In this section
The eligibility for each of the Complex Care Hub services is outlined as below:
Children being discharged from the RCH (including from the emergency department) are eligible for PAC support if their care needs have increased as a result of their admission or ED presentation.
Post-acute care services provide individually tailored packages of services to patients who have one or a combination of:
The eligibility for the Homecare Program is based on the patient requiring ongoing in-home interventional healthcare needs and the ability to self-fund the care requested. The funding source may be Individual Support Packages, National Disability Insurance Scheme, Local Government, TAC, Centrelink payments or other.
Each of the four below criteria must be met to be eligible
for the Complex Asthma service.
Does this child have
recurrent episodes of asthma?
3. Functional limitation
4. Complexity Any one of
Frequent ED presentations
Co-morbidities: e.g. anaphylaxis, cardiac disease,
Psychosocial complexity: e.g. CALD families, social isolation, poor
health literacy, parental health concerns, family violence
The first 4 of the below criteria must be met to be eligible for Complex Care. Criteria 5 and 6 provide information about the level of support required.
This child’s condition is expected to be present for 12 months.
Complex problems are not the same as complicated problems. There are components that interact and are not independent and predicting response and progress may be difficult.
Diseases may be present in different organ systems that effect each other in unpredictable ways or social factors may impact significantly on health and care provision.
This child has had more than one emergency admission in 12 months.
Note: this can be actual OR predicted. Consider the child’s condition or interventional care need and how that could increase the potential for an emergency admission, for example:
Does this child have an indwelling device that could increase their risk of infection?
Does this child have a condition that could require sudden unexpected medical attention, such as epilepsy or respiratory vulnerability?
4. Functional limitation
This child’s condition impacts on their participation in independent age appropriate activities.
Note: For an infant, please think of their potential for functional limitation.
Does this infant’s condition impact their ability to be cared for by others
Or does this child’s interventions affect their mobility or ability to undertake activities?
This child has had more than 5 hospital admissions in 12 months or 30 inpatient days in 6 months.
Note: Wallaby is included for hospital admissions, Bilby, Overnight Accommodation, Day Medical and Day Surgical do not.
This child has an interventional health care need and require a technology or a procedure in their home.
Examples of interventional health care needs
What does not apply?
If your patient meets one of or both of the fragility or intensity criteria then further information on the patient and family needs (Initial Needs Assessment) will be required to understand the level of support that they require. This information will be incorporated in the referral pathway through the EMR and the following guide will assist in providing accurate information.
These needs are scored as follows:
1. Respiratory needs
Note: This may also include other life-threatening paroxysmal events.
Q To adapt psychological factors for children who have developmental disability, please consider the question: How difficult is it for the child to remain content?
Note: scores for additional care needs are only given for impairment which is not expected at their age. For example, no score will be given for communication care or mobility needs for an infant.
Could someone who hasn’t met the child understand the child’s communication of their needs?
Can the child communicate to make a choice? For example, they would like to stop watching TV and listen to music?
These needs are scored in addition to the care needs to capture the family complexity, capacity and care burden.
Housing/isolation/availability of alternative carer
Adverse Life Events
Can the parents advocate and make decisions about the child’s health needs without the assistance of an interpreter?
Can the parents easily navigate the hospital system and do they have reasonable health literacy for decision making?
2. Carer physical and mental health
Note: Please also include an additional score of 1 for a family of 5 or more children under 16 years of age who are residing in the same home.
Please also include here a score for young parents, less than 20 years of age.
3. Housing/isolation/availability of alternative carer
Examples of appropriate factors:
4. Adverse life events for child or family