Outreach services policy
Information for providing outreach services to injured workers who have an accepted claim under the Victorian Worker’s Compensation Scheme.
The role of outreach services
Outreach services are person centred, non-clinical, psychosocial supports. When a worker experiences barriers to their recovery due to their work related primary or secondary mental injury, outreach services can:
- support with daily living activities
- assist to engage with services
- support to connect with community
- provide peer support
- assist to exercise choice and control
- develop goal setting and capacity building
- provide risk and safety planning
Outreach service providers develop an assessment and support plan with an injured worker to identify their needs and goals, so their recovery is fully supported.
Who can provide these services
Outreach services are delivered by approved providers who are registered with WorkSafe. To be approved, a provider must be a non-government organisation and hold:
- registration with the National Disability Insurance Agency (NDIA), and
- a relevant accreditation under a recognised set of services standards, such as the National Standards for Mental Health Services (NSMHS) or the Human Services Standards (HSS) Victoria
Providers must be able to show evidence of appropriate insurances to cover their operational and business risks.
All staff who are delivering outreach services must have:
- relevant qualifications - WorkSafe requires a minimum Certificate IV in Mental Health, or
- two years' experience in the provision of mental health services. This includes staff with lived experience
Information about registering as a provider
Referring and requesting services
Steps for referring and requesting outreach services:
A medical practitioner must provide a written referral to the Agent prior to the commencement of services.
Once the referral has been received, the Agent can approve up to 120 hours over three months. Services can commence once the Agent provides this approval.
Upon approval, the Agent sends a request to the provider detailing the injured worker's current barriers to recovery. If the provider accepts the request they will engage with the worker within five days.
The provider must submit to the Agent an initial assessment and support plan identifying the needs and goals prior to the fifth session with the injured worker.
After each three month period or if 120 hours is reached within that period, the provider must submit a further assessment and support plan to the Agent, to request more hours.
Outreach services can be delivered for up to 12 months from the date of approval. WorkSafe may initiate a review for workers who continue to experience barriers because of their work-related injury or illness after 12 months.
Service delivery expectations
WorkSafe expects all outreach service providers to:
- maintain one-on-one contact with the worker and actively collaborate with the worker's treatment team
- make reasonable attempts to communicate with the worker to maintain engagement with services
- collaborate with the worker regarding their treatment goals including development of self-management skills, connection with community and engaging with services
- align to the principles of the Clinical Framework for the Delivery of Health Services including measuring effectiveness, empowering the worker to manage their injury, and using evidence-based methods to optimise the worker's function and recovery
WorkSafe does not allow outreach providers to initiate referrals to other services. Where a need for other health services is identified, discuss this need with the injured worker and their treating team.
Reporting requirements
To identify and demonstrate progress towards the worker's goals and needs, the provider must submit an assessment and support plan to the Agent:
- prior to the fifth session
- at each three-month period or
- if 120 hours is reached within the three-month period
This is essential for services to continue.
The provider must submit a final assessment and support plan at the completion of outreach services and provide details of any ongoing barriers or support needs.
In line with the Clinical Framework, each assessment and support plan should include:
- outcomes and progress to date
- a summary of the hours of direct support provided to date
- the reasoning for ongoing service delivery, if required
- expected outcomes or SMART (specific, measurable, achievable, realistic, and timely) goals for ongoing service delivery
- likely duration that services will be required
- level of consultation with the referring medical practitioner and treating team
- if further support is not necessary, outline the plan for ceasing services and what supports are in place e.g. medical practitioner, psychologist
What we can pay for
WorkSafe can pay the reasonable costs of outreach services where needed because of a work-related injury or illness under Victorian workers' compensation 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 service provided must be:
- required because of a work-related primary or secondary mental injury based on referral from a medical practitioner and approval by the Agent
- reasonable, necessary, or appropriate in the circumstances
- likely to provide recovery and return to work outcomes
- provided by organisations who meet the criteria outlined in these guidelines
WorkSafe 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.
Please note that both worker-facing and non-facing activities are accounted for in the hourly fee schedule.
What we will not pay for
WorkSafe will not pay for any service provided outside of these guidelines, including:
- appointments where the worker cancels or does not attend, unless under exceptional circumstances and with written approval from the Agent
- treatment or services provided outside the Commonwealth of Australia without prior written approval from the Agent
How much we will pay
WorkSafe will pay for outreach services in line with our current fee schedule.
Compliance and suspension of services
Providers must immediately notify WorkSafe should they cease to have the applicable registration or accreditation requirements as outlined in these guidelines.
Information on actions WorkSafe may take if a provider is suspected of non-compliance are provided in the WorkSafe registration form.
For more information
Except where an agent is specifically mentioned, a reference to WorkSafe is a reference to WorkSafe and its Authorised Agents.
These guidelines operate under the Workplace Injury Rehabilitation and Compensation Act 2013 (Vic) and the Accident Compensation Act 1985 (Vic).