This funding can only be accessed by palliative care service providers. There are two categories available: Inpatient Palliative Care for core services, and Community Palliative Care for non-core, quality of life services.
Below are the links for the application form and instructions on how to complete the form and the ESAS (Edmonton Symptom Assessment Scale) form that must accompany the application.
Community palliative care services can access a capped funding source to assist with the provision of non-core palliative care services for clients with motor neurone disease (MND) to improve or maintain the quality of life for this client group. This funding is a result of the Motor Neurone Disease and Palliative Care Pathways Project and subsequent Department of Health and Human Services (DHHS) support for the program and its recommendations.
The treatment of the person living with MND must not be dependent on the service receiving any top up funding. If the application for top up funding is not successful, the person living with MND must still receive the normal and expected care and access to all services appropriate to their condition and situation. This funding is an adjunct to existing funding and does not represent a dedicated funding stream for the provision of care to people living with MND.
Up to $2,000 is available to community palliative care services per financial year per person with MND when specific eligibility criteria are met. The funding level was determined using historical data about number of people accessing community palliative care and divided by the total funding. The purpose of the funding is to ensure people living with MND can access programs at community palliative care services for the duration of their episode of care, which may be considerably longer than people with malignant or other conditions. The funding should be used to facilitate access to activities and programs that focus on quality of life (such as music therapy, social interaction, spiritual care etc) rather than the delivery of core nursing or medical services for symptom relief.
The average length of stay of people living with MND is longer than for many other people accessing community palliative care services. In addition, the range of services that are required for people with MND are often different. For example, there are often fewer nursing visits for people with MND compared to many people with malignant conditions. The top up funding is provided to community palliative care services so that the few people with MND are able to access community palliative care programs and services for an extended period of time at an appropriate frequency that may not always be possible due to a long length of stay.
The needs of people living with MND that are able to be met by community palliative care services include 'quality of life activities'. Activities such as massage therapy, music and art therapy and access to programs such as the biography service and pastoral or spiritual care services would be deemed as quality of life activities.
Below are the links for the application form, and instructions on how to complete the application form and appropriate assessment forms that must accompany the application:
Health services that are providing inpatient palliative care can access a capped funding source to assist with the provision of inpatient palliative care to people with Motor Neurone Disease (MND). Eligibility for this funding will apply to health services that provide palliative care in designated palliative care beds (care type 8), or services that provide and/or access palliative care during an inpatient admission where a Diagnosis Code of “Z51.5 Palliative Care” will be added to the Principal Diagnosis Code. Palliative care should be assigned (as an additional diagnosis code) when the intent of care at admission is 'for palliation', or if at any time during the admission the intent of care becomes 'for palliation', and the care provided to the person with MND meets the following definition.
Palliative care is care in which the clinical intent or treatment goal is primarily quality of life for a patient with an active, progressive disease with little or no prospect of cure. It is usually evidenced by an interdisciplinary assessment and/or management of the physical, psychological, emotional and spiritual needs of the patient; and a grief and bereavement support service for the patient and their carers/family. It includes care provided:
The clinical intent ('for palliation' or 'for palliative care') must be clearly documented by the treating doctor in the patient medical record in order to attract Z51.5 coding and be eligible for this funding.
The funding is a result of the Motor Neurone Disease and Palliative Care Pathways Project and subsequent Department of Human Services (DHS) support for the program and its recommendations. The project report is available at http://www.health.vic.gov.au/palliativecare/
The treatment options, length of stay or access to programs and service by the person living with MND must not be dependent on the health service receiving top up funding. If the application for top up funding is not successful, the person living with MND must still receive the normal and expected care and access to all services appropriate to their condition and situation. This funding is an adjunct to existing funding and does not represent a dedicated funding stream for the provision of care to person living with MND.
Funding[ii] can be per admission per person with MND when specific eligibility criteria are met. Different funding amounts are available depending on the scenario in question. The purpose of the funding is to assist health services to provide the increased level of resources that some people with MND require when admitted to an inpatient service. The funding should be used to provide additional nursing and allied health resources to allow adequate time and input into the person’s care and care planning. Examples of additional resources may include access to additional personal care attendants at meal times and early mornings for hygiene duties or assistance with communication and repositioning for comfort and pressure area management.
When people living with MND are admitted to inpatient palliative care services it has been shown that people with a high level of disability require greater resources to carry out their basic nursing and mobility needs. The additional resources required for some MND patients can result in other patients receiving less care or people with MND not receiving appropriate and effective support when additional resources are not available.
The rationalising and allocation of current resources at health services may have affected some people's ability to access inpatient palliative care due to resource based decisions at intake. The top up funding provided is aimed at assisting health services to have appropriate staffing levels and competencies to meet the specific needs of the people with MND and prevent any restriction to accessing inpatient palliative care services due to high care needs.
[i] National Centre for Classification in Health ICD-10-AM/ACHI/ACS Sixth Edition Australian Coding Standard 0224 Palliative Carehttp://nis-web.fhs.usyd.edu.au/ncch_new/2.aspx[ii] The funding level was determined using historical data about number of clients accessing community palliative care and dividing by the funding available.
For more background information on the MND and Palliative Care Project please see the Project Report.