ALPINE HEALTHANNUAL REPORT HIGHLIGHTS2009 - 2010

Contents

Highlights 3

Volunteers 4

Community Involvement 5

Scholarships 6

Financial Highlights 7

Professional Development 8

Healthy Communities 9

Services 10

Aged Care 10

Your Hospital 11

This financial year has been a challenging and difficult time

for Alpine Health. Our revenue base improved overall during the year with increased income from inpatient and outpatient fees. Grants from the State government increased while grants from the Commonwealth remained at similar levels to the last financial year. Costs continued to rise in line with the previous financial year, and we again experienced real cost pressures arising from the 2007 Nurses Enterprise Bargaining Agreement.

As a result it became necessary to develop and

implement a plan to rebalance our costs with our

income. A number of cost-cutting measures were

initiated in October and November 2009, and these

brought the 2009/10 operating financial result much

closer to our target of zero deficit.

The recovery plan was developed in accordance

with Alpine Health’s Service Plan. This was to ensure

that our front line services would remain secure.

The three major components of the plan comprised

a restructuring of Alpine Health’s administration

and senior management; the contracting out of allied

health services and the establishment of infrastructure

relationships with Goulburn Valley Health and North

East Health in Wangaratta. We are expecting this

recovery plan to return the organisation to a surplus

position in the 2010/2011 financial year, although this will

be very dependent on how an ongoing issue of the funding

formula for the 2010 rounds of enterprise bargaining is

resolved.

Our experience of the last two financial years have

clearly shown how vulnerable Alpine Health is to changes

in the wider economic, financial and social environment.

The value of planning for the future has been clearly

vindicated: the components of the 2009 financial recovery

plan had its basis in our Service Plans since 2002. We

expect that the financial pressures will continue, and

the Board is considering further strategies to protect

the security of Alpine Health’s services into the future.

These strategies are outlined in Alpine Health’s fifth

Service Plan (2010-14), and include the possibility of

further mergers and amalgamations of existing services,

as well as implementation of new services that have

clear sources of revenue, such as medical and nurse

training.

During the course of these disruptions, the

commitment and dedication of staff members,

volunteers and Board members have made it possible

for Alpine Health to deliver high quality services to the

community while continuing to implement our Service

Plan. We were also able to

review and update all of our

disaster planning processes

during this period, in

preparation for an uncertain

future.

Yours sincerely

Judy Barlee

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A message from the Board of Management Chair

The full report is printed in the 2010 Annual Report

Highlights

New Services

Alpine Health’s fifth Service Plan has been endorsed by

the Victorian Department of Health (formerly the Department of Human Services) and the Commonwealth Department of Health and Aged Care, with approval being extended from three to five years. This provides Alpine Health with a longer period to develop new services.

A significant proportion of service development this year was planned, led and delivered by volunteers, and it has been gratifying to see such strong support of volunteerism re-emerging in our communities.

The establishment of an Autism Spectrum Disorder Support Group in the Alpine Shire.

Consolidation of Men’s Sheds in Bright and Myrtleford.

The advancement of work to establish an Aged Care advocacy service.

A commitment to ‘Cancer Connect’ by our Cancer Support Groups.

Life Transition Planning (future care planning).

An agreement with the Dinner Plain community to establish a community-based first aid service to meet identified needs.

A draft discussion paper on the development of integrated family violence services in the Alpine Shire was developed.

A new plan for securing Adult Leisure Group services in the Bright community.

A Sustaining General Practice strategy.

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Management frameworks for people suffering from cancer, depression and anxiety were completed.

An operational plan for mental health in early Intervention services.

In the coming year, Alpine Health will progress further with its work in support of carers and the consolidation of community and volunteer services, especially in Cancer Support and Autism.

A new birthing system for our obstetric services in conjunction with three other hospitals in North East Victoria.

A $93,000 grant from the Department of Health for digital medical imaging equipment for Bright and Myrtleford.

Future

Improvements in governance processes including a revised handbook for Board members.

Extending the role of the Audit Committee to encompass risk management, disaster and bushfire plans.

Support for general practice registrars.

Funding to test the feasibility of medical intern training in the 2011 academic year.

A strengthened relationship with Tayside NHS Trust (Scotland) through staff exchange.

A funded program for educating nurses through the Nurses Board of Victoria.

Expansion of the MPS program, in particular, a new allocation of specific capital funding for local sub-acute services.

Community leadership and support for the redevelopment of the Bright Hospital and state government announcement of $150,00 to review a master plan.

Investment in leadership training programs for staff.

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VolunteersMount Beauty

The Bright Hospital Opportunity Shop continues to trade successfully

in both areas. We are very grateful to the men and women who man the shop and to the general public who purchase and provide goods for sale so that some of the proceeds can go towards providing equipment for Bright Hospital as necessary.

This year we have also been able to provide TV equipment for Hawthorn Village and games for the Bright Hospital Alpine Leisure Group which have been appreciated by staff and clients.

We look forward to another year of service to the hospital and the community.

The Mount Beauty community

raised $24,500 to help purchase Endoscopy equipment.

The generosity of the local community has allowed Alpine Health to purchase the latest up to date endoscopy equipment.

This is an important step in providing the service locally and minimise the need to travel outside the Shire.

Bright Hospital Op Shop

Myrtleford Hospital Op Shop The second full year of trading in the new shop at 86 Standish Street Myrtleford resulted in a slight

increase to that of last financial year’s income.Donations from local and nearby areas continue regularly with any surplus goods passed on to other charities.

The Op Shop would not be able to operate without the dedication of its enthusiastic group of 10 volunteers who work regularly to ensure the goods that are on sale are clean and in good order. We are indebted to each of them for their continued support.

The customers appear to be pleased with the prices and minor problems with theft are kept under control. Some difficult situations have been referred to the local police who have provided us with valuable assistance over many years.

Jean Ellis

Hawthorn Village nurse unit manager Vicki Southgate with Op Shop volunteers Leila Waldron (Treasurer) Jan Barker, Heather Selwood, Betty Seeley (Secretary) and Barbara Davey (President).

Ron Fenshem, Joy O’Connor, Dennis Wykes, Nick Brown, Trish Dixon, Naomi Piazza, Judy Hamilton, Ian Docking, Angela Toniolo and her son.

Jean Ellis has been managing the Myrtleford War Memorial Hospital Op Shop for over a decade.

Betty E Seeley / Honorary Secretary

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Alpine Health supports and empowers specific

groups within the Alpine Shire to address their own community and health needs through the provision of information, support and care. There is recognition that these community groups enable local people to contribute to decision making and drive change. Groups include the Upper Kiewa Valley Cancer Support Group, Bright Cancer Support Group, Myrtleford Cancer Support Group, the Bright Men’s Shed, the Myrtleford Men’s Shed, and the Mount Beauty Men’s Shed, Mount Beauty Dementia Support Group and Myrtleford Diabetes Support Group.

Highlights

A Cancer Connect Forum in April 2010 involving

a working group from the combined Cancer Support Groups was held to raise awareness and to recruit volunteers for the Alpine region. The Autism Support Group is working towards an “expo” event in 2011 to raise local awareness of autism.

The Mount Beauty Dementia Support Group restarted in April 2010 with a volunteer facilitator.

Steering Committees and reference groups involving consumers and community members have been established in the team Midwifery Program initiative and in the Rural Adolescent Program.

In 2009, the Alpine Health Board of Management

decided to expand the planning process by inviting a wider range of stakeholders to participate in its implementation planning. Participants included Community and Health Advisory Groups, community members, board and staff members, and representatives from a wide range of local and regional health, local government and community service agencies. The aim was to identify priorities and strategies for the 2009/2010 financial year and the first implementation plan for Service Plan 5.

A Service Planning Day was held on 26th March 2010 which saw the Community and Health Advisory Group (CHAG) and local community members in attendance. A separate meeting was held with Bright community members and CHAG working together on a redevelopment plan for Bright Hospital.

The three Community and Health Advisory Groups

are based within the Bright, Myrtleford and Mount Beauty communities. These groups are led by community members and their work is focused on service development, based on the principle of meeting local health needs.

Reporting on service planning and improvement issues is directed to the Board and this assists with the community consultation components of the service planning process ensuring relevance and responsiveness to the needs of specific communities.

Alpine Health Community and Health Advisory Groups are actively engaged in health promotion activities including Men’s Health and Community Support Services, Cancer Support Services and the development of support for families with autism.

Community InvolvementSupport Groups Board Planning

Community and Health Advisory Groups

Bright Autumn Festival NAB Young Ambassadors donate $3,660 to the Alpine Autism Support Group: From Left: 2010 Winner Alanah Tesoriero, Sera Paterson, Kate Henstridge, Leonie Gerke, Leanne Novak (Alpine Autism Support Group), and Sandra Gourlay (Alpine Health).

Alice Bellingham 2009 Winner Mark Robinson Scholarship for Rural Health

I would like to thank Mark Robinson and his family, Alpine Health and all those involved

with the Mark Robinson Scholarship. You have allowed me opportunities that have improved my academic capabilities and will increases my sense of fairness and humanity and my awareness of the diversity of health needs.Around six months ago I was awarded the 2009 Mark Robinson Scholarship. This Scholarship has allowed me many things but most importantly has reinvigorated my passion for studying Medicine at the University of Newcastle, it had allowed me to focus whole heartedly on my studies and take up some of the fantastic

opportunities allowed in my course. This time next year we have an 8 week placement focused on health equity. Our objective is to visit a community that experiences a health disadvantage due to a remote location, alcohol and substance abuse, and low socioeconomic background. I plan to spend my placement in the Torres Straight Islands with the

outreach program that visits the communities on the remote islands of that area, visiting communities that only receive heath care when a visiting doctor arrives with this program. Without this scholarship I would not have had the means to attend a placement so far away, and I would not be able to experience such heath inequity and I thank you very much for this opportunity. I am sure this will have a lasting effect on myself and the way in which I provide health care in the future.I have also been able to purchase many text books and Neurological assessment tools such as reflex hammers and tuning forks without the stresses of having to scrimp and save. You have allowed me the freedom to enjoy my time at University and for that I am endlessly grateful. Thank You.Alice Bellingham

ScholarshipsFaisal Sabih 2009 Winner of the Otto Schmalz Memorial Scholarship.

I would like to thank the Otto Schmalz family and the Alpine Health Board

of Management for their kind generosity in awarding me the 2010 Otto Schmalz Memorial Scholarship, and accordingly enabling me to undertake and continue my studies for a Masters in Science (Diabetes Education). This year has seen me undertake some interesting studies to include Health Research Methods, Chronic Illness, Health Project Preparation and Chronic Diseases Management.

In essence, the Otto Schmalz Memorial Scholarship has provided me with much needed financial relief to meet university course costs.

I hope to complete my studies mid next year and to incorporate learned knowledge and skills into the care and management of diabetes and its associated chronic illness co-morbidities. Also to continue in the support and provision of optimal nursing care for Alpine Health clients in the aged, acute and emergency health care settings and other Alpine Health initiatives across the local and culturally diverse communities.

I am optimistic about the future health directions of our unique region and communities and to being able to provide diabetes specific clinical nursing expertise, support, care and education for peers, clients and the community.

Once again, my thanks and appreciation for the Otto Schmalz Memorial Scholarship and to honouring the late Otto Schmalz’s memory, dedication and commitment to championing the Alpine Region’s communities’ health and wellbeing interests.

Faisal Sabih

Financial HighlightsHighlights

Alpine Health recorded a much improved financial operating surplus of $65,000

compared to the previous financial year’s large $591,000 operating deficit, following the implementation of a recovery plan in late 2009. This financial recovery strategy proved to be very effective in tackling an expanding deficit, especially as the difficult operating conditions of the Global Financial Crisis (GFC) continued to impact the organisation.

During the financial year, Alpine Health maintained and built revenues and services with a particular focus on containing and reducing costs where possible.

The net result, which is a less indicative measure of Alpine Health’s financial performance as it includes unfunded depreciation, was a $1,797,000 deficit compared to a $987,000 deficit for the previous financial year.

The major reason for the increase in the net deficit was a large rise of $1,260,000 in the depreciation charge following the revaluation of assets in 2009 by the independent Valuer-General.

Operating Revenues

Operating revenues rose 5.3% to $19,861,000 with the main contributors

to the increase being Government grants up by $526,000 (3.3%) and Patient & Resident Fee Income rising by $319,000 (13%). State government funding increased by about 4% for funding of service development projects and increased employment costs. Commonwealth grants increased marginally by $81,000 (1.8%).

A shorter average stay and a rise in the total number of acute patients treated, combined with substantial increases in pension rates – to which residential fee income is tied - were the main factors in the 13% increase in Patient & Resident Fee Income.

Capital Purpose Income fell to $565,000 from $636,000 last year (11.1% decline) as a result of a fall in interest income from lower GFC interest rates, and Donations & Bequests returning to average levels after targeted fundraising initiatives increased the donated amounts in the previous financial year.

Operating Expenses

The increase in Operating Expenses was contained to $356,000 (1.8%). Despite

average wage rises of 3.25% during the year, Employee Entitlements – which at $15,319,000 comprise 76% of Alpine Health’s total $20,154,000 operating expenses – rose by only 2% due to the restructure recovery plan implemented in late 2009. Most other expenses were restricted to similar levels to the previous year, except for Visiting Medical Officers’ Fees which rose by $159,000 (12.9%) due to fee increases and Fuel, Light & Power which increased by $34,000 (8.3%). The increases in these expenses at greater than the inflation rate was expected.

Capital Expenditure

Capital expenditure of $410,000 included digital X-Ray medical

equipment, nurses’ call system and patient beds and chairs partly funded by government capital grants and the $106,000 in donations from the community and Op-Shops. The final $10,000 capital grant for construction of the Bright United Men’s Shed was received from the State Department of Planning & Community Development.

Included in the financial accounts was a small deficit from Alpine Health’s proportional share of the operations of the Hume Rural Health Alliance, a joint venture of Hume region health services which primarily coordinates Information & Communications Technology initiatives.

The cash position of Alpine Health remains sound with Total Financial Assets of $4,487,000, comprising Cash & Cash Equivalents of $1,456,000 and Other Financial Assets of $3,031,000.

Lyndon Seys

Alpine Health CEO

Staff members are strongly encouraged and supported to maintain current and develop

new skills through professional development and training opportunities.

Staff Leadership Course

Thirty Five Alpine Health staff have been provided with the opportunity to attend two

high performance leadership programs delivered by Steve Griffith from Griffith Consulting Group.

The six month self directed learning program focuses on leadership development, incorporating health and wellbeing, personal and organisational change and team building.

The leadership participants came from a broad range of roles across the organisation ensuring that leadership development reached all parts of Alpine Health.

Those staff who successfully completed the program in 2009 are Nick Shaw, Maureen Ryland, Lisa Neville, Kate Duff, Lyndal Newton, Lisa Prior, Rick Salsibury, Matt DeNatris, Josie Hendricks, Susan Pack, Vicky Southgate, Jenny Stott, Rob Taylor, Mandy Barter and Joy O'Connor.

Professional Development

IRON / RTP courses

Alpine Health, with certification by the Nurses Board of Victoria (NBV), offers

an Initial Registration Overseas Nurses (IRON) course and a Return To Practice (RTP) course. These courses are applicable for Division 1 & 2 nurses that have been deemed suitable for the appropriate course, by NBV.

The IRON / RTP courses aim to; Provide participant’s an opportunity to refresh/update their clinical skills in a progressive and nurturing environment under the supervision of a clinical nurse educator supported by preceptors. To contribute to the long term sustainability to the nursing workforce in Australia.To facilitate the registration of nurses who have been trained internationally and are wishing to practice in Australia.To facilitate the re-entry into the workforce of nurses who have had break in practice.

This program ensures the appropriate preparedness for commencing safe nursing practice with a mix of clinical placement and theory as expected of the beginner nurse in Victoria.

Staff Pedometer challenge

The initiative to conduct a staff pedometer challenge originated from results of the Staff

Health and Wellbeing survey. Groups from all three sites registered to compete. A pedometer challenge sub-committee was formed

from the Health Promotion Working Party. All participants were provided with a starter kit

including developed resources, pedometers and a drink bottle.

146 participants competed in the six week challenge. It is envisaged this will become an annual event.

Blood Transfusion training

A Blood Transfusion Training Course was attended by Alpine Health Staff with the

intent to impart the knowledge gained, targeting nurses and doctors.

A self directed learning package has been developed predominantly for people, to provide a greater awareness of blood groups, products and compatibility.

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In 2010 High Performance Leadership Coach Program consultant, Steve Griffith, handed out certificates of achievement to: (left back) Primary Care Manager Trevor Marshall, Mary Newland, Sharon Short, Justine Inglis, Gill Graves, Sally Coates, Dianne Dickenson, Lee-Anne Winiata, Jane Newland, Caron Oakley, Mary-Jane Gilmore. Front (Left) Annemarie Armstrong, Christine Kruger, Sonia Hines and Wendi McClelland. Absent; Julie Reilly, Lucien Deane-Johns, Kerri Stewart and Veronica Baxter.

Healthy Communities

Myrtleford Men’s Shed

With Alpine Health support the Myrtleford Men’s Shed formed a Committee of

Management with meetings being held and run by the group independently.

The 9 committee of management members meet on a fortnightly basis.

The group held their opening on the 6th October, 2009, where 23 men attended.

The shed is open every Tuesday and Thursday from 10.00 am – 3.00 pm and provides a growing sustainable avenue for social connection between older men.

Mt Beauty Youth Centre

Due to requests by young people and community members, Alpine Blue

Light and Alpine Health have combined to provide a youth space in Mount Beauty.

Operating from the Lakeside community care building the youth space offers a time and a place for students of Mount Beauty Secondary College to catch up and socialise after school on Tuesdays and Wednesdays.

Cancer Support Group

A Cancer Connect Forum in April 2010 involving a working group from the combined

Cancer Support Groups was held to raise awareness and to recruit volunteers for the Alpine region.

Life! Taking Action on Diabetes

The first session of the Life! Taking Action on Diabetes Course was a great success with 10

community members attending in Myrtleford. The course runs over 6 sessions and is run by

specially trained staff, including dietitians and exercise professionals.

Communities that Care

A CTC Youth Survey, saw students of years 5, 7 and 9 at three schools within the Myrtleford

community, participate in a two day on-line Youth Survey.

With a 92% uptake from students, this provided solid data identifying risks and protective factors for the Myrtleford community.

Training and community consultation is underway to assess community readiness to adopt the CTC framework and identify the needs and strengths of the Myrtleford community.

Dementia Support Group

During Dementia Awareness Week – 14th September, 2009, saw a partnership between

Alzheimer’s Association and Alpine Health initiate two “What is Dementia” information workshops held in Myrtleford and Mount Beauty.

Topics covered were memory problems, different forms of Dementia, risk reduction and importance of early diagnosis. 11 females and 1 male attended the Myrtleford workshop and 15 females and 5 men attended the Mount Beauty workshop.

ServicesAccident and Emergency CareAcute Medical Inpatient CareAged Care ServicesAnte-natal and Maternity CareCentral Sterilising UnitCommunity Aged Care PackagesCommunity Health CentreDay Activity Program (Alpine Leisure Group)Day Surgery (minor including endoscopy)Diabetics Support DieteticsDistrict Nursing (including after hospital discharge care)Early ParentingHealth PromotionHome Referral Service (help in the Home )High care packages (Aged care)Independent Living UnitsInfection ControlMidwiferyMedical ImagingMen’s ShedsNursing Care – low and high levelNursing Education Occupational TherapyPain ManagementPalliative Care ServicesPalliative Care VolunteersPathologyPhysiotherapyPodiatryPost Acute CarePrimary Care TeamRadiologyRegional Health ProgramRural Adolescent ProgramRenal DialysisResidential Aged CareRespite Care Visiting Medical OfficersYouth Worker

Aged Care

“Without this approach I would not be as independent as I am now, nor would I be living at home,” Thelma said.

Alpine Health Residential and Aged Care Services offer affordable living for the residents of the Alpine area in either the independent living units or as a resident in a low or high care facility.

Residents are assisted to retain their personal, civic, legal and consumer rights, and to achieve active control of their lives within the residential care service and in the community.

Alpine Health acknowledges and supports the ongoing need for family and friends involvement by providing a home like environment for the residents in the residential care service facilities.

The relationship between the client and service provider is pivotal to the experience of good quality, person-centred care.

Thelma Dennis is a resident of Porepunkah in North East Victoria who has been assessed as having ‘high care needs’.

She and her daughter Glenda King work in a partnership with Community Aged Care Packages Case Manager Julie Reilly in delivering a package of care to support Thelma to remain living at home in the community.

As part of her individualised package of care Thelma can access a large number of services to meet her needs including, personal care, social support, transport to appointments, home help, advocacy, meal preparation, and gardening and general maintenance services.

Not withstanding the amount of Government subsidy received during the year, Alpine Health is still dependent upon the financial support of the public to enable us to continue and develop its services.

Alpine Health has a continuing need for facilities and equipment of the highest modern standards, to serve the needs of the communities of the Alpine Shire and surrounding districts. The range of quality of services provided by Alpine Health is a tribute to the excellent support of the communities over the many years.

To ensure this high standard of care can continue, we seek your financial support to purchase new and improved equipment, and to assist in the improvement of facilities.

YOU CAN ASSIST BY

• A donation towards a special item

• Defraying the cost of much needed equipment

• Remembering Alpine Health in your will

• Joining the bright and Myrtleford Opportunity Shops

• Assisting as a volunteer.

YOUR HELP IS MUCH NEEDED AND WILL BE APPRECIATED

SEND YOUR DONATIONS TO:

The Chief Executive Officer

Alpine Health

PO Box 236

Myrtleford Vic 3736

I am pleased to donate the enclosed sum of $…………………………...which should be used towards the purchase of

*……………………………………………………………………………………………

for the ………………………………………site of Alpine Health.

Mr/Mrs/Miss/Ms……………………………………………………………………………

Address……………………………………………………………………………………

Signature……………………………………………………………………………………

*insert equipment or area preferred or write “equipment for general use”

Your Hospital

Alpine Health Residential and Aged Care Services offer affordable living for the residents of the Alpine area in either the independent living units or as a resident in a low or high care facility.

Residents are assisted to retain their personal, civic, legal and consumer rights, and to achieve active control of their lives within the residential care service and in the community.

Alpine Health acknowledges and supports the ongoing need for family and friends involvement by providing a home like environment for the residents in the residential care service facilities.