Making a claim for household services
Subsection 214(1)(c) of the MRCA and subsection 29(2) of the DRCA provides that for compensation for household services to be payable a person must make a claim for compensation in respect of household services. The person is required to provide information about their home situation and obtain supporting documentation from their treating general practitioner.
The household services claim form D9319 must be used to gather information to inform the determination.
Assessment for household services
In most circumstances, the need for household services will need to be identified through a home assessment which will generally be conducted by a suitably qualified and experienced Occupational Therapist (OT)1,2.
Exceptions to a home assessment may be considered where sufficient information is available to demonstrate a reasonable requirement for household services exists because of the persons accepted conditions. Refer to section 7.4 of the Rehabilitation Policy Library for information about reviewing household services.
The need for an assessment must first be determined by DVA. If DVA did not request the assessment, there is no mechanism to provide payment to a third party for undertaking the assessment.
1 In exceptional circumstances, at the request of DVA, another appropriately qualified and experienced health professional may undertake the assessment.
2 OTs or other requested health professionals undertaking an assessment for household services do not need to be DVA accredited rehabilitation service providers. However, they must be appropriately qualified and experienced.
Nursing care needs
Where nursing care is required as well as personal care and/or household services the person may be able to receive Community Nursing services if there is an assessed clinical need for nursing at home. For more information, please visit the Community Nursing page on the DVA website.
Standard maximum rate for household services
To expedite the process for approving household services for clients, a standard maximum rate of up to $76.55 per hour has been set. This rate is not mandatory but provides a benchmark of reasonableness. It is aligned to similar programs delivered by DVA. The rate is indexed annually in January.
Using a standard rate removes the need for clients to source quotes from multiple providers.
There is flexibility for the DVA delegate to use their discretion to approve a higher rate to the standard so long as they are satisfied this is appropriate, given the client’s circumstances, and are assured of value for money.
Each client’s circumstances must be considered on their own merits.
One-off and irregular services
For services that are undertaken on a one-off or irregular basis, the delegate can determine the most appropriate hourly rate based on the service type, without reference to the VHC rate. This is because the market rate for these one-off services may be higher than the rate for regular services such as house cleaning and lawn mowing.
Statutory limit
The amount of compensation payable for household services is capped by a statutory limit which is indexed as at 1 July each year, by reference to the Consumer Price Index. Details of the maximum household services limits are available in the current payment rates chart in the CLIK Compensation and Support reference library. The MRCA limit is listed on the MRCA Rates and Allowances page. The DRCA limit is listed on the DRCA and Defence Act payments page.
Rehabilitation Coordinators must not approve household services in excess of this statutory limit. Further information about the approval and review of household services can be found in section 7.4 of this Guide.
Note: Some persons, who are eligible for household services, may also qualify for attendant care services. In such cases, they may be entitled to payment up to the statutory limit for both household services and for attendant care services. In other words, the statutory limits that apply to household services and attendant care are mutually exclusive.
Rehabilitation and the National Disability Insurance Scheme (NDIS)
Household services can be provided by both DVA, through the rehabilitation plan, or by the NDIS, through an individual care plan. Where DVA clients are accessing support through the NDIS, they can choose which of these options suits them best. However, an important principle is that the same household services must not be provided by both NDIS and DVA. Therefore, it is important for Rehabilitation Coordinators to advise Occupational Therapists or other allied health professionals undertaking assessments for attendant care services, that they should discuss with the client whether they are receiving anything from the NDIS. Providers should also be asked to notate in their report that the client has been made aware that they cannot ‘double dip’ for these services.