Rumbalara Oral Health Clinic operational review – shared experiences driving change

Background

Jawun is in partnership with several Indigenous organisations delivering health and wellbeing services focused on improving the quality of life for Aboriginal and Torres Strait Islander people. Two of these partners include the Rumbalara Aboriginal Cooperative in the Goulburn Murray region of Victoria and Yerin Eleanor Duncan Aboriginal Health Services in the Central Coast region of NSW.

A key element of a person’s health and wellbeing is their oral health. The Australian Institute of Health and Welfare research shows that Aboriginal and Torres Strait Islanders are more likely to have untreated dental issues and less likely to have received preventive dental care than non-Indigenous Australians.

To address this, the Rumbalara Oral Health Clinic delivers a comprehensive range of oral health services, including all basic dentistry needs, endodontics, prosthodontics, outreach services and oral health promotion and education. ​The Yerin dental clinic was established in 2018, providing access to culturally responsive dental care in a purpose-built facility, managed in partnership with the NSW Local Health District. 

The success of Rumbalara’s Oral Health program is evident from an increase of oral health awareness within the community. The program has progressed significantly from being a ‘toothache clinic’ in the early days, to eventually developing a preventative model with over 12,000 patients on file. In this time, however, the funding for the program has become constrained, leading Rumbalara’s Oral Health Practice Manager, Tracey Hearn to identify the need for a full review of their funding and operating model, seeking more sustainable operations.

Approach

In 2021, a University of Melbourne secondee with a background in strategy development, Joli Price, was placed to assist Rumbalara’s Oral Health clinic to explore opportunities to develop sustainable funding. Joli’s project also required advocacy for the appropriate funding for Aboriginal and Torres Strait Islander oral health care, so that oral health promotion and dental treatment for the benefit of community can continue well into the future.​

Early in the project, Jawun brought together the leaders of both Rumbalara and Yerin’s medical service and dental practices. From this meeting, Rumbalara learned how Yerin has integrated partnerships as one way they explore and have great success in creating a sustainable oral health model for their community.

Yerin’s Dental Manager, Kylie Nicholls, outlined how Yerin has partnered with the NSW Local Health District, leveraging their dentists and resources while maintaining a ‘community controlled’ approach over operations. Yerin shared how their value proposition to funders was based around providing early intervention through dental treatments, thus preventing the longer term chronic and complex illnesses (and their costs) associated with long term poor oral health.

Outcomes

Through development and delivery of the operational review project, Joli and Tracey worked to review the organisation’s budget and funding structure, identifying a range of significant opportunities to fund the oral health program sustainably. From these opportunities, 11 recommendations were developed across 3 key themes:

  • Partnerships
  • Optimising revenue
  • Improving service delivery

Drawing on the learnings from the initial meeting with Yerin, Rumbalara lead conversations with the state funding body, Dental Health Services Victoria, as well as the community health peak body, Victorian Aboriginal Community Controlled Health Organisation (VACCHO). Partnerships became central to the discussion as a possible way Rumbalara could support the sustainability of their Oral Health program.   

Tracey reflected on how Joli was able to develop Rumbalara’s understanding of ways to plan strategically for future sustainable funding of the clinic:

“[Joli] broadened my perspectives in future planning for the clinic and opportunities to source and generate additional revenue, as well as developing additional programs to encourage better oral health for our community… [The secondment] has been a great experience and has produced a future work plan for our clinic.”

Joli shared her own reflections:

“The secondment improved my understanding of the importance of self-determination when it comes to funding models for Aboriginal and Torres Strait Islander services such as the Rumbalara Oral Health clinic and how this can be challenging in standard government funding models.”

Next Steps

Given the limitations on the current funding model, the next steps will be ongoing discussions between Rumbalara, VACCHO and DHSV about piloting a potential new partnership model that will improve service delivery and generate additional revenue income to provide a more sustainable operating model.

Jawun will continue to provide support to implement the full suite of opportunities, including upgrading the dental van to provide an improved outreach service, reviewing opportunities to increase the number of private patients and utilising the newly appointed Oral Health Therapist to increase oral health promotions across the community.

Yerin’s Dental Manager, Kylie Nichols summed up the ongoing journey that Aboriginal controlled community health organisations undertake with this advice to Rumbalara: 

“Success is not final… Failure is not fatal… It’s the courage to continue …. That counts.”.