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8.8 Community Nursing Care

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Last amended 
12 September 2014

MRCA and SRCA clients who hold a DVA Health Card are able to access nursing services through the Community Nursing Program. The program provides community nursing services to address a client’s assessed clinical or personal care needs.

Services are considered based on evidence from an assessment completed by a contracted community nursing service provider. Access to the Community Nursing Program requires referral from an authorised referrer, such as the client’s treating medical practitioner, treating doctor, specialist in hospital, a hospital discharge planner or a Veterans’ Home Care (VHC) assessment agency.  More information can be found on the Community Nursing page of the DVA website.

The Community Nursing program has an Exceptional Case Unit that assesses the clinical and/or personal care needs of those entitled persons whose care requirements, due to their complexity and care regimes, are significantly outside the scope of normal community nursing services. The Exceptional Case Unit is an independent unit of Clinical Nurse Consultants contracted by DVA.

It is likely that clients who require community nursing services through the Exceptional Case Unit will also require levels of attendant care in excess of the legislated statutory limits under MRCA or SRCA. In these cases, Rehabilitation delegates are requested to contact rehabilitation@dva.gov.au so that the Community Nursing Program and the Rehabilitation Policy section can work together to ensure that coordinated assessments can be organised and an appropriate level of services can be provided to meet the client’s assessed needs.

A partner or relatives should not be paid to provide nursing care services to any of our clients. This applies regardless of whether the person has the appropriate nursing qualifications to deliver the care to meet the client’s needs. Approving such payments creates a conflict with the Code of Professional Conduct for Nursing provided by the Nursing and Midwifery Board of Australia, and conflicts with procurement guidelines and DVA’s community nursing contractual arrangements.

Where a serving member may need access to nursing care services just prior to discharge and being issued with a DVA Health Card, consideration should be given to accessing one of the DVA contracted Community Nursing providers, even if the cost of these services may initially be met by Defence or via reimbursement to ensure continuity of care. Please contact the Assistant Director, Community Nursing Program Policy in the first instance to discuss this.

Persons requiring ongoing nursing care should be provided with a DVA Health Card as soon as possible following discharge from the Australian Defence Force (ADF).

There is potential for overlap between Community Nursing care and Attendant Care services.  Both services provide for persons’ personal care needs.  While it is possible for a person to receive Community Nursing and Attendant Care services, particular care needs to be taken to ensure a person is not provided with duplicate services.  Accordingly any such cases require a case management approach to ensuring all of the persons’ needs are met.

Paragraph 7.3.7 of the MRCA Treatment Principles precludes services such as cooking, shopping, cleaning, laundry, transport and companionship from community nursing services. These services should therefore be provided through the household services provisions of the MRCA or the SRCA. More information about household services can be found in chapter 7 of this Guide.