Positive Futures
Join Alex, as he explores a wide range of topics that matter to our community, from sexual health and harm reduction to social issues and culture. The series aims to find the positives in how we face these challenges and the exciting changes that lie ahead.
Positive Futures
The Continuity of Care project
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The next three episodes will cover an exciting new project that we have undertaken to help some of our most vulnerable community members as they head back into the community from custodial settings.
Welcome back to another series of Positive Futures at Red Thread Studio Production. I'm your host Alex, and I want to broaden the scope of the podcast this year to uncover the wide array of people and organizations that work in our health and community sectors. We'll meet some of the key players and find out what exciting projects and initiatives are happening out there right now, and what our guests are most excited or hopeful for in the future. So, welcome back everybody. This is episode one of a little mini-series we're doing, the Continuative Care project. So Tazcard recently got awarded a grant from Hepatitis Australia, the Hip Link program, and that was to do an outreach project. And we actually hired someone very special who's in the studio today with me. Catherine, how are you going? Very well, that's very kind, thank you. Thanks for joining me. So Catherine was hired specifically for this role and hopefully into the future with us, and she is taking care of the continuity of care project, which we'll just call the CC project to save ourselves stumbling over continuity of care all the time.
SPEAKER_00Yes, good plan.
SPEAKER_01So I might hand over straight to you. Do you want to give the listeners a bit of a background on what the project is? What's it about? What's it for?
SPEAKER_00Yes, absolutely. I'm just going to put in there that I have come from the land of nursing and it's been really great to come and join Tesscart and working in, yeah, the post-prison, also sort of the custodial space. I've mostly been working with children and schools and young people and their families. So this has been a great learning curve and to learn about hepatitis a bit more.
SPEAKER_01Well, I mean you say that, but I think they're kind of the same thing, you know. The mini prisons, big prisons.
SPEAKER_00That's right. Yes. Um, yeah, so the project um was designed to to make sure individuals who um have left custodial settings are able to access hepatitis C testing and treatment in the back in the community. Um there's good availability for testing uh sort of on entry and at the start of someone's time in a custodial setting for hep C, but when people leave, it can be a time when people fall through the gaps with health. Yeah, so there's good testing for people when they uh enter prison for Hep C and they can get treatment while they're in there. Uh, and in the perfect world with all the systems working, someone will leave with their medications, they'll either get cured in prison or they'll leave with their medications and also uh be connected with the health services that Tasmania Health Service, so from the custodial setting out into the community, but people do still fall through gaps, and we've certainly heard that through some of the nurses, it just happens. Uh busy time, people might not have a fixed address or a phone, so it can be easy. Yeah. Yep, which is definitely being worked on.
SPEAKER_01So this project is aimed at those people falling through the gaps that you said. So that continuity of care, which I've now learnt from some of the other partner organizations, can also be called through care, which is a nice probably a nicer, easier phrase.
SPEAKER_00Yep.
SPEAKER_01Is about supporting people who maybe aren't on those traditional or formalised pathways. So, like you're saying, either cured inside or and put given medication upon their release or return to the community. Or people who maybe just, yeah, like you said, no fixed stress don't have the support networks once they actually are released.
SPEAKER_00Yep, absolutely. And nationally we know that custodial settings have a high prevalence of hepatitis C and are high risk, usually the use of yeah, needles, uh whether that's for drug use or tattoos, uh, and people might not get follow-up testing because again, it's not necessarily always easy to perhaps engage in those health services in the prison. So this is looking at non-health organisations outside of prison where we can reconnect those people through people who are already talking with them and supporting them.
SPEAKER_01Yep. So the project's about leveraging those existing referral and support pathways by adding a clinical component. Yeah, definitely another hepatitis.
SPEAKER_00Yeah, so we reached out to a lot of yeah, community organisations that work with people during custody and also, well, especially post-release. Yep. They always already sort of often have a good rapport anyway, and they're going to be chatting about all sorts of different parts of their health. So especially specifically housing and um access to resources. It's also been we've found the uh the support, the organisations that are supporting them have also benefited because they've in having those conversations, they've wanted to do some of our learning, so like the Bloodwise, so they're managers and the people going out into the community and on the streets and working with people.
SPEAKER_01And what's Bloodwise for those listening?
SPEAKER_00Uh Bloodwise is TASCADs, hepatitis, bloodborne virus, and STI online or in-person training module. So you've been offering that to some of the organizations we've been partnering with? Yes, and most of them have taken it up in yeah, one form or another.
SPEAKER_01So a bit of a two-way street going on between us and the other organizations?
SPEAKER_00Definitely, yes. Very important.
SPEAKER_01So maybe you can tell us a bit about what the practical steps are involved. So, what have we actually asked these organizations to do and what are we sort of offering them? How are we supporting their already pre-existing programs?
SPEAKER_00Yeah, um, absolutely. So initially we went out generally to their service and met with them, um, had a chat about what their work looked like with people post-prison, and then looked at ways that we could raise awareness about hepatitis C and then link them back in to care. That was taking out our hard copy resources. We made some cards, brochures, obviously our training module, the Bloodwise, we took out information about that.
SPEAKER_01Yeah. And were these aimed at raising awareness of the services that already exist for hepatitis and biohepatitis care?
SPEAKER_00Yeah, it was about giving the information and the skills to the people who are working with people post-prison to know how to have those conversations to help link them back into healthcare, specifically hepatitis C testing and treatment as needed. Yep.
SPEAKER_01And so, how did you go about partnering, choosing partner organizations? How did you select the ones we were working with on this project?
SPEAKER_00So we did a broad sort of search statewide of the existing post-prison supports. Yeah. Uh, whether that's yeah, one-on-one support or broader housing support, group work. So we had a look at all those different types of post-prison supports. Then we decided to sort of really, because we had some time limitations, we decided to really focus on the services that did the one-on-one support with people. So we thought that would give us a better chance of being able to see how the project might help people link back into the clinics.
SPEAKER_01Yeah. Rather than just sort of bulk advertising to some of those bigger services that offer.
SPEAKER_00Yes, exactly. Because we really thought those close the relationships with the people already in those community organizations would enable those conversations because yeah, not everyone wants to talk about their health. They might have had bad experiences with health services in the past. And yeah, we just thought it's a good way to go around it.
SPEAKER_01Which is one of the issues, yeah, I imagine, is those barriers, like you're saying, of stigma and um discrimination against those people, and particularly choices like or you know, where people have ended up in whether it's using drugs or in the prison system, obviously, suddenly you're already stigmatized just by that experience alone.
SPEAKER_00Yeah, definitely. And it's really great we've had a few services who have added either like a checklist or some sort of trigger point in their intake conversations or paperwork where they can bring up the hepatitis C testing and yeah, remind people about that they're in a bit of a high-risk time going back in the community if they're potentially um being exposed to things in the prison. So yeah.
SPEAKER_01So the because the plan is to embed that offering, I guess, into the existing service, right? So, like you're saying, make it as natural as possible through that intake or case management system they're already operating. Yes. And just add that extra category if you will.
SPEAKER_00Yep. And we created sort of a flow chart which had some additional information and questions to support the workers having those conversations. So it could just be a brief, you know, are you aware that leaving prison is a time to get tested for Hep C? Uh and if they've already said, yep, I've already done one, that's great. Yep. Otherwise, they can um have a look at that flow chart, call us if they need or HEP link. Yeah.
SPEAKER_01Yep. And if they haven't had a test, for instance, what um service offering do we have there? What sort of is the referral pathway?
SPEAKER_00Yeah, so we also part of the project we mapped out the different clinical pathways. The main one uh is definitely our um state uh health service hepatitis E clinics, and they're really great because they're already embedded in some different community organizations. Yep. City mission, neighbourhood houses, um, uniting VicTAS, no bucks, those sort of community locations.
SPEAKER_01And service is free, right?
SPEAKER_00And it's free, yeah, which is really great. And we also have um we did one of our clinic nurses also offers this is part of uh Uniting VicTaz have a program catalyst, um, which is an alcohol and other drug program, open to anyone in the community, but they do get um quite a few people coming post-custodial settings. And Naomi from TASCAD does a liver chat, and then the week after we have Adriana from the clinic comes in and does the testing, and we got great feedback saying we felt much more at ease being able to have that testing there, whether it was through the fear of being judged with stigma or whether it was a fear of needles, they just were more worried about how they might react. Um, but they had people around them that they knew from doing this program and felt much more comfortable and yeah, very high uptake of the testing.
SPEAKER_01Which I imagine is one of the benefits of embedding a service in pre-existing services, and like you were saying earlier about that trust issue, and these people have already formed relationships with the clients, you know, they've got caseloads, you know, they might be managing. I know the Salvos project often will work with people for a year, yeah, outside of custodial settings once they're back in the community. And it can take a long time to rebuild that trust. And I think you said earlier as well, the priorities for them. So sometimes health is lower than the priority for housing or food or something. So it is about making those available, which I think why is the program so positive or possible in its leveraging of existing services. So like you're saying, the even the location of those clinics is at community orgs already working to support these people. So they don't have to travel to a new location or meet someone new, they're probably already familiar with AGANA, Tina up in the north. So it seems like a good system.
SPEAKER_00I see it a little bit similar to say in the Tasmania Health Service or community services, where we have the brief intervention conversations for smoking cessation. Oh yeah. So the idea is that you um it could be someone on a ward, it could be a GP, it could be that you might not have the time to have that full conversation and counselling, and but it's those little conversations, so like on the intake for a post-prison service. Are you aware that you're in a high risk time leaving prison and you know about hepatitis C testing? And um if you need to go and get one, we can help you find the next local clinic.
SPEAKER_01And particularly, I think it's a good point, like with those brief conversations, for hepatitis C at least, unlike B, it's a pretty easy, quick story in some ways, isn't it? Because once you're tested, there is a readily available cure. That's quite easy. It's not even that long, six to twelve weeks, depending on you know your circumstances, and even the cost of the medication can be supported through this program. Yes. So it's a pretty even though it's a big issue, it's also relatively easy in some ways to overcome. Yep, definitely. So it is about having those small conversations and just getting people aware, isn't it? So testing's probably the most important message, isn't it, out there?
SPEAKER_00For sure. Similar to the smoking one. Yes, very much so. And it's been, yeah, I think a good refresher for all all the organizations, whether they were the ones we work the closest closest with, um, or sort of the broader organizations like your big housing um services, yep, they can help uh advertise the testing and also the incentive, the voucher, which is certainly, yeah.
SPEAKER_01Help stick things along. Yeah. And so have the organizations been receptive to this program that you've spoken to?
SPEAKER_00Yes, yeah, very much so. Yep. It's been uh very good and we look forward to continue working with them in some form.
SPEAKER_01Yeah, because I guess that's a good point too. These types of projects, you know, for people who don't work in the space, you know, you might get funding for an idea or a project or a pilot like this one, but the aim is to embed a permanent service offering or referral pathway or network, isn't it? Yeah. Into the existing program. So it's not like it will just stop existing afterwards. Yes. We hope the clinics will continue to run and testing facilities and options or treatment pathways for people.
SPEAKER_00We're looking at ideas of how we'll do that. Yeah, after the project finishes, um, whether it's some sort of monthly reminder of like where the next clinics are coming up, um, and if they need any more of our resources to hand out to clients. Certainly the business card size clinic cards were really popular because there's something easier that people can tuck in their pocket and stick with them.
SPEAKER_01Yeah. And we can do some fridge magnets or something we can stick on the fridge and just have the number there if you need it. We might tie out the episode. I am going to ask you our classic question of positive futures, uh, as the title implies, so what you're looking forward to for your future in a in a positive direction. Can be work-related or personal. But before we do that, we'll just, if people are looking for hepatitis services, obviously you can just give us a call here at TASCARD. Um, so you can call the office on 62341242. The other option is just call the HEPLINK number. HEPLINK's a national hepatitis information and referral pathway and information service. So that's just a national phone number, which Catherine's going to tell us because I don't have it in front of me.
SPEAKER_00Yeah, absolutely. Yeah, so Hep Link Australia, you can call between 9 and 5, Monday to Friday, and the number is 1-800-437-222 or 1-800-HEPABC.
SPEAKER_01Nice, very old school. So good. Which used to work well on the T9 dictionary phones, but I think it's hard in there. That's right.
SPEAKER_00People know how to type those numbers. I don't know.
SPEAKER_01I mean you and I do, but we're, you know, that's right. We've got wisdom on our side after all these years. And otherwise, come into the TASCAD office, of course, and come and chat to us. You can give us a call or just come in anytime. We're open. We also run the primary NSP, which can help you with any sort of injecting equipment supplies that you might need. And then those monthly clinics are on across the state, so both north and south Tasmania. If you jump on the TASCAD website, so Tazcard.org.au, you can actually find at the top there a clinics page, and those are free walk-in testing clinics available statewide. So, yeah, Catherine, let's just tie off the episode quickly to keep a bit of um synergy across my series. So, what positive future, what positive, exciting thing are you looking forward to, either for this project, if you want to keep it grounded in that?
SPEAKER_00Oh, thank you. Well, I'm professional, I'm definitely looking forward to building my knowledge in the bloodborne virus STI space because I have a 10-year background in gastroenterology, which obviously there's some crossover, and GP nursing and community nursing and school nursing. So it's really good. I mean, there's just so many areas of health. So I think it's great to come into yeah, new areas and build up that knowledge and experience. I'm looking forward to having more of that go out and spread even more of the information and awareness. Just in general life, I'm just looking forward to more hikes.
SPEAKER_01Nice, nice, right in the right state for that.
SPEAKER_00Decompressed, yeah, decompression time is hiking.
SPEAKER_01Well, like you live in Tazsies. Thank you so much for joining us.
SPEAKER_00Thank you.
SPEAKER_01You've been listening to Positive Futures, a red thread studio production. You can find earlier episodes on your favourite streaming service or wherever you get your podcasts.