Post Acute Support for Accidents on or after 1 January 2005 policy

Policy

The TAC can pay the reasonable costs of post acute support for clients following discharge from hospital where required as a result of a transport accident injury under section 60 of the Transport Accident Act 1986 (the Act).

This policy may be read in conjunction with the following:

• Attendant Care policy
• Child Care Services for Accidents on or after 1 January 2005
• Home Services for Accidents on or after 1 January 200
• Nursing Services policy
• Therapy Support policy.

Definitions

In this policy:

• Post Acute Support is the provision of assistance to, or for, a person who requires support in personal care, mobility, transfers, banking or shopping tasks which clients would normally perform for themselves but are unable to carry out after being discharged from hospital as a result of a transport accident injury. Post acute support includes tasks such as:
  • showering, bathing, dressing and grooming
  • personal hygiene including bowel and bladder care
  • assistance eating and drinking
  • fitting and use of aids and appliances, hearing and communication devices
  • mobility and transfers
  • banking and shopping
• Approved Child Care - is care provided by a service that has been approved by the Australian Commonwealth Government. Most long day care, family day care, before and after school care, vacation care, some in home care and occasional care services offer Approved Child Care. Approved Child Care services pass the Child Care Benefit on to families as a reduction in their child care fees. Approved Child Care services provide services that meet industry standards for quality improvement and accreditation. These industry standards include having trained and/or supervised staff, a safe environment, child-centred programs and activities and formal communication processes for accidents, who can administer medication, and who can have access to the child.

Guidelines

What can the TAC pay for in relation to post acute support?

The TAC can pay the reasonable costs of post acute support:

• required as a result of a transport accident injury
• that are reasonable, necessary or appropriate in the circumstances
• for no more than a combined total of 40 hours inclusive of child care services, domestic services or home services 
• where safe and effective
• in accordance with the TAC's policies

The TAC can pay the reasonable costs of post acute support for a maximum of five years from the date of the client's transport accident unless the client has sustained a severe injury. For clients with a severe injury the TAC can pay the reasonable costs of post acute support outside of this initial five year period.

Grocery shopping home delivery
The TAC can pay the reasonable costs of grocery shopping home delivery, including delivery memberships, from Coles and Woolworths supermarkets where the client:

• cannot access the community independently due to their transport accident injuries, and
• did not pay for shopping home delivery prior to the transport accident.

Who may provide post acute support? 

Post acute support may be provided by:

• an attendant care agency that meets the registration requirements for attendant care agencies; or
• a provider of Approved Child Care, where appropriate.

What information does the TAC require to consider paying for post acute support? 

The TAC requires the client's discharging hospital to submit a request to the TAC outlining the support required by the client with self-care tasks and community activities of daily living post discharge and the projected period that the client will be unable to undertake these tasks.

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.

To assist the TAC to make a decision regarding a request for post acute support, a request may be reviewed by the TAC Clinical Panel. The Clinical Panel may contact the requesting medical practitioner to seek further information and/or discuss the proposed treatment prior to making a recommendation to the TAC regarding the request. The TAC will respond to the request when they have received the Clinical Panel's recommendation.

What are the TAC's invoice requirements?

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

What fees are payable for post acute support?

Please refer to the TAC Attendant Care and Child Care Services fee schedules.

In relation to post acute support, what won't the TAC pay for?

The TAC will not pay for:

• services for a person other than the client
• services not authorised by the TAC under the Transport Accident Act 1986
• services for a condition that existed before, developed after or that is not a direct result of the transport accident injury
• services subcontracted to, or provided by a non-registered provider
• fees associated with cancellation or non attendance
• services provided outside the Commonwealth of Australia 
• services provided by telephone or other non face to face mediums 
• services provided more than 5 years after the transport accident injury unless the client has a severe injury
• telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
• any costs of travel for the client or attendant care personnel, except to and from transport accident related medical services, authorised rehabilitation services, authorised disability services or for an eligible student to travel to/from school. See also the Travel and Accommodation Expenses policy.
• the cost of food or other items not related to the transport accident injuries
• fees for grocery shopping home delivery cancellation or non-delivery
• fees for grocery shopping home delivery that are not part of a grocery order
• in excess of one grocery shopping home delivery per week
• 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.