Outreach service - information for clients

If you have claimed outreach services before and would like more information, please see the outreach service policy.

What is an outreach service?

An outreach service helps you to identify issues that are stopping you from getting better or returning to work. The service works with you to address these issues and get you back to work or help you to recover from your accident injuries.

The outreach service is provided in two stages over a six month period:

  1. An assessment, which includes treatment. This is provided during a  ten hour service package; then
  2. A support package, which includes more treatment. .

Will the TAC pay for an outreach service?

The TAC will pay for an outreach service when:

  • You have an accepted TAC claim
  • Your outreach service is for your accident related injuries
  • You need help getting better or returning to work in the first year after your accident
  • You have a mental injury caused by your accident.
The TAC will make decisions about paying for your outreach services in the time-frames set out in the TAC's Service Charter.

Can I choose my own outreach service provider, or will the TAC choose one for me?

You need the TAC's approval before you start receiving this service.

There are two ways you can access the service:

  1. Your doctor can send the TAC a letter that explains why you need an outreach service; or
  2. The TAC will contact you and ask you if you would like to use an  outreach service.

The TAC will then send a referral to an outreach service provider.

How long will the TAC pay for my outreach service?

  • Most outreach service programs are for six months
  • We may ask your doctor to submit reports that tell us what you need and for how long.

How your bills are paid

Your outreach service provider will bill the TAC directly. You do not need to pay any bills.

The TAC can pay the reasonable costs of the Outreach Service when required as a result of a transport accident injury under section 60 of the Transport Accident Act 1986.

The TAC will periodically review a client's entitlement to the Outreach Service to ensure that the treatment and services remain reasonable for the transport accident injury and are payable under the Act.

BACKGROUND

The Outreach Service is a non-clinical, time-limited and recovery-oriented service for clients who are experiencing barriers to returning to work and/or returning to heath and/or independence because of:

  • a primary mental injury, or
  • having, or being at risk of, a secondary mental injury.

The aim of the service is to provide practical solutions to help the client to overcome these barriers.

The Outreach Service can be provided as a stand-alone service for clients that have identified distress or psychosocial concerns as a direct result of their transport accident injury. In some cases it will be provided as an adjunct to clinical services.

The Outreach Service can provide a range of flexible psychosocial interventions targeted to match the individual needs of the client. For example, the Outreach Service could assist the client to:

  • implement self-management strategies
  • implement practical strategies recommended during clinical treatment
  • access the workplace, medical and other appointments more independently
  • learn or relearn activities of daily living, which may reduce the need for external support such as shopping assistance, carer support, and home help/domestic services.

The Outreach Service is based on the following components:

  • an assertive outreach model. This means it is the responsibility of the Outreach Service provider to maintain contact and provide support to the client. Outreach can entail meeting a client at their home or in the community
  • the service is recovery and empowerment-orientated, building on strengths so that clients and their families can take control of their own lives and develop self-management strategies
  • supportive counselling to develop and implement practical strategies to overcome barriers to returning to health and to work
  • a holistic approach by supporting the client and ensuring that the Outreach Service is consistent with the goals of the client's treating team. For example the client's medical practitioner, psychologist, pain management provider, or vocational rehabilitation provider.

DEFINITIONS

In this policy:

  • a primary mental injury is a diagnosed mental disorder that has occurred without a physical injury 
  • a secondary mental injury is a mental disorder that has developed as a result of a physical injury
  • psychosocial means a combination of psychological and social factors
  • an outreach worker is a person employed by an approved Outreach Service provider and who adheres to the Victorian Government Standards for Psychiatric Disability Rehabilitation and Support Services, and from 1 July 2014, Mental Health Community Support Services (Individual Client Support Packages)
  • an Outreach Service Plan is a document that is submitted after the conclusion of the assessment and initial support package and which is updated at the conclusion of any subsequent support hours provided. It includes assessment findings, baseline outcome measures, goals and recommendations which are agreed to by the client. Goals and recommendations should be holistic and formulated through liaison with the client's treating team. The Outreach Service Plan will include progress reporting about client goals and clinical justification for additional support hours.

GUIDELINES

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

The TAC can pay the reasonable costs of the Outreach Service for clients:

  • when required as a direct result of a transport accident injury
  • who have a primary mental injury, or who have or are at risk of developing a secondary mental injury
  • when referred:
    • directly by the TAC, or
    • following a request by a medical practitioner with prior approval from the TAC
  • when provided on an individual basis in a community setting
  • as part of an approved program that is focussed on the promotion of progress towards functional independence, participation and self-management
  • when provided in a way that is consistent with the principles of the Clinical Framework and with a focus on the achievement of return to work, return to health  and/or independence goals
  • for up to 6 months, unless exceptional and unforeseen circumstances occur which disrupt the client's engagement with the Outreach Service. For example, this may be due to medical factors, a breakdown of social supports, or other factors that have prevented the progress of recovery from the transport accident injury beyond that reasonably expected.

The Outreach Service includes two components:

  1. Assessment and initial support package, which comprises a package of 10 hours and includes:
    • a face-to-face assessment
    • delivery of psychosocial interventions to the client, and
    • completion and submission of an Outreach Service Plan which documents the assessment findings, baseline outcome measures and support recommendations (developed following liaison with the client's treating team) and progress to date.
  2. Subsequent support, which may be requested at the completion of the assessment and initial support package on the Outreach Service Plan. This subsequent support is paid at an hourly fee-for-service rate. In assessing requests for additional hours, the TAC will consider the client's progress towards their return to work and/or return to health and/or return to independence goals. Prior approval is required in writing from the TAC before any subsequent support is provided.

Who can provide the Outreach Service?

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

  • 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 by the TAC to provide the Outreach Service.

The TAC expects that the client will access services from an Outreach Service provider in their local area.

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

Assessment and Initial Support Package
The TAC can pay for the Outreach Service when referred directly by the TAC or when requested by a medical practitioner. For clients with a severe injury, approval of the Outreach Service may form part of the independence planning process, in consultation with the TAC Coordinator and the client's treating medical practitioner.

The medical practitioner must provide the following written information to the TAC:

  • nature of the client's transport accident injuries
  • prior medical history related to the client's mental injury
  • brief description of the client's psychosocial concerns and or barriers to returning to work and/or health and/or independence
  • the client's currently prescribed medication
  • the client's current or prior treatment for mental injury.

If the TAC believes that the client is suitable for the Outreach Service, a referral will be made by the TAC to the service.

The TAC requires the Outreach Service Provider to submit an Outreach Service Plan at the completion of the assessment and initial support package. The report should include (but is not limited to):

  • assessment findings
  • goals and evidence of progress towards goals
  • details of goals that have not been achieved and reasons for this
  • outcome measures collected at the start and end of the assessment and initial support package
  • when the Outreach Service ends:
    • risks and areas of ongoing concern
    • recommendations for future support/management
    • final outcome of return to work and/or return to health and/or return to independence.

Payment for services will only be made following receipt of the Outreach Service Plan and invoice for services provided.

Subsequent support 
Where subsequent support is being requested at the conclusion of the assessment and initial support package, the following is also required in the Outreach Service Plan:

  • reasons for subsequent support and why the client's goals were not met
  • areas of support the Outreach Service providers will focus on
  • the number of subsequent support hours (including travel) required and the areas of focus for service provision.

Prior approval is required from the TAC in writing before any subsequent support hours can be provided.

The Outreach Service Plan must be updated and submitted at the end of any approved TAC subsequent support hours.

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 the TAC information page.

What fees are payable for the Outreach Service?

Refer to the TAC Outreach Service fee schedule.

Fees for the assessment and initial support package is inclusive of all components of the service, including liaison with the client's treating team, administrative costs, and provider travel costs.

In relation to the 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 referred by an Outreach Service Provider without TAC prior approval
  • treatment or services not authorised by the TAC under the Transport Accident Act 1986
  • treatment or services subcontracted to, or provided by a non-registered provider
  • treatment or services provided concurrently with a Network Pain Management Program, unless exceptional circumstances apply
  • fees associated with cancellation or non-attendance
  • treatment or services provided outside the Commonwealth of Australia
  • treatment or services provided by telephone or other non face to face mediums as this is included in the TAC Outreach Service schedule of fees
  • 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.

Outreach Service

Current Fees (effective 1 November 2017)
Previous fees (up until 31 October 2017)

Effective 1 November 2017

Service DescriptionTAC item number1 November 2017
Maximum Payment Rate*
Outreach Service (per hour)ROS002$91.16

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.

Previous Fees - Up until 31 October 2017

Service DescriptionTAC item number1 July 2017 - 31 October 2017
Maximum Payment Rate*
2016/17 Maximum Payment Rate*
Outreach Service – Initial Package (Flat fee)ROS001$586.58$578.03
Outreach Service – Ongoing Services (per hour)ROS002$58.65$57.79

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 Outreach Services information sheet

Outreach Services information sheet

Summary:

This is the information sheet on the Outreach Service (OS) for health professionals. 

OS is a non-clinical, time-limited and recovery-orientated service for clients who are experiencing barriers to returning to work and/or returning to heath and/or independence.

The aim of the service is to provide individual solutions to help the individual overcome these barriers. It is a flexible, community based program tailored to each client's needs and circumstances.

View Outreach Services Plan form

Outreach Services Plan form

Summary:

The purpose of this form is to provide an assessment and progress report to the TAC in relation to the client being referred to an Outreach Service provider. 

The Outreach Service Plan is to be completed either prior to or at the completion of the initial approved 10 hours.
In the event that subsequent hours are approved a further Outreach Service Plan must be submitted prior to the completion of the approved hours. 

The Outreach Service Plan forms the basis of review outlining the progress the client has made by engaging with the service, however, it is expected that there will also be ongoing discussion between the Outreach Support Worker and TAC coordinator and/or clinician throughout the service provision engagement.

Summary:

These are the listings of Outreach Providers approved by the TAC. 

For further information please refer to the Outreach services policy.