A delegate may consider that it is reasonable for a partner, relative or friend to provide simple attendant care services to a client when exceptional circumstances apply. These circumstances may include instances where:
These circumstances are not exhaustive and if a delegate believes they have a case where exceptional circumstances may apply, they are requested to contact rehabilitation policy at rehabilitation@dva.gov.au [2] for advice.
It is important that where clients have been receiving attendant care services for a long period of time, particularly where that support is provided by family, that decisions are not made to immediately cease or change services. Rather, delegates must contact rehabilitation@dva.gov.au [2] for advice before a decision is made.
The decision that exceptional circumstances apply can only be made where there is clear evidence from a suitably qualified health or medical professional that:
As a general rule, before a decision can be made that exceptional circumstances apply for longer term care, the Exceptional Circumstances for attendant care form [3]must be completed by a suitably qualified health or medical professional who has a relationship with the client and understands their current circumstances and needs. This form can be found on the rehabilitation page of the R&C support site. It is not sufficient that the health professional describes the client as a private person, or states that the current arrangements should continue as this is what the client prefers. The decision that exceptional circumstances apply must be supported by evidence from a suitably qualified health professional and documented in the Exceptional Circumstances for attendant care form.
However, there will be cases where a flexible approach is required and the Exceptional Circumstances for attendant care form [3]does not need to be completed. This will be applicable where it is clear on the basis of available information that the person’s family are most appropriate people to provide their care. For example, where a person with an acquired brain injury has difficulties managing change to their routine, and their family has provided attendant care services for a long period of time, there is no requirement for the form to be completed, if there is evidence from an assessment by a suitably qualified health professional that the current arrangement is appropriate.
When a Rehabilitation Coordinator is satisfied that there is sufficient evidence that exceptional circumstances apply, the next step is to investigate whether it is appropriate for a partner, relative or friend of a person to be approved to provide time limited and straightforward attendant care services, by considering the following points:
If a Rehabilitation Coordinator is concerned about any of these issues, they must contact the rehabilitation policy section at rehabilitation@dva.gov.au [2] for policy advice, before a determination is made.
It is essential that if a partner, relative or friend is approved to provide attendant care services, these arrangements are regularly reviewed to ensure that the care continues to be appropriate to the client’s needs.
The decision must be correctly recorded with relevant documentation, including policy advice, saved into TRIM.
There may be exceptional circumstances where a person requires a short period of attendant care services and there are issues with accessing an external attendant care services provider. Examples include where the client only requires a short period of support each day, and this does not meet a provider’s minimum time limit for services. A client may also be living in a regional or rural area where there are a limited number of service providers, and none are available at the time that the client requires them. Before a delegate can decide that exceptional circumstances apply, they must first consider:
If it is not considered reasonable for the care to be provided on an unpaid basis, then the partner, relative or friend may be funded to provide an appropriate level of attendant care services to meet the client's assessed needs, for the required period of time. Services cannot be provided in excess of the statutory limit.
A client requires surgery and the Occupational Therapy (OT) assessment confirms that the client needs twenty minutes of assistance with showering and dressing at the beginning of each day for a period for a period of approximately two months, prior to and after the surgery. The OT assessment clarifies that there are no aids or appliances that will enable the client to shower and dress themselves without assistance from another person. As a first step, the client's rehabilitation provider should be asked to assist with sourcing providers to meet the client's needs. If there are barriers to finding an attendant care provider, such as providers requiring the care to be for a minimum of one hour per service, then this may be considered an exceptional circumstance. The rehabilitation provider confirms that the client's partner works shift work and is not usually at home in the mornings and therefore cannot provide assistance with showering and dressing the client. However, the client's brother lives nearby and is able to provide the twenty minutes of attendant care services on his way to work. In this case, the delegate can decide that exceptional circumstances apply, and the person’s brother can be paid to provide attendant care services of twenty minutes for day for a period of two months.
As a general rule, the industry standard that would be most appropriate for attendant care services provided by a partner, relative or friend of the person would be the base level rate for a personal care worker or disability support worker. This rate can be found on the Fair Work Ombudsman [4] website by searching for “personal care worker” and then identifying the base rate (level 2) under the Health Professionals and Support Services Award.
Links
[1] https://clik.dva.gov.au/user/login?destination=comment/reply/80157%23comment-form
[2] mailto:rehabilitation@dva.gov.au
[3] https://dvashare.dvastaff.dva.gov.au/BusinessUnits/Support/RehabServices/_layouts/15/start.aspx#/SitePages/Household%20Services%20and%20Attendant%20Care.aspx
[4] https://calculate.fairwork.gov.au/FindYourAward