The TAC can pay the reasonable cost of Support Navigation services to assist TAC clients to achieve transport accident-related injury goals.

Support Navigation services assist clients who require additional support to coordinate and navigate service systems to get their Life Back on Track (LBoT). These services put the client at the centre of planning, focusing on their needs, motivations and participation goals.

Clients can access different levels of Support Navigation depending on their goals, the complexity of their support needs and the extent to which the TAC is liable for their supports:

Tier 1:

Case Management
Case Management is a time-limited service which assists clients with transport accident-related disability to engage and coordinate their supports or navigate service systems to achieve their transport accident-related injury goals.

Specialised Housing Case Management
Specialised Housing Case Management is a Case Management service for clients with transport accident-related disability which specialises in client housing needs.

Community Access Planning
Community Access Planning services support clients with transport accident-related disability to connect with meaningful community engagement and recreation opportunities.

Tier 2:

Assertive Outreach
Assertive Outreach is a specialised form of Case Management support for TAC clients with transport accident-related disability or injuries who are hard to reach, experiencing crisis or have disengaged from supports. The service supports clients with complex disability or psychosocial support needs through active and persistent measures to (re)engage with services and achieve transport accident injury goals.

Rehabilitation service
The term rehabilitation service refers to the provision to or for a person for the purpose of rehabilitation of any aid, treatment, counselling, appliance, apparatus or other service (other than a disability service or a hospital service), the provision of which is an authorised service in accordance with section 23 of the Transport Accident Act.

Disability service
The term disability service refers to the provision to or for a person who is disabled as a result of an injury in a transport accident of any service (other than a rehabilitation service or a hospital service) relating to attendant care, assistance, accommodation support, community access, respite care or household help, the provision of which service is an authorised service in accordance with section 23 of the Transport Accident Act

Disability
In the context of schedule 2 authorised disability services, the term disability in respect of a person, means a disability that is:

• Attributable to an intellectual, psychiatric, sensory, physical or neurological impairment or acquired brain injury or any combination of those impairments caused by injuries received in a transport accident; and
• Which is permanent or likely to be permanent, and which:
  • causes a substantially reduced capacity of the person for communication, learning or mobility in at least one of the areas of self-care or self-management; and
  • requires significant ongoing or long-term episodic support; and
  • is not related to ageing; or
  • a pre-existing intellectual disability; or
  • a pre-existing developmental delay; or
  • a pre-existing psychiatric illness/condition.

Clinical Framework

The TAC expects Support Navigation providers to integrate the principles of the Clinical Framework for the Delivery of Health Services (Clinical Framework) in their daily practice.

This includes:

• measuring and demonstrating the effectiveness of services
• adopting of a biopsychosocial approach
• empowering the client to manage their injury
• implementing goals focused on optimising function, participation and/or return to work/health
• basing services on best available research evidence.

Professional Standards

Standards set a guideline that govern the practice of Support Navigation:

• Skill
  Providers must only deliver Support Navigation in areas of specialisation, using existing networks, knowledge and proven best practice.
• Independence
  Providers should enable client self-determination, recognise the client’s individual rights, choices and decisions. Providers should not foster client dependence.
• Wellbeing
  Services should advance the client’s wellbeing and aim to strengthen the client’s support system. Services must be culturally safe and demonstrate respect for a diversity of identities and lived experiences.
• No harm
  Providers must do no harm intentionally and/or unintentionally. The TAC recognises a client’s vulnerability when providers hold the power to assess, plan, implement, coordinate, monitor and evaluate options and services.
• Dignity
  Providers must maintain the reasonable privacy and dignity of clients. This includes compliance with legislated obligations which protect personal and health information.
• Justice
  Providers hold a duty of care to treat the client and their support system fairly and without malice, bias or prejudice. Providers must make all efforts to ensure that they do not breach the human rights of clients.
• Truth
  Providers must be truthful, accountable and professional.

Concurrent Services

In general, the TAC does not pay for multiple Support Navigation services at the same time. This is because:

• the support provided by one provider may counteract or duplicate the support of another provider
• the client may receive conflicting advice

The TAC may consider paying for concurrent Support Navigation services in exceptional circumstances when it is justified and approved by the TAC as part of a coordinated support plan. When providing concurrent services, Support Navigation providers are expected to work in close communication to ensure that supports and goals are aligned.

Conflict of interest

Providers are expected to deliver services in line with the TAC’s policy on Funding Treatment by a Member of the Client's Immediate Family.

Under the Transport Accident Act 1986 (the Act), the TAC can pay for the reasonable cost of a range of specified types of services. This includes rehabilitation and disability services that have been authorised by the TAC to assist with the client's rehabilitation or to support and assist them with their disability. These services require written approval before they are provided. The services must be performed and received in Australia, meaning the client and the provider must be in Australia to be eligible.

Case Management, Community Access Planning and Multiple and Complex Needs Model services have been authorised by the TAC as disability services to support and assist a client with accident-related disability in circumstances where it is needed. For full details of the authorisation, please refer to Schedule 2 Authorised Disability Services which includes what supports can be provided and the criteria for who can perform them.

Assertive Outreach services have been authorised by the TAC as a Rehabilitation expense to facilitate transport accident-related injury goals in circumstances where it is needed. For full details of the authorisation, please refer to Schedule 1 Authorised Rehabilitation Services which includes what services can be provided and the criteria for who can perform them.

Case Management is a time-limited service which assists clients with disability to navigate their supports to achieve their transport accident-related injury goals.

Case Management services support clients to:

• plan and coordinate their transport accident injury supports, treatments and services
• navigate government and non-government systems
• prepare for events or crises which may impact service access and/or achievement of goals relating to transport accident-related injury.

Case Management can support clients to achieve a range of goals relating to their transport accident injuries, including:

• transitioning from a clinical or forensic environment into the community
• sourcing housing that is appropriate for the client’s injuries
• exploring opportunities for access and inclusion in the community
• engaging with guardianship and VCAT administration applications
• navigating non-TAC related legal matters that impact the client’s accident injury goals.

The Case Manager role includes:

• developing a service implementation plan aligned to the goals in the client’s TAC MyPlan
• supporting the client to navigate the service system or achieve outlined goals
• liaising with members of the client’s treatment and support teams to ensure alignment of treatment and supports
• identifying and managing client risk, including completion of needs and risk assessments
• completing and submitting progress and exit reports to the TAC
• developing and implementing plans for client transition out of or between Support Navigation services.

The TAC can pay for the reasonable cost of approved Case Management services for clients who, due to their transport accident-related disability, require additional support to coordinate their treatment and services or navigate systems. Prior written approval for Case Management services must be provided by the TAC before payment for services can be made.

The TAC will pay the reasonable cost of:

• face-to-face Case Management support
• Case Management support delivered via phone or videoconferencing (Telehealth) where appropriate
• Case Manager travel to engage with the client or their service providers
• completion of client progress, evaluation and exit reports requested by the TAC.

• Case Management activities performed by persons who do not meet the Provider Guideline requirements or comply with the TAC Support Navigation policy
• Case Management support that is not evidence based, reasonable, clinically justified and outcome focused
• Case Management services that do not relate to the client’s transport accident injury supports or achievement of goals that have been approved by the TAC
• Case Management support that exceeds a reasonable duration
• costs associated with referring a TAC client to a service provider not approved by the TAC
• multiple Support Navigation services at the same time, except when a specialised service (Specialised Housing Case Management or Community Access Planning) is used in conjunction with a generalist Case Management service. When providing concurrent services, Support Navigation providers are expected to work in close communication and aligned goals
• Case Managers acting in the capacity of guardian, administrator or legal power of attorney

The TAC will gather information from the client, their treating team, support providers and networks when developing a referral.

The referral will outline primary and secondary reasons for referral and any known client goals.

The TAC matches clients with providers based on expertise, experience and location.

In general, the TAC approves services for three months at a time and requires 3-montly progress reports. Extensions depend on client progress and need.

Service Standards:

It is expected that Case Management services:

• Incorporate person-centred, strength-based approaches
  Recognising the client as an expert in their own circumstances, client engagement should be maximised to ensure support is tailored to individual goals, strengths and interests.
• Promote client independence
  Case Managment services aim to build the client’s capacity to plan, coordinate and navigate systems to achieve future goals independently. Providers should avoid client dependence by performing activities on the client’s behalf only when necessary.

For clients who require significant assistance to manage their supports, the Case Manager may work towards empowering the client to lead the Case Management process in incremental stages. For example:

• First Phase – Do for
  The Case Manager contacts a support provider to discuss the client’s requirements.
• Second Phase – Do with
  Alongside the client, the Case Manager contacts the support provider to organise an appointment
• Third Phase – Do for themselves
  The client schedules their own appointment with support. Once the client has developed capacity to complete tasks independently, the Case Manager oversees transition of remaining support requirements to attendant care or the client’s natural supports.
• Are goal-oriented and time-limited
  Case Management services should be used as a point-in-time intervention to assist in the achievement of a specific goal(s) approved by the TAC. It is expected that providers plan for clients to be transitioned off Case Management supports as approved goals are achieved. While service duration will vary, the TAC expects that most clients will transition out of Case Management within 12 months.

Some clients may require multiple periods of Case Management support across their lifetime due to the complexity of their injuries. It is expected that support hours are tailored to reflect periods of stability and instability. The TAC does not consider ongoing, continuous Case Management with consistent support hours to be reasonable in most circumstances.

• Engage the client’s support system
  Where appropriate, providers should work with the client’s formal supports (such as attendant carers) and natural supports (such as family and friends) to develop sustainable strategies for supporting the client. This should include building the skills of the client’s support network to maintain structures established by the Case Manager upon client transition and exit.
• Develop and implement transition plans
  Providers are expected to develop robust plans to support client transition out of Case Management services. It is expected that the transition plan is shared with the TAC and relevant members of the client’s support network to ensure ongoing stability.
• Be delivered in an appropriate format by providers with necessary skills and specialised knowledge

The TAC recognises that providers who specialise in a specific area are more likely to achieve positive client outcomes. Providers are expected to:

• be equipped with specialised skills and knowledge directly related to client goals, including knowledge of the service systems in the client’s local area where required
• only take on client referrals that align with their recognised area of expertise
• deliver services face-to-face, using Telehealth only where necessary.

Registration

All case management providers must meet and maintain the TAC’s disability service provider registration requirements in order to deliver services to a client with a disability.

• delivers safe and high-quality services
• employs staff with relevant qualifications, skills and experience.

Qualifications

Case Managers must be qualified and experienced in delivering Case Management. Minimum qualifications are required to be at a diploma level and can include social work, community service work, disability work, allied health or nursing.

Safeguarding

TAC Safer Services Support provides TAC clients and the community a pathway to raise concerns or complaints about the quality and safety of TAC funded services.

Reporting

Progress reports:
Providers are required to complete 3-monthly progress reports updating the TAC on the client’s progress. Reports will identify and record progress toward TAC approved client goals which are specific, measurable, achievable, realistic and timely (SMART).

When making decisions about funding for further support, the TAC considers whether the progress report demonstrates evidence that the support is reasonable, clinically justified and outcome focused.

Exit Reports:

The Case Manager must submit an Exit Report to the TAC upon conclusion of the service.

The Exit Report must include a summary of supports provided, the outcomes of the service, key areas of support moving forward, risk management information and how support roles have been handed over to key stakeholders (natural supports, attendant care providers, community access providers or other services).

The TAC uses the following principles to aid socially and economically responsible decision-making in line with the Transport Accident Act 1986:

1. Entitled:

The TAC client is entitled to Case Management if:

• the TAC has accepted liability for transport accident-related disability associated with the Case Management support
• the client is not able to coordinate their services or navigate systems to achieve transport accident-related injury goals.

When determining whether Case Management is a reasonable cost in the circumstances, the TAC considers:

• if the Case Management service is necessary because:
  • the client is unable to achieve their transport accident-related injury goals independently
  • the client’s natural support system (family, friends) is unable or does not have the skills to support the client to achieve their goals
  • the supports cannot be provided by an attendant carer.
• If the cost of the service is reasonable in relation to the service (see the Case Management Fee Schedule).

3. Clinical Justification:

When deciding if Case Management is clinically justified, the TAC considers whether:

• the support is recommended by the client’s treating team (e.g. General Practitioner, occupational therapist or psychologist) or is necessary to connect the client with services.
• the requested hours of support and duration of support are appropriate for the client’s condition and transport accident-related injury goals. While support duration may vary depending on client need, the TAC expects that most clients will not require Case Management for longer than 12 months.

When considering requests for additional support hours, the TAC considers whether reports provided to the TAC contain evidence that the:

• effectiveness of the support has been measured
• support provider has adopted a biopsychosocial approach
• provider has taken steps to build client independence and self-management
• support aligns with client goals
• support is based on best available research and evidence, including through compliance with the Case Management Service Standards.

When deciding if Case Management is outcome focused, the TAC considers whether:

• the service is progressing or achieving the referral goals
• the service promotes self-management and independence
• the support approach is adapted to the client’s progress, including tapering of services as the client’s situation stabilises.

Assertive Outreach is a non-clinical crisis support for clients with psychosocial or complex transport accident injury-related needs who require proactive support to (re)engage with services to achieve their transport accident injury goals.

Assertive Outreach is a specialised form of Case Management which supports clients with more complex support needs to overcome a range of barriers caused by their transport accident injuries, including:

• significant mental injury
• drug and/or alcohol dependency
• homelessness
• interactions with the justice system
• behaviours of concern
• breakdown of TAC-funded supports or services.

The Assertive Outreach role can include:

• assessing and managing client risk, including completion of needs and risk assessments
• initiating and building client engagement with the TAC and a treating team, ensuring alignment of treatment and supports
• developing service implementation plans
• supporting the client to overcome barriers to service access or achievement of transport accident injury-related goals
• engaging with guardianship and VCAT administration applications
• navigating non-TAC related legal matters that impact the client’s accident injury goals.
• completing and submitting progress and exit reports to the TAC
• developing and implementing plans for client transition out of or between Case Management services.

The TAC can pay for the reasonable cost of approved Assertive Outreach provided to TAC clients who, due to their transport accident-related injuries, require intensive and assertive support to (re)engage or coordinate services. Prior written approval from the TAC for Assertive Outreach must be provided by the TAC before payment for services can be made.

The TAC will pay the reasonable cost of:

• Assertive Outreach services delivered face-to-face
• Assertive Outreach services delivered via phone or video-conferencing (Telehealth) where appropriate
• completion of client progress reports requested by the TAC.

The TAC will not pay the reasonable cost of:

• Assertive Outreach services provided by persons who do not meet the Provider Guidelines or comply with the TAC Support Navigation policy
• Assertive Outreach support that does not relate to the client’s transport accident injury supports or goals
• Assertive Outreach support that is not evidence based, reasonable, clinically justified and outcome focused
• Assertive Outreach support that exceeds a reasonable duration
• support for client goals that have not been approved by the TAC
• costs associated with referring a TAC client to a service not approved by the TAC Claim Manager
• Assertive Outreach if the client is already accessing a generalised case management service at the same time. When providing concurrent services, Support Navigation providers are expected to work in close communication.

The TAC will gather information from the client, their treating team, support providers and networks when developing a referral.

The referral will outline primary and secondary reasons for referral and any known client goals.

The TAC matches clients with providers based on expertise, experience and location.

In general, the TAC approves services for three months at a time and requires 3-montly progress reports. Extensions depend on client progress and need.

Service Standards:

It is expected that Assertive Outreach providers:

• Incorporate person-centred, strength-based approaches
  Recognising the client as an expert in their own circumstances, client engagement should be maximised to ensure support is tailored to individual goals, strengths and interests.
• Promote client independence
  Assertive Outreach aims to build the client’s capacity to plan, coordinate and navigate systems to achieve future goals independently. Providers should avoid client dependence by performing activities on the client’s behalf only when necessary.
  
  For clients who require significant support, the Assertive Outreach provider may work towards empowering the client to lead the support process in incremental stages:
  • First Phase – Do for
    The Assertive Outreach worker contacts a support provider to discuss the client’s requirements.
  • Second Phase – Do with
    Alongside the client, the Assertive Outreach worker contacts the support provider to organise an appointment
  • Third Phase – Do for themself
    The client schedules their own appointment with support. Once the client has developed capacity to complete tasks independently, the Assertive Outreach worker oversees transition of remaining support requirements to attendant care or the client’s natural supports.
• Be goal-oriented and time-limited
  Assertive Outreach is a point-in-time intervention to assist in the achievement of a specific goal(s) during a period of crisis or disengagement. It is expected that providers plan for clients to be transitioned out of Assertive Outreach as goals are achieved. While service duration will vary, the TAC expects that most clients will transition out of Assertive Outreach within 12 months.
  
  Some clients may require multiple periods of Assertive or General Case Management support across their lifetime due to the complexity of their injuries. It is expected that clients are transitioned from Assertive Outreach to Case Management if their situation significantly stabilises, but they still require case management support. Support hours should be tailored to reflect periods of stability and instability.

In most circumstances, The TAC does not consider ongoing, continuous Assertive Outreach with consistent support hours to be reasonable.

• Engage the client’s support network
  Where appropriate, providers should work with the client’s formal supports (such as attendant carers) and natural supports (such as family and friends) to develop sustainable strategies for supporting the client. This should include building the skills of the client’s support network to maintain structures established by the Assertive Outreach worker upon client transition and exit.
• Develop and implement transition plans
  Providers are expected to develop robust plans to support client transition out of Assertive Outreach services. It is expected that the transition plan is shared with the TAC and relevant members of the client’s support network to ensure ongoing stability.
• Be delivered in an appropriate format by providers with necessary skills and specialised knowledge
  The TAC recognises that providers who specialise in a specific area are more likely to achieve positive client outcomes. Providers are expected to:
  • be equipped with specialised skills and knowledge directly related to client goals, including knowledge of the service systems in the client’s local area where required
  • only take on client referrals that align with their recognised area of expertise
  • deliver services face-to-face, using telehealth only where necessary.

Registration

• employs staff with relevant qualifications, skills and experience
• delivers safe and high-quality services.

Qualifications

Assertive Outreach workers must be qualified and experienced in working with clients with complex needs, including service breakdowns, behaviours of concern, or crisis events.

Safeguarding

TAC Safer Services Support provides TAC clients and the community a pathway to raise concerns or complaints about the quality and safety of TAC funded services.

Reporting

Progress reports:
Providers are required to complete 3-monthly progress reports updating the TAC on the client’s progress. Reports will identify and record progress toward TAC approved client goals which are specific, measurable, achievable, realistic, and timely (SMART).

When making decisions about funding for further support, the TAC considers whether the progress report demonstrates evidence that the support is reasonable, clinically justified and outcome focused.

Exit Reports:

The Assertive Outreach worker must submit a Exit Report to the TAC upon conclusion of the service.

The Exit Report must include a summary of supports provided, the outcomes of the service, key areas of support moving forward, risk management information and how support roles have been handed over to key stakeholders (natural supports, attendant care providers, community access providers or other services).

The TAC uses the following principles to aid socially and economically responsible decision-making in line with the Transport Accident Act 1986:

1. Entitled:

A client is entitled to Assertive Outreach if:

• the TAC has accepted liability for the accident-related injury or disability that relates to the Assertive Outreach service
• the client requires intensive and assertive support to (re)engage with services or manage during a crisis to overcome barriers to achieving their transport accident injury goals.

2. Reasonable:

When determining whether Assertive Outreach services are a reasonable cost in the circumstances, the TAC considers:

• if the Assertive Outreach service is necessary because:
  • The client is unable to achieve their transport accident injury goals independently
  • The client’s natural support system (family, friends) is unable or does not have the skills to support the client to achieve their goals
  • The supports cannot be provided by an attendant carer.
• If the cost of the service is reasonable in relation to the service (see the Assertive Outreach Fee Schedule).

3. Clinical Justification:

When deciding if Assertive Outreach is clinically justified, the TAC considers whether:

• The support is recommended by the client’s treating team (e.g. General Practitioner, occupational therapist or psychologist) or is necessary to connect the client with clinical services.
• The requested hours of support and duration of support are appropriate for the client’s condition and transport accident injury goals. While support duration may vary depending on client need, the TAC expects that most clients will not require Assertive Outreach for longer than 12 months.

When considering requests for additional support hours, the TAC considers whether reports provided to the TAC contain evidence that:

• The effectiveness of the support has been measured and demonstrated
• The support provider has adopted a biopsychosocial approach
• The provider has taken steps to build client independence and self-management
• The support aligns with client goals
• The support is based on best available research and evidence, including through compliance with the Assertive Outreach Service Standards.

4. Outcome Focused:

When deciding if Assertive Outreach is outcome focused, the TAC considers whether:

• The service is progressing or achieving the referral goals
• The service promotes self-management and independence
• The support approach is adapted to the client’s progress, including tapering of services as the client’s situation stabilises.

Community Access Planning services support clients with disability to build their independence and develop support networks by connecting them with meaningful community engagement and recreation opportunities. Community Access Planning is often delivered by recreational specialists.

Community Access Planning supports may include:

• identifying client recreation goals and interests
• assessing client support needs to enable participation in community-based recreation activities
• linking clients into mainstream recreation activities or supported community access services such as Community Group Programs
• monitoring client participation in community activities to ensure program suitability
• planning and coordinating logistics, supports and costs for holidays alongside clients and their support networks.

The TAC can pay for the reasonable cost of approved Community Access Planning services provided to TAC clients who, due to their transport accident-related disability, require short term support to identify, coordinate and connect with community engagement or recreational opportunities. Prior written approval for Community Access Planning services must be provided by the TAC before payment for services can be made.

The TAC will pay the reasonable cost of Community Access Planning services including:

• assessment of client needs and goals in collaboration with relevant treaters, such as occupational therapists
• development and implementation of Community Access Plans
• the reasonable cost of necessary provider travel
• completion of client progress reports requested by the TAC.

• Community Access Planning for clients who do not meet eligibility requirements
• services provided by persons who do not meet Community Access Planning Provider Guidelines
• services that exceed a reasonable duration
• client goals that have not been approved by the TAC
• activity costs associated with participation in recreational activities such as entry fees, materials or activity equipment
• holiday expenses which are not directly related to the client’s transport accident-related support needs, such as flights, accommodation, food and entertainment.

The TAC requires an initial request for a Community Access Planning services in writing from the client or the client’s family, treater or support provider.

If the client is entitled to the service and the support is reasonable, clinically justified and outcome focused, the TAC will approve the service. Once approved, the Community Access Planning provider must complete the Community Access Plan: Initial Plan and Request for Funding form before the start date of the requested program.

The TAC may request written client progress reports to monitor client progress toward approved goals.

Service Standards

It is expected that Community Access Planning services:

• Incorporate person-centred, strength-based approaches
  Recognising that the participant is the expert in their own circumstances, client engagement should be maximised to ensure support is tailored to individual goals, strengths and interests.
• Promote client independence
  Community Access Planning should aim to build the client’s capacity to plan, coordinate and engage recreation opportunities independently where possible. Providers should avoid client dependence by performing activities on the client’s behalf only when necessary. For clients who require significant support, the Community Access Planners may work towards empowering the client to lead in incremental stages:
  • First Phase – Do for
    In isolation from the client, the planner contacts recreation service providers to discuss the client’s requirements.
  • Second Phase – Do with
    In the presence of the client, the Community Access Planners contacts the service to organise the client’s participation.
  • Third Phase – Do for themself
    The client identifies and engages a recreation opportunity with support. Once the client has developed capacity to complete tasks independently, the Community Access Planner oversees transition of remaining support requirements to attendant care or the client’s natural supports.
• Are goal-oriented and time-limited
  Community Access Planning is a point-in-time intervention to assist in the achievement of recreation or community participation goals. It is expected that providers plan for clients to be transitioned out of the support as goals are achieved. While service duration will vary, the TAC expects that in most cases, Community Access Planning services will not exceed 6 months.
• Are delivered in an appropriate format by providers with necessary skills and specialised knowledge

Providers are expected to:

• be equipped with specialised skills and knowledge directly related to client goals
• deliver services face-to-face.

Registration

Qualifications

Providers of Community Access Planning must have:

• a minimum Certificate IV in either Disability or Recreation Studies
• at least three years of relevant experience in working with people with disability.

Safeguarding

TAC Safer Services Support provides TAC clients and the community a pathway to raise concerns or complaints about the quality and safety of TAC funded services.

Reporting

Approved Community Access Planning providers must complete the Community Access Plan: Initial Plan and Request for Funding form before the start date of the requested program.

The TAC may request written client progress reports to monitor client progress toward approved goals.

1. Entitled:

A client is entitled to Community Access Planning if:

• the TAC has accepted liability for the accident-related disability that relates to the Community Access Planning service
• The client requires short term support to identify, coordinate and connect with community engagement or recreational opportunities.

2. Reasonable:

When determining whether Community Access Planning services are reasonable in the circumstances, the TAC considers several factors, including:

• if the service is necessary because:
  • the client is unable to independently identify, plan and connect with recreation opportunities
  • the client’s natural support system (family, friends) is unable to support the client to achieve their community access goals
  • the support cannot be provided by an attendant carer.
• If the cost of the service is reasonable in relation to the Community Access Planners fee schedule.

3. Clinical Justification:

When deciding if Community Access Planning is clinically justified, the TAC considers whether:

• the support is recommended by the client’s treating team (e.g. General Practitioner, occupational therapist or psychologist)
• the requested hours of support are appropriate for the client’s condition and transport accident-related injury goals. In general, the TAC expects that most clients will not require Community Access Planning for longer than 6 months.

When considering requests for additional support hours, the TAC considers whether:

• the effectiveness of the support has been measured
• the support provider has adopted a biopsychosocial approach
• the provider has taken steps to build client independence and self-management
• the support aligns with client goals
• the support is based on best available research and evidence, including through compliance with the Community Access Planning Service Standards.

4. Outcome Focused:

When deciding if Community Access Planning services are outcome focused, the TAC considers whether:

• the service is progressing or achieving the referral goals
• the service promotes self-management and independence
• the support approach is adapted to the client’s progress, including tapering of services as the client develops skills to access the community independently.