Why the Terminology Matters for Aged Care Providers
Aged care providers working with Aboriginal and Torres Strait Islander communities frequently encounter two acronyms: ACCHO and ACCO. These terms are often used interchangeably in informal conversation, but they represent different organisational types with distinct governance structures, funding arrangements, and community relationships. Using them correctly signals to communities, auditors, and regulators that your organisation understands the sector.
The Aged Care Quality and Safety Commission expects providers to demonstrate culturally safe practice, which begins with understanding the structures through which Aboriginal and Torres Strait Islander peoples govern their own health and community services.
What Is an ACCHO?
An Aboriginal Community Controlled Health Organisation (ACCHO) is a primary health care service that is initiated by, and operated under the direction of, a local Aboriginal community. Governance sits with an elected Aboriginal board drawn from the community the organisation serves. This structure is not symbolic: board members make decisions about services, staffing, priorities, and the relationships the organisation enters into with governments and funders.
ACCHOs exist under a national framework coordinated by the National Aboriginal Community Controlled Health Organisation (NACCHO) and its state and territory affiliates. Membership of NACCHO is significant because it signals adherence to community-controlled principles and subjects the organisation to peer accountability within the sector.
The ACCHO model was developed in response to the documented failure of mainstream health services to meet the needs of Aboriginal people. By placing governance in community hands, ACCHOs embed cultural authority into every aspect of service delivery, from appointment booking to clinical consultation to referral pathways. In aged care, this means that older Aboriginal people accessing an ACCHO receive services shaped by the values, languages, and kinship structures of their own community.
What Is an ACCO?
An Aboriginal Community Controlled Organisation (ACCO) is a broader term. It encompasses any organisation that is governed and controlled by Aboriginal people for the benefit of their community, but one that may not be providing primary health care. ACCOs operate across sectors including housing, child protection, legal services, disability support, employment, and, importantly, aged care.
The ACCO model applies the same core governance principle as the ACCHO model: Aboriginal people control decision-making. However, an ACCO does not need to be a health organisation, and it may not hold NACCHO membership or affiliation. Many aged care providers delivering services specifically to Aboriginal communities operate as ACCOs rather than ACCHOs, because their primary function is social support or residential care rather than primary health.
Key Differences: ACCHO vs ACCO in Aged Care Context
The clearest way to separate these terms is by function and affiliation. ACCHOs are health-focused, affiliated with NACCHO or its state bodies, and deliver clinical primary health services alongside community health programs. ACCOs are community-controlled organisations in any sector, including aged care, that may or may not provide health services but share the same governance philosophy.
In practice, an aged care provider might partner with an ACCHO for health coordination, clinical referral pathways, and health assessments, while also engaging with an ACCO for cultural support, social connection, and community liaison. Both types of organisation carry authority within their communities, and both expect that mainstream providers approaching them will respect the governance structures that give them legitimacy.
For aged care organisations building formal partnerships, it is worth clarifying which type of organisation you are working with, what decisions they can make on behalf of community, and how your organisation's internal policies align with community-controlled principles. The Aboriginal and Torres Strait Islander Peoples Care Policy Template from Governa provides a structured starting point for formalising these commitments within your policy framework.
The ACCHO Philosophy in Aged Care
Whether you are working with an ACCHO or an ACCO, the underlying philosophy is the same: communities determine what good care looks like for their members. For aged care providers, this means:
- Consulting with community before designing service models
- Employing Aboriginal and Torres Strait Islander staff where possible
- Embedding cultural practices, languages, and protocols into daily care
- Allowing Elders and community members to shape activity programs, meal planning, and spiritual practice
- Treating community governance as a legitimate decision-making authority, not a consultation exercise
This philosophy directly supports the objectives of the Aged Care Act and the strengthened Quality Standards, which require providers to demonstrate genuine responsiveness to consumer identity and cultural background. A provider who treats the ACCHO or ACCO as simply a referral source misses the deeper expectation: that community governance is integrated into how care is designed, not just who gets referred.
How Mainstream Providers Should Engage with ACCHOs and ACCOs
Most mainstream aged care providers are not themselves community-controlled organisations. They may operate in areas where Aboriginal and Torres Strait Islander peoples represent a significant proportion of their consumer base, and they need practical guidance on how to engage appropriately.
The first step is to identify which ACCHOs and ACCOs operate in your service area and to understand their mandates. Do not assume that one organisation speaks for all Aboriginal communities in a region. Australia's First Peoples are diverse, and governance structures reflect that diversity.
The second step is to review your internal policy settings. Does your organisation have a documented commitment to culturally safe care? Is that commitment visible in your care planning approach, your staff training, and your complaints handling? Articles like Culturally Appropriate Home Care offer practical guidance on translating these commitments into day-to-day service delivery.
The third step is to ensure that consumer rights are upheld in a culturally informed way. Aboriginal and Torres Strait Islander consumers have the same rights as all aged care consumers, but the way those rights are exercised may differ based on language, family structures, and cultural protocols. Your Consumer Rights, Dignity and Choice Policy should explicitly acknowledge this.
Cultural Diversity Policy and the Distinction Between Groups
While this article focuses on ACCHOs and ACCOs specifically, the principles of community governance and cultural responsiveness apply more broadly. A robust Cultural Diversity and Inclusion Policy Template creates a foundation for serving all consumers with cultural awareness, including those from migrant communities, refugee backgrounds, and other distinct cultural groups.
However, it is important not to collapse Aboriginal and Torres Strait Islander communities into a general diversity framework. First Nations peoples have unique rights under Australian law, unique histories with the health system, and unique governance structures. Your organisational policy should treat these groups distinctly, with dedicated commitments for First Nations consumers alongside broader cultural diversity commitments.
Documentation and Compliance Considerations
When your organisation is delivering services to Aboriginal or Torres Strait Islander consumers, or is working in partnership with an ACCHO or ACCO, documentation obligations are the same as for any other consumer group. Care plans must reflect individual needs and preferences. Consent must be properly recorded. Complaints processes must be accessible and culturally appropriate.
Regulators examining your records will look for evidence that cultural needs were identified, discussed with the consumer and their family or community, and incorporated into care delivery. The Governa AI Policy Guides provide structured guidance on building policy documentation that demonstrates this responsiveness clearly and consistently.
