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ACC Update – April 1

Kia ora,

As we head into week two under Alert Level 4, I want to acknowledge the pressure our frontline providers are under. These are extraordinary circumstances and we are conscious of the stresses the COVID-19 response is placing on physical and staffing resources, and workers themselves. Urgent Care Clinics are among those heavily impacted, and we are encouraging managers to reach out to us for support in meeting contractual requirements.

Today, we can confirm the roles regarded as ACC Essential Services in Alert Level 4. Full details are below. If you have any queries about how this affects you, please get in touch with our team at: providerbusinesscontinuity@acc.co.nz.

We also have a Telehealth update for Allied Health providers, to accommodate restrictions in clients’ access to videoconferencing.

Thank you for standing with us and working alongside us. Kia kaha.

Ngā mihi nui,

Jade Walker-Clark
Head of Provider Service Delivery

Urgent Care Clinic Contracts

Urgent Care Clinics (UCC) have been identified by the Ministry of Health as an essential service. We know that clinics are currently operating under unprecedented conditions and meeting some contractual requirements during this period may be challenging.

The following issues are placing demand on UCCs:

  • Doctor and nurse staffing shortages causing reduced operating hours
  • Key staff being co-opted into supporting hospital acute services, COVID-19 Community Based Assessment Centres (CBAC), or other COVID-19 response related activities
  • Significant shifts in patient presentations, volumes, and timings
  • Reduced availability of radiology providers
  • Clinics being re-purposed as COVID-19 CBACs.


Where reasonably possible, we ask that contract holders meet the requirements of the contract.  

If your clinic is having difficulty meeting your contractual requirements, please contact providerbusinesscontinuity@acc.co.nz

It is important we understand the impact on your clinic so we can support you where needed. It also means we can take a broader look and factor in the reduced availability of UCC services on other health care services.

Telehealth extension for allied health providers

ACC will enable initial and follow-up Telehealth consultations provided by Physiotherapy (including Physiotherapy Specialists), Hand Therapy, Occupational Therapy and Speech and Language Therapy to also occur via telephone consultations from 1 April 2020, for the duration of the response to COVID-19.

This change has been made during the response to COVID-19 to improve access for clients without access to videoconferencing capable devices; it follows guidance from the Physiotherapy Board and Telehealth Resource Centre that telephone consultations may be used if videoconferencing is not possible.

ACC acknowledges that moving to telephone consultations will reduce the ability to effectively manage clients and therefore we only expect it to be used where other avenues are not available to clients.

Providers must clearly document the reason for its use in their patient’s clinical record when a telephone consultation is used in place of videoconferencing.

Please continue to use the payment codes below to invoice ACC for consultations provided over the telephone:

Cost of Treatment Regulations (CoTR) Providers

 

Professional Group Telehealth Code
PHYSIOTHERAPISTS
Initial Consultation PHT1
Follow-up Consultation PHY1
OCCUPATIONAL THERAPISTS
Initial Consultation OTT1
Follow-up Consultation OTT
SPEECH AND LANGUAGE THERAPISTS
Initial Consultation STT1
Follow-up Consultation STT

 

Contracted Providers

 

Professional Group Telehealth Code
PHYSIOTHERAPISTS
Initial Consultation PT1T
Follow-up Consultation PTTH
PHYSIOTHERAPY SPECIALISTS
Initial Consultation PTS1T
Follow-up Consultation PTS2T
HAND THERAPISTS
Initial Consultation HT1T
Follow-up Consultation HT2T

 

Reminder: for providers approved by ACC to use Telehealth Services

All providers approved to conduct their services via Telehealth must meet certain criteria and obtain patient consent. Information is available on our website.

ACC Essential Services during Alert Level 4 COVID-19 response

We have received feedback and questions about essential services during the Alert Level 4 period. Working with the Ministry of Health, we can now clarify our understanding of essential ACC services.

  • Table 1 lists essential services that can support injured clients in-person (when clinically necessary), or via Telehealth if appropriate and approved by ACC.
  • Table 2 lists essential ACC services that can be delivered via Telehealth and have been approved by ACC.
  • Table 3 lists non-essential services during Alert Level 4. However, if the client consents and where ACC has approved Telehealth, some of these services can be delivered by Telehealth. This must be clinically appropriate, technically possible, and in accordance with the relevant professional body guideline.

All lists are based on Ministry of Health essential services criteria.

A full list of ACC providers approved to use Telehealth, and the criteria required, is available on our website.

Table 1: ACC services covered by the Ministry’s criteria for essential health services in-person or via Telehealth

 

Service Comment
Ambulance – air and road
Artificial Limb Services Only if required to meet urgent needs, particularly for clients working in essential services
Blind Services For emergency or urgent needs only. Does not include activities of daily living
Dental For emergency and acute care only
Dietitians For emergency and acute care only
General Practice providers (GPs and nurses) Covers urban, rural, urgent care
Hand therapy For emergency and acute care only
Home and Community Support Priority should be on delivering necessary services requiring personal care that supports the necessities of life. Provider discretion should be applied on delivery of non-essential components relating to home help tasks
Housing Assessments Only to support discharge from hospital/spinal units. Assessments for standard and complex modifications can be put on hold
Housing Modifications Grab rails and some minor modifications for people to live in their homes safely when discharged from hospital
Living my Life Tailored Support Clinical judgement required for clients that need essential support eg high risk and vulnerable clients
Excludes other Living My Life components
Medical Consumables For necessity of life, emergency and acute cases, and/ or high risk and vulnerable clients only
Managed Equipment Services Only where equipment for the necessities of life is required. Non-essential items such as recreational equipment should cease during Alert Level 4
Non-acute Hyperbaric Oxygen For emergency and acute cases only
Non-acute Rehabilitation This will continue as required and deemed appropriate by service providers
Nursing Services contract
Optometry For emergency and acute care only
Outpatient Burns Clinical judgement required about the necessity of providing the service
Palliative Care
Pharmaceuticals
Physiotherapy For emergency and acute care only
Primary Response in Medical Emergency
Radiology For emergency and acute care only
Residential Rehabilitation Support Essential support for clients in residential rehabilitation
Residential Support Services We will continue to provide residential care for clients already in these facilities. Only clients who urgently need to be discharged from hospital into a residential facility will be admitted during the lockdown period
Sexual Abuse Assessment and Treatment Services will be delivered by Telehealth generally and in-person only when it is deemed essential by the service
Social Rehabilitation Needs Assessment Only where essential eg to access appropriate equipment to remain safely at home
Specialised Rehabilitation and Adolescent Rehabilitation Will continue as required and deemed appropriate by service providers
Speech and language therapy For emergency and acute care only
Spinal Cord Injury Rehabilitation Will continue as required and deemed appropriate by service providers
Spinal Cord Injury Rehabilitation For necessity of life, emergency and acute cases, and or high risk and vulnerable clients only.
Taxi/mobility taxi services Only when necessary for hospital discharges or hospital follow-ups
Traumatic Brain Injury – Residential Rehabilitation Will continue to provide residential care for acute seriously brain-injured clients
Wheelchair and Seating Assessments Only essential repairs or provision of chairs to allow some level of mobility. Place other assessments on hold

 

Table 2: ACC services covered by the Ministry’s criteria for essential health services that can be delivered remotely by Telehealth

A number of services that meet the Ministry’s essential services criteria can be delivered via Telehealth, where clinically appropriate. This means the business premises do not need to remain open and physical distancing can be maintained.

Service
Behaviour Support
Clinical Psychiatric Services
Communication Assistive Technology Assessments
Concussion
Counselling
Integrated Services for Sensitive Claims
Occupational Therapy
Psychological Services
Neuropsychological Services

 

Table 3: Services that do not meet the Ministry of Health criteria for essential services

There are some services that do not meet the Ministry of Health criteria for essential services during the Alert Level 4.

However, if the client consents and ACC has approved Telehealth, these services can be delivered remotely, or in emergency/acute cases (for High tech Imaging). This must be clinically appropriate, technically possible, and in accordance with the relevant professional body guideline.

A full list of ACC providers approved to use Telehealth and the criteria required are available on our website.

Service Comment
Acupuncture ACC has not enabled Telehealth for this sector group. This may be reviewed following submission from the professional bodies.
Audiology
Chiropractic ACC has not enabled Telehealth for this sector group. This may be reviewed following submission from the professional body.
Clinical Services Can be delivered by Telehealth where clinically appropriate.
Education Support Child needs to be at school setting to receive this service, so it is unable to be provided during the lockdown period.
Elective Surgery
Emergency Care Co-ordination Team
Functional Capacity Evaluation Not able to be delivered by Telehealth.
General Practitioners with Special Interest
High-tech Imaging For emergency and acute cases only.
Impairment Assessments
Living My Life Services Except for tailored support for high risk and vulnerable clients (set out in Table 1).
Major Trauma National Clinical Network
Orthotics ACC has not enabled Telehealth for this sector group. This may be reviewed following submission from the professional body.
Osteopathy ACC has not enabled Telehealth for this sector group. This may be reviewed following submission from the professional body.
Pain Management Service
Podiatry ACC has not enabled Telehealth for this sector group. This may be reviewed following submission from the professional body.
Spinal Injury Vocational Service
Support Needs Assessment
Transport for Independence Assessments
Vehicle Modifications
Vocational Rehabilitation Services
Vocational Occupational Assessments
Vocational Medical Services

 

PPE distribution through DHBs

The process for distribution of PPE through local DHBs is currently being formalised. We will provide updates through this email about each DHB’s process as information becomes available.

ACC supports the Ministry of Health’s response to COVID-19 and continues to follow its guidance, including recommendations related to the distribution and use of Personal Protective Equipment (PPE).

From today 7 million masks will start to be distributed to DHBs for further distribution to health and disability service providers; this will start over the next 48 hours with the distribution of 1.2 million masks from the national stocks to DHBs. This PPE will then be issued to community and disability health workers in their areas.

We are working with DHBs to understand the process for ordering PPE for each location and will be able to provide further information on that tomorrow. Providers may hear from DHBs directly before then.

The Ministry is regularly updating its guidance on the use of PPE for health professionals. We encourage providers to continue checking the website for the latest information.