title: Breaking down barriers to eye care for Indigenous people: a new scheme for delivery of eye care in Victoria.
abstract: This report describes the implementation of and outcomes from a new spectacle subsidy scheme and de-centralised care options for Aboriginal and Torres Strait Islander peoples in Victoria, Australia. The Victorian Aboriginal Spectacle Subsidy Scheme (VASSS) commenced in 2010, as an additional subsidy to the long-established Victorian Eyecare Service (VES). The Victorian Aboriginal Spectacle Subsidy Scheme aimed to improve access to and uptake of affordable spectacles and eye examinations by Indigenous Victorians. The scheme is overseen by a committee convened by the Victorian Government's Department of Health and Human Services and includes eye-health stakeholders from the Aboriginal community and government, not-for-profit, university and Aboriginal communities. Key features of the Victorian Aboriginal Spectacle Subsidy Scheme include reduced and certain patient co-payments of $10, expanded spectacle frame range, broadened eligibility and community participation in service design and implementation. We describe the services implemented by the Australian College of Optometry (ACO) in Victoria and their impact on access to eye-care services. In 2014, optometric services were available at 36 service sites across Victoria, including 21 Aboriginal Health Services (AHS) sites. Patient services have increased from 400 services per year in 2009, to 1,800 services provided in 2014. During the first three years of the Victorian Aboriginal Spectacle Subsidy Scheme program (2010 to 2013), 4,200 pairs of glasses (1,400 pairs per year) were provided. Further funding to 2016/17 will lift the number of glasses to be delivered to 6,600 pairs (1,650 per year). This compares to population projected needs of 2,400 pairs per year. Overcoming the barriers to using eye-care services by Indigenous people can be difficult and resource intensive; however the Victorian Aboriginal Spectacle Subsidy Scheme provides an example of positive outcomes achieved through carefully designed and targeted approaches that engender sector and stakeholder support. Sustained support for the Victorian Aboriginal Spectacle Subsidy Scheme at a level that meets population needs is an ongoing challenge.
authors.affiliation: Australian College of Optometry, Melbourne, Australia.|Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Napper
authors.affiliation: Australian College of Optometry, Melbourne, Australia.|Brien Holden Vision Institute, New South Wales, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Fricke
authors.affiliation: Indigenous Eye Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia.
authors.forename: Mitchell D
authors.initials: MD
authors.lastname: Anjou
authors.affiliation: Australian College of Optometry, Melbourne, Australia.|Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia.|Royal Group of Hospitals, Belfast, Northern Ireland.
authors.forename: A Jonathan
authors.initials: AJ
authors.lastname: Jackson
mesh_terms: D006297:Health Services Accessibility / Q000639:trends*; D006301:Health Services Needs and Demand / Q000639:trends*; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D009017:Morbidity / Q000639:trends; D009907:Optometry / Q000458:organization & administration*; D012030:Refractive Errors / Q000208:ethnology / Q000628:therapy*; D014739:Victoria / Q000453:epidemiology; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
keywords: Aboriginal eye care; access; disadvantage; equity; spectacle subsidy