4.5.20.3 Arrange a household help services needs assessment

A Household help services needs assessment is performed by an occupational therapist (OT Occupational therapy is a client-centred health profession concerned with promoting health and well being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want to, need to or are expected to do or by modifying the occupation or the environment to better support their occupational engagement .) at the request of an Agent to determine strategies to maximise a worker’s independence. It allows the OT to assess a worker’s functional capacity and assess the necessity and appropriateness of the requested household help services or adaptive household equipment.

Based on this assessment, the OT can provide a clinical recommendation to the Agent, which is considered as part of the Agent’s decision to approve, vary or deny a worker’s request for services or equipment.

A household help services needs assessment must be completed where more than 24 weeks (accumulated) of household help services have been funded by WorkSafe.

A household help services needs assessment may also be needed:

  • when all available information has been sourced from treating health practitioners (THPs) and the worker, but the Agent remains unable to determine if the request for services or equipment is reasonable and necessary

  • where requests for household help are not in line with typical expectations, and the reasoning from the THP Treating Health Practitioner or worker requires further information that can only be obtained via an on-site assessment

  • when a review of services is required, i.e. when ongoing household help is in place and the worker may benefit from alternative strategies to improve independence

  • when the HH request form outlines the need for adaptive household equipment or strategies to maximise and maintain a worker’s independence in undertaking household or gardening tasks.

Prior to confirming a HHSNA is required, the Agent must consider all information on the worker’s file alongside the Household help services guidelines, and consult the household help process flow and ready reckoners.

A HHSNA is not required where:

  • the worker is not eligible for household help services

  • the assessment is unlikely to change the outcome

  • the information being sought is available from another source such as an assessment from a hospital OT up to 12 weeks post discharge.

The Agent must consider whether a decision on eligibility of services can be made prior to making a referral for a HHSNA.

Communicating with the worker

At the time of the referral, the Agent should contact the worker to explain why a household help services needs assessment is being arranged in response to their Request for household help.

The worker should understand:

  • an OT will contact them to arrange a time to visit their home for the assessment

  • the purpose and scope of the assessment

  • the importance of functional observation

  • that their existing household equipment items may be reviewed, and should be ready and available for the assessment

  • that photos of the home will be taken by the OT for the report

  • that the OT will work with them on a recovery plan to improve independence

  • that not participating in some parts of the assessment may mean the Agent cannot make a decision regarding the need for household help services.

  • that OT recommendations do not guarantee service provision

  • that funding decisions are made by the Agent (and not the OT) in line with guidelines

  • that access to household help service provision is generally short-term

  • that gap fees or co contributions may apply in some circumstances

  • that the assessment may result in the decision that no further supports can be provided.

See: Standard Household Help Ready Reckoner | Long Term Household Help Ready Reckoner | Referral for Household Help Services Needs Assessment | Household Help Services Needs Assessment

4.5.20.4 Review HHSNA report and recommendations

Following receipt of a HHSNA report (the completed HHSNA form), the Agent should review it to ensure the following:

  • The household help services needs assessment (HHSNA) form has been used.

  • All relevant sections of the assessment report are completed; where this is not possible, clear clinical reasoning must be provided.

  • It is apparent the worker’s functional capacity was observed. Where this was not possible, details on how the information was sourced must be provided.

  • A recovery and services plan has been completed, including agreed upon SMART goals, a plan to increase the worker’s independence and, if applicable, a plan to cease services.

  • Recommendations:

    • align with the scope of referral, the clinical framework, and relevant WorkSafe guidelines

    • are clinically justified

    • make sense when read with details provided within the body of the report.

  • The report is objective, error-free, dated and signed.

If an HHSNA report does not meet the requirements set out above and in the HHSNA support material , it may be returned to the OT for amendment at their cost. Agents also have the right to refer reports to the WorkSafe Clinical Panel for review and consideration.

Agents must review the HHSNA report recommendations along with the following information to decide whether household help services should be approved, varied, or rejected:

  • information obtained from the worker and treating health practitioner (attached to the referral)

  • Household help services guidelines

  • Equipment and related services guidelines.

Note: Where the OT has recommended a ride on mower or like vehicle in place of long-term gardening/mowing services refer to Ride on mower supply.

See: 4.5.12.9 Ride on mower supply

It is the role of the Agent to determine liability for household help service provision. The Agent must make and communicate the decision to approve, vary or reject the request for household help services within 10 days of receiving the HHSNA report. A standard letter must be sent to the worker and the worker’s treating health practitioner advising them of the decision.

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