Yidaagay

We acknowledge Traditional Owners the Gumbaynggirr People and Elders past and present.

Darrundaygu

Becoming good for a purpose!

CONTENTS Chairperson Message 4 Board of Directors 6 Building Sustainability 8 Clinical Excellence 10 Health & Wellness 14 Business Excellence 18 Financial Audit 24

Chairperson Message

GIINAGAY NGUJAWINY

We are proud to present Galambila's Annual

Report for the 2015 Financial Year and the

achievements relating to this years theme

'Yidaagay Darrundaygu: Becoming good for a

purpose!'.

The continual improvements that have been made

throughout the year have resulted in a record

amount of Medicare Earnings on an ongoing

monthly basis, as well as a noticeable increase in

active clients and the number of visiting specialist

services.

All of which have contributed to greater enhanced

services for our community and further

complimenting Galambila’s overall Vision for

“Greater Choices for Our Mob to Improve Health for

All Stages of Life”.

Financial Highlights

This is the first General Purpose Annual Financial

Report aligned with the Australian Accounting

Standards and has been a result of improvements

in our Financial Management System to increase

financial accountability reporting to the Board and

its members. Highlights this year include:

7% increase in Medicare and Practice Incentive

Income

3.5% of income in retained earnings

Higher security in relation to the payment of

accounts

We are making major improvements toward

ensuring we achieve the outcomes as envisioned in

our “Towards 2017 Strategic Plan”, an in particular,

that “We Will be a Sustainable Business,

Maintaining Cultural Integrity Throughout”.

Focusing on the Future

At Galambila there has been a shift to focus on

young people. More and more of our activities are

within the schools and we will be establishing a

Youth Reference Group. To ensure a successful

future, we need to provide opportunities for Youth to

be engaged and valued within our Organisational

frameworks toward future growth. Currently 48% of

Our Clients are Youth (Aged 0-24), and our future

succession strategy will actively ensure that young

people will be actively engaged and working to help

shape the future of Galambila for Our Mob and

Community.

Investing in Growth

Although our major priority is on treatment and

primary health care, we are making major strides

toward a focus an intervention and prevention

processes (ie. Comprehensive Care).

Galambila is fast becoming recognized as a major

Regional Support for other AMS’ based on ‘Best

Practice’ throughout the Region. We currently

provide outreach support and associated program

service deliver to; Durri AMS @ Kempsey, Werrin

AMS @ Port Macquarie, Tobwabba @ Forster,

Darrimba Maarra @ Nambucca Heads and Birpai

AMS (Town Clinic – Port Macquarie).

All of which have expanded Galambila’s Footprint,

and has further highlighted how we have

strategically diversified and improved our services,

not only to our Mob here in Coffs Harbour, but has

been recognized and promoted across the Region.

Reuben Robinson, Chairperson

These include:

IT @ RAMS (Implementing, maintaining and

enhancing our IT Computer services to

Galambila AHSI and all of the above mentioned

Aboriginal Medical Services).

Regional Tackling Smoking & Healthy Lifestyles

Local Decision Making: (NSW Aboriginal Affairs

Strategy)

Mid North Coast Aboriginal Health Accord

(Ongoing Collaboration) in partnership with Mid

North Coast Local Health District.

Mid North Coast Regional AMS Alliance

(Ongoing Collaboration) in partnership with other

AMS’ (Ballina – Forster).

NDIS: The National Disability Scheme is a major

reform that is due to commence in Coffs Harbour

in 2017. We have decided invest in

enhancements to provide future services to our

clients that have a disability or a severe mental

illness. This is a major reform and Galambila are

fully committed to implementing a process

toward NDIS Accreditation and are working

diligently toward becoming a service provider for

our Mob.

To accommodate for increased services and

increased Staff, we are fast outgrowing our current

premises. We have finalised our design plans to

extend the reception area and anticipate that

constructions will commence in February 2017.

The new design will will accommodate for more

comfortable seating arrangements, tea/coffee

serving facilities and a designated play area for the

children. The new extensions will also increase our

general consultation rooms and potentially the

number of visiting specialists, and will greatly

contribute toward a more comfortable experience

when visiting Galambila for your health service

needs.

Recognition

Overall, it has been a very successful and busy 12

months with a substantial amount of work

undertaken by Galambila. All achievements

throughout the year would not have been possible

without good governance practices, strong

leadership between the Board of Directors and the

Executive Team, but most Importantly, the Very

Deadly and Dedicated Team of Health

Professionals and Administrative Staff that are

continually working toward maintaining and

enhancing our Aboriginal Medical Service, for All of

Our Community. Too Deadly!

“We Will Survive, We Will Thrive, We Will

Prosper -

Toward A Healthy And Empowered Mob”

Yaarri Yarraang

Reuben Robinson

Chairperson

Board of

Directors

Clark Webb Deputy Chairperson

Christian Lugnan Treasurer

Aunty Kerrie Burnet

Jen Cook Secretary

Christine Robinson

Diane Anthony

Julie Carey

Angela Cowan

Reuben

Robinson

$1,193

Julie

Carey

$477

Diane

Anthony

$404

Christian

Lugnan

$186

Christine

Robinson

$477

Kerrie

Burnet

$404

NAIDOC 2015—’On Sacred Ground’

Building

At Galambila sustainable development relates

to our capacity to uphold our organisational

identity as being Aboriginal Community

Control that specialises in meeting the needs

of Aboriginal people and their families now and

into the future. It takes into account our social

responsibility, the community and political

landscape and the financial impact.

We have a long-term agenda to undertake a

journey of continuous improvements to

empower our mob, including staff, increase

community participation and strengthen our

organisational structures. It recognises that

uncertainties exists, and that we need to be

flexible and that change is an ongoing

process. It also supports diversity and

differences within our community and

Galambila's workforce. Sustainable

development requires looking at the broader

picture and constantly thinking critically about

the fine tuning of the many parts of Galambila's

relationships and service components to

ultimately share these with our community.

At times we have to balance tensions between

identifying needs, developing strategy to

address these needs with scarce

resources. Our overall intent is to improve the

quality of life of our mob. We are constantly

thinking critically about fine tuning our practices

and relationship to meet the health and cultural

need of our clients and community.

Our Value Proposition

Operationally we have been striving to

demonstrate our capacity and capability to

provide the best possible service to our clients

and community. Areas we have been focusing

on include:

Excellence in Clinical and Business Practice

Culturally Appropriate Comprehensive Care

Building Sustainability

Towards Excellence

The Corporate Service Unit has achieved a

milestone and introduced a new financial

system allowing improved Budget Planning

processes and financial reporting. These

changes have allowed the Executive Team to

make informed decisions to the financial

Karl Briscoe Clinical Services

Manager

Paul Fernon Community Health

Manager

Peter McFadyen Corporate Services

Manager

Jon Rolph Regional IT

Manager

Sustainability

impact on any changes that are occurring to program and service

delivery.

It has been a year since the Clinical Service Unit introduced our new

practice model whereby the Aboriginal Health Worker Workforce

provide frontline services. Over the last twelve (12) months we have

seen the benefits of this practice in the increased Medicare revenue

and much improved quality of data.

The redesign of our Tacking Indigenous Smoking Initiative by the

Community Health Services Unit has had an immediate impact through

providing Smoking Cessation advice on a one-to-one basis and

increased focus toward young people with the Health Promotion

activities being well received in Schools from Coffs Harbour to Port

Macquarie. Mental Health Services maintains its stability even though

we recognise it is under resourced.

Our journey towards excellence continues through a systems approach

to provide improved healthcare to our clients and community.

Kristine Garrett

Chief Executive Officer

Clinical

Excellence

Throughout 2015/2016 year Clinical services have

ceased the Statistics indicate that there has been a

great deal of need for this service not only to assist

our GP with the treatment of clients by undertaking

Clinical checks with an added bonus of generation

of Medicare income which was reinvewsted back

into the organisation.

Evidence indicated that there was a great deal of

need for this service not only to assist the GP with

the Clinical checks, however to assist clients with a

more comprenhensive approach to their care whilst

accessing health care at Galambila. Work continues

to refine the process with constent evaluations

being undertaken by:

Aborignal Health Practitioners/Workers

General Practitioners (GP’s)

Nurses

Pharmasist

Receptionist

Cultural Integrity Throughout this year we have been focused on the

delivery of high quality health care for our clients

with respect being given to the cultural integrity of

the organisation.

The clinic ensures local customs and protocols of

the Gumbaynggirr nation are respected and abided

by the organisation. Some of the many ways in

which clinical services have implemented strategies

within our work environment include:

Conducting language classes/questionnaires as

part of staff development days

Signage on the front clinic door along with

telephone message

Undertaking a Smoking ceremony with all staff

and buildings within the organisation.

All new General Practitioners Registrars who come

and work for Galambila undertake a localised

cultural orientation in order to provide a more

comprehensive cultural understanding of the

community’s history. opportunities to further

enhance and refine our client’s health journey

through the clinic. With the main objectives of the

Clinical team in providing ‘Excellence in Clinical and

Business Service’ for clients. We continue to

evaluate our progress in order to provide the highest

possible level of Clinical care for our community.

Galambila staff involved in providing Clinical

services included: Doctors, Nurses, Pharmacist,

Aboriginal Health Practitioners/Workers and

Receptionists.

Our Community and Clients Aboriginal and Torres Strait Islanders people make

up 4.1 % of the population within Coffs Harbour and

surrounding areas, equating to 2,820 of the total

population of 68,415. Galambila’s reputation

through clients narrative as the preferred service

provider for Aboriginal and Torres Strait Islander

people, with 85% of the total client population

accessing the service more than 3 times over the

past 12 months.

During the 2015/2016 year a total of 3,117 clients

accessed Galambila staff for Health care. There

was around 31,400 Episodes of care provided to our

clients throughout 2015/2016. Figure 1 breaks down

our male and female clients being distributed across

the age groups with the largest being the 0-14 age

bracket.

Figure 1 Client Age Distribution

Client Arrival and Departure Time Averages Over the 2015/2016 year we have seen client

average wait times increase and decrease

throughout the year. Figure 2 outlines the monthly

wait time fluctuations, what the data is suggesting

the highest wait times is in the months August and

February. The major factor behind these months is

the commencement of new GP Registrars with

Galambila and them coming up to speed. As Figure

2 also illustrates the average wait times is lower in

the afternoon which is when we have booked

appointment for our clients

Figure 2 - Average Arrival / Departure Waiting times

Introduction of New Practice Model Major focus areas for this year include the

introduction of a new Practice Model with the first

point of clinical care for clients in seeing an

Aboriginal and/or Torres Strait Islander Health

Practitioner / Health Worker. Clients have

commented on how good it is to have an Aboriginal

Health Worker as their first point of clinical contact.

The standout of achievements during the 2015/2016

year in comparison to the 2014/2015 achievements

was the lifestyle health information that was

captured. The screening of clients for Smoking,

Alcohol and Physical Activity status meant referrals for brief intervention

were able to be arranged. This approach allowed Galambila staff to

address the unhealthy lifestyle conditions in order to prevent chronic

related conditions.

Figure 3: Lifestyle Factor Comparisons

Building Clinical Competency Galambila consistently abides by the clinical standards which are set

through the RACGP and accredited through AGPAL. By undertaking a

continually quality improvement approach to the way in which we

undertake our clinical business we consider our practice to be evidence

based best practice standards. All Clinical staff at Galambila abide by

the Chronic Conditions Manual 1st Ed 2015 which sets standards of care

which are evidence base best practice.

Operational Excellence Throughout this year we have completed a total of 1107 Health

Assessments in comparison to 960 in the 2014/2015 year (see figure 6).

By undertaking Health Assessments allows a comprehensive approach

in order to address identified health needs of our clients.

This was coupled with 1391 GP Management Plans/Team Care

Arrangements and Reviews activities being undertaken throughout the

year (see figure 6)

Figure 4: Yearly 715 Health Assessment Comparison

Figure 6: Yearly GP Management Plans and Team Care Arrangements and Reviews, Numbers and Income

Our Staff and Workplace Clinic staff employed at Galambila in a Fulltime

Equivalent capacity includes:

1 x Principal General Practitioner (GP)

3 x General Practitioners (GP’s)

2 x Registered Nurses

1 x Allied Health Practitioner (Pharmacist)

5 x Aboriginal Health Workers

1 x Aboriginal and Torres Strait Islander Health

Practitioners

4 x Reception staff (Including trainee

receptionist)

University student placements Galambila continues to host Medical students from

the University of Western Sydney with 5 students

attending placement at Galambila throughout the

year. This experience enables them to gain a

greater insight into the working environment of an

Aboriginal Medical Service with the hope of enticing

them to work in Aboriginal Health post completion of

their studies.

Outreach Services Galambila has now completed 12 months of

managing the Rural Doctors Network (RDN)

contracts which provides our clients access to

Specialist and Allied Health services in order to

assist in addressing the identified Health needs.

Services Provided through RDN Include:

Asthma Educator

Cardiac Educator

Child and Adolescent Psychologist

Dietitian

Endocrinologist

Exercise Psychologist

Fitness Instructor

Podiatrist

Psychiatry

Psychology

Group Social Worker

Gunnumba Consulting

Nurse

Aboriginal Health Worker

Health and

Galambila’s community health programs contribute

to the prevention, early detection and self-

management of illness and disease. The

Community Health team delivers:

Social and emotional wellbeing, mental health

and substance misuse programs

Preventative programs for smoking, nutrition,

physical activity, Elders health and chronic

disease

Programs for the early detection of kidney

disease, ear health, hearing and vision problems

The third year of operation for Galambila’s

Community Health Team was a very successful

year. Highlights included:

Successfully tendering to continue to deliver the

Tackling Indigenous Smoking program until 2018.

This program now only focuses on smoking as

the Commonwealth Government decided to

discontinue the healthy lifestyle component of the

previous program.

Commencing a drug and Alcohol support

program (2 days a week) with new funding

through the Commonwealth Medical Outreach

Program.

Expanding the spring into shape chronic disease

prevention and management program to 5 days a

week for 20 weeks. The program now includes 3

exercise sessions, nutrition and cooking and the

weekly Guunumba Support Group.

Successfully developing proposals to deliver two

mental health system’s improvement projects for

the North Coast Partners in Recovery program.

Social emotional wellbeing

The Community Health team deliver an integrated

primary mental health care service that provides

clinical interventions, community-based recovery

support, care co-ordination, employment services

(provided by CHESS), and comprehensive physical

healthcare and preventative health programs.

Services provided in 2015/16 included:

A total of 1963 clients contacts by our

Aboriginal Mental support Health Workers

180 Psychiatry consultations

680 psychology sessions

168 Drug and alcohol counselling sessions

75 employment and vocational support

consultations

Wellness

The Mental Health Support, Drug and Alcohol

Support and Partners in Recovery programs

provide intensive mentoring, support and care co

-ordination to approximately 40 clients. As clients

graduate from the programs, new clients can

come on.

The System’s Improvement Project team

developed a Coffs Aboriginal Mental Health

System improvement plan that was provided to

the Mid North Coast’s IMHpact service delivery

group for consideration. To develop this plan, the

project team conducted an Action Learning

project with Ontrack Community Programs, and

completed narrative enquiry sessions with 9

organisations involved in mental health service

delivery.

The team also conducted narrative enquiry

sessions with 38 community members about

their experiences, and consulted with 9 youth

organisations and schools and 72 youth about

youth service delivery issues.

Tackling Indigenous Smoking Program

READY MOB successfully tendered to continue

delivering until 2018 and have set an ambitious

target to work with the community and

stakeholders to achieve a 15% reduction in

Aboriginal smoking rates in the Mid North Coast

by June 2018.

The 2015/16 program outcomes included:

Provided smoking cessation education and

brief interventions at 55 community and school

events across the region. 6792 community

members (client contacts) received brief

interventions or participated in education at

these activities.

The team conducted 292 Get Fit and Quit

Program sessions across five locations (Coffs

Harbour, Port Macquarie, Nambucca,

Kempsey and Port Macquarie) during the

reporting period. There was a total of 3936 client

contacts through these sessions.

On 12 December 2015 the Ready Mob team

delivered a fantastic event called the READY

MOB fitness challenge. Five teams and over

120 people from across the Mid North Coast met

in Scott’s Head to participate in a gruelling

regional fitness challenge and to celebrate

healthy lifestyles.

A total of 140 people received smoking cessation

support through Stop the Juums program. 99

smokers registered with the smoking cessation

clinic at Galambila and attended appointments

between February and June 2016. This is about

10% of all current smokers at Galambila.

Designed and selected service providers to assist

the team to implement two community based

social marketing campaigns: 1) youth tobacco

prevention and 2) Second-hand smoke. These

campaigns will be integral to our program

implementation over 2016-2018.

Developed and delivered a campaign about

Nicotine Replacement Therapy (NRT). This

included providing free NRT to all adult smokers

on request and creating three short films with local community

members that had over 7000 views on Facebook.

Health education and interventions

Community Health deliver priority clinics and programs that contribute to

early detection and self-management of illness and disease.

Health education, intervention and education programs included:

Spring into Shape (including fitness, cooking, nutrition and Guunumba

Group Support) and Elders Health Days

Ears and Eyes School Program

Ear Health and Hearing Clinics and Audiometry

Kidney Health and Nutrition clinics

One Deadly Step

The program outcomes included:

172 Spring into Shape Program session were conducted with a total

of 48 program participants. There was a total of 1687 client contacts

over the program.

13 Ear Health and Hearing screening clinic were conducted including

4 outreach clinics held at local schools. 145 children had hearing and

ear health screening tests as a part of these activities. 89 clients were

also seen by an Audiologist for follow-up.

4 Kidney health screening clinics held over the year. A total of 36

clients attended these clinics.

12 Elder’s health day activities were held over the year. An average

participation of 16 Elders attending each session. In June 2016 day a

very successful day with 50 Elders from Yaegel, Bundjalung and

Gumbaynggirr country attending.

Over 400 people attended

the One Deadly Step event

which included 125 people

completing the

comprehensive health

screening activities on the

day. 87% of people that

completed the screening

activities were Aboriginal

and 72% of those screened

choose Galambila as their

preferred health provider for

any follow up.

Business

Excellence

The Corporate Services Team performs a variety of roles including

Finance, Human Resources, Industrial Relations, Workplace health and

Safety, Transport, cleaning and maintenance.

Following are the major goals we have achieved this year:

Skilled and deeply knowledgeable workforce

Improved and facilitated the Annual Performance Assessment’s used to

better capture performance requirements and development

opportunities for staff.

Presented the new EA to staff and initialised staff committee to help

develop knowledge of the process among staff and to produce a better

outcome on the EA

An Empowered Mob

During the year our trainee cleaner successfully applied for a full time

position at Galambila. We will now engaged a new trainee to again

provide employment opportunities for our mob.

Excellence in business and clinical practices

Reconfigured general ledger to match our financial system to our

business needs and allow more meaningful reporting.

Developed monthly internal reporting and

forecasting to management and Board, which

provides monthly information on our financial

performance to date and for the rest of the year.

(Our auditor stated that this was by far the most

advanced and informative reporting she has seen

in any AMS)

Finalised our conversion to a general purpose

financial reporting format for our Annual Financial

Statements to allow consistency or presentation

and inter-year comparison

Digitised the HR records to enable better tracking

and improve confidentiality

Worked with the Clinical Services team to make

our transport more responsive to client needs

Extended GPS coverage to the rest of our fleet to

improve the safety of our staff

Embedded the new AGPAL compliant cleaning

methodology to meet infection control

requirements

Best use of resources

Our new Telstra set-up is working well and has

reduced our call costs.

Our new electricity deal is working well and is

saving us money on electricity.

Development Application approved for the

building extension

Growth at a glance for the 2012 to the 2015 financial years Income (in $Millions)

Staff Numbers (as at end of fin year)

Some statistics from the Corporate

services area

Transport - In 2015/2016 our drivers assisted

7,297 clients with their travel to and from our

clinic, specialists and the hospital.

Cleaning – In 2015/2016 our cleaners have

provided over 58,000 scheduled cleaning items.

Finance – during the year we processed over

$2,056,000 worth of payments and paid out over

$4,592,000 in staff costs.

Human Resources – During the year we

recruited 22 people to full time, part time, fixed

term and casual positions and our overall

numbers grew to 50.

Key Performance Indicators

Percentage of revenue sources

Number of IT staff

IT@RAMS is a regional service based at Galambila. It works with a consortium of Services made up of Durri, Biripi, Werin, Tobwabba and Galambila. It provides the following:

IT Support

Provision of a dedicated IT Helpdesk

Monitoring and maintenance of IT hardware and software

Replacing hardware on a scheduled, regular, basis

Upgrading and implementing new hardware and software

Reporting on service levels

Information Management Support

Providing clinical and operational reports

Assisting in the analysis, documentation and improvement of clinical and operational processes

Providing training in priority areas (e.g.

induction)

IT/IM Management

Contract manage IT/IM vendors

Manage IT/IM project

Develop and maintain IT/IM governance processes

Provide advice and guidance in relation IT/IM matters

The services provided by IT@RAMS are governed by a Memorandum of Understanding between the consortium members.

Financial Stewardship

Resources were managed to ensure the maximum benefit to the region within the budgetary constraints set by the Department of Health and IT@RAMS Memorandum of Understanding.

This included:

Implementation of Office 365, providing a more flexible platform for communicating within and between Services

Development of Intranet sites for all Service and deployment to two, with the other Services preparing to deploy

Upgrade and improvement to the technology that delivers access to applications

Upgrading the operating systems on all computers including PCs, Notebooks and Servers

Deployment of new backup software to local and remote backups

Figure 1: Staff Inductions

Enhancing the capabilities of the Business Continuity solution

Create a new Disaster Recovery capability to provide a fully redundant capability

Provided a secure file storage area where files can be shared with third parties

Upgrade the Tele-Health system

IT@RAMS retained a small surplus at the end of the financial year to be available to support services in 2016/17.

Staff & Workplace

Training developed and delivered 12 new user guides and procedures were developed and published. Their subject areas included:

Office 365

Medical Director

Pracsoft

Pen CAT

Vidyo

32 staff inductions performed. This is consistent with the previous year but incorporated a wider

range of roles. (Figure 1) 43 other staff training sessions were provided, again to a wider range of staff and subjects (Figure2)

Out of hours’ support

The implementation of 24x7x365 monitoring of the

IT environment was introduced at the start of the

year. It has been responsible for the resolution of

incidents overnight or at weekends, resulting in

avoidance of outages impacting staff and clients.

Focus on data quality

During the year there has been a greater focus on

data quality with the initiation of quarterly quality

reviews with key clinical staff.

Challenges

The bi-annual reporting for the Department of

Health underwent some major changes during the

year that resulted in considerable additional time

and effort on behalf of IT@RAMS and the wider

organisation. Warranty

Figure 2: Staff Training Sessions

Community & Clients

Through the IT@RAMS managed service a total of

4,455 instances of support were provided. These

was spread across the sites within the IT@RAMS

region

The support are further broken down by month and category below

The priority of each incident, with 1 as the highest,

represents the impact and scale of issues

encountered. Below is a breakdown of incidents

by month and priority.

You will see that there is a peak of incidents

between November and March. This was the

period of highest project activity, causing some

additional disruption for users.

* Galambila includes all tickets that impacted more than one site

Vision for the next year

Keep Galambila and IT@RAMS at the forefront of clinical and technical

best practice within the Community Controlled Health Sector and to

support innovation in health care. In particular:

Deploy an on-line training service

Embrace the opportunities created by MyHealth

Look at new ways of engaging with, and supporting, our Clients

Galambila Aboriginal Health Service Inc.

FINANCIAL AUDIT

2015/16

Galambila Aboriginal Health Service Inc.

Clinic: (02) 66520800

Cnr Harbour Drive & Boambee StreetCoffs Harbour, NSW 2450

PO Box 4186Coffs Harbour, NSW 2450

www.galmbila.org

www.justgiving.com/galambila

Opening TimesMonday to Friday8:30am to 5:00pm