4.5.32 Outreach services

WorkSafe Victoria can pay the reasonable costs of an outreach service when required as a result of a work related injury or illness in accordance with Victorian workers’ compensation legislation.

Outreach services are person centred, non-clinical, psychosocial supports. When an injured worker experiences barriers to their recovery due to their work related primary or secondary mental injury, outreach services can:

• support with daily living activities

• assist to engage with services

• support to connect with community

• provide peer support

• assist to exercise choice and control

• develop goal setting and capacity building

• provide risk The probability of the worker not returning to work is known as the risk or risk factor. For example: if a worker is likely to return to work, the claim is categorised as low risk. and safety planning

Outreach service providers develop an assessment and support plan with an injured worker to identify their needs and goals, so their recovery is fully supported.

WorkSafe can also pay for the reasonable costs of a medical and like expense where a worker is entitled to provisional payments on a claimed mental injury.

See: 6.5 Provisional payments for a mental injury

Policy

The policy provides guidelines for outreach services including:

• expectations for service delivery
• who can provide services
• what costs will be paid for
• what costs will not be paid for
• referral requirements
• reporting requirements

See: Policy for Outreach Services

Fee schedule

WorkSafe publishes a fee schedule for the maximum amounts that it will pay for Outreach Services.

See: Fee Schedule for Outreach Services

Criteria for outreach services

The following should be used as a guide. A worker may benefit from Outreach services where:

• the worker has sustained a mental injury (primary or secondary)
• the worker has been identified as being at risk of developing a secondary mental injury, e.g. as indicated by the worker:
• not engaging with treatment
• having minimal social supports and/or is feeling isolated
• having psychological and mental health support needs
• requiring early intervention
• requiring crisis support

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Service delivery expectations

WorkSafe expects all outreach service providers to:

• maintain one-on-one contact with the worker and actively collaborate with the worker’s treatment team

• make reasonable attempts to communicate with the worker to maintain engagement with services

• collaborate with the worker regarding their treatment goals including development of self-management skills, connection with community and engaging with services

• align to the principles of the Clinical Framework for the Delivery of Health Services including; measuring effectiveness, empowering the worker to manage their injury, and using evidence-based methods to optimise the worker’s function and recovery.

Referral and reporting requirements

WorkSafe does not allow outreach providers to initiate referrals to other services. Where a need for other health services is identified, discuss this need with the injured worker and their treating team.

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Steps for referring and requesting outreach services

Follow these steps to assess an outreach services request.

Step	Agent action
1. Referral for outreach services	A medical practitioner must provide a written referral to the Agent prior to the commencement of services. To initiate referrals, Agents/providers must link with the treating medical practitioner to action in writing
2. Review referral	Once the referral has been received, the Agent can approve a maximum of 120 hours over three months. If the request is approved The Agent should send an approval letter to the worker and medical practitioner notifying approval of services, service provider details and expectations for initial engagement. Services can commence once the Agent provides this approval. If the request is denied The Agent should send denial letter to the worker and medical practitioner notifying them of the rejection of Outreach Services within 10 days of receiving a request.
3. Engage service provider	To confirm approval, the Agent will send the following documents to the provider: the request for Outreach Services letter a completed Outreach service referral form and a copy of theInitial Assessment and Support Plan template This information will provide details around the injured worker’s current barriers to recovery. If the Outreach provider accepts the referral - they will engage with the worker within five days. If the Outreach provider does not accept the referral - they will call the Agent to discuss the reason why.
4. Initial assessment & support plan	The provider must submit an initial assessment and support plan to the Agent, identifying the needs and goals prior to the fifth session with the injured worker. The provider’s initial assessment and support plan must include the following information: reason for referral person-centred goals - SMART (specific, measurable, achievable, realistic and timely) expected outcomes of evidence based supports number of service hours required level of consultation with the referring medical practitioner and treating team. WorkSafe have developed the following template that providers should use when completing, the initial assessment and support plan, plan update and discharge plan
5. Further assessment and support plan	After each three month period or if 120 hours is reached within that period, the provider must submit a further assessment and support plan to the Agent, to request more hours. The Agent determines liability for subsequent support hours and should consider: has there been clear progress toward the worker’s goals? are there additional barriers to the worker reaching their return to health and or return to work goals? The Outreach Service provider may not utilise additional hours prior to receiving written approval from the Agent. It is important that the Agent notifies the Outreach service provider of the outcome of the request for subsequent hours, within 10 days to allow continuity of supports and avoid worker disengagement.
6. Review of Outreach services	Outreach services can be delivered for up to 12 months from the date of approval. WorkSafe may initiate a review to determine suitability of ongoing Outreach services for workers who: continue to experience barriers because of their work-related injury or illness after 12 months, or have used a high level service hours, with limited progress towards their goals
7. Injured worker exit	A worker discharge can be triggered if a worker elects to voluntarily opt out of the program or successfully achieves all goals identified within their support plan and no longer requires Outreach services. Within 10 business days of a worker discharging from the program, the provider must submit a final Assessment and Support Plan to the case manager. This report must include: reason for discharge recommendations regarding appropriate ongoing management strategies or alternative interventions for the worker ongoing support services/barriers to recovery total hours of services provided

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