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What DVA-funded services are available in general practice?
The department’s Chief Health Officer outlines the key funded healthcare services available for veterans outside of the MBS.
To support the unique needs of veterans who have, or are transitioning from the Australian Defence Force (ADF), the Department of Veterans’ Affairs (DVA) offers a suite of healthcare resources which are funded separately to Medicare.
But Professor Jenny Firman, GP and Chief Health Officer at the DVA, believes there is a lack of awareness regarding the different funding supports available when providing veteran healthcare in the general practice setting, and the number of DVA-funded services beyond that of Medicare.
‘GPs are spending a fair bit of time trying to get information to veterans, and it’s always hard to remember exactly what’s available, when and how,’ Professor Firman told newsGP.
‘Veterans have access to a number of DVA services that they can’t get under the MBS, and we really want to make sure that GPs – who are central to their care coordination – also are aware of these things so they can provide the best possible care for their veterans.’
Under the DVA, veterans are eligible to be Veteran Card holders, which provides access to tailored health services related to DVA-approved conditions, such as annual health checks, mental health services, case coordination, counselling and home care.
In the primary care setting, Veteran Cards are used to pay for health services at the DVA rate, and GPs cannot charge gap fees with these bulk-billed payments. The DVA funds care for veterans, and if a GP wishes to claim for a service provided to a veteran, they must use the DVA fee, which is funded at 115% of the schedule fee for general practice.
If the patient uses a Medicare card instead of a Veteran Card only the MBS rate will be paid. As Veteran Cards provide different levels of coverage for card holders, primary care providers need prior approval from the DVA for treatments not listed on the MBS.
To assist practitioners, the DVA has developed ‘quick guides’ for primary care providers, which Professor Firman says are ‘a handy place to start’.
In addition, a ‘lookalike’ of the MBS Quick Guide – the DVA Claiming Guide – is set up with a list of item numbers and what they are worth.
Comprehensive health assessments
The One-off Veteran Health Check is offered any time after transitioning out of the ADF and is available to non-Veteran Card holders. The DVA GP fee for a standard 45-minute consult is $167.70, while a 60-minute consult is $231.35.
The Annual Veteran Health Check, introduced in 2019, provides a comprehensive health assessment for those who transitioned out of the ADF from 1 July 2019, and is available every year for five years following discharge.
Professor Firman says these comprehensive health assessments can help GPs become aware of what issues veterans may experience once they leave the ADF.
‘Knowing if you’ve got someone in front of you with [for example] a complex mental health problem who’s struggling, that you can actually arrange to have comprehensive care funded by the DVA, can be really reassuring and helps you manage that patient,’ she said.
‘It’s really important to also be that aware not all veterans perceive themselves as veterans. They might see a veteran as someone who must have served on operational service, but anyone who has served one day full time in the ADF is a veteran and is entitled to services funded by DVA.
‘So it’s important for GPs to ask the patient to identify who they are and what they need.’
According to Professor Firman, the key to veterans accessing DVA-funded services is lodging a claim for a condition which they think is related to their service. Once that claim is accepted, they are able to access other services, including the Coordinated Veterans’ Care (CVC) Program.
Originally for Gold Card holders with chronic, more complex conditions, the program has now been expanded to veterans with a White Card for a mental health condition that is part of an accepted claim, and funds the general practice to provide coordinated care for the veteran.
‘Veterans love [the CVC] because they’ve got that regular contact with their practice and it’s really about identifying what care they need, how they can access it, and linking them to it,’ Professor Firman said.
‘For someone who might be really struggling to access the healthcare they need to improve their health, they can be supported by the practice and DVA funds payment for that.’
GPs can get up to $2355 for the first year for coordinating care under the CVC Program, and $1900 each year thereafter, which is separate to any fees associated with seeing the veteran for a service.
Mental health care
Anyone who served a minimum of one day full time in the ADF is entitled to DVA-funded non-liability mental health care for the rest of their life. This includes GP visits, psychologists, psychiatrists, treatment programs and inpatient care.
Professor Firman said the service was set up to provide support for an important area of need for this patient group.
‘This is a unique and excellent service in recognition that a number of veterans struggle with their mental health after leaving, to ensure that they get early access to mental health care as soon as they can,’ she said.
The DVA’s national counselling service, Open Arms, is available to anyone who served in the ADF and was expanded to include families. Veterans do not require a referral, and in addition to free counselling, group programs, a peer-support program, crisis accommodation, suicide prevention and training are provided.
‘Open Arms is a really important resource,’ Professor Firman said.
‘It can be really useful for a GP if they’ve got a family member of a veteran who might be also struggling, and whether it might be related to the veteran or not, they can still access that free care.’
Allied health and home care
If someone has an accepted claim, the DVA funds allied health visits in cycles of 12 visits with a review by the GP at the end of 12 visits, with additional visits available for as long as is necessary.
Older veterans with a Gold or White Card for number of conditions can get access to community nursing, as well as access to Veterans’ Home Care which provides domestic assistance, personal care, home maintenance, gardening, etc.
‘Home care is designed to try to help the veteran stay in their own home as long as possible and provide the services to give them an independent, good quality of life and hopefully support their health a lot better,’ Professor Firman said.
DVA funds a full range of rehabilitation aids, appliances and products, which GPs can refer veterans to.
Medication reviews
The DVA funds a number of pharmacy items including medication reviews and reviews of dose administration aids such as Webster packs.
Professor Firman said the DVA supports veterans and primary healthcare providers to ensure quality and accessible care.
‘For GPs seeing a veteran, it’s about knowing these services exist so that you can offer it,’ she said.
‘And for many patients who may not be able to necessarily afford nor access some of these services, DVA can fund them.
‘GPs who want to do that coordinated care really well and look after your veterans, it’s remunerated to support that.’
RACGP Specific Interests Military Medicine and Veterans’ Health also has a role in supporting GPs to understand the resources available, and how to best support veteran patients.
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