Webinar 1: Introduction to Department of Veterans’ Affairs (DVA) services – video transcript

MAREE MONTGOMERY [00:00:12]: Welcome to a webinar series with the Department of Veterans' Affairs. And this is the first in many of the webinars aimed at raising awareness of the DVA services and programs that enable you as a health practitioner, navigator and advocate to navigate services through DVA. Many of these services are very easy to establish and provided at no or very little cost.

This particular webinar series is brought to you today by the Department of Veterans' Affairs and OPAN, the Older Persons Advocacy Network. My name is Maree Montgomery and I'm your facilitator for the webinars.

I'd like to introduce our panellists here this morning and thank you so much for coming in. We're very fortunate to have Doctor Trish Batchelor. Trish is the acting Chief Medical Officer for DVA and also practicing GP and I think still currently deputy as well. Welcome today. It's wonderful to have you on board.

DR TRISH BATCHELOR [00:01:26]: Thanks, Maree.

MAREE MONTGOMERY [00:01:27]: It's a pleasure. Then we also have Chris Jones. Chris is the Assistant Director, Client Engagement and Health Entitlements. Just entitlements, isn't it?

CHRIS JONES [00:01:41]: Yes, entitlements.

MAREE MONTGOMERY [00:01:42]: It's a very long title.

CHRIS JONES [00:01:45]: Yeah it makes me sound more important I think. [Laughter]

MAREE MONTGOMERY [00:01:47]: [Laughter]. Excellent. Chris has come on at the 11th hour, so thank you so much for being with us today.

CHRIS JONES [00:01:52]: Happy to be here.

MAREE MONTGOMERY [00:01:54]: Good. So I'm going to take it over to particularly Dr Trish. Tell us about your, I guess passion for providing services to DVA, and particularly in the ageing sector.

DR TRISH BATCHELOR [00:02:07]: Thanks, Maree. So as you mentioned, I'm a practicing GP. I'm also more recently become an occupational physician which is a type of doctor that looks at the impact of work on health and working with pre-existing conditions. I also have a strong interest in public health. When the opportunity came to work at DVA, I recognised what a great job they were doing with reform and a real focus on the whole of life, health and just not the medicine, but they're looking at well-being from a holistic perspective. It’s what we call the social determinants of health so there's mental health, physical health, but there's all those other aspects like social connectedness, respect, education, employment, financial stability, and so forth. And supporting a really, you know, unique group of people who have put, you know, themselves out there, yeah, what I call the ultimate sacrifice. So that was very appealing from a personal perspective. I am the daughter of a career Army officer, so I did live that life of an army brat and also had that lived experience of, you know, what it's like for the family as well working with the veteran. As a GP I see the great services that are available to DVA clients.

MAREE MONTGOMERY [00:03:22]: So that's fabulous. That lived experience just adds so much depth to understanding and I guess rapport as well with your clients. A big hello to your dad. I think he's watching at the moment, so hi.

DR TRISH BATCHELOR [00:03:35]: Hi dad and mum. [Laughter]

MAREE MONTGOMERY [00:03:40]: Then so Chris. We spoke to you last night very briefly to get you on board for today and the passion that just came through was amazing. So tell us a bit about your background.

CHRIS JONES [00:03:51]: Well, first of all, I guess professionally I've been in the public service now for about 16 years and for the first six I bounced around a couple of different departments. But for the last ten I've been with DVA. I think it's the first time I've really felt like I've been making a difference to people and it’s such an important community out there. Like Doctor Trish, I'm an army brat. My dad was a career officer for 20 years – a Vietnam veteran. I’m also the grandson of a World War Two veteran. So I've seen first-hand, you know, the Army experience for a family and also the wonderful services that are being provided to my father, my grandfather and my grandmother. I'm really proud now to be a part of that. So yeah.

MAREE MONTGOMERY [00:04:37]: It's a unique experience, isn't it? Being a brat? [Laughter] Excellent, thank you so much.

Now to viewers out there. There is an opportunity to actually have a Q&A. Up in your right hand corner, there is a button that you can access and ask a question. It will come through and if you see me looking at my phone, that's exactly what I'm doing is looking for your questions. So if we can, we will answer them today and if not, we will look at some way of finding the answer for you shortly.

Let's go to now the overview of what we're actually going to be chatting about in this particular webinar. So we're looking at:

• an introduction of DVA's broad range of services available to older veterans and their families;
• the types of services specifically provided by DVA and I guess some of the wonderful benefits – trying to re-engage DVA clients to use some of these services;
• DVA veteran cards – the different types and eligibility; and
• finally, applying for that card through MyService.

That's pretty much what we'll be chatting about today. In the following webinars there will be more, I guess, specific information on each of those services.

OK, so. Well, just go to Trish. Who are DVA and what's the importance of their role in health care and supporting, I guess, the older veteran and their family?

DR TRISH BATCHELOR [00:06:21]: Yeah, so DVA is a federal government department whose mission is to support those who serve or who have served in the defence of our nation. And I'm not sure you can see on the banner behind, but our current motto is for ‘what they have done, this we will do’.

MAREE MONTGOMERY [00:06:36]: Absolutely.

DR TRISH BATCHELOR [00:06:37]: I think that's really important. We're just over 100 years old now, set up after World War One.  Back in 1917, Prime Minister Billy Hughes declared to the armed forces when you come home, we will look after you.

MAREE MONTGOMERY [00:06:50]: Good.

DR TRISH BATCHELOR [00:06:51]: And that was the genesis of DVA. There's three main areas of activity. There's the respect and commemoration. There's the financial support. And then what we're talking about today. From the health perspective, we're a funder of services, mainstream services, but also run a whole lot of programs, particularly that we're going to talk about today with a real emphasis on helping people to stay independent and within their homes and stay out of hospitals and so forth.

MAREE MONTGOMERY [00:07:16]: Yeah, that is so crucially important. I think enabling and empowering people to maintain home life with supports and community particularly as you said earlier, that veteran life or life in the defence has a specific community and I think that's so vital for health.

We, DVA and OPAN have developed this amazing explainer video. I think we should watch it now.

[Explainer video starts] [00:07:47]

Title: Services for veterans and their families.

Narrator: As your clients get older, they may require additional support and services to help them live a full and active life. This may include support for carers and support from providers to help your client with living at home independently.

Your client may need assistance in unexpected circumstances, such as after hospital visits or on an ongoing basis. And your client may need assistance when transitioning into permanent aged care.

While the Australian Government offers many services to assist older people, there are additional services available to eligible veterans and their families provided by the Department of Veterans' Affairs. These services are easy to access and often at no or low cost.

Heading: Who is eligible?

Narrator: Those eligible to receive these additional services include most veterans, serving and former serving members of the Australian Defence Force and their families. Services available vary depending on what type of card your client is eligible for. While some veterans are aware of their access to these services, there are many that aren't. If you think that your client may be eligible, you can encourage them to apply online using their myGov account (my.gov.au). Or they can contact DVA directly on 1800 VETERAN (1800 838 372).

Heading: Living Independently

Narrator: The Department of Veterans' Affairs offers a range of services aimed at helping those eligible to continue living independently at home for longer. These services include:

• Domestic assistance – providing basic support around the home, such as help with cleaning, washing, shopping and more.
• Personal care – for assistance with some non-medical tasks to help you stay independent.
• Safety related home and garden maintenance – to keep your home safe and liveable through minor upkeep and handiwork in and outside your home.

Additional help can include:

• Community nursing services such as assisting with taking medication, wound care and personal care.
• Support and rehabilitation aids, including mobility aids, personal aids and equipment, continence products and also home modifications.

Services include:

• Support for carers for when carers need to take a break.
• Social assistance helping your clients stay connected to their community.
• As well as support to help manage chronic health conditions or support after hospital care.

Heading: Moving into Permanent Aged Care

Narrator: There may be a time when your client may no longer be able to live independently and may require the support of an aged care home. The Department of Veterans' Affairs can assist those eligible with a range of services, including:

• mental health and well-being support through Open Arms - Veterans' and Families counselling who provide free and confidential counselling, group programs and online resources.
• Access to aids and equipment such as hearing tools for when others are complaining about things like TV volume, speech and visual assistance tools, limbs supports, prosthesis and more.
• Medical related travel for your client to appointments with their GP, specialist and other health professionals.
• Staying connected to the community, including helping keep your clients connected to ex-service organisations and more.

Remember, access to services vary depending on your client’s eligibility and services are designed to complement those already provided by the Australian Government.

Heading: More Information

Narrator: To find out more about services available to veterans, including more information about eligibility, resources, self-help booklets or for links through to a local military welfare advocate, visit the Department of Veterans' Affairs website at dva.gov.au or call 1800 VETERAN (1800 838 372).

Heading: Support Services

Narrator: If your client is having trouble accessing aged care services, feel like they're being treated unfairly, or if they'd like to know more about the rights of older people, your client can contact OPAN, the Older Persons Advocacy Network on 1800 700 600 or by visiting their website at opan.com.au

Their national network of trained advocates are there to listen and assist free of charge.

This video has been funded by the Department of Veterans' Affairs and is proudly brought to you by OPAN, the Older Persons Advocacy Network.

[Explainer video ends]

MAREE MONTGOMERY [00:13:41]: I'm just going to really talk about the key messages of the overall webinars that we're doing. So it's really to raise awareness of DVA services that can provide to veterans.  We've been chatting here behind the scenes and how important that is to raise that awareness and illustrate that DVA is truly committed, I guess to enabling the veterans to stay independent and live a full and active life at home. Then I guess, furthermore, from that, is equipping practitioners, letting them understand and know where these services are, what they mean, how someone is eligible for them, etc. So, as a GP, I'm sure you can see that there are benefits of that.

DR TRISH BATCHELOR [00:14:21]: Absolutely.

MAREE MONTGOMERY [00:14:23]: So we're going to be looking at some of the programs. So Trish I'm going to go across to yourself. I mean, you use many of these programs to support families. So there are, gosh, CVC program and also the Veterans Home Care program, rehab appliance. Do you want to just run through a few of those for us?

DR TRISH BATCHELOR [00:14:46]: Sure. So CVC stands for Coordinated Veteran Care. This is a program that really highlights the key role of the GP, and often the practice nurse with the veteran working together with all of their allied health and specialists to offer a really holistic care package that's designed for veterans who have chronic medical conditions that could be quite stable, but suddenly deteriorates. So for example, heart failure, chronic airways disease, diabetes. What we know is that really coordinated care is the best way of keeping people out of hospitals. It is also really, we talked about empowerment before, having that strong connection, particularly with the practice nurse. Yeah, it can really help empower people to manage their medication better, because as people get older, more medications, more conditions, it gets pretty complicated. I just wish that I could access it for all of my patients and not just veteran patients. [Laughter]

MAREE MONTGOMERY [00:15:39]: You took the words out of my mouth. [Laughter]. Because it is so difficult sometimes to coordinate all those, particularly with the amount of chronicity that we have now in our older population.

DR TRISH BATCHELOR [00:15:49]: Absolutely.

MAREE MONTGOMERY [00:15:51]: I saw this program and I was doing the research. I was just like wow! We really need to expand this program out across Australia to all older Australians because it has so many unique things. It's individualised, and you know, it looks at what they want from their health rather than a prescriptive this is what you're having. Fantastic, yeah.

DR TRISH BATCHELOR [00:16:16]: Absolutely.

MAREE MONTGOMERY [00:16:18]: And we have also the Rehab Appliance Program.

DR TRISH BATCHELOR [00:16:22]: So this is the rehabilitation or RAP as we call it for short. Another great program because it really is designed again to help people stay independent. Aids and appliances to help people stay independent and safe in their own homes. A big long list of aids. So people tend to think of things, like mobility aids, walkers and so forth. But there's also, you know, continence aids, oxygen, CPAP, prosthesis, visual aids, diabetes services, massive long list and also home modifications. So my parents recently had a great experience with the OT coming into their home. Within a couple of weeks they had a plan and then they had the ramps and the railings. I've got to say I was particularly concerned about this little lip going up into their bathroom because I saw it as such a trip hazard. Yeah, it's got this little ramp there. So I was really happy, really happy to see that, you know. So a terrific program there and I don't think it costs the gold card holder anything which is pretty amazing.

MAREE MONTGOMERY [00:17:24]: Yeah, excellent, brilliant. And there's also DVA community nursing program, so pivotal, isn't it?

DR TRISH BATCHELOR [00:17:33]: Absolutely. There's another way of trying to keep people out of hospitals. So nurses may come in and help with medication issues, wound care. Can also be some personal hygiene issues and they even go to providing palliative care if that's necessary. Yes, yeah.

MAREE MONTGOMERY [00:17:50]: Yeah, because at every stage it's important, yeah.

DR TRISH BATCHELOR [00:17:53]: Yeah, and again that relationship that people build with their community nurse is important.

MAREE MONTGOMERY [00:17:57]: Fabulous. Chris do you have anything to add to any of that? I know that you assist through the health card and understanding what sort of services like physio, etc, that they can be eligible for.

CHRIS JONES [00:18:10]: Yes, so I think Trish touched on it earlier. But DVA under the health card arrangements covers a vast suite of treatment and services. So that includes all of the items available on the Medicare Benefits Schedule. A number of allied health services, dental, optical, physio. And also where something beyond those like fee schedules is actually required, we can look outside the box as well. Whereas under programs like Medicare, it is very strict. So yeah, but we're always looking for ways to improve.

MAREE MONTGOMERY [00:18:47]: Fabulous good, excellent, thank you. So Trish as a GP and in the practice, like I said earlier, you use a lot of these programs, but there's a few others that you really wanted to talk to you about. Yeah, so heart health?

DR TRISH BATCHELOR [00:19:02]: Yeah, so a couple. So heart health. I really like this program. It's a 12 month program. People need to check their eligibility online, but it's designed to again give a more holistic view. It looks at exercise, diet, stress management and it can be occurring in groups, or it can recur remotely. I've mentioned before that I was speaking to a psychiatrist who was saying what a fantastic program this was for some of his Vietnam Veterans with PTSD from two perspectives. One was they got together as a group and socialized with their peers and how helpful that was. The other thing is that PTSD we now know is not just a mental health condition, it's a whole body condition and people with PTSD often have other comorbid conditions and getting them healthy and fit and back into exercise is really helpful. So that's a terrific program.

Possibly my academic favourite, if you like, is veterans MATES which is a world leader. So this is a program that DVA works with the University of Adelaide. It looks at medication issues and every three months there's a new topic and letters go specifically to GPs and the veterans about their medication usage and education around that. So recent topics have been around diabetes, pain, sleep, and it's really empowering to the veteran because they get a personalised letter that talks about what you could think about and go to their GP and talk about it. Everyone thinks it's a terrific program and I always learn something when I sit on the editorial committee.

MAREE MONTGOMERY [00:20:39]: Fabulous.

DR TRISH BATCHELOR [00:20:40]: Fantastic program.

MAREE MONTGOMERY [00:20:42]: So that has dual benefits.

DR TRISH BATCHELOR [00:20:44]: Absolutely.

MAREE MONTGOMERY [00:20:46]: Yeah I'm just looking at some questions that we're getting through before we move across to the demographics. So this is from Anne, apart from counselling, what other help is available to veterans entering an aged care home?

DR TRISH BATCHELOR [00:21:01]: Well, I think that's a little bit more complicated because it does depend a bit on the card status and also the kind of grading of complexity that's aged care specific, so that that would probably need to be discussed more separately.

MAREE MONTGOMERY [00:21:18]: Absolutely, sorry and that was Anne. So Anne we are doing a suite of webinars and we're looking at that towards the end. I think it's about the Webinar 8. So please stay on board, watch these series and we will get your answer. And also, we have one here. Veterans’ Home Care from Alex. So what in particular in regards to Veterans’ Home Care, can you talk to me, either of you? If not, I can find the information?

DR TRISH BATCHELOR [00:21:54]: So Veterans’ Home Care. I'm sorry we didn't talk about that. It's kind of a lower level care to help people with day to day activities in the home. So it could be things like helping with the shopping or meal prep, vacuuming that sort of thing.  Even you know things you might not think of like putting on compression garments, which can be really tricky if you've got arthritis in your hands or back pain. Something like that. And then there's also a safety related home maintenance type services. So cleaning the gutters. I don't think we want any of our elderly parents up on the ladder cleaning the gutters.

MAREE MONTGOMERY [00:22:28]: You know, I had an issue with that recently.

CHRIS JONES [00:22:30]: Yes, yes my father. [Laughter]

DR TRISH BATCHELOR [00:22:32]: Yes, people would like to keep doing that. But you know, I think if people know they've got the opportunity to get help with that, it's probably a pretty good idea. You know changing light bulbs, things like that. So really again helpful for helping people maintain independence in the home at quite a low level of support, but very useful.

CHRIS JONES [00:22:51]: Yeah, and very individually tailored as well to their needs.

DR TRISH BATCHELOR [00:22:53]: Yeah, and they can access that themselves. They can ring up and get assessed on the phone.

MAREE MONTGOMERY [00:22:59]: Yeah, brilliant. We will be talking more about assessment and the different criteria a bit later in the webinar. But again in further future webinars we'll be diving deeper in what we're doing today. We're just looking at all the services that are provided.

So tell us a little bit more about the demographics and I guess the uniqueness, we'll get into that shortly, of DVA clients. So I'm going to go to Chris. The population demographics, tell us a little bit about that?

CHRIS JONES [00:23:30]: So we have more than 287,000 clients at the moment. 207,000 of those have a DVA gold or white health card or veteran card. At the moment our client base is 67% above 60. So that's more than two thirds of our clients are actually in the 60 or above age range. So they fit perfectly into what we're talking about today and why it is so important for DVA to keeps such a strong focus on these sort of services. By the same token, we still have younger veterans coming through, and they have different needs and health care needs, and so we're still maintaining focus on that. But I think that showing how our client base is ageing does keep the focus for us on these sort of services.

MAREE MONTGOMERY [00:24:20]: Absolutely and essential too, because as you said, the requirements and the uniqueness of the age demographic changes ever so slightly with the different services that you can provide. So we really do need to focus on what we can do for the older veteran.

How about we have a look at the 20 most common conditions. There are quite a few and you wouldn't expect it, but tinnitus is at the top.

DR TRISH BATCHELOR [00:24:53]: That's right, yes. So I might speak to this, you know, as an occupational physician, I have a great interest in this. You can see there's a number of conflicts there. I did a similar table myself when I first joined that include the Vietnam veterans and it was actually pretty similar at the top of the top conditions. But you know when we think about the particular occupational risks to Defence Force members, particularly if they're in a conflict scenario, they are required to follow orders and they are not as free as other Australians basically to choose to avoid personal injuries. So there's a particular risk there – put in high risk situations with high risk exposures undertaking high risk activities – so lots of opportunities for injuries. You know, that is the risk they take for us. But if we look at the top 20, fairly consistent is tinnitus which is the ringing in the ears and noise induced hearing loss which could come from, as you know, multiple different opportunities. Of course we would think about weapons and so forth, but even on a ship, you know, with the engines.

MAREE MONTGOMERY [00:25:56]: Yeah, turbines.

DR TRISH BATCHELOR [00:25:57]: Yeah, engines and etc. Then PTSD is a very common condition. Musculoskeletal conditions of all sorts are very common as well. Also as veterans get older we see skin cancer comes out, you know. I have a photo of my father in Vietnam that I share, which shows two things. One is the big guns going with no hearing protection and of course they're all just wearing pants or shorts and nothing else. And you can bet your bottom dollar they didn't wear sunscreen. So no wonder, you know, skin cancer is problematic. Also we see other mental health conditions, which is really important we have a lot of support for them. But having said that, interestingly older veterans, once they get older, have a better life expectancy than other Australians now. That could be partly explained by what we call the healthy worker or in this context, the healthy warrior effect. OK, you have to be fit and healthy to get into the Defence Force, so you start with a better basis even though you have all these occupational exposures, but you start off healthy. So that's a good thing.

MAREE MONTGOMERY [00:27:04]: Yeah, good place to start. And you're right, you do need to be quite fit, don't you? I did some teaching for Defence and yes, I would often see them with PT. I was like oh, that's harsh. [Laughter]

Excellent, good. So Chris, we're going across to non-liability health care. This is pivotal as well, isn't it? What exactly does it mean and can you provide a little bit more detail in regards to this area?

CHRIS JONES [00:27:29]: Yeah, well non-liability health care actually dates back to World War One.

MAREE MONTGOMERY [00:27:32]: Wow!

CHRIS JONES [00:27:33]: So a lot of the veterans coming back with tuberculosis. So for more than 100 years we've provided non-liability health care for pulmonary – I think I said that right, sorry Trish?

DR TRISH BATCHELOR [00:27:43]: Yes.

CHRIS JONES [00:27:44]: Tuberculosis. What non-liability health care means is the condition that you have doesn't have to be related to your service, you just need a diagnosis. In more recent years, that's expanded towards all malignant neoplasms or cancers, and particularly in the past 15 to 20 years, it's been focused on all mental health conditions. So since 2017, if you've served one day of full time service or have a relevant reserve service like peacekeeping force or disaster relief, then you are entitled to treatment from DVA for all mental health conditions. So there's no need to link the service. So what that does is providing for people where it may be linked to service, it provides them that early intervention, early access to treatment at no cost and they use their card. The DVA white card is now given to all members who are separating. So from the day you leave the services you instantly have non-liability health care and have your mental health treatment covered.

MAREE MONTGOMERY [00:28:48]: Wow! So that’s fabulous, isn’t it?

CHRIS JONES [00:28:50]: Yes, a really good service.

MAREE MONTGOMERY [00:28:52]: And deserved.

CHRIS JONES [00:28:53]: Yes.

MAREE MONTGOMERY [00:28:54]: Beautiful. OK, so as we discussed earlier, the importance of professionals, I guess, knowing where to gain support for veterans and their families. That's a very important thing as well; it's not just the veteran – it's their families. DVA has a program called Open Arms. Can you tell me a little bit more about Open Arms program and the very important role that it plays?

DR TRISH BATCHELOR [00:29:22]: So Open Arms originally was the Vietnam Veterans Counselling Service and more recently turned into, I guess, rebranded if you like, as Open Arms. So this is a free mental health service dedicated to serving members, can contact the service, veterans and their families, so very broad. It offers counselling, it's open 24/7, offers telephone counselling, face to face usually, but at the moment obviously moving into the telephone space. They have mental health first aid training. They have some suicide assist training. They run group programs. They've really got, you know, a whole lot of great services that are there to be offered. I was thinking earlier. You know we think about older people. People tend or they may think about Open Arms for younger veterans and PTSD, but depression is not uncommon in older people. You know, as people get isolated, coming to terms with maybe loss of physical health, loss of independence, loss of their friends, yeah, and you know Open Arms is open to everyone. It's really again an amazing service that I wish was available to all Australians. The other great thing is a lot of the people who work there do have lived experience and they have peer programs and things like that.

MAREE MONTGOMERY [00:30:44]: That underlying, yeah, lived experience and understanding of the situation. I don't know how you could do it without it, if that makes sense. To be able to understand where you've come from, the situations, etc. and what you perhaps are feeling at that time is essential. Fabulous.

So as we discussed, military service has unique risk factors and understanding the context of the client service not only improves that therapeutic relationship, it really provides greater understanding of their needs. So we really, I guess, want to understand some of the importance of accessing services, but also some of the barriers that we have to accessing services. Chris, yeah, so I think yeah, I think that's your background.

CHRIS JONES [00:31:33]: Yeah, I think some of the barriers to accessing services, well, one of the main ones is clients just don't know what they're entitled to or what's available to them. So DVA is reaching out as much as we can to try and bring that to the forefront. In particular, you know, as I mentioned before, given white card on transition that we're trying to engage with the clients earlier so they understand how to put claims in for liability. So they can access treatment and they can access all of the wonderful services we've talked about. I think that's very important. But, what we've discovered as well is that we estimate only about a third of our veterans have actually engaged with the department before. So whether it's because they've lived a healthy and full life and they have no need for our services – we'd love to think that – but I'm sure there's probably people out there that just don't know that they are entitled to DVA. We see it when they do come in at a later age as their health is starting to fail, they are getting older, their needs are changing, and as Trish mentioned before, their mental health concerns can come at a later age as well. So I guess it's getting the message out there. Sometimes as well and I know I'm a bit like this that, you know, 'us men' we're very proud.

MAREE MONTGOMERY [00:32:53]: Yes.

CHRIS JONES [00:32:54]: I don't need to see the doctor. My wife has to tell me to go see the doctor.

MAREE MONTGOMERY [00:32:57]: Yes and a couple of times?

CHRIS JONES [00:32:58]: Yes, you know, even booked the appointment for me. [Laughter]. So when that's ingrained in you, it's very hard to accept as well that, you know, yes, and Trish could probably say more on this than I could, but, you know, it's actually accepting that. Yes, I do need help and knowing what's out there and actually taking that first step in reaching out to DVA and making that phone call and saying “hey I need help what can you do for me?”

MAREE MONTGOMERY [00:33:22]: Vitally important and hopefully webinars series such as this, where you can either watch directly or at a later date will spread that word that you know there are services – fantastic services – out there. It's just a matter of engaging and [asking] are you OK, yeah. Fabulous, thank you.

Alright cards – DVA cards – is our next topic. Now, going through this, I come from a health background in an ICU and anyone that had a DVA gold card was like, yep, get them through the door. But really to understand the eligibility, what they mean, it's really a lot deeper than that. I would like that we take this baton for health practitioners and improve their awareness and understanding that this is a vital service, the eligibility card. So I guess Chris, how do the cards differ? I know you've touched on them, but how do they really differ and how importantly can a veteran demonstrate that they are eligible for those services? I think that's through those cards?

CHRIS JONES [00:34:35]: Yeah. So obviously the first, the big one and as you said, it's the DVA gold card. Now that covers you for all treatment, for all conditions within Australia. As I've touched on before, that gives you access to anything that's on the Medicare Benefits Schedule and a number of allied health modalities that we have. It's also free for the client to use. So the provider just bills DVA and that's it. The white card on the other hand can be a bit more complicated. So the white card is only for specific conditions. Initially, as I said, we give them or we hand out these for separating members for their mental health, in like, right from the word go. But, if you also have liability accepted for a specific condition, say an ankle condition which you can trace back to a training accident or something that happened overseas, then you are covered by DVA by your white card for any treatment, medications, surgery, whatever you should need for that condition. So providers when a client presents to them and they say I have a white card and it covers my ankle. The best thing to do for the provider is just to give our Veterans’ Access Network a call and just say I want to provide this treatment to this client and is that covered by their conditions. It's a 30 second phone call and really easy to find out.

MAREE MONTGOMERY [00:36:03]: Fabulous and I know that access to DVA is great. It's like you say, it's a 30 second phone call, you're there chatting away with assessors and/or people that totally understand what's going on. So again, that's another huge benefit to veterans.

CHRIS JONES [00:36:19]: Yeah, we do have a dedicated provider line as well where they can call up and they can speak to the staff in our health approvals area just to query like “there's this sort of treatment which doesn't quite fit under your arrangements, what are the options for me and the funding for the client?” So, very experienced staff to help as well.

MAREE MONTGOMERY [00:36:39]: And I guess just on that as well. You're vamping up the website. Is that correct?

CHRIS JONES [00:36:43]: Yes.

MAREE MONTGOMERY [00:36:44]: And also the cards are going to be changing slightly in their name. Is that correct?

CHRIS JONES [00:36:51]: Yes. We transitioning from the DVA health card to DVA veteran card.

MAREE MONTGOMERY [00:36:56]: Ok, right.

CHRIS JONES [00:36:57]: Yeah, sorry my language is still old. I apologise.

MAREE MONTGOMERY [00:37:00]: No not at all. I was just wasn't sure if I actually beat the cart before the horse. So I was going to bring it up, but that's great. So that really shows you that there is a lot of innovation going into services by DVA and that they are really committed to re-engaging and supporting veterans in all of these services.

So to actually access now, besides the phone call, to get online, is MyService. MyService is the online platform and it's linked to your myGov account. So if we just bring up quickly some of the slides. This is for, I guess probably, the younger veteran, but also an older veteran that has access to assistance to get online and actually link their cards. It really is quite an easy way of doing it. I had a little play the other day myself. I got so far, obviously I couldn't get any further. So you link your account through MyService and the platform allows for them to, there we go, see claim details and progress payments made to you, your digital card, associated conditions, offers transport – really, really important so you can get online here and book your transport, which I think is fabulous. It's so autonomous and that is empowering. Then obviously as we see, update personal details. So there will be further information in regards to MyService in up and coming webinars.

Let's move on now. I can see some questions coming through. So again, if there is nothing that we can answer here today, we will definitely find it for you.

From Ben. Could you please describe the difference between a white card and a gold card and how a veteran acquires one?  Can we quickly run over that again for Ben?

CHRIS JONES [00:39:09]: Yeah, not a problem. So gold cards are provided to totally and permanently incapacitated veterans, veterans over the age of 70 with qualifying service like war-like service, also to war widows and pensioners and orphans. And also, yeah, so that's your gold card. The white card is, as I said it, you can get a white card if you have one day of continuous full-time service. That will cover you for your mental health or if you have a condition – liability for a condition accepted by DVA.

MAREE MONTGOMERY [00:39:46]: Beautiful, thank you.

From Sarah. You have asked how does the system work with a home care package? Can we answer that today? Yeah, I think Sarah we need to in Webinar 3. We will be looking further at those types of programs, VHC – the Veterans’ Home Care program. It'll be really detailed. We'll have a panel specifically for that and we would love for you to text us back. Ask those questions and any other questions that you may have in relation to that. Get on board and we'll get ready for you.

DR TRISH BATCHELOR [00:40:33]: I think I can say that this is the one where you can phone and have an assessment even over the phone and refer yourself. But then you know it is very individualised based on what your needs are.

MAREE MONTGOMERY [00:40:45]: Fabulous, good. Alright.

So we have Laurel. Does DVA have any programs that are specific to people with dementia? That is a really, really good question. And again as we go towards aged care process which will be down in about Webinar 7, we will possibly look at that in detail and in fact I may do some more research because I think that's warranted. What do you think?

CHRIS JONES [00:41:15]: Yeah, I agree.

MAREE MONTGOMERY [00:41:17]: So Laurel, fantastic question. Keep them coming through. It’s how we improve things; is getting feedback, questions and things that we may not have thought of. So definitely, I'll do a little bit more research on that for the upcoming webinars.

All right, so we're now moving into assessments and eligibility criteria for aged care. Trish, I'm going to yourself. So in relation to accessing aged care services through DVA, what are the assessments and eligibility criteria?

DR TRISH BATCHELOR [00:41:51]: So as I've already mentioned, the home care is an over the phone assessment and people can refer themselves.

The CVC or Coordinated Veteran Care, because the GPs are at the centre of that, that's really a discussion with your GP to see or with the veteran’s GP to see whether they are eligible. Then the doctor engages with DVA.

For the community nursing, there's a few different referral pathways. So it could be from the GP, another specialist doctor, it could be a hospital discharge planner, or even be the home care provider who's noticed that the services that they are providing aren't quite enough anymore or they're outside of their scope of practice.

For the rehabilitation program, it depends a bit on the product. It could be the GP, it could be the allied health provider, and you know, obviously the OT or the physio or whoever. So it has to come though from a health professional, on that side of things.

For respite care, if it's in an aged care facility, although we're not talking about that particularly today, you do need an aged care assessment team – what's known as an ACAT assessment – for any entry into an aged care facility in Australia.

Lower level respite care, though I think would be assessed within a DVA process.

So it does depend, and that's where the providers probably need to look onto the website and see what the options are. It is potentially pretty quick. It's often, you know, two to four weeks to get to get assessed and get things going. It can be longer if you're in a remote and rural area of course, you know, to have someone looking into things.

MAREE MONTGOMERY [00:43:24]: Fabulous. In fact, the website is really easy to navigate. The tabs are quite explanatory and the information through them is quick and easy to find. Much improved, I think.

CHRIS JONES [00:43:39]: Thank you.

MAREE MONTGOMERY [00:43:40]: Yeah, did you have something?

CHRIS JONES [00:43:41]: No.

MAREE MONTGOMERY [00:43:42]: [Laughter]. Alright. So let's go on to the importance of consent and a representative. Being prepared. It's having that constant communication and support around. So what is the importance of consent and having a representative? My favourite thing is ageing positive because I think, I believe we can. Obviously these supports and programs are in place to do that. So Trish, will I go to you first? Or Chris?

CHRIS JONES [00:44:14]: Yeah, let's be honest, any sort of legislation is difficult to navigate. The fact that DVA operates under three different legislations is very complex, and for anyone of any age, I think, I definitely recommend go down and talk to one of your ex-service organisations. There's over 700 advocates around Australia who are very well trained in DVA legislation. They can help you get, as I like to say, in the door. Get your liability accepted, get your card and then on the other end they can help you with the sort of health services that we provide. Obviously with that you just give them consent to act on your behalf and then they can contact DVA for you. This is also important as you get older. Have a son, a daughter, a friend or your partner, have them, and give them the authority to act for you. Like I said, it's difficult to navigate a lot of things. We like to think our health care system is very straightforward and for the most part it is, but just have someone to help, another voice. You know, they can make the phone calls for you and then explain it back to you. I think it's really important.

MAREE MONTGOMERY [00:45:29]: Fabulous. Advocacy is so, so important and obviously I'm with OPAN, the Older Persons Advocacy Network. Please, if you also want outside advocacy support in any of these issues as well, there's the 1800 700 600 number. So they're trained advocates as well. Not in Defence or Veteran, but they will have an understanding of all of the other programs available.

Just on a few points before I answer some more questions. There are these two wonderful booklets. Available or coming to or they're available online. They are new/updated and fantastic. One here is the living independently, which we've been discussing today and how important that is. But also the second one in regards to aged care homes and moving into them. Such an important time, needing supports and understanding of that situation as well. So brilliant booklets available to you all.

Few more questions. There is one here from Anne. Does the gold card automatically go to a widow or widower?

CHRIS JONES [00:46:48]: That does for if the deceased veteran sorry is/was totally and permanently incapacitated, so TPI, it's a buzzword right here. That does go automatically to the spouse. However, for other gold card holders, if the cause of death Is one of the conditions which we've accepted liability for, Then that will go to the spouse as well.

MAREE MONTGOMERY [00:47:15]: Beautiful. Thank you.

CHRIS JONES [00:47:18]: Horrible topic, sorry.

MAREE MONTGOMERY [00:47:19]: But important and I think that's the important thing Chris, is that we need to have these conversations.

CHRIS JONES [00:47:24]: Yes.

MAREE MONTGOMERY [00:47:25]: We need to acknowledge that it is time to prepare and acknowledge that we need supports during that time. If we can't have the conversation, how can we ask? So thank you for that.

CHRIS JONES [00:47:38]: Actually, my mother asked me the same question. That's my dad's got a gold card and she pointedly said to him, so make sure when you, you know.

MAREE MONTGOMERY [00:47:45]: Yeah.

CHRIS JONES [00:47:46]: He's been instructed. [Laughter]

DR TRISH BATCHELOR [00:47:47]: He's done it, so he's fine I think. [Laughter]

MAREE MONTGOMERY [00:47:50]: I can tick that. [Laughter]. Fantastic. What a great session today and really looking forward to further webinars coming up. I'd like to extend a very warm thank you to you both for being with us today. Thanks Trish. Thanks Chris, particularly in the 11th hour and also your wonderful knowledge and a big hello to your dad and mum. I look forward to seeing you all again in the next webinar and we're looking at the CVC program. Take care of everybody. Please be safe and use the gel hand wash. See you. Thank you.

This video has been funded by the Department of Veterans' Affairs and is proudly brought to you by OPAN, the Older Persons Advocacy Network.

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