Australian Government
Veterans’ Entitlements Act 1986
Military Rehabilitation and Compensation Act 2004
Veterans’ Affairs (Treatment Principles – Rehabilitation in the Home and Other Amendments) Determination 2020
Instrument 2020 No.R3/MRCC3
Military Rehabilitation and Compensation Act 2004
Instrument 2020 No.R3/MRCC3
The Repatriation Commission, under subsection 90(5) of the Veterans’ Entitlements Act 1986, makes the variations to the Treatment Principles in the following determination.
Dated this 22nd day of July 2020
The Seal of the ) Repatriation Commission ) was affixed hereto in the ) presence of: )
…Elizabeth Cosson… …Kate Pope… …Donald Spinks…
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We, as delegates of the Military Rehabilitation and Compensation Commission, under subsection 286(5) of the Military Rehabilitation and Compensation Act 2004, make the variations to the MRCA Treatment Principles in the following determination.
Dated this 22nd day of July 2020
The Seal of the ) Military Rehabilitation and ) Compensation Commission ) was affixed hereto in the ) presence of: )
…Elizabeth Cosson… …Kate Pope… …Donald Spinks…
MEMBE |
1 Name
This instrument is the Veterans’ Affairs (Treatment Principles – Rehabilitation in the Home and Other Amendments) Determination 2020.
2 Commencement
This determination commences on the day that it is registered.
This determination is made under:
(a) subsection 90(5) of the Veterans’ Entitlements Act 1986 in respect of the variations to the Treatment Principles in Schedule 1; and
(b) subsection 286(5) of the Military Rehabilitation and Compensation Act 2004 in respect of the variations to the MRCA Treatment Principles in Schedule 2.
4 Schedules
Each instrument that is specified in a Schedule to this instrument is varied as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this determination has effect according to its terms.
Schedule 1-Variations to the Treatment Principles (Instrument 2013 No. R52) (F2019C00908)
[1] Paragraph 1.4.1
Definition of “Co-ordinated Veterans’ Care Program”
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[2] Paragraph 1.4.1
Omit definition of “Department of Human Services”.
[3] Paragraph 1.4.1
Insert:
“Human Services Department” means a Department, or Executive Agency, administered by the Minister administering the Human Services (Centrelink) Act 1997.
[4] Paragraph 1.4.1
Definition of “neuropsychologist” and “occupational therapist (mental health)”
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[5] Paragraph 1.4.1
Insert:
“Rehabilitation in the Home” means the coordinated, home-based, rehabilitation program provided by a Rehabilitation in the Home Provider to an entitled person, in respect of which the Commission will accept financial responsibility under Principle 7.7B of the Treatment Principles.
“Rehabilitation in the Home Provider” means the ambulatory service providing a coordinated, home-based, rehabilitation program who has entered into an agreement with the Commission to provide Rehabilitation in the Home to an entitled person.
“Rehabilitation in the Home care co-ordinator” means the person who will co-ordinate the rehabilitation services provided to an entitled person under a Rehabilitation in the Home program.
[6] Paragraph 1.4.1
Definitions of “social worker (mental health)” and “speech pathologist”.
Omit the reference in ‘social worker (mental health)” to “Department of Human Services” and the reference in “speech pathologist” to “Department of Human Services” and substitute (in both) a reference to “Human Services Department”.
[7] Paragraph 3.4.4(b)
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[8] Paragraph 3.4.5(b)
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[9] Note 2 to paragraph 3.5.2
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[10] Paragraph 3.5.3(a)
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[11] Paragraph 4.3.2(a)
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[12] Paragraph 4.7.3
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[13] Paragraph 4.8.1(g)
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[14] Note to Paragraph 6A.4.2
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[15] Paragraph 6A.9.2
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[16] Paragraph 7.4.4
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[17] Paragraph 7.4.5
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[18] After Principle 7.7A, insert
7.7B Rehabilitation in the Home
7.7B.1 Outline
Rehabilitation in the Home is a coordinated, home-based, rehabilitation program for entitled persons who would otherwise receive functional rehabilitation services in hospital. Examples of where it would be appropriate include rehabilitation after joint replacement surgery or for “re-conditioning” purposes following exacerbation of a chronic illness.
Those entitled persons who are not suitable to receive rehabilitation services in the home, in particular if they are not medically stable or do not have a suitable home environment, will continue to receive rehabilitation services in hospital.
Rehabilitation in the Home will offer the choice of a complete at home option for rehabilitation for select patients who meet the requirements for admission to the Rehabilitation in the Home program or for patients who have received part of their rehabilitation services under the Commission’s hospital arrangements and who wish to complete their rehabilitation at home.
The Rehabilitation in the Home program will be based on the standards for quality, safety and performance that meet the Commonwealth and State requirements for Hospital in the Home services including mandatory admission protocols and significant data reporting.
Rehabilitation in the Home will use a client-centred, coordinated and case managed approach to rehabilitation care based on clinical need. Individual treatment plans will be goal based and subject to regular assessment, similar to rehabilitation programs in hospitals.
The Rehabilitation in the Home program can only deliver rehabilitation services. It will not replace or displace other community based supports provided under the Treatment Principles, including community nursing services, Veterans’ Home Care Program or the Coordinated Veterans’ Care Program.
To remove any uncertainty, a Rehabilitation in the Home provider will explicitly be prohibited from delivering any nursing or mental health services. However, where it is appropriate the Rehabilitation in the Home care co-ordinator is expected to communicate potential issues outside the scope of the Rehabilitation in the Home program to a relevant care provider including a community nurse.
7.7B.2 For the purposes of principle 7.7B:
home in relation to the Rehabilitation in the Home program includes the premises or part of the premises in which a person temporarily resides and may also include the premises where the person is receiving residential care.
7.7B.3 The Commission will accept financial responsibility for the provision of a Rehabilitation in the Home program for an entitled person only if:
(a) the person has been referred to a Rehabilitation in the Home provider by a general practitioner, a treating doctor in a hospital, a hospital discharge planner or a medical specialist; and
Note: paragraph 7.7B.5 sets out the Rehabilitation in the Home provider to whom an entitled person can be referred under paragraph 7.7B.3(a).
(b) a Rehabilitation in the Home provider, pursuant to an arrangement with the Commission, has undertaken an assessment of the entitled person for the provision of Rehabilitation in the Home and assessed that the person has a clinical need for the provision of the program and is suitable for the Rehabilitation in the Home program; and
(c) in deciding whether to accept financial responsibility for the provision of a Rehabilitation in the Home program the Commission must take into account whether the medical and allied health services provided as part of the Rehabilitation in the Home program duplicate the medical and allied health services the entitled person is receiving under other provisions of the Treatment Principles (double-dipping).
7.7B.4 All of the care documentation for an entitled person prepared by a Rehabilitation in the Home provider shall be provided to the Department upon request by the Department to the Rehabilitation in the Home provider.
7.7B.5 A referral to a Rehabilitation in the Home provider is to be made only to a Rehabilitation in the Home provider in the geographical area in which the entitled person will reside while receiving treatment.
7.7B.6 If no Rehabilitation in the Home provider referred to in paragraph 7.7B.5 can provide the relevant Rehabilitation in the Home program within a reasonable time, the Rehabilitation in the Home provider may refer the entitled person to another Rehabilitation in the Home provider.
7.7B.7 The Commission will not accept, as part of a Rehabilitation in the Home program, financial responsibility for other health or domestic help services, or goods, provided under the Treatment Principles, including but not limited to community nursing services, Veterans’ Home Care Program, the Coordinated Veterans’ Care Program or the Rehabilitation Appliances Program.
[19] Paragraph 10.10.1
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[20] Paragraph 10.12.1
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
Schedule 2-Variations to the MRCA Treatment Principles (Instrument 2013 No. MRCC53) [F2019COO927]
[21] Paragraph 1.4.1
Definitions of “clinical psychologist” and “Co-ordinated Veterans’ Care Program”
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[22] Paragraph 1.4.1
Omit definition of “Department of Human Services”.
[23] Paragraph 1.4.1
Insert:
“Human Services Department” means a Department, or Executive Agency, administered by the Minister administering the Human Services (Centrelink) Act 1997.
[24] Paragraph 1.4.1
Definitions of “neuropsychologist” and “occupational therapist (mental health)”
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[25] Paragraph 1.4.1, insert:
“Rehabilitation in the Home” means the coordinated, home-based, rehabilitation program provided by a Rehabilitation in the Home Provider to an entitled person, in respect of which the Commission will accept financial responsibility under Principle 7.7B of the Principles.
“Rehabilitation in the Home Provider” means the ambulatory service providing a coordinated, home-based, rehabilitation program who has entered into an agreement with the Commission to provide Rehabilitation in the Home to an entitled person.
“Rehabilitation in the Home care co-ordinator” means the person who will co-ordinate the health care services provided to an entitled person under a Rehabilitation in the Home program.
[26] Paragraph 1.4.1
Definitions of “social worker (mental health)” and “speech pathologist”.
Omit the reference in ‘social worker (mental health)” to “Department of Human Services” and the reference in “speech pathologist” to “Department of Human Services” and substitute (in both) a reference to “Human Services Department”.
[27] Paragraph 3.4.4(b)
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[28] Paragraph 3.4.5(b)
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[29] Note 2 to paragraph 3.5.2
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[30] Paragraph 3.5.3(a)
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[31] Paragraph 4.3.2(c)
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[32] Paragraph 4.7.3
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[33] Paragraph 4.8.1(g)
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[34] Note to Paragraph 6A.4.2
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[35] Paragraph 6A.9.2
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[36] Paragraph 7.4.4
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[37] Paragraph 7.4.5
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[38] After Principle 7.7A, insert
7.7B Rehabilitation in the Home
7.7B.1 Outline
Rehabilitation in the Home is a coordinated, home-based, rehabilitation program for entitled persons who would otherwise receive functional rehabilitation services in hospital. Examples of where it would be appropriate include rehabilitation after joint replacement surgery or for “re-conditioning” purposes following exacerbation of a chronic illness.
While delivery of home-based rehabilitation (as a hospital-substitution program) has been available under the hospital arrangements, the service has been under used.
Those entitled persons who are not suitable to receive rehabilitation services in the home, in particular if they are not medically stable or do not have a suitable home environment, will continue to receive rehabilitation services in hospital.
Rehabilitation in the Home will offer the choice of a complete at home option for rehabilitation for select patients who meet the requirements for admission to the Rehabilitation in the Home program or for patients who have received part of their rehabilitation services under the Commission’s hospital arrangements and who wish to complete their rehabilitation at home.
The Rehabilitation in the Home program will be based on the standards for quality, safety and performance that meet the Commonwealth and State requirements for Hospital in the Home services including mandatory admission protocols and significant data reporting.
Rehabilitation in the Home will use a client-centred, coordinated and case managed approach to rehabilitation care based on clinical need. Individual treatment plans will be goal based and subject to regular assessment, similar to rehabilitation programs in hospitals.
The Rehabilitation in the Home program can only deliver rehabilitation services. It will not replace or displace other community based supports provided under the Principles, including community nursing services, MRCA Home Care Program or the Coordinated Veterans’ Care Program.
To remove any uncertainty, a Rehabilitation in the Home provider will explicitly be prohibited from delivering any nursing or mental health services. However, where it is appropriate the Rehabilitation in the Home care co-ordinator is expected to communicate potential issues outside the scope of the Rehabilitation in the Home program to a relevant care provider including a community nurse.
7.7B.2 For the purposes of principle 7.7B:
home in relation to the Rehabilitation in the Home program includes the premises or part of the premises in which a person temporarily resides and may also include the premises where the person is receiving residential care.
7.7B.3 The Commission will accept financial responsibility for the provision of a Rehabilitation in the Home program for an entitled person only if:
(a) the person has been referred to a Rehabilitation in the Home provider by a general practitioner, a treating doctor in a hospital, a hospital discharge planner or a medical specialist;
Note: paragraph 7.7B.5 sets out the Rehabilitation in the Home provider to whom an entitled person can be referred under paragraph 7.7B.3(a).
(b) a Rehabilitation in the Home provider, pursuant to an arrangement with the Commission, has undertaken an assessment of the entitled person for the provision of Rehabilitation in the Home and assessed that the person has a clinical need for the provision of the program and is suitable for the Rehabilitation in the Home program; and
(c) in deciding whether to accept financial responsibility for the provision of a Rehabilitation in the Home program the Commission must take into account whether the medical and allied health services provided as part of the Rehabilitation in the Home program duplicate the medical and allied health services the entitled person is receiving under other provisions of the Principles (double-dipping).
7.7B.4 All of the care documentation for an entitled person prepared by a Rehabilitation in the Home provider shall be provided to the Department upon request by the Department to the Rehabilitation in the Home provider.
7.7B.5 A referral to a Rehabilitation in the Home provider is to be made only to a Rehabilitation in the Home provider that has entered into, and is bound by, an agreement with the Commission or the Department to provide a Rehabilitation in the Home program during the relevant period of treatment and in the geographical area in which the entitled person will reside while receiving treatment.
7.7B.6 If no Rehabilitation in the Home provider referred to in paragraph 7.7B.5 can provide the relevant Rehabilitation in the Home program within a reasonable time, the Rehabilitation in the Home provider may refer the entitled person to another Rehabilitation in the Home provider.
7.7B.7 The Commission will not accept, as part of a Rehabilitation in the Home program, financial responsibility for other health or domestic help services, or goods, provided under the Treatment Principles, including but not limited to community nursing services, MRCA Home Care Program, the Coordinated Veterans’ Care Program or the Rehabilitation Appliances Program.
[39] Paragraph 10.7.1
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[40] Paragraph 10.9.1
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.
[41] Paragraph 10.11.1
Omit the reference to “Department of Human Services” and substitute a reference to “Human Services Department”.