Outcome 2 focuses on maintaining and enhancing the physical wellbeing and quality of life of eligible persons and their dependants through health and other care services that promote early intervention, prevention and treatment, including advice and information about health service entitlements.
This is achieved in the following ways:
- ensuring access to general and specialist medical and dental services that are responsive to the unique needs of the veteran community
- providing quality inpatient and outpatient services throughout the Australian hospital network
- providing a comprehensive array of pharmaceuticals and wound dressings for the treatment of health care needs
- supporting veterans with community care programmes that enable them to remain independent in their homes and to delay entry into residential care
- delivering responsive, relevant mental health care and counselling support for the veteran and service members and their families. Other support services include allied health, aids and appliances, and travel for treatment
- paying for medical treatment, rehabilitation services and other related services under the Safety, Rehabilitation and Compensation Act 1988 (SRCA) and the Military Rehabilitation and Compensation Act 2004 (MRCA).
In 2013–14, major priorities for health were the continued development of relevant mental health care services and implementation of a new research model, to ensure the Department can respond effectively to emerging issues in the veteran community.
Other highlights for the 2013–14 year included an update of the Rehabilitation Appliances Program National Schedule; the launch of the Veterans’ Home Care Pilot Provider Portal; and the provision of White Cards to eligible SRCA clients.
Focus on mental health
Tackling the mental health challenges for veterans and their families is a key pillar of the Government’s plan for veterans’ affairs. This includes an emphasis on prevention and early intervention, which is especially relevant for younger servicemen and women as they leave the Australian Defence Force.
In 2013–14, DVA continued to develop and implement this policy priority of the Government. Key initiatives included the establishment of a new Prime Ministerial Advisory Council in March 2014 to focus on the mental health of veterans and their families. The Council is chaired by former Chief of Navy, Vice Admiral Russ Crane AO CSM RAN (Ret’d), with Corporal Ben Roberts-Smith VC MG as Deputy Chair. Members of the Council are drawn from representatives of the Australian Defence Force, the veteran community, business, and mental health experts.
DVA also prepared for the implementation of the 2013 budget measure, Veteran Mental Health Services – Expansion. A number of new initiatives will start from 1 July 2014. Additionally, the increase that was recognised in 2013–14 has occured due to a number of factors, including additional allowance for the emergence of deferred incapacity and permanent impairment claims and changes to the calculation methodology of the provision.
They include expanding the current arrangements under which DVA pays for mental health treatment for eligible veterans with diagnosed posttraumatic stress disorder, anxiety and depression. Under these arrangements, clients do not need to establish that their mental health condition is related to service. Treatment to be covered will include diagnosed alcohol and substance use disorders, and eligibility will be expanded to include more individuals with peacetime service.
Counselling through the Veterans and Veterans Families Counselling Service (VVCS) will be extended. Newly eligible groups will include people with border protection service, service in a disaster zone either in Australia or overseas, service as a submariner, personnel involved in training accidents resulting in serious injury and members who have been medically discharged. Access to VVCS services will also be available to partners and dependent children, up to the age of 26, of these newly eligible servicemen and women. In addition, the partners, dependent children and parents of members killed in service-related incidents will be eligible for VVCS support.
Another initiative is a one-off post-discharge physical and mental health assessment for former serving personnel, from their general practitioner, to be funded under Medicare. The assessment will help GPs to identify early any mental and or physical health concerns.
DVA conducted an open tender for the ongoing provision of mental health services for veterans in Australia’s private hospital system, with an estimated annual expenditure of around $30 million. New contracts with private hospitals that provide acute inpatient care and outpatient day programmes will commence in 2014–15. The tender process placed an emphasis on best practice and evidence-based outpatient programmes, to support effective mental health care outcomes for the veteran community.
Research and development Initiatives
On 11 June 2014 the Government launched the Transition and Wellbeing Research Programme, a jointly-funded collaboration between DVA and Defence. It is the largest and most comprehensive study undertaken in Australia to examine the impact of contemporary military service and deployment experiences on the mental, physical and social health of serving and ex-serving personnel.
The research will focus on the wellbeing of contemporary serving and ex-serving personnel and their families. It will provide a picture of mental disorders in the initial years after transition from full-time service, how mental health issues change over time and the impact of service in a combat zone.
The programme includes three major studies: The Mental Health and Wellbeing Transition Study; the Impact of Combat Study (on personnel deployed to the Middle East Area of Operations (MEAO) between 2010 and 2012); and the Family and Wellbeing Study.
Other DVA and Defence research collaborations in 2013–14 included the Mothers in the MEAO Study: The health impacts of maternal deployment, due to be completed in 2014; and the development of a long-term study of the effectiveness of rehabilitation under the Military Rehabilitation and Compensation Act 2004.
An Evidence Compass, developed by the Australian Centre for Posttraumatic Mental Health, was launched by the Minister for Veterans’ Affairs in December 2013.
The compass is an online database that provides the most up-to-date evidence-based research to guide policy development and treatment pathways for veterans.
Other research developments
Progress was made on a number of research projects in 2013–14. These included the Vietnam Veterans’ Family Study (VVFS), which is on track to be completed in 2014, two years ahead of time. Another initiative is the Australian Gulf War Veterans’ Health Study Follow-Up, which in 2013 received additional funding to undertake a more in-depth assessment of exposures experienced by Australia’s veterans of the 1990–91 Gulf War.
Under the new research model, DVA also strengthened its partnership with the Australian Institute of Health and Welfare and the Australian Institute of Family Studies, by collaborating on a range of research projects.
Updated Rehabilitation ApplianceS Program schedule
The ageing and younger veteran populations, and their dependants, will be better served following the revision of the Rehabilitation Appliances Program (RAP) National Schedule of Equipment and National Guidelines in 2013–14. They will take effect from 1 July 2014.
The changes have made way for improvements in the management of dementia, which is an increasing health concern for the wider community and for DVA. As part of the changes, items designed to address the specific, day-to-day needs of those with dementia, and to support their independence and quality of life, were added to the RAP schedule. These include:
- orientation signs within the home to provide easily-understood visual cues
- orientation clocks
- coloured toilet seats
- GPS tracking devices
- sound and movement monitors.
The updated schedule will also include use of the latest technologies such as iPhones and iPads fitted with speech pathology applications for treatment of clients with clinically assessed complex communication needs.
Veterans’ Home Care Pilot Provider Portal
In 2013–14, DVA began the implementation of an online, self-service portal to expand the ways in which service providers are able to conduct business with the Department. The project involves a staged approach, and began with the launch of the Veterans’ Home Care Pilot Provider Portal on 2 June 2014. There are approximately 160 VHC service providers who deliver in-home care for eligible veterans and widows. Through the new portal they are able to access service plans and claim for work they have completed.
The initiative makes it easier and more efficient to do business with the Department, enabling the providers to spend more time helping veterans and their families and less time on administrative functions.
White Cards for SRCA clients
Since December 2013, clients eligible under the Safety, Rehabilitation and Compensation Act 1988 (SRCA) have been issued with a Repatriation Health Card – For Specific Conditions (White Card) to simplify their access to medical and allied health services for chronic conditions.
The White Card provides SRCA clients with greater recognition as a DVA client and of their valued role in the service of the nation. The card alleviates the need for prior approvals for most treatments; enables providers to bill DVA directly; cuts back on administration for both clients and providers; and entitles the client to the same White Card benefits as other former service members.