Therapy Support Services

Policy

The TAC can pay the reasonable costs of therapy support services where 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 therapy support services to ensure that the treatment and services remain reasonable for the transport accident injury and are payable under the Act.

Background

Therapy support is a rehabilitation service that supports a client to participate in rehabilitation activities and achieve rehabilitation goal.

The TAC has developed the Clinical Framework for the Delivery of Health Services (Clinical Framework) to set out key principles for delivery of services to clients.

The Clinical Framework is based on the following principles:

• Measurement and demonstration of the effectiveness of treatment
• Adoption of a biopsychosocial approach
• Empowering the client to manage their injury
• Implementing goals focused on optimising function, participation and/or return to work/health
• Base treatment on best available research evidence.

The TAC expects that all health professionals providing services to clients integrate the principles of the Clinical Framework into their daily practice.

Further information about the Clinical Framework can be found at www.tac.vic.gov.au.

Guidelines

What can the TAC pay for in relation to therapy support services?

The TAC can pay the reasonable costs of therapy support services:

• required as a result of a transport accident injury
• requested and supervised by a client's treating occupational therapist, speech pathologist or physiotherapist
• that are reasonable, necessary or appropriate in the circumstances
• where safe and effective
• in accordance with the TAC's policies

Who may provide therapy support services?

Therapy support services may be provided by:

• An Allied Health Assistant who satisfies the TAC Authorised Service Provider Eligibility Criteria (Rehabilitation and Disability); or
• An attendant carer who is employed by an attendant care agency registered by the TAC to provide attendant care services to clients.

What information does the TAC require to consider paying for therapy support services?

For clients with a 'severe injury' therapy support services will be approved as part of the independence planning process between the client, their treater and the TAC coordinator.

For all other clients, the TAC requires a request submitted by an occupational therapist, speech pathologist or physiotherapist. The request must include:

• reasons why the client cannot complete an independent rehabilitation program
• which exercises the client needs assistance to perform
• goals of the rehabilitation program
• measurable outcomes of the program, including smart goals
• timelines to achieve the measurable outcomes
• details of the supervising therapist, and how they will provide supervision and direction to the provider of therapy support
• other recommended strategies to increase independence, such as a graded activity plan, equipment, alternative techniques for task performance, etc.
• details of the therapy support provider's experience in occupational therapy, speech pathology or physiotherapy. 

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? 

Please refer to the How to Invoice the TAC information page. 

What fees are payable for therapy support services?

Please refer to the therapy support provided by an allied health assistant fee schedule and therapy support provided by an attendant carer fee schedule.

In relation to therapy support 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 in line with the Clinical Framework
• the cost of travel for an Allied Health Assistant to provide therapy support
• 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
• 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
• telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
• provided more than once on the same day to the same client
• treatment, services, prostheses or equipment where there is no National Health and Medical Research Council level 1 or level 2 evidence that the treatment, service, prostheses or equipment is safe and effective. Refer to the Non-Established, New or Emerging Treatments and Services policy
• 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.