Health service requirements for Department of Veterans' Affairs' patients
Relevant ministers, secretaries and delegates have recently signed the Hospital Services Arrangement between the Commonwealth of Australia and the Repatriation Commission and the Military Rehabilitation and Compensation Commission and the State of Victoria (the Arrangement). The Arrangement underlines the provision of public health services to Department of Veterans' Affairs patients. The Arrangement will govern the period from 1 July 2014 to 30 June 2019.
As part of the Arrangement, the Department of Health and Human Services (the department) has agreed to use its best endeavours to ensure that providers of public health services are compliant with requirements set out in the Arrangement's clauses.
Department of Veterans' Affairs' patient eligibility and admission requirements
Within two days of admission to hospital, health services should complete a Department of Veterans' Affairs Hospital Admission Voucher (or form which captures equivalent information) for each admitted Department Veterans' Affairs' patient. Health services should ensure that the admission of Department of Veterans' Affairs' patients is in accordance with Victoria's admission policy and other relevant policies and procedures.
Health services should confirm the eligibility of Department of Veterans' Affairs' patients prior to treating patients at the expense of the Department of Veterans' Affairs, keeping in mind that different cards have different entitlements. This is particularly the case for white card and orange card holders.
Department of Veterans' Affairs' patients will continue to be provided public health services on a private patient basis, which entitles them to a minimum of:
- choice of doctor (subject to doctor having rights of private practice)
- shared accommodation
- if medically necessary, private accommodation
- private accommodation, if available, where the patient or their private health insurer agrees to pay the difference between the shared and private accommodation.
Department of Veterans' Affairs' patients are eligible to access convalescent care or respite care in public health services following an acute or subacute stay without the need for financial authorisation from the Department of Veterans' Affairs.
Health services should ensure medication reviews (including self-management) are completed prior to discharge by the clinical pharmacist or doctor for patients:
- who require administration of four or more different medications or more than 12 doses of medication daily
- where a change in medication has occurred during the admission
- where anti-coagulant therapy has commenced during the admission.
Medication reviews are to be documented on an appropriate approved form, be available to the patient and care providers on discharge and involve education as a component.
For more information, the Veterans' Affairs Pharmaceutical Advisory Centre can be contacted on 1800 552 580.
If the hospitalisation of a Department of Veterans' Affairs' patient is likely to exceed a continuous period of 35 days in any care type other than nursing home type and palliative care, the Department of Veterans' Affairs requires that health services ensure the veteran's status is reviewed and that either:
- a certificate similar to that previously required under s. 3B of the Health Insurance Act 1973 is completed by a medical practitioner and held on the patients file for audit purposes
- reclassifies the patient as either maintenance care or in the case of small rural health services, the Department of Veterans' Affairs' patient is reclassified to a nursing home type patient and the changed status and payment adjusted accordingly. Where the patient is reclassified, the hospitals should use their best endeavours to ensure the patient is assessed and a discharge plan is developed.
Under the Arrangement, the Acute Care Certificate or equivalent is no longer required to be sent to Department of Veterans' Affairs.
Nursing home type patients
If a Department of Veterans' Affairs' patient is assessed as needing nursing home type or respite care and are at a multi-purpose services (i.e. at facilities that receive commonwealth funding to operate residential care beds) then the health service must attempt to reclassify the patient from a hospital patient to a residential aged care recipient. If there are no residential aged care beds available, the patient should be reclassified as a nursing home type patient and Department of Veterans' Affairs charged at the nursing home type patient rate. Department of Veterans' Affairs will not pay for residential aged care under the Arrangement.
Health services should collect any co-payment for nursing home type patient from the patient with the exception of Victoria Cross or Prisoners of War recipients. For this group, health services should make a claim directly based on prior approval to Department of Veterans' Affairs for reimbursement using Medicate Benefits Schedule item number NH05.
Health services will use their best endeavours to demonstrate effective discharge planning for Department of Veterans' Affairs' patients including the regular contribution of a multidisciplinary team, supporting documentation, discharge follow up and communication with care providers and family and carers (with permission from the patient).
Written documentation in the form of a Discharge Plan should be provided to the patient or carer on the day of discharge. Should e-Discharge summaries be available these are to be used. The Department of Veterans' Affairs may request to see documentation of hospital discharge policies and procedures, as well as copies of the patient and hospital discharge plans. If the patient is enrolled in a Coordinated Veterans' Care program then the local medical officer or nurse coordinator must also receive a copy of the patient discharge plan (and is involved as appropriate).
Health services should coordinate for a health professional to assess Department of Veterans' Affairs' patients prior to discharge for community nursing, personal care, aids and appliances, home modifications or convalescent care. Any aids, equipment or modifications will be arranged through the Department of Veterans' Affairs' services in a timely manner and be available to the patient prior to discharge. Public hospitals must provide a summary of discharge to the original referring doctor and local medical officer at, or within, 48 hours of discharge. Referrals for community nursing services for Department of Veterans' Affairs' patients may be made to a Victorian or Commonwealth government funded program or to a Department of Veterans' Affairs' contracted provider.
To arrange home and personal care services for Department of Veterans' Affairs' patients, health services must contact the National Veterans' Home Care assessment agency (1300 550 450). Discharge aids and equipment for veteran patients must be provided to facilitate safe discharge for a period of thirty days post discharge. For further information contact the Rehabilitation Appliances Program (RAP) schedule at www.dva.gov.au or ring 1300 550 457 (metro) or 1800 550 457 (rural).
Funding arrangements for Department of Veterans' Affairs patients receiving care in Victorian public hospitals are detailed in the Department of Health and Human Services' Policy and Funding Guidelines and updated annually.
If health services have any queries about this information, or any other information about the provision of public health services, they should contact their performance lead.
Acting Executive Director
Health Service Policy and Commissioning
Health and Wellbeing Division