Community Health Program access policy

The Community Health Program is funded by the Victorian Government and provides nursing, allied health and counselling services to the Victorian community.

Access to the Community Health Program is targeted to those with the greatest risk of poor health and the greatest economic and social need, who may face barriers to accessing care through other services and in other settings.

Community Health Program eligibility criteria

The following people, including children and young people, are eligible to receive services through the Community Health Program:

• People who hold a healthcare or pensioner concession card, or who are a dependent of a concession card holder
• Aboriginal and Torres Strait Islander people
• Refugees and people seeking asylum
• People who are homeless or at risk of homelessness
• Children in care, child protection and, Orange Door clients
• People who face barriers to accessing alternative safe, inclusive and/or accessible services (determined in accordance with the access policy principles)

Access Policy Principles

When making decisions about access to services through the Community Health Program (CHP), service providers must apply the following principles:

• Service providers must consider intersectionality and/or individual circumstances, when determining eligibility for an individual facing barriers to accessing alternative safe, inclusive and/or accessible services.
• Service providers must waive eligibility criteria where the organisation is the only local provider of a particular service.
• Service providers must not restrict access to the CHP based on a person's eligibility for another funding stream or program, where that person is not in receipt of a service or funding. Community health services should support people to access appropriate funding streams and programs, and where practicable and required, provide interim services.
• Service providers may restrict access to the CHP where an individual is also receiving funding for the same service through another funding source, for example, NDIS or My Aged Care or other sources.
• Service providers must not restrict access to the CHP based on where people live or work, however, may prioritise access for people who live or work in the local area. In determining priority, service providers should seek to understand an individual’s motivation for travelling outside of their local area, and whether a closer service exists. Service providers may apply geographical restrictions where services are provided outside of the clinic setting, such as home-based and outreach services.
• Service providers may implement fees for CHP funded activities in accordance with the Community Health Program fees policy[LT2.1]. Service providers must not deny a CHP eligible person a service because of their inability to pay.
• Service providers must maintain an open waitlist for CHP funded services. People placed on a waitlist must be provided with clear guidance on expected wait times, as well as alternative service options, to ensure that they can make an informed choice about whether or not to wait. Service providers must actively manage waitlists, checking-in on clients at regular intervals to provide updates on wait times and identify any change in the client’s condition that might necessitate a higher priority for service.
• Service providers that accept fee-paying clients outside of the CHP, must ensure adequate resources are directed to service CHP clients, in line with CHP funding and target hours. Private clients must be billed appropriately to ensure that one hundred percent of CHP funding is directed to CHP clients and target hours.
• Once eligibility is confirmed, service providers should consider an individual's clinical and social needs to prioritise access for services using the guidance provided in the Community Health Demand Management Toolkit.