access to critical health facilities.

 TARGET                          PROCESS                    INDICATORS/TIME                INDICATORS/TIME           INDICATORS/TIME           COMMENTS,
                                                            FRAME By 2013                  FRAME By 2018             FRAME By 2028             REFERENCE,
                                                                                                                                               RESOURCES

 Ensure the development                                     Within 2 years
 of a set of community
 level health service facility
 standards that are
 nationally agreed
                                                                                           Within 10 years.
 Ensure that all community
 level facilities meet the
 health service facility
 standards

 That adequate staff                                        Within 5 years
 housing is available

 Ensure that all community
 facilities have access to
 the appropriate equipment
 and technology necessary
 to delivery comprehensive
 primary health care to
 Aboriginal and Torres
 Strait Islander
 communities in a timely
 manner.

 Ensure immediate                  Use a standardised,      Critical healthy living        Assess that the goal of   Assess that the goal of
 maintenance of houses at          repeatable               practices* are available in    75% of all houses         75% of all houses
 time of assessment using          assessment of houses     75% of all houses              functioning has been      functioning has been
 a safety and health priority      based on the National    (*electrical safety, gas       maintained                maintained
                                   Indigenous Housing       safety, structural safety
 Use a majority of local           Guide (NIHG)             and access, working
 Indigenous teams for              principles of safety     washing, laundry and
 house assessment and              and health determine     toilet facilities, all waste
 maintenance                       the function of houses   water safely removed from
                                                    the house and yard, and
                                                    the ability to store prepare
                                                    and cook food)

Ensure that EHW are      Career pathways to all
provided with capacity   environmental health
development support      workers to move through
                         different levels of
                         competency

                         Develop support and
                         mentoring programs for
                         EHWs

                         Ensure new entrants have
                         appropriate numeracy and
                         literacy skills
INFRASTRUCTURE TARGETS (cont.)

(d) Data
GOAL: Achieve specified levels of completeness of identification in health records

 TARGET                         PROCESS                     INDICATORS/TIME              INDICATORS/TIME   INDICATORS/TIME   COMMENTS,
                                                            FRAME By 2013                FRAME By 2018     FRAME By 2028     REFERENCE,
                                                                                                                             RESOURCES

 Recording of Indigenous                                    Indigenous Australians                                           (See also Health Status
 status in every jurisdiction                               Identification in National                                       Targets, table 2.4)
 to achieve 80% accuracy                                    Datasets
                                                            2-5 years

 Define an Indigenous           The Federal Government
 Australians’ oral health       will resource the
 data set                       Australian Research
                                Centre for Population and
                                Oral Health to develop
                                and negotiate an agreed
                                Indigenous Australians’
                                oral health data set with
                                public dental providers,
                                NACCHO and the
                                Indigenous Dentists’
                                Association of Australia
Mr Gary Highland, National Director,
Australians for Native Title and Reconciliation,
introducing Ms Catherine Freeman and Mr Ian Thorpe.
Mr Gary Highland, National Director,
Australians for Native Title and Reconciliation
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