VHC Guidelines - Section 9 - Continuity of Services by hjkuiw354

VIEWS: 12 PAGES: 5

									Veterans’ Home Care	                                                    Guidelines — February 2010



Section 9                   Continuity of services following the death
                            of a veteran or war widow/widower, or when
                            a veteran or war widow/widower is absent
                            from home for health reasons

In certain circumstances an approval for domestic assistance and/or home and garden
maintenance should be extended for twelve weeks following the death of an entitled person.
This twelve week period is consistent with the period for which bereavement payments are
payable to the widow/widower of a person who was in receipt of a disability pension at the
time of his or her death.

9.1 	         Maintaining services following the death of a veteran or
              war widow/widower
If a veteran dies and at the time of death the veteran was receiving domestic assistance
and/or home and garden maintenance, then a person who lived with the veteran immediately
before the veteran’s death and who is:
•	   a widow/widower of the deceased veteran; or
•	   a child of the veteran; or
•	   a former child of the veteran (being a former child with a serious disability); or
•	   a former child of the veteran who was a full-time carer of the veteran immediately prior
     to the veteran’s death;
is eligible to receive the domestic assistance or home and garden maintenance services the
veteran was receiving for a period of 12 weeks following the death.
Where the deceased was a war widow/widower who had remarried, the surviving spouse is
not eligible to receive this 12 week extension of services.
Where a claim for war widow/widower pension is lodged during this twelve week period,
the services can be continued until the date that the initial determination of the claim is
notified by DVA to the assessment agency where this date is after the 12 week period. In
these circumstances assessment agencies should contact their DVA Location Office.
The twelve week period allows time for the assessment agency to assess the
war widow/widower for VHC services, where war widow/widower status is granted, and
notify the service provider/s of the change in circumstances and service arrangements. The
war widow/widower is a new entrant to the VHC program. Where the application has not
been lodged in this time or has not been successful refer the widow/widower to HACC or
other services, as they will not meet the eligibility criteria in Section 2.
There is no discretion for an assessment agency to extend services beyond the 12 week
period in cases where the application for a war widow/widower pension has not been lodged
during this time or where it has been lodged but is unsuccessful.
A dependent child is a person who has not turned 16 or, in the case of a child receiving full-
time education, has not turned 25, for whom the deceased veteran had legal responsibility, or
for whom he or she had a legal obligation to provide financial support, such as a Child
Support Agency order.



These guidelines replace all previously issued VHC Guidelines
Veterans’ Home Care	                                                                   Guidelines — February 2010



9.1.1 	        VHC assessment agency actions upon the death of a veteran or
               war widow/widower
               On notice of a veteran’s or war widow/widower’s death the assessment agency
               undertakes the actions outlined below:

                Situation                  Action
                On notice of the           •    Receives advice from DVA:
                veteran’s or war                –    regarding surviving spouse or dependant’s VHC eligibility to
                widow/widower’s                      continue limited VHC services
                death
                                                –    whether the surviving spouse has been granted automatic war
                                                     widow / Gold Card status
                                           •    Notifies the service provider of the veteran or
                                                war widow/widower’s death (if service provider is not
                                                already aware)
                                           •    If appropriate, advises the spouse or dependant that they will
                                                need to lodge a compensation claim (eg application for
                                                war widow/widower or orphan pension) during the 12 week
                                                period following the veteran or war widow/widower’s death.
                                                Where the application has not been lodged or a determination
                                                made within the 12 week period, services cannot continue
                                                beyond the 12 week period
                Where there is no          Formally end dates existing service plan from the date of death
                surviving spouse or
                dependant
                Surviving spouse           •    Continues previous VHC service plan for 12 weeks (ie end-date
                (without VHC                    from the date of death plus 12 weeks)
                eligibility)               •    If ongoing assistance is required refer the person to the
                                                Commonwealth Carelink Centre for HACC and other services
                Application of             •    Arranges for relevant VHC services to continue for 12 weeks
                war widow status or             following the date of death or until the determination of a claim is
                orphan pension is               made
                lodged and awaiting        •    Liaises with DVA on the application outcome
                determination
                                           •    Confirms the date VHC services cease
                                           •    Where the existing plan does not cover the full 12 week period,
                                                forwards an amended care and service plan extending the VHC
                                                services accordingly
                Where the application      •    Recognises the war widow/widower or dependant is a potential
                is successful ie Gold           new client to the VHC program
                Card is granted            •    Assesses, approves and arranges services for the new Gold Card
                                                holder
                                           •    Informs the new Gold Card holder of additional support services
                                                available
                Where the application      •    If ongoing assistance is required, refer the widow/widower to the
                is unsuccessful                 Commonwealth Carelink Centre for HACC and other services
                                           •    Continues previous VHC service plan for 12 weeks following the
                                                date of death
                                           •    Arranges the cessation of VHC services with the service provider
                When a determination       Refer to Section 9.1.3 When a determination is not made within 12
                is not made within 12      weeks for actions
                weeks




These guidelines replace all previously issued VHC Guidelines
Veterans’ Home Care	                                                               Guidelines — February 2010



9.1.2 	        VHC service providers actions upon the death of a veteran or
               war widow/widower
               On notice of a veteran’s death, the service provider undertakes the actions
               outlined below:

                 Situation                  Action
                 If service provider        Contact the assessment agency first who will check if there is an
                 becomes aware of           eligible dependant and will confirm that domestic assistance
                 veteran or                 and/or home and garden maintenance services can continue.
                 war widow/widow            Service plan will be amended accordingly and forwarded
                 er death
                 Where there is no          •   Services of the veteran or war widow/widower cease from
                 surviving spouse or        the date of death according to end dated service plan
                 dependant
                 Surviving family           •   Ceases VHC services from the date of death
                 member (without            •   Records the date VHC services cease
                 eligibility to
                 receive limited
                 VHC services)
                 Automatic pension          •   Delivers VHC services according to the new service plan for
                 / Gold Card holder         the war widow/widower or dependant
                 status
                 Pension claim              •   Checks existing service plan and arranges for relevant VHC
                 lodged within 12           services to continue as specified by the service plan (12 weeks
                 weeks of date of           following the date of death) and notes the date VHC services
                 death and awaiting         will cease
                 determination              •  Where the existing plans do not cover the full 12 week
                                            period the VHC services are extended and amended care and
                                            service plans are generated by the assessment agency
                 When a claim               Refer to the following table for actions
                 determination is
                 not made within 12
                 weeks




These guidelines replace all previously issued VHC Guidelines
Veterans’ Home Care	                                                               Guidelines — February 2010



9.1.3 	        When a determination is not made within 12 weeks
               Where a determination has not been made within 12 weeks, the parties undertake
               the actions outlined below:

                Step Who?                  Action
                1        DVA               Confirms with assessment agency that relevant services are to
                                           continue beyond the 12 week period due to a delay in the first
                                           determination of a claim. These extended services are monitored
                                           until the determination is made
                2        Assessment        Approves and arranges VHC services to continue by issuing a
                         Agency            letter of authority to the service provider (or notation on the
                                           service plan) allowing services to be delivered
                                           Note: the assessment agency cannot record the approval to
                                           extend services on the VHC system so service providers will
                                           therefore not be able to claim on-line for any services provided
                                           beyond the 12 week period
                3        Service           •   Receives a letter of authority from the assessment agency
                         Provider              (or indication on service plan) for services extending beyond
                                               12 weeks
                                           •   Manually generates a tax invoice and forwards to DVA. This
                                               invoice should, as a minimum include:
                                               –    ABN
                                               –    card holder’s name
                                               –    card holder’s file number
                                               –    service details
                4        DVA               Arranges payment for service provider



9.2 	          Maintaining services when the veteran or
               war widow/widower is absent from home for health
               reasons
Assessment agencies have discretion to continue an approval for domestic assistance and/or
home and garden maintenance for a period of up to twelve weeks to an entitled person living
with a partner, dependent child, disabled adult child or full-time carer who is a dependant or
former dependant (child), where the entitled person is absent from home for health reasons,
for example, for a period of hospitalisation, during a respite episode or entry to a nursing
home.

9.3            Copayment arrangements
               	
The copayment arrangements that applied to the deceased/or absent veteran or war
widow/widower will apply to the spouse/widow/widower, or child of the veteran or war
widow/widower receiving those services during the 12 week period or, if applicable, until
the first determination of the war widow/widower’s claim.

If there is a waiver in place at the time of the veteran’s or war widow/widower’s death that
waiver will continue while the services are being provided under this entitlement. However,



These guidelines replace all previously issued VHC Guidelines
Veterans’ Home Care                                                  Guidelines — February 2010



there is no automatic entitlement to that waiver when/if the spouse becomes an entitled
person in his/her own right and is assessed as requiring services. The newly entitled war
widow/widower would need to submit a new application for waiver to DVA.




These guidelines replace all previously issued VHC Guidelines

								
To top