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Aboriginal and Torres Strait Islander Patient Registration to the PIP & PBS Co Payment 2
Cost
Cost of health services can affect the access of many people to health services. The following programs have been introduced to help address these issues:
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Practice Incentive Program- Indigenous Health Incentive: Provides financial incentive support to General Practice to provide comprehensive chronic condition care to Aboriginal and Torres Strait Islander people. Pharmaceutical Benefits Scheme Closing the Gap Co-payment: Provides financial support to Aboriginal and Torres Strait Islander people to access medication. Medical Outreach- Indigenous Chronic Disease Program (RDWA): Provision of health services in remote locations significantly reduces client cost in accessing specialist care where travel and time off work is required. Integrated Team Care: Provides support to clients via Supplementary Services funding, which provides conditional gap funding for consults with Specialist and Allied Health Providers, select medical aids and for transport and accommodation where health services are not available locally.
The Medicare Benefits Schedule also has Aboriginal specific items to address access issues. This is separate to the IAHP. These items include:
The 715 Preventative Health Assessment for Aboriginal and Torres Strait Islander people; Specific follow-up items for Practice Nurses, Aboriginal Health Practitioners and Aboriginal Health Workers; Specific follow-up items for Allied Health services that can be provided in addition to those allied health services available to eligible patients with chronic disease under MBS items 1095010970. Items for preventing the onset of, investigating the risk of or monitoring the progression of chronic disease in a patient. For instance, facilitating diagnosis and monitoring of diabetes as a part of the Quality Assurance in Aboriginal Medical Service (QAAM) Program items.
One initiative under the Stronger Rural Health Strategy, announced in the 2018-19 Budget, was the reform of MBS access for doctors. The aim of the reform was to reward investment in attaining general practice fellowship and encourage more doctors to work in regional, rural and remote areas of Australia. One part of this reform was to close the Other Medical Practitioner (OMP) programs to new participants on 1 January 2019. These programs were:
Medicare Plus for Other Medical Practitioners Program (MOMPs) Rural Other Medical Practitioners Program (ROMPs) After Hours Other Medical Practitioners Program (AHOMPs) Outer Metropolitan Other Medical Practitioners Program (OMOMPs)
The Stronger Rural Health Strategy also committed to providing extra funding to support Aboriginal and Torres Strait Islander Health Professional Organisations (ATSIHPOs). Over four years from 1 July 2018, $33.4 million is being provided to continue the role of four ATSIHPOs to support and develop an appropriately trained health workforce and improve service provision to Indigenous Australians. For further information, please click here.
There are a range of support services available to enhance the capacity of General Practices to deliver services that are culturally appropriate for Aboriginal and Torres Strait Islander patients. These supports are in the form of:
Tools and resources that can be implemented in the Practice; Access to Cultural Awareness and Safety Training; and Indigenous Health Project Officer knowledge, advice and support.
Resources
The RACGP
An Introduction to Aboriginal and Torres Strait Islander Health Cultural Protocols and Perspectives
RACGP Online Cultural Awareness and Safety Training
Five steps towards excellent Aboriginal and Torres Strait Islander healthcare
Five Steps Guide Five Steps Visual Poster Five Steps Summary Sheet
Department of Human Services
Indigenous Health e-Learning Program
Indigenous Health MBS Items e-Learning Program
Australian Commission on Safety and Quality in Health Care
User Guide for Aboriginal and Torres Strait Islander Health (National Safety and Quality Standards)
Improving Care for Aboriginal and Torres Strait Islander People
Integrated Team Care Resources
Indigenous Health Project Officers (IHPOs) provide support in building the capacity of mainstream primary health services to deliver culturally appropriate care. IHPOs can offer support by providing knowledge and different resources which are subject dependent. Cultural Awareness Training is provided throughout the year within local areas and your local IHPO can provide you with further information (please see below for contact details).
The IHPOs can assist General Practice through the Five Steps Process. IHPOs cannot undertake the work for a General Practice as it will require internal General Practice staff to complete any required changes.
Organisation
Far West & Lower Eyre
Contact Details
Port Lincoln Aboriginal Health Service Ph: (08) 8683 0162 Fax: (08) 8683 0126 Email: reception@plahs.org.au Web: http://www.plahs.org.au/ Service Location: 19A Oxford Terrace, Port Lincoln SA 5606
Upper Eyre, Far North, Flinders and Outback
Country and Outback Health Ph: (08) 8643 5600 Fax (08) 8642 3766 Web: http://cobh.com.au/ Service Location: 12 Chapel Street, Port Augusta SA 5700
Barossa, Gawler, Mid North and Yorke Peninsula
Sonder Ph: (08) 8209 0700 Fax: (08) 8252 9433 Email: info@sonder.net.au Web: http://sonder.net.au/ Service Location: 2 Peachey Road, Edinburgh North SA 5113
South and East
Moorundi Aboriginal Community Controlled Health Service Ph: (08) 8531 0289 Email: admin@macchs.org.au Web: https://www.moorundi.org.au/ Service Location: Ninkowar, Murray Bridge, SA 5253
The Five Step Process set out by the RACGP includes the following:
1. 2. 3.
4. 5. Prepare the practice Identify your Aboriginal and Torres Strait Islander patients Offer the patient an Aboriginal and Torres Strait Islander health assessment (MBS Item 715) and make arrangements for appropriate follow up Register eligible patients for the PIP and the Closing the Gap PBS co-payment Use appropriate clinical guidelines and programs from the RACGP, Medicare and PHNs to enhance access and quality of care.
These steps assist General Practice in implementing access initiatives for Aboriginal and Torres Strait Islander people.
Resources
Department of Health
Indigenous Health MBS Items e-Learning Program
Aboriginal and Torres Strait Islander MBS Item Cheat Sheet
Benefits for Aboriginal and Torres Strait Islander Patients of undertaking steps to improve access
Early detection of chronic disease and risk factors Aboriginal and Torres Strait Islander patients are eligible to receive annual Aboriginal and Torres Strait Islander Health Assessments. These help to screen for risk factors and identify chronic diseases that could be managed through medical treatment.
Local Aboriginal and Torres Strait Islander Outreach Workers may be available to organise transport or help organise attendance for patients at follow-up appointments and appointments with other health providers.
The Care Coordination and Supplementary Services Program provides a flexible funding pool to enable Aboriginal and Torres Strait Islander patients with chronic disease to access specialist and allied health services, as outlined in their care plan.
Improved access to affordable medicines
Accredited practices and practices working towards accreditation, including Aboriginal Community Controlled Health services, can prescribe more affordable PBS medicines for eligible Aboriginal and Torres Strait Islander patients with, or at risk of, chronic disease, and who meet the measure’s needs-based criteria.
Benefits for General Practices of undertaking steps to improve access
Additional resources
Accredited General Practices and those working towards accreditation are eligible to access significant additional resources through the PIP Indigenous Health Incentive.
Ability to prescribe PBS medicines that patients can afford, in order to continue treatment
Access to a variety of PBS medicines will help improve the prevention and management of chronic disease for Aboriginal and Torres Strait Islander people. The PBS Co-payment measure (CTG Scripts) is available for patients with, or at risk of, chronic disease who also meet needs-based criteria. Services that have the ability to complete ‘CTG Scripts’ usually have higher rates of Aboriginal and Torres Strait Islander engagement into their services.
