Victoria and COVID-19

Victorian COVID Update – effective 11.50 pm 22 November, 2020

Following the Premier’s announcement yesterday, find attached a copy of Summary of last step restrictions for metro Melbourne and regional Victoria (effective as of 11.59pm, 22 November 2020).

Based on this document, there are limited changes for Allied Health and primary care providers, which are summarised below:

  • Indoor group therapies in clinical treatment settings and fitness industry settings may increase to a maximum cap of 20 participants (within density quotients).
  • Indoor group therapy classes conducted in a fitness industry setting may now operate with a density quotient of 1 to 4 metres square (i.e. previous density quotient was 1 to 8 metres square). This brings into alignment the density quotients for clinical treatment settings and fitness industry settings.
  • Outdoor group therapies may increase to a maximum cap of 50 participants. Owing to the proximity to other participants and potential for contact, face masks still should be worn by all participants.
  • Caps on group sizes for hydrotherapy in indoor and outdoor pools have been removed, however a density quotient of 1 to 4 metres square still applies.
  • Restrictions on the purpose, number and time limits for visitors to hospital and care facilities have been removed, but remain subject to the rules/regulations of each individual facility.

PPE Advice has not changed - The conventional use of PPE guidance (upon which the Allied Health private practice PPE guidance is based) has not changed at this time. The requirement for use of a face shield remains under all three risk Tiers, noting where practicable.

DHHS is continuing to seek further guidance from Public Health regarding provisions for therapy services operating from a residential address, and we will update you as soon as we have additional detail.

The Guiding Principles in Victoria are Ending

The Guiding Principles for residential aged care – keeping Victorian residents and workers safe (the Principles) have been in place since 27 July 2020 to reduce the risk of COVID-19 spreading among aged care residents and workers. Based on current case numbers in the community and within aged care residents and staff in Melbourne and Mitchell Shire, the risk of infection is now considered low.

The Principles will end on 30 November 2020 in Melbourne and Mitchell Shire. This means that providers of non-government aged care facilities should commence transition out activities so that normal working arrangements can recommence from 1 December 2020. Public Sector facilities in Victoria are continuing single site arrangements until February 2021, as funded by the Victorian Department of Health and Human Services.

The activity period for the Support for Aged Care Workers in COVID-19 (SACWIC) grant, as funded by the Australian Government, will end on 30 November 2020 in line with the Principles. Eligible providers can submit applications for the SACWIC grant up until 30 June 2021.

While the risk is low, providers are encouraged to continue to limit workforce mobility where possible. The government encourages providers to take steps to understand your workforce by developing a register for recording each workers mobility and their skills and training. The Department is currently updating the CDNA national guidelines for the prevention, control and public health management of COVID-19 outbreaks in residential care facilities in Australia to include advice relating to preparing for single site workforce arrangements should these be implemented in the future.

The Support Hub, by ACSA and LASA, is available for Victorian aged care providers using the Principles to support transition out activities. Providers can visit The Guiding Principles Support Hub or seek assistance by phoning 1800 491 793 (free call). 

Updates to Student clinical placement Coronavirus (COVID-19) guidance

Student clinical placement Coronavirus (COVID-19) guidance (13 November 2020) has been updated. Amendments are highlighted in aqua. View guidance document.

Reopening Victoria – is your workplace ready?

WorkPlacePLUS has shared the following information with the Association to support workplaces that are reopening as COVID-19 restrictions ease. It includes details of policies, procedures and systems it would be helpful to have in place at this time. Visit the WorkPlacePLUS website to read more
 
Members are also reminded to review the Association’s resources about Returning to Work.

Updated Industry Restart Guidelines – Allied Health and Primary Care

Updated Industry Restart Guidelines – Allied Health and Primary Care This graphic is associated with the hyperlink that precedes it and indicates the document is in PDF. have been issued by the Victorian Government to reflect the easing of restrictions effective as of 11.59 pm 27 October 2020.

This document is also available from the Business Victoria website

Metro Melbourne has now entered the Third Step.

Public Health have provided confirmation that indoor group therapies will be permitted for metro Melbourne in the Last Step – now confirmed that indoor therapy groups (in both clinical settings and fitness industry settings) will be allowed to recommence in metro Melbourne from 11.59 pm on Sunday 8 November 2020.

For clinical settings, indoor groups (when permitted) will need to operate with a density quotient of 1 person per 4 square metres, maximum number of 10 people per group – practitioners excluded from the group numbers.

For health professionals, that provide clinical services in a fitness industry setting (i.e. public/commercial gym) a density quotient of 1 person per 8 square metres will apply with a maximum group size of 10 people – practitioners again excluded from the group numbers.

Speech pathologists operating from a residential address

The Association has received advice that to operate a ‘business from the home’, the owner/practitioner of the business must ensure their compliance with Victoria’s COVID-19 restrictions as follows:

  • The residential premise must be registered as a business premise and have a COVID-safe plan in place
  • A separate entry/exit point must be available for patients/clients to access the premise
  • Patients/clients cannot access any shared facilities in the owner/practitioner’s place of residence – including bathrooms/toilets and foyer areas
  • Density quotients, physical distancing and PPE requirements remain applicable
  • Patients/clients must wear a face covering for the duration of the intervention/treatment – the only exception being where a patient/client is legally exempt from the requirement to wear a face covering as per DHHS directives.

Coronavirus (COVID-19) cleaning guidelines for workplaces

The Victorian government is actively working with health services, agencies and businesses to keep the Victorian community safe and slow the spread of coronavirus (COVID-19). As restrictions ease, workplaces will be required to have a COVIDSafe plan, which outlines the key actions that are in place to mitigate the introduction and potential impacts of coronavirus (COVID-19).

One of the key areas that must be addressed in the plan is environmental cleaning.

The Coronavirus (COVID-19) cleaning guidelines for workplaces – Information for business owners, managers and cleaners This graphic is associated with the hyperlink that precedes it and indicates the document is in PDF. provides advice on how businesses can ensure they have the right cleaning structure, processes and equipment in place to meet the cleaning requirement. The principles outlined in this document apply to all workplaces including retail and public facilities, schools, childcare centres, accommodation, factories, healthcare services and aged care facilities.

Fact sheets

Easing of lockdown restrictions in Melbourne (as at 11:59 pm 27 October)

In the context of recent announcements regarding allied health and other primary care services being able to resume routine care, the following applies.

Allied health practitioners (including speech pathology) were able to commence routine care from last week (19 October), and all other practitioner groups will be able to do so effective 11:59 PM 27 October. The only exception / restriction for metro Melbourne that remains is indoor group activity.

Indoor group therapy is still not permitted until metropolitan Melbourne aligns with regional Victoria on 8 November. Any form of indoor activity that brings members of different households together is still considered the highest risk, irrespective of the reason those people might be in the indoor space.

Further detail regarding density quotients and numbers will follow in the next few days, however it is anticipated that group clinical intervention / therapy will be able to re commence from 8 November 2020.

In regards to providing services across multiple sites, the advice on limiting movement across sites remains, with guidance drawn from COVID Safe Plans. This involves creating “workplace bubbles” to:

  • Keep the same workers rostered on the same shifts and in the same areas within a site, where practical;
  • Avoid overlap in shift changes where possible; Minimise number of workers working across a business’ other premises where practical;
  • Maintain records of workers working across multiple sites.

Clinicians planning to provide services in non-clinic settings i.e. aged care facilities and schools are advised to contact those external organisations for specific advice and PPE guidance, and to comply with that organisation’s COVID-Safe Plan.

Members should continue to apply risk management decision-making, maintain appropriate cleaning and infection control, and where appropriate and possible, continue telehealth services.

Further updates will be provided as these are available.

Coronavirus disease 2019 (COVID-19) – PPE for Allied Health in Private Practice Settings (Update 21 October 2020)

This document about PPE for Allied Health in Private Practice Settings aligns with the Victorian Department of Health and Human Services’ (DHHS) guide to the ‘conventional use of PPE’ and ‘PPE and its levels of protection’. NB. that this guide does not apply to PPE use in residential aged care facilities. Table 1 outlines the recommended PPE for allied health professionals in private practice settings as per the general guidance issued to all healthcare worker on 21 October 2020. All updates or amendments highlighted in yellowCoronavirus disease 2019 (COVID-19) – PPE for Allied Health in Private Practice Settings Update 21 October 2020This graphic is associated with the hyperlink that precedes it and indicates the document is in PDF.

Easing of restrictions for Allied Health services in metro Melbourne (effective as of 11.59pm, 18 October 2020)

The Association is pleased to share the following information about easing of restrictions for Allied Health services in metro Melbourne (effective as of 11.59pm, 18 October 2020).

  • All AHPRA registered health workers – and in addition, social work, speech pathology, dietetics, audiology, exercise physiology, orthotists and prosthetists, orthoptists, art therapists and music therapists may provide routine and preventative care for individual patients.
  • Telehealth should remain the first preference for service delivery and be provided wherever clinically appropriate.
  • Indoor group classes are not permitted.
  • Outdoor classes are permitted with a maximum of 2 patients to 1 health professional.
  • Home visits may be provided with strict infection prevention and control and use of PPE.

Any further updates will be available on the Association’s website.

Members returning to in person work are reminded:

  • All workplaces must have a COVIDSafe Plan in place. As part of this plan, all businesses must keep records of every person who attends your workplace/s.
  • To conduct a risk assessment and to undertake appropriate cleaning and infection control.
  • Members are able to work across multiple locations (such as schools, aged care facilities and homes), but the Government has requested providers limit movement between sites and reduce the number of providers visiting each site as much as possible to reduce the likelihood of spread in case of a COVID outbreak. Members will also need to comply with the CovidSafePlan of any external organisations they visit.
  • Employers must keep a log of all employees working across multiple sites including date, time and place of attendance and employees must provide a written declaration to each employer to advise that they are working at more than one work site.

Resources are available on the Association’s website to share with clients/families about seeing a speech pathologist.

The Government have provided additional following links:

Industry Restart Guidelines: allied health and other primary health services.

Information for people with a disability-COVID 19.

Testing of asymptomatic residential aged care workers in Victoria

The Australian Government has expanded capacity for testing of asymptomatic aged care workers, particularly prioritising ‘hot spot’ locations. Participation in testing is voluntary; however, all residential aged care workers are being strongly encouraged to participate.

Aged Care workers include those on staff at the facility whether in direct personal care, hospitality services or administrative support. Testing is also encouraged for workers who may regularly attend the facility, such as medical practitioners, allied health, and National Disability Insurance Scheme staff. Further information is available from this fact sheet.

Statement from Victorian Department of Education

Schools are managing on-site arrangements in line with requirements for school operations, using a combination of strategies to minimise coronavirus (COVID-19) transmission risk. Health and safety advice for all Victorian schools outlines the range of COVIDSafe principles and activities aimed at reducing the risk of transmission within a school environment.

Within this context, all schools are required to limit outside visitors to those delivering or supporting essential school services and operations (such as student health and wellbeing services, and safety, cleaning and maintenance workers). For student health and wellbeing, essential services are defined as responding to critical incidents and providing assessments for the Program for Students with Disabilities. See Health, Wellbeing and Inclusion Workforce (HWIW) advice. For non-school employees it will also be appropriate to consider permit arrangements.

The Department’s speech pathology workforce is continuing to provide other services, such as therapy and teacher consultations, remotely via telepractice, and this will also be the case for external service providers working with schools during the return to on-site learning.

VACRC PPE donning and doffing posters

The Victorian Aged Care Response Centre has published new posters to assist aged care workers with correctly donning and doffing personal protective equipment (PPE). These help to show how to correctly put on and take off PPE when entering or leaving areas with confirmed cases (red zones), suspected cases (amber zones) or no cases (green zones).

NB. that this advice contains recommendations to wear N95 masks at all times in red and amber zones. Refer to advice below regarding access to N95 masks in residential aged care. The Association also reminds speech pathologists to consider a risk assessment of each individual clinical service to determine if additional precautions , including additional PPE is required for the clinical task being undertaken (refer to the Association’s Guidance for Service Delivery)

Additional P2/N95 masks for Melbourne / Mitchell Shire for aged care workers

To support the Victorian Government, capacity for asymptomatic testing of aged care workers will be extended and an additional seven million P2/N95 respirator face masks will be provided as the Commonwealth continues to help the sector drive down case numbers.

Minister for Health, Greg Hunt and Minister for Aged Care and Senior Australians, Richard Colbeck announced last week that the government will extend testing and bolster the supply of Personal Protection Equipment (PPE) throughout residential aged care facilities across Melbourne and the Mitchell Shire. 

Additional P2/N95 masks are being made available from the National Medical Stockpile to residential aged care facilities in metropolitan Melbourne and the Mitchell Shire to ensure the continued delivery of safe care.

All facilities in these areas will be able to request P2/N95 respirator masks using a one-off request form. Requests must be submitted by 30 October 2020. A separate form is also available to individual aged care providers (who are not RACFs).

Safe Care Victoria webinar: Behind the scenes with the Victorian Chief Clinical Officers

The fifth and final webinar in a series hosted by Safer Care Victoria and facilitated by Acting CEO Adjunct Associate Professor Ann Maree Keenan is on Thursday 15 October from 3.15–4 pm.

The final webinar of the series will provide insights from Victoria’s Chief Clinical Officers - Alan Eade Chief Paramedic Officer, Tanya Farrell Acting Chief Nurse and Midwifery Officer, Donna Markham Chief Allied Health Officer and Andrew Wilson Chief Medical Officer.

The panel will reflect on:

  • the emotional, physical and psychosocial challenges of coronavirus (COVID-19)
  • strategies they have used to practice self-care
  • the challenges and triumphs during the pandemic and how we can prepare for COVID normal.

Register online and then help shape the discussion by uploading your questions in advance and entering event code #8490.

PPE for allied health in private practice settings update

This is an updated (2 October) version of the Department of Health and Human Services PPE guidance specific to Allied Health in private practice settings issued previously in August 2020. Amendments to content are highlighted in yellow. Read the updated PPE guidance This graphic is associated with the hyperlink that precedes it and indicates the document is in PDF..

Further details for Victorian Metro Melbourne members on Step 2 restrictions and Step 3 for Regional Victoria

As members were notified on 28 September, industry restart guidelines have been developed for Allied Health (including speech pathology).

Details of the specific guidance under Requirements for Clinical Services are outlined in the Industry Restart Guidelines Allied Health and other primary health services This graphic is associated with the hyperlink that precedes it and indicates the document is in PDF..

For Metro Melbourne areas (Step 2), it clearly states that Telehealth should be the preferred delivery of services.

Telehealth services must be preferred as the first option for care delivery and provided where and as appropriate.

Additionally, the following specific requirements applies to speech pathologists when considering to provide face-face services:

All AHPRA-registered health workers - and in addition, social work, speech pathology, dietetics, audiology, exercise physiology, orthotists and prosthetists may provide face to face services:

  • to prevent a significant change/deterioration in functional independence which would result in an escalation of care needs (e.g. an increase in frequency of treatment needed, an increased need for prescription medication due to a significant increase in pain, requirement for specialist input or review, an increase in care needs, and/or a substantial increase to anticipated recovery time associated with a delay in receiving services)
  • to provide assessment and diagnostic services to clients / patients whose care have been delayed as a result of Stage 4 restrictions, with any further delay likely to result in deterioration in functional independence or adverse health outcomes (including access to diagnostic imaging services or assessment for prescription of assistive equipment and technology)
  • to provide services that are essential as part of a broader plan of care with a medical practitioner (e.g. fitting a brace post-surgery)
  • to provide services that are part of a conservative management plan to avoid or delay elective surgery (as agreed with treating team)
  • to provide services immediately following elective surgery that prevent secondary complications or aid functional recovery (as agreed with treating team).

These details can also be found in the permitted work premises list for the ‘health care and social assistance industries’ which has been updated to align with the restart guidelines.

Note also: No group classes / services to be provided (face-to-face), unless the session can be conducted safely outdoors (maximum two (2) people plus health worker).

Some useful guidance for members of the public on leaving home to seek health services is available online.

One such guide includes:

Can I attend an appointment with an allied health professional (e.g. physiotherapist, speech pathologist)?

Selected allied health providers can operate under current restrictions. Information on permitted allied health providers and the permitted work premises where they can work.

Face-to-face appointments with allied health professionals should only be for urgent care. Urgent care means your appointment is needed:

  • to prevent a significant deterioration to your health and function (i.e. prevents need for a specialist review or escalation of care needs)
  • for pain management services
  • for therapy services require to prepare for or recover from elective surgery (as recommended by the surgical team)
  • for assessment and diagnostic services that have been delayed due to Stage 4 restrictions.

There are no restrictions on the delivery of allied health services using telehealth and Victorians are encouraged to use these services where they can. 

For Regional Victoria members, also refer to the Industry Restart Guidelines – at this stage in Step 3, your guidance is as follows:

  • Telehealth services must be preferred as the first option for care delivery and provided where and as appropriate.
  • Most face-to-face clinical services provided with COVIDSafe Plan in place
  • Indoor group classes may only be provided for clinical interventions:
    • to prevent a significant deterioration in functional independence which would result in an escalation of care needs (such as increased frequency in treatment, significant increase in pain, specialist input, or substantial increase in recovery time as a result of delayed care); or
    • to provide essential pre-operative or postoperative elective surgery care.
  • Density quotient applies.

Further updates will be provided on the Victorian COVID page of the Association’s website as this becomes available, including how Step 2 relates to members providing services in schools. Members are also advised to refer to official Government information and consider your decisions in line with your organisational/employer policies.

Refer also to Association’s Guidance on Service Delivery, Clinical Procedures and Infection Control during COVID-19 and the Speech Pathology Australia Risk Assessment Tool.

Further information for clients can also be found on the Association’s website.

Update for Victorian members on easing of restrictions in Metro Melbourne and regional Victoria

On 27 September, the Premier provided further detail of the ‘second step’ of easing of restrictions for metro Melbourne.

An industry restart guideline has been developed for Allied Health (including speech pathology). This link is to the Industry Restart Guideline document which contains detail for Allied Health and other primary health services during each step of the easing of restrictions. It also outlines the COVID Safe principles, and what workplaces need to do to ensure a COVID Safe environment. View Industry Restart Guidelines Allied Health and other primary health services This graphic is associated with the hyperlink that precedes it and indicates the document is in PDF.

Both Metro Melbourne and Regional Victoria allied health services are described as ‘Restricted’ however have different levels of restrictions outlined under ‘Requirements for Clinical Services’. Members are encouraged to carefully read the descriptions of service permitted relevant to their location.

The updated permitted work premises list for the ‘health care and social assistance industries’ has now been updated to align with the content of industry restart guidelines.

FAQ’s have also been developed which aim to address common practitioner and consumer questions, with some additional FAQs to be available shortly.

Members should continue to visit the Victoria and COVID-19 pages on this website for further details as they become available.

Updates for providers working in the early childhood sector in Victoria

Speech pathologists can subscribe to COVID-19 communication updates to the early childhood sector from the Department of Education and Training. Visit this page to subscribe.

Allied Health Webinar - DHHS Infection Control and Outbreak Squads – 30 September at 6pm

DHHS is pleased to invite allied health professionals to a webinar aimed to assist Allied Health Professionals in reducing COVID transmission.

Attached are details of a forthcoming webinar on the findings of the DHHS Outbreak Squads in relation to outbreak prevention.

This session is specific to Allied Health and open to Allied Health professionals, including speech pathologists, across the state.

Join the webinar via Teams, or join with a video conferencing device 886843700.(VTC Conference ID)@video.dhhs.vic.gov.au VTC Conference ID: 1319385015 
The agenda is available here This graphic is associated with the hyperlink that precedes it and indicates the document is in PDF..

 

Slight easing of restrictions for speech pathology services in metropolitan Melbourne (17/9)

Following the Victorian Premier's recent press release regarding some slight easing of restrictions for Allied Health during Step 2 of the roadmap from the 28 September, the Victorian Chief Allied Health Advisor has provided further advice This graphic is associated with the hyperlink that precedes it and indicates the document is in PDF..

The recent decision for the Melbourne metropolitan area will allow all Australian Health Practitioner Regulation Agency (Ahpra) registered allied health professions, as well as audiology, dietetics, exercise physiology, orthotists and prosthetists, social work and speech pathology, to provide essential face to face services, where the following applies:

  • to prevent a significant deterioration in functional independence which would result in an escalation of care needs (such as increased frequency in treatment, significant increase in pain, specialist input, or substantial increase in recovery time as a result of delayed care)
  • for assessment and diagnostic purposes for those people whose care has been delayed during stage 4 restrictions, and where further delay likely to result in deterioration (e.g. diagnostic imaging and assessment for prescription of assistive technology)
  • to provide essential pre-operative or post-operative elective surgery care.

The intention of the easing is to provide a broader range of consumers with access to services, while still focusing on the need to reduce movement and face-to-face interactions wherever possible.

Routine care and regular monitoring, other than via telehealth, is not permitted during the second step and practitioners should continue to delay services that can safely be delayed until Step 3.

Further details of Melbourne moving towards Step 3 around 26 October, which will then include allied health being ‘open with a COVID safe plan’, will be confirmed when available.

In regional and rural Victoria, all allied health services as well other primary health care services will continue to remain open as per Step 3 restrictions, with the exception of indoor group sessions.

Members are strongly encouraged to continue to use a risk management framework to support clinical decision making.

Members should also reference the Speech Pathology Australia Risk Assessment Tool and COVID-19 Guidance document.

For further queries concerning specific restrictions, members can also contact Business Victoria - Coronavirus (COVID-19) business support and the Industry Coordination Centre on 13 22 15.

Advice for speech pathologists working in Education in Victoria (17/9)

Members are encouraged to review relevant departmental guidelines regarding completing assessments for school funding purposes.

Department of Education – Victoria – Current Advice (17/09/2020)

In recognition of the challenges related to COVID-19, flexibility is being applied to PSD timelines this year. Supplementary PSD application dates have been established and are outlined in the PSD operational guidelines. Guidelines for alternative meeting arrangements have also been outlined.

Health, Wellbeing and Inclusion staff may continue to visit schools to undertake assessments related to the PSD, especially where the PSD application impacts on essential support or an enrolment decision. Students attending onsite by agreement with the school principal can participate in these assessments.

The issues around telehealth are complex and while we are aware of the potential benefits for delivery of a range of allied health services, the considerations for remote delivery of standardised assessment require more evidence/investigation, particularly where these assessments inform decision-making such as diagnosis, program eligibility and educational placements. In terms of the PSD our current advice is:

  • Assessments to determine eligibility under the Intellectual disability and Severe language difficulties with critical educational needs categories should continue to be referred to Assessments Australia, the contracted service provider.
  • Where assessors are advised they are able to attend schools to provide essential services such as PSD assessments, and the assessor, school, parent/carer(s) and students are happy to proceed, face to face assessment can be conducted.
  • Where it is not possible to conduct a face to face assessment, our advice is that assessment should be delayed. PSD timelines have been extended in recognition of the current situation. See the PSD operational guidelines web page.

We also recognise that the COVID-19 situation is rapidly evolving, and if further adjustments to PSD guidelines or timeframes are required, they will be published on the PSD operational guidelines web page. In the meantime, speech pathologists with questions about the PSD may contact the relevant Regional Disabilities Coordinator in their region for advice. For contact details see: Regions.

Department of Education: Victoria - Use of face coverings:

The Department provides advice on wearing of face coverings in schools is available online.

The following update has also been provided by the Department:

Health, wellbeing and inclusion staff are required to wear face coverings, unless an exemption applies, including the need for ‘clear enunciation or visibility of their mouth’ (for example, when undertaking a speech therapy intervention or working with individuals who are deaf or hard of hearing).

Advice and Considerations:

Refer to the relevant Education department guidelines and make direct contact if further advice on completion of funding assessments is required. These guidelines will outline if extensions to the timeframe for funding applications are in place.

Clinicians are expected to continue to use their clinical judgment to determine if assessment with a mask is appropriate for a student, referral question and situation. There may be circumstances where it is more appropriate to delay the assessment.

Clinicians should continue to use their expertise, professional skills and knowledge to identify if there are impacts on the findings of an assessment due to modifications required during COVID-19 e.g. wearing a mask/face shield. Clinicians should include a comment on any impacts on the outcome of the assessment in the report. The Victorian Education Department has provided the following additional advice “ The assessor should use their clinical judgment when determining if the results were compromised by use of a mask and may decide to not report the scores and only describe performance."

Members are reminded to consult the Association's Guidance for Service Delivery Document and the Association's online Risk Assessment Tool in considering whether to proceed with in-person services. Additionally, members are advised to stay up to date with relevant local State and Territory health department advice as the situation relating to COVID19 and advice re PPE use is rapidly changing.

Updated: Student Clinical Placements Guidance (15/9)

DHHS has released a guidance note that provides specific advice to education providers, students, Victorian public health sector entities and aged care providers on student clinical placements scheduled during the current First Step restrictions in metropolitan Melbourne and Second Step restrictions in regional and rural Victoria.

This guidance note contains a number of general risk management principles related to the provision of student clinical placements in the context of COVID, that may also apply in private practice settings.

The main changes to the 14 August guidance include clarification that the guidance applies to both public and private facilities, and revision to some environmental requirements aligned to COVID Emergency Departments. Changes have been highlighted.

Further update: Victorian COVID-19 roadmap to reopening

Speech Pathology Australia, and other AHPA members, today (10/9) met with the Victorian Chief Allied Health Officer and representatives from the Department of Health and Human Services (DHHS) to seek further clarification in relation to the Coronavirus (COVID-19) reopening roadmap for Metropolitan Melbourne. Unfortunately, at this time there is no further official guidance and we are continuing to wait for details, which we understand will be available next week.

However, based on our discussions to date it is our understanding that restrictions remain at their current levels for an additional 14 days from 14 September to 27 September. The Association encourage members to contact clients with bookings over the next 14 days that do not meet the current definitions outlined in the permitted workplaces guidance to reschedule appointments appropriately.

The Association is cautiously optimistic that restrictions will be eased slightly from the 28 September (Step 2), however we will provide further updates early next week, or whenever further information is available.

The Association also understand that guidance on student clinical placements issued by DHHS on 4 August remains current, and the department will advise if/when there is any update available.

Speech pathology businesses in regional Victoria remain under Stage 3 restrictions and should expect to remain under similar restrictions for now. The Association expects further information about potential easing of those requirements as part of the regional roadmap to also come next week.

DHHS has expressed thanks to allied health professionals, including speech pathologists, for their ongoing support for the community and their diligence in managing the difficult balance between maintaining the health of their clients and reducing potential exposure to COVID-19.

Members will be informed of further information as soon as it becomes available.

UPDATE – Victorian COVID-19 roadmap to reopening

The Victorian Premier yesterday (6 September) formally announced Victoria’s Coronavirus (COVID-19) roadmap to reopening, providing a four-step return to 'COVID Normal' from Stage 4 to Stage 3 restrictions.

Those plans include updated information about Industry Restriction levels. Allied Health, including speech pathology, falls under the Healthcare and Social Assistance industry category. The new guidance states that ‘healthcare and social assistance’ allied health businesses industries for metropolitan Melbourne will be ‘Highly Restricted’ during Steps 1 and 2, and ‘Restricted’ levels during Steps 3 and 4. The Association notes that regional services commence under Step 2. Further information about these levels is outlined in the Common Requirements - Industry Restriction Level document.

Unfortunately, it is not currently clear what these restrictions mean for allied health providers/speech pathologists and whether they are part of the ‘healthcare and social assistance’ industry group in the ‘roadmap’, or will be covered by the current permitted workplaces guidance. It is also not clear whether that guidance will be updated to provide access to services for an expanded consumer cohort, particularly for those where delaying treatment will be detrimental.

We understand that the government and the Department of Jobs, Precincts and Regions is currently reviewing guidance for the sector and that this may result in some expansion of criteria for eligible services from 13 September. However, we are still seeking clarity on this and will provide further updates in the coming days. At this stage, the Association advises speech pathology practices to prepare for at least two additional weeks of restrictions continuing at their current levels, unless we inform members otherwise.

The allied health sector has met with the Victorian Chief Allied Health Officer, seeking further guidance in relation to the Roadmap. Speech Pathology Australia, and all AHPA members, remain concerned that if restrictions remain at current levels until Step 3 is reached, on or after 26 October 2020, this represents an unacceptable level of risk for those consumers that cannot currently access services.

Considerable advocacy and seeking clarification on the timelines for the easing of restrictions for allied health is underway at various levels, through AHPA and associations including Speech Pathology Australia.

Members will be informed as soon as further information is available.

 

DHHS COVID-19 - Psychosocial Support Response for Allied Health Clinicians working in public health services and private hospitals

The Department of Health and Human Services (DHHS) has engaged Nursing and Midwifery Health Program Victoria (NMHPV) to provide time-limited psychosocial support for frontline Allied Health clinicians engaged in Victoria’s COVID-19 response.

NMHPV is an independent support service for Victorian nurses, midwives and students of nursing and midwifery experiencing health issues related to their mental health, substance use and family violence concerns. For further information about the NMPHV website. https://www.nmhp.org.au/index.html

NMPHV’s support response for Allied Health is available to clinicians employed in frontline roles within our public and private health services and is based on a ‘brief intervention and referral’ (BI&R) episode model.

The B&IR episode model consists of a maximum of two (2) telephone consultations per individual, and provides frontline Allied Health clinicians with access to qualified counsellors and immediate guidance, support and information regarding appropriate referral options for ongoing support (as required).

This program is free to access, confidential and independent. Full details of the NMHPV Privacy Statement are available online.

To access the Allied Health COVID-19 Support Response program, telephone (03) 9415 7551 (Hours of operation: Monday to Friday - 9.00 am to 5.00 pm)

Health care and social assistance restrictions under metro Melbourne stage 4 restrictions

Department of Health and Human Services (DHHS) website has now been updated with corrected information for 'Health care and social assistance restrictions' under metro Melbourne stage 4 restrictions, and frequently asked questions pertaining to the ability to access allied health services. Updated information is available from DHHS: Health care and social assistance stage 4 restrictions and DHHS: Stage 4 restrictions summary.

Speech Pathology in Education – Program for Students with Disability Guidelines

The following is a response from a representative of the Victorian Department of Education.

In recognition of the particular challenges related to COVID-19, flexibility is being applied to PSD timelines this year. Supplementary PSD application dates have been established and are outlined in the PSD operational guidelines. Guidelines for alternative meeting arrangements have also been outlined.

Health, Wellbeing and Inclusion staff may continue to visit schools to undertake assessments related to the PSD, especially where the PSD application impacts on essential support or an enrolment decision. Students attending onsite by agreement with the school principal can participate in these assessments.

The issues around telehealth are complex and while we are aware of the potential benefits for delivery of a range of allied health services, the considerations for remote delivery of standardised assessment require more evidence/investigation, particularly where these assessments inform decision-making such as diagnosis, program eligibility and educational placements. In terms of the PSD our current advice is:

  • Assessments to determine eligibility under the Intellectual disability and Severe language difficulties with critical educational needs categories should continue to be referred to Assessments Australia, the contracted service provider.
  • Where assessors are advised they are able to attend schools to provide essential services such as PSD assessments, and the assessor, school, parent/carer(s) and students are happy to proceed, face to face assessment can be conducted.
  • Where it is not possible to conduct a face to face assessment, our advice is that assessment should be delayed. PSD timelines have been extended in recognition of the current situation. See the PSD operational guidelines web page.

We also recognise that the COVID-19 situation is rapidly evolving, and if further adjustments to PSD guidelines or timeframes are required, they will be published on the PSD operational guidelines web page. In the meantime, speech pathologists with questions about the PSD may contact the relevant Regional Disabilities Coordinator in their region for advice. For contact details see: Regions.

Student Clinical Placements (Guidance note as at 14 August 2020)

DHHS has provide updated guidance on 'Coronavirus (COVID-19) - Student Clinical Placements'. Although this guidance is specific to public health sector entities and aged care providers, it contains a number of general risk management principles related to the provision of student clinical placements in the context of COVID, that may also apply in private practice settings. Amendments to the guidance (14 August 2020) provide clarification regarding students who may be engaged in a part-time capacity in a residential care facility and their ability to concurrently undertake clinical placements in another setting.  Updates are highlighted in yellowView Student Clinical Placement Guidance This graphic is associated with the hyperlink that precedes it and indicates the document is in PDF..

Updated PPE guidance for all healthcare workers – Victoria

Due to an increased risk of transmission of coronavirus (COVID-19) the Victorian PPE Taskforce has updated its advice for all healthcare workers in Victoria. The updated Guide to the conventional use of PPE is available for download. Further information is available online from the Department of Health and Human Services. Read more…

DHHS requests assistance from Allied Health Professionals in Residential Aged Care Facilities

The information below is a request made by the Victorian Chief Allied Health Officer for qualified allied health professionals to provide support and care to people residing in residential aged care facilities where DHHS / public health services are coordinating the crisis and in-reach response during the COVID19 pandemic.

DHHS has provided assurance that clinical governance and workplace safety arrangements (including e.g. access to PPE) are in place at sites where AHPs would be asked to provide assistance.

The Association recommends that interested members confirm such details around governance, supervision and support structures and PPE access / training at a minimum directly, when considering these roles.

Dear Colleagues

You would be aware that there has been a significant shift in the numbers of cases of COVID-19 that have been identified in Victoria, particularly within residential aged care facilities.

The Department of Health and Human Services is seeking assistance from qualified Allied Health professionals to assist in the support and care of people residing in public and private residential aged care facilities.

This support will involve the provision of basic care (such as bathing, dressing, continence management, mobility/transfers and feeding) for confirmed/suspected COVID positive residents and non-COVID residents. Varying shifts are available – morning, afternoon and evening/overnight.

Interested Allied Health professionals are requested to lodge their expression of interest via the Torrens Health portal; http://www.torrenshealth.com.au/

Thank you for your consideration of this request during this critical time.

Donna Markham
Chief Allied Health Officer
Safer Care Victoria

Sharon Downie
Manager, Allied Health Workforce
Department of Health and Human Services

NEW Call-to-Test service – information for health providers and clients

About the service

The Victorian Government has established a new Call-to-Test service. The service provides in-home testing for COVID-19, conducted by a clinician, to people who can’t easily access other forms of testing.

The service is now in operation in the Melbourne metropolitan area. The Victorian Government is currently looking at whether this can be extended to the rest of Victoria. We will update you on any changes or expansions to the service when they happen.

Who can use the service?

The service is open to Victorians who:

  • are symptomatic
  • are over 5 years of age
  • have a referral from their GP and
  • meet eligibility criteria.

The following people are eligible for the in-home testing service:

  • a person with an injury, chronic health issue, or frailty affecting mobility
  • a person with moderate to severe physical or psychosocial disability
  • a person with moderate to severe mental health or behavioural issues not otherwise classified as a psychosocial disability
  • a carer for a person with moderate to severe disability.

People without symptoms may also be eligible if they:

  • have been identified by the Department of Health and Human Services (DHHS) as being a close contact
  • have received direction from DHHS to be tested, and
  • meet any of the criteria detailed above.

How to access the service

The key steps to access the service are listed below.

  1. Call the hotline: A person experiencing the symptoms of COVID-19 contacts the Victorian Corona Virus Hotline on 1800 675 398, then selects option 9
  2. Talk to a nurse: The caller is transferred to a trained nurse who will talk with the person to understand their unique circumstances and determine their eligibility for the program.
  3. Confirm or get a GP referral: The nurse will ask the a caller if they already have a referral from their GP. If the caller does not have a referral they will be asked if they would like to arrange one with their own GP, or if they would like the nurse to arrange a Telehealth consultation on their behalf (the nurse will only be able to arrange this service for holders of a valid Medicare card).
  4. Receive an appointment: Once the GP referral has been received, the caller’s details will be provide to the testing provider, who will arrange a next-day visit of a trained nurse.

Testing and results

On the day of the appointment, the nurse will telephone ahead to make sure the person is ready for the visit.

When the test is complete the nurse will drop-off the labelled swabs together with the GP referral at a laboratory for processing.

If the result comes back positive, the person will receive a follow-up GP referral.

If the result comes back negative the person will receive an SMS message.

For more details see (more resources are planned for development).

Free reusable face masks for Victorians with disability

Free reusable face masks for Victorians with disability in accessible format for people with disability.

The Easy English factsheet on “Who can get free face masks in Victoria” explains who can get the free masks, what type of masks you can get, when it will be available, and where you can get the free masks. Members can access this and other information from the DHHS website.

The DHHS are updating other resources about the restrictions directions for metropolitan Melbourne and the rest of Victoria. These will also be shared as they become available.

COVID Safe Workplan (updated 11 August 2020)

As Metropolitan Melbourne has moved to Stage 4 ‘Stay at Home’ restrictions to help slow the spread of coronavirus (COVID-19) in Victoria, businesses in Melbourne can only operate for on-site operations if they are a Permitted Work Premises and have a COVIDSafe Plan.

Regional Victoria has moved to Stage 3 ‘Stay at Home’ restrictions to help slow the spread of coronavirus (COVID-19) and, a COVIDSafe Plan is mandatory for high-risk industries and advised for all other permitted work- this includes work carried out by speech pathologists.

Failure to comply could result in an on the spot fine.

COVID Safe plan FAQs can be found at online on the Business Victoria website.

The Association also encourage any employees or contractors to ensure they are familiar with the COVID Safe Plan in their workplace and understand any obligations contained in that plan.

Business and industry stage 4 restrictions- advice for speech pathologists in Melbourne

Stage 4 restrictions are aligned to Victoria’s current State of Disaster and are focused on saving and protecting the lives of all Victorian’s through restricting non-essential movement across the state.

The ‘Permitted Work Premises for the purposes of the Restricted Activity Directions (Restricted Areas)’ instructions, provides the information about health professionals, including speech pathologists, who can provide services during the stage 4 lockdown period.

Under these ‘Permitted Work Premises for the purposes of the Restricted Activity Directions (Restricted Areas)’ instructions, if you provide a critical Allied Health service within the context of an ‘approved workplace’, such as a public or private hospital, you can continue to deliver this service/s without issue.

If you operate as a private practitioner or within an Allied Health private practice setting, you (or your employer) will need to ensure that your patients/clients fit within the prescribed inclusion criteria for an ‘essential’ service, namely:

“All AHPRA registered health workers - and in addition, social work, speech pathology, dietetics, and any other health worker required to fulfil a care plan endorsed by NDIS, TAC, Workcover or DVA - to provide services that prevent a significant change/deterioration in functional independence necessitating escalation of care (e.g. a requirement for specialist input/review, an increase in care needs and/or alternate accommodation, avoiding a hospital admission or emergency department presentation)".

Speech pathologists, in private practice, can continue to provide critical and essential in-person services during the 6-week lockdown period and do not require a medical referral (as previously proposed).

Of critical importance, before conducting in-person services, please note the following directives from the Department of Health and Human Services (DHHS):

  • Routine services are not permitted.
  • Essential services can continue but must only be provided if the absence of, or delay of this care, would result in a significant change/deterioration in the patient/client’s functional independence necessitating escalation of care, as outlined above.

DHHS is very clear that the above directives are about saving lives and are in place in order to limit movement within the community and minimise any risks of further transmission of COVID 19 and protect the public and health workers. Speech pathologists must consider if the service is essential for the patient/client in the next 6-week period.

There are no restrictions on the delivery of Allied Health services via Telehealth and the Association would encourage private practitioners to consider using Telehealth where at all possible so that patients/clients can continue to benefit from their Allied Health services.

Home visits and visits to RACFs are also possible but should be limited to essential services.

Employers for Permitted Work Premises are only permitted to have employees on-site if it is not reasonably practicable for the employee to work from home and the employer and employee comply with the Directions currently in force. Speech pathologists can work from clinics to provide telehealth services if this cannot be carried out at home.

DHHS has advised that if members are providing services to third party providers (such as residential aged care facilities or disability group accommodation), you should contact the service provider directly to determine if face to face service delivery is required. Access to PPE guidance specific to these facilities is available via the DHHS website:

Stage 3 restrictions in Victoria (all areas except Melbourne where Stage 4 restrictions apply)

Speech pathologists are considered to be essential workers and can leave home for work if it is not possible to do this from home. For more details see:

PPE for allied health in private practice settings

The DHHS has shared the attached document with the Association that outlines recommended PPE for allied health providers, non-clinical staff and clients in private settings.

DHHS have provided the following additional advice:

  • Provision of ‘essential’ Allied Health services within a patient’s home environment should be interpreted as the equivalent of entering a clinical area and appropriate infection control/PPE guidance adhered to.
  • If completing more than one home visit within a single day, this is in effect a change of workplace and a full change of PPE should be instituted – including reassessment of the potential risk and required PPE tier for each individual patient/client.

Coronavirus disease 2019 (COVID-19) – PPE for Allied Health in Private Practice Settings This graphic is associated with the hyperlink that precedes it and indicates the document is in PDF.

Use of N95/P2 respirators

Healthcare workers must wear a N95/P2 respirator:

  • in settings where suspected or confirmed COVID-19 patients are cohorted, where frequent, prolonged episodes of care are provided (i.e. providing care for a patient on a dedicated COVID-19 ward)
  • in uncontrolled settings where suspected or confirmed COVID-19 patients are cohorted, to avoid the need for frequent changes of N95/P2 respirators
  • where suspected or confirmed COVID-19 patients are cohorted and there is risk of unplanned aerosol generating procedures (AGPs) and/or aerosol generating behaviours
  • when undertaking an AGP on a suspected or confirmed COVID-19 patient.

Use of N95/P2 respirators are not required for healthcare workers:

  • undertaking surgery or AGPs on patients who are not suspected or confirmed to have COVID-19 risk factors (Tier 1 PPE precautions)
  • working at a COVID-19 testing site and/or undertaking testing for COVID-19 (Tier 2 PPE precautions)
  • undertaking procedures (e.g. sample collection) at hotel quarantine sites (Tier 2 PPE precautions)
  • patients with aerosol generating behaviours who are not confirmed or suspected of COVID-19 (Tier 1 PPE precautions).

Level 1/Type 1 surgical masks should be worn as a minimum in the workplace at all other times.

Use of face coverings

See DHHS information about Face coverings: whole of Victoria.

The DHHS have indicated that an exception can be “persons whose professions require clear enunciation or visibility of their mouth”. This includes speech pathologists. However, the Association would strongly encourage members to conduct a risk assessment to support decision making around not wearing a mask and ensure health and safety of the clients and clinician is paramount in this decision-making process.

Information for clients in Melbourne

As per current guidance about Stage 4 restrictions, individuals can leave their homes to seek ‘care and health care’ – this guidance does not specific a geographical limit.

Clients can leave home to see a speech pathologist and should do so if this care is essential. Clients should be encouraged not to put off getting any essential health care, however allied health professionals must determine if the in-person service meets the criteria of a service that must be provided, because the absence of, or delay of this care, would result in a significant change/deterioration in the patient/client’s functional independence necessitating escalation of care, including hospitalisation and/or presentation to an emergency department.

Individuals can leave home to care for a sick or elderly relative. If they are providing care for someone, they should try to adhere to 1.5 m distancing and wear a face covering.

Parent, guardians or necessary support persons can leave home to accompany someone for essential medical treatment