Client Independence Skills Service (CISS)

The TAC can pay the reasonable costs of Client Independence Skills Services for clients when required as a result of a transport accident injury under section 60 of the Transport Accident Act 1986 (the Act).

The TAC will periodically review a client's entitlement to receive Client Independence Skills Services to ensure that they remain reasonable for the transport accident injury and are payable under the Act.

BACKGROUND

Client Independence Skills Services (CISS) are time limited and goal directed skill development services aimed at increasing clients' independence and reducing their reliance on formal supports, such as attendant care. CISS are designed for clients with an acquired brain injury (ABI) as a result of their transport accident who require targeted input to learn or relearn a skill to increase their independence. CISS allows a client to learn or relearn a skill in a safe and focused environment through a method of repetitive practice, targeted strategies and/or access to equipment.

DEFINITIONS

In this policy:

  • The Clinical team is the client's treating team which may include, but is not limited to, a physiotherapist, occupational therapist, speech pathologist, neuropsychologist, general practitioner or other medical specialist.
  • A CISS provider comprises either a Disability Services provider or an ABI support organisation approved by the TAC. The CISS provider facilitates skill development in a safe environment which may be in the client's home or out in the community. 
  • A CISS worker is a staff member of a CISS provider (either a Disability Service provider or an ABI support organisation) who possesses an Associate Diploma or Certificate IV qualification in disability, community services or equivalent at a minimum. The CISS worker should also have the skills required to facilitate client discharge from their services

GUIDELINES

What can the TAC pay for in relation to CISS? 

The TAC can pay the reasonable costs of CISS where required as a result of a transport accident injury for clients who:

  • have an acquired brain injury; and
  • have clearly defined and measurable independence goals that are reasonably achievable through the objectives of the service

CISS are paid on an hourly basis. For more information please see the TAC Client Independence Skills Service Fee Schedule.

The TAC can pay for up to twelve weeks of CISS (or longer by exception for more complex skills where clinically justified). CISS must have an articulated, pre-defined and achievable outcome for the client.

CISS includes the following components: 

  • the clinical team
  • a CISS provider who assists the client in learning the skill by providing an appropriate environment
  • other treating practitioners
  • the TAC support coordinator
  • the client, who is central to treatment planning, program implementation and decision making.

Travel

The TAC will not pay for travel for a CISS worker to attend an appointment at a client's residence or in the community setting (hospital, office, school etc.). The TAC will only pay for travel for a CISS worker where they are required to accompany the client to a clinic or hospital in the event of a medical emergency.

The CISS worker should obtain a companion card to deliver services to a client with a public transport independence goal (for example to independently ride the train). For more information please see the companion card website

Client travel will be reimbursed under the Travel and Accommodation Expenses policy.

Please see the Driving Programs policy for further requirements where a client's goal is to return to driving.

Who can provide Client Independence Skills Services?

CISS can only be provided by Disability Service providers and ABI support organisations. The service provider must:

  • be pre-approved by the TAC in writing
  • provide SMART client goals (specific, measurable, achievable, realistic and timely) that are consistent with the client's Independence Plan focus on empowering the client to achieve pre-defined independence outcomes
  • use a model of supported repetitive functional task practice

A CISS worker must be an employee of a Disability Service provider or ABI support organisation and possess either an Associate Diploma or Certificate IV qualification in disability, community services or equivalent.

The CISS provider should monitor the client's progress towards their goals during the program and contact the TAC if the client is not making gains as outlined or if the program has been unable to proceed for any reason. The suitability of the service will be re-evaluated if this occurs.

What information does the TAC require to consider paying for CISS?

CISS are authorised under section 23 of the Act as a rehabilitation service. Participation requires written approval from the TAC before the service can be provided to the client.

The request and approval of a CISS program may form part of the independence planning process for clients with a 'severe injury'. The TAC otherwise requires a written request from a client's treating health practitioner outlining the following:

  • A clear statement detailing what the client wishes to achieve in their involvement with CISS, a baseline of where the client is presently at (eg. using a Goal Attainment Scale) and an outline of how the service will assist in meeting these goals.
  • Current level of community participation, domestic participation and personal care.
  • Information about strategies that have been implemented previously and outcomes achieved.
  • Other services/providers who may be currently involved with the client and will be able to support the client to achieve their goals through participation in the CISS program.

Evaluation 

The CISS provider must report to the TAC on the client's progress towards their goals at the conclusion of the program in consultation with the referring health practitioner. The report must include (but is not limited to):

  • Goals of the program and how they were measured (eg. using a Goal Attainment Scale).
  • Progress and outcomes supported by evidence such as the results of outcome measures and the client's functional performance.
  • Areas of focus for the client's self-guided work.
  • Recommendations on the client's attendant care needs, based on how these have changed through increased independence as a result of the CISS program.

When will the TAC respond to a request? 

The TAC will respond to written treatment and service requests as set out in the TAC Service Charter.

What are the TAC's invoice requirements?

Refer to the How to Invoice TAC information page.

In relation to Client Independence Skills Services what won't the TAC pay for?

The TAC will not pay for:

  • treatment or services for a person other than the client
  • treatment or services not authorised by the TAC under the Act
  • treatment or services subcontracted to, or provided by a non-registered provider
  • fees associated with cancellation or non-attendance
  • treatment or services provided outside the Commonwealth of Australia 
  • the separate costs of telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
  • any fees associated with the training of CISS provider staff
  •  treatment or services provided more than two years prior to the request for funding except where the request for payment is made within three years of the transport accident, refer to the Time Limit to Apply for the Payment of Medical and Like Expenses policy.

Client Independence Skills Service

Effective 1 July 2017

Service DescriptionTAC Item Number

2017/18
Maximum
Payment
Rate

2016/17
Maximum
Payment
Rate
CISS - Client Independence Skills Service CISS01* $48.23 per hour $47.53 per hour
CISS - Group Program of 2 Clients (High needs) CISS02* $27.58 per hour $27.18 per hour
CISS - Group Program of 3-5 Clients (Core needs) CISS03* $19.69 per hour $19.40 per hour

GST

*The TAC maximum fee includes a 10% allowance for GST for items which TAC believes are taxable supplies.  If you are a provider not registered for GST:

  • You are not legally permitted to charge GST
  • You should indicate on all invoices submitted your status as 'not registered for GST purposes'
  • The TAC will only reimburse you an amount which excludes the GST component for items billed where the maximum fee includes a 10% allowance for GST

If you are not registered for GST please state on all invoices the TAC item number listed for providers not registered.


View Client Independence Skills Service (CISS) information sheet

Client Independence Skills Service (CISS) information sheet

Summary:

This information sheet outlines the Client Independence Skills Service (CISS) for health professionals.  CISS is a time limited and goal directed skill development service.

The aim of the service is to increase a client's independence and reduce their reliance on formal supports, by providing targeted input to learn or relearn a skill. Support is holistic and based on the needs and circumstances of the client.

View Client Independence Skills Service (CISS) provider list

Client Independence Skills Service (CISS) provider list

Summary:

This is a list of providers who can perform the Client Independence Skills Service (CISS) service.