Respite care (POAC)
Overview
Treatment of patients who are acutely unwell and for whom 3 nights of respite care would be sufficient to avoid a hospital admission.
This service is part of the Primary Options for Acute Care (POAC) programme.
Your Pinnacle Services Contract applies to this service. By claiming for this service, you have indicated that you have read and agreed to the business rules set out here.
This is NOT a clinical guideline.
Details
All Pinnacle practices in the Te Whatu Ora Lakes area.
- Patients domiciled in Te Whatu Ora Lakes area.
- Patients who are acutely unwell and for whom 3 nights of respite care would be sufficient to avoid a hospital admission.
- Patient have to be assessed in general practice in the 48 hours prior to the request for respite.
- A definitive plan has to be in place for the patient on discharge from Primary Options funding and is to be communicated at the time of the placement.
- Respite care is for those patients who require rest home level care rather than hospital level care.
- Patients who are prone to wander or are frequent fallers are not suitable for respite care
- Patients not domiciled in Te Whatu Ora Lakes area.
- Patients funded under ACC .
- Patients under the care of Hospice.
- Patient with a current DSL allocated carer support respite.
- Patients with mental health or social issues.
- Patients who are unsafe to be in a respite facility i.e. prone to wander.
- Patients who would require more than 3 nights respite.
Note respite care under POAC is not to be utilised to support discharge from hospital or a failed discharge from hospital.
Exclusion criteria to access POAC funding should not preclude emergency treatment of any medical conditions.
The initial 15-minute GP/NP consultation incurs the usual consultation fee paid by the patient. All POAC services thereafter are provided at no cost to the patient. If the claim cannot be funded by POAC, the patient may be liable to the practice for the fees incurred.
Respite care is for those patients who require rest home level care rather than hospital level care.
The request for respite care is to be made via the Primary Options team who will then authorise funding for the placement of the patient.
Once funding is approved the practice can then liaise directly with the whanau and respite care providers to determine the most suitable available placement.
Please note:
- Patients who need continence products, must provide their own products while in respite care to avoid being charged
- Medications need to be blister packed
- Patients need to have their own transport arranged.
- Patients who are prone to wander or are frequent fallers are not suitable for respite care
Contracted respite providers are funded directly through Primary Options. The facility can contact the Primary Options team to confirm funding should they choose, however providing the facility with the patients authorised Primary Options number is sufficient.
Please make your claim via Primary Options, select Respite Care and then attach the appropriate invoice(s).
Prices listed below are GST inclusive.
GP/NP/CP extended consultation: $81.37 or
Rural GP/NP/CP extended consultation: $91.67 or
This funding is available to those practices that receive rural funding.
Afterhours GP/NP/CP Extended consultation: $101.97
This funding can be claimed when care is provided after 6pm, on weekends or on public holidays.
To cover an additional 15 minutes of GP/NP time above the initial 15-minute consultation. This invoice can be claimed twice per episode of care to fund a maximum of 30 minutes of additional time. This invoice can only be claimed at the time of the initial consultation
Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of POAC funding.
Respite care is for those patients who require rest home level care rather than hospital level care.
The request for respite care is to be made via the Primary Options team who will then authorise funding for the placement of the patient.
Once funding is approved the practice can then liaise directly with the whanau and respite care providers to determine the most suitable available placement.
Please note:
- Patients who need continence products, must provide their own products while in respite care to avoid being charged
- Medications need to be blister packed
- Patients need to have their own transport arranged.
- Patients who are prone to wander or are frequent fallers are not suitable for respite care
Contracted respite providers are funded directly through Primary Options. The facility can contact the Primary Options team to confirm funding should they choose, however providing the facility with the patients authorised Primary Options number is sufficient.
The initial 15-minute GP/NP consultation incurs the usual consultation fee paid by the patient. All POAC services thereafter are provided at no cost to the patient.
The service is funded by Te Whatu Ora.
