HCWA – Early Intervention Service Provider Panel Operational Guidelines – revised July 2012
Helping Children with Autism (HCWA)
Early Intervention Service Provider Panel
Operational Guidelines
July 2012
Revision History
Version / Reference / Section/Page / Date / RevisionVersion 1 / Multiple / Multiple / June 2010 / Multiple revisions. New Deeds from 1 July 2010.
Version 2 / Page 13 / Section 3.4 (g) / August 2010 / Changes to guidelines on purchasing resources
Version 3 / Pages 16 and 25
Page 7
Pages 5-8, 12, 14, 15, 17-22, 24, 26-32 / Sections 6 and 17
2.1
Multiple / December 2010 / Updated contact email to , replacing asdpanel and asd email addresses
Revised Speech Pathology and Psychology requirementsMultiple revisions
Version 4 / Multiple / Multiple / February 2012 / Multiple revisions
- Rearrangement of sections to make consistent with Better Start
- Update of document names
- Modification of requirements for Specified and Other Qualified Personnel
- New details in Section 3 (3.1.3, 3.1.4, 3.1.5, 3.1.6
- New information in Section 4 on In and Out of Scope Interventions
- Modification of Service Delivery Section 5
TABLE OF CONTENTS
PART A – HCWA Early Intervention Service Provider Panel…………………………………………………….4
1 Introduction 4
2 Access to Early Intervention Funding and Services 6
3 About the HCWA Early Intervention Service Provider Panel 9
4 What are service providers required to deliver? 11
5 Service Delivery 14
6 Confirmation of eligibility 22
7 Payment for Services 24
8 Consortium Arrangements 27
9 Sub-Contractors 29
10 Operational Requirements for Providers 29
11 Privacy Issues 33
12 Reporting 34
13 Reviews 35
14 Complaints 35
15 FaHCSIA National Office Responsibilities 36
16 Contact information 36
PART B – Funding Management System 38
1 FaHCSIA Online Funding Management System (FOFMS) 38
2 User Access 39
3 Funding 42
4 Using FOFMS 42
5 Further technical support 45
PART A – HCWA Early Intervention Service Provider Panel
1 Introduction
The Helping Children with Autism Early Intervention Service Provider Panel: Operational Guidelines provide the operational framework for the Early Intervention Service Provider Panel (the Panel) and form the basis for the business relationship between the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) and Service Providers on the Panel.
The Operational Guidelines form part of the Funding Agreement between FaHCSIA and each Provider on the Panel. These Guidelines should be read in conjunction with the Early Intervention Services for Children with Disability Program Guidelines (Parts A, B and C), the cover letter and the Standard Terms and Conditions – Standard Funding Agreement (July 2011) (hereafter referred to as the Standard Terms and Conditions).
FaHCSIA reserves the right to vary any aspect of, or replace these Guidelines from time to time by whatever means it may determine in its absolute discretion, provided the changes are not inconsistent with the Standard Funding Agreement.
Amendments made to these Guidelines will be notified by email to the contact person named in the Standard Funding Agreement within 20 business days of any variation. FaHCSIA will ensure that the most current version of the Guidelines is located within the Literature Tab of the FaHCSIA Online Funding Management System (FOFMS).
It is the responsibility of each organisation on the Panel to ensure that they are familiar with the content and requirements of these Guidelines as detailed in the current version maintained in FOFMS.
1.1 The Helping Children with Autism (HCWA) Package
The Early Intervention Service Provider Panel was established in October 2008 by FaHCSIA as the mechanism to provide increased access to services for children with autism spectrum disorder (ASD). Early Intervention funding is one component of the HCWA Package (for more information on the complete HCWA Package see Part C: Application Information for the Helping Children with Autism (HCWA) Package
1.2 Components of HCWA Early Intervention
The Early Intervention Service builds on existing services being provided by state and territory governments. Eligibility to the HCWA Early Intervention funding should not restrict access to state and territory services and funding. It will contribute towards the 20 hours a week of early intervention for children with ASD as recommended by the Guidelines for Best Practice 2006[1].
1.2.1 Early Intervention funding
Eligible children have access to a funding package of up to $12,000 (maximum of $6,000 per child per financial year up till their seventh birthday) to assist with the cost of early intervention services.
The funding can be accessed across a number of financial years, up until the child turns seven, or until the child has used all of their available funds, whichever comes first. Depending on the child’s age at their eligibility start date, some children may not be able to access the full $12,000.
The funding package will provide structured and intensive early intervention services, such as one-on-one intensive activities and tailored group and individual programs that can be delivered in a range of settings.Families can use their child’s funding to pay for interventions delivered by Providers on the Panel that best suit the needs of their child. As services are delivered to eligible children, FaHCSIA will make payments in arrears, to Providers, on behalf of families.
1.2.1.1 Family Activity Statements
FaHCSIA will generate a monthly report known as a Family Activity Statement (FAS) for each child who has had claims processed during the preceding month. The FAS will detail the child’s name, the Lead Agency or Provider’s name, the services received during the month and the amount paid by FaHCSIA on the child’s behalf. Families will not receive a FAS if they have not had any claims processed during the preceding month.
The FAS also shows the child’s current period (Financial Year) overall balance and resource balance as well as their overall balance and resource balance until the eligibility end date.
A FAS will be emailed to families through the FaHCSIA Online Funding Management System (FOFMS). Families who do not have an email address will receive their FAS in the post.
1.2.2 Autism Advisor Service
Autism Advisors confirm eligibility for the funding package by providing the family with a Letter of Introduction which must be presented to the Provider on the family’s first visit. Further information on the Letter of Introduction is in Section 7.1
Autism Advisors provide a central contact point for advice, information and linkages to service options for families and carers. Autism Advisors provide information about local early intervention and community based services that would best meet the particular needs of the child and family. This includes up to date information about Providers in the local area, the interventions being delivered, the schedule of fees, the availability of service (i.e. waiting times) and relevant contact details.
Autism Advisors support families to apply for the Outer Regional, Remote and Access Support Payment– see 1.2.3 below.
1.2.3 Outer Regional, Remote and Access Support Payment
Eligible children may also qualify for an additional $2,000 Outer Regional and Remote Access Support Payment (OR&R Access payment). Eligibility for the OR&R Access payment is confirmed by the Autism Advisors, based on the child’s residential address.
This one-off payment will provide families and carers with additional options for accessing or supporting early intervention services for eligible children including training, respite, resources and accommodation and travel to and from support services.
The OR&R Access payment is in addition to the early intervention funding of up to $12,000 that is available per eligible child.
For more information on eligibility see Section 2.3 Eligibility for Outer Regional, Remote and Access Support Payment.
1.2.4 Medicare component
Under the HCWA Package, children with ASD (including those over the age of six) may also be eligible for Medicare items. A Medicare item for the development of a treatment and management plan is available for children under the age of 13. Medicare items are also available for up to four allied health diagnostic services and 20 allied health services (in total) for every eligible child.
Specifically, Medicare items are available for:
· paediatricians and psychiatrists to diagnose and develop a treatment and management plan for children aged under 13 years on referral from a general practitioner;
· audiologists, occupational therapists, optometrists, orthoptists, physiotherapists, psychologists and speech pathologists to provide up to four services in total per child, per lifetime, to collaborate with the paediatrician or psychiatrist on the diagnosis, where required. These services must be provided before the child’s 13th birthday; and
· audiologists, occupational therapists, optometrists, orthoptists, physiotherapists, psychologists and speech pathologists to provide up to 20 early intervention treatment services in total per child, per lifetime, following a diagnosis of autism/PDD for the child, and consistent with the treatment and management plan prepared by the referring practitioner. These services must be provided before the child’s 15th birthday, provided an autism/PDD treatment and management plan was in place before the child’s 13th birthday.
For information about the Medicare items refer to the Department of Health and Ageing website at www.mbsonline.gov.au and www.health.gov.au/mbsprimarycareitems
2 Access to Early Intervention Funding and Services
2.1 How will families access the funding package?
To access the Early Intervention funding package:
· Children require a diagnosis of an ASD from a paediatrician, psychiatrist or multidisciplinary team (including a paediatrician or psychiatrist) to be eligible to access funding through the Early Intervention Service; AND
· Families must register their child prior to their sixth birthday with an Autism Advisor service. Autism Advisors are located in the Autism Association in each state or territory and contact details can be accessed at the FaHCSIA website, see http://www.fahcsia.gov.au/autism
2.2 Eligibility for Early Intervention funding
To be eligible for the Early Intervention funding children must satisfy each of the following eligibility criteria:
· Age - Eligible children are those who have been diagnosed in Australia with an ASD who have been registered by an Autism Advisor before their sixth birthday;
· Diagnosis - The Autism Advisor must sight a written conclusive diagnosis made in Australia by or through any one of the following:
o a State/Territory Government or equivalent multidisciplinary assessment service; or
o a private multidisciplinary team; or
o Paediatrician; or
o Psychiatrist;
A multidisciplinary assessment team must consist of a psychologist and speech pathologist but may also include an occupational therapist.
An acceptable diagnosis is one of the following as listed in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) IV under Pervasive Developmental Disorders:
· Autistic Disorder;
· Asperger’s Disorder/Syndrome;
· Rett’s Disorder;
· Childhood Disintegrative Disorder; or
· Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS).
Please note that having “similar characteristics” to autism is not a conclusive diagnosis.
An acceptable form for a diagnosis should include either:
· letter-head paper, which includes the signature and position of diagnosing person; or
· as an email with ‘approved for transmission’ in the email by the appropriate diagnosing person.
· Residential eligibility - Residence requirements for access to funding is the same as that for Carer Allowance (Child). That is, both the carer and the child being cared for must be:
o an Australian resident - this means they are living in Australia on a permanent basis and they are either:
o an Australian citizen, or
o the holder of a permanent resident visa, or
o 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.
For more information on Carer Allowance residence requirements see www.centrelink.gov.au/internet/internet.nsf/payments/ca_child_residence.htm
2.3 Eligibility for Outer Regional, Remote and Access Support Payment
2.3.1 Outer Regional and Remote
The HCWA Package provides a payment of $2,000 for families of children who are registered for Early Intervention funding and live in a location defined as Outer Regional, Remote or Very Remote by the Australian Bureau of Statistics’ Accessibility/Remoteness Index of Australia (ARIA+). The Outer Regional, Remote and Access Support Payment (Access Payment) is intended to assist families in outer regional, remote or very remote locations with the higher costs of accessing services.
Process
Payments to families who are eligible for the Access Payment based on their residential address are processed through FaHCSIA’s Online Funding Management System (FOFMS) by Autism Advisors.
2.3.2 Access Support
In “exceptional circumstances”, families who do not qualify for the payment on the basis of their residential address may be eligible for the Access Payment. To be eligible under exceptional circumstances, the family must:
· Demonstrate that they are experiencing multiple, significant barriers that directly impact their ability to access HCWA Early Intervention services for their child;
· Demonstrate how the Access Payment will assist the family gain better access to HCWA Early Intervention services for their child; and
· Provide evidence that they have investigated all other options of getting access to Early Intervention service providers and other options of support that may be available to them.
This funding will provide families with additional options for accessing early intervention services as well as training, respite, resources (such as computers to access online information and books), and accommodation and travel to and from support services.
This payment is in addition to outreach services available to regional and remote areas and in addition to the funding package of up to $12,000 per eligible child.
Process
· Each case will be assessed individually by FaHCSIA. Applications for consideration due to “exceptional circumstances” must be submitted by an Autism Advisor on the appropriate form.
· A family with more than one child eligible for HCWA funding may be eligible for the Access Payment in respect of each eligible child on the proviso that exceptional circumstances exist for each child.
· FaHCSIA will notify Autism Advisors of all decisions by email. Where a request for consideration due to exception circumstances is approved, FaHCSIA will adjust the eligibility flag in FOFMS.
· Payment is processed on FOFMS by Autism Advisors.
· Where an application for consideration due to exceptional circumstances is unsuccessful, families may wish to request a review of the decision. Requests should be addressed to the Branch Manager, Autism and Early Intervention Branch in FaHCSIA via email at or post to FaHCSIA Box 7576, Canberra Business Centre, ACT, 2610.