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Disability

Navigating the Funding Maze – Family Assistance Fund – NSW

by bronwyn
written by bronwyn
Autistic boy getting assistance at computer

Welcome to the eighth  installment of ‘Navigating the Funding Maze‘. Today I hope to give alittle more insight into the Family Assistance Fund (NSW). I hope that this will be useful information.

This is one that I have not yet used myself but I do hope to use it in the very near future. I remember when we first started talking to our case worker from ADHC about them getting us an appointment with an OT and getting a trampoline or something similar but nothing came of it.

I am going to try and find out if there is anything similar for the other states … if you know anything please either put a comment or send me a email.

What is the Family Assistance Fund (NSW)?

The Family Assistance Fund was established to help families with ongoing care for their child with a disability.

The Family Assistance Fund provides small amounts of one-off funding (up to $2,000) for families to purchase services and equipment to help them care for their child with a disability at home and increase family well-being.

Funding can be used to make practical changes at home, provide support for individual family members that is otherwise unavailable, and purchase non-recurrent assistive equipment. The funding helps families to address specific needs and stresses before they become a crisis and to make a difference in the care of the child or young person with a disability.

Who is eligible?

Eligible families are those who are caring for a child or young person with a disability under 18 years of age and who are receiving case management from Family and Community Services – Aging Disability and Homecare (otherwise known as ADHC and previsouly known as DADHC) or an ADHC-funded service provider.

Priority will be given to:

  • families on low to moderate incomes (in 2006 $62,647 or less per annum);
  • families where the child or young person has multiple or complex medical and behavioural needs and/or where parents have health or other issues that impact on their parenting role or capacity to manage behaviours, routines and stresses;
  • families where the care of the child or young person with a disability is having a
  • significant impact on the well-being of their siblings;
  • families with little or no access to extended family support or local support within
  • their communities;
  • families living in geographically isolated areas; and
  • families who have not received Family Assistance Funding previously.

Boy at computer getting assitance

Being eligible does not automatically mean that you will receive funding. The number of families able to be helped is dependent on funding availability and level of need.

What can be funded?

Examples of how Family Assistance funding can be used include:

  • purchase of assistive equipment to help families care;
  • resources to promote play activities and interaction between children/young people in the family and/or their parents;
  • recreation activities for both the child with a disability and other children in the family (e.g. a total family outing, assistance to attend holiday activities);
  • new resources to support the child or young person through transition stages and to help families manage care changes;
  • services to increase parenting skills, communication and improve family routines in the longer term;
  • training to improve caring skills;
  • counselling or other forms of personal support for family members, including siblings;
  • equipment/support to assist the child or family’s community involvement and the development of personal support/peer networks;
  • modifications to the house and garden to provide a safe, secure environment, or a car modification for transportation; and
  • household equipment such as a washing machine or clothes dryer to assist with laundry for children with incontinence or a heater to prevent medical problems for a child with complex health care need

What is excluded?

Funding is provided strictly on a one-off or time-limited basis. The Family Assistance Fund
will not provide funding to:

  • purchase any item or support that has ongoing, long term or recurrent costs;
  • duplicate existing services or funding;
  • fund shortfalls in existing services;
  • act as bridging funding while awaiting longer-term care options;
  • where the support service(s) or aids requested are available through other NSW or Australian Government programs;
  • provide clinical assessment or therapy services;
  • provide out-of-home placements and respite; nor
  • purchase basic items such as food and clothing

How can you apply for funding?

Families need to fill in and sign an Application Form. The Form includes a budget section where details of at least one written quote for the equipment or services to be funded needs to be added. Your case manager (or other DADHC worker) will provide advice and assistance in filling in the form and you will need to make sure they complete the checklist at the back of the form.

Additional application forms are available through the ADHC website (www.dadhc.nsw.gov.au), your case manager (or other ADHC worker). You can put in an application at any time.

A regional panel will consider applications regularly and make recommendations to the Regional Director or a delegated officer. The panel will include a DADHC officer, a government or non-government service and a person with a disability and/or a family member who is not seeking funding.

If approved, applicants will receive:

  • notification of approval;
  • a cheque for the amount of funding allocated; and
  • information about how to account for spent funds.

To find out more about the Family Assistance Fund ask your case manager or contact
your DADHC Regional/Area Office:

  • Metro North Region – (02) 8855 4200
  • Metro South Region – (02) 9334 3700
  • Western Region – 1300 134 450
  • Northern Region – 1300 364 563
  • Hunter Region – (02) 4908 5229
  • Southern Region – Illawarra (02) 4254 0319 or  Southern Highlands (02) 6200 730

What have your experience been of the Family Assistance Fund? Do you have any lessons/scars? 

Please feel free to add links to more relevant information you have found useful in the comments below.  

Photo by Jordan Whitt on Unsplash

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Disability

Navigating the Funding Maze – Inclusion Support

by bronwyn
written by bronwyn
Welcome to the sixth  installment of ‘Navigating the Funding Maze‘. Today I hope to give alittle more insight into the Inclusion Support Funding. I hope that this will be useful information.
 
 

Inclusion Support Program

What is the Inclusion Support Program?

The aim of the Australian Government funded Inclusion Support Program is to remove the barriers to accessing child care that may be experienced by children with a disability,  Culturally and Linguistically Diverse (CALD) backgrounds, and Indigenous children. The Inclusion Support Program assists child care services with a range of practical supports, including advice, planning and resources, so that they are better able to provide all children with the opportunities to participate in activities that encourage learning and development within relationships with peers and adults and in a manner that reflects the interests and strengths of all children inclusive of physical, cultural and linguistic diversity.

In practices this means that it supports childcare facilities to provide quality inclusive child care environments that

  • provide welcoming, accessible and engaging environments that are responsive to all children and their families including those with additional needs (like Autism)
  • use flexible programming approaches that are responsive to individual strengths, interests and needs
  • build on and develop the strengths of the child care community (child, family, educators and community)
  • work in partnership with families and respect their cultural values, needs and circumstances
  • are well supported through networking with other relevant services and supports

As part of this support childcare agencies have access to Inclusion Support Agencies (ISAs) that are are responsible for the provision of support to child care services that includes practical advice and access to a range of supports designed to strengthen the service‘s ability to create a quality care environment inclusive of all children. These supports include, but are not limited to, providing onsite assistance with developing  Service Support Plans, facilitating access to Specialist Equipment provider, General Resources Library, professional support, funding through  Flexible Support Funding or  Inclusion Support Subsidy, and Bicultural Support.

KU Children’s Services operates ISAs in 7 NSW regions. Find out more about the KU Inclusion Support Agencies or contact your local Inclusion Support Agency for more details.

Inclusion Support Subsidy

What is the Inclusion Support Subsidy?

The Inclusion Support Subsidy (ISS) is paid to child care services to support the inclusion of a child or children with ongoing high support needs. The ISS is a contribution towards the costs associated with employing an additional child care worker. In Family Day Care and In Home Care the ISS can also be used as a payment in recognition of the impact on the carer of the additional care and attention required by children with ongoing high support needs. The ISS is limited to a flat hourly rate, which is determined by the Department of Education, Employment and Workplace Relations (DEEWR) and is indexed annually.

Children with ongoing high support needs include those with a diagnosed disability, children undergoing continuing assessment for a disability and humanitarian refugee children. So in practice this means if you have a diagnosis of Autism or are in the process of getting a diagnosis your childcare provider can access this subsidy.

Since 1 January 2009, the Inclusion Support Subsidy has been administered nationally by KU Children‘s Services, the  National Inclusion Support Subsidy Provider.

What does this mean in practice for my child?

If your child has ongoing high support needs and attends a centre based child care service then the service may decide that an Additional Educator is needed for some of the time that your child attends.

In Family Day Care or In Home Care ISS provides an additional payment to the carer in recognition of the additional care and attention required to include a child with ongoing high support needs.

How is the Inclusion Support Subsidy Used?

ISS is money paid to your child care service to assist them to employ an Additional Educator for the room your child is in to increase the staff to child ratio. Having an Additional Educator for the busiest times of the day can help make sure that the environment is inclusive for all the children as Additional Educators are employed to work with all the children in the room, not just your child.

ISS can also be applied for by Family Day Care and In Home Care Services. This ISS money is paid to the carer to acknowledge the extra work involved in caring for children with ongoing high support needs and the impact this has on the carer and care environment.

What as a parent do you need to do to assist in the Application for the Inclusion Support Subsidy?

To support an ISS Application, your child care service will be required to provide current evidence (dated within the last 12 months) that your child has ongoing high support needs. If a child has a diagnosed permanent disability, documentary evidence which provides confirmation of the child’s diagnosis
may be sufficient (this does not have to be dated within the last 12 months). Your service will be responsible for completing the application and you will just need to provide them documentation to assist.

What evidence should you provide?

If your child has a diagnosed disability, evidence may
include:

  • A qualified medical practitioner’s confirmation of diagnosis
  • The results of an assessment by a registered psychologist
  • Evidence of a diagnosis provided by an Allied Health Professional (Speech Therapists, Occupational Therapists etc), Registered Nurse or Nurse Practitioner
  • Any diagnosis documentation from
  • Centrelink documentation stating your eligibility for Carers Allowance with respect to your child
  • Your child’s Health Care Card stating the code (CD)

If your child is undergoing continuous assessment,
evidence may include:

  • An appointment letter for an assessment by a medical practitioner
  • Supporting documentation or diagnostic report signed by a qualified medical practitioner or registered psychologist
  • Report or supporting documentation signed by an Allied Health Professional, Registered Nurse or Nurse Practitioner

What happens when/if the application is successful?

Your service will be notified that ISS has been approved for up to 12 months. If your service still requires additional support after the initial approval period they may talk to you about making a Renewal Application.

For more information visit the KU Children‘s Services Inclusion Support Website.

Opinion

We have been … or I should say our child care service has been utlising the Inclusion Support Subsidy for just over 12 months now. This has been unbelievable valuable. LittleMan’s aide (and friend) is just wonderful. She has done and continues to do great work to help him participate in the childcare community. For me I think it is really important for him to have time to socialise with children his own age and have opportunities to generalise skills he is learning in therapy. This he gets thanks to the support of his aide for 2 days a week at childcare. For me this program is instrumental in his overall care/therapy program. 

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Disability

Navigating the Funding Maze – Medical Expenses Tax Offset

by bronwyn
written by bronwyn
Calculator
Before I start I think I need to be very very clear … the information below is not intended to be taken as legal, taxation or financial advise. The purpose is for information purposes only. I strongly recommend that you speak to an accountant, taxation agent or other appropriate financial advisor to get specific advise on your own situation.

Welcome to the fifth  installment of ‘Navigating the Funding Maze‘. Today I hope to give alittle more insight into the Net Medical Expenses Tax Offset. I hope that this will be useful information.

What is the Net Medical Expenses Tax Offset?

If your net medical expenses are over the ATO threshold (from 2010-2011 Tax Year it is $2000, previously $1500) , you can claim an offset of 20 per cent (20 cents in the dollar) in your tax return.

To claim the medical expenses tax offset in your tax return, you need to know the total amount of medical expenses you incurred for yourself and your dependants. You then deduct any refunds from Medicare Australia, your private health fund or any other reimbursements that relate to those expenses receiving during the financial year.

There is no upper limit on the amount you can claim.

What can I claim?

It is important when you are looking at the Net Medical Expenses Tax Offset to consider all of the relevant Autism expenses (more on this below) but also your other medical expenses. including

Medical expenses include payments:

  •  to GPs that charge over the scheduled fee
  • to dentists, orthodontists or registered dental mechanics
  •  to opticians or optometrists, including for the cost of prescription spectacles or contact lenses
  • to a carer who looks after a person who is blind or permanently confined to a bed or wheelchair
  • for therapeutic treatment under the direction of a doctor
  • for medical aids prescribed by a doctor
  • for artificial limbs or eyes and hearing aids
  • for maintaining a properly trained dog for guiding or assisting people with a disability (but not for social therapy)
  • for laser eye surgery, and
  • for treatment under an in-vitro fertilisation program.

Expenses which do not qualify as medical expenses include payments made for:

  • cosmetic operations for which a Medicare benefit is not payable
  • dental services or treatments that are solely cosmetic
  • therapeutic treatment where the patient is not formally referred by a doctor (a mere suggestion or recommendation by a doctor to the patient is not enough for the treatment to qualify; the patient must be referred to a particular person for specific treatment)
  • chemist-type items, such as tablets for pain relief, purchased in retail outlets or health food stores
  • inoculations for overseas travel
  • non-prescribed vitamins or health foods
  • travel or accommodation expenses associated with medical treatment
  • contributions to a private health insurer
  • purchases from a chemist that are not related to an illness or operation
  • life insurance medical examinations
  • ambulance charges and subscriptions, and
  • funeral expenses.

So does Autism Therapy count towards the Net Medical Expenses Tax Offset?

Ok … this is where things start to get a bit legal … and my knowledge only really relates to ABA therapy and my own experiences … The short version is yes but it only includes direct therapy costs (costs for Supervisors/Psychologists, Senior Behaviour Therapists, Junior Behaviour Therapists and Speech Therapists) and not any tools, books, toys etc where it has been recommended/refereed and under the direction of a medical practitioner. The appropriate rulings that are worth looking at are ATO Interpretative Decision 2011/82 and edited version of private ruling 4119 and 6093 (however I think that these have been withdrawn and replaced … your tax profession would know the most up-to-date reference).

From what I understand the key aspect to what is covered is that “therapeutic treatment must be at the direction of a legally qualified medical practitioner in order to be considered a medical expense for the purposes of the medical expenses tax offset” however “the treatment need not be administered by such a practitioner”. (ATO 2001/243)

What should I do now?

1. Talk to your accountant, taxation agent or other appropriate financial advisor. Let them know before your appointment what you want to discuss. Get from them a understanding on what is covered, what isn’t and what/how you need to keep your records so that you can make the most out of what is available. It is alot better to get this done ASAP and get advise that relates to your own unique circumstances. What is right for me is probably is not right for you. And preferably do this before tax time. Being prepared can save you alot of money

2. Talk to your doctor. You probably already have got the Health Care Plans etc … but make sure that they are up to speed with what you are doing and you have in writing a appropriate “referral” to cover you for tax purposes.

Just to be clear  … the information above is not intended to be taken as legal, taxation or financial advise. The purpose is for information purposes only. I strongly recommend that you speak to an accountant, taxation agent or other appropriate financial advisor to get specific advise on your own situation.

Image:99Club

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Disability

Navigating the Funding Maze – Carer Allowance and Health Care Concession Cards

by bronwyn
written by bronwyn

Welcome to the fourth instalment of ‘Navigating the Funding Maze‘. Today I hope to give alittle more insight into Centrelink and some of the benefits you may be entitled to.

Carer Allowance

What is the Carer Allowance?

Carer Allowance (caring for a child under 16 years) is a payment that may be available if you are a parent or carer who provides additional care and attention on a daily basis for a child aged under 16 years with a physical, intellectual or psychiatric disability or medical condition … just so you know … Autism counts.

Who is Eligible for the Carer’s Allowance?

You may receive Carer Allowance (caring for a child under 16 years) if you:

  • are looking after a child with a physical, intellectual or psychiatric disability who needs additional care and attention on a daily basis, or
  • you care for 2 children with disabilities and the children do not individually qualify you for Carer Allowance (child) but together create a substantial caring responsibility, and
  • you live with the child (or children) you are caring for.

To qualify for Carer Allowance (caring for a child under 16 years), you and the child you care for must be living in Australia permanently as:

  • an Australian citizen, or
  • the holder of a permanent resident visa, or
  • a New Zealand citizen who was in Australia on 26 February 2001, or for 12 months in the 2 years immediately before that date, or was assessed as “protected” before 26 February 2004.

You do not have to meet income or assets tests to receive Carer Allowance.

What can you get?

This payment rate of Carer Allowance (caring for a child under 16 years) is effective from 20 September 2011.

You can get either:

Which of these you receive depends on the level of functional disability of the child.

If you are receiving a Carer Allowance (caring for a child under 16 years) payment on 1 July each year, you are also paid an annual:

  • Child Disability Assistance payment of up to $1,000 to help you with the costs of caring for a child with a disability, and
  • Carer Supplement of up to $600 for each child in your care who qualifies you for Carer Allowance.

In some circumstances, you may qualify for back payment of Carer Allowance for up to 12 weeks before you lodge your claim.

You do not have to pay tax on Carer Allowance, Child Disability Assistance or Carer Supplement.

Why is the Health Care Card Important?

A Health Care Card entitles you to cheaper medicines under the Pharmaceutical Benefits Scheme (PBS) and various concessions from the Australian Government—these could include:

  • bulk billing for doctor’s appointments (this is your doctor’s decision)
  • more refunds for medical expenses through the Medicare Safety Net
  • assistance with hearing services through the Office of Hearing Services
  • discounted mail redirection through Australia Post.

State and Territory Governments and local councils may offer concessions, such as:

  • energy and electricity bills (NSW)
  • health care costs including ambulance, dental and eye care
  • public transport costs
  • water rates.

Another benefit I have found is that you get access to cheaper tickets at the Royal Easter Show.

How to claim?

1. Contact Centrelink on 13 2717 or visit a Centrelink Customer Service Centre and our staff will ask you some questions to determine your circumstances and issue you with the appropriate claim forms.

2. Return your completed forms, proof of identity for yourself, your partner (if you have one) and for the person being cared for, medical reports and any other documents we have asked for to your nearest Centrelink Customer Service Centre.

Information sourced from Centrelink
Images: Istockphoto.com

What have your experience been with the Carer’s Allowance and Health Care Concession Cards? Do you have any lessons/scars? 

Please feel free to add links to more relevant information you have found useful in the comments below.  

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Disability

Navigating the Funding Maze – Helping Children With Autism Package

by bronwyn
written by bronwyn

Welcome to the third installment of ‘Navigating the Funding Maze’. Today I hope to give alittle more insight into the Heling Children with Autism Package (HCWA) … where it came form .. what it includes … and how you can make the most of it.

Helping Children with Autism Package

Where did I (HCWA) come from?

In 2006, the Department of Health and Ageing faced with data that demonstrated that children with autism traditionally missed on many essentials services advised the community  (politicians,
bureaucrats, clinicians, service providers, families and carers) in 2006 that each child with autism needs
a minimum 20 hours per week (1000 hours per year) of intense autism-specific early intervention for
at least two years (Roberts, J. M. A., & Prior, M. (2006). A review of the research to identify the most effective models of practice in early intervention of children with autism spectrum disorders. Australian Government Department of Health and Ageing, Australia.)

Just before the 2007 election, John Howard announced the Helping Children with Autism package. John
Howard said this package was just a beginning for people with autism. Kevin Rudd also committed to
implement the package and subsequently rolled it out through its 2007-2010 term of Government.

What does the package include?

The package includes:

  • Autism Advisors Program and early intervention funding
  • Funding for diagnosis and early intervention services (Medicare Items)
  • Early Days family workshops*
  • PlayConnect Playgroups*
  • Raising Children Network – Autism Subsite
  • Positive Partnerships Workshops

* Access to PlayConnect Playgroups and Early Days workshops is also available to children with ASD like symptoms

 Autism Advisor Program

The program offers families and carers the following

  • evidence based information to support the making of informed decisions about a range of early intervention options that meet the needs of the child and the family
  • information on all components of the HCWA package
  • application for the HCWA early intervention funding package of up to $12,000 (up to $6,000 in any financial year)
  • determination of child’s eligibility for the HCWA $2,00 regional and remote payment

The program is available for families and carers of children who:

  • are aged 0-7 years of age (must register pior to their 6th birthday)
  • have a conclusive diagnosis of a Pervasive Developmental Disorder (see below)
  • are citizens, permanent residents of Australia

A conclusive diagnosis is require of one f the following conditions listed in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM IV) under Pervasive Developmental Disorders

  • Autism disorder
  • Aspergers disorder (Aspergers syndrome)
  • Rett’s Disorder
  • Pervasive Developmental Disorder – Not Otherwise specified (PDD-NOS)
  • Childhood Disintegrative Disorder

The child will need a written Australian diagnosis made viaone of these options:

  • Pediatrician
  • Psychiatrist
  • State of territory multidisciplinary diagnosis
  • Private multidisciplinary diagnosis (a multidisciplinary diagnosis must include a psychologist, speech therapist and occupational therapist with autism expertise)
  • State/territory Autism Association

This is really important. When we got our diagnosis … well we actually got 2 sets. We could only use 1 of them for the application for funding as it included a Pediatrician. The diagnosis we received from the psychologist working alone would have been insufficient to be able to meet this requirement.

Application Steps (NSW)

1. Call the Autism Advisor Program 1300 978 611. You may need to leave a message but they are pretty good and getting back to you. They can send you a application form or you can get it from the website here)

2. Register by completing an application form and consent form

Ensure that the forms are returned to the Autism Advisor Program with the following documents

  • copy of diagnosis
  • copy of treatment plan (if available)
  • proof of your child’s birth date (ie birth certificate or passport)
  • proof of child’s residential address (eg ultities or rates notice)
  • proof of your child’s centrelin reference number (this is your child’s CRN. Do not confuse it with your own. Contact Centrelink if you are unsure)
  • any parenting plans or court orders

2. Have an appointment with an Autism Advisor

  • The Autism Advisor who works with families in your area will read your application and will asssist in determining the child’s eligibility for the program.
  • They will make contact with you to book an appointment if your child is deemed eligible. You can the option of a face to face or phone appointment.
  • At the meeting you will be given information about lots of different services registered with this program.

3. Recieve letter of introduction by mail or email

  • This is the important one. This is the letter to say that you have been approved to receive the funding. You will need to bring this to your provider to be able to acces the funding.
  • Treat this letter like gold.

Funding for Medicare Items

Helping Children with Autism (Treatment)

  • Helping Children with Autism Package includes Medicare items for the diagnosis of Autism.
  • Helping Children with Autism Diagnosis Plan can be prepared by Pediatrician (Item 110-131) or Psychiatrist (Item 296-370)
  • Your Pediatrician (Item 110-131) or Psychiatrist can get collaboration (up to 4 visits) from Allied Health Professionals with with the diagnosis and development of a treatment and management plan – Psychologists (Item 82000),  speech pathologists (Item 82005), occupational therapists (Item 82010),  audiologists (Item 82030), optometrists (Item 82030), orthoptists (Item 82030), and physiotherapists (Item 82030).
  • Eligibility – The child must be aged under 13 years on referral from a general practitioner (GP).
  • Medicare rebate of $69-79 per service, with out-of-pocket costs counting towards the extended Medicare Safety Net. You get more back if you have already reached your safety net

Helping Children with Autism (Treatment)

  • Helping Children with Autism Package separate to the $12,000 funding (discussed above)
  • Helping Children with Autism Treatment Plan can be prepared by Pediatrician (Item 135) or Psychiatrist (Item 135)
  • Maximum of 20 sessions in total (not per year) to be used for the child from 0-15 years
  • Helping Children with Autism Treatment Plan can be used by Pediatricians and Psychiatrists to refer to Allied Professionals – Psychological Sessions (Item 82015),  Speech Therapy (Item 82020) and OT (Item 82025)
  • Eligibility – The child must be aged under 15 years .
  • Medicare rebate of $69-75 per service, with out-of-pocket costs counting towards the extended Medicare Safety Net. You get more back if you have already reached your safety net

Early Days Workshops

The Early Days online workshops provide information on various topics related to autism spectrum disorder (ASD). They also help you build a personal plan that you can put into practice at home with your own child and family. The workshops have been developed to provide the latest evidence-based information about ASD and equip participants with some skills needed to promote their child’s early development.

You participate in an online workshop individually, in your own time. If you need to leave the workshop at any time, you can come back to where you left off.

Online workshop topics

  • Building your resilience to stress
  • Managing stress
  • Supporting siblings
  • Video modelling
  • Self-management
  • Sleep
  • Fathers

You can get started with an Early Days workshop at the Parenting Research Centre’s online learning centre.

PlayConnect Playgroups

PlayConnect Playgroups areplaygroups for families with children with Autism. Families that have a child aged from 0-6 years with ASd or ASD liky symptoms are welcome to join PlayConnect Playgroups. You don’t need a diagnosis to join.

PlayConnect Playgroups meet weekly for 2 hous. During playgroup session, caregivers and children particpate in a viarty of play activities suited to the needs of children with Autism.

Sessions are initally run by a Development Worker for betweeen 6-24 months until they become community, parent-run playgroups.

Helping Children With Autism funding helps families access PlayConnect during the first two years of operation. Some PlayConnect Playgroups may decide to undertake certain activities that are not covered by the funding so families may be asked to make a contribution.

To find a PlayConnect Playgroup near you .. visit www.playconnect.com.au or call 1800 171 882.

Raising Children Network – Autism Site

The Raising Children Network (RCN) ASD website provides information, online resources and interactive functions to support parents, families, carers and professionals. The RCN is an Australian Government funded site providing information to parents of children from birth to school age. The RCN ASD website provides:

  • Impartial and evidence based information about ASDs and early intervention approaches
  • Information on diagnosis and assessment
  • A guide to navigating the service system
  • Locations and contact details of the advisory services and approved early intervention services
  • Links to other websites and information
  • Film clips
  • A ‘My Neighbourhood’ mapping tool that will identify services in the local neighbourhood
  • Parent forums.

Positive Partnerships Workshops

Positive Partnerships delivers the two components of the Helping Children with Autism package implemented by the deparment of Education, Employment and Workplace Relations (DEEWR).

The aim of both components is to improve the educational outcomes for school aged children with autism spectrum disorders (ASD).

The two components are:

Both components are delivered nationally by the Australian Education and Training Consortium (AAETC).

Opinion

Well … Phew. That is alot of information. Congratulations if you have read everything and got this far.

What do I think .. Hmm. Well I guess for most people the Helping Children with Autism Package really just comes down to the funding. I am sure that there are many parents who do not know about all the other aspects. The $12, 000 funding is the core element of the package and this is also where it falls down.

How can I say that? $12, 000 is alot of money … right? Well no. Let’s look at it as a percentage of the direct cost of therapy. If you look at it that way it is not much at all. How do I work this? The $12,000 has to be spent on with on therapy delivered directly from Specified or Qualified Personnel. A scan of FaHCSIA’s list shows panel providers cost $120+ per hour, so the cost of 1000 hours (recommended as part of the Government’s Best Practice Recommendations)  of early intervention from these people exceeds $120,000 … so in FaHCSIA’s existing model $6,000 per year from the HCWA package provides under 5% of a child’s early intervention need. Now if this was for another other health condition there would be an outcry. But for some reason it is OK for children with Autism.

So in my opinion it really should be called … the ‘Making a Token Gesture to So You Can Have A Answer for Press Conferences & Appears to Do Something But Really Makes No Significant Difference’ Package.

What have your experience been of the Helping Children with Autism Package? Do you have any lessons/scars? 

Please feel free to add links to more relevant information you have found useful in the comments below.  

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Disability

Navigating the Funding Maze – Medicare

by bronwyn
written by bronwyn

I remember before Autism, Medicare used to be really simple. You got a doctors bill and you took it to Medicare and then depending on what it was and how much you had already spent that year, you got back some money. Really simple. I remember when I was pregnant I used to go to Medicare regularly … but it was really simple. However, unfortunately, this is not the case when it comes to managing the paperwork for a child with Autism. I know when I was starting I found it a bit confusing .. but I hope that I can help someone out there with some of the things I have learnt.

  • Enhanced Primary Care (EPC) (DOHA)
  • Better Outcomes for Mental Health (DOHA)
  • Helping Children with Autism – Treatment

Health Care Plans

Enhanced Primary Care

  • Enhanced Primary Care Plan is for people with chronic or complex health conditions.
  • Enhanced Primary Care Plan must be prepared by your GP (Item 721 or 725)
  • Maximum of 5 sessions per calendar year
  • Unused sessions can not be transferred to the next year
  • Enhanced Primary Care Plan can be used by GPs to refer to Allied Professionals – Psychologists (Item 10968), Occupational Therapists(Item 10958), Speech Therapists(Item 10970), Physiotherapy (Item 10960) and Dietitians (Item 10954)
  • Enhanced Primary Care Plan requires the GP to specify how many services to what professional. So you need to know how you want to allocate them before you get to the office.
  • Medicare rebate of $47.85 per service, with out-of-pocket costs counting towards the extended Medicare Safety Net. You get more back if you have already reached your safety net

For more information visit the Department of Health and Ageing

Better Outcomes for Mental Health

  • Better Outcomes for Mental Health Plan is for people with identified Mental Health needs that would be best serviced by Allied Health Professionals.
  • Better Outcomes for Mental Health Plan can be prepared by your GP (Item 2710) or Pediatrician (Item 2702)
  • Number of Visits – Unfortunately this was affected by cuts in the recent budget. Changes will be implemented from 1 November 2011. See Medicare for more details
    • On or Before October 31 2011 – up to 12 individual sessions (with the possibility of an additional 6 if deemed required by referring GP or Pediatrician) per calendar year and up to 12 group sessions per calendar year
    • After 1 November 2011 – Maximum of 10 visits per calendar year
  • Unused sessions can not be transferred to the next year
  • Better Outcomes for Mental Health Plan can be used by GPs and Pediatrician to refer to Allied Professionals – 1:1 Psychological Sessions (Item 80110),  Group Psychological Sessions (Item 80120) and OT
  • Medicare rebate of $53-94 per service, with out-of-pocket costs counting towards the extended Medicare Safety Net. You get more back if you have already reached your safety net

For more information visit the Department of Health and Ageing Website

Helping Children with Autism (Treatment)

  • Helping Children with Autism Package in addition to the $12,000 funding ($6000 a year for 2 years) has additional funding for Medicare treatment.
  • Helping Children with Autism Treatment Plan can be prepared by Pediatrician (Item 135) or Psychiatrist (Item 135)
  • Maximum of 20 sessions in total (not per year) to be used for the child from 0-15 years
  • Helping Children with Autism Treatment Plan can be used by Pediatricians and Psychiatrists to refer to Allied Professionals – Psychological Sessions (Item 82015),  Speech Therapy (Item 82020) and OT (Item 82025)
  • Medicare rebate of $69-75 per service, with out-of-pocket costs counting towards the extended Medicare Safety Net. You get more back if you have already reached your safety net

Medicare Safety Net

  •  The Medicare Safety Net provides families and individuals with financial assistance for high out-of-pocket costs for out-of-hospital Medicare Benefits Schedule services. Once you meet a Medicare Safety Net threshold, you may be eligible for additional Medicare benefits for out-of-hospital MBS services for the rest of the calendar year.
  • Medicare will pay 80% of out-of-pocket costs for out-of-hospital Medicare Benefits Schedule services once you have reached the safety net.
  • You need to register to use the safety net … go now and do it now if you haven’t … here
  • The Standard Threshold is $1157.50 however drops to $578.60 when your child has a Health Care Card (if you have a child with Autism, you should have a Health Care Card as it is provided with the Carer’s allowance).

For more details … see the Medicare website

Tips

If you want to get paid … Medicare Receipt requirements

For a Medicare payments to be made the account/receipt must include the following information:

  • patient’s name;
  • date of service;
  • MBS item number;
  • allied health professional’s name and provider number, or name and practice address;
  • referring medical practitioner’s name and provider number, or name and practice address;
  • date of referral; and
  • amount charged, total amount paid, and any amount outstanding in relation to the service.

You may find that you need to get your account/receipts reissued with all the necessary information for Medicare (as your provider won’t know what you are claiming and when). If you turn up just with your account/receipts) without the Medicare Item numbers and the Care Plan Details they will reject them … trust me … it happened

Getting Set-Up

From my experience … the best way to get set-up is

  1. Register for Medicare Safety Net 
  2. Book 2 Long Appointments with GP. Most GP practices want you get book a long appointment for Health Care Plans. Check with their receptionist when you book appointment
  3. Visit your GP and …
    1. Complete the Enhanced Primary Care Plan (Item 721 or 725)
    2. Get Referral to Pediatrician
    3. Get Referral for Treatment (for tax reasons)
  4. Visit your GP and get the Better Outcomes for Mental Health Plan
  5. Book appointment with Pediatrician
    1. Complete Helping Children with Autism Treatment Plan
    2. Get Referral for Treatment (for tax reasons)

Once you get each of your Treatment Plans and Referrals provide a copy (keep the original) to your provider. I prefer to scan them in and email them to my provider.

Summary

  • Get all of your Health Care Plans as soon as possible. You can only claim from the date of your health care plan. Make sure that you keep them up-to-date.
  • Get to know the Medicare Item Codes. This is the terminology that everyone talks in. If you don’t know it and use the name of the Health Care Plans most people (including Medicare employees) won’t be able to help you.
  • All of your Medicare professional can only use 1 Medicare item code per visit. So if you need to get more than 1 health care plan from the same doctor you need to do 1 visit per health care plan
  • Most doctors want you to book a long appointment for a Health Care Plan. Check when you book the appointment with the receptionist on the polciy used at that surgery.
  • Make sure that you have all of your paperwork in order before you go to Medicare (especially the Receipt Requirements). If you don’t you will be sent away.

What have your experience been with Medicare? Do you have any lessons/scars? Please feel free to add links to more relevant information you have found useful in the comments below.  

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Disability

Navigating the Funding Maze

by bronwyn
written by bronwyn
green plant in clear glass vase

I remember last year when we entered into the Autism world I felt completely overwhelmed. Not just from the diagnosis and what it would/could mean in LittleMan’s life but also the area around government funding for Autism. I know for me I just found it so confusing.  We were lucky however. I got alot of information from both our  Autism Advisor and the  Lizard Centre.

So I will be sharing in a series of posts some of my learnings that I hope will be useful for you in getting around Medicare, Centrelink, Taxation Office and Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA).

Topics will include

If you have any questions or suggestions for things that you would like to also cover … please let me know.

Photo by Visual Stories || Micheile on Unsplash

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