Support for disability care

Better care for people with disability during COVID-19: Information for GPs and primary care providers.

Page last updated: 12:40pm, 4 August 2021

The nature of the COVID-19 response magnifies health issues and human rights concerns for people with disability. It is vital that primary care providers can continue to meet the needs and rights of people with disability during the pandemic.

People with disability are generally at greater risk of more serious illness if they contract COVID-19 as they may have chronic conditions or weakened immunity. People with disability may find it difficult or impossible to socially distance from others, including family members, carers and support workers. Some people may also find it difficult to implement basic hygiene measures and safely wear face masks.

People with disability may also find it more difficult than usual to access person-centred care, including telehealth.

Resources for people with disability and their families and carers are available on our website. The following resources will help GPs and primary care providers provide better care for everyone with disability in the North Western Melbourne Primary Health Network (NWMPHN) region during COVID-19.

 Disability provider alerts from the Australian Department of Health.

Diagnosing and managing a person with disability who may have COVID-19

  • HealthPathways Melbourne

  • COVID-19 Health Professionals Disability Advisory Service

    The Australian Department of Health has established the COVID-19 Health Professionals Disability Advisory Service.

    Health professionals can access this service by calling 1800 131 330 from 8:00am to 9:00pm, Monday to Friday.

    The service provides specialised advice to health professionals responsible for the medical care of people with disability diagnosed with COVID-19 or experiencing symptoms.

    This service is in place until 17 November 2020.

  • Fact sheet for primary health care

  • Call-to-Test service

    People with disability may prefer to be tested at home due to impaired mobility, social anxiety, or difficulty travelling to you or other testing services. If these patients want to get tested at home, they may be able to access the Victorian Department of Health and Human Services (DHHS) Call-to-Test service:

    Accessing the service

    People with disability and their carers can:

    • Call DHHS on 1800 675 398 and select Option 9.
    • Alternatively, call the Disability Information Helpline on 1800 643 787 and explain that they need an at-home test.

    More information

Working with people with disability during COVID-19

  • What mental health support is available?

    People with disability are at increased risk of poor mental health, abuse and violence during COVID-19. This is due to increased social isolation, potential disruption of services and support groups, and anxiety and stress.

    The following services and resources are available:

Increased risk of abuse and violence against people with disability

National Disability Insurance Scheme (NDIS)

  • About the NDIS

    The National Disability Insurance Scheme (NDIS) is a new way of providing individualised support for people with permanent and significant disabilities. People need to meet certain eligibility requirements to qualify for support under the scheme. Examples of disability given by the NDIS include physical disability, intellectual disability, and functional impairment resulting from a mental health condition.

    The NDIS aims to provide support that fulfils each individual’s needs, such as home modifications, personal care, mobility aids and development of skills to help a person become more independent. It will also fund allied health and other therapy needed because of a person’s disability (such as behavioural therapy or speech therapy) but it is not intended to replace health or other public services.

    GPs can assist by identifying patients who are likely to be eligible for the NDIS, directing them to current NDIS information and supporting them to apply. GPs can provide crucial evidence for patients’ access request forms when they apply to join the NDIS.

    The Brotherhood of St Laurence is both the Early Childhood Early Intervention partner (for children 0-6 years old) and the Local Area Coordinator (for people over 7 years old) for the north western Melbourne region. The Brotherhood’s role is to work with individuals with disability to identify their support needs, apply to the NDIS, develop and use their NDIS plans, and link them to support and services.

    Note that many people with disabilities are unable to access NDIS support as they may not meet the strict requirements (there are an estimated 4.4 million Australians with a current disability; around one in 10 are supported by the NDIS).

  • NDIS resources

Psychosocial Support Services

  • About Psychosocial Support Services

    New Psychosocial Support Services are now available and can provide functional support to people with severe mental illness who are ineligible for NDIS services. These services are commissioned by North Western Melbourne Primary Health Network (NWMPHN) with funding from the Australian Department of Health.

    Psychosocial Support Services can assist people to participate in their community, manage daily tasks, secure stable employment and housing, and connect with family and friends. They can help support people who are not eligible for NDIS supports.

    Psychosocial Support Services use an evidence-informed, non-clinical approach. They provide support at the times when it is most needed and are flexible, timely and assist recovery. The length of support can range from eight weeks to a maximum of 12 months. Services can be one-to-one or group support. There is no requirement for a person to have a mental health plan.

    Support can include the development of learning strategies and skills to help a person:

    • identify their strengths
    • build resilience
    • achieve their goals
    • find people to help them improve their wellbeing
    • connect with family or their community
    • improve their physical health
    • enjoy a full and vibrant life.
  • Eligibility

    To be eligible for our Psychosocial Support Services a person must:

    • live, work or have connections to the North Western Melbourne Primary Health Network region
    • experience severe mental illness
    • not be supported by the NDIS through an Individual Funded Plan
    • not be receiving supports through the state-funded Early Psychosocial Intervention Support Response (EIPSR) or be clinically case-managed through Area Mental Health.
  • Accessing the services

    Anyone can refer to the service, including GPs. People can also self-refer.

    See ‘Providers’ below for information on how to refer.

  • Providers

    The following organisations provide Psychosocial Support Services in the North Western Melbourne Primary Health Network region:

    Neami National provides services in northern Melbourne, including the local government areas of Darebin, Hume, Moreland, Yarra, Melbourne, Moonee Ponds and Macedon Ranges.

    Contact number: 1300 052 588
    Referral form

    More information is available on the Neami National website.

    cohealth provides services in western Melbourne, including the local government areas of Brimbank, Melton, Maribyrnong, Wyndham, Moorabool and Hobsons Bay.

    Contact number: 03 9448 6880
    Referral form

    More information is available on the cohealth website.

    Visit our System of Care search tool for more information on Psychosocial Support Services and other mental health services.

Ensuring your practice is accessible for people with disability

The following tips will help ensure your practice is accessible and welcoming for people with disability:

  • Physical accessibility

    This includes ensuring you have:

    • accessible car-parking spaces
    • doorways wide enough to allow wheelchair access
    • ramps/lifts/single-storey facilities
    • accessible toilet facilities
    • appropriate infection control procedures that still allow people to use mobility aids if needed.

    Also consider supporting patients to access community transport or multi-purpose taxi programs if eligible.

  • Accessible appointments

    This means ensuring you have:

    • a wide range of times available and/or longer opening hours which suit both the patient and their carer or support person if they have one
    • ‘double’ appointments to ensure that complex needs can be explored and to allow people enough time to communicate their story
    • a choice of in-person, telephone and telehealth appointments.

    For telehealth, note that:

      • Medicare subsidies for telehealth have been extended until 31 March 2021
      • each person is different and has different needs
      • those with mobility issues or anxiety about being out in public may prefer telehealth appointments
      • others, such as people with cognitive or communication impairments, may not be suited to a telehealth-type setting. See below for more information on telehealth consultations for people with disability.
  • Telehealth and virtual consultations: things to consider

    Keep the following in mind when using telehealth or virtual consultations to manage patients with disability.

    Assessment

    Consider if your client can interact safely in this medium. Consider:

    • suicide/mental health risk (for example – if the patient becomes distressed and hangs up)
    • physical conditions
    • if family violence is present, and if the perpetrator could be in the area, where the patient is having telehealth contact.

    Access

    Consider everything needed to interact technically in a telehealth consultation, including:

    • access to a private space
    • Wi-Fi, a working device and enough data
    • computer literacy
    • spyware not installed on their device (if in a family violence situation).

    Availability

    Assessing availability needs to be done as part of an initial assessment, but also needs to be performed on a per-session basis.

    Preparation prior to session

    When preparing for a telehealth or virtual consultation:

    • think about things like the privacy of your space, especially if you are working from home
    • check the settings of your telehealth software and turn off things you don’t want to use
    • ensure the meeting is not being recorded
    • if you share your screen, make sure you don’t have private information displaying.

    Beginning and during a session

    When starting a session:

    • check you are talking to the intended client
    • check their environmental safety (for example, make sure they are not driving).

    Remember that telehealth and especially virtual consultations can be fatiguing. Consider making the session short. It’s likely you will also have to ask more questions, as you can’t rely as much on visual cues —especially over the phone!

    Ending a virtual consultation

    • Ensure that you end the meeting for all participants: don’t just leave the meeting yourself.
  • Telehealth decision tool

    A decision tool is available to help clinicians and consumers decide together when telehealth is a safe and effective option for care. The tool was developed in partnership between the Victorian Department of Health and Human Services and clinical experts and is suitable for all primary health care providers. It is available on the Safer Care Victoria website.

  • Accessible information

    • Appropriate use of interpreters, including Auslan for those who are deaf or hard of hearing. It is important not to make assumptions about a person’s ability to ‘get by’ without the use of interpreters. Informed consent is a duty of care issue. Visit HealthPathways Melbourne for more information on interpreter and translation services.
    • Availability of printed information, including information in languages other than English, information in Easy Read and pictorials.
    • You may need to take more time to explain something. Consider the best way to communicate with your patient if they have a different way of communicating.
    • Use the teach-back method to check if someone has understood something:
      • This resource is specifically about using teach-back with interpreters, but it also explains what teach-back is
      • This video has a demonstration of the teach-back method
  • Welcoming environment

    • Clear signage
    • Well-trained staff who understand the needs of people with disability
    • Friendly attitudes
    • Allowing people enough time, and trying not to rush people through appointments
    • Making patients feel important, listened to and respected
    • Accommodation of certain needs. For example: providing a separate quiet area (where possible) to someone with disability who suffers from anxiety in busy unfamiliar spaces, or allowing a family member to accompany them as their support person.
  • Improving access to other services

    • Consider making medicines easier to access. For example: by sending a digital script straight to the pharmacy after a telehealth consultation.
    • Ensure you help transmit health information to others involved in COVID-19 prevention, testing and treatment if necessary, and if given patient consent.
  • More resources

Supported Residential Services and residential care

  • About these facilities

    Supported Residential Services are privately operated residential homes where people with disability receive accommodation and support for daily activities.

    Residential care includes group homes and respite services, usually with fewer than six residents, and Supported Residential Services that accommodate 10–80 residents.

    The potential for COVID-19 to spread in these facilities and cause outbreaks and associated poor health outcomes is high, similar to the potential in residential aged care facilities. This is due partly to:

    • communal living
    • the requirement for close contact with personal care workers who support residents with daily living activities such as feeding, bathing and getting dressed
    • a highly mobile workforce of personal care workers, who come into contact with vulnerable people across homes and services.

    In addition, some people with disability have other chronic conditions or weakened immunity, making them vulnerable to severe COVID-19.

    People with disability may also face difficulties implementing safety measures such as social distancing and wearing a mask, and basic hygiene such as washing hands.

  • Resources

  • COVID-19 strategy for Supported Residential Services in Victoria

    The Victorian Department of Health and Human Services has a strategy in place that involves assessment of local Supported Residential Service providers by community health services (cohealth and IPC Health). This involves the review of systems and procedures and planning for a safe environment for residents should a COVID-19 outbreak occur. Planning involves infection control, prevention and preparedness strategies, outbreak management plans and recovery plans.

    The aim is for residents to be able to remain in their home if they need to quarantine and self-isolate, unless they need to move for health reasons. However, relocation and repatriation of clients may be required in some circumstances. This is due to the complexity of the client cohort, as well as difficulties presented by shared facilities and the capacity of providers to prevent and respond to COVID-19 outbreaks.

  • Provider template for recording residents' needs

GP education

  • We recommend the following courses for GPs:

    • NDIS access and psychosocial disability for clinicians – developed by Transition Support Project
      • Aims to provide GPs with knowledge about the role of clinicians in identifying people who are likely to be eligible for NDIS support, and how to provide helpful evidence to support their application.
      • This training takes 30-40 minutes to complete.
    • GP clinical audit to improve the assessment and management of behaviours of concern in people with intellectual disability
      • Takes 6 hours
      • Qualifies for RACGP QICPD Category 1 = 40 points
  • NWMPHN webinars

  • RACGP Disability Special Interests Group

    The RACGP has a Disability Special Interests Group. Visit the RACGP website for more information on joining the RACGP to gain free membership of this group.

Resources for disability support workers

  • What support is available?

    The following resources and support are available for disability support workers in the NWMPHN region during COVID-19:

    DHHS: Disability services sector

    This page includes information for people working in disability residential services and people who work in the community. It also includes information about PPE.

    DHHS: Community services

    This page includes:

    • eLearning for community service workers including disability support workers. There are three free short (20-minute) eLearning courses available about staying safe from COVID-19including:
      • COVID-safe for residential carers
      • PPE for community workers
      • use of P2/N95 masks.
    • PPE for providers of Supported Residential Services and disability group homes (how to use PPE, how to request it, and FAQs)
      Engaging interpreters during COVID-19 if the client speaks another language.

    Australian Department of Health: COVID-19 resources for disability services