FRIDAY, 27 MARCH 2020
Open communication to members from the CEO and ESSA National Board
We hope all our members and accredited professionals are currently all safe and healthy.
Over the last week there has been communication into the office and on social media surrounding ESSA's position regarding our professionals providing essential services. In relation to these comments/questions, the Board and I would like to make the following statement.
Members and accredited professionals:
- Must be following Government rules (both State and Federal) regarding COVID-19 or face fines if they do not comply.
- Must put patient/client/staff’s health and safety first.
- Need to make an individual assessment of their clients to determine if it is essential for a face-to-face appointment. If not deemed essential, ESSA urges our people to move services online/remote to support the government's communication to keeping people at home.
- Follow ESSA's recommendations that go beyond that of the government, i.e. cancelling of groups classes or having a maximum of 2 in outdoors classes.
We are committed to keeping our members up-to-date with the emerging issues associated with COVID-19 and the potential impact on their practices/businesses. As the situation changes, we will update our position to members.
Clarification on Allied Health in Gyms
ESSA’s advice on the relaxation of rules governing gym closures came in a letter on 26 March 2020 from Dr Lisa Studdert, Deputy Secretary for the Australian Government Department of Health. Here is the exact paragraph form that letter posted here:
Gyms used for clinical treatment
While there has been a decision taken by National Cabinet to close gyms catering to the general public, small gyms used for clinical treatment can remain open as long as they meet the general social distancing requirements, namely, space for social distancing of four square metres per person and not more than 10 people attending at the same time.
This letter does NOT provide for the re-purposing of commercial gyms or large gyms into clinics that have been closed.
ESSA advocated strongly on your behalf on Monday 23 and Tuesday 24 March 2020 (after the Prime Minister’s announcement on Sunday 22 March 2020) to get the concession we did for essential allied health services to be allowed to continue to operate out of small gyms. Please work within the rules we have been given, otherwise there is risk that governments may shut down all AEP clinics.
Further advice was provided to ESSA by the National Allied Health Advisors Committee (NAHAC) on Tuesday that AEPs need to change the language used in relation to where they practice. AEPs need to say that they practice in a range of clinical spaces and not say that they operate in gyms.
NAHAC is comprised of each State’s or Territory’s Chief Allied Health Officer or Advisor along with a representative from the Australian Government.
We re-iterate what you can do:
· Deliver essential health services for individuals in small private practice clinic spaces with no more than 10 people in attendance at any one time.
· Deliver essential health services for individuals in recognised hydrotherapy pools.
· Allow individuals to independently (without an appointment) complete AEP prescribed programs in hydrotherapy pools and clinics (updated from previous advice).
· AESs can work independently in AEP practices delivering personal training under the NDIS and group exercise classes for Medicare Item 81115 for type 2 diabetes group services.
· Promote on your website that you offer clinical services for clinical conditions.
· Give any police who may visit your business the letter from Dr Lisa Studdert.
No AEP clinics can operate out of large or commercial gyms that are open to the public.
Indoor Group Classes Need to Cease
Given the new limit of no more than ten people being able to attend personal training classes at any one time, indoor group/personal training classes should cease.
ESSA does not believe indoor group/personal training classes can be classified as essential health services.
The ONLY exceptions are for:
- AEP providing group exercise classes for Medicare Item 81115 for type 2 diabetes group services
- Those ESSA accredited professionals who are registered as personal trainers with the National Disability Insurance Scheme (NDIS).
How does the Government define a small gym?
We have no definition on size.
NSW police visited a Sydney gym of 247 square metres this morning and shut it down as of tomorrow without issuing a fine. We suggest that anyone with a clinical space bigger than 12-14 square metres per person or a maximum of 140 square metres should be seriously thinking about whether your space can be classified by police as a small gym.
Clinics with an integrated small private gym should be okay to stay open. Large gyms with attached clinics definitely need to close or can expect fines.
ESSA is reluctant to seek advice on a specific size as this will no doubt result in more closures.
Swimming Pools
You can treat clients in their own home pool. You cannot treat clients in a privately owned pool which would normally be open to the public.
What is an allied health profession?
There is no consistent definition across Australia. Rather, there are different definitions for the Australian Government and each state and territory government. Therefore, ESSA uses the definition from the Australian Government.
Telehealth
ESSA Telehealth Policy Statement
Thanks to some amazing work by ESSA staff and feedback from our member advisory groups, we are proud to release our ESSA Telepractice Policy Statement today. Editable check list here.
We have fast tracked this statement to help you to deliver telehealth services under various compensable schemes and to private clients.
Please note the Policy Statement applies to all ESSA professions including Accredited Exercise Physiologists (AEPs), Accredited Exercise Scientists (AESs), Accredited Sports Scientists (ASpSs) and Accredited High Performance Managers (AHPMs).
Medicare
Stage 4 of the telehealth measures will include a whole-of-population approach, including telehealth delivery of allied health services. This will include expansion of telehealth items for all patients, with or without COVID–19, to see any general practitioner, medical specialist, mental health or allied health professional during the COVID–19 health emergency. AHPA is working with the government as it consults key sections of the health sector to co-design this initiative.
Stage 4 is expected to be implemented next week from 30th March.
Private Health Insurance
ESSA has lodged a submission to Private Healthcare Australia today (the Australian private health insurance industry's peak representative body that currently has 22 registered health funds as its members).
We hope to hear back on the success of our submission next week and will advise you on the outcomes immediately.
NSW Health recommendations for community-based and outpatient health services
NSW AEPs can continue providing treatment in dedicated allied health clinics provided the current NSW Health recommendations for community-based and outpatient health services are followed.
The information here is a good guide for everyone, particularly those doing home visits:
https://www.health.nsw.gov.au/Infectious/diseases/Pages/covid-19-community-outpatient.aspx
Urgent update regarding NDIS one-off advance payment for registered providers On 26 March 202, ESSA heard from members with concerns about the advanced payments being offered to NDIS registered providers.
Registered providers that have received an email from the NDIA about their advanced payments flagged concerns that the NDIA was offering large amounts of funding (i.e. $50,000) on the condition that providers would repay the amount at a later date. It was noted that very little information was provided on when, how and over what period of time the repayments were expected to be paid.
This morning ESSA spoke the NDIA’s Business Manager for Payments and asked several questions about the repayment process. Below is a summary of the discussion:
When will repayments start?
The NDIA cannot advise on when repayments will start. A date for repayment has not been provided because it is a fluid situation and the NDIA will wait until the pandemic crisis is over and there is a healthy economic environment before seeking repayments.
How will repayments be made?
Repayments will be made by offsetting future payment claims.
What percentage of future claims will be used to offset repayments?
At this stage, 100% of future claims will be used to offset repayments until the debt has been cleared.
Example - an AEP claiming for one individual one-hour session of $166.99 (GST incl) will be required to offset the entire amount of $166.99 (GST incl). If the AEP delivers and claims 10 individual sessions in one day, all 10 individual sessions will be offset against the debt.
Can the opt-out date of Friday 27 March 2020 be extended to allow providers time to consider this payment in depth and seek legal advice?
No, there is no flexibility on the opt-out date.
If a provider misses the opt-out date and receives the lump sum payment in their account automatically, can they make an immediate repayment to the NDIA if they choose?
Yes, providers can contact the NDIA National Contact Centre and ask for an invoice to be issued for the repayment.
Will additional payment offers be made in the future?
The NDIA does not know if additional payments will be made available in the future.
ESSA has concerns about the proposed offsetting of 100% of future claims against provider debt and the financial impact this may have on providers who are struggling to get back on their feet following an extended period of reduced business or business closure.
Next Steps
ESSA will be advocating strongly on this matter and is preparing a letter to the Minister for the National Disability Insurance Scheme (NDIS) to seek adjustments to the repayment schedule to ensure that providers are not having their income reduced to zero when the repayment process begins.
However, we cannot be certain that we will be successful with that so providers should take the advance payment on the basis that they could manage under the circumstances of having no income once the repayments are due.
Exercise is Medicine (EIM) Contingency during COVID-19
ESSA operates Australia’s Exercise Is Medicine (EIM) program as part of the global EIM network run by EIM US. The primary objective of EIM is to support primary health care professionals to prescribe exercise as medicine and understand when and who to refer patients to.
There are several strands to our EIM Program and have prioritised the health and safety of our Facilitators, in response to COVID-19, and as a result have suspended implementation of our Hospital Education Program until further notice. Our EIM Online eLearning Education is available for primary healthcare providers and our Primary Care Face-to-Face Workshops are now eligible to be delivered via Zoom or other videoconferencing software. Both attract CPD points for the AEP Facilitator and for primary healthcare professionals. Please contact Rhiannon Bennett, the EIM Project Officer, if you would like more information or if you are interested in becoming an EIM Facilitator.
Where do we get our Information?
Our advice to you comes from government websites, Ministerial advisors, senior government employees, from the Australian Government to ESSA via Allied Health Professionals Association (AHPA) or from State government websites. We rely only on information from trusted sources, not social media chatter or hear say!
If you want to keep track of things yourself and search for your own information, please consider that ESSA:
· regularly monitors the Prime Minister’s media statements (not media releases) here for the latest decisions by the Australian Government at https://www.pm.gov.au/
· monitors news for each state and territory for new public health orders and emergency orders on behalf of our members (we posted a list of these websites in Tuesday’s Communique on 24 March 2020.
Support for Businesses
We will have much more for you next week on support, but this is the Australian Government’s website with details on financial assistance, eligibility and timing for the new government support for Australian businesses: https://business.gov.au/risk-management/emergency-management/coronavirus-information-and-support-for-business
Self-Care
ESSA encourages you to practice some self-care to enhance your energy, restore your health and reduce your stress.
Here are several reputable resources for you to draw on during this challenging time:
https://www.beyondblue.org.au/personal-best/topics/?q=Self-care
https://www.blackdoginstitute.org.au/news/news-detail/2018/10/04/how-you-can-empower-your-team-with-self-care-planning
https://everymind.org.au/need-help/self-care