Domain 4 - Victorian Government Investment and Action

The Victorian Government is working with service providers, Aboriginal organisations and communities to ensure that all Aboriginal Victorians have access to high-quality, culturally safe and responsive health and wellbeing services.

Aboriginal Health and Wellbeing Partnership Forum

The Aboriginal Health and Wellbeing Partnership (AHWP) Forum is a strategic partnership between the Aboriginal Community Controlled health sector, the mainstream health sector, and the Department of Health. The AHWP Forum was established in 2021 and is co-chaired by the Minister for Health and the Chairperson of the Victorian Aboriginal Community Controlled Health Organisation (VACCHO). Forum members are guided by the principles of self-determination, working in an open and transparent manner, sharing information, knowledge and resources and ensuring partners remain accountable to each other and to Community. The following five domains provide a focus for the AHWP Forum through the AHWP Agreement and Action Plan:

1. Prevention and early intervention
2. Culturally safe healthcare
3. A self-determined health system
4. Working from a shared evidence base
5. Building a sustainable health sector

AHWP Forums in 2024 included:

• A two-day March Forum held in Bendigo focusing on the theme of sustainability.
• A one-day June Forum held on Bunurong Country for government and Koorie Caucus members to focus on 2024-25 budget outcomes and 2025-26 preparation.
• A two-day September Forum held on Wathaurong country focusing on cultural safety.

Thirteen actions from the AHWP Action Plan remain on track, 15 are not due to start and 3 actions have been delayed. The AHWP Action Plan is due for expiry in June 2025. However, it will be extended to June 2026 with preparations for developing a new AHWP Action Plan from mid-2025.

Ambulance Victoria’s Reconciliation Action plan

Ambulance Victoria’s (AV) Reconciliation Action plan (RAP) provides a vision for reconciliation and how AV will build strong, sustainable and meaningful relationships with Aboriginal communities. The RAP aims to increase awareness and appreciation of culture and elevate the voices of AV's Aboriginal staff, patients and communities to improve their experience and outcomes with AV. Activities delivered as part of the plan in 2024 include:

• Building on relationships with Aboriginal Community Controlled Health Organisations (ACCHOs) through AV’s Operational Community Engagement and Liaison Coordinators (OCELCs). The OCELCs assist AV’s workforce in planning community engagement activities, support and resources. Engagement with local health services, local government services and emergency workers enable Aboriginal communities to make informed health decisions and deliver better health outcomes. AV currently has six OCELCs across the state in each region.
• An Aboriginal and Torres Strait Islander Employment Specialist was appointed to design a sustainable employment program for First Peoples at AV. This initiative reflects AV’s commitment to fostering opportunities in employment, procurement, professional development, retention, and ensuring equitable access to employment opportunities.

By end 2024, AV had delivered 42 of the 43 commitments of its RAP. The remaining commitment to develop and deliver cultural safety training is in progress.

Public Health

Victorian public health and wellbeing plan 2023-27

The Victorian public health and wellbeing plan 2023-27 is Victoria’s fourth legislated plan under the Public Health and Wellbeing Act 2008. The plan provides a framework for whole-of-government coordinated action and sets 10 priority areas for improving health and wellbeing that link to targeted plans. The plan recognises the need to embed self‑determination in health and wellbeing policies and programs to build on the strengths of Aboriginal communities to support effective and sustainable outcomes for Aboriginal people living in Victoria.

The Public Health and Wellbeing Interdepartmental Committee provides oversight for implementation across Victorian Government departments. The Victorian Public Health and Wellbeing External Sector Advisory Group supports implementation as part of the expanded governance under the plan to ensure consumers with lived experience are well represented. The group comprises of statewide and peak bodies in key health areas, including VACCHO. Other ways to ensure Aboriginal voices are reflected in the plan include:

• Acknowledgement that the self-determined priorities of the Aboriginal Health and Wellbeing Partnership Agreement and Action Plan 2023-2025 must be aligned to the Victorian public health and wellbeing plan 2023–2027
• Aboriginal-led or informed health and wellbeing plans such as Balit Murrup: Aboriginal social and emotional wellbeing framework 2017–2027 must be embedded in health and wellbeing policies.
• Victoria’s commitments to improving health outcomes under the National Agreement on Closing the Gap provide a focus for delivering sustainable outcomes for Aboriginal Victorians.

Local Public Health Units

Local Public Health Units (LPHUs) respond to local notifiable communicable disease by managing population health catchment planning at a regional level to promote equity so that related programs are inclusive and responsive to the needs of their Aboriginal communities.

New LPHU engagement guidelines were developed by a working group with representatives from VACCHO, LPHUs, and the Department of Health. Endorsed in November 2024, the Guidelines for Engagement between LPHUs and the Aboriginal Community Controlled Health Sector provide principles, key stakeholders and structures. It also includes recommended actions to build, maintain and monitor culturally safe and sustainable engagement for population health across Victoria.

To enable regionally tailored approaches, LPHUs adopt various mechanisms to engage with Aboriginal-led organisations in their catchment. These include:

• Grants to the Victorian Aboriginal Health Service and Your Community Health for catchment planning priorities, including self-determined ACCO priorities.
• Financial resources delivered via a Memorandum of Understanding with local ACCOs to provide culturally appropriate guidance and advice to mainstream health services around the needs of local Aboriginal communities.
• Agreements for strengthening Aboriginal engagement, signed by four ACCOs to support self-determined models of healthcare.
• Employment of an Aboriginal health lead or Koori Engagement Officer to support the development of relationships with ACCHOs or Aboriginal communities. This action has been adopted by two LPHUs.

Improving cancer outcomes for Aboriginal Victorians

Cancer disproportionately affects Aboriginal Victorians, with the five-year survival rate among Aboriginal Victorians to be 12 per cent lower than non-Aboriginal Victorians. To address this disparity, in 2023-24 the Victorian Government provided a total of $2.2 million in funding to VACCHO for the following initiatives:

• Development and implementation of VACCHO’s Aboriginal Cancer Journey Strategy 2023-2028, including funding support to VACCHO to lead the development of the Strategy and commencement of pilot initiatives, including a partnership with Echuca Regional Health (ERH) to pilot a new Aboriginal cancer journal.
• Funding support to VACCHO to implement the Victorian Cancer Screening Framework.
• Funding support to VACCHO to lead Framework Respect, a culturally responsive and safe framework to boost participation in cancer clinical trials. In partnership with local ACCOs, the framework will form part of the Cancer Clinical Trials Program 2024-2028. This will sit alongside a new culturally safe lung cancer screening pilot to be developed in partnership with the Victorian Comprehensive Cancer Centre Alliance.

Additionally, the Department of Health has provided funding support for the Eastern Health and Monash Partners Comprehensive Cancer Consortium to open a dedicated First Nations Cancer Clinic at Eastern Health’s Healesville Hospital. The program will deliver free, culturally safe oncology services to the region’s large Aboriginal population.

Aboriginal Women’s Health Clinic

As part of a $153 million package from the 2023-24 State Budget, ACCHOs were invited to submit applications to deliver a dedicated Aboriginal Women’s Health Clinic from 1 July 2025 to 30 June 2027. First Peoples’ Health and Wellbeing (FPHW) has been appointed to deliver the care Aboriginal women need through its Thomastown and Frankston Clinics, providing referral pathways with other healthcare providers to ensure these women receive high quality and culturally safe healthcare

Bloodborne viruses and sexually transmitted infections

To support health equity in some blood borne virus (BBV) and sexually transmitted infections (STI), Aboriginal people are prioritised for public health follow up. Aboriginal people are disproportionately impacted and at higher risk of severe disease or complications due to a wide range of factors. These factors include a lack of tailored and culturally responsive BBV and STI services, complex social and medical factors, concerns around privacy and confidentiality, stigma and shame and over-representation in custodial settings.

The Department of Health’s communicable disease protocols ensure that cases of BBV and STIs are notified through LPHUs who provide follow up as a priority. For example:

• Newly diagnosed cases of human immunodeficiency virus identified in First Peoples are referred to the Department of Health’s Victorian Investigation of Complex STIs (VICS) team for immediate follow up.
• Pregnant Aboriginal women diagnosed with syphilis are considered a ‘very’ high priority for follow-up by the VICS team.
• The main goal of public health follow-up for this cohort is to ensure they receive culturally safe case management and supports, are connected with the most appropriate antenatal and post-natal services, and that all treatment and testing for the person, their partner/s, and the baby before and after birth is coordinated and carried out.

Victorian Virtual Emergency Department

Victorian Virtual Emergency Department (VVED) is led by Northern Health to provide statewide access to virtual consultations with emergency trained doctors and nurses for non-life-threatening conditions. It is open 24 hours a day, seven days a week, providing virtual emergency care to the Victorian community wherever they are. More than $235 million over four years is being invested to expand the VVED so that it can grow to support 1,000 patients every day.

The VVED is particularly valuable for Aboriginal Victorians living in rural and regional areas, where access to emergency care can be challenging. First Peoples are over-represented in VVED consultation with 2.4 per cent of all VVED presentations. A dedicated First Peoples nurse supports enhanced engagement with Aboriginal Victorians by raising awareness of the VVED to improve health literacy and follow up with patients post consultation.

VicHealth – Strong Young Mob

In 2024-25, VicHealth invested $1 million in Strong Young Mob, a committee made up of members from ACCOs to improve the health and wellbeing of Aboriginal people. The committee has been working together with VicHealth to inform and oversee the design and development of VicHealth’s priorities for Community. Strong Young Mob remains a priority for VicHealth as they continue to build meaningful, ongoing relationships with Aboriginal organisations and communities. The initiative will elevate the efforts of 19 ACCOs in working with Strong Young Mob clients (0-30 years) to strengthen leadership, healing and wellbeing, healthy eating, movement and cultural connection through music and arts.

Cultural safety

Victorian Aboriginal Community Controlled Health Organisation’s Culture + Kinship program

Good health and wellbeing for Aboriginal people requires a specific focus on preventing the onset of chronic health conditions using Aboriginal models of Care. One such program is VACCHO’s Culture + Kinship project that focuses on creating, strengthening or restoring connections to Culture, Kinship, Community and Country, all of which are known protective factors for Aboriginal health and wellbeing.

• The model was piloted with four regional ACCOs to design their own programs, including Budja Budja’s Gariwerd Youth Project to engage children in knowledge sharing and cultural practices, and Goolum Goolum’s initiative to bring pregnant women and new mothers together in weekly gatherings to learn to make possum skin cloaks from their female Elders.
• The pilot was reviewed by external consultants and found to be highly effective with a ‘social rate on return’ for the investment, delivering $8.29 for every dollar spent.
• Consequently, four-year funding was provided through the 2024-25 State Budget proposal for the Aboriginal Health in Aboriginal Hands initiative, which will see an expansion of the Culture + Kinship program in up to 16 ACCOs.

Performance Monitoring Framework

The Department of Health reset its Performance Monitoring Framework (PMF) for public health services from 1 July 2024 so that health services’ cultural safety performance can be assessed more effectively. One requirement is for health services to deliver mandatory cultural safety training as follows:

‘Implement mandatory cultural safety training and assessment for all staff in alignment with the Aboriginal and Torres Strait Islander cultural safety framework, and developed and/or delivered by independent, expert, and community-controlled organisations, Kinaway or Supply Nation certified Aboriginal businesses.’

Other changes to the PMF include the following strategies:

• Setting minimum standards and expectations for health services to meet their cultural safety commitments, including more specific guidance to meet the requirement of ‘high-quality’ training, such as having this training delivered by independent community-controlled organisations.
• Specific measurement and analysis of leave event data, such as ‘Did Not Wait’ (DNW) and ‘Leave/Discharge Against Medical Advice’ (LAMA) in Emergency Department settings are to be reviewed by the Department of Health to inform discussions with health services about their cultural safety performance.

Culturally safe paediatric services

Improving access to culturally safe paediatric services has been enhanced with a funding commitment for ACCHOs to deliver specialist health services that support general developmental, autism and targeted assessments for Aboriginal children entering care.

The 2023-24 State Budget provided $1 million annually to Victorian Aboriginal Health Service (VAHS) to deliver specialist clinics that include paediatricians and allied health professionals. This builds on work VAHS had done to develop strong clinical capability and engagement with the community to deliver services that support an average of 300 children and families each year.

The 2023-24 State Budget also included $37.7 million over four years to deliver statewide screening and assessment for all Victorian children who enter statutory out-of-home care due to child protection involvement. To support culturally safe health services for Aboriginal children in care, VACCHO worked with its members to design three demonstration pilots that will enable ACCHOs to deliver health care that Aboriginal children, their carers, and their families need. Funding of $5.5 million over three years has been allocated for these self-determined demonstration pilots that will be supported by VACCHO to foster a strong collaborative partnership between VACCHO and the Department of Health.

Under the Victorian Autism Plan, $0.27 million of fixed-term funding over two years was allocated to Wathaurong Aboriginal Health Service and VAHS to deliver autism assessments for Aboriginal children in their local areas. This funding supports the accessible delivery of services in community for children with lower complexity autism needs.

Victoria’s LGBTIQA+ strategy 2022–32

In 2023-24, the Victorian Government continued to support culturally safe service delivery for First Peoples LGBTIQA+SB communities under the Strategy through targeted funding, partnerships and inclusive programming, including:

• $33,000 provided by the Department of Families, Fairness and Housing to the Victorian Aboriginal Child and Community Agency (VACCA) through the LGBTIQA+ Organisational Development Program. The funding supported VACCA to build staff capability and strengthen service delivery that is inclusive and affirming of LGBTIQA+ communities.
• $100,000 provided by the Department of Families, Fairness and Housing to the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) to enhance its existing Rainbow Mob initiatives. The funding supported VACCHO to further build on their Rainbow Mob inclusion work by enabling ACCOs to undertake Rainbow Tick accreditation and join their Rainbow Mob Community of Practice.

Industry, Trade and Investment

Aboriginal workforce

• In 2024-25, 25 ACCHOs and two ACCOs continued to receive recurrent funding to build their social and emotional wellbeing workforce. This funding has also enabled ACCHOs to commission services to support the social and emotional wellbeing needs of children and young people. With this recurrent funding supporting self-determined social and emotional wellbeing services and programs, nearly 5,000 Aboriginal community members across Victoria were able to access the supports they need to heal, to be healthy and well.
• The Victorian Government continues to invest to deliver an Aboriginal Social and Emotional Wellbeing Scholarship Program (the scholarship program). The scholarship program has awarded 49 scholarships to Aboriginal students studying an undergraduate or postgraduate mental health related discipline. The scholarship program is being delivered by the Department of Health in partnership with the Balit Durn Durn Centre of Excellence in Aboriginal Social and Emotional Wellbeing, together with Deakin, RMIT and La Trobe universities. The scholarship program is helping meet the growing demand for qualified and skilled Aboriginal staff to work in social and emotional wellbeing teams and in the mainstream mental health sector.
• The Victorian Government has funded 10 dedicated Koorie Mental Health Liaison Officer (KMHLO) positions in Infant, Child and Youth Mental Health and Wellbeing Services. As of January 2025, seven KMHLOs are employed across six health services. The Department of Health is working with other health services to fill current vacancies. Building the capacity of the Aboriginal Mental Health workforce is helping support more responsive and culturally safe mainstream mental health services.
• The Aboriginal Mental Health Traineeship program is a workforce program established in 2017 under the Balit Murrup Aboriginal Social and Emotional Wellbeing Framework 2017-2027. The traineeship program provides Aboriginal trainees full-time employment in mental health services while concurrently undertaking a funded Bachelor of Health Sciences (Mental Health) through Charles Sturt University. Trainees are offered full-time ongoing employment with their health service employer upon graduation. Since the traineeship program was established, 12 trainees have graduated from the program as qualified Aboriginal Mental Health Clinicians and have entered full time employment in either a mental health service or within an ACCHO working in the field of social and emotional wellbeing.

National Aboriginal and Torres Strait Islander Environmental Health Conference

Healthy environments are a fundamental prerequisite for good health. Environmental health is about relationships between people and the environment, both social and physical, aimed at preventing disease and creating health-supporting environments.

In May 2024, the Department of Health hosted the 14th National Aboriginal and Torres Strait Islander Environmental Health (NATSIEH) conference, marking the first time it being held in Victoria since it began in 1998. The conference had more than 160 delegates that attended and included a strong focus on community-led initiatives, co-design, collaboration and engagement. Throughout a wide variety of presentations, the conference advocated the need for ongoing and further measures to monitor and act on the health and wellbeing of First Peoples with a clear purpose of reducing inequities.

Community-led Research - Empowering Aboriginal and Torres Strait Islander Communities to Conduct Research

The Department of Jobs, Skills, Industry and Regions has funded VACCHO to investigate First Peoples medical research priorities and foster community research skills. The project will engage with ACCOs and Community members across the State to ensure that research priorities align with the diverse values and needs of First Peoples in Victoria. Through workshops and networking opportunities, VACCHO will foster collaborative learning and knowledge exchange among ACCOs. This will empower ACCOs across the State to lead and conduct medical research projects that address Community priorities.

Marra ngarrgoo, marra goorri: the Victorian Aboriginal Health, Medical and Wellbeing Research Accord

The 2024-25 State Budget included $4.5 million to support VACCHO to implement Marra ngarrgo, marra goorri: the Victorian Aboriginal Health, Medical and Wellbeing Research Accord. The Accord was launched by VACCHO in October 2023 and aims to improve the ethical standards of First Peoples health, medical and wellbeing research in Victoria so that they align with First Peoples principles of self-determination.

The Victorian Government has endorsed the Accord and is working in partnership with VACCHO to support its implementation.

Support for marra ngarrgo, marra goorri through mRNA Victoria Research Acceleration Fund (Round 4)

The mRNA Victoria Research Acceleration Fund Round 4 Guidelines strongly encouraged applications from organisations and collaborative partners that have endorsed marra ngarrgo, marra goorri. Applicants were also encouraged to outline in their application how they and their organisation uphold the objectives and principles of the Accord. The Guidelines were updated following consultation with VACCHO.

2023-24 Premier’s Awards for Health and Medical Research – Aboriginal Researcher undertaking research in any field of health and medical research Award

The Department of Jobs, Skills, Industry and Regions runs the annual Premier’s Awards for Health and Medical Research. One category of award is the ‘Aboriginal Researcher undertaking research in any field of health and medical research’. Ms Joanne Luke from the University of Melbourne was announced as the winner of the award on 23 April 2024 and received a certificate and prize money of $5,000 (excluding GST). Dr Petah Atkinson from Monash University was a finalist in the category and received a certificate.

Fostering Achievement in Research (FAIR) Fellowships

The Department of Jobs, Skills, Industry and Regions funded the FAIR Fellowships, to support 13 early and mid-career researchers who narrowly missed out on National Health and Medical Research Council (NHMRC) Investigator Grant funding in the Emerging Leaders 2 stream. Applications from First Peoples, among other under-represented cohorts, were prioritised. The FAIR Fellowships are an initiative that supports the Victorian Government to deliver a diverse, secure and highly skilled health and medical research workforce. The FAIR Fellowships were delivered by Veski.

Sport and Experience Economy

Surfing Victoria’s Indigenous Surfing Program

The Together More Active 2023-27 program is providing funding of $200,000 over 4 years to Surfing Victoria to support its Indigenous Surfing Program. The Indigenous Surfing Program utilises surfing as a vehicle to connect Aboriginal Victorians with the ocean, their Community and nature whilst learning new skills, water safety knowledge and healthy habits. It aims to enrich First Peoples communities across the State through surfing and stand up paddleboarding; being physically active in a safe, fun environment, whilst building confidence, social cohesion and connection to community and reducing barriers to participation and teaching water safety skills.

Victorian Aboriginal Sporting Partnership

The Victorian Aboriginal Sporting Partnership (VASP) will provide a formal agreement to increase sport and active recreation participation opportunities for Aboriginal Victorians through a self-determined approach. The VASP will be a positive mechanism for Aboriginal sporting bodies to come together to share experiences, connect and have a voice on sport and recreation to the Victorian Government. In March 2024, the Victorian Aboriginal Sporting Partnership Working Group (the Working Group) was established by Sport and Recreation Victoria to design and develop the model, strategy/action plan for the VASP. In alignment with Aboriginal self-determination principles, the Working Group consists of 10 Aboriginal community leaders with roles across the sport, government and primary prevention sectors. The Working Group plays an important role in helping shape Sport and Recreation Victoria’s approach to policy, programs and projects.