SHFPACT 2016-2017 Annual Report by SHFPACT

SEXUAL HEALTH AND FAMILY PLANNING ACT

ANNUAL 2016 REPORT 2017 Read our full report online

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ANNUAL 2016 REPORT 2017

DON’T TURN YOUR BACK ON YOUR SEXUAL HEALTH

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LESBIAN BISEXUAL TRANS QUEER STRAIGHT OR EVEN SOMEWHERE IN BETWEEN?

SEXUAL HEALTH AND FAMILY PLANNING ACT

Visit our website at shfpact.org.au where you’ll find heaps of information — or make an appointment at the SHFPACT clinic by calling 02 6247 3077. • • • • • •

Cervical Screening and HPV Vaccine STI and HIV screening, checks and advice Reproductive and sexual health services Sexual difficulties and contraception services Canberra Menopause Centre Services for people with disabilities

FEMALE DOCTORS AND NURSES ARE AVAILABLE

The SHFPACT clinic is located at Level 1, 28 University Ave, Canberra City. We offer a holistic, confidential and respectful service. Call 02 6247 3077 or email shfpact@shfpact.org.au to make an appointment. More at shfpact.org.au

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ABOUT SHFPACT SERVING THE CANBERRA COMMUNITY AND THE REGION FOR MORE THAN 45 YEARS, SEXUAL HEALTH AND FAMILY PLANNING ACT IS A COMMUNITY NOT-FOR-PROFIT, NON-GOVERNMENT, MEMBERSHIP-BASED INCORPORATED ASSOCIATION AND AN ATO-ENDORSED HEALTH PROMOTION CHARITY AND DEDUCTIBLE GIFT RECIPIENT.

Getting involved! ASSOCIATION MEMBERSHIP Our membership is varied and includes community members and community organisations, government service providers, academics and health professionals. Members of the Association have voting rights at general meetings and are eligible for nomination to SHFPACT Council once a minimum period of financial membership is served. Association Membership is a way to get actively involved in the life of the Association. FRIENDS OF SHFPACT ‘Friends of SHFPACT’ enjoy the same benefits of ordinary membership of the Association without the obligations of attendance or voting rights at general meetings. Becoming a ‘Friend of SHFPACT’ is a great way to show your support for the work and goals of our organisation, and means you will be kept up to date on SHFPACT activities through regular communications. Members and Friends of SHFPACT enjoy the following member benefits: • Discounted clinic consultations • Discounted purchases from bookshop (5%) • Invitation to annual Member Events • Members communications (3x per year) • Discount on training course fees (10%) – Professional Members VOLUNTEERS AND STUDENT PLACEMENTS Friends of SHFPACT are regularly called on to assist with the preparation of condom packs for distribution in the Canberra community. This activity can be an engaging way to start a conversation about safe sex in your family or social network! SHFPACT welcomes inquiries from students in programs of study relevant to our areas of work for student placements and projects. In the past, these have involved people studying health promotion, community education, sexology, nursing, medicine, and gender studies amongst others undertaking needs assessment and research projects, and participating in SHFPACT’s service delivery activities.

BECOME A MEMBER OR ‘FRIEND OF SHFPACT’ TODAY AND SUPPORT OUR WORK! Become a member online at shfpact.org.au or call 02 6247 3077 for more information. DONATIONS TO SHFPACT OVER $2.00 ARE TAX DEDUCTIBLE.

BECOM A MEMB E AND SA ER V TODAY E !

ANNUAL 2016 REPORT 2017 OUR PURPOSE SEXUAL HEALTH & FAMILY PLANNING ACT’S PURPOSE IS IMPROVED SEXUAL AND REPRODUCTIVE HEALTH FOR THE CANBERRA COMMUNITY, WITHIN A FRAMEWORK OF HUMAN RIGHTS, SOCIAL JUSTICE, AND PRUDENT FINANCIAL MANAGEMENT FOR LONG-TERM SUSTAINABILITY. Sexual Health & Family Planning ACT’s purpose is improved sexual and reproductive health for the Canberra community, within a framework of human rights, social justice, and prudent financial management for longterm sustainability. Sexual Health and Family Planning ACT is a leader in integrated sexual and reproductive health workforce development, health promotion and education, and clinical services delivery to: a. reduce barriers to reproductive and sexual health; and, b. build the capacity of individuals, communities and organisations to improve sexual and reproductive health. Sexual Health and Family Planning ACT seeks opportunities to support, influence and collaborate with others to achieve its purpose and goals, recognising that it is neither possible nor desirable for any single group or organisation alone to improve sexual and reproductive health of the community. Sexual Health and Family Planning ACT operates financially for a sustained, viable long-term presence in the Canberra community in pursuing its purpose. Sexual Health and Family Planning ACT develops and delivers services on at least cost recovery basis where gaps exist in sexual and reproductive health. Sexual Health and Family Planning ACT recognises that gender is a key social determinant of sexual and reproductive health, that promoting gender equity results in improved health and wellbeing for the whole community, and that the biological, psychological, relational, and social dimensions of sex and gender are central to improved sexual and reproductive health outcomes across the lifespan. Sexual Health & Family Planning ACT identifies barriers to improved sexual and reproductive health as: a. the availability, accessibility and affordability of high quality health services; b. the availability of workforce skills development opportunities in the community that improve the responsiveness of primary healthcare providers, and other workers and carers in the area of sexual and reproductive health; c. access to accurate and appropriate knowledge and information to inform public policy and personal choices about sexual and reproductive health; d. the structuring of health and community support services in ways that create separation and ‘silos’ that do not reflect the lived experience of sexuality, sexual and reproductive health as an interconnected whole.

PRIORITY POPULATIONS SEXUAL HEALTH & FAMILY PLANNING ACT IDENTIFIES PRIORITY POPULATIONS FACING BARRIERS TO ACHIEVING IMPROVED SEXUAL AND REPRODUCTIVE HEALTH AS: a. Young people b. People on low incomes or who are otherwise facing financial hardship and disadvantage; c. People from culturally and linguistically diverse backgrounds d. People with disabilities e. Aboriginal and Torres Strait Islanders, and f. People who identify as gay, lesbian, bisexual, or queer, and people who are same-sex attracted, sex and/or gender-diverse

SEXUAL HEALTH AND FAMILY PLANNING ACT RECOGNISES THAT OTHER POPULATION GROUPS ALSO FACE BARRIERS TO IMPROVED SEXUAL AND REPRODUCTIVE HEALTH, AND DEVELOPS AND DELIVERS RESPONSES CONSISTENT WITH THESE ENDS INFORMED BY AN EVIDENCE BASE, INCLUDING RESEARCH, POLICY PRIORITIES AND FRAMEWORKS, AND NEEDS ASSESSMENT FOR NEW AND EMERGING AREAS OF WORK.

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SEXUAL HEALTH AND FAMILY PLANNING ACT

AREAS OF WORK • Clinical services in the area of sexual and reproductive health o Providing a client-centred suite of reproductive and sexual health primary healthcare services, including sexual health screening, contraception, pregnancy, menopause, and gynaecological care. • Professional Development Training o Delivering classroom and clinical attachment training for medical practitioners, registered nurses and allied health professionals in sexual and reproductive health, nationally VET-accredited training programs for education, youth, community and disability sector workers, seminars and workshops focused on workforce development. • Community & Schools Education and Health Promotion o Providing comprehensive, responsive and tailored programs to a broad range of community groups and schools on all aspects of sexual and reproductive health and rights, sexuality and relationships education. o Working with partner organisations to promote access to sexual health services and sexual health literacy through community-based health promotion projects. • Information Services o Making information available to inform decisions about sexual and reproductive health available in person in print and online.

STRATEGIC GOALS 2014-2018 VISION FOR STRATEGIC DIRECTIONS 2014-2018

SHFPACT IS A VIBRANT, EFFECTIVE AND TRUSTED ORGANISATION LEADING RESPONSES THAT SUPPORT EXUAL AND REPRODUCTIVE HEALTH AND RIGHTS.

DELIVER HIGH QUALITY SERVICES THAT IMPROVE THE SEXUAL AND REPRODUCTIVE HEALTH OF THE CANBERRA COMMUNITY

DEVELOP HIGH QUALITY INFORMATION, EDUCATION, TRAINING AND CLINICAL SERVICE MODELS IN AN EVOLVING ENVIRONMENT IN AREAS OF COMMUNITY NEED

COLLABORATE EFFECTIVELY WITH KEY PARTNERS AND BUILD NEW PARTNERSHIP TO ACHIEVE COMMON GOALS

INCREASE THE PROFILE OF SEXUAL AND REPRODUCTIVE HEALTH ISSUES AND ADDRESS BARRIERS TO REPRODUCTIVE AND SEXUAL HEALTH

INCREASE AWARENESS OF SHFPACT AND ITS SERVICES IN THE CANBERRA COMMUNITY

MANAGE AND GOVERN THE ORGANISATION AND ITS RESOURCES EFFECTIVELY

STRATEGIC GOALS FOR 2014-2018

ANNUAL 2016 REPORT 2017

CANBERRA MENOPAUSE CENTRE

SEXUAL HEALTH AND FAMILY PLANNING ACT

shfpact.org.au

Based at Sexual Health & Family Planning ACT the Canberra Menopause Centre is a specialist service for women seeking information, support and/or medical management of menopause symptoms. Appointments call 02 6247 3077

PAP TESTS ARE CHANGING

From 1 December 2017 the 2 yearly Pap test for women aged 18-69 will be replaced by tharly Cervical Screening Test for women aged 25-74. This new test will improve early detection and save more lives.

The procedure for collecting the sample for a Cervical Screening Test will be the same as the procedure for having a Pap test. MAKE AN APPOINTMENT WITH ONE OF OUR EXPERIENCED NURSES TODAY 6247 3077 SHFPACT.ORG.AU 04

SEXUAL HEALTH AND FAMILY PLANNING ACT

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SEXUAL HEALTH AND FAMILY PLANNING ACT

COUNCIL AND EXECUTIVE REPORT THE LAST YEAR HAS SEEN THE ORGANISATION ENGAGE IN CHALLENGING RESTRUCTURING TO ENSURE A CONTINUING HIGH QUALITY OFFER TO THE CANBERRA COMMUNITY AND FINANCIAL SUSTAINABILITY, AND THE CONSOLIDATION FOLLOWING MAJOR CHANGES IN THE FUNDING ENVIRONMENT. After a period of uncertainty in funding, in January 2017 SHFPACT commenced working with ACT Education Directorate on shaping an ACT-specific model for continuing work started under the national Safe Schools Coalition Australia program providing support to Canberra schools and education programs to be safe, inclusive and welcoming of al students, regardless of sexual orientation, intersex status, or gender identity/presentation. This followed a decision last year made with our collaborating partners that continuing under national arrangements could not make sense in the ACT. ACT Government support and commitment to maintain has translated into a development project that has involved continuing engagement from our collaborating health and community service partners in the old program model, and an expanded reference group and consultations with other stakeholders to ensure this support to school communities continues to reflect unique ACT contexts and needs as the ACT Safe and Inclusive Schools Initiative. SHFPACT recognises the political leadership and resource support shown by the ACT Government in this important area. SHFPACT, like our sister family planning organisations nationally, stepped up to address the lack of information and confusion about changes to Australia’s cervical screening program, and the alarm that was generated about poorly understood risks to women’s health and lives. The delay in implementation of these changes, at short notice, from May to December 2017 also affected health service provision, health workforce training, and community-direct health information. Through social media and health information resources, and from October 2017 onwards a specific health workforce briefings and training opportunities, SHFPACT has attempted to ensure the Canberra community is supported. Nationally, family planning organisations also engaged in a very public debate to correct misinformation and misunderstandings about the changes. Demand for training to support social safety for people with disabilities under the SoSafe! Program, acquired by SHFPACT last year, has continued to be popular, and we’re forging partnerships to provide support, tools and knowledge to people across the world. IN the coming year, we will be completing a major review and refresh of the primary resource material and framework, and developing new tools for implementation. The SHFPACT Education & Training team have developed several new groupwork, behaviour support and parent/carer support programs based on the concepts and tools provided in SoSAFE! Program. These services are primarily provided through NDIS plans for individuals, with small numbers of ‘scholarship’ places offered at no cost or free for those people without an NDIS plan and who cannot afford the fees. Through our training partnerships, we will look to share and expand these SoSAFE!-based activities with others nationally and internationally. Inside our organisation, the SHFPACT Council and team worked through important restructures of programs and staffing to respond to our changing environment. Throughout, SHFPACT has endeavoured to minimise the impact to clients and community, and communication of changes to what can be offered and fee structures for previous funded work have been important challenges to meet. We have sought to identify new opportunities, and to minimise impacts of changes in our service delivery profile, especially for people with disabilities, and for access to clinical services for people on low incomes. We’re pleased to have achieved a small surplus in this year’s financial accounts, after the implementation and consolidation of important budget decisions last year to achieve this result. SHFPACT will continue to work to increase this surplus result, so that we can channel retained earnings back into service-provision. We want to make sure everybody can use our quality health services, and we know that people who struggle financially have to make important decisions about how their limited resources are stretched, and can often go without when it comes to healthcare. SHFPACT will continue to do more to make sure nobody misses out on the high-quality information and services that enables them to enjoy safe and healthy sexual and reproductive lives. Finally, and most importantly, we’d like to thank our staff and volunteers. It can never be said too often or too much: without your commitment, enthusiasm and specialist skills, SHFPACT would not be the respected, high-quality organisation that it is. Thank you.

President: Joanna Spratt Treasurer: Jane Hadrill Executive Director: Tim Bavinton

ANNUAL 2016 REPORT 2017 STRATEGIC PLAN 2014-2018 SHFPACT IDENTIFIED 12 STRATEGIC OBJECTIVES TO ACHIEVE ITS GOALS AS PART OF STRATEGIC PLANNING IN 2014. IN 2016-17, THE FOLLOWING WORK PROGRESSED THESE AREAS OF WORK OBJECTIVE 1. EXTEND SPECIALISED CLINICAL SERVICES FOR MENOPAUSE An advertising and promotional strategic for the Canberra Menopause Centre has been implemented during 2016-17, significantly lifting the number of appointments and community and other health service awareness of SHFPACT’s specialised services in this area. OBJECTIVE 3. DELIVER HIGH QUALITY SERVICES FOR PEOPLE WITH DISABILITY AND THEIR CARERS, AND EVOLVE SERVICE MODELS RESPONSIVE TO THE NEW NDIS FUNDING ENVIRONMENT In 2016-17, SHFPACT maintained its NDIS registration and continued to grow the range of programs and services offered under NDIS funding arrangements. Demand for group work programs exceeded individual education and training services, and new group programs were developed: Nice to Meet Me, a relationships education program for young women with ASD based on Canadian; and, Me & You, an adaptation for a younger pre-teen audience of the highly demanded SHFPACT group work and counselling program Family, Friends & Relationships. SHFPACT has evolved the one-day training program for the SoSAFE! program to cater more specifically for the needs of parents/carers distinct from educators and other professionals, and to maintain ACT Teacher Quality Institute accreditation for this training in the ACT. We look forward to the continuing development of training partnerships for SoSAFE! with interstate and international partners that were initiated in 2017. SHFPACT applications for the 2017 ACT round of NDIS ILC (Information, Linkages and Capacity Building) funding were not successful. OBJECTIVE 4. PROVIDE RELEVANT AND ACCESSIBLE INFORMATION ABOUT: a. Sexuality, health and ageing b. Sexuality, relationships, reproductive and sexual health for people with disabilities c. Long-acting, reversible contraceptive options d. Cervical screening program changes e. Unplanned pregnancy counselling, pregnancy support and abortion services OBJECTIVE 6. WORK WITH LOCAL PARTNERS, THROUGH FAMILY PLANNING ALLIANCE AUSTRALIA AND WITH OTHER PARTNERS NATIONALLY, TO ADVANCE SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS PRIORITIES IN THE CANBERRA COMMUNITY AND AUSTRALIA Consistent with its identified strategic themes, these areas were identified as information priorities. Through our membership of Family Planning Alliance Australia, work has continued to educate the health workforce and wider community about long acting reversible contraceptives (LARCs), and access to abortion in Australia. Locally, SHFPACT continued to work with Women’s Centre for Health Matters to identify barriers to abortion access for women in the Canberra region. Funding from ACT Government Community Services Directorate (information, disability services sector capacity building) and Education Directorate (sexual health education for students with disabilities) ended in June 2016. Broader health information activities specifically for people with disabilities that were supported by these funding sources have also ended, and are not replaced by services eligible for NDIS funding. SHFPACT supported research work by Women with Disabilities ACT (WWDACT) on contraceptive decision making for minors with impaired decision making ability. Implementation of changes to Australia’s cervical screening program were delayed from May to December 2017. Nationally, family planning organisations and other women’s health advocates responded to heightened community alarm about the changes, in the absence of an information campaign by the Australian Government to explain what the changes and their impact. SHFPACT deferred allocated resources for workforce development and community information into the next funding period. SHFPACT maintains its active membership in the Family Planning Alliance Australia (FPAA), where national priority policy and advocacy issues include: • • • •

Long acting reversible contraceptive (LARC) use in Australia Access to comprehensive sexuality and relationships education Access to abortion services in Australia The role of nursing workforce in primary healthcare advancing reproductive and sexual health

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SEXUAL HEALTH AND FAMILY PLANNING ACT

OBJECTIVE 5. SUPPORT ACT IMPLEMENTATION OF NATIONAL STRATEGIES (2014-2017) FOR STIS & BBVS WITH LOCAL COMMUNITY AND GOVERNMENT PARTNERS SHFPACT collaborated with AIDS Action Council, Hepatitis ACT and consulted with Canberra Sexual Health Centre to put forward a bid for two joint projects under these priorities: • Enhanced outreach health promotion and STI/BBV testing activities • Sexual health and BBV needs analysis of the ACT community These projects will roll out in 2017-18. SHFPACT is also contributing to other projects looking at the impact of HIV/Hepatitis in the lives of ageing Canberrans, and the continuing impacts of stigma and discrimination against people living with viral hepatitis and/or HIV. OBJECTIVE 8. ATTRACT AND RETAIN HIGH QUALITY STAFF AND VOLUNTEERS, AND SUPPORT THEIR PROFESSIONAL DEVELOPMENT This is an ongoing strategic objective. SHFPACT values and supports the professional development of staff, budgetin a minimum of $1000 per full time equivalent employee for training and professional development, supporting attendance in relevant conferences and workshops, and offering generous study leave and other support for participation in accredited training programs. With the upcoming HIV/AIDS 2017 and Australasian Sexual Health Conferences in Canberra in November 2017, resources have been committed from the 2016-17 financial year to support SHFPACT staff participation in these valuable professional learning and networking opportunities. During 2016-17, SHFPACT engaged with volunteering program through Volunteering & Contact ACT and the Australian National University, which resulted in new volunteer support for National Condom Day 2017 activities. OBJECTIVE 11. INVEST IN THE FACILITIES, INFORMATION AND COMMUNICATIONS TECHNOLOGY INFRASTRUCTURE REQUIRED TO ACHIEVE OUR GOALS AND OBJECTIVES SHFPACT was the grateful recipient of an ACT Government Community Services Infrastructure Grants program grant for the purchase of equipment to assist access to clinical services for clients with mobility limitation or overweight. Facilities repair and upgrade at Level 1, 28 University Ave in accordance with an established repairs and maintenance priority schedule. An App development and maintenance service agreement was put in place to shape Apple Store Apps for the SoSAFE! Program to market in early 2018. OBJECTIVE 12. DIVERSIFY REVENUE SOURCES TO ENHANCE ORGANISATIONAL SUSTAINABILITY Changes to the mix of funding sources saw SHFPACT’s revenue concentration index continue to drop from 0.5530 (2014) to 0.4142 (2017), and projected 0.3779 in 2018. Revenue concentration is a measure of the relative diversity of revenue sources, capturing both the number of different revenue sources and the balance of revenue across these sources. Values and movement closer to 0 indicate diversification, and closer to 1 indicate concentration of revenue. The SHFPACT Council met in May 2016 to review progress against the Strategic Plan 2014-2018, to consider the priority of remaining strategic objectives, and to clarify financial sustainability goals. Following a year of major change in the staffing levels and service offerings of the organisation, the follow strategic objectives were de-prioritised in the current strategic environment or deemed difficult to achieve in the remaining year of the strategic plan: MEET OBJECTIVE 2. DEVELOP AND DELIVER ACCREDITED TRAINING OPTIONS IN SEXUALITY, REPRODUCTIVE AND SEXUAL HEALTH ISSUES FOR THE AGED CARE SECTOR WORKFORCE The development of new accredited workforce training and professional development programs for aged care remains in focus, including in our work developing the SoSAFE! Program for new contexts and audiences. This strategic objective de-prioritised to be pursued my opportunistically, in context of continuing our focus to consolidate transitions and grow the service offer under NDIS for people with disabilities. MEET OBJECTIVE 7. DEVELOP A NEW OUTCOMES MEASUREMENT FRAMEWORK FOR THE ORGANISATION’S CURRENT AND FUTURE ACTIVITIES BASED ON EXISTING INTERNAL AND EXTERNAL DATA SOURCES Develop a new outcomes measurement framework for the organisation’s current and future activities based on existing internal and external data sources. MEET OBJECTIVE 10. COMPLETE A RECONCILIATION ACTION PLAN FOR THE ORGANISATION TO ENHANCE OUR UNDERSTANDING AND RELATIONSHIP WITH ABORIGINAL AND TORRES STRAIT ISLANDER COMMUNITIES IN THE CANBERRA COMMUNITY A Reconciliation Action Plan (RAP) was originally identified as one common, but not exclusively, means for businesses and community service organisations in Australia to achieve the goal of building a stronger relationship with Aboriginal and Torres Strait Islander people and communities. SHFPACT remains committed to culturally safe and accessible services, and to the relationships built with other indigenous service delivery organisations.

ANNUAL 2016 REPORT 2017 PROVISION OF REPRODUCTIVE AND SEXUAL HEALTH CLINICAL SERVICES SHFPACT makes a direct contribution to ensuring high quality, accessible and affordable clinical services for the Canberra community by delivering free services funded by the ACT Government, and applying a billing concessions policy to other unfunded family planning, reproductive and sexual health services that minimises or eliminates the cost barrier for clients, and the use of outreach clinical activities to reach individuals and communities who may not access a mainstream clinic. SHFPACT’s clinic is a mixed-model business, operating primarily on a fee-for-service basis (either bulk-billed, concession or standard fee charged). 17.3% of consultations were funded by ACT Government in 2016-17. More routine issues and patient flow is central to SHFPACT’s ability to provide high quality, intensive clinical training placements for medical, nursing and allied health professionals. At all times, clients are advised and may decline to have a training health professional present in or providing the consultation. Increasing, SHFPACT is used as a referral point by general practice, and other primary and specialist healthcare services, to address more complex health needs in our areas of expertise: contraception, menopause, and other investigations related to important health conditions like pelvic pain and painful sex.

IN 2016-17 WE SERVED 4,363 INDIVIDUALS IN A TOTAL OF 6,276 VISITS. STIS AND WOMEN’S REPRODUCTIVE HEALTH REMAIN MOST USED FUNDED SERVICES

IN ONE-THIRD OF CONSULTATIONS CONTRACEPTION WAS THE PRINCIPAL SERVICE PROVIDED

ONE IN FIVE

INTERPRETING SUPPORT MOST COMMONLY NEEDED FOR WOMEN’S REPRODUCTIVE HEALTH

OF CLIENTS HEALTH CARE CONCESSION OR PENSION CARD HOLDERS

OF CONSULTATIONS WERE FUNDED BY ACT GOVERNMENT

IN 2016-2017 MORE THAN 1800 NEW MEMBERS ENJOYED MEMBERSHIP DISCOUNTS

4,363

YOUNG MEN ARE

25% OF TOTAL CONSULTATIONS WERE FREE TO THE CLIENT (42% OF NURSE APPOINTMENTS)

CLINIC CLIENTS BORN OVERSEAS

IDENTIFIED AS ABORIGINAL / TORRES STRAIT ISLANDER

INDIVIDUALS SERVED

1/3

OF CLIENTS AGED 40 AND OVER

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45%

SEXUAL HEALTH AND FAMILY PLANNING ACT

12%

45%

OF CLINICAL OUTREACH CLIENTS

20% OF PATIENTS IDENTIFIED A PREFERRED LANGUAGE OTHER THAN ENGLISH

OF CLIENTS ARE YOUNG ADULTS 1529 YEARS

17%

VISIT

THE SHFPACT WEBSITE TODAY SHFPACT.ORG.AU

STATS ABOUT SHFPACT

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SEXUAL HEALTH AND FAMILY PLANNING ACT

CONCESSIONS AND BULK-BILLED SERVICES (SERVICES NOT FUNDED BY ACT GOVERNMENT)

From October 2016, SHFPACT introduced a new concessions and billing policy. In previous years 45% of doctors’ appointments were bulk-billed, a level unsustainable in private general practice and other primary healthcare settings. These levels of bulk-billing had been supported by drawing down on retained earnings over many years.

SCAN ME WITH SMART PHONE QR CODE READER*

The way clinical services are billed was reviewed in detail, with a keen eye to the impact of introducing fees on access for those most adversely affected. In particular, SHFPACT is working with key referral partners to ensure that timely and financially accessible services are maintained for clients most in need. More information about these changes can be found on the SHFPACT website at: shfpact.org.au/about-us/news-updates/275-concession-feeschanges-for-shfpact-clinical-services or scan the QR code with your mobile device. *A QR CODE READER App can be downloaded from the Apple App Store or Google Play.

The new policy introduced a concession rate to replace the majority of bulk-billed services, with eligible clients out of pocket approximately $25 per consultation. Alongside this change, SHFPACT introduced new membership discounts. For many clients, this resulted in a concession membership payment of $15 providing access to nursing services at no additional cost throughout the year, and a reduced rate to see a doctor. The new concessional rate applied to identified priority groups, including: • Young people aged 21 or under • Full-time students to age 25 years • Health Care Card holders, and other pensioners or entitlement holders • People with disabilities Bulk-billed appointments were reduced but continued to be offered on a case-by-case basis during this transition to support access for clients facing financial hardship. Combined with services funded by ACT Government, for which no fee is charged, one-quarter of all clients seen by the SHFPACT clinic last year paid no fee.

STANDARD 4190 — CLIENTS

67%

BULK BILLED — 494 CLIENTS

CONCESSIONAL FEE — 494 CLIENTS

FUNDED — 1086 CLIENTS

17%

CLINICAL CONSULTATIONS — BILLING-TYPE 2016/2017

ANNUAL 2016 REPORT 2017 ACCESSIBLE CLINICAL SERVICES PROVISION 739 CONSULTATIONS WERE PROVIDED TO PEOPLE WHO ARE LOW INCOME EARNERS OR WERE NOT OTHERWISE ELIGIBLE FOR A CONCESSIONAL FEE RECEIVED A FREE SERVICE FROM SHFPACT CLINIC FUNDED BY ACT GOVERNMENT (ACT HEALTH). Clients accessing this service include: • low income earners accessing sexual health nursing services; • international students who do not have access to Medicare; • young people who do not have their own Medicare card; • workers in the sex industry; • clients referred through community partner organisations as part of combined health education/clinic visits that involved a consultation.

94% OF THESE CONSULTATIONS WERE FOR WOMEN, 40% YOUNG ADULTS AGED 15-24 YEARS, AND PREDOMINANTLY FOR SHFPACT’S SPECIALISED RANGE OF WOMEN’S HEALTH AND GYNAECOLOGICAL SERVICES (68%), FOLLOWED BY SEXUALLY TRANSMISSIBLE INFECTIONS (21%). Working within a revised national data dictionary for family planning organisations, ‘Gynaecology’ refers to a broad principal service category related to female reproductive health. The consultation is not provided by a specialist gynaecologist, and the category includes: • Cervical screening services and follow up of abnormal results • A range of vaginal and vulval symptoms and conditions, that may require investigation and treatment • Irregular menstrual cycle and bleeding problems • Painful sex • Investigation, treatment and referral for pelvic pain • Information and management of menopausal symptoms, including advice on HRT and non-HRT management of gynaecological symptoms both related and unrelated to menopause or perimenopause Many of these issues require more complex follow up than some GPs feel skilled to manage and/or that require longer consultations that earn less income in general practice.

OUTREACH CLINICAL SERVICES THIS PROGRAM ALSO SUPPORTS CLINIC VISITS FOR YOUNG PEOPLE, PEOPLE USING SPECIALIST HOMELESSNESS SERVICES, MEN AND WOMEN WITH DISABILITIES REFERRED FROM OTHER COMMUNITY-BASED DISABILITY SUPPORT SERVICES. Tertiary education institutions and university residential colleges regularly request sexual health information for university students. The SHFPACT Outreach program combines these presentations with outreach chlamydia and other STI/BBV testing opportunities and direct referral for additional services at the SHFPACT clinic. SHFPACT Clinic outreach activities included our continuing partnership with Canberra Sexual Health Centre to provide: • coordinated health outreach services to Canberra Community Cares, a nationally-recognised program that supports young parents to stay connected with the education system. A significant proportion of the young people using this service are Aboriginal/Torres Strait Islander • SWOP Shop, a regular outreach program to sex workers in parlours and brothels to provide sexual health screening and information The ongoing SHLiRP (Sexual Health Lifestyles and Relationships Program) partnership with Canberra Sexual Health Centre and ACT government secondary colleges continues to an engaging health education and sexual health testing opportunity to Year 11 and 12 students.

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SEXUAL HEALTH AND FAMILY PLANNING ACT

The program runs on a calendar year. In 2016-17 four ACT secondary colleges were visited, resulting in a slightly lower number of participants in this program compared with last year when five schools participated. The participation rate by young men in the SHLiRP consultations (45% of clients in the SHFPACT Outreach program in 2016-17) is well above young men’s attendance in other primary care clinical settings for sexual health issues. ACT Government funding supported delivery of a total of 3,258 services were provided to 1,027 individuals in our outreach and access clinical services programs in 2016-17. 94% of services were for sexually transmissible infections (STI) testing and treatment.

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COUNSELLING SESSIONS WERE PROVIDED TO

WOMEN BY THE UNPLANNED PREGNANCY COUNSELLING SERVICE IN 2016-2017

UNPLANNED PREGNANCY COUNSELLING SHFPACT PROVIDES THE ONLY FREE, ALL-OPTIONS, UNBIASED PREGNANCY COUNSELLING SERVICE IN THE ACT, TO ASSIST WOMEN WITH AN UNPLANNED PREGNANCY WITH INFORMATION AND COUNSELLING SUPPORT. The service can also extend to her partner and other family, or partner-in-pregnancy. The service is provided at no cost to clients to reduce barriers to the service and meet needs of young and/or financially disadvantaged women in this area, and is funded by ACT Health on an availability basis. • 31 counselling sessions were provided to 28 women by the unplanned pregnancy counselling service in 2016-17 SHFPACT has developed resources relating to unplanned pregnancy including a Pregnancy Options brochure which provides information for women and their partners facing an unplanned pregnancy and includes referral points and contacts, and an Early Pregnancy information handout which provides basic information regarding health in pregnancy, pregnancy care, birth options, referral points and contacts, including relevant websites.

ANNUAL 2016 REPORT 2017 MEDICAL EDUCATION AND TRAINING PROGRAMS SHFPACT OFFERS THE FOLLOWING ACCREDITED TRAINING COURSES FOR MEDICAL PRACTITIONERS:

• FPAA Certificate in Sexual & Reproductive Health for Doctors: The nationally recognised and RACGP/RANZCOG endorsed curriculum is delivered by family planning organisations, including SHFPACT. The program delivered in the ACT covers six one-day Theory Modules, Objective Structured Clinical Examination and a 30-hour Clinical Placement, representing a substantial commitment by participants. • 16 GPs participated in the theory components of the course in 2016-17, and 9 completed the Clinical Attachment Component of the Doctors Course in 2017 at time of report, and have been awarded the FPAA Certificate in Reproductive and Sexual Health for Doctors. Several more from this cohort are anticipated to complete clinical attachment training by the end of the year. and two short-course programs for GPs focused on long-acting reversible contraception (LARC): • IUD Insertion (theory + clinical practicum) • Implanon® Training • Implanon Training – Theory and Practical Components – was delivered to the new cohort of General Practice Trainees at the request of GP Synergy and MSD • The interactive IUD Workshop was enjoyed by 8 participants, 7 of whom have completed clinical IUD insertion training in the clinic, and are ready to independently deliver this LARC service to our local and regional communities Over the years, SHFPACT’s work in this area has significantly increased access to these improved forms of contraception in primary care settings in the Canberra region. SUPPORTING CONTINUING PROFESSIONAL DEVELOPMENT SHFPACT supports on the continuing professional development of the health workforce in the areas of reproductive and sexual health through: • Ensuring regular clinical meetings attract RACGP CPD points, and are opened by invitation to clinicians who have undertaken training with SHFPACT or work in the reproductive and sexual health area • Hosting a multidisciplinary ACT Pelvic Pain Group attended by GPs, gynaecologists, dermatologist, nurses, psychosexual therapists, and pelvic floor physiotherapists who are interested in the care of women experiencing pelvic pain conditions • Offering meeting space for the ACT Chapter of the Society of Australian Sexologists, an interdisciplinary forum for therapists, educators and researchers working broadly in the field of sexual therapy, sexuality education, and sexology • Presenting updates on key reproductive and sexual health issues and clinical practice to other professional networks and organisations NURSE AND MIDWIFERY EDUCATION AND TRAINING PROGRAMS

• SHFPACT Well Women’s Screening Course for nurses The program includes distance education modules, a one-day classroom learning and skills workshop, followed by minimum 15-20 hours clinical placement to learn clinical skills and demonstrate competency. The Program is designed for and trains to a scope of practice relevant for practice nurses in general practice and other primary healthcare settings. • 6 registered nurses participated in the SHFPACT Well Women’s Screening Course and completed clinical placements for the program in 2017

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SEXUAL HEALTH AND FAMILY PLANNING ACT

• University of Canberra Midwifery Program placements SHFPACT has continued offering observational placements for students from the midwifery program at University of Canberra. Students are exposed to family planning, reproductive and sexual health services generally and to the work of SHFPACT specifically through a one-day placement, and over time it is anticipated that this engagement will improve the knowledge of and referral to family planning, reproductive and sexual health services as midwives graduate and begin to practice. • 25 UC Midwifery students participated in placements in 2016-17. As in previous years, participants highly valued the placement experience at SHFPACT PROFESSIONAL EDUCATION & TRAINING SHFPACT provides non-clinical professional development education and training courses, workshops and seminars for professionals working in the education, community services, disability support and other allied health fields on request. This program is partly supported by funding from ACT Health. In 2016-17, activities focused significantly on the education sector. • 101 primary and secondary teachers and learning support assistants participated in professional education workshops, including at non-mainstream education programs to support students at risk of education disengagement, and in specialist inclusion schools for students with high support needs SCHOOLS EDUCATION SHFPACT continues to actively engage with primary and secondary schools to build the capacity of school communities to provide accurate, comprehensive, age and developmentally appropriate, relationships and sexual health education. SHFPACT views the role of parents and teachers as central in this endeavour, and our services are provided to support and enhance these roles, not to replace them. SHFPACT prioritises the delivery of programs in schools to those where an existing program is in place and the use of external facilitators or guest speakers has been well considered. • 1120 senior primary school children and young people attending secondary school participated in health education programs delivered in schools by SHFPACT staff, primarily puberty education programs in ‘mainstream’ school settings, and tailored sexuality education program delivery for students with disabilities • 4090 senior secondary students participated in SHLiRP health education sessions in secondary colleges • 218 parents and carers attended Parent Information Evenings facilitated by SHFPACT staff in conjunction with schools-based health education and other community programs SAFE SCHOOLS COALITION ACT TO ACT SAFE AND INCLUSIVE SCHOOLS INITIATIVE Following relentless public attacks during 2016 on the Safe Schools Coalition Australia program, and subsequent changes to program guidelines imposed by the Australian Government, SHFPACT and our local collaborating partners determined not to continue providing these supports to Canberra schools under the national program arrangements. SHFPACT ceased delivery of SSCA in September 2016. Prior to the ACT Election in October 2016, ACT Government made a commitment to continue funding this work. This commitment was restated by Labor and Greens during the election. SHFPACT continued to provide training, advice and support on request to schools during the period October 2016 to February 2017 without a funding agreement in place. From January 2017, SHFPACT has worked with the ACT Education Directorate on a development project for a new program model suited and responsive to local ACT conditions and needs, drawing on our experience of providing the Safe Schools Coalition program here. This development project continued through 2017, with an expanded Reference Group including representative school parent bodies, health and community organisations, key Education Directorate representatives, and canvassing the views and needs of schools across the public, Catholic and independent sectors. SHFPACT and other stakeholders look forward to the delivery of the new program model in ACT schools and education programs later in 2017.

ANNUAL 2016 REPORT 2017 CANBERRA MENOPAUSE CENTRE

MENOPAUSE AND YOU FIND OUT HOW MENOPAUSE MAY AFFECT YOUR LIFE AND WHAT THE CANBERRA MENOPAUSE CENTRE CAN DO FOR YOU

Canberra Menopuase Centre at Sexual Health and Family Planning ACT L1, 28 University Ave, Canberra City. 02 6247 3077 or shfpact@shfpact.org.au 14

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MEDICAL EDUCATION AND TRAINING PROGRAMS (CONT.) COMMUNITY HEALTH EDUCATION SHFPACT continues to respond to requests to provide other community education and health information events, including: • Men’s and women’s health information events at ANU residential colleges, CIT and University of Canberra including international students recently arrived in Australia • Presentation to small groups of young people on sexual health issues, with other community and youth service providers, youth homelessness and out-of-home-care services • 478 young adults participated in health education activities. Some of these included outreach STI/BBV testing opportunities • 93 young apprentices participated in sexual health education presentations organised through CIT NDIS - EDUCATION AND BEHAVIOUR SUPPORT PROGRAMS In 2016-17, SHFPACT maintained its NDIS registration and continued to grow the range of programs and services offered under NDIS funding arrangements. • 11 young adults participated in Family, Friends & Relationships group education programs. These include three sessions one-on-one with a counsellor/educator to ensure individual needs are being met and to identify additional information, education, skills training needs, or referral for other therapeutic supports • 8 adults participated in a pilot Family, Friends & Relationships group education program run with L’Arche Genneseret, an intention community of people, some living with disabilities Demand for group work programs exceeded demand for individual education and training services, and two new group programs were developed: • Nice to Meet Me, a relationships education program for young women with ; and, • Me & You, an adaptation for a younger pre-teen audience of the highly demanded SHFPACT group work and counselling program Family, Friends & Relationships SOSAFE! PROGRAM SHFPACT continued to delivery training in the award-winning, evidence-based social skills safety training program SoSAFE! throughout the year. SHFPACT has evolved the one-day training program for the SoSAFE! program to cater more specifically for the needs of parents/carers distinct from educators and other professionals, and to maintain ACT Teacher Quality Institute accreditation for this training in the ACT. We look forward to the continuing development of training partnerships for SoSAFE! with interstate and international partners that were initiated in 2017. During 2016-17: • 158 educators, allied health professionals, or parents/carers participated in one-day SoSAFE! User Training in the ACT • 45 educators participated in SoSAFE! training interstate

ANNUAL 2016 REPORT 2017 SPECIAL THANKS Association of Parents & Friends of ACT Schools (APFACTS) ACT Cervical Screening Program Australian Education Union (ACT) Capital Health Network Advocacy for Inclusion A Gender Agenda AIDS Action Council of the ACT Australian National University ANU Students Association ANU Medical School Australian Primary Health Nurses Association (APNA) Australian Research Centre for Sex, Health & Society (ARCSHS) at La Trobe University ASHHNA (Australasian Sexual Health & HIV Nurses Association) Assurance Accounts Atom Software Burton & Garran Hall residents Canberra Institute of Technology Canberra Rape Crisis Centre Canberra Sexual Health Centre, The Canberra Hospital Capital Pathology CentreRed IT CIT Students Association Coast City Country Training Companion House Philip Brown and Veneta Amies, EdICTs (Educational ICTs) Forensic and Medical Sexual Assault Care (The Canberra Hospital) Foundation for Young Australians FUSE Magazine & Lithium Innovation Pty Ltd Griffin Legal The Green Shed Hepatitis ACT Koomarri Melissa McGrath Royal Australasian College of General Practice Sex Worker Outreach Project Dr Sheridan Kerr Society of Australian Sexologists (SAS) The Junction Youth Health Service University of Canberra UC Students’ Association Vincents Winnunga Nimmityjah Aboriginal Medical Service Women’s Centre for Health Matters Women’s Health Service Women With Disabilities ACT (WWDACT)

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OUR BOARD PRESIDENT

BOARD MEMBERS

• JOANNA SPRATT

• SCOTT MALCOLM

VICE PRESIDENT

• ALICE KNIGHT

• MATT SAMMELS

• BRONWYN CLARK • CAMILLA BURKOT

TREASURER

• MATHEW NOONAN

• JANE HARDRILL

• DR SUN-HEE LEE

OUR STAFF RECEPTION AND CLINIC SUPPORT • Kylie King • Raylene Foster • Susanne Gardiner • Mandy Mottram • Laura Mathias • Janet Munday • Susan Boden • Kate King SEXUAL HEALTH NURSES AND UNPLANNED PREGNANCY COUNSELLORS • Anne Carroll • Carey Ann Davidson * • Amy Faden • Hilary Freeman (Nurse Education Coordinator) • Catherine Maher • Libby McCutchan • Kristen Reed • Antonia Taylor MEDICAL OFFICERS • Tracey Baker • Jill Bestic • Jenny Leung (Senior Medical Officer, Medical Education Coordinator) • Jennifer Leung • Clare Holberton Senior Medical Officer) • Rosa O’Kane (Senior Medical Officer) • Sonia Res • Kelly Teagle • Kaisa Thomson (Senior Medical Officer) • Kath Turner

HEALTH PROMOTION, EDUCATION AND TRAINING, LIBRARY RESOURCE CENTRE • Riddhi Blackley (Project Officer) * • Amy Duncan (Community Education & Health Promotion Officer) * • Sue Ellerman (Community Education & Health Promotion Officer) • Patricia Jones (Manager Education, Health Promotion & Training) • Pi Lee (Project Officer) • Jen Lewis (Project Officer, Educator and Trainer) • Majka McLean-Engström (Project Officer) * • Elle Reid (Coordinator: Library and Information Services) * • Erin Smith (Safe Schools Coalition Project Officer Community Education & Health Promotion Officer) * • Louise Stockton (Project Officer) • Aga Włodarczyk (Community Education & Health Promotion Officer) BUSINESS SERVICES, FINANCE & ADMINISTRATION • Leanne Blewitt (Manager Business Services Unit) • Karen Huggett (Programs Administration Officer) * Marketing and Communications • Alexander Thatcher MANAGEMENT TEAM • Leanne Blewitt (Manager Business Services Unit) • Anne Carroll (Clinic Nurse Coordinator) • Lisa Grant (Director Client Services) • Drs Jenny Leung, Clare Holberton, Kaisa Thomson (Senior Medical Officers) • Patricia Jones (Manager Education, Health Promotion & Training) • Kylie King (Coordinator Reception) EXECUTIVE DIRECTOR • Tim Bavinton

* Staff member departed during the year

ANNUAL 2016 REPORT 2017 SEXUAL HEALTH AND FAMILY PLANNING ACT

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SEXUAL HEALTH & FAMILY PLANNING ACT Street: Mail: Telephone Fax SMS Email Web Facebook Twitter Issuu

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Level One, 28 University Ave, Canberra ACT 2601 GPO Box 1317, Canberra ACT 2601 +61 2 62473077 + 61 2 62575710 0400 770 999 shfpact@shfpact.org.au shfpact.org.au facebook.com/shfpact twitter/shfpact issuu/shfpact

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