TUESDAY 26 MARCH 2019

UNDETECTABLE = UNTRANSMISSABLE – Dr Fiona Fargie

•    What does undetectable HIV viral load mean
•    How does someone achieve and maintain an undetectable viral load
•    The journey of the evidence to support U=U
•    Implications for transmission
•    Contentious issues – breast feeding, child birthing decisions

What is the ‘Viral Load’?

 
What is the effect of Antiretrovirals?
 

 




Nov 2017

U equal U
 
Contentious issues?
  • Breast feeding
  • Not covered by U=U
  • Needs supportive multidisciplinary care
  • A separate talk…
Prevention of Vertical Transmission

pctct 


UNDETECTABLE = UNTRANSMISSABLE (U=U) – Craig Cooper

What does it mean for people living with HIV (PLHIV)?

What does U=U mean?

Undetectable=Untransmissable

2016 Partners Study

  • Over 1000 couples had sex (anal and vaginal) more than 58,000 times without condoms
  • Heterosexual and same sex (gay) couples
  • No transmissions of HIV between partners with a viral load (VL) below 200
  • 6.2% reported a detectable VL at some point in the study

2017 Opposites Attract Study

  • 358 same sex couples had anal sex 16,899 times without condoms
  • No transmissions of HIV
  • 0.9% reported sex with a partner with a detectable VL
  • 32.1% were on PrEP  (a pill that prevents HIV)
  • The 3 men in the study who seroconverted – sex outside their primary relationship

Treatment as Prevention (TasP) & Undetectable Viral Load (UVL)

  • HIV treatments prevents the onward transmission of HIV, known as TasP
  • TasP reduces the Patient viral load to undetectable
  • UVL is known as 200 copies or less, in Australia the doctors understand UVL as under 20 copies
  • When people have an UVL there is zero risk of passing on HIV – U=U

Undetectable HIV

  • Undetectable means you remain HIV positive, but has undetectable virus levels
  • To remain Undetectable, people need to take their medication as prescribed – every day
  • Remaining engaged in your health, regular appointments with your doctor and blood tests
  • If you have medication breaks, HIV will rebound

Disclosure, the Public Health Act & Reasonable Precautions

Disclosure

  • Legal
  • When to disclose?  Why?   How?
  • Risks/benefits of disclosing earlier / later
  • Positive Life can help with disclosure –peer support

Stigma & Discrimination

HIV Stigma & Racism

  • Stigma in your communities
  • The intersection of stigma and racism
  • The role of Education
  • U=U – what difference could it make? How?
  • What can you do about Stigma?
  • The role of Positive Life NSW
U = U  DISCUSSION – Dash

After Fiona’s presentation Dash facilitated a quick discussion about the implications and gaps in knowledge for CALD affected communities and CALD people living with HIV.
Cultural Support Workers in small groups answered a number of questions and gave feedback to the rest of the group.

Key ideas from these small discussions were:
-    Confirmation that knowledge about U=U is not understood by a broad range of CALD communities – the need for further education – and this as a key message for an anti-stigma message.
-    Further work is needed  to also ensure that the U=U understanding is shared and reinforced with all people living with HIV.
-    Comments and suggestions about how the U=U messaging could be translated into other languages meaningfully.

MANAGER’S REPORT – Barbara

Barbara informed staff about the newly established Cultural Support Program (CSP) which is part of Diversity Programs and Strategy Hub within Population Health. Denise Voros is the Co-ordinator for CSP.

Denise has been working tirelessly to recruit new Cultural Support Workers (CSW). There were 175 applicants. It seems that around 60 of them have been chosen as new CSWs. They will have the induction training at the end of April and beginning of May.

They will be working on tasks other than HIV and viral hepatitis.

We would like to say welcome to them.

 
Next meeting: 6 - 8pm, Wednesday 7 August 2019 KPEC Auditorium 4.1 RPA



 
 
 

 

A selection of Co-worker experiences from previous MHAHS News editions.

 

ZAINAB'S EXPERIENCE

 

What is your family story?
I came from Somalia, which is a 100% Muslim country. As a girl, I was circumcised and was a child bride at the age of 12 years. My religion allowed a girl to be a bride as soon as she had her menstrual period, but I have always been against it since I was a little.

I had my first child at the age of 13 and my 4th child by the age of 18. I was able to divorce my first husband eventually when my father passed away. It was a domestic violent relationship. I left Somalia alone because of the war and my children were in the care of my mother. I fled to Kenya where I met my second husband. He was from Indonesia and was working at the embassy in Kenya at the time. I went to Indonesia with him when I was pregnant and later had 2 children with him in Indonesia.

We lived with his family but there were many cultural differences. He and his family were mentally and verbally abusive towards me. I was able to make my way to Australia and ended up in Villawood Detention Centre in 1998 and claimed myself as a refugee. I was released from detention later that year. I was reunited with all my 6 children plus a grandchild and since then I have another 10 grandkids all living in Sydney.

What you do outside the MHAHS?

I am a full-time student at Ultimo TAFE working towards a Certificate IV in Community Services. I am also a self-employed interpreter and I speak 4 languages including Somali, English, Swahili, and Indonesian. Furthermore, I am a public speaker for the Positive Speaker Bureau at Positive Life NSW.

What made you join the MHAHS?

I joined MHAHS in 2010. Because of where I come from, religious beliefs and culture play a big part in HIV stigma and nobody wants to help people who are living with HIV. I see my work with MHAHS as an opportunity to help people from the same background as me and raising awareness about HIV and viral hepatitis.

What are your impressions of the service?

It is a great service which focuses on peoples’ well-being and the community. Without MHAHS, the community might not be educated about HIV and viral hepatitis and people would not know much about the viruses. Lastly MHAHS is about inclusion and valuing diversity.

What do you think of the training provided by MHAHS?

Without the training we as co-workers would not be able to provide support for clients. I feel grateful for the training MHAHS has provided, as every training is a about gaining knowledge and skills. I have made a lot of friends from training sessions, they love Zainab’s story! I feel I am influential for some of my friends. The staff at MHAHS are very supportive and helpful and make me feel comfortable to be part of the organisation.


What activities have you carried out for the MHAHS so far?

Community education session with school children about hepatitis; African community festivals where I gave people information about HIV and viral hepatitis including condoms and calendars; the African Women’s Dinner Dance which also included giving away condoms and calendars; translating flyers; photo shoots for campaigns and calendars; and attending training and meetings.

What do you see are the challenges/rewards as a co-worker?

A fear of being unable to help a client and not knowing how. I have also helped people of the same culture outside of the organisation by giving them information. I have also worked as a volunteer, and feel that it is rewarding when I can help them.

Do you have any other comments/reflections?
I’m very grateful that I work for MHAHS particularly the support I get from other staff, and the education opportunities. I would love to work with a client one day, because I have a lot of knowledge and feel I am very good at supporting people, especially empowering them.

 

 ROCIO'S EXPERIENCE

 

Where do you come from? What is your family story?
I came from Peru. My father was a school teacher and my mother was a nurse. Both are now retired. I moved to Australia 8 years ago.

What do you do outside the MHAHS?
I’m an accountant. I work for the University of Sydney, based at the Royal North Shore Hospital. I am part of the team which assists the medical school.

What made you join the MHAHS?
I found out about MHAHS while I was studying at TAFE to become an interpreter. My teacher let us know about an opportunity available at MHAHS. The agency was looking for co-workers with language skills and having that under my belt, I decided to apply. At that time, I had a basic knowledge about MHAHS and its role in the community.

What are your impressions of the service?
The service is rewarding. It gives a chance to people who suffer from HIV and hepatitis to reconnect with the community, to seek assistance and not isolate themselves. The education role that MHAHS plays is pivotal; it educates the community about these diseases and to be aware of their progression and new benefits that may arise from drugs and government initiatives. Unfortunately, not having enough information could turn people towards discrimination. In Peru, the majority of people are religious and conservative. That’s why many people could easily be discriminated against. MHAHS’ service helps people to understand, be aware, and not live in fear.

What do you think of the training provided by MHAHS?
I think it’s important, but not enough. It’s important for co-workers to have regular training in order to be aware about services that are available to clients. The supervision nights are great for discussion with fellow co-workers. To me, when a co-worker reports the progression of their client and what they did to assist, that is gold, especially for those like me who are relatively new.

What activities have you carried out for the MHAHS so far?
I’ve done a bit of everything. I started with media promotion with Sonam. I went to a radio station twice for campaigns related to HIV, basically to help raise awareness among the Spanish speaking community. I’ve done some translation of documents for Marina. I also did a bit of clinical work with a client for a short period of time.

Tell me more about your client work?
I worked with a female client. Her husband was infected with HIV but she wasn’t. She needed emotional support at the time. Originally they wanted to have a baby, but later the idea took second place when they became fully involved in a personal venture.

What do you get from supervision?
I think supervision is very important and critical, especially when you face a problem. Supervisors give you ideas about what to do. I listened to conversations with other co-workers and they mentioned many issues with their clients like housing or financial difficulties. I really appreciated having Donatella and Effie with me, especially when I was new to the service.

What do you see are the challenges/rewards as a co-worker?
To me the challenge is communication, because you have to connect with your client and if your client doesn’t open up to you, you won’t be able to know what they really need. For the rewarding part, the job gives you an opportunity to help people who are suffering. It’s really fulfilling as a human being.

Any other comments/reflections?
MHAHS is important for the community. I really like the idea that the government is assisting people; not only providing assistance towards medicines but also re-connecting people back to the community. Unfortunately, not many countries have the level of support or similar organisations to MHAHS. I’m really glad to be a part of MHAHS!

 

 KIM'S EXPERIENCE

 

 “Chào các bạn!” My name is Kim Trang and I am from Vietnam.
I came to Australia at the age of 21 after staying in a Malaysian camp for a short period of time in 1983.
I have been married to my husband since 1987 and have three children aged 27, 22 and 15 and they are all still at home.
My first job in Australia was in the factory for two years. I then got a job at the bank and worked part-time with the industry for 13 years. I also worked part-time in the education system as a Community Liaison Officer and Teacher’s Aide for over 12 years. During my work at the school I also studied at university and gained two degrees: Bachelor of Arts and MT of Early Childhood.
I currently work part-time with the Multicultural HIV and Hepatitis Service and the Smith Family store.
I joined the MHAHS in 2015 and believe that I can transfer my understanding and knowledge about HIV and Hepatitis diseases to people in my Vietnamese community. I speak, read and write fluently in Vietnamese. This gave me a high confidence to apply and join the MHAHS team.
I was amazed to see and hear about the work that our service has done so far in contributing to the wellbeing of people living with HIV and Hepatitis C. Our service also provides support and training to all the co-workers in professional and ethical manners.
The ongoing training provided by the MHAHS give me more and more knowledge about HIV and Hepatitis that continues to improve and change through time. I am more aware of how important these issues can be detected, prevented and treated. I have gained wonderful experience, learnt so much and will keep on learning.
The activities that I have carried out for the MHAHS includes translating resources for the media campaign in Vietnamese language; I joined the health promotion and media training; I worked as a clinical co-worker and currently hold a position as Vietnamese Community Development Project Officer for hepatitis B.
Recently, I have a client who is living with HIV and she came from Vietnam. I attend regular individual supervision and group supervision meetings. My supervisor has helped create a plan to assist the client and my senior project officer has given me great support in organizing workshops and connecting with wider community.
For me, the challenge that I am facing as a co-worker is how to fulfill my role in different tasks. My reward is that I feel I belong to the organisation that looks after the wellbeing of people in a caring and supporting ways.
I really enjoy the work here because it helps me to maintain and develop my skills. I feel proud and happy that I can contribute to health and well of people particularly to my Vietnamese community

 

1. Introduction

Welcome to the Multicultural HIV and Hepatitis Service (MHAHS).

This handbook provides an overview of the MHAHS, its structure and role, and policies and procedures relevant to co-workers.

It is for use by all co-workers and may be read during the induction training or within the first few weeks of employment, and can be kept as a reference.

An accompanying handbook, Co-worker clinical handbook, available for co-workers who provide client support, outlines the MHAHS policies and procedures related to client support.

The policy and values framework within which the MHAHS works is based on the principles of multiculturalism defined in the NSW Community Relations and Principles of Multiculturalism Act (2000) and the NSW Policy and Implementation Plan for Healthy Culturally Diverse Communities (2012-2016).

In its broadest sense, multiculturalism acknowledges that Australians come from all over the world, as well as Australia, and that bring a diversity of languages, cultures, beliefs and values.

The NSW Community Relations and Principles of Multiculturalism Act includes the following principles:

Diversity and acceptance

The people of NSW are of different linguistic, racial and ethnic backgrounds who are free to practise and maintain their heritage.

Shared values

All individuals, irrespective of their backgrounds, should demonstrate a unified commitment to Australia, its interest and future, and recognise the importance of shared values.

Participation and contribution

All individuals should have the opportunity to contribute to, and participate in, all levels of public life.

Respect for cultural diversity

All individuals and institutions should respect and make provision for the culture, language, and religion of others within the Australian context where English is the primary language.

Equal access

All individuals should have the opportunity to make use of, and participate in, activities and programs provided by government.

Using diversity

All institutions should recognise the linguistic and cultural assets of the population as a valuable resource and promote this resource to maximise the development of the State.

The multicultural health principles set out by the NSW Government also guide the work of the MHAHS:

  • People from culturally, religiously and linguistically diverse backgrounds will have access to appropriate health information.
  • People from culturally, religiously and linguistically diverse backgrounds will have access to quality health services that recognise and respect their linguistic, cultural and religious needs.
  • Health policies, programs and services will respond in an appropriate way to the health of people from culturally, religiously and linguistically diverse backgrounds.
  • People from culturally, religiously and linguistically diverse backgrounds will have an opportunity to contribute to decisions about health services that affect them.
  • Multicultural health programs and services will be evidenced-based and/or support best practice in the provision of health services in a culturally, religiously and linguistically diverse society.

The MHAHS specifically targets communities across NSW speaking the following languages:

Akan, Amharic, Arabic, Burmese, Chinese (Cantonese and Mandarin), Croatian, Farsi, Greek, Indonesian, Italian, Khmer, Korean, Macedonian, Indonesian, Italian, Khmer, Korean, Krio, Polish, Portuguese, Serbian, Shona, Somali, Spanish, Swahili, Thai, Turkish, Urdu and Vietnamese.

2. History of the MHAHS

Human Immunodeficiency Virus (HIV) was first diagnosed in Australia in 1982. In subsequent years, the NSW Ministry of Health (formerly known as the NSW Department of Health), recognised the difficulties faced by people from culturally and linguistically diverse (CALD) backgrounds in accessing information and support. In May 1991, the service was funded as a short-term, 12-month project. The first co-workers were recruited and trained by October 1991.

The MHAHS is now a state-wide service funded by the NSW Ministry of Health, Centre for Population Health. The service has expanded its role and works to respond to both HIV and viral hepatitis among CALD communities. It is hosted by Sydney Local Health District (SLHD).

3. Mission statement

To work with and empower culturally and linguistically diverse individuals and communities to improve health and well-being in relation to HIV, hepatitis B and hepatitis C; to encourage other agencies to respond appropriately and equitably to affected communities; to work collaboratively, embrace innovation and demonstrate leadership in responding to emerging needs.

4. Goals

The MHAHS has four goals:

  • To reduce the transmission of HIV, hepatitis B and hepatitis C among people from CALD communities.
  • To improve the health and wellbeing of people with HIV and/or hepatitis C from CALD communities.
  • To enhance the capacity of health services and communities to respond to HIV, hepatitis B and hepatitis C within CALD communities.
  • To increase the capacity of MHAHS to plan, implement and evaluate its activities.

5. Organisation

5.1 Structure

The MHAHS has a state-wide brief, but is hosted by the Division of Population Health, Sydney Local Health District (SLHD).

The service works in three areas, with specific goals, which complement and overlap each other:

Area of work Goals
Care, Treatment & Support To improve the health and well-being of people with HIV and/or hepatitis C from CALD communities.
Education & Prevention To reduce the transmission of HIV, hepatitis B and hepatitis among people from CALD communities.
Capacity Building To enhance the capacity of health services and communities to respond to HIV, hepatitis B and hepatitis C within CALD communities;
To increases the capacity of MHAHS and its staff to plan, implement and evaluate activities.

5.2 MHAHS advisory group

The MHAHS benefits from the expertise and advice of HIV, hepatitis and multicultural agencies through its advisory group which includes: ACON; Australasian Society of HIV Medicine (ASHM); Hepatitis NSW; NSW Ministry of Health; NSW Refugee Health Service; NSW Sexually Transmissable Programs Unit (STIPU); NSW Users and AIDS Association (NUAA); Positive Life NSW; Pozhet as well as representatives from the HIV and Related Programs Unit (HARP), multicultural, gastroenterology and sexual health services.

5.3 Staffing

The MHAHS core positions include:

  • Manager
  • Deputy Manager
  • Workforce and Service Development Officer
  • Community Development Officer
  • Clinical supervisors x 2
  • Education and Media Officer
  • Health Promotion Officer
  • Publications Officer
  • Co-worker Liaison Officer
  • Office Manager
  • Administration Assistants x 2

The Service employs more than 100 casual bilingual/bicultural co-workers who are central to the implementation of the service’s programs and activities.

Organisational chart

The MHAHS organisational chart is found at Appendix A.

5.5 Website

The MHAHS has a multilingual website at www.mhahs.org.au

The site includes a range of information and fact sheets on HIV, hepatitis B and hepatitis C in community languages. It also provides links to key documents and services, and has a media centre.

The secure co-worker section contains information and resources relevant to co-workers including meeting, supervision and training schedules.

Co-workers should visit this section regularly for up-to-date information relevant to their work.

6. Services and programs

6.1 Care, treatment and support

Care, treatment and support work aims to improve the health and wellbeing of people from CALD backgrounds living with HIV or hepatitis C. This includes providing one-to-one support for people living with HIV or undergoing treatment for hepatitis C, as well as ensuring individuals have access to accurate information about HIV, and viral hepatitis in their preferred language.

This work both acknowledges and promotes an individual's right to access information and services. It also acknowledges that cultural factors influence identity, beliefs and behaviour and that these factors can either enhance or impede a person’s health and wellbeing.

6.2 Education and prevention

Education and prevention work aims to enhance knowledge of and reduce the transmission of HIV, hepatitis B and hepatitis C among CALD communities. This includes developing information resources in community languages, using ethnic media to promote awareness of testing and treatments, as well as working with CALD communities to implement appropriate prevention activities.

Education and prevention work is based on the principle that communities know how to reach, inform and empower their members. It encourages and supports communities to develop education and prevention activities to ensure cultural appropriateness, involvement of community stakeholders and community ownership.

6.3 Capacity building

The capacity building work of the MHAHS aims to improve the ability of health services and communities to respond to HIV-, hepatitis B- and C-related issues for people from CALD backgrounds. Activities include delivering training, contributing to policy and planning, and advocating for CALD communities.

Capacity building work recognises that while the MHAHS has a lead role in addressing HIV and viral hepatitis among CALD communities, improving the ability of other services and agencies is vital to achieving an effective impact for CALD individuals and communities.

7. Co-worker roles and responsibilities

Co-workers are a key component of the MHAHS. They provide an essential link between the MHAHS and CALD communities in all areas of our work.

The primary aim of the co-worker’s role is to provide cultural and linguistic input into the work of the MHAHS, including working with mainstream services to support clients living with HIV and those undergoing treatment for hepatitis C, as well as facilitating access to services; assisting in media and education activities; developing culturally appropriate resources or delivering education sessions; strengthening links with CALD communities and implementing community development initiatives.

7.1 General duties

  • Respond in timely manner when contacted by the MHAHS
  • Report on work which has been completed, to the relevant staff member
  • Report hours worked within 24 hours and no later than midnight on Sundays, to the MHAHS office
  • Abide by the policy and procedures outlined in the MHAHS Co-worker Handbook
  • Attend on-going training as specified by the manager or her delegate
  • Attend relevant MHAHS meetings, including co-worker staff meetings
  • Attend a minimum of two co-worker staff meetings each calendar year
  • Advise the Co-worker Liaison Officer of any changes to personal circumstances in a timely manner e.g. address, contact phone numbers, overseas travel
  • Other duties as requested by the Manager or her delegate.

7.2 Care, treatment and support role - duties

A co-worker’s care, treatment and support role includes:

  • Providing emotional support for clients from CALD backgrounds who are living with HIV or undergoing treatment for hepatitis C
  • Assisting in the assessment of the client’s coping skills, needs, and support networks
  • Assisting the Clinical Supervisor develop a case plan, which may include liaison with other services involved
  • Assisting in implementing the case plan
  • Providing regular feedback to the Clinical Supervisor
  • Attending group and individual supervision as directed by the Clinical Supervisor
  • Liaising with client’s case manager and other agencies
  • Accompanying the client to relevant appointments, if included in the case plan
  • Clarifying and discussing information which has been given to the client
  • Providing information and facilitating access to support structures and services in the relevant CALD community
  • Providing information on cultural issues, to service providers, which may affect the client’s needs and support networks
  • Providing cultural information, to service providers, about attitudes to HIV, hepatitis C, illness, death, dying, grief, sexuality and drug use.

7.3 Education and prevention role - duties

A co-worker’s education and prevention role includes:

  • Delivering HIV and/or viral hepatitis community education sessions in language
  • Assisting the MHAHS access community networks
  • Assisting the MHAHS to identify community needs and strengths e.g. focus groups, community consultations
  • Developing and providing feedback on HIV and/or viral hepatitis information and resources in language. The process is based on the recognition that linguistic and cultural meaning is often lost in direct translation from English
  • Distributing HIV and viral hepatitis information and resources
  • Assisting in the implementation of community development activities
  • Monitoring ethnic media
  • Assisting with the development of media materials in a community language
  • Participating in media interviews.

7.4 Capacity building role - duties

A co-worker’s capacity building role includes:

  • Attending co-worker training organised by the MHAHS
  • Attending a minimum of two co-worker staff meetings each calendar year
  • Assisting with training for community workers/organisations about HIV- and viral hepatitis-related issues.

7.5 Limits of the co-worker role

  • Interpreting - Co-workers are not interpreters. While bilingual skills are an important aspect of the role, if clients only require language support, the Health Care Interpreter Service or Telephone Interpreter Service (TIS) should be used
  • Translating - Co-workers are not to undertake direct translation of written materials. However, they may participate in the development of written materials in a community language
  • Commenting on government policy, funding or controversial issues e.g. when being interviewed by the media.

7.6 Co-worker rights

A co-worker has the right to:

  • Be paid according to the Health Education Officer Award
  • Be assigned work appropriately, with consideration given to their abilities and skills
  • Decline any work offered by the MHAHS that they feel unable to do
  • Regular supervision, training and on-going education
  • Use MHAHS computers for MHAHS-related work
  • Use MHAHS fleet cars for work-related activities
  • Access information about SLHD, the MHAHS and its policies and programs.

7.7 MHAHS rights

The MHAHS has the right to:

  • Allocate work to co-workers considered the most suitable for a task
  • Expect that work be completed in a responsible, efficient and professional manner
  • Expect the standards of the MHAHS to be upheld at all times
  • Expect a commitment to the principles of the Service. See introduction
  • Evaluate work performance and give feedback to co-workers
  • Re-allocate tasks where there are concerns regarding a co-worker’s work performance
  • Expect co-workers to communicate with MHAHS staff on allocated work on a regular and on-going basis
  • Expect co-workers to report their work hours within 24 hours of completing the work or by midnight on Sunday
  • Expect co-workers to attend at least two co-worker staff meetings in a calendar year
  • Expect co-workers to advise the MHAHS of any extended periods when they will not be available for work. See Leave of Absence.

7.8 Co-worker training

All co-workers must attend the face-to-face induction training program, at the completion of which they receive a certificate.

Mandatory online training courses are available through the Health Education Training Institute (HETI) Online at www.heti.nsw.gov.au. Users access the training using a secure log-on. See StaffLink.

To ensure co-workers’ skills and knowledge are up-to-date, ongoing training is provided regularly.

This is provided by the MHAHS at no cost and includes:

  • Annual half-day intensive training session
  • Training incorporated into one co-worker staff meeting each year
  • Three training sessions each year for co-workers who provide client support.

8. General policies and procedures

8.1 Employment

Co-workers are employed as casual staff under the Health Education Officer Award. A copy of the Award is available from the Manager or from Sydney Local Health District, Human Resources, located on Level 8, King George V Building, Missenden Road, Camperdown, NSW, 2050.Ph: 9515 9888.

As casual employees under the Health Education Officer Award, co-workers are entitled to a minimum payment of two hours plus an additional 10% casual loading. Penalty rates apply for work carried out after business hours or on week-ends. Work on public holidays is only undertaken in exceptional circumstances must be approved in advance by the Manager.

Co-workers are not entitled to paid sick leave, paid annual leave, or any other paid leave, but may be entitled to paid parental leave under the Commonwealth Paid Parental Leave Scheme.

All employees of the MHAHS are subject to Sydney Local Health District (SLHD) Conditions of Employment. Co-workers are required to sign a Position Description before starting employment with the MHAHS.

Co-workers are expected to follow the principles and policies of:

  • Equal Employment Opportunity (EEO)
  • Workplace Health and Safety (WHS)
  • Charter of Cultural Diversity.

For co-workers who are also employed full-time with other employers, arrangements must be made for casual work with the MHAHS to be conducted in the worker’s own time e.g. after hours, flexi-time, leave. Work for the MHAHS cannot be paid if it is conducted in another employer’s time.

Sydney Local Health District policy states that staff employed on a full-time basis by another service/department within SLHD cannot also be employed on a casual basis by another service within the health district. This means that if a co-worker takes up a full-time position with another service/department in SLHD they can no longer work for the MHAHS.

8.2 Code of conduct and ethics

All co-workers must observe the SLHD Code of Conduct. It is set out under six sections:

  • Promote a positive work environment
  • Demonstrate honesty and integrity
  • Acting professionally and ethically
  • Use official resources lawfully, efficiently and only as authorised
  • Maintain the security of confidential and/or sensitive official information
  • Maintain professional relationships with patients and clients.

Of particular importance are:

Confidentiality

All information pertaining to clients must be kept confidential and not communicated to any third party other than the Clinical Supervisor. The client’s consent is required before discussion occurs with any other professional or service.

Impartiality

Co-workers must observe impartiality and neutrality in all situations. Personal preferences and religious or political views must not interfere with the performance of duties.

Conflict of interest

Co-workers are not to be advantaged by a client's situation for personal, financial or professional gain. In this case, ‘client’ refers to the person living with HIV or undergoing treatment for hepatitis C, or their family, partner or carer. Similarly, co-workers (or their partner, or close family member) cannot use MHAHS work for personal gain.

General conduct

Co-workers must act at all times in accordance with professional standards and comply with the lawful requirements and procedures of SLHD. Co-workers are required to relate to both colleagues and clients in a professional and respectful manner at all times, regardless of personal, religious, or political preferences.

If there is any conflict at the workplace, the co-worker is responsible for pursuing the matter in the appropriate manner. See Grievance Procedure.

Reporting child abuse

Sydney Local Health District policy states all health workers must notify suspected physical, sexual, and emotional abuse and neglect of children. A co-worker, who has contact with children when supporting clients and suspects any abuse, must inform the Clinical Supervisor who will provide further details of this responsibility.

8.3 StaffLink human resources and payroll system

StaffLink is on an online human resources and payroll system used across the NSW public health system. The Employee Self-Service (ESS) function allows co-workers to view payslips the same day they are paid as well as update personal and banking details.

StaffLink can be accessed from any location at any time via a secure log-on at https://stafflink.hss.health.nsw.gov.au

Co-workers are paid at the end of every two-week pay period, directly into their nominated account.

Co-workers are required to report their work hours within 24 hours of completing the work and no later than midnight on Sunday. See Reporting work hours.

Co-workers must keep the MHAHS informed of any change to their personal details ie. postal address, phone numbers, email, by contacting the Co-worker Liaison Officer on 9515 1234.

For StaffLink password or technical issues contact the HealthShare Service Desk on 1300 285 533.

For pay enquiries please call the Co-Worker Liaison Officer on 9515 1234.

8.4 Identification card

Co-workers are issued with an SLHD identification (ID) card and are expected to carry it when conducting work for the MHAHS.

8.5 Co-worker staff meetings

Three co-worker staff meetings are held each year in March, September and December. These provide co-workers with updates on MHAHS business, and are a venue for discussing work-related issues and on-going training.

Co-workers are required to attend a minimum of two co-worker staff meetings each calendar year.

8.6 Work allocation

Depending on the activity, work is allocated to co-workers by one of the MHAHS core staff members. This is done in a face-to-face meeting, by telephone or email.

Co-workers are entitled to decline any work offered by the MHAHS. If a co-worker agrees to undertake the work, they are briefed about the work by the relevant staff member. For co-workers supporting clients, see the Clinical Co-worker Handbook.

Briefing involves a detailed discussion about the task as well as the number of hours required to complete the task. If you feel the time allocated is insufficient, discuss this at the briefing. If, while carrying out the task, you realise the time is not sufficient, for instance while developing information resources in your language, inform the staff member who allocated the work and negotiate additional time before continuing. See Briefing.

When the work is completed, debriefing with the relevant staff member will take place. This is important for quality assurance, allows co-workers to provide feedback about the task and its management as well as discuss their performance. See Debriefing and evaluation.

8.7 Reporting work hours

Co-workers are required to email their work hours to the MHAHS at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Work hours must be reported within 24 hours of the work being completed and no later than midnight on Sunday. Late reporting of hours will result in a delay in payment.

When reporting work hours, please provide:

  • Day and date worked e.g. Monday 8 July 2012
  • Hours worked e.g. 10am -12noon/li>
  • Type of work completed e.g. community festival
  • ;Name of staff member who allocated the work e.g. Sonam

If claiming mileage, the relevant details must also be provided. See Travel expenses, below.

8.8 Travel expenses

Travel expenses are claimed at the same time as claiming hours worked. See Reporting work hours, above.

Co-workers may claim mileage, when using their own car for MHAHS work, for distances of more than 15km, but not for travel to and from the MHAHS office in Camperdown.

Please note that clients are not to be transported in private vehicles due to insurance, and work health and safety issues. If a co-worker is required to transport a client e.g. to/from an appointment, a MHAHS fleet car can be used. See MHAHS fleet cars.

When claiming mileage please provide:
  • Car make and model e.g. Toyota Corolla
  • Engine capacity e.g. 1.8 litres

First trip:

  • Suburbs travelled from and to e.g. Campsie to Liverpool
  • Odometer reading at the start and finish of the trip eg. 62345 - 62364
  • Distance travelled e.g. 19 km

Second trip:

  • Suburbs travelled from and to e.g. Liverpool to Campsie
  • Odometer reading at the start and finish of the trip eg. 62364 - 62383
  • Distance travelled e.g. 19 km

Parking fees may be claimed through the petty cash system. A receipt is required and a Petty Cash Claim form can be obtained from the administration assistant. See Petty Cash, below.

Expenses for travel on public transport can be claimed through petty cash, but not for travel to and from the MHAHS office. A receipt is required and a Petty Cash Claim form is available from the administration assistant. See Petty Cash, below.

If travelling to the MHAHS from another work place, co-workers may be able to claim travel expenses through an income tax deduction, but should check this with a tax adviser.

8.9 Off-site security

The MHAHS is committed to ensuring safe working conditions for all staff.

Co-workers should not knowingly place themselves, other staff or clients at risk.

They should always carry the MHAHS office phone number, and the supervising staff member’s contact details with them when working after hours or on weekends. See Appendix B.

8.10 Petty cash

In principle, any item a co-worker purchases essential for carrying out work allocated by the MHAHS, can be claimed through petty cash. However, approval for these purchases must be gained in advance. No single purchase or receipt can be more than $50.00

To make a petty cash claim, receipts must be provided and a Petty Cash Claim form completed. The form is available from the MHAHS administration assistant. The form and attached receipt are submitted to the Manager for approval and photocopied for MHAHS records. Once approved, take the claim form to the cashier’s office, level 7, King George V Building. You also need to show the cashier your SLHD ID card. The cashier is open Monday and Friday 9am-4pm (closed 1-1.30pm), and Tuesday, Wednesday, Thursday 9am-12noon.

8.11 MHAHS fleet cars

MHAHS fleet cars are available for use for work-related activities by co-workers holding a valid driver’s licence. Car bookings should be made in advance through the Administration Assistant.

Co-workers should not transport clients in private vehicles. However, MHAHS fleet cars can be used for this purpose.

8.12 Leave of absence

Co-workers are required to advise the MHAHS Manager of any periods when they are unavailable for work e.g. when travelling overseas.

When unavailable for work, it is necessary to:

  • Advise the MHAHS by telephone or email for periods of up to three months.
  • Request leave in writing for periods between three and six months.

The Manager will only approve periods of unavailability up to a maximum of six months. After this time, a co-worker may request an extension.

8.13 Grievance procedure

A grievance is any work-related matter that causes a co-worker concern or distress. It may be the result of a decision, action or omission, which is perceived as wrong, unjust or discriminatory.

If a co-worker has a grievance, they need to address it with the most appropriate person, usually the MHAHS staff member who is supervising the work being done.

If the matter cannot be resolved, the co-worker should:

  1. Speak to the MHAHS Manager who will determine if documentation of the grievance is warranted.
  2. If a co-worker feels unable to speak to the MHAHS Manager, they can take the grievance to Debbie Killian, General Manager Population Health, SLHD. Ph: 9515 9503.

8.14 Disciplinary procedure

The Manager or her delegate, may discipline a co-worker whose behaviour or performance is considered unsatisfactory. Every attempt is made to ensure co-workers are aware of the expected behaviour or performance, supported to improve and treated consistently and fairly.

Examples of unsatisfactory behaviour or performance include:

  • Breaches of the SLHD Code of Conduct, such as breaking confidentiality, accepting money or gifts, entering into financial arrangements with a client.
  • Unsatisfactory job performance, such as missing appointments or supervision, endangering self or others.
  • Inappropriate behaviour, such as dishonesty, being affected by drugs or alcohol while on duty, engaging in verbal abuse or physical violence.

Disciplinary action depends on the severity of the offence with due consideration of all associated factors. It ranges from an informal telephone call to a verbal or written reprimand, allowing the

co-worker to resign, or in the case of a very serious offence, dismissal without notice.

The disciplinary process also depends on the offence, but may include a:

  • Fact-finding interview/s to ascertain the circumstances of the incident from witnesses and others involved.
  • Disciplinary interview with the employee. In this instance, a co-worker is entitled to choose an observer or union representative to be present. Interviews may be recorded depending on the seriousness and complexity of the matter.

8.15 Resigning from the MHAHS

Co-workers need to notify the Manager in writing if they wish to resign.

9. Care, treatment and support - policies and procedures

Co-workers provide clients with culturally relevant support. Support relies on a relationship, built on trust and confidentiality, that operates within a clearly defined role as set out in the client case plan.

See the MHAHS Clinical Co-worker Handbook for policies and procedures relating to client support.

10. Education, prevention and capacity building - policies and procedures

Education and prevention work aims to reduce the transmission of HIV, and hepatitis B and C among CALD communities. This includes developing resources in community languages, using ethnic media to promote awareness and access to testing and treatment, as well as working with communities to implement culturally appropriate prevention initiatives.

The capacity building work of the MHAHS aims to improve the ability of both health services and communities to respond to HIV and viral hepatitis among CALD communities, as well as increase the ability of the MHAHS to plan, implement and evaluate its programs. Capacity building activities include delivering and attending training, contributing to planning with other services and advocacy for people from CALD backgrounds.

These activities are generally supervised by the Education/Media Officer, Health Promotion Officer, Community Development Officer, and the Workforce and Service Development Officer.

The co-worker’s role is crucial in assisting the MHAHS make links with community networks and reach CALD communities.;

10.1 Allocation of work

The Co-worker Liaison Officer will contact a co-worker when work is required. The co-worker should phone or email the Co-worker Liaison Officer within 24 hours of being contacted.

The co-worker will be given some initial details about the work e.g. what the work entails, when it needs to be done, the name of the staff member responsible for the work, etc. A detailed briefing is provided by the supervising staff member. See Briefing, below.

10.2 Briefing

Once a co-worker has confirmed their availability, they are fully briefed about the work by the staff member who will supervise them. Briefing may occur during a meeting at the MHAHS, by phone or email. All relevant information and material required for the work will be given to the co-worker. For some work, the co-worker may be required to participate in extra training e.g. media training, training in community education.

The briefing also provides an opportunity for co-workers to raise issues, either professional or personal, about the work. Professional issues may include unfamiliarity with the material or target group, or disagreement with the approach for cultural reasons. Personal issues may include feeling uncomfortable e.g. demonstrating the use of a condom at an education session, or not feeling confident. Discussing these issues ensures an effective and appropriate service.

Any issues that arise after the briefing should be discussed with the relevant staff member as soon as possible and before continuing with the allocated work.

10.3 Debriefing and evaluation

Co-workers are expected to debrief about allocated work. Debriefing with the relevant staff member and/or other co-workers allows for discussion of issues in a supportive environment. It allows

co-workers to provide feedback regarding the overall task and its management which contributes to evaluation of the activity, as well as gain feedback about their performance.

Debriefing is also a vital part of quality assurance for the MHAHS. By identifying difficulties with the task or possible areas for improvement in their performance, co-workers contribute to helping the MHAHS identify training needs. For example, if a co-worker identified a lack of confidence in

public speaking, the MHAHS might provide a workshop on public speaking and presentation skills.

10.4 Responsibilities

Co-workers are responsible for their transport to the work location/venue and for ensuring they are on time. In some instances, transport may be arranged with other MHAHS staff. However,

the co-worker is responsible for making these arrangements.

The work entailed in education, prevention and capacity building may require some preparation. It is important that co-workers take the time necessary to prepare for the allocated task.

While carrying out allocated work, co-workers represent both the MHAHS and the NSW Ministry of Health, and must dress appropriately, conduct themselves in a professional manner, and abide of the SLHD Code of Conduct and Ethics. Co-workers are also required to carry their identification card at all times.

10.5 Media policy

Co-workers may be asked to act as media spokespeople for the MHAHS. Additional training on working effectively with the media is provided before such work is offered.

As employees of the NSW Ministry of Health, co-workers are bound by strict policy governing contact with the media and must inform the Education/Media Officer if approached regarding an interview. The Education/Media Officer will follow-up the journalist and then seek approval for the interview from the Media and Communications Unit, SLHD. If approval is gained, the co-worker will be briefed by the Education/Media Officer.

During an interview, it is important the co-worker stays within the agreed topic and not comment on government policy, funding issues or controversial issues. The co-worker should not attempt to answer inappropriate questions e.g. detailed medical questions.

Co-workers have the right to refuse all or part of an interview to be used/broadcast, if they feel uncomfortable about the content e.g. if a journalist has misled them. The Education/Media Officer will advise co-workers on the appropriate action in this situation.

11. Appendix A. MHAHS organisational chart


11. Appendix B: Important phone numbers and email addresses

  • MHAHS office
  • Monday - Friday: 9am-5pm
  • 9515 1234
  • Co-worker liaison officer
  • Monday, Tuesday, Thursday: 9am-5pm
  • 9515 1234
  • This e-mail address is being protected from spambots. You need JavaScript enabled to view it This e-mail address is being protected from spambots. You need JavaScript enabled to view it
  • Reporting work hours
  • This e-mail address is being protected from spambots. You need JavaScript enabled to view it This e-mail address is being protected from spambots. You need JavaScript enabled to view it
  • Clinical supervisor after hours
  • Monday - Friday: 5pm-9pm
  • Saturday, Sunday, Public Holidays: 9am-9pm
  • 0425 262 557
  • Mental Health Line
  • Provides phone number for the nearest Mental Health Crisis Team
  • 1800 011 511


Below are some useful guidelines for co-workers when preparing cultural presentations or reports for the co-worker staff meetings, as well as when writing a co-worker viewpoint for the newsletter MHAHS News:

Guidelines for preparing a “Cultural Presentation” for the co-worker staff meetings

The time allocated for cultural presentations is 30 minutes. Written information presented during cultural presentations may be on PowerPoint and as bullet points. Read More

Guidelines for the “Co-worker Report” at the co-worker staff meetings

The purpose of the “Co-worker Report” is to provide an opportunity for co-workers to share their experience of recent work they have undertaken. It is expected that you prepare some notes, speak from the front of the room (i.e. not from your seat), and speak for 5-10 minutes. Read More

Guidelines for MHAHS News (Editorial)

This guideline is for co-workers working as part of our editorial team on the quarterly newsletter MHAHS News. Read More

Cultural Presentation Guidelines

The alloted time for MHAHS cultural presentations is 30 minutes. The written information presented during cultural presentations may be on PowerPoint and as bullet points.

Some suggested content includes:

Background information about the country and culture, for example:

  • History and geography
  • Demographics and population information
  • Language(s) spoken
  • Traditions, food, art, literature
  • Religion, beliefs, values
  • Economy and tourism
  • Consider: How has culture influenced your own personal identity?

Information about HIV & Hep C in the country you are speaking about:

  • When HIV/AIDS first appeared (First case of HIV/AIDS)
  • Current HIV/AIDS and hepatitis C rates and which populations are most affected (eg homosexual men, heterosexuals, women, injecting drug users, sex workers etc.
  • Response to HIV/AIDS and hepatitis C
    • Government policies and strategies
    • Public education and awareness
    • Stigma and discrimination (attitudes to positive people, drug use, sexuality)
    • Prevention strategies
    • Access to HIV treatments
    • Organisations and services for HIV positive people and people living with hepatitis C
    • Consider: Does culture influence the response to HIV/AIDS and hep C?
  • Some websites that might be useful to find information for your presentation:
    • Joint United Nations Program on HIV/AIDS (UNAIDS): www.unaids.org
    • World Health Organisation: www.who/int/en
    • Google search (eg Google “HIV in Argentina”): www.google.com
    • Government or health department websites of the country you are researching

We estimate preparation of this presentation would take around 5 hours. If you think it would take longer for you, please contact the Co-worker Liaison Officer.

Example of a cultural presentation

Co-worker Report Guidelines

The purpose of the “Co-worker Report” is to provide an opportunity for co-workers to share their experience of recent work they have undertaken.

It is expected that you prepare some notes, speak from the front of the room (i.e. not from your seat), and speak for 5-10 minutes

The key things you should cover are:

  • What projects or tasks you were involved in
  • E.g. What was the project or event?
    • What was your role?
    • When/dates of the task or project
  • Challenges you came across or experienced
  • What you have learnt or improved as a result of the task
  • Enjoyment, satisfaction or frustration experienced

MHAHS News Editorial Guidelines

Aim and purpose

The MHAHS News is the internal co-workers’ newsletter of the Multicultural HIV and Hepatitis Service (MHAHS).

It aims to increase communication between the MHAHS and co-workers, and provide them with up-to-date information regarding HIV and viral hepatitis.

Published quarterly, in autumn (March), winter (June), spring (September) and summer (December), the newsletter reports the main highlights of MHAHS activities for the previous three months as well as recent, relevant HIV and viral hepatitis issues.

Responsibilities: editorial committee

The members of the editorial committee include the Co-worker Liaison Officer, the Research and Publications Officer and three MHAHS co-workers.

The Co-worker Liaison Officer is responsible for coordinating the overall production and dissemination of the newsletter.

The Publications Officer is responsible for sourcing and/or editing the content for the following sections:

  • Around the world
  • Co-worker’s viewpoint
  • Feature.

The co-worker members of the committee are responsible for the following sections:

  • Around the world - selecting content
  • Co-worker’s viewpoint - conducting and writing-up interview
  • Feature - selecting content.

Process

Co-worker expressions of interest for the editorial committee are voluntary and are invited through:

  • co-worker staff meetings
  • email
  • MHAHS News.

Each editorial committee produces two sequential issues of the MHAHS News and convenes for a period of six months.

Meetings of the committee are arranged by the Co-worker Liaison Officer and chaired by the Publications Officer.

The first meeting of each committee is held face-to-face to discuss the role and function of the committee, and to allocate tasks to the members. Subsequent communication occurs electronically or via telephone. Further face-to-face meetings are convened as needed.

Following publication of two sequential issues of the MHAHS News, all members of the committee participate in an informal review of the process. A brief report/feedback may be given at a subsequent co-worker staff meeting.

Content

  • Front page
  • Includes editor’s notes, messages as well as recent news items. The Co-worker Liaison Officer is responsible for drafting this section.
  • Word limit: 250
  • Contents box
  • Included on the front page, this details the newsletter content. The Co-worker Liaison Officer is responsible for this section.
  • Word limit: 30
  • Project news
  • This section provides brief updates on current MHAHS projects and activities including main highlights and outcomes. The Co-worker Liaison Officer seeks contributions from relevant MHAHS staff which are edited by the Publications Officer.
  • Word limit: 650
  • Co-worker’s viewpoint
  • This features one co-worker’s perspective of their work with the MHAHS. It is based on an interview with the co-worker, usually conducted by a co-worker who is a member of the editorial committee, and if this is not possible, by the Publications Officer.

The interview seeks to answer the following questions about the co-worker’s experience and may be reported in a question/answer format:

  • Where do you come from/family story?
  • What you do/did outside the MHAHS?
  • What made you join the MHAHS/Why you want to work in this area?
  • (Your experience of the initial training)
  • What activities/tasks have you been involved in at the MHAHS
  • What activities/tasks have you been involved in at the MHAHS
  • Client work if you had any (what was easy/what was hard)
  • What do you get from supervision (individual and group)
  • What do you see are your challenges/rewards of being a co-worker
  • What would you tell new co-workers about the work and the MHAHS?
  • Other comments

The co-worker Liaison Officer selects the co-worker to be interviewed with the aim of representing co-worker diversity. The interview may occur face-to-face or on the telephone. The Publications Officer edits the interview draft and checks with the interviewed co-worker that it is acceptable to them. A photo, provided by the co-worker, accompanies this item.

Word limit: 600

  • Feature
  • This includes current or emerging HIV or viral hepatitis issues and often features human interest or research articles. The Publications Officer sources the article and edits it following selection by the editorial committee.
  • Word limit: 1000
  • Around the world
  • Includes brief, international items, covering both viral hepatitis and HIV-related issues and initiatives eg. community development projects, advocacy, research and human interest stories. Items should be geographically diverse and always include at least one with wide global significance as well as one about hepatitis. Items are sourced by the Publications Officer and selected by the editorial committee.
  • Word limit: 1000
  • What’s new on the MHAHS website?
  • Includes an update of new information and resources posted on the website. The update is provided by the Education and Media Officer and edited by the Publications Officer.
  • Word limit: 250
  • Did you know?
  • An occasional item that provides current facts (including the source) about HIV and viral hepatitis. The Publications Officer is responsible for sourcing these.
  • Word limit: 100
  • Images
  • Pictures of recent MHAHS events and activities, and other relevant images are included in the related section of the newsletter. Images are provided by MHAHS staff and/or sourced by the Co-worker Liaison Officer.

Format

The MHAHS News consists of eight x A4 pages, in pdf format. The Co-worker Liaison Officer is responsible for formatting the content.

Dissemination

The Co-worker Liaison Officer is responsible for coordinating uploading the onto MHAHS website and electronic dissemination of the newsletter and uploading to the MHAHS website. Email alerts are sent to co-workers. Hard copies are provided on request only.

Evaluation

An evaluation of MHAHS News will be conducted regularly.


Dear Colleague

Welcome to the Winter 2018 issue of MHAHS News.

The Feature articles discuss why an imperfect HIV vaccine could be better than none at all and the eradication of hepatitis C in 10 patients following lifesaving transplants from infected donors.

The Around the World section presents interesting viral hepatitis and HIV related news from USA to Philippines and Australia.

In Project News, we bring you highlights of recent projects, campaigns, health promotion activities and the clinical support programme at the MHAHS.

Finally, Faten, our Arabic-speaking CSO, shares her story about how she joined MHAHS and her positive experiences at the MHAHS.

Enjoy the read

Riza Yaman