FRIDAY, 18 SEPTEMBER 2020
ESSA yesterday received correspondence from the Victorian Chief Allied Health Officer providing additional guidance about the easing of restrictions as part of the next stage (Step 2) of the Victorian Roadmap to reopening. This guidance is intended to provide further clarification ahead of the release of the full industry roadmap.
The letter outlines guidance as to which allied health professions can provide services and under what circumstances. The intention of the easing is to provide a broader range of consumers with access to services, while still focusing on the need to reduce movement and face-to-face interactions wherever possible. ESSA is pleased to see a recognition of the need to see not only clients with a recognised need for services, but also for the need to be able to undertake assessment as part of the triaging work that allied health professionals are currently undertaking to manage clients’ health needs.
We encourage all practitioners to continue to use telehealth as the first option for care delivery where appropriate. Routine care and regular monitoring, other than via telehealth, is not permitted during the second step and practitioners should continue to delay services that can safely be delayed until Step 3. When determining whether a service can no longer be delayed, you will need to use your clinical judgement to ensure the service is essential to preventing deterioration and an escalation in care needs.
ESSA has been advised that those practitioner groups providing services within a permitted workplace during stage four (e.g. public hospitals, aged care or mental health settings) will remain permitted to do so under Step 2 guidelines. However, practitioners should continue to apply clinical reasoning and only see those clients in-person face to prevent a significant change/deterioration in functional independence which would result in an escalation of care needs.
As a final note, ESSA wishes to highlight that while the Chief Allied Health Officer has written to provide guidance around allied health restrictions as part of Step 2, all decisions relating to the easing of restrictions are made independent of the Chief Allied Health Officer and Allied Health Workforce Team.
If you have further questions or concerns specific restrictions, ESSA recommends that you contact Business Victoria - Coronavirus (COVID-19) business support and the Industry Coordination Centre on 13 22 15.
Extension of Medicare Telehealth
The Australian Government will extend subsidised telehealth sessions for an extra six months, as part of a $2 billion top up to keep COVID-19 health measures going during the pandemic.
The additional funding will ensure Medicare-subsidised telehealth for general practitioners, nursing, midwifery, allied health and allied mental health services will continue until 31 March, 2021.
The Prime Minister's media release is available here.
Updates for metropolitan Melbourne –Second Step Private Practice
What can I do now? From 28 September, 2020, metropolitan Melbourne will move to Second Step restrictions subject to trigger points and public health advice.
Different sectors are subject to different levels of restrictions:
- Healthcare is ‘heavily restricted’.
- Professional sport is ‘restricted’.
- Indoor physical recreation facilities (e.g. gyms, fitness centres and studios) are ‘closed’.
Only AEP and ASpS workplaces are recognised as permitted work premises allowing for travel to attend work but workers must work from home, if they can.
Where telepractice is not suitable, delivery of in-person health and exercise services in private practice can now include:
AEPs - you can see these clients in-person:
Clients who require essential clinical exercise treatment for a medical condition, injury or disability which
- prevents a significant deterioration in functional independence which would result in an escalation of care needs (such as increased frequency in treatment, significant increase in pain, specialist input, or substantial increase in recovery time as a result of delayed care)? AND/OR
- for assessment purposes for those people whose care has been delayed during stage 4 restrictions, and where further delay likely to result in deterioration? AND/OR
- Please see ESSA’s updated AEP Decision Tool for Service Delivery to help determine which clients are ‘essential’.
No group services are allowed.
AESs - you can see these clients in person:
Clients with a medical condition, injury or disability when AESs work as an allied health assistant under supervision of an allied health professional to provide essential clinical exercise treatment.
NDIS clients for essential services under the NDIS (when services are deemed essential by the NDIS participant).
ESSA recommends vulnerable clients be treated via here.
ASpSs - you can see these clients in person:
Professional and high-performance sports persons only at elite sport facilities.
- AEPs, AESs, ASpSs can see any client outdoors.
- Maximum group size is 1 practitioner: 2 clients (3 in total) though children under 12 months of age are not included in this limit.
- AESs must not travel more than 5km to lead outdoor exercise sessions and should only work for up to two hours per day total, split into a maximum of two sessions.
- Clients must not travel more than 5km to attend outdoor exercise sessions.
- Clients are only allowed to exercise for up to two hours per day total, split into a maximum of two sessions.
*Hospitals, emergency services, COVID-19 clinics, high performance sport, aged care & disability services: Operate within the guidance from your employer. DHHS advice, directions and support for the aged care sector is here. DHHS advice, directions and support for the disability sector is here
Be COVID Safe: All in-person services require:
Mandatory face covering for clients - Where clients are doing any exercise or physical activity where they are out of breath or puffing, or they are affected by a relevant medical condition - including problems with their breathing, a serious skin condition on the face, a disability, or a mental health condition - then they are not required to wear a face covering. If you are just talking to clients in a non-exercise environment, then the client should wear a mask (apart from the exceptions above).
A COVIDSafe Plan – including social distancing hygiene protocols.
Wearing of PPE (eye shield, Minimum Level 1 surgical mask). Guidance remains unchanged as per DHHS requirements for healthcare workers.
# The Victorian Chief Allied Health Officer (CAHO) advises that indicative modelling suggests around 26 October, 2020 (Third Step) is when people in metropolitan Melbourne will be able to recommence seeing their allied health provider or other primary health care provider for all elements of their health care needs. The CAHO is optimistic thatindoor group exercise classes (including clinical Pilates) will be able to re-commence from the 23 November, 2020 (Last Step).
Updates for regional Victoria – Third Step Private Practice
What can I do now? From 11.59pm 16 September, 2020, regional Victoria moved to Third Step restrictions.
Under Victoria’s roadmap for reopening – How we work in regional Victoria healthcare and social assistance are considered ‘restricted’. This means health workers should work from home wherever possible using telepractice.
Professional sport is ‘restricted’.
Indoor physical recreation facilities (e.g. gyms, fitness centres and studios) are ‘heavily restricted’. ESSA confirmed with Business Victoria on 16 September, 2020 that indoor physical recreation facilities are NOT permitted work premises and therefore not allowed to open. ESSA appreciates this advice is contradictory to the Victoria’s roadmap for reopening – How we work in regional Victoria and has been told that further updates will be provided over the coming days. Please note, as of 15 September, 2020, Fitness Australia has also interpreted that gyms, fitness centres and studios are still closed in regional Victoria.
Where telepractice is not suitable, delivery of in-person health services in private practice can now include:
AEPs - you can see these clients in-person:
Clients who require clinical exercise treatment for a medical condition, injury or disability.
No indoor group services# are allowed.
AESs - you can see these clients in-person:
Clients with a medical condition, injury or disability when AESs work as an allied health assistant under supervision of an allied health professional to provide clinical exercise treatment.
NDIS clients for essential services under the NDIS (when services are deemed essential by the NDIS participant).
ESSA recommends vulnerable clients be treated via telepractice. The definition of who is a vulnerable client in Victoria is here.
ASpSs - you can see these clients in person:
Professional and high-performance sports persons only at elite sport facilities.
Outdoor exercise services
- AEPs, AESs, ASpSs can see any client outdoors.
- Maximum group size is 1 practitioner: 10 clients (11 in total) though children under 12 months of age are not included in this limit.
*Hospitals, emergency services, COVID-19 clinics, high performance sport, aged care & disability services: Operate within the guidance from your employer. DHHS advice, directions and support for the aged care sector is here. DHHS advice, directions and support for the disability sector is here
Be COVID Safe: All in-person services require:
Mandatory face covering for clients - Where clients are doing any exercise or physical activity where they are out of breath or puffing, or they are affected by a relevant medical condition - including problems with their breathing, a serious skin condition on the face, a disability, or a mental health condition -then they are not required to wear a face covering. If you are just talking to clients in a non-exercise environment, then the client should wear a mask (apart from the exceptions above).
A COVIDSafe Plan – including social distancing hygiene protocols.
Wearing of PPE (eye shield, Minimum Level 1 surgical mask). Guidance remains unchanged as per DHHS requirements for healthcare workers.
# The Victorian Chief Allied Health Officer (CAHO) is optimistic that indoor group exercise classes (including clinical Pilates) will be able to re-commence from the 23 November, 2020 (Last Step).