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Factsheet HIP06 - Providers - Community Nursing Services

Purpose

This Factsheet explains who can provide community nursing services to the veteran community, who in the veteran community is eligible and how they access this service, how payment is arranged, and the link with the Coordinated Veterans' Care (CVC) Program.

What is the DVA Community Nursing program?

The Department of Veterans' Affairs (DVA) Community Nursing Program provides eligible members of the veteran community (entitled persons) with access to community nursing services to meet their assessed clinical needs.

The Community Nursing Program (CN) aims to enhance the independence and health outcomes of the entitled person to remain at home by providing access to community nursing services.

Who can provide community nursing services?

DVA procures services for the provision of community nursing services via a Community Nursing Services Invitation (the Offer) across Australia to form a panel of community nursing providers (Panel) to deliver community nursing services to entitled persons in their homes.

The Panel can be found on the Panel of CN providers page of the DVA website at http://www.dva.gov.au/providers/community-nursing/panel-community-nursing-providers.

All qualified CN providers who satisfy requirements of the community nursing Terms and Conditions and, notes for Community Nursing Providers (Notes), and agree to the non-negotiable Fee Schedule can apply to DVA to participate in the Community Nursing Program, on the following conditions:

  • the Offer will ‘stand’ indefinitely allowing new CN providers to join at any time,
  • providers self-certify their compliance, and
  • providers enter and exit at any time (subject to accepting the Terms and Conditions and Notes, without prejudice).

To apply, please complete the required documentation, which can be found on the AusTender website at www.tenders.gov.au. The Invitation documents provided on AusTender comprise of:

  • Community Nursing Terms and Conditions,
  • Notes for Community Nursing Providers,
  • Community Nursing Schedule of Fees, and the
  • Community Nursing Pro Forma on Administrative Information.

DVA does not guarantee any level of business to a CN provider on the Panel and will only pay for community nursing services delivered to an entitled person by an authorised DVA CN provider.

Who can access community nursing services?

To be eligible to receive community nursing services for an assessed clinical need, an entitled person must hold a Gold Card – (eligible for all assessed clinical and/or personal care needs) or a White Card.

For more information on the Gold Card, please see Factsheets HSV59 – Eligibility for the DVA Health Card All Conditions or Totally & Permanently Incapacitated (Gold Card) and HSV60 – Using the DVA Health Card – All Conditions (Gold) or DVA Health Card Totally & Permanently Incapacitated (Gold).

If a client has a White Card DVA will fund community nursing services if they are required because of an accepted war or service caused injury or disease (accepted disability).

For all White Card holders, the CN provider must contact DVA to determine eligibility to receive community nursing services for an assessed clinical need prior to the commencement of community nursing services. For more information, please see Factsheet HSV61 - DVA Health Card - Specific Conditions (White).

How do entitled persons access community nursing services?

A CN provider must receive a written referral for an entitled person from one of the following authorised referral sources:

  • a Local Medical Officer (LMO) or other General Practitioner (GP),
  • a Nurse Practitioner specialising in a community nursing field,
  • a treating doctor in hospital,
  • a hospital discharge planner, or
  • a Veterans’ Home Care (VHC) Assessment Agency.

Referrals

A referral is required for:

  • newly admitted entitled persons to the Community Nursing Program, or
  • entitled persons starting a new episode of care.

A verbal referral can be accepted as long as the written referral follows within seven days.

Upon receiving a referral from an authorised referral source, the CN provider must:

  • undertake a comprehensive assessment of the entitled person, and
  • provide all of the community nursing services required to meet the entitled person’s assessed clinical needs.

A small number of entitled persons have complex or frequent care needs which require them to be managed on a case-by-case basis. More information can be found on the DVA website at www.dva.gov.au/providers/community-nursing/exceptional-case-unit.

Specialist Services

Please contact DVA for additional information, using the contact details provided under More Information below.

How do community nursing providers obtain payment for services?

DVA pays CN providers for the delivery of community nursing services to an entitled person on a 28-day claim period basis. The 28-day claim period includes all the community nursing services delivered to an entitled person during that time. Please contact DVA in regards to claiming for specialised services.

A CN provider claims for payment for the delivery of community nursing services to an entitled person through the Department of Human Services Medicare (DHS-Medicare). DHS pays the claim for payment on behalf of DVA.

Other information about the DVA Community Nursing Program can be found on the DVA Community Nursing Program page of the website at www.dva.gov.au/providers/community-nursing-program.

What is the Coordinated Veterans’ Care (CVC) Program?

The CVC Program is a DVA program to better manage and coordinate primary and community care for eligible Gold Card holders who are most at risk of being admitted or readmitted to hospital.

The CVC Program is focussed on providing additional support for Gold Card holders with one or more chronic diseases or conditions, and who have been identified as having complex care needs.

The key element of the CVC Program is the core team of the participant, the participant's carer (if applicable), the nurse coordinator and the GP. The team uses care planning, coordination and review as tools to focus on better management and self-management of the CVC participant's health.

What is the community nurse’s role?

Where a GP does not have access to a practice nurse, they may choose to work with a DVA CN provider. The Panel can be found on the Panel of CN providers page of the DVA website at: http://www.dva.gov.au/providers/community-nursing/panel-community-nursing-providers.

For participants in the CVC Program, the role of the community nurse is to coordinate care for the CVC participant. Regular dialogue between the community nurse and the GP is vital to the success of the program.

For further information refer to the Notes for Community Nursing Providers Attachment E at https://www.dva.gov.au/providers/community-nursing#cnnotes.

More Information

DVA General Enquiries

Phone: 1800 550 457 *

Email: GeneralEnquiries@dva.gov.au

Factsheet website: www.dva.factsheets.gov.au

DVA Website: www.dva.gov.au

Additional Information

DVA Service Provider Enquiries

Phone: 1800 550 457*

Email: GeneralEnquiries@dva.gov.au

DVA Website: www.dva.gov.au

Service Provider Website: www.dva.gov.au/service_providers

Factsheet Website: factsheets.dva.gov.au

Open Arms

Open Arms – Veterans & Families Counselling

Phone: 1800 011 046

Open Arms Website: https://www.openarms.gov.au/

At Ease Website: www.at-ease.dva.gov.au

Related Factsheets

Disclaimer

The information contained in this Factsheet is general in nature and does not take into account individual circumstances. You should not make important decisions, such as those that affect your financial or lifestyle position on the basis of information contained in this Factsheet. Where you are required to lodge a written claim for a benefit, you must take full responsibility for your decisions prior to the written claim being determined. You should seek confirmation in writing of any oral advice you receive from DVA.

 

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27 June 2019