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Section A - Policy

16. Specific Programs & Technical Details

Appendix 10-Victorian Artificial Limbs Program

The Victorian Artificial Limbs Program (VALP) provides funding for artificial limbs (primary and replacement), repairs and socks for public inpatients and non-admitted patients. The cost of the interim limb is met by health care providers through rehabilitation grants.

1. Background

Responsibility for the management of artificial limb services was transferred from the Commonwealth to the State in July 1994 as part of national reforms to devolve service delivery to the States.

Following the transfer, the Department redeveloped the existing service system and created the Victorian Artificial Limbs Program. Services are now provided through 11 amputee clinics, 6 in metropolitan Melbourne and 5 in country Victoria.

The 1998/1999 Program devolved responsibility for service provision arrangements to participating Health Care Networks and rural hospitals. Following a competitive tender process, these HCNs and hospitals have entered into new arrangements with providers selected through this process.

2. Program Aims

The 1999/2000 Victorian Artificial Limbs Program aims to :

• Provide high quality artificial limbs services to eligible consumers;
• Support the devolution of service provision arrangements to HCNs and hospitals, promote integration and continuity of service; and
• Continue to refine policy and purchasing arrangements for the provision of artificial limbs.

3. Consumer Eligibility

The VALP provides artificial limb services to consumers who:

• Are public inpatients and non admitted patients;
• Are managed by a hospital participating in VALP;
• Are not covered by compensable insurance arrangements such as Transport Accident Commission or WorkCover;
• Are not Department of Veterans Affairs patients; and
• Make a standard co-payment.

The provision of second limbs for adult consumers, including limbs for occupational or recreational purposes is not available through the VALP. The Program will provide second limbs for children if they are assessed to be clinically required.

4. Service Quality

Providers are expected to provide services within a quality framework which:

• Are accessible to consumers;
• Reflects current best practice in clinical, manufacturing, follow-up and other areas of service delivery; and
• Incorporates a rigorous acquittal process.

5. 1999-2000 Budget and Funding Arrangements

As indicated on the 1998-99 Policy and Funding Guidelines, the Department has reviewed existing purchasing arrangements for the Program with a view to streamlining program administration and funding arrangements. In 1999-2000 funding for artificial limb services will be reviewed with the aim of incorporating it within the rehabilitation funding system in 2000-2001.

In 1999-2000, funding for artificial limb services will be provided as a block grant based on expenditure in 1998-1999. Operating budgets have been rolled into the expenditure budgets. Budgets are capped and providers must ensure that services provided are cost effective and operate within their allocated budgets. Budget deficits will be borne by the provider. Unlike previous years, budgets will not be reviewed on a quarterly basis, but will be reviewed at the end of the financial year. Surpluses from participating providers will be recalled by the Department and distributed to meet deficits by providers in the Program. The arrangements for reporting expenditure and adjusting funding in previous years will no longer apply. This leaves providers in a position to prescribe more flexibly on the basis of assessed clinical need within the total budget available.

Revenue budgets are based on the number of limbs manufactured estimated by providers for the full year 1998-99 and consumer co-payments. Participating providers are expected to collect co-payments at the specified rates as set out in Section 6 below. Shortfalls in revenue resulting from non collection of co-payments will be borne by providers.

Following receipt of the final Income and Expenditure Reports for 1998-99, budgets will be adjusted subject to the availability of funds within the Program.

Funds will be paid as specified grants as part of regular cashflow arrangements.

6. Consumer Co-payments

Co-payment for children is only chargeable for the first prescription in a three year period. No co-payment applies for subsequent limb/s within the period.

7. Reporting Requirements

Participating providers are required to submit the following via AIMS:

• Quarterly activity reports;
• Quarterly income and expenditure statement; and
• Certified income and expenditure statement for the year ended 30 June 2000 by Friday, 28 July 2000. The certification must be signed by the Chief Executive Officer and states that "funds paid by the Department of Human Services under the Victorian Artificial Limbs Program (VALP) have been expended in accordance with the 1999-2000 Policy and Program Guidelines".

8. Future Directions

The 1998-99 Program initiated the process of devolution of service provision arrangements to HCNs and hospitals through a competitive tendering process. In 1999-2000, the Program will build on this process and support integration and continuity of service, as well as more flexible funding arrangements. As such, the Department will explore the feasibility of incorporating the Program in 2000-2001 as part of the rehabilitation payment system.

9. Contact Persons

Vivien Adler, Manager Continuity, Acute Health
Tel: (03) 9616 7100 Fax: (03) 9616 8347 e-mail: vivien.adler@dhs.vic.gov.au

Amos Yee, Senior Project Officer, Continuity, Acute Health
Tel: (03) 9616 7322 Fax: (03) 9616 8347 e-mail: amos.yee@dhs.vic.gov.au

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