COMMONWEALTH OF AUSTRALIA
Safety, Rehabilitation and Compensation Act 1988
SECTION 34E
VARIATION OF OPERATIONAL STANDARDS FOR
REHABILITATION PROGRAM PROVIDERS
Notice 20 of 2003
Comcare, pursuant to section 34E of the Safety, Rehabilitation and Compensation
Act 1988, varies the operational standards determined under that section by
Notice 3 of 2002 on 22 March 2002 and published in the Gazette on 26 March
2002 by substituting the following standards in their place with effect on and
from 1 July 2004.
Dated 8 October 2003
The seal of Comcare was affixed
in the presence of:
NOEL ARTHUR SWAILS
Acting Chief Executive Officer
Standards Pages 1-7 attached
OPERATIONAL STANDARDS FOR REHABILITATION
PROGRAM PROVIDERS
In this determination:
“employee” has the same meaning as in section 5 of the Safety, Rehabilitation
and Compensation Act 1988
“provider” means a person (including a partnership or company) who has
been approved as a rehabilitation program provider under subsection 34F(1)
of the Safety, Rehabilitation and Compensation Act 1988 or has had such
approval renewed under subsection 34L(1) of the Act
“rehabilitation authority” has the same meaning as in section 4 of the Safety,
Rehabilitation and Compensation Act 1988
“relevant authority” has the same meaning as in section 4 of the Safety,
Rehabilitation and Compensation Act 1988
“approval period” means the interval between renewal dates as determined
by the Minister under section 34 of the Safety, Rehabilitation and Compensation
Act 1988. These operational standards are applicable during the approval
period commencing on 1 July 2004 and ending on 30 June 2007.
Explanatory Note
Comcare has developed a model of occupational rehabilitation to assist employers to meet their responsibilities under the Act. Effective occupational rehabilitation is a managed process combining early intervention with appropriate, adequate and timely services based on the assessed needs of the individual. In determining the operational standards to be complied with by all persons who are approved as rehabilitation program providers Comcare has established outcome and service standards. These standards relate to the effectiveness, availability and cost measures that an approved rehabilitation program provider is required to meet. These standards are designed to balance a range of performance indicators, both qualitative and quantitative, that consider issues of efficiency, effectiveness and quality.
Outcome Standards
These Outcome Standards apply in relation to all rehabilitation programs
completed by the provider in the approval period.
Outcome Standard 1 – Return to Work Rate
1. The provider shall achieve a return to work rate of 90%.
Outcome Standard 2 – Duration of Return to Work Plans
2. The provider’s median duration of return to work plans shall not exceed
eighteen weeks.
Outcome Standard 3 – Cost of Return to Work Plans
3. The provider’s median cost of return to work plans shall not exceed $1590.
Service Standards
Service Standard 1 - Service Philosophy
1.1 A provider must develop and maintain a service philosophy that:
(a) reflects the requirements and intent of the Safety,
Rehabilitation and Compensation Act 1988 and the policy
guidelines and procedures that may be issued by the
Commission or Comcare from time to time; and
(b) incorporates the key principles of occupational rehabilitation.
1.2 In providing rehabilitation services, a provider must focus on the
following objectives:
(a) early intervention and assessment;
(b) employee involvement in the development of the return to
work plan;
(c) returning the employee to the same, modified or a different job
with the original employer;
(d) coordination of the return to work plan with all key
stakeholders;
(e) an assessment and planning process which is workplace
focussed; and
(f) return to work plans that are outcome based.
1.3 A provider must ensure that no conflict of interest arises when
providing rehabilitation services. Specifically, treatment and
occupational rehabilitation services must not be provided to the same
individual.
1.4 A provider must ensure that the provider:
(a) complies with the Commonwealth Privacy Act 1988;
(b) abides by the Information Privacy Principles, National
Privacy Principles or any Approved Privacy Code under
that Act as applicable; and
(c) where necessary, maintains registration on the Register of
Businesses That Have Opted into Coverage by the National
Privacy Principles maintained by the Privacy
Commissioner.
Service Standard 2 – Return to Work Management
Early Intervention
2.1 A provider must ensure the timely acknowledgment, acceptance and
recording of referrals for assessment of an employee’s capability of
undertaking a rehabilitation program.
2.2 A provider must ensure contact with all key parties (employee,
supervisor, case manager, medical practitioner) is made where possible
no later than three working days after receipt of a referral for
assessment.
2.3 A provider must ensure that within ten working days of a referral for
assessment:
(a) a workplace visit has been completed;
(b) the initial assessment of the employee’s capability of
undertaking a rehabilitation program is complete; and
(c) the referring rehabilitation authority has been advised of the
outcome of the initial assessment.
2.4 When requested to do so, a provider must ensure that as soon as
possible after an assessment is completed, a return to work plan is
developed and negotiated with, and approved by, the referring
rehabilitation authority.
Return to Work Plans
2.5 A provider must ensure the employee’s return to work plan details the
goals, nature of interventions, costs and expected duration of the plan.
2.6 A provider must ensure that key stakeholders (the employee, case
manager, supervisor, medical experts) are involved in planning and
monitoring the return to work plan as needed.
2.7 A provider must ensure the close management and monitoring of
return to work plans in consultation with treating health professionals
and any other relevant medical provider. The return to work plan must
be consistent with appropriate medical advice regarding the medical
condition of the employee and any relevant medical restrictions as a
result of the injury.
2.8 A provider must ensure that the return to work plan is workplace
based. Worksite program monitoring and review meetings with key
parties should be included in the plan.
2.9 A provider must ensure that in the planning and implementation of a
return to work plan, the provider will be sensitive to the cultural and
social requirements of the employee.
2.10 A provider must ensure that in the planning and implementation of a
return to work plan, the provider will be sensitive to personnel
management issues and employee relations at the employee’s
workplace.
2.11 As soon as a provider becomes aware that an employee has failed to
begin to undertake a return to work plan or has discontinued
undertaking a plan, the provider must contact the rehabilitation
authority and relevant authority immediately.
Plan Closure
2.12 A provider must contact the employee prior to any decision to
recommend that the return to work plan be closed. When closure of
the return to work plan is not agreed to by the employee, the provider
must communicate this to the referring rehabilitation authority,
treating medical practitioner and relevant authority.
2.13 A provider must seek feedback from the referring rehabilitation
authority regarding the level of satisfaction with the outcome of the
return to work plan and the nature of the services provided.
Service Standard 3 - Suitable and Durable Employment
3.1 A provider must, wherever possible, approach the return to work of an
employee in the following sequence:
a) Same job/Same employer
b) Similar job/ Same employer
c) New job/Same employer
d) Same job/New employer
e) Similar job/New employer
f) New job/New employer
3.2 A provider must consider whether the employee can return to work in
the employee’s pre-injury employment or whether the employee
should return to modified or alternative duties with the original
employer prior to exploring other vocational options.
3.3 Where return to work with the original employer is not possible, the
provider may then assist the employer and the employee to identify
suitable alternative vocational options for the employee and facilitate
placement into suitable and ongoing alternative employment.
3.4 A provider must only consider vocational retraining after all other
return to work options have been pursued (taking into account the
employee’s age, education and existing skills) and where it is
considered that such options are unlikely to achieve desired outcomes.
Where retraining is considered, it must be linked to future employment
outcomes.
Service Standard 4 - Staff and Subcontractors
4.1 A provider must ensure that individuals employed or engaged by the
provider to manage return to work plans under the SRC Act have met
the competency requirements of Criterion 1 in force under Section 34D
of the SRC Act.
4.2 A provider must ensure that individuals employed or engaged by the
provider to manage return to work plans under the SRC Act complete
the Comcare training course for approved rehabilitation providers as
soon as possible.
4.3 A provider must ensure that individuals employed or engaged by the
provider to provide return to work services under the SRC Act have
the qualifications and experience appropriate to the service delivery
required for the particular task.
4.4 A provider must ensure all rehabilitation services provided under an
SRC Act return to work plan on behalf of the provider are consistent
with these operational standards.
Service Standard 5 – Administrative / Financial Responsibilities
5.1 A provider must ensure that its financial affairs are managed in
accordance with accepted financial practices and applicable
Commonwealth, State and Territory laws, including keeping correct
accounts and full details of all receipts and expenditure.
5.2 A provider must ensure that all individuals employed or engaged by
the provider to provide return to work services under the SRC Act hold
current coverage for professional indemnity. The provider must hold
current public liability insurance and, if it employs staff, workers'
compensation insurance.
5.3 A provider must have appropriate record keeping systems that
provide for the adequate handling, security and storage of case records,
and the tracking and billing of services provided.
5.4 A provider must invoice according to the requirements of the relevant
authority.
5.5 Where a provider uses a subcontractor to provide services under the
SRC Act, the provider remains liable for reimbursing the subcontractor
for any costs or expenses incurred by the subcontractor and must allow
for this on the plan.
5.6 A provider must advise Comcare immediately it becomes apparent
that it is no longer able to continue trading, is placed into
administration, becomes insolvent or is the subject of bankruptcy
proceedings.
5.7 A provider must advise Comcare within seven days of being notified
of any professional misconduct proceeding being taken against the
provider or any individuals employed or engaged by the provider.
Service Standard 6 – Evidence of Compliance with Operational Standards
6.1 A provider must ensure that documentation is on file to demonstrate
ongoing compliance with these standards and must make such
information available to Comcare on request.