MRCA Treatment Principles (In-Home Telemonitoring for Veterans Initiative) Instrument 2012 (No. M11/2012)

Link to law: https://www.comlaw.gov.au/Details/F2012L01729

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Australian Government
Military Rehabilitation and Compensation Act 2004
 
MRCA Treatment Principles (In-Home Telemonitoring for Veterans Initiative) Instrument 2012
 
Instrument No.M11/2012
 
 
I, Warren Snowdon, Minister for Veterans’ Affairs, pursuant to subsection 286(3) of the Military Rehabilitation and Compensation Act 2004, approve this instrument made by the Military Rehabilitation and Compensation Commission.
Dated this  fourteenth             day of    August                     2012
Warren Snowdon
………………………………………………
WARREN SNOWDON

The Military Rehabilitation and Compensation Commission, by its delegates, pursuant to subsection 286(2) of the Military Rehabilitation and Compensation Act 2004, varies the MRCA Treatment Principles (Instrument No.M21 of 2004) in accordance with the Schedule.
Dated this          24th                  day of             July                       2012
 
The Seal of the                                                )
Military Rehabilitation                                    )
and Compensation Commission                   ) SEAL
was affixed hereto in the                                )
presence of:                                                     )
 
Ian Campbell                   Shane Carmody             Major General Mark Kelly
………………………………………………………………………………………....
IAN CAMPBELL                     SHANE CARMODY       Major General Mark Kelly
        PSM                                                                                                         AO DSC
CHAIR and DELEGATE   MEMBER and DELEGATE        MEMBER and DELEGATE
 
 

 
 
 
 
[1]     Name of Instrument
This instrument is the MRCA Treatment Principles (In-Home Telemonitoring for Veterans Initiative) Instrument 2012.
 
[2]     Commencement
 
This instrument commences, or is taken to have commenced, on 1 September 2012.
 
 
                                Schedule
 
1.         Paragraph 1.4.1
 
insert:
 
Authorised Representative, in relation to a medical practice in which a participating LMO is employed, means the person whose name is given as the Authorised Representative for the Practice in the form: “Application for Practice and Provider registration to In-Home Telemonitoring for Veterans Initiative” lodged with the Department of Human Services.
 
data repository means a repository of telemonitoring initiative data controlled by the data repository controller for the purposes of monitoring a telemonitoring initiative participant’s physiological and behavioural data according to the telemonitoring care plan for that participant.
 
data repository controller means a person engaged by the Department to establish and maintain the data repository for the purposes of the In-Home Telemonitoring for Veterans Initiative.
 
DVA Telemonitoring Practice Incentive means the payment of that name referred to in the “Department of Veterans’ Affairs Fee Schedules for Medical Services” and which is payable once only to the Authorised Representative for a medical practice — where, in the Commission’s opinion, all necessary steps have been taken to enable a participating LMO (and any Practice Nurse of the LMO) employed in the Practice to effectively participate in the In-Home Telemonitoring for Veterans Initiative
 
enrolment day, in relation to a person, means the date given for a decision by a participating LMO to enrol the person as a participant in the In-Home Telemonitoring for Veterans Initiative.
 
Note: see 6B.2.4 - 6B.2.6.
 
in-home telemonitoring equipment, for a telemonitoring initiative  participant, means apparatus (including computer software) that, in conjunction with an internet carriage service provided by an ISP Provider, enables the user of the apparatus to utilise the National Broadband Network so that the user may participate in the In-Home Telemonitoring for Veterans Initiative, and includes a video-conferencing facility.
 
In-Home Telemonitoring for Veterans Initiative means the Initiative of that name established by the Department which has the following features:
 
(a) telemonitoring initiative participants electronically transmit telemonitoring initiative data to the data repository using in-home telemonitoring equipment that utilises the National Broadband Network; and
(b) participating LMOs (or LMOs Practice Nurses) electronically retrieve telemonitoring initiative data from the data repository and analyse it for the purpose of monitoring the health of telemonitoring initiative participants.
 
internet carriage service has the meaning it has in Schedule 5 to the Broadcasting Services Act 1992.
 
ISP Provider means “Internet Service Provider” as defined in Schedule 5 to the Broadcasting Services Act 1992.
 
National Broadband Network has the meaning it has in the National Broadband Network Companies Act 2011.
 
NBN means National Broadband Network.
 
NBN wave site means an area, including part of an area, covered by the NBN.
 
nominated residence means a residence nominated by an entitled person as the place where the person would participate in the In-Home Telemonitoring for Veterans Initiative.
 
participating LMO means an LMO:
 
(a) whose name is given as a participating GP in the form: “Application for Practice and Provider registration to In-Home Telemonitoring for Veterans Initiative” lodged with the Department of Human Services; and
 
(b) who is approved in writing by the Commission to be a participating LMO in the In-Home Telemonitoring for Veterans Initiative.
 
Note: in practice a Commission delegate may grant the approval.
 
telemonitoring care plan means a care plan prepared by a participating LMO in conjunction with a telemonitoring initiative participant that:
 
(a)     is based on the electronic transmission of telemonitoring initiative data and;
(b)     satisfies the minimum requirements for a GPMP (General Practitioner Management Plan), as if the telemonitoring care plan is to be a GPMP, as set out in the Notes for Coordinated Veterans' Care Program Providers.
 
telemonitoring equipment, for a participating LMO, means computer software and similar tools that will enable the participating LMO (or the LMOs Practice Nurse) to participate in the In-Home Telemonitoring for Veterans Initiative.
 
telemonitoring initiative data means physiological and behavioural data about a telemonitoring initiative participant (participant), assembled with reference to the telemonitoring care plan for the participant, and transmitted by the participant, or by a person on the participant’s behalf, to the data repository via the participant’s in-home telemonitoring equipment where it may be electronically retrieved by the participating LMO for the participant or the LMOs Practice Nurse.
 
telemonitoring initiative participant means an entitled person who has in-home telemonitoring equipment installed in the person’s nominated residence and who has been enrolled in the In-Home Telemonitoring for Veterans Initiative by a participating LMO.
 
telemonitoring treatment means treatment provided by a participating LMO (or the LMO’s Practice Nurse), a data repository controller, a contractor or an ISP provider, as the case may be, under Part 6A.
 
2.      PART 6A
 
after Part 6A, insert:
 
6B – TELEMONITORING TREATMENT INITIATIVE
 
6B.1    Telemonitoring Treatment
 
6B.1.1 A treatment (telemonitoring treatment) is established by this Part and may be arranged by the Commission for an entitled person, in the circumstances, and subject to the conditions, set out in this Part.
 
6B.1.2 Telemonitoring treatment is comprised of:
 
(a) in respect of a participating LMO (or the LMO’s Practice Nurse):
 
(i)      monitoring the health of a telemonitoring initiative participant (participant) in accordance with the telemonitoring care plan, including monitoring the  telemonitoring initiative data for the participant;
 
(ii)     taking any appropriate healthcare action in response to telemonitoring initiative data;
 
Note: an example of appropriate action could be the LMO arranging a face-to-face consultation or video consultation with the telemonitoring initiative participant.
 
(iii)    disclosing the telemonitoring initiative data to the Department or to any consultant acting for the Department in the In-Home Telemonitoring for Veterans Initiative; and
 
(iv)    taking action reasonably incidental to any of the above actions.
 
Note: in practice an LMO could delegate some of the LMO’s functions in the In-Home Telemonitoring for Veterans Initiative to the LMO’s Practice Nurse e.g. electronically retrieving telemonitoring initiative data from the data repository, evaluating it and instituting care planning based on that evaluation.  In this situation the Practice Nurse, as the employee or agent of the LMO, is acting on the LMO’s behalf and the Practice Nurse’s actions constitute telemonitoring treatment as if those actions had been performed by the participating LMO.
 
(b) in respect of the data repository controller:
 
(i)      training a participating LMO (including staff of the participating LMO such as a Practice Nurse) in:
 
(a)        the use of telemonitoring equipment; and
(b)        the electronic retrieval of telemonitoring initiative data from the data repository; and
(c)        electronically accessing and using any video consultation between the participating LMO and the telemonitoring initiative participant; and
(d)       the use of any other tools necessary for monitoring the telemonitoring initiative participant’s condition for the In-Home Telemonitoring for Veterans Initiative;
 
(ii)     training a telemonitoring initiative participant (participant) or a person on behalf of the participant, in the use of in-home telemonitoring equipment necessary for the participant’s participation in the In-Home Telemonitoring for Veterans’ Initiative and, if need be, supplying that equipment (including leasing it);
 
(iii)    maintaining in-home telemonitoring equipment (equipment) and providing technical assistance in respect of that equipment when necessary;
 
(iv) maintaining the data repository;
 
(v)     taking action reasonably incidental to any of the above actions.
 
(c) in respect of a person (contractor) engaged by the Department to train Practice Nurses for the purposes of the In-Home Telemonitoring for Veterans’ Initiative:
 
(i) training a participating LMO’s Practice Nurse in telemonitoring initiative data evaluation and care planning and care planning co-ordination based on that evaluation;
 
(d) in respect of an ISP provider, its action of enabling a telemonitoring initiative participant to use in-home telemonitoring equipment.
 
Note: the ISP provider would connect the telemonitoring initiative participant’s equipment to the NBN.
 
6B.2    Participation in the In-Home Telemonitoring for Veterans Initiative
 
6B.2.1 An entitled person is eligible for participation in the In-Home Telemonitoring for Veterans Initiative as a telemonitoring initiative participant if the person:
 
(a) holds a Gold Card; and
 
(b) is admitted to, or in the opinion of the participating LMO for the person is likely to be admitted to, the Coordinated Veterans' Care Program; and
 
(c) has one or more of the following chronic conditions:
 
(i)   congestive heart failure;
(ii) coronary artery disease;
(iii) chronic obstructive pulmonary disease;
(iv) diabetes; and
 
(d) does not have a severe unstable co morbidity; and
 
(e) is not receiving residential care; and
 
(f) has been assessed by a participating LMO for the person to be suitable for the In-Home Telemonitoring for Veterans Initiative in terms of, among other relevant factors, the person’s cognitive ability to be trained in the use of in-home telemonitoring equipment, where the equipment will not be operated by a person on behalf of the entitled person; and
 
Note: where a person (carer) will operate in-home telemonitoring equipment on behalf of the potential telemonitoring initiative participant (participant), the carer must be assessed by the participating LMO as having the cognitive ability to be trained in the use of the equipment in order for the participant to be eligible for participation in the In-Home Telemonitoring for Veterans Initiative.
 
(g) is the subject of a telemonitoring care plan prepared by the participating LMO for the person which was prepared in conjunction with the person; and
 
(h) resides in an NBN wave site; and
 
(i)   nominates a residence (nominated residence) for the purposes of the person participating in the In-Home Telemonitoring for Veterans Initiative; and
 
(j)   consents to the disclosure to the Department, the Department of Human Services, and to any person acting for the Department in the In-Home Telemonitoring for Veterans Initiative, of telemonitoring initiative data in relation to the person.
 
Note: the participating LMO is to obtain the consent and keep evidence of it.
 
6B.2.2 Where a person is eligible for participation in the In-Home Telemonitoring for Veterans Initiative (eligible person), it is necessary for the eligible person’s participation to be approved by the Commission.
 
Note: in practice a Commission delegate may grant approval.
 
6B.2.3 Where the Commission gives (or does not give) its approval it is to notify the participating LMO for the eligible person accordingly.
 
6B.2.4 Upon being notified of the Commission’s approval, the participating LMO for the person is to enrol the person in the In-Home Telemonitoring for Veterans Initiative.
 
6B.2.5 Enrolment consists of the participating LMO for the person making a record (which may be in electronic form) that the person is enrolled in the In-Home Telemonitoring for Veterans Initiative.
 
6B.2.6 The record is to be dated and stored by the participating LMO.  The date on the record is the enrolment day for the relevant telemonitoring initiative participant.
 
6B.3    Approval of LMO as Participating LMO
 
6B.3.1 The Commission may approve an LMO as a participating LMO if:
 
(a) the LMO’s name is given as a participating GP in the form: “Application for Practice and Provider registration to In-Home Telemonitoring for Veterans Initiative” lodged with the Department of Human Services; and
 
(b)  in the Commission’s opinion, all necessary steps have been taken to enable the LMO (and a Practice Nurse of the LMO) to effectively participate in the In-Home Telemonitoring for Veterans Initiative such as appropriate training and installation of any necessary telemonitoring equipment.
 
6B.4 Payment for telemonitoring treatment
 
6B.4.1 If the Commission arranges with a participating LMO for the LMO (or the LMO’s Practice Nurse) to provide the telemonitoring treatment described in 6B.1.2(a) to an entitled person who is eligible for the treatment under this Part, the terms of payment to the LMO for the treatment are set out in the DVA document entitled “Department of Veterans’ Affairs Fee Schedules for Medical Services”.
 
Note 1: payments to participating LMOs for providing telemonitoring treatment for a person are in addition to any payments to the LMO for the LMO (or the LMO’s Practice Nurse) providing treatment to the person under the Coordinated Veterans’ Care Program or for the LMO providing consultations to the person (including teleconsultations) other than pursuant to a telemonitoring care plan.
 
Note 2: payments to participating LMOs for providing telemonitoring treatment will be comprised of a DVA Telemonitoring Practice Incentive (made to the LMO’s Practice) and other relevant payments (general payments) as set out in the Department of Veterans’ Affairs Fee Schedules for Medical Services. 
 
Note 3: the general payments for telemonitoring treatment (i.e. exclusive of the DVA Telemonitoring Practice Incentive ) will be made on the similar basis as payments to LMOs under the Coordinated Veterans’ Care Program i.e. quarterly payments in arrears.
 
6B.4.2 An Authorised Representative for the Practice in which a participating LMO is employed (the LMO) is only to be paid a DVA Telemonitoring Practice Incentive if the Commission is of the opinion that all necessary steps have been taken to enable the LMO (including a Practice Nurse of the LMO) to effectively participate in the In-Home Telemonitoring for Veterans Initiative.
 
6B.4.3 If the Commission arranges with a person (data repository controller) for the person to provide the telemonitoring treatment described in 6B.1.2(b) to an entitled person who is eligible for the treatment under this Part (or to a person on the entitled person’s behalf) or to a participating LMO, the terms of payment to the person are those agreed to by the Department and the person.
 
6B.4.4 If the Commission arranges with a person (trainer in data evaluation) for the person to provide the telemonitoring treatment described in 6B.1.2(c) to a participating LMO or to a participating LMO and the LMO’s Practice Nurse, the terms of payment to the person are those agreed to by the Department and the person.
 
6B.4.5 If the Commission arranges with an ISP provider to provide the telemonitoring treatment described in 6B.1.2(d) to an entitled person who is eligible for the treatment under this Part, the Department will pay the reasonable costs of such treatment for the duration of the entitled person’s participation in the In-Home Telemonitoring for Veterans Initiative where the treatment is provided to the person on or after the enrolment day for the person.
 
Note: the cost of an NBN connection for an entitled person will only be paid by the Department to an ISP provider and only for a connection on or after the enrolment day for the entitled person in the In-Home Telemonitoring for Veterans’ Initiative.
 
6B.5    Coordinated Veterans’ Care Program Rules to Apply
 
6B.5.1 The rules in the DVA document entitled “Notes for Coordinated Veterans' Care Program Providers” are to apply to participating LMO’s and telemonitoring initiative participants to the extent practical as if participating LMO’s and telemonitoring initiative participants under the In-Home Telemonitoring for Veterans Initiative, are, respectively, LMOs and entitled persons under the Coordinated Veterans’ Care Program.
 
Note: the rules would include those governing patient transfers between participating LMOs.
 
6B.6    Authorised Representative - Agent of LMO
 
6B.6.1 For the purpose of:
 
(a) the Commission arranging telemonitoring treatment with a participating LMO or the LMOs Practice Nurse or for taking action incidental thereto;
 
(b) the Department or the Department of Human Services making payments to the participating LMO (including for the services of the LMOs Practice Nurse) or for taking action incidental thereto;
 
if the Commission, the Department or the Department of Human Services, as the case may be, deals with the Authorised Representative for the Practice in which the participating LMO and Practice Nurse is employed, then for the purposes of these Principles the Commission, the Department or the Department of Human Services is taken to have dealt with the participating LMO (including the LMO’s Practice Nurse).