TRAINING FOR NEW VHC SERVICE PROVIDERS 2011

1. TRAINING FOR NEW VHC SERVICE PROVIDERS 2011

2. Overview Today’s training session will provide information about: • Introduction to the VHC program • VHC Guidelines and the Deed of Standing Offer • eligibility and access • assessment process • rights & responsibilities (veterans and VHC service providers) • VHC services types • subcontracting • claiming and copayments • common questions/issues experienced by VHC service providers The use of the term veteran throughout the presentation should be taken to mean veteran or war widow/widower.

3. Introduction • The VHC program is a low level home based care program • The VHC program has been running for 10 years and was first introduced in January 2001 • Your organisation has entered into a contractual relationship with DVA (via a mutually signed “Deed of Standing Offer”) to provide services under the VHC program to entitled veterans • The start date for the Deed of Standing Offer is 1 October 2011. New VHC service providers will start receiving service plans to deliver VHC services from this date

4. Structure of the VHC program The VHC program comprises two separate components: • assessment and coordination; and • delivery of VHC services. From 1 October 2011, DVA will have contracts with: • 15 VHC assessment agency organisations (who will undertake the assessment and coordination); and • approximately 170 VHC service provider organisations who will deliver: • domestic assistance; • personal care; • home and garden maintenance; • respite care; and • CVC social assistance CVC social assistance is provided for a small number of veteran clients who will be participating in the Coordinated Veterans’ Care (CVC) Program

5. The Deed of Standing Offer • The Deed of Standing Offer is the ‘contract’ between the Department of Veterans’ Affairs and the VHC service provider. The Deed outlines the various requirements of the signatories. • The Deed prescribes what needs to be delivered and the VHC Guidelines provide information on how to do this from a day to day perspective.

6. The VHC Guidelines • The Veterans’ Home Care (VHC) Guidelines – Service Provider, October 2011 (Guidelines) are Attachment 1 to the Deed of Standing Offer (the Deed). The Guidelines are also available at on the DVA website: http://www.dva.gov.au/service_providers/veterans_homecare/index/Pages/VHC_Guidelines.aspx • The VHC Guidelines outline the VHC service provider’s responsibilities under the Deed. Compliance with the Guidelines is a mandatory component of the Deed of Standing Offer.

7. Eligibility & access To be eligible for assessment for VHC services a person must be: • a veteran of the Australian defence forces; or • an Australian mariner; or • a war widow/widower of an Australian veteran or an Australian mariner and have • a Gold Card (DVA Treatment Card – covers all medical conditions); or • a White Card (DVA Treatment Card – covers specific service related conditions) To determine eligibility veterans should be referred to the VHC assessment agency.

8. Which veterans have limited or no eligibility? Those people with limited or no eligibility for VHC services include: • Veterans of Commonwealth and Allied Forces • Australian participants in the British nuclear tests program • Partners and carers, unless they have a DVA Gold or White card in their own right • Veterans in Commonwealth accredited Residential Aged Care Facilities (RACF)s • Veterans receiving Commonwealth funded packaged care or in transition care • Veterans from other non Commonwealth countries

9. How do VHC assessment agencies and VHC service providers differ? • VHC assessment agencies • determine eligibility & assess needs of the veteran • develop an appropriate package of care • assign services to a VHC service provider • monitor and review ongoing needs of veteran • VHC service providers • deliver the services in accordance with the determination made by the VHC assessment agency & as per the service plan

10. The assessment process • The VHC assessment instrument is a standardised online assessment instrument. • Assessments can be undertaken in three different ways: • standard telephone assessment; or • standard in-home assessment; or • complex in-home assessment. • The majority of assessments done over phone. • The VHC assessment agencies are part of a national network that is serviced by a national phone system. The 1300 550 450 is designed to connect callers from a landline to the agency in their phone region. Veterans are always advised to call using a landline and to make the call from their own suburb**.

11. 1.VHC assessor completes an assessment 4. AA sends care plan to veteran 2.VHC coordinator completes approval 3. AA allocates service to a VHC service provider 6. VHC service provider contacts veteran within 2 working days 7. VHC service provider negotiates service delivery days/times 8. Services are delivered & claimed by VHC service provider 9. AA conducts regular reviews with veteran The assessment process 5. VHC service provider able to download service plan

12. Other DVA programs Rehabilitation Appliance program (RAP) – through the LMO/GP Home Front Community Nursing Referral to a VHC assessment agency • Self referral • Third party referral Referral from a VHC assessment agency • ACAS/ACAT for assessment for • CACP • EACH, EACH(D) • Commonwealth Care Respite Centre • Other community care

13. Summary • Structure of program • Eligibility • Assessment process • Referral

14. Role & responsibilities – service provider • Provide services 7 days a week (including public holidays) in accordance with the service plan • Contact veteran promptly within 2 working days following receipt of service plan (within 24 hours if for personal care or respite) • Deliver quality services in a timely manner • Undertake services as outlined in the service plan • Manage all aspects of sub-contracting arrangements • Correctly submit all claims for payment • Ensure staff are appropriately trained/qualified

15. What are VHC service providers not responsible for? • VHC service providers are not required to: - determine veteran eligibility for assessment - assess eligible veteran’s needs (but feedback to VHC assessment agencies is appropriate) - determine level of co-payment - determine any changes to the service plan

16. Developing service arrangements

17. What is a service plan • VHC assessment agencies assess a veteran’s need, approve services and allocate services to an appropriate VHC service provider using a service plan • Service plans detail all the information required by the VHC service provider to deliver the approved services • The service plan is created by the VHC assessment agency on the VHC IT system • The service plan can be downloaded by the VHC service provider from the VHC IT system after an approval or an amendment to an approval is completed

18. Downloading service plans You can download, view and print service plans using the VHC IT system (VHC service provider application) • every service plan has an individual service plan ID • every service plan has one (or more) plan items indicating the services approved and the frequency • A notification email is sent when an urgent plan is generated or an existing service plan is modified

19. Service delivery - the initial contact & visit • confirm tasks and working arrangements • confirm and make co-payment arrangements (if applicable) • discuss suitable day/timeframe for provision of service • provide the veteran with VHC service provider contact details • complete a safety appraisal of the working environment

20. VHC Services • domestic assistance • personal care • home and garden maintenance • respite • CVC social assistance.

21. Domestic Assistance • Essential household tasks (eg, wash floors, vacuuming, clean bathroom/toilet etc) • Other household tasks on a priority basis • Shopping/bill paying on behalf of veteran (ie unaccompanied) • Assistance with ad hoc meal preparation • Equipment arrangements

22. Personal Care May include assistance with daily self-care tasks such as: • dressing/ grooming • bathing/ showering • Where veterans have emerging higher level personal care needs (more than 1.5 hours per week) or a clinical need develops, then this is beyond the scope of the VHC program and a referral should be made by the VHC assessment agency to the DVA Community Nursing program • Equipment and consumables used in personal care – veterans do not supply these with the exception of over the counter products

23. Safety-related Home & Garden Maintenance (HGM) • Focus is not routine but rather to minimise environmental health and safety hazards • Minor handyman tasks to help keep the home safe and habitable • Periodic tasks (ie, gutter cleaning) could be considered • Tradesperson, specialised, or routine/cosmetic gardening tasks excluded • Maximum amount of HGM is limited to 15 hours in any 12 month period • Equipment arrangements

24. Respite Care Temporary relief for carer • Respite may include: • Residential; • In-home; or • Emergency Short-Term Home Relief (ESTHR) respite • DVA will pay for up to 28 days (196 hours) of in-home or residential respite or a combination of both - per financial year • ESTHR in addition to residential/in-home hours. Three days per episode with a maximum of three episodes per year

25. CVC Social Assistance Is provided as part of the Coordinated Veterans’ Care (CVC) Program – will only be provided to those persons whose LMO/GP has admitted them to the CVC program: • CVC social assistance is of a short term nature - up to 12 weeks. • The aim is to promote social health and independence. • Activities to be undertaken will be either: • community based socialisation • home based socialisation • accompanied outings • a combination of the above activities

26. Linkages with other community care programs • Veterans have the same right of access to HACC and packaged care as any other member of the community. • Examples of possible programs/services include, but are not limited to: • DVA contracted community nursing organisations • Aged Care Assessment Teams (ACATs) • DVA Rehabilitation Appliance Team • Community Aged Care Packages or HACC services • Delivered Meals

27. Summary • Rights and responsibilities • Service types • Linkages with other services

28. Modification of services – when or why are services modified? • Services are insufficient/inappropriate • The veteran has just been discharged from hospital and their needs have changed • If the veteran is continually absent for scheduled visits • If the veteran requires medical attention or is deceased

29. Continuation of services • Where there is a current service plan in place for a household based service (i.e. DA or HGM) and the veteran is deceased or absent from home for health reasons: • the assessment agency may continue the existing approval for a spouse or dependentchild • health reasons – for 12 weeks, the assessment agency has no discretion to approve beyond 12 weeks • death of a veteran – for 12 weeks, assessment agency can extend over 12 weeks if spouse has lodged a war widow/widower pension application and the determination has not been made • death of a war widow, where there is a dependent/disabled child (of the veteran) or where the former child was a full time carer of the war widow/widower – for 12 weeks, the assessment agency has no discretion to approve beyond 12 weeks • VHC service provider will receive direction from the VHC assessment agency in these cases.

30. Liaison with assessment agency – when to contact them... Upon receipt of service plan, advise the assessment agency immediately if there will be any possible delays in providing services: • advise of any problems with service delivery • seek clarification regarding service plan details if necessary • notify of changes in veteran’s circumstances • advise if services are no longer being provided • mutual obligation by assessment agencies and service providers to maintain open and effective communication • unable to provide services due to emergency i.e. fire, heat wave, flood.

31. Rights and Responsibilities - Veteran Rights 1. General 2. Participation 3. Care and Services 4. Personal information 5. Communication 6. Comments & complaints 7. Fees Responsibilities 1. General 2. Care & Services 3. Communication 4. Access 5. Fees

32. Personnel & Training Qualifications Personal care, social assistance and respite services – Cert. 3 is required. • Domestic Assistance - Cert. 3 is recommended. • Home and garden maintenance – Cert. 3 not required. Current competencies • Personal care, domestic assistance, CVC social assistance, respite care: • manual handling • infection control • first aid • CPR. • Home and garden maintenance • manual handling

33. The Care Environment • Personal trust • Risk/insurance • OH&S • Communicating about Behaviours of Concern • Publicity • Privacy/confidentiality

34. Subcontracting Arrangements When is it appropriate to subcontract? • long term arrangements can be made to deliver a wider number of service types; • short term arrangements can be made to overcome staff shortages or unforseen situations. • The contracted VHC service provider remains responsible for all aspects of compliance in accordance with the VHC Deed of Standing Offer • DVA must be advised (in advance) of all subcontracting arrangements

35. Subcontracting Arrangements The contracted VHC service provider must ensure that the subcontractor: • delivers services in accordance with the VHC Guidelines; • is aware of co-payment arrangements; • has an adequate level of insurance cover; and • follows appropriate communication channels

36. VHC IT System • IT manual available for VHC service providers • IT training will be provided to all new VHC service providers and this will include all aspects the IT system, including: • downloading service plans; and • submitting claims online • DVA service provider application or IT support – send an email to vhc&cnsdops@dva.gov.au

37. Copayments • Collection • Waiver • Impacts that may affect the copayment process • refusal to pay – refer to VHC assessment agency if unable to resolve with veteran – veterans acknowledge agreement of their responsibility to pay the copayment as part of the assessment process; • death of veteran; • not at home for scheduled visit; • absent from their home (on medical grounds) but services continuing; and • unable to be provide at specified time.

38. Copayment Caps VHC copayments are nationally consistent

39. Verifying service provision • Important that transparent processes are in place to ensure the validity of claims – in particular there is a need to verify: • That veteran has received the service (i.e. signature, tag system) • How long the service took to deliver (time in/time out)

40. Accessing the system IT Security Arrangements • Staff responsible for accessing the VHC service provider claiming portal will be provided with an individual logon ID and password (staff need to login with their own LOGON ID to the SP system every 28 days for their access to remain active.) • It is a security violation for VHC service provider staff to share logon IDs (this is monitored) • There is a LOGON ID reactivation process in place for staff who go on leave and are not able to login within the 28 days

41. Submitting Claims Lodgement of claims: • must be submitted within 60 days of the frequency start date for each individual service frequency on the plan • if claims are not made within 60 days of the start date for the frequency, these will be re-credited back into the system and the VHC service provider will be unable to claim – If this occurs, VHC service provider staff will need to request DVA ‘undo’ re-credit by contacting the VHC & CN Operations team • It is good practice to ‘save & submit’ at the same time • It is good practice to attend to claims regularly rather than leaving it to the last few days before the payments run is scheduled.

42. Summary • Service delivery • Modification of services • Validating delivery of services • Subcontracting • Claiming

43. Complaints management • The VHC service provider’s feedback management plan should: • be accessible and widely published; • inform a process of continuous improvement; • maintain and permit confidentiality; • be fair and equitable (including the principle of natural justice); • produce effective outcomes for complaints and feedback received by VHC service provider organisations; • encourage regular review of the process; and • be open, transparent and accountable.

44. Performance monitoring& contract management • VHC Deed of Standing Offer outlines the contract management and performance monitoring processes expected. • DVA and VHC service providers communicate on a regular basis to discuss aspects of the Deed of Standing Offer. • Formal Contract Management meetings are held regularly

45. Communication – how we will keep you informed • via regular contract management meetings and visits by local VHC Operations staff from DVA; • through regular VHC Bulletins which are issued throughout the year and when there is important information for service providers to know; • via informal phone and email correspondence.

46. Common Issues/discussion points • difficulties in establishing definitive time for service delivery; • flexibility with tasks (domestic assistance); • total approved time not delivered; • care worker routinely missing service – veteran given short, or no, notification; • co-payment collection – process of invoicing/receipting; and • public holidays – rescheduling of services.

47. Summary • Complaints management • Performance/quality management • communication

48. DVA contact details & information Contacting DVA For enquiries regarding VHC service provider contract issues and operational support, contact the DVA VHC Operations team on: • 1300 550 466 (select option 1 for service providers); or • via email VHC&CNSDOPS@dva.gov.au DVA Website For information on VHC generally, go to the DVA web site and access the VHC Homepage – at www.dva.gov.au and go to Service Providers and choose veterans’ home care. For factsheets www.dva.gov.au/factsheets/defaults.htm (under topic choose Veterans’ Home Care) VHC Guidelines - http://www.dva.gov.au/service_providers/veterans_homecare/Pages/index.aspx

49. Contacting the VHC assessment agency • For assessments / referral only call 1300 550 450. Ask the veterans to call from a landline from their own suburb. • For all other matters use the VHC assessment agency’s direct number. Attachment A of the VHC Guidelines – Service Provider.

50. Are there any questions?Questions about information provided?Questions still unanswered?