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Outcome Two: Health

During the financial year, DVA implemented a range of initiatives to further expand and improve the care available to the veteran and Australian Defence Force (ADF) communities, including mental health care initiatives; the Veterans’ Pharmaceutical Reimbursement Scheme (VPRS); improving access to medical aids and appliances; and research.

Other initiatives for the financial year included collaboration with the taxi industry and ex-service organisations to enhance services for clients using the Booked Car With Driver Scheme. DVA contributed to driver training programs and industry articles to ensure that drivers are knowledgeable about DVA’s expectations.

Mental health care

Mental health has continued to be a high priority for the Department and a highlight for the year was the release of the Veteran Mental Health Strategy on 27 May 2013. It updates and builds on DVA’s previous mental health strategy and will provide a 10-year framework for mental health care.

The strategy will guide the expenditure of $26.4million in new initiatives, including expanding access to mental health treatment without the need to make a compensation claim; post-discharge health assessments by GPs; extending the eligibility of the Veterans and Veterans Families Counselling Service(VVCS) to include certain peacetime service and family groups; and improvements to claim processing times.

DVA also established a Veteran Mental Health Clinical Reference Group of eminent health care professionals to provide expert advice and to highlight the unique needs of contemporary veterans. The committee is chaired by DVA’s Principal Medical Adviser, Dr Graeme Killer AO.

It is important that veterans, ADF members and their families can identify mental health issues early and seek help if they need it. To support this goal, in 2012–13 DVA launched a range of mental health educational resources and self-help tools, including:

  • the new At Ease web portal, which offers path ways to achieving mental fitness and resilience, self-help tools, access to professional support, treatment options, and healthy drinking and clinical information for GPs and mental health professionals
  • a series of videos about the impact of mental ill health on current and former serving personnel and their families, featuring veterans, family members and leaders within the veteran community and ADF ranks, published on the Department’s YouTube channel
  • two smart-phone applications, using mobile technology:
    • The Right Mix On Track, which allows users to track their drinking habits and encourages them to think about the impact of drinking on their lifestyle and physical health
    • PTSD Coach Australia, which helps veterans and ADF members identify and manage mental health symptoms, and includes tools for relaxation, positive self-talk, anger management and a scheduler to organise self-care, health appointments and other activities.

Veterans’ Pharmaceutical Reimbursement Scheme

More than 40000 veterans benefited from their first annual payment under the VPRS in March 2013. The average payment was $116 per veteran for the 2012 calendar year.

The scheme recognises that veterans have complex health needs due to their war service and consequently experience higher out-of-pocket costs for their medications. It reimburses eligible veterans for out-of-pocket costs associated with the concessional pharmaceutical co-payment.

Working with health providers

A major focus for the Department in 2012–13 was working with health and service providers to build their understanding of the needs of DVA clients and ensure high standards of service for the veteran community.

DVA refined its Pay for Performance initiative, which each year rewards private hospitals that meet or exceed quality care thresholds in surgical practice, chronic medical conditions, patient satisfaction and patient safety. A payment for achieving these standards gives hospital providers an incentive to refine and improve their practices, particularly for clients with chronic and multiple illnesses.

DVA also focused on improving communication and links with the health sector, including reaching about 15 000 delegates at health provider conferences and distributing regular information about DVA health programs and the VVCS. The Coordinated Veterans’ Care (CVC) Program continues to attract a lot of interest with in the health sector, and is seen by many as best practice in managed care. Raising awareness in the sector about this important initiative will enable more veterans with chronic illness to benefit from CVC.

Another initiative in the mental health sector is to help providers better meet the needs of veteran patients by providing them with the latest evidence-based training and resources, and promoting a deeper understanding of veteran mental health issues. In 2012–13, DVA launched the new mental health portal At Ease Professional, which offers the latest veteran mental health research, evidence-based assessment and outcome tools, training courses and treatment options.

Purchase of health services

In 2012–13, DVA ran a national tender for private hospital services and day centres, enabling services to be provided to the veteran community through 240 private hospitals, 58 mental health facilities and 224 day procedure centres. This is in addition to current agreements with all states and territories for hospital services provided in the public sector. This network of health services for veterans ensures they can access local treatment as a private patient and avoid waiting lists.

The Department also conducted an open tender for the procurement of Veterans’ Home Care assessment and coordination services, ensuring the continuation of this important program for veterans and war widow/ers. In April 2013, the Department successfully negotiated Deeds of Agreement with 12 assessment agencies to provide services for clients throughout Australia, including domestic assistance, personal care, in-home respite and safety-related home and garden maintenance.

Access to rehabilitation appliances and medical equipment

In 2012–13, the Department commenced a review of the Rehabilitation Appliances Program (RAP) Schedule to better assist eligible veterans in accessing a wide range of medical aids and appliances, based on clinical need.

The review is particularly relevant with an increasing number of contemporary veterans likely to be applying for RAP aids. It is important that the schedule caters to our clients’ broad range of needs, taking into account age and lifestyle.

Since the last review, there has been significant growth in new technologies, and for many veterans, particularly those from recent conflicts, such technologies are an integral part of their daily lives. Many of these technologies can help the veteran to remain independent while living in the family home.

Other initiatives to improve access to rehabilitation and health equipment included removing the need for prior approval from DVA for routine treatment and a range of aids, and the introduction of the Essential Medical Equipment Payment. This helps clients meet the costs of running essential medical equipment or medically required heating or cooling.

Health and community services reforms

In 2012–13, DVA contributed to a range of health reform initiatives.

These include technology-based reforms that are supporting innovation in service delivery. As part of the National Broadband Network (NBN) rollout, in 2012–13 DVA commenced an in-home telemonitoring trial, which involves installing health monitoring devices in clients’ homes. This enables clients’ GPs to identify and respond early to changes in their health conditions, which can help prevent unplanned hospitalisations.

The eHealth record system, launched by the Department of Health and Ageing on 1 July 2012, can support coordinated care for participating clients by giving health providers a consolidated view of a consenting client’s key health information.

During 2012–13,DVA worked with the Department of Health and Ageing to implement aged care reform initiatives. This included legislation for the introduction of a new Veterans’ Supplement in residential care and home care packages, which will improve access to these services for veterans with an accepted mental health condition.

DVA is working with the Department of Families, Housing, Community Services and Indigenous Affairs on the National Carer Strategy and National Disability Strategy. The National Carer Strategy acknowledges the role of carers and provides a 10-year framework for implementing policies and initiatives that support them. The National Disability Strategy sets out a 10-year plan to improve life for Australians with disability, their families and carers. For both of these initiatives, DVA has ensured that the needs of veterans, their carers and families have been considered.

Research priorities

The development of a new Strategic Research Framework was a key piece of work in 2012–13. The Repatriation Commission and the Military Rehabilitation and Compensation Commission agreed to the new research model on 7 February 2013 for implementation from 1 July 2013.

The new framework will guide future DVA research, with a focus on current veteran issues. These include the diversity of veteran cohorts across age, gender and experience; the implications of withdrawing from Afghanistan; and the emergence of mild traumatic brain injury and PTSD as key illnesses from Middle East conflicts.

In 2012–13, DVA finalised a number of significant research studies. This included the Female Veteran Health and Wellbeing Study. The women interviewed served in conflicts including Vietnam, Iraq and Afghanistan, as well as in peacekeeping missions. After considering the report in November 2012, the Commissions requested that DVA, in conjunction with the Department of Defence, establish a steering committee that includes serving women. The ADF Service Women Steering Committee met for the first time on 2 May 2013, and will examine the services required to further support women.

The Timor-Leste Family Study was also finalised. It revealed the importance of social support for the families of deployed troops. Since 1999, more than 20 000 ADF personnel have been deployed to East Timor in 10 operations. The study showed that partners who had more social support experienced better mental health, lower psychological distress and fewer behavioural issues with their children.

Work continued on the Vietnam Veterans’ Family Study (VVFS), which is the most significant research program ever undertaken into the health of Australia’s Vietnam veteran community, with project funding of $11.5 million. The study commenced in 2008 and is on track to be completed in 2014, two years earlier than originally planned.

The findings of these studies will assist DVA and the Department of Defence to better understand the impact of deployment on families and which support services will best help them.

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