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6.5.2 Child care assistance through a psychosocial rehabilitation plan
Short term support
There are two options for providing short term child care support for clients who are struggling to cope with unexpected circumstances that are impacting on their ability to manage their child care responsibilities. These are:
- through the psychosocial rehabilitation provisions where a lack of child care support is creating barriers to the person being able to access treatment or programs that will help them to manage the impact of their accepted conditions; or
- through the household services provisions where time limited child care support is “required for the proper running and maintenance of the person's household” – refer to section 7.2.7 of the Rehabilitation Policy Library.
Child care under a psychosocial rehabilitation plan
Short-term assistance with the costs of discrete periods of child care can be considered and provided through a psychosocial rehabilitation plan where the veteran:
- is experiencing a flare in mental health symptoms which is placing them at risk, and they require urgent treatment, medical support or hospitalisation;
- requires urgent treatment or surgery for a physical health condition, due to an unexpected situation such as a fall or injury;
- requires short-term treatment that was not anticipated or part of their regular treatment regime or routine, such as, for example;
- counselling sessions;
- a PTSD treatment program; or
- physiotherapy sessions;
- is participating in a short-term illness self-management program such as, for example;
- brief intervention counselling to assist with adjustment to disability or injury;
- brief intervention counselling to assist with pain management; or
- an arthritis or diabetes self-management course; and
- the veteran is experiencing barriers to being able to access this support because a lack of child care support is preventing them from being able to attend.
If the client is already participating in a rehabilitation program, then participation in the self-management course/treatment would need to be clearly identified as an approved psychosocial activity under that plan. It may be necessary to make some adjustments to rehabilitation activities for the time that the person is undertaking the treatment/illness self-management program. If for example, the client is undertaking a vocational rehabilitation plan, then it may be appropriate that job seeking or other similar activities are temporarily paused, to give them a chance to focus on their recovery.
If the client has not already had a whole-of-person rehabilitation assessment, then the request should be considered under the household services provisions. This will enable the person’s request to be considered as quickly as possible without the need for a rehabilitation assessment and helps to ensure that the principle of early-intervention is utilised. In these cases, it would be appropriate for a referral to be made for a whole-of-person rehabilitation assessment, to investigate what other needs the person may have, and help to maintain momentum following their treatment or self-management course.
Barriers to accessing treatment
The key consideration that must be used to guide decision making, is whether the lack of child care support is creating barriers to the person accessing appropriate evidence-based treatment due to a change in their health and/or wellbeing that could not have been anticipated. This type of support can also assist a person to avoid a crisis situation, when they may need to access evidence based treatment due to an unexpected flare in symptoms. Some examples to guide decision making are included in the next section.
Child care support should not be provided where a client is participating in their regular treatment such as attending their GP or regular sessions with their psychiatric specialists, physiotherapist or exercise physiologist.
It is essential that where a veteran is at risk due to a change in their mental or physical health, a pro-active approach is taken and urgent requests for assistance are considered and approved as quickly as possible. This is particularly important where a veteran has experienced a flare in their health symptoms, needs to access treatment or medical support and is experiencing difficulties in managing their child care responsibilities. In this case, Rehabilitation Coordinators are asked to utilise the psychosocial policy guidelines and provide appropriate time limited assistance through a psychosocial rehabilitation plan to ensure that the veteran is able to access they support they need as quickly as possible. Where a lack of child care is creating barriers to the veteran accessing unexpected or urgent treatment or medical support, it is not necessary for a Rehabilitation Coordinator to request policy advice before making a decision to approve this support.
Barriers to participating in self-management programs
Child care support can also be provided through a psychosocial rehabilitation plan to enable a veteran to be able to develop skills in self-managing their health conditions. This approach recognises that participation in these types of programs or treatment can help the person to learn to focus on recovery and improving quality of life and moving forward with their rehabilitation.
Child care support could be provided where, for example, a veteran wishes to participate in a short-term outpatient treatment program to learn to self-manage a major depressive disorder, or to participate in a PTSD management program (either with or without their partner). Child care support could also be provided to enable a veteran to access brief intervention counselling to assist with adjustment to disability or injury, or pain management. If a lack of child care support would create major barriers to the client being able to participate in this type of program, then a psychosocial rehabilitation plan may be opened to facilitate funding for child care for a short-term period.
Ongoing childcare assistance
Making decisions about how to manage ongoing child care responsibilities is something that all parents need to do. Finding the most appropriate child care options for a family can be challenging, particularly where one family member is experiencing ill-health. Compensation payments, such as incapacity payments, are an important part of the assistance that DVA provides, to assist families to meet their costs of daily living, which may include the costs of child care.
However, where a lack of child care support is creating barriers to a person being able to access treatment or programs that will help them to manage the impact of their accepted conditions, short term support can be considered under a psychosocial rehabilitation plan. There is no intention that this approach would enable ongoing child care support to be provided. Rather, it helps to ensure that clients receive the right type of support at the right time, and that the Department utilises a pro-active approach to assisting clients to move forward after a service injury.
Child care examples
Some examples are included below to help guide decision making about whether child care support can be provided through the psychosocial rehabilitation provisions. It is important to note that each case needs to be considered on its own merits, using a client-centric focus:
A veteran’s mental health has deteriorated due to a flare in their PTSD symptoms. PTSD is an accepted condition. The veteran is the primary carer for his children and he is no longer able to manage his child care responsibilities. His partner has no leave entitlements remaining, which would enable her to take time off work to care for their children. The veteran requires urgent inpatient care at a hospital and is considered at risk. Lack of child care support is creating extreme stress and barriers to the person being able to access treatment at the hospital urgently. In this case, child care support can be approved for the period that the veteran admitted to hospital for treatment, and if required, for a reasonable time-limited period while they recover. Rehabilitation Coordinators may consider seeking advice from the DVA Psychology or Mental Health Adviser about what an appropriate period of post treatment support may be. It is however, important that the client and their family understand that the child care support will be time-limited and ongoing services cannot be provided. In this scenario, the client’s rehabilitation provider is expected to support the veteran and their partner to explore alternatives for ongoing child care, and to help the family to put arrangements in place to manage the impact of the veteran’s health conditions in the long term.
A veteran who is currently participating in rehabilitation has an accepted knee condition and requires urgent and unexpected surgery to her knee after a fall. The veteran shares child care responsibilities with her partner and cares for the children 3 days a week. The veteran will be unable to care for her children for the period that she is in hospital and for a month following surgery when she will be using crutches. In this scenario, as the lack of child care is creating barriers to the person being able to access urgent treatment, short-term support can be provided through a psychosocial rehabilitation plan.
- A veteran has an accepted back condition and suffers chronic pain due to this condition. Following a whole-of-person rehabilitation assessment, one of the recommendations from the rehabilitation provider is for the veteran to participate in pain management counselling. The counselling takes place for one full day a week however the veteran has explained that they cannot attend because they have full-time responsibility for caring for their young child, while their partner is at work. The veteran also explains that they live away from their immediate family and do not feel comfortable asking friends for help. In this scenario, the lack of child care support is creating a barrier to the veteran participating in a recommended self-management program. It would be appropriate to consider short-term support for the period that the counselling program runs for.
Working with Children checks
A Working with Children check is a requirement for people who work or volunteer in child-related work. It involves a national criminal history check and a review of findings of workplace misconduct.
It is mandatory that in all cases where DVA funds child care, that the person providing the care has passed a Working with Children or equivalent check in their relevant state or territory.
The responsibility for ensuring that carers have passed this check lies with the DVA client. This is because while DVA is responsible for considering whether child care is reasonably required and approving the level of service, it is the DVA client who is responsible for choosing and “contracting” the service provider and ensuring that they meet all of the necessary requirements to be able to fulfil their contract.
In many cases, particularly where a child will be cared for in a professional child care centre, then clients can be confident that the carer’s employer will have ensured that the necessary requirements have been met. However, where child care is being provided by a nanny or a family day carer, either in the provider or the client’s home, it is important that clients ensure that they sight the provider’s current and valid Working with Children or equivalent state or territory card before any care is provided.
Clients may find the links to state and territory government child care information on the mychild.gov.au website useful for finding out more about these checks.
Payment of child care costs
Please note that the administration of Child Care Benefits through the Department of Human Services requires that all child care costs approved by DVA are to be paid on invoice from the service provider, that is directed to DVA, indicating DVA is the party liable for the costs. Clients do not have the option to pay these costs, and then be reimbursed for them.