What WorkSafe will pay for
The WorkSafe agent (the agent) will pay the reasonable costs of outreach services where required as a result of a work-related injury or illness under Victorian workers' compensation legislation (the legislation).
WorkSafe can also pay for the reasonable costs of outreach services for workers* who are entitled to provisional payments on a claim that includes a mental injury.
The agent will periodically review a worker's entitlement to outreach services to ensure that the treatment and services remain reasonable and are payable under the legislation.
All references to 'work-related injury' on this page may also apply to workers who are entitled to provisional payments on a claim that includes a mental injury.
*Eligible Victorian volunteers are also entitled to provisional payments.
Psychosocial support provided through outreach services are non-clinical, person centred supports that assist workers experiencing barriers to their recovery due to their work related primary or secondary mental injury. Outreach services include the development of a recovery plan with an injured worker which identifies the individual worker's needs and goals.
This can include:
- support with daily living activities
- assistance to engage with services
- development of self-management skills
- support to connect with community and build natural supports
- peer support
- assistance to exercise choice and control
- goal setting and capacity building according to individual need
- risk and safety planning
What the agent can pay for in relation to outreach services
The agent can pay the reasonable costs of Outreach Services:
- that are required as a result of a work-related primary or secondary mental injury upon referral from a medical practitioner and approval by the Agent
- that are reasonable, necessary or appropriate in the circumstances
- focused on recovery and return to work outcomes, and
- provided by individuals who meet the criteria outlined in this policy
Who can provide outreach services?
Providers must be:
- approved by WorkSafe to provide outreach services
- non-government organisations
- registered with the National Disability Insurance Agency and have a service agreement with the Victorian Department of Health to deliver Mental Health Community Support Services
- able to provide evidence of appropriate insurances
- accredited in the National Standards for Mental Health Services (NSMHS)
Staff within approved organisations delivering outreach services must have relevant qualifications and/or two years experience in mental health service provision. This includes staff with learned or lived experience. As a guide, WorkSafe recommend staff have a minimum Certificate 4 qualification.
WorkSafe expectations for service delivery
Providers must measure and demonstrate effectiveness, empower the worker to manage their injury, and use evidence-based methods to optimise the worker's function and recovery. This support aligns to the principles of the Clinical Framework for the Delivery of Health Services.
Providers must maintain one-on-one contact with the worker and actively collaborate with their treatment team.
Referral and reporting requirements
The agent will decide whether to approve an Initial Assessment and Support Package after receiving the treating medical practitioner request. An initial package can be pre-approved for up to 30 hours and subsequent hours can be pre-approved in one or more blocks of up to 30 hours.
WorkSafe does not allow outreach providers to initiate referrals to other health services. To initiate referrals, providers must link with the treating medical practitioner to action in writing.
Providers must submit an Assessment and Support Plan to the agent, prior to the fifth session with the worker. Further updates and plans will be reviewed by the agent, and must be submitted after the initial 30 hour package and then at the completion of any further hours requested. A final update must also be submitted at the completion of engagement.
This provider's request must include the following information:
- outcomes and progress to date
- a summary of the hours of direct support provided to date
- the reasoning for ongoing service delivery
- expected outcomes/ SMART (specific, measurable, achievable, realistic and timely) goals for ongoing service delivery
- likely duration that service is still required
- level of consultation with the referring medical practitioner and treating team
WorkSafe have developed an Assessment and Support Plan form to use for reporting.
Outreach services are considered to be a time limited intervention. From the date of agents approval of service, the initial support package is valid for 12 months.
What the agent will not pay for in relation to Outreach Services
- any service provided that is not aligned with this policy
- appointments where the worker cancels or does not attend
- treatment or services provided outside the Commonwealth of Australia without prior written approval from the agent
What are the WorkSafe's invoice requirements?
What fees are payable for Outreach services?
Please note that all support such as telephone calls, report writing and travel time are accounted for in the hourly fee schedule.
Suspended from providing services
If WorkSafe gives notice to a provider advising that they are suspended from providing services to WorkSafe clients, WorkSafe expect that the Disability Support Commission is also advised.
Note: This policy is a guideline issued by WorkSafe Victoria under Victorian workers compensation legislation in respect of the reasonable costs of services, and services for which approval should be sought from the WorkSafe agent or self-insurer (as the case may be) before the services are provided.