A Guide for ROMAC Regional Managers

GUIDELINE

ROMAC

A GUIDE FOR ROMAC REGIONAL MANAGERS

Congratulations, and thank you, for accepting the role of ROMAC Regional Manager. Like many before you, you will find that being involved with the ROMAC Program can be one of the most rewarding and heart-warming experiences of your time as a Rotarian.

The purpose of this guide is to give you some insight into the inner workings of ROMAC and to point you in the right direction as you go about the main functions of the position. It should be read in conjunction with other documents within the ROMAC Manual of Procedure, particularly the “Guide for District Chairs”.

What is ROMAC?

Rotary Oceania Medical Aid for Children (ROMAC) assists children aged fifteen years or younger, by bringing them to Australia or New Zealand for lifesaving or dignity restoring procedures to improve their quality of life. Cases are accepted only when the required medical treatment is not available to them in their own country.

Patients come from developing countries in South East Asia and the Pacific Islands. Priority is given to those countries that form part of Australian or NZ Rotary Districts (i.e. PNG, Timor Leste, Fiji, Solomon Islands, Vanuatu, etc). Patients outside these regions may be referred to the Board for special consideration.

Role of the Regional Manager

The ROMAC Regional Manager is appointed by the Board of ROMAC, and should preferably come from within the existing Regional ROMAC structure and be acceptable to the current members of that Region’s Regional Committee.

Your primary responsibilities will focus on:

  • Administering the function and operation of the Regional Committee.
  • Reporting regularly to the Board and Operations Committee on activities within the Region.
  • Care and support of ROMAC patients and their parents/guardians.
  • Fundraising and promotion
  • Maintaining awareness of hospital facilities and surgeons available for the treatment of ROMAC patients within the Region
  • Liaison with the local Region’s District Governors, District Governors Elect and District Governors Nominees and to assist them when requested.
  • Liaison with the local Region’s ROMAC Committees and to ensure that they are familiar with ROMAC procedures and practices.
  • Awareness of ROMAC within the Regionand its Rotary Clubs

You will not be expected to do all of this on your own, and you will be assisted and supported by others within the ROMAC “family”. There are also guidelines and procedures available in the ROMAC Manual of Procedures which you can refer to.

Regional Committee

Probably one of the most important functions is to ensure that you have viable Regional and District Committees to assist you.

In addition to yourself, the Regional Committee should generally comprise:

  • District Chairs
  • Regional Medical Consultant:Co-ordinates any patient medical issues, and is heavily involved in sourcing both patients and medical facilities for the treatment of those patients.
  • Secretary / Treasurer
  • Public Relations Manager
  • Fund Raising Manager
  • Carer Manager
  • Other committee members as required

There is usually considerable experience across members of the Regional Committee, and they can be a handy resource to address issues to in the first instance.

District Chairsand Committees

Having viable District Committee is crucial to the local operation of ROMAC. The structure of these committees will vary across Districts, and depend largely on whether or not they are likely to be responsible for assisting with ROMAC patients.

Positions that should be considered for these committees are:

  • Promotions Co-ordinatorFor media, District and Club promotions and displays.
  • Fund Raising Co-ordinatorTo manage fund raising within the District
  • Carer’s Co-ordinatorTo liaise with host carers and co-ordinate patient treatment and care
  • Committee MembersTo undertake a host of activities, such as hospital visits, speaking to Rotary Clubs, manning booths, etc

The Regional Manager is a member of the ROMAC Operations Committee, and is your primary contact upwards within the ROMAC organisation structure.

ROMAC Board and Operations Committee

The ROMAC Board and the Operations Committee are the governing bodies of ROMAC, and are in turn accountable to the District Governors of the day. The Board itself is an executive group, with the Operations Committee managing the day to day activities,and consisting of the Regional Managerslike yourself and a number of other key positions.

Key positions that you will have considerable involvement with are:

  • Medical DirectorReviews and makes recommendations as to the suitability of patients to be treated under the Program
  • Operations DirectorManages the logistics of patient referral process, including record keeping, passports, visas and travel arrangements.
  • Fund Raising ManagerFor co-ordinated fund-raising ideas and suggestions
  • Marketing ManagerFor media, marketing and promotional ideas

ROMAC Referral Process

ROMAC patients come to our attention in a number of ways, including:

  • Referral by visiting medical practitioners. The Royal Australasian College of Surgeons (RACS) arranges specialist outreach clinics in many of the Pacific Islands. Whilst they often undertake minor surgeries during these clinics, more serious cases must be brought back to Australia or New Zealand for surgery, and are often referred to ROMAC to assist in this process. Note that Interplast is a Program of the Plastic and Reconstructive Surgery Division of RACS. Other teams cover cardiac, opthalmogical, orthopaedic, ENT and general surgery. Close liaison is maintained with both the College and Interplast, and referrals are often made to those teams if they are travelling to a patient’s area, often to obtain more detailed diagnostic information.
  • Overseas medical practitioners. ROMAC has a number of senior medical practitioners who act as our co-ordinators in countries such as Timor Leste, PNG, Vanuatu, Solomon Islands and Fiji. They often become aware of cases locally and make the appropriate referrals. They also undertake initial vetting of any cases from their area.
  • Travelling Rotarians. Particularly visiting RAWCS teams undertaking project work, and who may come across patients suitable for consideration.
  • Website and word of mouth.

The Medical Director assesses all patient referrals as to suitability for treatment by ROMAC before being submitted to the Board of ROMAC for approval. This assessment is undertaken in consultation with the Regional Medical Consultants and other medical experts as required.

If you, or any member of your committee, become aware of a potential ROMAC patient, or have an enquiry in that regard, you should refer it immediately to the ROMAC Operations Director on .

The Operations Director will register the case, and follow up the enquiry to obtain all the necessary information to send it to the Medical Director for advice as to whether it meets the Medical Acceptance Criteria.

Full details of the case management process are contained in the ROMAC Case Flow Chart.

Promotion and Fund Raising

ROMAC cannot exist without the support of Rotary Clubs, and needs to raise around $750,000 each year to support the treatment of the current number of patients – between 40 and 50 children each year.

Ideally the support of Rotary Clubs in your Region can be encouraged through

  • Encouraging District Chairs and Committee members to be actively promoting ROMAC within their Districts.
  • Guest speaker engagements, particularly at “group” meetings of several Rotary Clubs.
  • Presentations and information booths at District Conferences, Assemblies, PETS and Presidents’ meetings.
  • Regular communications with each club, particularly at the start of each Rotary year, when Clubs are formulating their plans and budgets, and again about March/April when they are considering disbursements of funds raised during the year. Again, your Regional Manager can assist with suitable draft letters.
  • Local follow up of broader ROMAC newsletters and publications

Donations

Any donations received are to be forwarded to the following address:

ROMAC Treasurer

C/- Rotary Down Under

PO Box 779

PARRAMATTA NSW 2124

The ROMAC Treasurer will forward the official receipt to you and in turn you should forward it to the donor Rotary Club, organisation or individual, together with a letter of appreciation.

District Directories and Website

You should ensure that District Chairs liaise with their District Secretary and/or Webmaster, to ensure that their contact details are correctly shown in both the District Directory and the District website, together with the appropriate address for forwarding on any donations proposed by Clubs (see above under Donations). Ideally the District website and any social media pages, such as Facebook, should also provide a link to the ROMAC website.

Some Districts allow for insertion of full or half page display advertisements in their Directories. If this is the case you should liaise with the ROMAC Marketing Manager for the appropriate art work to be provided.

Patient Care and Support

As Regional Manager you will have the primary responsibility for the care and support of patients being treated within your Region. You should become familiar with the various policies, guidelines and procedures associated with this core activity.

Whilst the initial enquiry and Referral process is managed by the Operations Director, you will become involved at an early stage if treatment options are identified within your Region. It helps if, in conjunction with your Regional Medical Consultant, you can maintain a close working relationship with the various Children’s Hospitals and other medical institutions within your Region.

At an early stage in the consideration of a ROMAC Patient for treatment, you will be requested to liaise with the hospital and treating surgeon to obtain and estimate of cost, which is then forwarded to the Operations Director for processing through the approval process. In parallel with this process, you should start to think about care and support arrangements, in conjunction with the relevant District Chair and other members of your Regional Committee.

Once a patient arrives, there are a number of key responsibilities that you should be aware of

  • Take possession of the patient and guardians passports and any air tickets, with copies sent to the Operations Director
  • Give your address as the patient’s address when checking them into the hospital, etc. This ensures that any accounts are sent direct to you.
  • Regular reports provided so that other members of the ROMAC Board and Operations Committee are kept up to date with the patient’s progress.
  • Each patient is required to be a project of a “sponsoring” Rotary Club. This is primarily to ensure coverage under the provisions of the Rotary Insurance Policy and does not impose any financial or other obligation on that Club.
  • No one should personally be out of pocket and all expenses will be reimbursed.

Generally, the preferences for hosting of patients and their guardian are, in order:

  • When the child is in hospital, the parent/guardian will normally stay with the child. Regular, preferably daily, visits by committee members are required. The parent/guardian needs to be provided with suitable food, and their laundry also needs to looked after.
  • Local families from their own cultural background. Visits will need to be made by committee members on a regular basis, and assistance may need to be given to ensure that medical appointments are met, etc. A daily allowance is available to cover the costs incurred.
  • Ronald McDonald House – these are associated with various Childrens’ Hospitals and often well supported by local Rotary Clubs (it is worth fostering a close relationship with House management, as placements can often be a short notice!). As these are self catering facilities, the patient and their guardian may well need to be supported on a daily basis during their stay.
  • Rotarians. Not ideal, but sometimes there is no other option. A daily allowance is available to cover the costs incurred.

In Australia, patients and their guardians are covered under the provisions of the Rotary Insurance Policy for their first 90 days. Patients staying beyond that time frame need to be advised to the insurance underwriter by the Operations Director. Refer to the ROMAC Procedure “Long Term Patients in Australia” for details.

Similarly, most patients arrive on three month Medical Treatment Visas. Patients who need to stay longer will need new visas and these will be arranged in conjunction with the Operations Director, with the process starting about three weeks prior to expiry of the original visa, with details again contained in the ROMAC Procedure “Long Term Patients in Australia”.

Most ROMAC’s patients are treated at the specialist Children’s Hospitals. This is because of the specialist paediatric expertise and ICU capability often needed for the type of patients referred. As such opportunities for treatment in regional areas are limited. However, regional areas can be used as respite opportunities and to give regional Rotary Clubs exposure to ROMAC patients.

Financial Matters

As Regional Manager, you will have prime responsibility for management of accounts and expenses generated by patients and supporters.

Most Regions operate a Regional Imprest Account managed by the Regional Treasurer. Minor expenses can be paid out of this account, which is replenished on an as required basis by the ROMAC Treasurer. More significant accounts are forwarded direct to the ROMAC Treasurer for payment.

In terms of patient accounts, the procedure “Authorisation and Payment for Medical Services” was developed by a previous Regional Manager to assist in this process, as he had found the volume and duplicity associated with most hospital billing systems. The procedure includes a set of instructions and a spreadsheet which is commended for your use.

The “A Guide to Reimbursement of Expenses” sets out the procedures for reimbursement of expenses, for which the guiding principles are:

  • for there to be fair and equitable reimbursement of costs incurred;
  • that no one is substantially out of pocket as a result of caring for a ROMAC child;
  • that no one is discouraged from assisting with the vital work of ROMAC due to financial constraints or embarrassment; and
  • there are safeguards for the integrity of ROMAC’s financial systems and records.

Reporting

Regular feedback to other members of the ROMAC Board is part and parcel of the position. This is not only from a “good governance” perspective, but also ensures that the good news associated with the treatment of ROMAC patients is spread around.

At Appendix A is a suggested form of report to each Board Meeting, and Regional Managers are encouraged to seek reports from District Chairs as input into these quarterly reports to the Board and Operations Committee.

Regional Managers are also requested to provide an annual statement on activities within their Region, to assist in preparation of the ROMAC Annual Report, which is presented at the Annual General Meeting to the District Governors of the day.

Communications

Dealing with the vast array of issues associated with a program such as ROMAC generates considerable e-mail and other traffic, and a certain level of discipline is required to handle this efficiently.

The Procedure “Guide to E-Mail Communications” was developed to assist in managing this important way of doing business.

It is important to realise that some positions, in particular the Operations and Medical Directors, are dealing with up to 100 cases at any one time, so it is important to put the correct subject headings on all emails, and to adjust any from outside prior to sending them on to others.

The following format is to be adopted for all patient related emails:

First Name Second Name ROMAC Number Topic

Examples:Joe Bloggs R-6789 Hospital quotation

Mary Flowers R-3456 Return Home

If you are writing about a proposed meeting, make that meeting and its dates clear in the heading:

Examples:ROMAC Board Meeting Perth 2/3 Dec 2010 Accommodation

ROMAC Medical Panel Meeting Sydney 1 Oct 2010 Agenda

Similarly it is important to the appropriate people are included in any email distribution, with careful use of “To”, “CC” and “BCC” fields. The following as a sample for key Regional issues:

Issue / Originator / To / CC / BCC
New patient enquiry / Any Board Member / Operations Director
Patient arrival and departure / Regional Director / Chairman
Operations Director
Medical Director / All other Board/ Operations Committee members / Supporters within Region, but as separate email to that addressed to Board members
Progress on patient treatment / Regional Director / Chairman
Medical Director
Operations Director / Other Board / Operations Committee members as required / Supporters within Region, but as separate email to that addressed to Board members

Refer to the Guide for more information.