The TAC can help pay for supported accommodation when a client has:
- sustained a transport accident injury which precludes them from returning to their pre-accident accommodation; and
- been assessed by an appropriate therapist and/or multidisciplinary team as requiring supported accommodation services or by an Aged Care Assessment Team (ACAT) as requiring care and supported accommodation in a Residential Aged Care Facility.
We can help pay the reasonable costs of supported accommodation services under section 60 of the Transport Accident Act 1986 (the Act) where the client requires residence in a supported accommodation facility on a permanent or semi-permanent basis in order to meet their care and support needs as a result of a transport accident injury.
We will periodically review a client's entitlement to supported accommodation to ensure that the level of support and services remain reasonable for the transport accident injury and remains payable under the Act.
Supported accommodation services
Supported accommodation is a model of care that responds to the needs of clients who have multiple physical, sensory and/or cognitive disabilities arising from their transport accident injury which impacts significantly on their capacity for independent living. The care provided may relate to physical assistance and/or support required to address cognitive and psychological issues.
The types of supported accommodation used by the TAC are:
- Shared Supported Accommodation (SSA),
- Supported Residential Services (SRS), and
- Residential Aged Care (RAC)
The TAC can help pay for supported accommodation services where the services:
- are identified as being the most appropriate and enabling response to a client's clinically justified care and support needs,
- optimise functional independence and actively support the client to achieve their independence goals (see information on the Independence model),
- have the required registration/accreditation appropriate for that type of supported accommodation setting, and
- are delivered using a client centred approach.
Supported accommodation services may provide personal care, domestic support, community access, supervision, nursing care, or a combination of all of these.
Supported accommodation facilities should offer:
- a separate bedroom of adequate size to accommodate a resident’s personal belongings;
- a 'home-like' environment with furnishings;
- standard equipment appropriate to the client's care and support needs;
- varied meal choices with high nutritional value;
- appropriate staffing to meet all support needs of the client;
- supervision and/or support relevant to the needs of the client; and
- accommodation that is safe, clean, hygienic and kept in good repair.
The accommodation service should endeavour to maximise a client's personal dignity, privacy, choice and control, independence, functional skills and capabilities and should encourage and facilitate the resident's participation in their chosen social and community activities and/or valued social roles.
The choice and location of a supported accommodation facility is made by the client; however, the supported accommodation setting must have the required registration/accreditation appropriate to the setting type in order to be funded by the TAC. The client can consult with their representative or advocate (if applicable), their treating team, their TAC coordinator, supported accommodation service providers and Aged Care Assessment Team (ACAT) (if required) in making their decision. See also the Client Information sheet Choosing a supported accommodation service.
We can consider engaging a TAC-approved case manager to facilitate admission into a supported accommodation facility in circumstances where a client requires additional support to source and choose a supported accommodation facility.
In these guidelines:
- Supported Accommodation refers to the following accommodation facility options available:
- Shared Supported Accommodation (SSA)
- Supported Residential Services (SRS) within the meaning of section 5 of the Supported Residential Services (Private Proprietors) Act 2010
- Residential Aged Care (RAC)
- Shared Supported Accommodation (SSA) facilities provide care and support for people with disabilities. They are shared houses with paid carers that provide support with personal care, medication, behavioural management (if required) and enabling of client participation in day to day activities and household tasks. Support is provided within a shared care model across a 24-hour period, 7 days a week.
- Supported Residential Services (SRS) facilities are private businesses that provide accommodation and support with personal care and everyday activities for people who do not demonstrate the ability to return to living independently. SRS facilities vary in the services they provide, the people they accommodate and the fees they charge. Services may include support with personal care (e.g. showering, dressing), domestic activities of daily living (e.g. preparation of meals, laundry) and community activities of daily living as well as physical and emotional support.
These facilities must be registered with the Victorian Department of Families, Fairness & Housing (DFFH) as a SRS and remain compliant with the criteria and quality standards for registration.
- Residential Aged Care (RAC) facilities provide care and support services to people who are no longer able to care for themselves or be cared for by others in their own homes. Other than in exceptional circumstances, RAC facilities are usually only suitable for people aged 65 or over. Care is provided under the Commonwealth Aged Care Act 1997 and facilities must be accredited by the Australian Government’s Aged Care Quality and Safety Commission as a residential aged care provider.
- Daily Living Expenses (DLE) are a client's expenses associated with accommodation, such as food and household items, power, water and other utility services, and room temperature control expenses that are incurred when living in a supported accommodation facility. The DLE is a capped amount a client can be charged per day as a contribution towards their daily living expenses when residing within an SSA, SRS or RAC.
Shared Supported Accommodation (SSA)
What we can pay for in relation to SSA
|Fees that can be paid by the TAC for SSA||Fees payable by the client for SSA|
The Daily Support Fee
The TAC can pay a Daily Support Fee (previously referred to as Daily Bed Fee) for a TAC client living in a SSA setting. This fee covers the provision of assistance and/or supervision with daily tasks within the shared support model. Shared support is where support and/or supervision is able to be safely provided to a number of residents at the same time, either individually or in a small group, where a client can be safely left during an activity to enable a support worker to attend to another client.
The shared support is provided to each client living in the SSA in accordance with their individual needs, with the staffing for support provision being available over a 24-hour period. Support provided must be person centred, focussing on maximising the client’s capacity to be as independent as possible and enabling engagement in valued life roles wherever possible.
The Daily Support Fee (DSF) rate has been calculated based upon a staffing roster allowing 20 hours daytime support provision (includes 4 extra hours per day to account for busy times) and 8 hours of inactive (sleepover) overnight care. Note that the inactive overnight shift is inclusive of 1 hour of active support, in line with the TAC Attendant care policy. Fee modelling has used the current TAC Attendant Care (IRQS) hourly rates, factoring in weekend and public holiday rates. For the current Daily Support Fee rate please refer to the Shared Supported Accommodation fees.
Determining what support is necessary and can be reasonably provided to a TAC client by the shared care model of an SSA property is based upon consideration of:
- a client’s individual needs and goals
- recommendations made by the appropriate TAC funded health professionals
- the TAC’s determination of reasonableness
- the sharing of support between residents to maximise the efficient use of resources, and ensuring the smooth operation of the household
What is included under the Daily Support Fee?
Active support provision which the TAC expects to be provided under the 24 hour shared support model (and therefore included in the Daily Support Fee) includes (but is not limited to):
- Assistance, supervision or prompting with personal care tasks, showering, bathing, dressing, grooming
- Toileting, bladder and bowel care.
- Maintenance exercise programs, such as daily stretches, walking program (as prescribed by the recommending health professional).
- Assistance or supervision with meals/feeding/PEG feeds
- Actively engaging clients in day to day household activities such as meal preparation and cooking, cleaning, laundry activities, routine development.
- Enabling client participation and inclusion in structured or ad hoc meaningful activities within the home
- Assisting clients with planning and organising of activities and appointments, including attending telehealth appointments
- Implementing and adhering to behavioural support strategies with clients (as directed by the recommending health professional)
- Monitoring and administering medication.
- Support with supervision, prompting, safety and security
- Fitting and using aids, orthotics and appliances, hearing and communication devices
- 8 hour sleepover shift where the support worker can sleep, but is available to respond to client’s personal support needs if required, for example assistance with toileting. Sleepover shifts includes one hour of active support, measured in 2 x 30 minute increments.
Individual Attendant Care
The TAC may consider paying for Attendant Care support when it cannot be safely provided within the shared support model, in line with clinical recommendations by a health professional. Examples of these situations may include:
- when a client cannot safely be left unsupported for the completion of a task or activity
- when a staffing ratio of higher than 1:1 is required for a set period of time for the safe completion of a task
- where a task or activity consistently requires a support worker for an extended duration, or is of high frequency
- unplanned support requirements (for example client illness resulting in increased support needs for a limited duration, unplanned medical appointments)
Attendant care must be considered reasonable, be clinically justified in writing by the appropriate TAC funded health professional, and be approved by the client’s TAC coordinator. Approval will be for a time-limited period only, following which a further request for appropriate clinical justification may be required by the TAC. The TAC may request copies of staffing rosters from the SSA support provider in order to understand where the support needs are not able to be met under the shared care model.
What is not included in the Daily Support Fee?
Support provision not included in the Daily Support Fee (therefore able to be requested and billed as attendant care) are the following:
- TAC approved planned community access activities that require a staff member to accompany a client to an offsite activity or planned appointment
- Note: A client should be encouraged to exercise choice in their selection of a Disability Support Provider other than the provider staffing the SSA for their community access.
- Attending a planned medical appointment.
- Note: It is the TAC coordinator’s decision whether attendance with a client is paid for under the client’s approved Community Access attendant care hours, or paid for in addition to regular Community Access hours. Factors such as the type of appointment, reason for appointment and time frame required for attendance are considered. A client may choose to be accompanied by a support worker who provides the in-home SSA support to accompany them to certain appointments, as they may be able to provide support and knowledge of the client’s current health and functional status.
- Therapy Support where the client is assisted to actively participate in goal directed home or community based rehabilitation activities where support is needed to achieve specific goals and outcomes. Therapy support is documented in the client’s Support plan, and will be revised as required by a treating health professional.
- TAC approved active overnight support where the support worker stays awake and works with the client on planned or scheduled activities. Examples of activities considered to be active support include:
- Assistance with personal care such as toileting and continence management
- Medication and pain management
- Managing spasms, turning, repositioning
- Assisting clients with medical needs requiring frequent attention
- Activities to reduce behaviours of concern, including implementing strategies identified in a client’s behaviour support plan
If a client unexpectedly requires more than one hour of active support during a sleepover shift, the additional active support hours will be paid at the appropriate hourly attendant care rate. If the support worker performs more than 4 hours of active support during the sleepover shift the entire 8 hour shift will be paid at the appropriate attendant care rate.
The TAC may request supporting documents from service providers, such as duty logs, which demonstrate the time and tasks undertaken during active support hours. For further information on Overnight Support please refer to the TAC Attendant care provider guidelines.
New client entries into SSAs will require their holistic support needs to be reviewed for changes once the client has settled into their new home environment. The TAC will arrange an assessment by the appropriate health professional to help determine the level of support required by the client, ideally within 3 months of entering the SSA.
Other fees the TAC can pay for clients living in SSA
- Daily Living Expenses (DLE) are a client's usual living expenses associated with accommodation including food and household items, power, water and other utility services. DLE is paid in full by the TAC for the first 18 months post client discharge from hospital. After 18 months post hospital discharge the client is expected to pay the DLE up to $37.70 per day which is indexed annually. The TAC may consider paying the SSA support provider the reasonable costs of any daily living expenses above the client’s capped contribution amount (a gap payment).
- Holding Fee. The TAC will pay a Holding Fee in place of the Daily Support Fee when a client is on planned leave. Planned leave means a period during which a client will not be living at a Residence and the Provider has been given at least 10 business days notice of the leave. It includes leave such as planned hospital admissions, holidays and leave over holiday periods (i.e. Christmas). Daily Living Expense contribution will not be paid by the TAC where a client is on planned leave and a holding fee is being paid.
- Program Establishment Fee. The TAC will pay this fee to service providers when establishing a support program for a new client. The funds assist in the recruitment and induction of support workers to their employer, as well as the development of care plans and rosters. The Program Establishment Fee does not include client specific training.
- TAC client death. The TAC will pay the Daily Support Fee for two weeks after a TAC client's death. The TAC does not pay a Daily Living Expenses contribution or any other Attendant Care hours provided in addition to the Daily Support Fee following a client’s death. The provider must notify us as soon as possible via the Serious Incident Reporting portal.
- Staff Training. The TAC can help pay the reasonable costs for an allied health or other medical professional to provide client specific training to SSA support workers if a client requires tailored support. The SSA provider is responsible for SSA staff to be trained according to the minimum requirements under IRQS registration.
For full guidance on TAC funded staff training for support workers, please see the TAC Attendant care provider guidelines.
Who can provide SSA?
SSA support providers are required to be registered as an SSA provider with the TAC in order to support TAC clients in shared supported accommodation settings.
If not already SSA registered with the TAC, an SSA provider must meet the registration criteria and agree to become SSA registered before a client takes up residency. There is a service specification of expected support provision standards, as well as standards for the property in which the support is taking place. This information is available on the TAC website at Registration for Shared Supported Accommodation.
Information we need to consider paying for SSA
Approval in writing is required for all clients. We require an initial request for SSA services from the client or the client's family, treating medical practitioner or health professional.
We may request completion of one of the following reports from an appropriately qualified health professional/treating team before deciding whether to pay for SSA services for a client:
- Transition allied health and support plan
- Occupational therapy review of capabilities
- Occupational therapy supported accommodation review of capabilities
Letters of recommendation from relevant treaters will also be considered.
Supported Residential Services (SRS)
What we can pay for in relation to SRS
We can help pay the reasonable costs of support in SRS accommodation when the client’s need to live in this type of supported accommodation is related to a transport accident.
|Fees that can be paid by the TAC for SRS|
Fees payable by the client in an SRS
The daily or weekly fee is determined by the SRS provider, but must be approved in writing by the TAC before the client takes up residence. The TAC may accept full or partial liability for the SRS fees.
Individual attendant care. We will consider paying for additional attendant care to supplement what the SRS provides under their fee, where clinically justified and considered reasonable by the TAC.
Daily Living Expenses (DLE). The SRS fee includes the DLE component associated with accommodation including rent, food and household items, power, water and other utility services. The client will be required to pay a $37.70 per day contribution towards their DLE from 18 months post hospital discharge. The client’s DLE contribution is Indexed by CPI each July.
Equipment. The TAC will consider paying for specific equipment in a SRS for use by a particular client with the consent of the owner of the facility.
Who can provide SRS?
SRSs are privately operated businesses that provide accommodation and support for residents. Each SRS determines the services it offers and its fee structure. For the TAC to consider paying for a client’s support within an SRS, the SRS setting must be registered with the Department of Families, Fairness & Housing (DFFH) and comply with the Supported Residential Services (Private Proprietors) Act 2010 and its regulations.
A current list of registered SRS providers is available on the Supported Residential Services page on the DFFH website.
Information we need to consider paying for SRS
Approval in writing is required for all clients before they reside in a SRS. We require an initial request for supported residential services from the client or the client's family/advocate, treating medical practitioner or health professional.
We may request completion of one of the following reports from an appropriately qualified therapist/treating team before deciding whether to pay for SRS:
- Transition allied health and support plan
- Occupational therapy review of capabilities
- Occupational therapy supported accommodation review of capabilities
Letters of recommendation from relevant treating providers will also be considered.
We will ask the proposed SRS provider for information about their services and fees before deciding whether the service can be approved for the client. The Supported Residential Services (Private Providers) Act 2010 requires a SRS provider to enter into a written residential and services agreement with a resident about the items, services and fees applicable to the SRS. A copy of this agreement must be provided to the TAC.
Residential Aged Care (RAC)
Who can provide RAC?
For the TAC to consider paying towards cost of a RAC for a client, the RAC provider must be approved by the Commonwealth Government under the Aged Care Quality and Safety Commission Act 2018 to provide services under the Aged Care Act 1997.
A client must be assessed by an Aged Care Assessment Service (ACAS) as eligible to receive that type of care for the approved provider to be eligible to receive subsidies.
Information we need to consider paying for RAC
We require an initial request for RAC from the client or the client's family/advocate, treating medical practitioner or health professional.
We require a completed:
- ACAS assessment before a client can enter RAC; and
- A letter of fee determination from the Commonwealth Government which includes an Aged Care Funding Instrument (ACFI) subsidy calculation
If a TAC client is required to complete a means assessment before entering a RAC, this form should be returned by the client to Services Australia (previously known as Centrelink) or the Department of Veterans Affairs (DVA), whichever is applicable to the TAC client. This form does not need to be provided to the TAC. This information is used by the government to calculate the correct ACFI subsidy rate, which covers a client’s direct support needs.
Fees payable for RAC
We can help pay the reasonable costs of a client's Residential Aged Care (RAC) accommodation if this need is related to the client’s transport accident. The fees and subsidies will be paid directly to the facility by the TAC if it has accepted liability for the client's care and support at a RAC facility. The TAC may accept part or full liability for a client’s RAC fees.
The TAC will pay RAC fees and supplements at the rates determined by the Commonwealth Government. The TAC does not have control over the calculation of the fees or subsidies for clients in RAC facilities.
|Fees that can be paid by the TAC for RAC||Fees payable by the client for RAC|
The Basic Daily Fee must, at a minimum, cover the provision of services listed in part 1 and part 2 of Schedule 1 of the Quality of Care Principles 2014. The TAC will pay the entire Basic Daily Fee for the first 18 months after a client is discharged from hospital post-accident.
After 18 months the client will be required to make a $10 per day contribution towards their Daily Living Expenses, which will be deducted from the Basic Daily Fee amount paid by the TAC.
Aged Care Funding Instrument (ACFI) Subsidy. The TAC must be provided with a copy of the ACFI letter from the DoSS sent to the RAC facility setting out the fee subsidies applicable to the client. It is the RAC facility's responsibility to contact the DoSS to have the subsidies reviewed if it does not agree with them. Whilst awaiting ACFI rating for new residents the RAC provider may charge the interim ACFI default rate, at the rate determined by the Department of Health. The TAC will provide back payment to the facility for the shortfall once the correct ACFI subsidy rate has been established. Alternatively, a RAC provider can wait for the ACFI level determination and invoice the TAC for back payment of this amount.
Specialised equipment and attendant care. The TAC expects that the facility accepts full responsibility for the provision of care and services to a resident as specified in Schedule 1 and 2 of the Quality of Care Principles 2014. In exceptional circumstances, the TAC may consider funding specialised equipment not covered by this legislation, if it is clinically justified and considered reasonable by the TAC. The TAC cannot pay for additional attendant care to provide physical assistance or prompting with personal care tasks. This type of support should be included in the ACFI subsidy level determination. The TAC can however provide a TAC client residing within an RAC facility with attendant care to support community access where considered reasonable and clinically justified by the TAC.
Daily Accommodation Payment (DAP) or contribution. The TAC can pay a Daily Accommodation Payment (DAP) or Contribution as our guiding legislation does not allow us to pay a refundable accommodation deposit (RAD) or lump sum payment.
Responses to requests for funding Supported Accommodation
We will respond to written treatment and service requests as per the TAC Service Charter.
A supported accommodation services request may be reviewed by the TAC Clinical Panel to assist the TAC to make a decision on a request for supported accommodation services. The Clinical Panel may contact the requesting health professional or supported accommodation service provider to seek further information and/or discuss the proposed services before making a recommendation about the request. We will respond to the request after they have received the Clinical Panel's recommendation.
What we cannot pay for
In relation to supported accommodation services, we cannot pay for:
- supported accommodation services for a person other than the injured client
- supported accommodation services for a condition that existed before a transport accident injury or that is not as a direct result of a transport accident injury
- supported accommodation services that are not consistent with the level of care that a client requires as a result of their transport accident injury
- supported accommodation services that do not have the required accreditation/registration specific to that setting type (as specified by the TAC in these guidelines)
- related costs such as rent, accommodation bonds and rates
- room temperature controls/air-conditioning, unless deemed medically necessary and approved as reasonable by us
- capital expenses, such as periodic payments in Residential Aged Care (RAC) facilities
- extra services (i.e. dry-cleaning, hairdressing, paid TV, room upgrade)
- care provided to a client in the client's private home
- care provided in hospital
- additional attendant care services for the facilitation of community access and participation where approval has not been given by us
- supported accommodation services provided outside the Commonwealth of Australia
- 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.
Also see general items we cannot pay for.
For more information
Access our Supported accommodation policy.