OT and Discharge Planning

Sep 1, 2017

Hospital to Home OT Services

Enhance OT provide consultancy discharge planning services to private and public hospitals across Adelaide. Our inpatient service is same day and can address a number of complex, chronic or cognitive conditions.

OT Discharge Planning is popular when a patient has sudden change in mobility, a need for more support or has a long period of recovery.

The OT will look at a wide range of factors that impact a patient's daily life and their ability to care for themselves on returning home. Indicators for an OT assessment may include sudden life change or injury. Short term recovery from surgery can impact how we can care for ourselves and the support we need in daily life. Recommendations will cover short and long term needs.

Why OT at Hospital Discharge?

An occupational therapy home assessment soon after the patient returns home from hospital can help to identify any unexpected difficulties that may arise, ensure the patient is safe and supported at home. If required, an OT will assist by linking patients to further supports.

These may include:

Short term assistance at home eg. Meals, showering, transport, cleaning
Long term rehabiliation programs eg. stroke, cardiac or injury
Short term equipment eg. toilet raisers, shower chairs, temporary ramps
Long term home modification eg. rails in bathrooms, door widening, access

An OT home assessment is an opportunity to identify any further equipment, modification or other home safety recommendations.

Does the patient need to be present?

If a discharge planner has concerns regarding how someone might manage in their home environment, our therapists are able perform access visits to assess the home and how someone may manage. A pre-discharge home assessment is a popular service that can make the transition from hospital to home an easier, quicker and safer event. This is particularly the case if someone needs to return home in a wheelchair or other mobility aid and can often be completed whilst the patient is still in hospital.

Rates are charged hourly and cover travel, reports, assessment and coordination with hospital, family and carers. For more information on our discharge planning occupational therapy services please feel free to contact our friendly client services team on 82763355.

Who funds OT in hospitals?

Private Hospitals - Inpatient

Whilst the patient is admitted, the cost for allied health lies with the hospital.

If a third party is requested to fund the OT service whilst during the inpatient period, approval from the funding body will need to be provided with the referral.

DVA Gold Card funded Inpatient

If the Gold Card holder is an inpatient, prior approval for funding is submitted to the department of veterans affairs. Subsmissions need to include full medical history and letter from specialist.

Funding applications should expect 14-21 days to process.

When patient is discharged, DVA Gold Card can fund outpatient services with letter from specialist, GP or Discharge Planning team. (OT, Nurse, DC Planner).

Inpatient Fees

Inpatient attendance is charged per consult at the locum rate. Reports are invoiced per hour.

Our clinicians are "on call" for urgent inpatient assessments. We can usually attend within 24 hours of referral.

Please contact our practice to discuss fee schedule for inpatient OT services.

Who funds OT in age care facilities?

Aged Care - Low Care

Residents in low care are responsible for their own allied health costs. Third party funding (DVA, insurance) referrals follow usual outpatient guidelines.

Privately funded and insurance paid (extras) service require no formal referral, however a medical summary from GP or specialist will assist in the assessment and treatment.

Aged Care - High Care

Residents in high level care have Commonwealth funded allied health costs paid direct to the facility. Third party funding will have specific guidelines for OT referrals.

For Gold Card holders in High Level Care, DVA will require a funding submission to the department. Submission will require letter from GP or specialist. Submissions for funding using Gold Card whilst patient is in High Level RACF requires 14-21 days.

Requests for Gold Card holders in HLC should review the Age Care Matrix for eligibility.

Alternatively, resident or facility can fund OT service privately.

Who funds OT at home?

Home Assessment Fees

Home assessments are charged per hour. The minimum consultation for hospital to home is one hour. A report to hospital and GP is recommended, but not mandatory.

Many hospitals will directly fund our Home OT service to better support discharging patients, assist complex case managers and contribute to hospital avoidance programs.

Please contact our practice to discuss a fee schedule for home OT service.

Self Funded

OT can be provided to any individual without medical referral. Hospital to Home consultations are usually one hour and reports are billed as required.

Private health extras will cover OT outpatient service. Individuals should check with their own insurer to confirm rebate. Please contact our practice to discuss self funded OT service, we will be pleased to outline the scope of service and advise on out of pocket costs.

Medicare Funded OT

Medicare programs are prescribed only by General Practice as part of an overall care plan. Patients with chronic or mulitple conditions should discuss with GP prior to surgery or admission. Rebates are provided for only 5 allied services per year and patients will have some out of pocket costs for OT services. All care plans require initial and summary reports per calendar year.

Discharge Planning - Veterans

Enhance OT accepts referrals for clients under the Department of Veteran’s Affairs (DVA) Rehabilitation Appliance Program following discharge from hospital. Hospital staff should check the patient is eligble and list the condition for treatment on a clincial referral.

Patient's with white card are eligible for funded service that treats their accepted condition.

Funding for OT services by Department of Veterans Affairs is only available to patients who have RAP referrals.

DVA provide clear guidelines for referrals, please see the link to updated resource guide:

https://www.dva.gov.au/about-dva/publications/health-publications/effective-discharge-planning-guide

DVA forms & Links:

Enhance OT are very pleased to service any discharging patient. Funding from DVA will rely on adquate referral from hospital, specialist or GP.

Referrers should note the only valid formats for DVA funding are:

Attached D904 Form

Download DVA form

Letter of referral - on hospital letterhead

More info from DVA: "Ensure your Referral for Treatment is Valid"

Home Care Packages

Enhance OT have service agreements with most major HCP providers. Since early 2017, patient's with any level of package can access allied health from any provider.

Enhance OT offer same day and after hours service for discharging patients. We are pleased to accept payment on account from HCP.

Referrals for patient's on HCP should have an attached approval from appropriate coordinator.