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5.1 What is Medical Management Rehabilitation
Medical management rehabilitation intends to assist veterans to understand and learn to utilise the civilian health system. The aim of medical management rehabilitation is that veterans will be able to independently access treatment and support for their accepted conditions.
Medical management rehabilitation includes:
- assisting veterans to develop skills and strategies to find and access health professionals in their geographic area
- encouraging and assisting veterans to find and independently access veteran and family specific assistance programs from DVA and Open Arms
- supporting veterans with chronic or complex health conditions to develop skills in building their health literacy and proactively managing their health and wellbeing
- working with veterans to find resources and programs in their community that promote a focus on recovery and effective health self-management – these may include Veterans’ and Families’ Hubs.
A medical management rehabilitation plan may include psychosocial rehabilitation or vocational rehabilitation interventions as a part of a whole of person approach to helping the person to achieve their rehabilitation goals. Goal Attainment Scaling is mandatory when developing a whole-of-person rehabilitation plan that includes medical management. Information about Goal Attainment Scaling can be found in chapter 15 of the Rehabilitation Guide.
A medical management rehabilitation plan cannot be used to pay for treatment. This includes the cost of nursing or other similar medical care. Similarly, a medical management rehabilitation plan cannot be used to pay for attendant care or household services.
DVA and Open Arms offer a range of services and support outside the rehabilitation program, which can support veterans to access treatment, or services to support them to more effectively manage their health and wellbeing needs. These include veteran cards, mental health services, trauma recovery, pain management and peer assistance programs through Open Arms, assistance with travel for treatment, the Rehabilitation Appliances Program, the Coordinated Veterans Care Program and Community Nursing.
Management of medical treatment needs
A medical management rehabilitation plan may be indicated in cases of severe injury, complex multiple injuries or where a person requires support to coordinate their medical treatment program or clinical self-care activities. Support for clients with psychological illness should be given particular consideration.
The Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 (DRCA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) include provisions to engage a rehabilitation service provider to help the client access and coordinate their treatment needs.
Normally these activities would be coordinated by the person's treating medical practitioner. However where the person, because of their specific injury or condition, is struggling to pursue treatment in a consistent way, a rehabilitation service provider can be engaged to coordinate a medical management rehabilitation plan. This may involve the rehabilitation service provider facilitating attendance at necessary appointments and assisting the person to manage their medical conditions more effectively by accessing appropriate treatment and support from health professionals or organisations.
Medical management rehabilitation is provided as an adjunct to medical treatment. It cannot be used to provide treatment or to meet the costs of medical care, including nursing care. The role of the rehabilitation provider is not to provide medical advice, but to support the client to remain on-track, in continuing to access treatment.
Such a rehabilitation intervention can involve an intensive case management approach, including regular contact and follow-up with the client and their treating practitioner or team of practitioners, by a rehabilitation provider with appropriate skills and experience in working with clients in this way. The intervention can be developed as part of a stand-alone rehabilitation plan, or incorporated into a more integrated whole of person rehabilitation plan which could also address the client's psychosocial and vocational needs. Where this occurs, the medical management and psychosocial rehabilitation interventions can be paid as third party costs under the person's non return to work or return to work (vocational rehabilitation) plan.
Medical management rehabilitation can also help to support a client to seek further information about medical guidelines and restrictions relevant to their accepted conditions, which will assist in promoting effective management of their medical needs in their home, community or workplace.
Rehabilitation Coordinators must contact rehabilitation@dva.gov.au as soon as they become aware of difficulties in meeting a client's care and treatment needs. The Rehabilitation and the Community Nursing Programs can then work together to organise coordinated assessments and an appropriate level of services to meet the client's assessed needs, in line with the legislation and the department's usual contractual arrangements.