CQML Annual Report 2012/13

CQ Medicare Local Annual Report

2012/13

table of contents

Page 5: Message from the CQML Board Chairman Page 6: CQML Board DirectorsPage 8: Year in review - CQML CEO, Jean McRuviePage 10: Our Achievements 2012-13 Clinical service deliveryPage 12: Aboriginal and Torres Strait Islander HealthPage 14: Preventative healthPage 16: eHealth Page 17: Primary health care innovation Page 18: Clinician and General Practitioner support servicesPage 19: Engaging and getting to know our communityPage 20: CQML Corporate Governance Principles Page 22: Directors report 2012-13Page 26: Our valuesPage 27: Our members

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message from theCQ Medicare Local Chairman

Bruce Elliot

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Our first year is a strong indication of the contribution that CQML can make to the health

of both individuals and the way that health is delivered in Central Queensland.

I am very proud to introduce this first annual report for the Central Queensland Medicare Local (CQML) on behalf of the Board. This first year has been a challenging year for both the Board and Management as it has involved us all in the operational issues of bringing to life a new and dynamic company, while at the same time having to provide comprehensive health services and beginning the conversation about the reform of the health system.

The political environment in which CQML operates has also brought us challenges with a reduction in funding by Queensland Health both for their services and contracts and a Federal election held just recently. Both of these events have impacted on our operations financially but also by creating a climate of uncertainty. While we had no doubt that Medicare Locals were contributing significantly to

the reform of health, it was with relief that we heard Tony Abbott on behalf of the Coalition, say he would not be closing down any Medicare Locals if he was elected.

The Board of CQML met for the first time in July 2012 and I am delighted to say that our Board members bring a strong mix of skills and experience in health, community and business. They have already shown both dedication and strategic knowledge to guide CQML in the development of the initial strategic plan. In addition we have a talented Senior Executive Team who also bring comprehensive skills so we are in a good position for the future.

While health care in Australia is generally very good, there has traditionally been duplication in primary and community care services, organisations working in silos driven by funding restrictions and a lack of co-ordinated care across tertiary, secondary and primary care. A major objective of CQML is to facilitate system change resulting in more integrated services, partnerships of individuals and agencies to enhance the patient journey and a strong focus on preventative health - keeping people well and out of hospital. Health care is expensive and the less people who need health services the better.

No organisation could exist without staff and a leadership team. Central Queenslanders are blessed to have the 90 staff currently in our employ who really do care about Central Queensland, the health of Central Queenslanders and the organisation. Led by our talented CEO, Jean McRuvie, who works tirelessly with her team, they deliver the board’s vision and we could not ask for a better bunch. Thanks guys!

As the new ‘kid on the block’, the Board recognises that it will take time to build trust within established partnerships, clinician networks, and local community groups. However, as you will see from the content and achievements outlined in this report, this first year is a strong indication of the contribution that CQML can make to the health of individuals and the way that health is delivered in Central Queensland.

In closing, I pay my respects to the boards of the Capricornia and Central Queensland Rural Divisions of General Practice. Their cooperation, forethought and wisdom paved the way for CQML’s creation and the seamless delivery of health care services during the transition period. I also wish to extend my appreciation to Vice Chairman, Dr. Ewen McPhee, Deputy Vice Chairman, Mr. Mark Tobin for their sage advice and personal support and to our entire board for the diligence, dedication and passion they demonstrate in discharging their duties for CQML.

I take pleasure in presenting to you the 2012/2013 Annual Report.

In good health,

Bruce ElliotCQ Medicare Local Board Chairman

6 CQ Medicare LocalBoard Directors

Bruce Elliot B.Pharm; FPS; AACPA; J.P(Qual)

ChairmanBruce is based in Yeppoon, working as the Regional Managing Partner of five Central Queensland based community pharmacies. Bruce is also an accredited consultant pharmacist and finds this a very rewarding part of his role. He is the immediate Past President of the Pharmaceutical Society of Australia (QLD Branch) and a member of their national board from 2009-2011. Previously, a Board member of the Capricornia Division of General Practice Ltd., Bruce joined the CQ Medicare Local Ltd Board on the 1st July 2012 and was appointed Chairman.

Member of the Corporate Governance and Finance, Risk and Audit Sub Committees. Ex-offio member of Clinical Governance Committee and Partnership and Engagement Committee.

Dr Ewen McPhee MB.BS (Hons); FRACGP; FACRRM; DRANZCOG (Adv); DipPDerm (Cardiff); GCertAvMed;MAICD

Vice ChairmanEwen is a rural GP since completing his Intern year in 1986. Ewen is a long term resident of Emerald, Queensland and has owned his own practice since 1992 and started as a GP supervisor in 1997 with the RACGP Family Medical Program. Ewen was a previous board member of the Central Queensland Rural Division of General Practice and has been actively involved in the Rural Doctors Movement as Queensland President. Ewen joined the CQ Medicare Local Ltd Board on the 1st July 2012 and was appointed Vice Chairman.

Chair of Clinical Governance Committee and member of the Finance Risk and Audit Committee.

Mark Tobin MAICD; Qld. Cer. in Animal Husbandry;’ Trade Qualified Diesel Fitter; Assoc. Dip Applied science - Ambulance; Advanced Diploma Pre-hospital care.

Deputy Vice ChairmanMark was a Paramedic for 25 years and now currently enjoys the position of Manager, Clinical Skills Training Unit at the University of Queensland, School of Medicine, - Rural Clinical School Rockhampton. Mark has held past director roles with the Australian College of Ambulance Professionals and Anglicare Central Queensland and presently with the Capricorn Helicopter Rescue Service. Mark joined the CQ Medicare Local Ltd Board on the 1st July 2012.

Member of Clinical Governance and Partnership and Engagement Committees.

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Dr Patricia Harris MBBS, FRACGP

Non-Executive DirectorPatricia relocated from Brisbane to Yeppoon in 1981 to commence a sole general practice. She has now added another fully qualified GP to her practice and has been involved since 2006 in assessing GP registrars within the CQ area for CSQTC. Patricia is a previous member of the Board of the Capricornia Division of General Practice, was a GP representative for the Aged Care Panel in Yeppoon and joined the CQ Medicare Local Ltd Board on the 8th August 2012.

Member of Clinical Governance and Partnership and Engagement Committees.

Dr Ricki Jeffery Prof Doc, B Ed, Dip T, JP (qual)

Non-Executive DirectorRicki is Diocesan Director of Centacare: Catholic Diocese of Rockhampton. As well as working in key leadership roles in the Social Services, University and Vocational Education sectors, Ricki has experience with chairing Not for Profit Boards, Community Reference or Advisory Groups for Tertiary Institutions and Industry Reference groups. Ricki joined the CQ Medicare Local Ltd Board on the 1st July 2012.

Chair of Partnership & Engagement Committee and Member of the Corporate Governance Committee.

Dr Wayne Sanderson BA,BD, D

Non-Executive DirectorPrincipal of Re-Image Associates, a small policy consultancy company, Wayne is a member of the Health Practitioners Tribunal and holds current memberships with the Public Health Association of Australia (PHAA) and the Australasian College of Health Service Management (ACSHM). Wayne has considerable board experience with most recently at A Just Australia and Amnesty International Australia and joined the CQ Medical Local Ltd Board on the 1st July 2012.

Chair of Corporate Governance Committee and Member of the Partnership and Engagement Committee.

Mr Kenn McCall Dip CM, F Fin.

Non-Executive DirectorKenn has over 35 years experience in the financial service industry principally with Commonwealth Bank of Australia (CBA) and Suncorp Bank. He has extensive Board experience including a term on the Board of the Royal Flying Doctor Service for eight years from 2003. Kenn now works as a Business Consultant in banking, business redesign, leadership and management is also a company director and joined the CQ Medicare Local Ltd Board on the 8th August 2012.

Chair of the Finance Risk and Audit committee and member of the Corporate Governance committee.

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year in review CEO Jean McRuvie

I am pleased to report on the first year of operation of the Central Queensland Medicare Local (CQML) which has been exciting,

challenging, frustrating, demanding and rewarding.

Medicare Locals were formed as a result of the Health Reform Agenda occasioned by the release of the Health and Hospital Reform Commission Report in 2009 and were designed to replace the work of the Divisions of General Practice as well as take on additional roles and responsibilities. There are 61 throughout Australia with 11 in Queensland. Medicare Locals were established in three waves beginning in July 2011. CQML was in the last wave so we opened our doors on the 1st July 2012 and our boundaries directly align with those

of the Central Queensland Hospital and Health Service (CQHHS). At the moment the majority of our funding comes through the Federal Department of Health with other smaller contracts from Queensland Health, Check Up and NPS. In line with good business practice our long term aim is to reduce our reliance on Department of Health funding and diversify our revenue streams to ensure sustainability. In addition the heavy reporting requirements associated with government funds adversely impact on our service delivery.

The Boards of the Capricornia and CQ Rural Divisions provided a strong platform for the new organisation by setting up the company, negotiating a transition deed and

providing sufficient funding from the Capricornia Division to enable my appointment as CEO in April 2012 with the resources to offer contracts to all staff of the two Divisions. This meant that we started work with a staff of 70 based in offices throughout the region.

This first year has required us to both build the governance and infrastructure of the new company and at the same time continue and enhance service delivery. The new Board was appointed in July 2012 and the final member of the Senior Executive team was in place by October 2012. As the work of Medicare Locals is very different from Divisions we have been constantly recruiting for new skill sets with 42 people offered positions in the first year.

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In only one year of operation we have begun to build a strong reputation as a well governed, financially sound and transparent organisation which is rapidly gaining strength as an employer of choice and an 'honest broker' enhanced by strong working partnerships across the region. Our focus is working towards system change within health which will result in keeping people well and out of hospital.

One of our initial challenges was the lack of integrated business systems and reasonably poor infrastructure so we needed to install a regional IT system, accounting and payroll system, HR system and Intranet and a regional patient data base. We have upgraded all the offices and clinics across the region by moving staff into new, air conditioned and more appropriate premises, all of which have clinic rooms integrated into the fabric of the building.

We started operations without any equity and through judicial financial management have managed to end the year with a small equity and program surplus which will make cash flows in 2013/2014 considerably easier.

Unlike a number of Medicare Locals, CQML has a strong focus on direct service delivery through attracting clinical and professional staff and building the capability of

the region. We now have teams providing multi disciplinary clinical services, Indigenous health services, preventative health initiatives, practice support programs and professional development.

Highlights of this work are included in the remainder of the Annual Report but of particular note are the 26,379 free clinical services, a 600% increase in the telehealth consultations, 1854 practice visits and supports, 398 Care Co-ordination services and a range of innovative preventative health initiatives.

A core principle of our work is partnering and during this first year we have fostered working partnerships with general practice, the CQHHS, the regional NGOs, the Mater Hospital, industries such as Rio Tinto, local governments, political leaders, allied health providers and communities. This has resulted in a number of new services such as the

Emerald After Hours Clinic, the GP led Diabetes Clinic, the Blackwater Midwifery services, projects such as “How Far Can Your Town Walk”, Couch 2 Classic, the Gladstone Health Action Group, headspace, Partners in Mind and the Gladstone Refugee Action Group.

As a foundation for the future, we have produced a health needs analysis of the region through consultation, online surveys and focus groups. The findings of this analysis will drive our work in 2013/2014. I believe that CQML now has all it needs to make a significant difference to the health of our region and our aim is to work with others to decrease the incidences of chronic diseases and keep people healthy and out of hospital.

Jean McRuvieCEO, CQ Medicare Local

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Various funding streams have allowed CQML to offer Allied and Mental Health Services as well as Medical Specialist Outreach across the Central Queensland Region to enhance the care provided by General Practitioners.

A blended model of service delivery has seen CQML employ and / or sub-contract local Health Practitioners to work with clients who have chronic health conditions under the following funding program streams:

1. Access To Allied Psychology Services (ATAPS)

2. Mental Health Services in Rural and Remote Areas (MHSRRA)

3. Rural Primary Health Services (RPHS)

4. Mental Health Nursing in General Practice (MHNIP)

5. Home and Community Care (HACC State)

6. Home and Community Care (HACC Commonwealth)

7. Alcohol and Other Drugs (AOD)

8. Medical Specialist Outreach Assistance Program (MSOAP)

9. Medical Specialist Outreach Assistance Program - Indigenous Chronic Disease (MSOAP-ICD)

10. Medical Specialist Outreach Assistance Program - Maternity Services (MSOAP-MS)

11. Urban Specialist Outreach Assistance Program - (USOAP)

our achievements 2012-13:Clinical Service Delivery

our achievements CQ Medicare Local 2012-13

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CQML Rockhampton based Central Referral Hub had received and triaged all referrals before allocation to employed and sub-contracted clinicians.

CQML employed 27 and sub-contracted 44 Clinicians to deliver 26,379 free services to the community in the following disciplines:

1. Psychology2. Social Work (Mental Health)3. Mental Health Nurse4. Physiotherapy5. Exercise Physiology6. Podiatry7. Midwifery8. Diabetic Education9. Dietetics10. Occupational Therapy11. Speech and Language Therapy12. General Practitioner (Diabetes Clinic)13. Chronic Disease Nursing14. General Physicians15. Dermatology16. Obstetrics and Gynaecology17. Ophthalmology18. Paediatrics19. Endocrinology20. Gastroenterology21. Psychiatry

Clients who have been diagnosed with mild to moderate mental health disorders were supported towards recovery through the provision of Focused psychological Strategies

under the ATAPS Program. Under ATAPS we have received 1064 referrals of which 987 came from General Practitioners and delivered 4193 free services:

1. General Mental Health Counselling - 2020 2. People in Rural and Remote Areas - 10223. Suicide Prevention - 3694. Peri-natal Depression - 3425. Aboriginal and Torres Strait Islander People - 2056. Children Mental Health Service - 1977. Extreme Climatic Conditions - 358. Homelessness - 3

CQML has received 3210 referrals under the Rural Primary Health Service (RPHS), Alcohol & Other Drug (AOD) and Mental Health Services in Rural and Remote Areas (MHSRRA) Programs leading to 16,120 Services being delivered by Allied Health Professionals. That included 1273 sessions under the AOD Program and 2466 under MHSRRA. Our Mental Health Nurse delivered 325 sessions in General Practices.

Medical Specialists (MSOAP and USOAP) paid 627 visits delivering services to 5741 patients of which 1226 were to Aboriginal and Torres Trait Islander People.

Clinical Services has facilitated two Level 1 Mental Health Skills Training Modules in Gladstone which twelve GPs have successfully completed.

CQML employed 27 and Sub-contracted 44 Clinicians to deliver 26,379 free services to the community

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Our Indigenous Health Team has been raising awareness of the Closing the Gap measures (PBS Co-Payment, Indigenous

Health Incentive, Care Coordination and Supplementary Services). We have had 152 contacts with General Practices and Aboriginal Medical Services, participated in 23 community events and attended many meetings with primary health care organisations.

Some of the community events and education sessions we have participated in and supported include:

• NAIDOC

• Reconciliation Carnival

• Summer Markets

• Sports and Recreation Expo

• Anti-Poverty Week

• Mental Health Week

• Swap It Launch

• Women’s Yarning Up

• Vibe 3 0n 3

• Community Expo (Yeppoon)

• Probation and Parole

• Hooked on Health (Theodore)

• Indigenous Youth Sports Mobility Program

• Romp in the Park

The Care Coordination and Supplementary Services (CCSS) program is gaining momentum with referrals into the program increasing daily. Recruitment of 3 Care Coordinators was finalised in May 2013.

• 398 x Care Coordination Services provided

• 15 x Allied Health / Specialist Services

• 18 x Transport Services provided

• 10 x GPs referring into the service/s

• 48 x Referrals received

• 29 x Individuals received Care Coordination and/or Supplementary Services

our achievements 2012-13:Aboriginal and Torres Strait Islander Health

our achievements CQ Medicare Local 2012-13

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Phase one of our Indigenous Needs Assessment has been completed. Focus groups with community and relevant organisations are to be conducted in the future. Our Cultural Awareness training to meet RACGP standards is under development, to be delivered across the footprint in 2013/14.

CQML is committed to contributing to improve the health of our Aboriginal and/or Torres Strait Islander People’s in CQ. We proudly display our commissioned Aboriginal artwork; “Coalfields to Coast” painted by local Ghungalu artist, James Waterton. This artwork represents our service area and aspects of the piece are featured on all CQML’s Indigenous resources, making it easy to identify us and our programs.

We look forward to having a full compliment of staff in 2013/14 and continuing to work together to improve access to mainstream primary health.

398 free Care Coordination Services provided to the CQ community

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The Preventative Health Team have facilitated 26 healthy lifestyle workshops and information sessions on topics including food label reading, healthy cooking on a budget, portion control, general healthy lifestyle information, and the preparation of healthy meal options. There were 178 participants across the region.

We have also worked collaboratively with the Healthy Communities Initiatives in Central Highlands and Rockhampton, delivering 17 workshops with 155 participants.

We have also participated in the following community events to deliver health promotion and early intervention messages:

We have also provided support to community programs, including Day to Day Living (CQML), PHAMS (Red Cross) and Big Cook, Little Cook (The Salvation Army).

our achievements 2012-13:Preventative Health

The Team also developed projects including:

How far can your town go? 5 week challenge

Five week walking competition between towns where participants were provided with pedometers and logged steps for their town - town with the most steps at end of competition won.

• 321 participants across the Central Highlands• Collectively, the 321 participants walked a

total of 26,726,915 steps, approximately 20,847km.

HEAT (Healthy Eating and Teens)

This program aims to increase participant knowledge of the benefits of healthy food choices through cooking classes and health information sessions.

Healthy lifestyle sessions for clients with intellectual disabilities

The women’s program content included healthy cooking, healthy lifestyle education (supermarket tour, discussion of portion sizes, discussion of dietary requirements, oral health, etc), and exercise opportunities.

The men’s program involved bi-weekly cooking and exercise sessions.

• July 6, 2012: NAIDOC Expo • September 27, 2012: Indigenous Youth Sports

Program • October 03,10, 17, 2012, March 20, April 18,

May 22, 2013: Talking It Up In the Pub (Men’s Health) Events

• November 9, 2012: World Diabetes Day Event

• January 20-27, 2013: Australia’s Healthy Weight Week

• February 24, 2013: Lane 4 Sports and Aquatics Sports and Health Expo

• April 12, 2013: Youth Week Event • May 21, 2013: Swap It, Don’t Stop It Launch,

Diabetes Queensland

our achievements CQ Medicare Local 2012-13

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26 healthy lifestyle workshops

178 participants

321 participants

walked a total of 26 726 915 steps

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I n April 2013 we recruited the final member of our eHealth team, which was formed to deliver the telehealth and eHealth contracts across the

Central Queensland region.

The eHealth team provided telehealth support to General Practice, which resulted in a 20% increase in the number of practices with telehealth capability, and a 600% increase in the number of Telehealth MBS items claimed during the 9 month contract period.

The eHealth team then assessed the eHealth readiness of every general practice in the region, supporting 83% to implement the eHealth foundations required to meet the eHealth Practice Incentive Payment (ePIP) Program.

Work then began on assisting General Practice to begin uploading shared health summaries to the PCEHR system, of which 40% of practices in the region are currently able to do. Simultaneously we began to train practices in the use of the Assisted Registration Tool (ART) so that they are able assist their patients to register for an eHealth record. Currently 50% of

practices in the region are now using ART, and at 30th June 2013 we had over 3000 people registered with an eHealth record (a number that has increased daily since).

During this first 12 months of operation the eHealth team delivered nearly 30 workshops, reaching approximately 200 attendees. We had 868 engagements with General Practice in regards to eHealth and provided eHealth awareness sessions to nearly 2000 consumers.

We have produced a range of marketing material to promote the PCEHR and developed the eHealth section of the CQML website. Our web pages provide current information about what is happening in eHealth, an online support request function and resources for providers to download.

It has been an exciting and successful year for the CQML eHealth team, and the fast paced journey continues as we engage with Pharmacy and Allied Health providers to embed their eHealth foundations and work our way towards demonstrating “meaningful use” of the PCEHR system.

our achievements 2012-13:eHealth

We had 868 engagements with General Practice in regards to eHealth and provided eHealth awareness sessionsto nearly 2000 consumers.

20% more GPs able to access Telehealth

600% increase in Telehealth MBS claims since June 2012

OVER 2350 eHealth Record (PCEHR)registrations since the start of 2013

our achievements CQ Medicare Local 2012-13

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As part of the Commonwealth government health reform agenda, the Medicare Local After Hours Program was

initiated with the aim of improving access to after-hours services in the community. Under this program, Central Queensland Medicare Local (CQML) is responsible for coordinating after-hours primary care within our region. For the purposes of the National Health Reform, after hours primary care is defined as accessible and effective care for people whose health condition is urgent and cannot wait for treatment until regular services are next available.

The after-hours period is defined as:

• Before 8:00am and after 6:00pm weekdays;

• Before 8:00am and after 12:00pm Saturdays; and

• All day Sundays and public holidays.

To assist us in planning for improved after hours primary care services, after hours services in the CQML region were mapped. This included ascertaining general practices opening hours, billing practices and opened and closed books. Other providers of After Hours services were also mapped and focus groups were held with patients/communities to explore the demand for after-hours services and community expectations.

As a result of this engagement CQML have:

• Assisted General Practices in Boyne Island/Tannum Sands and Gladstone to expand their practice hours to cater for the needs of the local community

• Engagement with General Practice in Emerald has resulted in a trial of extended after hours. This trial is also in collaboration with the Central Queensland Health and Hospital Service

• Collaborating with the Central Queensland Health and Hospital Service and Local General Practices to progress workable solutions to after-hours in Yeppoon and Gladstone

Engaged General Practices within CQ to continue their after hours PIP and currently there are 42 practices that will work with CQML to receive PIP payments

our achievements 2012-13:Primary Health Care Innovation

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T he Health System Support Team has had a very busy 12 months with one of the biggest tasks being the mapping of all service providers within the CQML

catchment area. This involved the research and collation of over 700 providers from within the region. This information was then forwarded for inclusion in the National Health Services Directory. Training has now been provided to the Health System Support team to ensure the currency of the information.

Another success for the team is the consistently higher than average childhood immunisation coverage rates within the CQML catchment area. At present the rates are as follows:

12-<15 Months 91.38%24-<27 Months 92.86%60-<63 Months 92.04%

This result is due to the commitment of General Practices in the area, and also the support and promotion of the Immunisation Program by the Health System Support Team in collaboration with the Central Queensland Public Health Unit.

Other accomplishments include:

• 986 contacts with General Practice;• Bi-monthly Practice Manager and Practice

Nurse Meetings;• 19 Continuing Professional Development

opportunities offered;• Provision of General Practice Accreditation

assistance ;• Clinical software support;

our achievements 2012-13:Clinician and General Practitioner Support Services

986 contacts with General Practice

our achievements CQ Medicare Local 2012-13

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Central Queensland Medicare Local (CQML) took the first step towards understanding the health needs of the community during the 2012 - 2013 period, with the completion

of the Population Health Needs Assessment, Closing the Gap Needs Assessment and the After Hours Regional Stage One Plan. Additionally, CQML conducted eight community forums throughout the region and developed an online survey, which resulted in over 1700 responses.

Through this engagement some of the key issues identified included:

• 64% of the population were either overweight or obese as a lack of exercise and poor nutritional intake

• 40% of the population suffer from one or more chronic diseases

• The Indigenous population make up 5.3% of the population

• The Indigenous population have high rates of chronic disease

• The top four causes of mortality in CQ are cancer, cardiovascular disease, ischemic heart disease and lung cancer

• One in three CQ residents have high cholesterol • Access to services is a significant issue for CQ

residents and many residents believed they could not access services quickly

• Lack of sociable and unsociable after hours services in most areas in CQ

• There is lack of transport options to access primary health care providers and specialist care

The CQML have commenced establishing five Primary Health Care Chapters within each Local Government Area with the aims to identify healthcare gaps and provide primary health care

providers a chance to shape strategies affecting their communities.

CQML have formed multiple partnership throughout the regional to progress investments and allow stakeholders the opportunity to engage with the CQML. Some of the key partnerships formed include:

• Central Queensland Primary Care Partnership• Practice Nurse partnerships• CCACC• Fitroy River Elders Basin• Peak Indigenous Groups such as Bidgerdii,

Darumabl Youth Service CQID, Nhulundu• Central Queensland Health and Hospital Service• CQUniversity• Clinical Leaders Group• Refugee Reference Group• Welcoming Intercultural Neighbours• Local Government Interagency Networks

our achievements 2012-13:Engaging and getting to know our community

CQ Medicare LocalCorporate Governance Principles

Principle 1: Lay solid foundations for management and oversightThe Board has developed and adopted a Corporate Governance Manual which outlines the roles and responsibilities of the Board and the policy structure which underpins its’ activities. All Board sub committees have developed a Terms of Reference and all Senior Executive positions including that of the CEO, have comprehensive position descriptions.

In addition all Board Directors undergo a performance review with the Chairman and the whole Board contribute to a Board Performance Review annually. All staff within CQML are subject to annual performance reviews assessed against their position descriptions and the requirements of their roles.

All Directors appointed to the Board had previously undertaken governance training and CQML is committed to ensuring that Board Directors and Senior Executives have access to continuing governance professional development.

Principle 2: Structure the board to add valueBoard members are elected against a skills matrix designed to ensure the Board is composed of people with a mixture of skills and experience in the primary care sector but also in governance, business and finance. Board member profiles are included in this Report.

The Board Constitution provides for a rotational system for Board Directors. The Governance Sub Committee of the Board annually appoints a Nominations Committee comprising the Chairman and two external members with responsibility to make recommendations to the members on individuals who are eligible to fill vacancies at the AGM.

The Constitution allows for a Board of not more than 9 Directors and not less than 6 as a method of ensuring a sound skills mix designed to ensure good governance and management of the business.

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Principle 3: Promote ethical and responsible decision makingOver the first year of operation CQML has developed a comprehensive set of policies and procedures and will undertake full accreditation through the new Medicare Local Accreditation Standards in 2014. The Governance Manual for the Board, includes a Code of Conduct for Board Directors CQML staff operate within a Code of Conduct as part of the organisation policy structure.

Board Directors and staff developed a set of values and principles in the first year which are included in this Report and these govern the way we interact internally but also with the community, stakeholders, members and suppliers.

We are committed to ethical decision making, equity of service delivery, recognition of diversity and fairness in all our work. This is one of the reasons that we have maintained a significant presence in towns throughout the region, investing in both infrastructure and skilled personnel.

As an equal opportunity employer, we are proud of our diverse mix of staff which includes Indigenous Australians as well as people from other countries. We believe this assists CQML in ensuring that decisions made by

Principle 4: Safeguard integrity in financial reportingWe are very conscious that the majority of funds that we spend comprises public money and this carries with it a greater need for a higher level of transparency. The Board has established a Finance, Audit and Risk Committee chaired by Kenn McCall who has worked in banking for many years. This Committee oversees compliance by CQML with Australian accounting standards and we have continued to strengthen the Finance Team under the leadership of Rayleen Galdal the CFO, by the inclusion of new staff with additional skills.

In addition we have appointed BDO Kendalls to provide external audit advice and support and the Board has access to the auditors at any time without the presence of management.

Principle 5: Make timely and balanced disclosureWhile this Principle is a requirement of listed companies to disclose under the ASX Listing Rules, CQML recognises that it is our responsibility to disclose to members, funders and stakeholders any matters that would impact on our credibility or our financial solvency. The Board of Directors has put in place safeguards to minimise the risks and has committed to ensuring transparency in our operation.

Principle 6: Respect the rights of shareholders/membersCQML has developed a range of strategies to ensure continuous communication with members and stakeholders through a Marketing and Communications Policy which is available to members on request. Members will be provided with all relevant reports at the AGM and there is time provided for questions.

In addition we have convened Advisory Groups in which members can participate; member events and individual consultations to ensure Members have the opportunity to comment and input into the future operation of CQML.

Principle 7: Recognise and manage riskCQML has developed a comprehensive risk register which is monitored by the Finance, Audit and Risk Committee and presented to each Board meeting. The main areas of risk CQML has identified include:

• governance, financial management, clinical governance and clinical delivery, people, culture, operational ability, relationships and reputation, WH&S, program management and new opportunities

The Board has tasked management with reporting to each Board meeting against these risks including details of new risks, reduced risks and the mitigation strategies being employed. Risk management will be included in the accreditation standards to which CQML must comply in 2014.

Principle 8: Remunerate fairly and responsiblyAll Directors receive a Stipend remuneration according to the Remuneration Policy included in the Governance Manual. Director remuneration is reviewed annually and the Board has discretion to remunerate Directors with additional payments for work over and above the conditions of the Stipend.

The CEO salary is negotiated directly with the Board based on performance against identified milestones. All Senior Executives are remunerated through negotiation with the CEO also based on performance against milestone. Staff within CQML are remunerated against the EBA negotiated by the Rural Division prior to the inception of CQML which CQML was obliged to adopt. This EBA will be renegotiated during the 2013/2014 year.

CQML has a rigorous recruitment and retention process with wages, salaries and benefits benchmarked against other similar organisations. As an NGO, CQML is aware that our ability to increase wages is limited and the Organisation has developed a range of incentives to complement our wage structure.

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directors report CQML 2012-13

The directors present their report, together with the financial statements, on the company for the year ended 30 June 2013.

Directors

The following persons were directors of the company during the whole of the financial year and up to the date of this report, unless otherwise stated:

Board Member Appointed ResignedBruce Elliot 1/7/2012 -

Ewen McPhee 1/7/2012 -Wayne Sanderson 1/7/2012 -

Mark Tobin 1/7/2012 -

Ricki Jeffery 1/7/2012 -Patricia Harris 8/8/2012 -Kenn McCall 8/8/2012 -John Lamb - 1/7/2012

Michael Donohue - 1/7/2012Kenneth Woodward - 1/7/2012Michael Belonogoff - 1/7/2012

Company Secretary

The following person held the position of Company Secretary at the end of the financial year, Ms Rayleen Galdal.

Short- and long-term objectives and strategy

The vision of CQML is “Partnering to provide innovative solutions to improve the health and wellbeing of the Central Queensland community”.

Strategic Direction 1: Be a leader in Organisational Development, Governance and Best Practice

Strategic Direction 2: Utilise partnering as a core element of our work

Strategic Direction 3: Understand our region well

Strategic Direction 4: Develop and promote innovation in the region

Strategic Direction 5: Be a sentinel site for best practice program delivery

The company’s strategies for achieving these objectives include:

• linking and bringing together services• identifying service gaps and working with others to find

innovative solutions to fill those gaps• delivering holistic care • taking the role of honest broker identifying and sourcing

the required service• making sure services are not duplicated• establishing and maintaining relationships with key

stakeholders including the CQHHS Board (Queensland Health)

• leading by example• establishing sustainable solutions• being involved in research and gathering evidence to

determine best practice

Principal Activities

The principal activity of CQ Medicare Local Ltd was to coordinate primary health care delivery and tackle local health care needs and service gaps. CQML drives improvements in primary health care to ensure that services are better tailored to meet the needs of local communities.

There have been no significant changes in the nature of CQ Medicare Local Ltd’s principal activity during the year.

Performance measures

The company measures performance through the establishment and monitoring of benchmarks as directed by the Department of Human Services in its contractual arrangements. CQML is funded to undertake performance reporting as determined by the National Health Performance Authority and must improve accountability by reporting against the Performance and Accountability Framework.

Internally, CQML has Finance, Risk and Audit, Corporate Governance, Clinical Governance and Partnership and Engagement Sub-Committees which report directly to the Board. These sub-committees support the monitoring of key benchmarks to ensure the sustainability and viability of the organisation.

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directors report CQML 2012-13

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Corporate Structure

CQ Medicare Local Ltd is a company limited by guarantee that is incorporated and domiciled in Australia. Its registered office is at 44 William Street, Rockhampton, QLD, 4700.

1. Business review

a. Operating Results

The profit/(loss) of CQ Medicare Local Ltd after providing for income tax amounted to $376,137. The reported surplus is largely due to the effect of timing of program funding, surplus from unexpended funding and revenue generation. The directors are developing plans for the investment of these funds into community programmes in the future.

A full copy of the financial statements are available via the website www.cqmedicarelocal.com

b. Dividends Paid or Recommended

No dividends were declared or paid during the year.

c. Review of operations

There are no material changes in the operations of the company.

d. Members’ Guarantee

The company is a company limited by guarantee. If the company is wound up, the Constitution states that each member and each person who has ceased to be a member in the preceding year is required to contribute a maximum of $100 towards any outstanding obligations of the company. At 30 June 2013, the number of members was 54.

2. Directors’ Benefits

No director of the company has, since the end of the previous financial year, received or become entitled to receive a benefit (other than a benefit included in the total amount of emoluments received or due and receivable by directors shown in the financial statements) by reason of a contract made by the company, or a related body corporate with the Director or with an entity in which the Director has a substantial financial interest that is not disclosed in the accompanying financial statements.

3. Proceedings on Behalf of Company

No person has applied for leave of Court to bring proceedings on behalf of the company or intervene in any proceedings to which the company is a party for the purpose of taking responsibility on behalf of the company for all or any part of those proceedings.

The company was not a party to any such proceedings during the year.

4. Indemnifying Officers or Auditors

No indemnities have been given or insurance premiums paid, during or since the end of the financial year,for any person who is or has been an officer or auditor of CQ Medicare Local Ltd.

5. Other items

a. Significant Changes in State of Affairs

No significant changes in CQ Medicare Local Ltd’s state of affairs occurred during the financial year.

b. Matters subsequent to the End of the Financial Year

No matters or circumstances have arisen since the end of the financial year which significantly affected or may significantly affect the operations of CQ Medicare Local Ltd, the results of those operations or the state of affairs of CQ Medicare Local Ltd in future financial years.

c. Future Developments

In the opinion of the directors, there will be no change in the activity of the entity in the subsequent financial years. Please refer to Principal Activities

d. Environmental Regulations and Performance

The company’s operations are not regulated by any significant environmental regulation under a law of the Commonwealth or of a state or territory.

e. Auditor’s Independence Declaration

The auditor’s independence declaration for the year ended 30 June 2013 has been received and can be found on page 7 of the full financial report.

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Meetings of directors

The number of meetings of the company’s Board of Directors (‘the Board’) and of each board committee held during the year ended 30 June 2013, and the number of meetings attended by each director were:

Board Meeting Finance, Risk and Audit

Partnership and Engagement

Corporate Governance

Clinical Governance

Directors Attended Held Attended Held Attended Held Attended Held Attended HeldBruce Elliot 6 8 1 2 1 3 1 3

Ewen McPhee 8 8 2 2 2 3Wayne Sanderson 7 8 1 3 2 3

Mark Tobin 8 8 1 3 3 3

Ricki Jeffery 8 8 2 3 1 3Patricia Harris 8 8 2 3 3 3Kenn McCall 7 8 1 2 1 3

Held: represents the number of meetings held during the time the director held office or was a member of the relevant committee

Chairman’s Declaration

This report is made in accordance with a resolution of directors, pursuant to section 298(2)(a) of the Corporations Act 2001.

On behalf of the directors,

Mr Bruce ElliotChairman

our values...Our work will be approached through a set of values and underlying principles which will underpin everything we undertake. In caring for our community we need to be:

Responsive: Our work will always be client and consumer focused and we will value and seek consumer input at all times.

Innovative:We will be open to innovative models

of care, cross sector collaborations

and be prepared to challenge old

ideas and champion new evidence

based practices. Respectful:We will embed cultural practice into

all the work of CQML respecting

diversity and ensuring access and

equity to all the citizens of CQ.

Accountable: We will be honest, transparent and open in our communication both internally and to our community.

Professional:We will have a high level of corporate

governance in all our activities,

positively representing CQML in our

community and with our stakeholders.

Equitable: We will respond to the health service needs of identified population groups in CQ.

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our members... as at June 30 2013

Organisational Members

Anglicare Central Queensland

Attune Hearing

Australia Hearing

Baralaba Community Aged Care Ass Inc

Baralaba Private Clinic

BITS Medical Centre

Boyne Island Family Medical Centre

Capricornia After Hours Service

Carers Qld

Carinity Communities Wahroonga

Centacare

CheckUp

Cognition Psychology

Community Solutions

CQ Eye

CQ Physio Group

CQ University

Davis St Anaesthetic - Pracman Plus Pty Ltd

Diabetes Queensland

Emerald Medical Group

Enterprise Biloela Association Inc

Family Planning Qld - Rockhampton Office

Gladstone Physio & Fitness

Helen Madell Psychology

Home Support Association Inc

James Street Medical Centre

Le Smileys Early Learning Centre

Malouf Pharmacy

Mount Archer Medical Centre

North Rockhampton Chiropractic

Northside Plaza Medical Centre

Platinum Chiropractic Centre

Port Curtis Medical Centre

Qld Alliance for Mental Health Inc

Qld Network of Alcohol & other Drug Agencies Ltd

RFDS

Rockhampton Psychology Services P/L

Rolleston Health Committee Inc

SARRAH

Scotvale Medical

Snore Australia

Springsure Medical

The CQ Family Practice

The Pharmacy Guild of Australia

Theodore District Health CouncIl

Theodore Medical Centre

UQ Rural Clinical School

Vector Health

Yeppoon Chemmart Pharmacy

General Members

Berserker Clinical Psychology

Biloela Discount Chemist

Central Queensland Multicultural Association

DJAB Pty Ltd

Dr Aloysius Achusiogu

Dr Ian James Etherington

Jean Bourne

Mr Rob Stanton

Ms Lorna Perrett

Sharlene Dodds

Suncare Community Services Inc

Terry Zillmann

Biloela 07 4992 5544 | Gladstone 07 4972 7786 | Emerald 07 4982 4233 | Theodore 07 4993 2300 |Woorabinda 07 4935 0038 | Springsure 07 4984 1538

Level 1 / 44A William StreetRockhampton, QLD 4700

Rockhampton 07 4921 7777 | Blackwater 0408 241 980 |