Appendix A
George Beltchev
Office for Country Health
PO Box 287 Rundle Mall
Adelaide SA 5000
Tuesday, 5 August 2008
Dear George
I am pleased to provide this report on the activities of the Umoona Community Council Inc Sobering up Centre and mobile assisted patrol services for the fourth quarter of 2007/08. After a very busy year where we faced a large increase in client numbers we are proud to advise that we kept the average costs per client serviced in the sobering up centre to $68.25 and the average costs per MAPS client serviced to $9.15. Our accountants will be providing your department with a financial acquittal in the next few weeks. I undertook a review of the data we have collected on the operations of the Sobering up Centre and Mobile Assistance Patrol Service since operations began and found a number of errors which are corrected in this report, the errors did not distort trends previously reported on.
MAPS Statistics | |||||
|---|---|---|---|---|---|
| 2003/04 | 2004/05 | 2005/06 | 2006/07 | 2007/08 | |
| July | 189 | 334 | 426 | 1248 | |
| August | 207 | 284 | 740 | 1459 | |
| September | 234 | 315 | 544 | 1382 | |
| October | 231 | 433 | 567 | 1507 | |
| November | 246 | 389 | 648 | 1686 | |
| December | 369 | 588 | 816 | 1470 | |
| January | 399 | 787 | 1029 | 1850 | |
| February | 488 | 810 | 988 | 1735 | |
| March | 211 | 497 | 825 | 923 | 1372 |
| April | 341 | 284 | 778 | 1155 | 1560 |
| May | 185 | 546 | 734 | 1441 | 1585 |
| June | 119 | 453 | 769 | 1085 | 1439 |
The Mobile Assistance Patrol Service operated Tuesday through to Friday from 16:30 until 00:30 the following morning. Average monthly demand for the financial years 2004/05, 2005/06, 2006/07 and 2007/08 is depicted in the chart on page 2, from this it can be seen that average monthly demand has increased from under 400 per month to nearly 1,600 per month in three years. The chart on page 3 presents the statistics for the Mobile Assistance Patrol Service since statistics were first collected in March 2004. The trend of an increase in demand for the service that has been reported in previous reports continues. Demand by month in each successive year has increased with the exception of the month of April in 2004/05. The Chart on page 4 presents the MAPS stats by month since statistics were collected. The Chart on page 5 presents the data on the numbers of transient clients assisted by the Mobile Assistance Patrol Service since July 2006. This demonstrates a very large increase in demand for the service in the period July 2007 through to June 2008. The chart on page 6 demonstrates that the proportion of transient clients to locals increased over the same period and therefore it is transients that have been the major cause of the very rapid and large increase in demand for this service.
The Sobering up Centre continued to operate Tuesday through to Saturday morning and is open between the hours of 16:00 and 08:00 the following morning. Admissions for the Sobering up Centre for the period January 2006 through to the end of the third quarter of the 2007-08 financial year are set out below. This tabular information has been provided in the Chart on page eight (8)
| 2005-06 | 2006/07 | 2007/08 | |
|---|---|---|---|
| July | 99 | 255 | |
| August | 128 | 356 | |
| September | 98 | 337 | |
| October | 148 | 390 | |
| November | 168 | 445 | |
| December | 221 | 387 | |
| January | 90 | 227 | 531 |
| February | 79 | 200 | 421 |
| March | 77 | 256 | 356 |
| April | 91 | 246 | 395 |
| May | 113 | 307 | 365 |
| June | 105 | 244 | 329 |
The Centre is continuing to work at more than 100% occupancy so the marginal costs of operations have increased with double or more the amount of linen and bedding requiring to be washed and a significant increase in client's clothing being washed.
The Chart immediately below provides information on the patterns of clients’ use of the sobering up centre in the quarter ending June 30 2008. Again by far the largest numbers of clients (99 of them) used the centre just once. The clients using the centre for ten or less stays in the quarter accounted for 521 stays in total. The numbers of clients using the centre for more than ten stays in the quarter accounted for a total of 735 stays. One hundred and ninety four (194) clients used the centre for ten (10) or less stays, thirty eight (38) clients used the centre for eleven (11) or more stays. Sixteen (16) clients used the centre for 20 or more stays in the quarter. These 16 clients make up 6.8% of the client numbers but made up 30.7% of the demand on the services.
The chart above and the table below provide details of the home community for the Sobering up Centre clients who live outside of Coober Pedy.
Twenty three percent of clients of the Sobering up Centre claim to come from interstate communities. Fifty nine (59) clients claim to have come from Alice Springs and eighteen (18) from Finke. Twenty three clients claim to come from WA communities.
As reported previously UCC believes it is unlikely that all the clients who responded with Alice Springs as their home community actually come from there and advises it is highly likely that, while these clients come from the NT, their departure point from the NT was Alice Springs rather than it being their home community.
| Ernabella | 1 |
| Adelaide | 2 |
| Amata | 2 |
| Uluru | 5 |
| Yuendumu | 5 |
| Port Augusta | 7 |
| Ceduna | 17 |
| Finke | 18 |
| WA | 23 |
| Oodnadatta | 33 |
| Fregon | 39 |
| Alice Springs | 59 |
| Mimili | 74 |
| Indulkana | 202 |
NT Intervention and the Increase in Transients visiting Coober Pedy
There has been a pattern of influx of transients into Coober Pedy over the
summer period since UCC first started collecting statistics. We have also
seen a dramatic increase in the demand for our services over time. However,
the increase in demand following the intervention in the NT has been remarkable
and is clearly demonstrated in the chart below.
The NT Intervention commenced in June 2007. Comparing the data for June 2006 with June 2007 and the subsequent months through to February 2008 demonstrates for all months other than December and February a more than doubling of transients for each month in 2007/08.
Further investigation using interviews with clients and a longer period of observation is required to conclusively prove that the NT intervention is responsible for this, but the data is indicative of a very significant effect.
Again the largest numbers of transients claim Indulkana as their home community. Over the reporting period 202 of the clients at the sobering up centre named Indulkana as their home community.
Our staff are not trained to gather qualitative data such as finding out from clients why they have travelled to Coober Pedy rather than Alice Springs or any other destination.
Accordingly I suggest that Country Health SA fund us to engage a person skilled in interview techniques to come to Coober Pedy for two weeks in the month of January 2009 and interview clients after they have sobered up but prior to their leaving the Centre. The purpose being to determine their reasons for coming to Coober Pedy to drink.
Harm Minimisation and a Reduction in High Cost Presentations to the Hospital
The Coober Pedy Hospital made available statistics for the 2006 and 2007 calendar years on Emergency and Accident presentations to the hospital and this was reported on in the last quarter. The Hospital has again made statistics available for alcohol related A & E presentations for the period January 1 2008 to June 30 2008, however due to a change in data collection method they are unable to separately report on Aboriginal people presenting at the Hospital for alcohol related A & E injuries or illness. Also the Hospital did not provide data on the numbers of accident and emergency presentations at the hospital for injuries where alcohol related assault was alleged.
UCC has data for the preceding 24 months that allows an Indigenous and non-Indigenous breakdown for alcohol related A & E presentations at the Hospital. I’ve used this data to the calculate the two year monthly average numbers of non-Indigenous presentations for alcohol A & E presentations at the Hospital. Deducting this average from the total monthly A & E related presentations may give an approximation of the Indigenous presentations and this data has been used to produce the Chart on page 11 which presents data for alcohol related accident and emergency presentations at the Coober Pedy Hospital together with the numbers of transient admissions to the sobering up centre.
The data in this quarter again demonstrates the relationship between the low number of high cost presentations to the Hospital and the very large increase in transient Aboriginal people accessing our services provided under the Coober Pedy Alcohol Strategy.
Transients are at high risk because they are out of their home community and away from their residences, families and the support services they are accustomed to accessing. They are homeless and usually their resources are very rapidly expended. As a result they very quickly end up in high stress situations which fuelled by excessive alcohol consumption rapidly and unexpectedly turn to violence.
The services we provide under the Coober Pedy Alcohol Strategy provide for a circuit breaker/safe haven for the transients to access whereby they avoid the worst excesses in consumption of alcohol and the risks contingent to that. We contend this represents a very significant cost saving to the State and delivers high priority policy outcomes as well.
I shall write to the Hospital and request that the method used to collect
data on alcohol related assault and A & E be changed to allow for separate
reporting on Aboriginal people presenting at the Hospital for alcohol related
A & E injuries or illness.
The Chart on page 12 shows the numbers of transient clients using the service since January 1 2006 while the Chart on page 13 shows the total numbers of clients using the service in the same period. The Chart of page 14 shows that the rate of increase in demand at the Sobering up Centre has increased, demand is still going up but at a significantly slower rate.
The Chart on page 15 provides a comparison between the numbers of transients and locals using the service and demonstrates that transients for most months since December 2006 provide the majority of the clients using the service.
As part of UCC’s continuous improvement policy we now review the admissions of clients to the centre to determine if policies and procedures are being followed. 98.3% of the clients were tested for their BAC and 99.8% had their blood sugar levels tested.
The lowest BAC reading for a client was .078, the median BAC was .199 and average was .210. Note our BAC tester only reads to .4 so these figures understate the actual median and average BAC. We remain unable to refer clients onto other service because those services are closed during our operating hours. A non-residential rehabilitation service is to be opened in Coober Pedy, UCC made strong representations to the funding agency that it should be the organisation to provide this service, we await a decision from OATSIH on this matter. Our view is that the delay in providing funding to UCC to provide this service is unnecessary and funds should be released immediately so that we can begin to meet a very significant need.
Day Care Centre
This service did not operate as there is no facility in which to conduct it but it was announced in October 2007 that DASSA would open and operate a drug and alcohol rehabilitation service in Coober Pedy. UCC successfully lobbied OATSIH and Aboriginal Affairs and Reconciliation Division of PM&C and they allowed UCC to bid for the delivery of the service.
Nutritious meals delivery program
The nutritious meals program provides evening meals to members of the Aboriginal community unable to provide their own meals. This group included the aged, homeless and those suffering from sever and chronic alcoholism who would otherwise go undernourished.
The delivery of the 20 or more meals per MAPS shift continues during this current period. Additional to these meals the Sobering up Centre staff prepare meals and light snacks for between 25 to 35 people per afternoon shift worked.
| Delivered meals | Admission Meals | Additional meals | Breakfast | |
|---|---|---|---|---|
| May-07 | 536 | 309 | 109 | 110 |
| Jun-07 | 448 | 246 | 67 | 68 |
| Jul-07 | 442 | 257 | 49 | 62 |
| Aug-07 | 494 | 364 | 45 | 75 |
| Sep-07 | 416 | 338 | 36 | 73 |
| Oct-07 | 468 | 387 | 48 | 84 |
| Nov-07 | 468 | 447 | 41 | 81 |
| Dec-07 | 416 | 387 | 72 | 71 |
| Jan-08 | 494 | 536 | 84 | 92 |
| Feb-08 | 482 | 458 | 153 | 86 |
| Mar-08 | 444 | 391 | 92 | 72 |
| Apr-08 | 540 | 437 | 89 | 75 |
| May-08 | 540 | 415 | 59 | 82 |
| Jun-08 | 480 | 385 | 50 | 81 |
Umoona Community Council Inc participation in the Coober Pedy Alcohol Strategy
On May 1 2007 the regulations for the declaration of Umoona Community as a dry zone came into effect. Drinking on the community remains a significant problem although there has been a reduction due mainly to problem residents moving to accommodation off the Umoona Aboriginal Lands Trust. The Mobile Assisted Patrol Service still does an hourly check through the Community to observe for unruly behaviour and drinking.
The Coober Pedy Liquor Accord continues to meet with Eugene Milograd of the Liquor Commission. Membership of that group is drawn from Aboriginal Affairs and Reconciliation Division, Coober Pedy Hospital, Families SA, SAPOL, UCC, District Council of Coober Pedy and the licensed liquor outlets.
Policies and procedures
We made links with the organisation providing a Sobering up Centre and Mobile Assisted Patrol Service in Pt Augusta in this period and recently their manager visited UCC and attended the Sobering up Centre during opening hours. We have reached agreement for temporary staff exchanges and for sharing resources in policy reviews and improvement. I expect to report on a review of the policies and procedures in our next report.
IT
There remains an urgent need for additional funds to allow staff of the Centre to undertake courses in computer and IT use. We are not funded sufficiently to take staff off production work and place them into accredited courses, our level of productivity and quality of service would be greatly enhanced if we were.
Staffing issues
No issues to report on in this period.
Funding of Municipal Services and community management and administration
Towards the end of June 2008 we received $280,000 from FaHCSIA to cover most of our overhead and administration and management costs so we have been able to defer increasing the administration levy on our grants and they remain at a very economical 12.5%. As previously foreshadowed if we are unable to secure ongoing Commonwealth funding for the management and administration of Umoona Community Council we will have to increase the administration levy charged against major grants from 12.5 % up to 20%.
Extension of hours of operation
We hope that additional funding can be sourced to extend the hours of operation for the Coober Pedy Alcohol Strategy services in the new financial year. As advised previously there is very strong support from the lead agencies in Coober Pedy for operation to be extended to 7 days a week.
If you require any further information please do not hesitate to ask.
Yours faithfully
Forrest Holder
CEO Umoona Community Council Inc