Intensive Outreach Services - Information for clients

If you have claimed Intensive Outreach Services before and would like more information, please see the Intensive Outreach Services policy.

What is an Intensive Outreach Service?

For clients with moderate to severe challenging behaviours, an Intensive Outreach Service provider works with your treating team to help you achieve specific goals, such as:

  • Increased community participation
  • Activities of daily living
  • Maintaining accommodation.

An Intensive Outreach Service provider can also:

  • Mentor your attendant carers
  • Help you to decrease your challenging behavior
  • Coordinate your care.

Will the TAC pay for Intensive Outreach Services?

The TAC will pay for Intensive Outreach Services when:

  • You have an accepted TAC claim
  • Your Intensive Outreach Services are for your accident-related injuries
  • You have moderate to severe challenging behaviors, for example you have problems controlling your anger due to an acquired brain injury. .
The TAC will make decisions about paying for Intensive Outreach Services in the time-frames set out in the TAC's Service Charter.

What do I need to do?

  • You or someone in your family can call the TAC and ask us to pay for an Intensive Outreach Service provider; or
  • Your doctor or treating team can send us a letter that explains why you need an Intensive Outreach Service provider
  • The TAC will then decide if we can pay for the Intensive Outreach Service provider.

Can I choose my own Intensive Outreach Service provider, or will the TAC choose one for me?

How long will the TAC pay for an Intensive Outreach Service provider?

  • As long as the service is helping you, there is no limit to how long the TAC can pay for an Intensive Outreach Service provider.
  • We may ask your Intensive Outreach Service provider to submit reports that tell us what you need and for how long.

How the bills are paid

  • Your Intensive Outreach Service provider will bill the TAC directly. You do not need to pay any bills.

The TAC can pay the reasonable costs of participation in the Intensive Outreach Service 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 participate in the Intensive Outreach Service to ensure that the treatment and services remain reasonable for the transport accident injury and are payable under the Act.

BACKGROUND

The Intensive Outreach Service (IOS) is an intensive, time-limited service for a client who has moderate to severe behaviours of concern and/or co-morbidity. Support is holistic and based on the needs and circumstances of the client. The IOS will support a client to achieve specific goals and may provide support to increase their community participation, develop their activities of daily living skills, access and maintain appropriate accommodation and provide positive behaviour support.

The IOS may be one of a range of service options the client requires. For example, while the IOS will address and manage many of the client's support needs, this does not include personal care requirements. Should the client have personal care support needs, additional services such as attendant care may be required.

The IOS is based on the following components:

  • An assertive outreach model – it is the responsibility of the IOS provider to maintain contact and provide flexible support to the client that matches their needs and circumstances. 
  • IOS providers having the skills to mentor additional staff, such as attendant care workers, in positive behaviour support to better assist clients.
  • Provision of care coordination – IOS providers directly supporting the client in addition to coordinating additional supports as required.
  • IOS providers building on strengths to empower clients and their families to take control of their own lives and develop self-management strategies.
  • IOS providers supporting a client to achieve their goals, and, where appropriate, increase independence.

The aims of the IOS are:

  • Supporting the client to achieve their independence goals
  • A measurable reduction in client behaviours of concern
  • Supporting a client to further develop their community participation
  • Supporting a client to further develop their activities of daily living skills
  • Where appropriate, supporting a client to increase their independence and reduce the need for support from others.

A clinical team will provide clinical direction to the IOS providers. The IOS providers will work collaboratively with the clinical team, incorporating clinical direction and recommendations into their support and engagement of the client.

DEFINITIONS

In this policy:

  • The Intensive Outreach Service (IOS) is a time-limited assertive outreach service designed to improve individual outcomes through intensive support and planned service intervention.
  • An assertive outreach model means it is the responsibility of the IOS provider to maintain contact and provide support to the client. Support is flexible and matches the needs and circumstances of the client. An assertive outreach model considers all aspects of a client's situation, such as social, physical, emotional and economic needs.
  • Clinical team is the occupational therapist and neuropsychologist involved in the support and management of the client. This includes any other specialist clinical support such as a neuropsychiatrist and clinicians/providers with brain injury expertise.
  • Co-morbidity is the presence of one or more disorders. For example, clients who have an acquired brain injury, a diagnosed mental illness, intellectual impairment and/or alcohol and other drug support needs.
  • Protective factors are the aspects of a client and their environment or personal experience that make it less likely they will experience risks and vulnerabilities associated with their behaviours of concern and/or co-morbidity.
  • An Activity Sampling Schedule is a document that is developed by the client, clinical team and IOS provider to provide the client with the opportunity to access different activities. This process will support the client to better understand and participate in activities they are interested in.
  • A Behaviour Support Plan is a behaviour management tool which identifies the underlying causes of a particular behaviour of concern. It provides a clear response for the carer to assist in the client's management of the behaviour. It is a concrete plan to reduce behaviours of concern and to promote positive coping strategies.

GUIDELINES

What can the TAC pay for in relation to the Intensive Outreach Service?

The TAC can pay the reasonable costs of the IOS when required as a result of a transport accident injury for clients who have moderate to severe behaviours of concern. The IOS includes:

  • services provided with a ratio of at least 1:1 support delivered within an assertive outreach model
  • if appropriate, the development of a risk management plan to provide understanding of the risk associated with the client's clinical and psychosocial presentation
  • the development and review(s) of a Behaviour Support Plan
  • training for the IOS providers and relevant direct support staff (such as attendant carers).

Services are delivered in collaboration with the clinical team. This includes but is not limited to:

  • The neuropsychologist and/or occupational therapist, in consultation with the IOS provider and the TAC, recommending the level, duration and intensity of support required by the client. This will occur at commencement of the service. Subsequent decisions related to which support stream the client should be managed in will be made by the TAC and IOS provider.
  • The occupational therapist, as appropriate, undertaking regular client functional assessments and provide recommendations to the IOS providers to incorporate into their engagement with the client.
  • The neuropsychologist developing a comprehensive Behaviour Support Plan which will be reviewed with the IOS providers at regular intervals.
  • Where appropriate, the neuropsychologist having the capacity to deliver training to the IOS providers in relation to the Behaviour Support Plan.
  • Where appropriate, the neuropsychologist having the capacity to provide specialist consultation services to the IOS providers in relation to clinical management of the client. This may include recommendations related to additional brain injury expertise/services which the client may benefit from.
  • Where appropriate, the neuropsychologist having capacity to maintain direct engagement and support with the client.

The services of the clinical team are provided under the Occupational Therapy policy and the Mental Health (Psychology and Neuropsychology) policy.

Services are delivered in three streams based on the needs of the client according to a recommendation from the clinical team:

  • Stream 1 is for clients with severe behaviours of concern
  • Stream 2 is for clients with moderate to severe behaviours of concern
  • Stream 3 is for clients with moderate behaviours of concern.

The TAC can also pay the reasonable costs of a transitional stream for all clients as they lead into or exit from the service.

Who can provide the Intensive Outreach Service?

The IOS can only be provided by a non-government organisation which is:

  • a party to a service agreement with the Victorian Department of Health and/or the Victorian Department of Human Services to deliver:
    • Psychiatric Disability Rehabilitation and Support Services, and
    • from 1 July 2014, Mental Health Community Support Services (Individual Client Support Packages), and
  • registered with the TAC to provide the IOS to clients.

What information does the TAC require to consider paying for Intensive Outreach Service?

The IOS is authorised under section 23 of the Act as a disability service and as such, participation requires prior approval from the TAC in writing before the service can be provided to the client.

Initial approvalTo consider approving a client's participation in the IOS, the TAC requires the following information about the client:

  • Degree and frequency of behaviours of concern
  • Co-morbidity diagnosis
  • Historical/current use of drugs and/or alcohol dependence
  • Whether the client poses a risk to themself and/or others
  • Criminal history
  • Details of any difficulty engaging with support
  • Accommodation status
  • Level of community participation.
  • Accommodation and support options implemented historically
  • Other services/providers who may be currently involved with the client
  • Alignment of the client's independence goals with the aims of the IOS and the type of service it delivers.

Recommendations in relation to the level, duration and intensity of support the client requires from the IOS providers will be made by the treating occupational therapist and/or neuropsychologist in collaboration with the TAC and IOS providers.

Progress reportsThe TAC requires progress reports for each client at three month intervals. The progress report should include (but is not limited to):

  • progress of the independence goals and evidence to support this
  • analysis and assessment of data about the frequency of behaviours of concern and the cause of the behaviours
  • frequency and analysis of critical incidents
  • critical observations and learnings
  • areas of support the IOS providers will focus on with the client for the next three months
  • the number of indirect and direct contact hours the client has received during the previous three month period
  • the number of travel hours required for future service provision 
  • outcomes the IOS providers have achieved in the previous three month period
  • details of outcomes that have not been achieved, including reasons
  • areas of focus for indirect work
  • a transition plan for the client which is completed by the relevant IOS providers three months prior to the anticipated conclusion of the IOS. The transition plan must clearly detail the ongoing accommodation and support options for the client following their exit from the service.

At the conclusion of the IOS providers will provide an exit report. The exit report must include (but is not limited to):

  • the most appropriate accommodation and support model for the client
  • the client's strengths and protective factors
  • the most appropriate staff ratio to work with the client
  • the most appropriate services for the client's ongoing support
  • any change in frequency and/or severity of behaviours of concern over the duration of the program
  • documented causes of behaviours of concern
  • risks and areas of ongoing concern
  • recommendations for future support/management related to optimum accommodation and support options.

The IOS provider will document and report contact and non-contact hours in all reporting periods.

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 fees are payable for the Intensive Outreach Service?

Refer to the TAC IOS fee schedule.

In relation to the Intensive Outreach Service 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, as these costs are included in the package fee
  • 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.

Intensive Outreach Service

Fees from 1 November 2017 are paid in line with our new service model. Please refer to the Outreach services fee schedule for the current amount.

Previous Fees - Up until 31 October 2017

Service Description TAC item number 1 July 2017 - 31 October 2017
Maximum
Payment Rate*
2016/17
Maximum Payment
Rate*
Intensive Outreach Service – Stream 1 (26 – 37 hours per week)  IOS01 $263.95
per day
$260.10
per day
Intensive Outreach Service – Stream 2 (16 – 25 hours per week) IOS02 $171.78
per day
$169.27
per day
Intensive Outreach Service – Stream 3 (6 – 15 hours per week) IOS03 $83.78
per day
$82.56
per day
Intensive Outreach Service – Transitional (1 – 5 hours per week) IOSTR $29.31
per day
$28.88
per day
Intensive Outreach Service – Additional Hours (only available under Stream 1 and must be approved prior to use) IOSHR $58.65
hourly 
$57.79
hourly

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 Intensive Outreach Services information sheet

Intensive Outreach Services information sheet

Summary:

This is the information sheet on Intensive Outreach Services (IOS) for health professionals.

IOS is an intensive, time-limited service for a client who is demonstrating moderate to severe behaviours of concern (BoC) and/or co-morbidity. 

The aim of the service is to support a client to achieve specific goals, access and maintain appropriate accommodation and provide positive behaviour support. Support is holistic and based on the needs and circumstances of the client.

View Intensive Outreach Service Progress report

Intensive Outreach Service Progress report

Summary: The purpose of this form is to provide a progress report to the TAC in relation to the client being managed within the Intensive Outreach service. The form is to be completed by the Intensive Outreach Service (IOS) provider every three months and forms the basis of a general review period in which you will discuss the progress your service is making with the client.

The providers below are currently registered with the TAC to provide Intensive Outreach Services.

Cohealth (inner and outer Northern and Western suburbs of Melbourne)
215 Nicholson Street,
Footscray VIC 3011
Ph: 03 9448 6314

Eastern Region Mental Health Association (ERMHA) (South East and Barwon Southwest regions)
Specialist Services Building
69 Robinson Street,
Dandenong VIC 3175
Ph: 03 9706 7388

MIND (Metro and La Trobe, Upper and Central Hume, Grampians and Loddon Malle)
Level 2 76-80 Turnham Ave
Rosanna VIC 3084
Ph: 03 8640 5623

NEXTT (Melbourne and Geelong regions.  Please call for other regional areas including Bendigo, Ballarat, Wangaratta, Benalla, Shepparton and Horsham)
3/74 Gheringhap Street, Geelong
12/520 Collins Street, Melbourne
2/6 Railway Parade, Camberwell
Ph: 03 5272 7700