Individualised funding

At the TAC we are reviewing how we can best support our clients to use Individualised Funding (IF). For now, we will not take on new IF clients. We will update this page on our website when IF is available to new clients.

If you are already using IF, nothing has changed. You can continue to use your allocated funds to manage the services you need because of your transport accident.

A Guide to Individualised Funding

Summary:

This booklet explains how Individualised Funding works and provides detailed information about setting up your bank account, budgeting your finances and paying for your services.


Terms sheet for provision of Financial Intermediary (FI) Services

Summary:

This is a sample of the terms sheet which is to be signed by the provider of FI Services (the Provider) and the employee who will be providing the services to the TAC client on Individualised Funding (the Client) on the Provider’s behalf (the Employee).

Before the Provider and the Employee are able to provide FI Services to the Client they must both read and sign a terms sheet and return it to the TAC.


Individualised Funding

Please note: At the TAC we are reviewing how we can best support our clients to use Individualised Funding (IF). For now, we will not take on new IF clients. We will update this page on our website when IF is available to new clients.

If you are already using IF, nothing has changed. You can continue to use your allocated funds to manage the services you need because of your transport accident.

Policy

The TAC will consider entering into an individual funding agreement with a client who has a severe injury and would like to arrange the purchasable TAC funded services that they receive.

Transport Accident Act 1986 reference: s.61A and s.61C

Background

Individualised Funding has been developed by the TAC to promote client choice and control over the disability and allied health services provided to them for the management of their accident related needs. Individualised Funding gives clients the flexibility to arrange their own services in a way that best meets their needs and lifestyle, and empowers them to work directly with their service providers.

Eligible clients who would like to be considered for Individualised Funding are required to complete the Life Area Needs Self-Assessment so that the TAC can determine their suitability. To commence Individualised Funding clients need to enter into an Individual Funding Agreement with the TAC.

While Individualised Funding can provide clients with the opportunity to flexibly self-manage their own services, it comes with extra responsibilities. The TAC has employees with specialised Individualised Funding knowledge who are available to assist clients and their families with making the move to Individualised Funding.

Definitions

Individualised Funding – means clients receive their funding on a monthly basis and accept responsibility for sourcing and engaging providers, arranging services in a way that best meets their needs and lifestyle, and paying for the services they receive.

Individual Funding Agreement - is an agreement between a client and the TAC which enables the TAC to make payments to a client and for that client to use these payments to purchase TAC funded services.

Individualised Funding Allocation – refers to the amount ($) that is determined by the TAC to represent a reasonable estimate of the client's likely costs or expenditure each month in relation to purchasable services.

Life Area Needs Self-Assessment – is a form completed by the client that contains questions about their accident related support needs, including how much and how often they need support. It also contains questions for clients to identify their current abilities to undertake the tasks required to self-manage their Individualised Funding.

Purchasable Services – means any services which are approved services as that term is defined under section 61A of the Transport Accident Act 1986 (Vic).

Self-Management - refers to clients who are independently managing the responsibility for completing all Individualised Funding obligations according to the terms of the Individual Funding Agreement. Obligations including managing the funds allocated to them by the TAC to meet their needs, making self-determined decisions and self-efficacy in managing and paying for the services they receive.

Financial Intermediary – where the TAC deems reasonable and necessary, a Financial Intermediary Service may be approved for the purpose of providing support to pay invoices electronically from the clients IF bank account. Financial Intermediary Services are provided by a Financial Intermediary (FI). The FI may only act on the client and TAC's instructions and in accordance with the terms sheet for the provision of FI services. Refer to the Financial Intermediary services policy.

Guidelines

Who is eligible for Individualised Funding?

A client who is eligible for Individualised Funding:

  • has a severe injury as a result of a transport accident; and
  • has needs related to their accident injuries that can be predicted for up to 12 months; and
  • is willing and able to enter into an Individual Funding Agreement with the TAC.

A client who has a guardian or administrator, or a child who is under the age of seventeen years, is eligible for Individualised Funding provided they meet the eligibility criteria noted above.

How is the Individualised Funding Allocation determined?

The TAC will calculate an Individualised Funding Allocation that is tailored to the client's predictable needs. The Individualised Funding Allocation is determined by considering a client's historical use of services. If there is inadequate history (e.g. relatively recent accident) the TAC will take reasonable steps to develop a suitable Allocation. This may include the use of other comparative measures like responses from the client's Life Area Needs Self-Assessment, and consideration of the client's level and severity of injuries, and the duration of time since the injury.

The Individualised Funding Allocation is a fixed amount of funding that will be deposited to an Individualised Funding bank account established by the TAC. This will enable a client to manage their services to their Allocation. The TAC will provide clients with a decision letter to confirm their annual and monthly Allocation.

What is an Individual Funding Agreement?

The Individual Funding Agreement is an agreement between a client and the TAC which enables the TAC to make payments to a client and for that client to use these payments to purchase TAC funded services.

The IFA specifies:

  • what approved services the agreement covers
  • how and when payments under the agreement are to be made
  • information that must be reported to the TAC to enable the monitoring of the agreement
  • all obligations of the parties under the agreement
  • how the agreement may be amended, suspended or terminated
  • if the agreement is terminated, any obligations that apply to the parties under the agreement
  • that the agreement is covered by the law of Victoria
  • how overpayments and payments not applied in accordance with the agreement will recovered
  • how disputes will be resolved.

    Transport Accident Act 1986 reference: s.61B

Which services may be purchased under an IFA?

Eligible clients may use their Allocation to purchase any of the following services they are entitled to under the Act, and may choose more of one type of service and less of another depending on their needs. If a client needs a service that is on the list the service is to be paid from the client's Individualised Funding allocation.

List of Purchasable Services:

  • Acupuncture
  • Attendant care (including overseas attendant care)
  • Audiology
  • Child care - only if eligible under section 60(2)(c) of the Transport Accident Act 1986
  • Chiropractic
  • Community group programs
  • Continence equipment
  • Dietitian
  • Equipment purchase or hire that costs less than $1000 per item inclusive of delivery
  • Exercise physiology
  • Gym and swimming programs - when certified by a medical practitioner or registered physiotherapist for the purpose of treatment or rehabilitation of transport accident injuries.
  • Home services/ Domestic services (including gardening)
  • Nursing
  • Occupational therapy
  • Orthoptics
  • Osteopathy
  • Physiotherapy
  • Podiatry
  • Psychology
  • Respite
  • Social work
  • Speech pathology
  • Specialist disability laundry services - reasonable costs when required for 'soiling' as caused by the transport accident injuries.

Which services may not be purchased under the IFA?

A client may not use their Allocation to purchase any of the following services:

  • services for a person other than the injured client (except for child care)
  • services that cannot be funded by the TAC
  • services for a condition that existed before a transport accident or that is not a direct  result of a transport accident
  • continence equipment when the client has a valid continence prescription form (refer to the Equipment policy)
  • maintenance for equipment when the client has preventative maintenance approved (refer to the Equipment policy)
  • TAC funded services that are infrequent, difficult to predict, high cost or cannot be substituted for another service, for example, home modifications or residential care services.

A client may still access these services however the TAC will continue to arrange them on the client's behalf.

Does entering into an IFA affect a client's income?

The TAC does not consider any payment made as part of a client's Individualised Funding to be income. If a client receiving TAC income benefits enters into an IFA this will have no impact on their TAC income payments.

Does entering into an IFA mean a client can choose any service provider?

The TAC requires clients on Individualised Funding to choose service providers who hold a certificate of business/incorporation registration and are appropriately qualified and experienced. This means service providers will be established as a business and hold the appropriate level of insurances and occupational health and safety certificates.

Health practitioners must hold the relevant professional registrations including registration with the Australian Health Practitioner Regulation Agency (AHPRA) where applicable. Disability service providers (e.g. Attendant Care and Community Group Programs) should comply with the relevant state or federal disability service industry standards.

For more information on choosing the right service provider, refer to Find an Individualised Funding purchasable service.

What happens if a client's needs or circumstances change during Individualised Funding?

If a client feels that something significant has happened, such as a change in their health or circumstances that would make it difficult for them to complete all of their tasks under the IFA, the client must contact the TAC to discuss these changes.

If the TAC becomes aware that there is a significant change in a client's health or circumstances that would make it difficult for them to complete all of their tasks under the IFA, the TAC may:

  • offer additional TAC support (e.g. Individualised Funding Specialist)
  • initiate a review
  • maintain the current Individualised Funding Allocation
  • vary the Individualised Funding Allocation to reflect the changed circumstances
  • suspend or terminate payments of the Individualised Funding Allocation in accordance with the client's IFA

The TAC will discuss these options with the client and advise them in writing of the TAC's decision.

What happens if Individualised Funding is no longer required?

When payments are suspended or terminated in accordance with the client's Individual Funding Agreement, the TAC will resume managing all services to which a client is entitled. The client will be advised in writing of the contact details for their new claims employee.

See also Schedule 3 Individualised Funding – Approved Services.

Use the search tools below to find a provider and check if they are appropriately registered and qualified. You can also ask your provider to show you their certificates of qualification, registrations and accreditation.

Don't forget to consider these five points when choosing your provider.

  1. Professional registrations, accreditation/certification and qualifications*
  2. Innovation and value
  3. Experience
  4. Person-centred approaches
  5. Location, accessibility and flexibility

*When using IF, you must choose providers for purchasable services who hold a certificate of business/incorporation registration and are appropriately qualified and experienced. This means providers are established as a business and hold the appropriate level of insurances and occupational health and safety certificates. Health practitioners must hold the relevant professional registrations including registration with the Australian Health Practitioner Regulation Agency (AHPRA) where applicable. Disability service providers (e.g. Attendant Care and Community Group Programs) should be accredited/certified with the relevant state or federal disability service industry standards.

A client on IF may use their funding allocation to purchase any of the services listed below.
Equipment that costs less than $1,000 per item (inclusive of delivery costs) applies to all service equipment purchases.

Attendant care

Attendant care services should be appropriate, promote your functional independence and be least restrictive to your needs.

You may need attendant care services to increase your independence with:

  • personal care such as activities of daily living
  • therapy support to enable the client's active participation in rehabilitation activities, such as a home exercise program
  • accessing the community to undertake activities such as personal banking and shopping.

View the TAC Attendant Care policy and fee information.

Find an Attendant Care service provider:

Acupuncture

Acupuncture services should promote progress towards functional independence, participation and self-management. Services can only be provided by a person:

  • who is registered as a Chinese medicine practitioner in the Division of Acupuncturists under the Health Practitioner Regulation National Law, or
  • whose registration is endorsed under section 97 of the Health Practitioner Regulation National Law as being qualified to practice as an acupuncturist (for example by the Chiropractic, Osteopathy or Physiotherapy Boards of Australia).

View the TAC acupuncture policy and fee information.

Find a provider:

Australian Acupuncture and Chinese Medicine Association Practitioner 

Check that your service provider is appropriately registered:

Audiology

Audiological services can only be provided by an audiologist eligible for full membership of the Audiological Association of Australia and/or accredited by the Australian Hearing Service (AHA).

View the TAC Audiology policy and fee information

Find a service provider:

Child care

Child care services are only purchasable if eligible under section 60(2)(c) of the Transport Accident Act 1986 and can only be funded and purchased up to a maximum of five years after your transport accident.

Child care services refer to duties and tasks that relate to the direct care of a child, such as feeding and bathing, which you performed prior to the transport accident. These services replace the care and supervision of a child when you have sustained injuries that prevent or limit the normal provision of these services.

You should ensure that your child care provider/s are:

  • compliant with the National Best Practice Standards, and
  • regulated by either Commonwealth or State governments (with the exception of in home care services which are regulated and monitored by local councils), and
  • holders of, or employ staff who are holders of, a current assessment notice pursuant to the Working With Children Act 2005 (Victoria).

View the TAC Childcare policy and fee information.

Find an appropriate child care service:

Australian Government My Child

Chiropractic

You may purchase chiropractic services:

  • that are clinically justified, safe and effective
  • that have a clear rehabilitative purpose and are not for non-transport accident injury rehabilitative purposes
  • that are likely to achieve or maintain a measurable functional improvement
  • that promote progress towards functional independence, participation and self-management.

View the TAC Chiropratic policy and fee information

Find a chiropractor:

To check if your provider is appropriately registered:

Community group programs

As a result of a transport accident, you may need support to access and participate in recreational and leisure activities in your community.

Community group programs should:

  • maintain and enhance peer support networks
  • facilitate sharing of support services
  • assist with independent access to the community
  • assess and review the support needed to enable you to participate in community based leisure or recreational activities
  • link you into mainstream or supported community-based leisure or recreational activities
  • ensure programs continue to appropriately address your needs and goals.

View the TAC community group program policy and fee information.

Find a service provider:

Dietitian

Dietitian services can be provided by a dietitian who meets the accreditation requirements of Dietitians Associsation of Australia.

View the TAC dietitian policy and fee information.

Find a service provider:

Equipment that costs less than $1000 per item, inclusive of delivery

This information is for TAC clients who use Individualised Funding. If you don't use Individualised Funding, please see our equipment page here.

Equipment can be used to assist with activities such as bathing, dressing, eating and drinking.

Equipment purchases should address one or more of the following aspects of your life following a transport accident injury:

  • mobility
  • function
  • independence
  • community involvement (through return to work, educational or leisure activities)
  • relief of pain or discomfort
  • communication
  • safe environment.

IMPORTANT NOTE: Please contact your IF Support Coordinator if you require items that exceed the $1,000 limit.

View the TAC equipment policy and fee information.

Find a service provider

The three equipment providers below have contracted arrangements with the TAC and can offer you a TAC rate for certain equipment items. They may ask you for your TAC Claim number and don't forget to plan ahead to allow for delivery times.

Gym and swimming programs

A gym or swimming program is an exercise program that is developed and monitored by a health professional, such as a physiotherapist. It is for you to perform independently in a gym or pool to support your rehabilitation.

An appropriate gym and/or pool facility:

  • is a commercial gym and/or pool facility designed for public use or a gym and/or pool within the premises of a health professional
  • is located in a practical location, within a reasonable distance of your home or work
  • is designed and equipped for various modalities of exercise, sports and physical training
  • has suitable equipment to meet your needs as recommended by your health professional
  • has suitably qualified staff to ensure your safety.

View the TAC exercise physiology policy and fee information.

To find an appropriate gym and/or pool facility, check with your health professional, yellow pages, local council or private gym and swimming facility.

Home services/Domestic services (including gardening)

Home services refer to the household tasks you normally perform for yourself or others in your family. If there are certain household tasks you can't do because of your transport accident injuries, you can pay for workers to do these tasks for you.

It is important that you continue doing the household tasks you are still able to perform and take on more as you build your independence.

View the TAC support at home policy and fee information for accidents on or after 1 January 2005

View the TAC domestic services policy and fee information for accidents on or before 31 December 2004

Find a service provider:

Nursing

Nursing refers to services, care and tasks carried out by a registered nurse at your home.

View the TAC nursing policy and fee information.

Find a nursing service provider:

To check that your provider is appropriately registered:

Occupational therapy

Occupational Therapy services may include:

  • prescribing exercises to maximise your function
  • prescribing adaptive and/or alternative techniques to make it easier for you to perform activities. For example, breaking strenuous tasks into smaller more manageable tasks
  • identify and in some cases trial suitable equipment to maximise your independence
  • to advise what support services you may require, for example, attendant care.

View the TAC occupational therapy policy and fee information.

Find a service provider:

To check that your provider is appropriately registered:

Orthoptics

Orthoptists are eye healthcare professionals who can provide treatment for your eyes after your transport accident.

Orthoptics services must be performed by an orthoptist eligible for membership with the Orthoptics Association of Australia.

View the TAC orthoptics policy and fee information.

Find a service provider:

Osteopathy

Osteopathy focuses on how your skeleton, joints, muscles, nerves and circulation work together to improve your indepedence.

Osteopathy services must be performed by an osteopath registered with the Osteopathy Board of Australia.

View the TAC osteopathy policy and fee information.

Find a service provider:

To check that your provider is appropriately registered:

Physiotherapy

Physiotherapy aims to improve your movement and function after your transport accident.

Physiotherapy services can be provided by a physiotherapist who is registered under the Health Practitioner Regulation National Law (other than as a student).

View the TAC physiotherapy policy and fee information.

Find a physiotherapy service provider:

Check that your service provider is appropriately registered:

Podiatry

Podiatrists specialise in medical care of the foot, ankle and lower leg.

Podiatry services can be provided by a podiatrist who is registered registered under the Health Practitioner Regulation National Law (other than as a student).

View the TAC podiatry policy and fee information.

Find a provider:

Check that your provider is appropriately registered:

Psychology

Psychologists are experts in human behaviour, the brain, memory, learning and human development. Psychology services focus on your mental health, to help you achieve your independence, work productively and contribute to community life.

Psychology services can be provided by a psychologist who is registered under the Health Practitioner Regulation National Law to practice (other than as a student).

View the TAC mental health and wellbeing policy and fee information.

Access mental health and persistent pain resources.

Find a provider:

Check that your service provider is appropriately registered:

Respite

If a family member is providing you with substantial unpaid care, you may wish to use respite services. Respite services provide positive short/long-term breaks for you and your carer from your regular support routine.

View the TAC respite policy and fee information.

Find a provider:

Social work

Social workers can work with you to address life challenges and enhance your independence. Social workers may undertake counselling, community engagement and development to address issues at both a personal and social level.

Social work services can be provided by a qualifed social worker who is eligible for full membership with the Australian Association of Social Workers.

Information about social work is in our mental health and wellbeing policy and fee information.

Find a provider:

Speech pathology

Speech pathology services may be required if you have sustained communication or swallowing disorder(s) as a result of your transport accident.

Speech pathology services must be provided by a qualified speech pathologist.

View the TAC speech pathology policy and fee information.

Find a provider:

Specialist disability laundry service

Specialist laundry services may be required if you have major incontinence issues as a result of your transport accident.

You may wish to discuss these services with your IF Support Coordinator and continence nurse when putting your continence management plan and prescription in place.

To find an appropriate service provider check with your local linen or laundry service.

 

Disclaimer

The links to the following websites are provided by the TAC for clients self-managing their purchasable services. They should be viewed in conjunction with the TAC Individualised Funding policy.