EXPLANATORY STATEMENT
Veterans’ Affairs (Treatment Principles – Orthotists) Amendment Instrument 2018 (Instrument No. R88/MRCC88 of 2018)
EMPOWERING PROVISIONS
For Schedule 1 of the attached instrument which varies the Treatment Principles (VEA Treatment Principles) — section 90 of the Veterans’ Entitlements Act 1986 (the VEA).
For Schedule 2 of the attached instrument which varies the MRCA Treatment Principles — section 286 of the Military Rehabilitation and Compensation Act 2004 (the MRCA).
PURPOSE
The attached instrument (No. R88/MRCC88 of 2018) varies the VEA Treatment Principles and the MRCA Treatment Principles – collectively known as the “Treatment Principles”.
The Treatment Principles set out the circumstances in which treatment may be provided to clients of the Department of Veterans’ Affairs (DVA).
The purpose of these variations to the Treatment Principles is to recognise orthotists as health care providers under the Treatment Principles.
Orthotists are allied health care professionals who are qualified and specifically trained in the assessment, prescription, design, manufacture and fitting of orthoses for the human body, including footwear, splints, slings, braces and supports.
These variations to the Treatment Principles will ensure that orthotists who are registered DVA providers can be reimbursed for their clinical time spent on the assessment, prescription, fitting and review of orthoses when providing services to eligible members of the veteran community. In addition, it will ensure they can be reimbursed for the supply of prefabricated, customised or custom orthoses, provided by a supplier who is not contracted with the Rehabilitation Appliances Program (RAP).
To be registered as a DVA provider, an orthotist must hold membership of, or be qualified for membership of, the Australian Orthotic and Prosthetic Association (AOPA) – the professional association that determines competency, the ethical code of conduct and mandatory professional development standard for orthotists. AOPA is a member of the Allied Health Professions Australia (AHPA) and the National Alliance for Self-Regulating Health Professions (NASRHP).
This instrument will provide for the inclusion of the treatment provided by orthotists with similar treatment provided by other allied health care providers in the Treatment Principles who are not regulated by Australian Health Practitioner Regulation Agency (AHPRA), such as social workers and exercise physiologists.
In addition, the attached instrument varies the Treatment Principles to make minor consequential and technical amendments.
The variations will take effect on 1 February 2019.
CONSULTATION
Section 17 of the Legislation Act 2003 requires a rule-maker to be satisfied, before making a legislative instrument that any consultation the rule-maker considered appropriate and reasonably practicable, has been undertaken.
Consultation has taken place with AOPA, the peak body representing orthotists and prosthetists in Australia. AOPA supports the amendments to the Treatment Principles and the Notes for Allied Health Providers to bring orthotists in line with DVA health care arrangements.
In addition, the Department of Health (Health) was consulted in connection with this measure. Orthotic services are not available to the general Australian population under the Medicare Benefits Schedule. However, Health recognises that DVA provides orthoses to eligible members of the veteran community under the RAP. The amendments will not change or include orthotic services on the Medicare Benefits Schedule, which is supported by Health.
Further, the Department of Human Services (DHS) was consulted to implement the Orthotists Schedule of Fees and registration of orthotists as DVA providers within the Medicare payment system. DHS supports the amendments and is able to implement them in February 2019.
Consultation was by way of meetings and written exchanges.
In these circumstances, it is considered the requirements of section 17 of the Legislation Act 2003 have been fulfilled.
RETROSPECTIVITY
None.
DOCUMENTS INCORPORATED BY REFERENCE
Yes, the amendments add a document to the list of non-legislative documents in Schedule 1 to the Treatment Principles. These documents are incorporated by reference into the Treatment Principles in the form in which they exist from time to time.
The document is the “Orthotists Schedule of Fees”. It is freely accessible on the DVA website at:
https://www.dva.gov.au/providers/fee-schedules/dental-and-allied-health-fee-schedules
Amendments were made to the VEA and the MRCA last year to support the incorporation of non-legislative material into the Treatment Principles in the form in which it may exist from time to time.
REGULATORY IMPACT
None.
HUMAN RIGHTS STATEMENT
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.
The attached legislative instrument engages positively with the Right to Health, and the Rights of Persons with a disability.
Right to health
Article 12 of the International Covenant on Economic, Cultural and Social Rights refers to the “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health”.
Rights of people with a disability
The rights of people with a disability are set out in the Convention on the Rights of Persons with Disabilities. Article 26 requires countries to organise and strengthen rehabilitation programs for people with disability, particularly in health, employment, education and social services.
Overview
The attached instrument recognises orthotists as health care providers under the Treatment Principles. Orthotists are trained in the assessment, prescription, design, manufacture and fitting of orthoses for the human body, including footwear, splints, slings, braces and supports.
The amendments made by the attached instrument will extend DVA’s arrangements with orthotists to enable them to claim for a wider range of orthotic services provided to eligible members of the veteran community, including clinical assessment, prescription, fitting, review, manufacture and supply of orthoses.
The funding of these additional orthotic services will support the rehabilitation and return to health of eligible members of the veteran community including those with disabilities from a service injury or service disease.
Conclusion
The attached instrument engages with and promotes the right to health, and the rights of a person with a disability. Accordingly, the attached instrument is considered to be “human rights compatible”.
Darren Chester
Minister for Veterans’ Affairs
Rule-Maker
FURTHER EXPLANATION OF PROVISIONS
See Attachment A.
Attachment A
FURTHER EXPLANATION OF PROVISIONS
Section 1
This section sets out the name of the instrument - the Veterans’ Affairs (Treatment Principles – Orthotists) Amendment Instrument 2018.
Section 2
This section provides that the instrument commences on 1 February 2019.
Section 3
This section sets out the legislative authority for the making of the variations to the Treatment Principles.
Section 4
Section 4 provides that the variations to the Treatment Principles, as outlined in each of the Schedules to the instrument, have effect.
Schedule 1 – (Variations to the Treatment Principles under the Veterans’ Entitlements Act 1986)
Item 1 omits from paragraph (a) of the definition of “Veterans’ Home Care Program” in paragraph 1.4.1. (Interpretation provision), the words “the Determination 13/2000” and replaces it with the words “section 7 of the Veterans Affairs (Extended Eligibility for Treatment) Instrument 2015”.
The purpose of the amendment is to update a definition in the Treatment Principles.
Determination 13/2000 (the Veterans’ Entitlement Treatment (Veterans’ Home Care) Determination 2000) was revoked by the Veterans’ Affairs (Extended Eligibility for Treatment) Instrument 2015 and replaced by the provisions in section 7 of that instrument.
The amendment at item 1 ensures that the definition of “Veterans’ Home Care Program” remains current.
Item 2 omits the definition of “In force on the date in Schedule 1” in paragraph 1.4.1. (Interpretation provision). This definition is no longer required as all occurrences of the term are omitted from the Treatment Principles - see item 3.
Item 3 omits the words “In force on the date in Schedule 1” wherever they appear in the Treatment Principles, and replaces it with the words “referred to in Schedule 1”.
This is a consequential amendment that flows from earlier amendments to the Treatment Principles (2018 No. R12/MRCC12) to change the method of incorporation of the non-legislative documents listed in Schedule 1 to the Treatment Principles, from the form in which they exist on a specified date to “the form in which they exist from time to time”.
Item 4 adds a new subparagraph (ma) to paragraph 3.5.1(1) of the Treatment Principles.
Paragraph 3.5.1(1) of the Treatment Principles outlines the extent of the financial liability that will be accepted by the Repatriation Commission for the provision of treatment to an eligible person by the health care providers covered by the Treatment Principles.
New subparagraph (ma) adds “orthotists”. It provides that the extent of financial responsibility that the Commission will accept in respect of treatment by an orthotist will be the amount worked out under the “Orthotists Schedule of Fees” where the treatment was provided in accordance with the Principles and the Notes for Allied Health Providers (Section 1 General information and Section 2(n) (Orthotists)).
Both the “Orthotists Schedule of Fees” (see item 7) and the “Notes for Allied Health Providers” are publicly accessible documents listed in Schedule 1 as documents incorporated by reference into the Treatment Principles in the form in which they exist from time to time.
The “Notes for Allied Health Providers” set out the parameters for providing allied health care services, and the procedures to be followed by allied health providers when rendering services, to eligible members of the veteran community. The extent of the financial responsibility the Commission is required to accept in respect of treatment of eligible members of the veteran community by orthotists is set out in the “Orthotists Schedule of Fees”.
Item 5 adds a new subparagraph (ga) to paragraph 7.1.2 of the Treatment Principles.
Paragraph 7.1.2 of the Treatment Principles sets out a list of additional health services for which the Repatriation Commission may accept financial responsibility.
New subparagraph (ga) adds “orthotic services” to that list.
Item 6 adds a new item to the table in paragraph 7.1A.1 to cover “orthotists”.
Paragraph 7.1A.1 provides that in order for the Commission to be taken to have arranged treatment provided to an entitled person by a health care provider in an item in Column A, the treatment must have been provided in accordance with the section of the Notes for Allied Health Providers for that item in Column B.
This provision adds new item 10A to the table to include “orthotists” (in Column A) and “Section 1 – General Information” and “Section 2(n) – Orthotists” (in Column B).
Section 2(n) of the Notes for Allied Health Providers deals with treatment by orthotists and sets out the parameters for providing orthotic services, including registration as a DVA provider, referrals, fees, prior financial authorisation and prescribing and supplying orthoses.
The effect of this amendment, consistent with the provisions dealing with treatment by other health care providers, is that the treatment by an orthotist is to be in accordance with Section 1 and Section 2(n) of the Notes for Allied Health Providers for the Commission to accept financial responsibility for that treatment.
Item 7 adds a new item 29 to the list of documents in Schedule 1. Schedule 1 lists the non-legislative documents that are incorporated by reference into the Treatment Principles. All listed documents are incorporated by reference in the form in which they exist from time to time.
Item 7 adds to the list of documents in Schedule 1 “Orthotists Schedule of Fees”, the paragraph reference to the Treatment Principles (paragraph 3.5.1), and the hyperlink where the document can be accessed:
https://www.dva.gov.au/providers/fee-schedules/dental-and-allied-health-fee-schedules
Schedule 2 – (Variations to the Treatment Principles under the Military Rehabilitation and Compensation Act 2004) (MRCA)
Item 1 inserts into paragraph (a) of the definition of “MRCA Home Care Program” in paragraph 1.4 (Interpretation provision), the words “section 7 of the Veterans Affairs (Extended Eligibility for Treatment) Instrument 2015”.
The purpose of the amendment is to update a definition in the Treatment Principles.
The amendment at item 1 ensures the definition of “MRCA Home Care Program” remains current and brings it in line with the corresponding definition (Veterans’ Home Care Program) in the Treatment Principles.
Item 2 omits the definition of “In force on the date in Schedule 1” in paragraph 1.4.1. (Interpretation provision). This definition is no longer required as all occurrences of the term are omitted from the Treatment Principles - see item 2.
Item 3 omits the words “In force on the date in Schedule 1” wherever they appear throughout the Treatment Principles, and replaces it with the words “referred to in Schedule 1”.
This is a consequential amendment that flows from earlier amendments to the Treatment Principles (2018 No. R12/MRCC12) to change the method of incorporation of the non-legislative documents listed in Schedule 1 to the Treatment Principles, from the form in which they exist on a specified date to “the form in which they exist from time to time”.
Item 4 is a minor and technical amendment to paragraph 2.2.2. The amendment omits the words “a service injury or disease injury or disease’ and replaces them with the words “a service injury or a service disease”.
Item 5 adds a new subparagraph (ma) to paragraph 3.5.1(1) of the Treatment Principles.
Paragraph 3.5.1(1) of the Treatment Principles outlines the extent of the financial liability that will be accepted by the Military Rehabilitation and Compensation Commission for the provision of treatment to an entitled person by the health care providers covered by the Treatment Principles and outlined in paragraph 3.5.1.
New subparagraph (ma) adds “orthotists”. It provides that the extent of financial responsibility that the Commission will accept in respect of treatment by an orthotist will be the amount worked out under the “Orthotists Schedule of Fees” where the treatment was provided in accordance with the Principles and the Notes for Allied Health Providers (Section 1 General information and Section 2(n) (Orthotists)).
Both the “Orthotists Schedule of Fees” (see item 8) and the “Notes for Allied Health Providers” are publicly accessible documents listed in Schedule 1 as documents incorporated by reference into the Treatment Principles in the form in which they exist from time to time.
The “Notes for Allied Health Providers” set out the parameters for providing allied health care services, and the procedures to be followed by allied health providers when rendering services, to eligible members of the veteran community. The extent of the financial responsibility the Commission is required to accept in respect of treatment of eligible members of the veteran community by orthotists is set out in the “Orthotists Schedule of Fees”.
Item 6 adds a new subparagraph (ga) to paragraph 7.1.2 of the Treatment Principles.
Paragraph 7.1.2 of the Treatment Principles sets out a list of additional health services for which the Military Rehabilitation and Compensation Commission may accept financial responsibility.
New subparagraph (ga) adds “orthotic services” to that list.
Item 7 adds a new item to the table in paragraph 7.1A.1 to cover “orthotists”.
Paragraph 7.1A.1 provides that in order for the Commission to be taken to have arranged treatment provided to an entitled person by a health care provider in an item in Column A, the treatment must have been provided in accordance with the section of the Notes for Allied Health Providers for that item in Column B.
This provision adds new item 10A to the table to include “orthotists” (in Column A) and “Section 1 – General Information” and “Section 2(n) – Orthotists” (in Column B).
Section 2(n) of the Notes for Allied Health Providers deals with treatment by orthotists and sets out the parameters for providing orthotic services, including registration as a DVA provider, referrals, fees, prior financial authorisation and prescribing and supplying orthoses.
The effect of this amendment, consistent with the provisions dealing with treatment by other health care providers, is that the treatment by an orthotist is to be in accordance with Section 1 and Section 2(n) of the Notes for Allied Health Providers in order for the Commission to accept financial responsibility for that treatment.
Item 8 adds a new item 29 to the list of documents in Schedule 1. Schedule 1 lists the non-legislative documents that are incorporated by reference into the Treatment Principles. All listed documents are incorporated by reference in the form in which they exist from time to time.
Item 8 adds a new document the “Orthotists Schedule of Fees”, the paragraph reference to the Treatment Principles (paragraph 3.5.1), and the hyperlink where the document can be accessed:
https://www.dva.gov.au/providers/fee-schedules/dental-and-allied-health-fee-schedules