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Safety, Rehabilitation and Compensation Act 1988

 

Approved form for application for renewal of a person as a rehabilitation program provider

 

 

I, Susan Weston, Chief Executive Officer Comcare, acting pursuant to section 34S of the Safety, Rehabilitation and Compensation Act 1988 (the Act):

 

1. revoke the instrument Safety, Rehabilitation and Compensation Act 1988 – Section 34S – Approval of Form of Renewal Application for Approval as a Workplace Rehabilitation Provider, dated 5 November 2015 and registered as instrument F2015L01783 on the Federal Register of Legislation; and

 

2. approve the attached Renewal Application for Approval as a Rehabilitation Program Provider as the approved form for the purposes of paragraph 34K(1)(a) of the Act

 

This instrument takes effect on 15 October 2019. 

 

 

 

 

 

Susan Weston, Chief Executive Officer Comcare

 

Dated:  5 September 2019

 

 

 

 

 

 

 

 

 

Attachment: Approved form Renewal Application for Approval as a Rehabilitation Program Provider


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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RENEWAL APPLICATION FOR APPROVAL
AS A REHABILITATION PROGRAM PROVIDER

 

INTRODUCTION

Under the Safety, Rehabilitation and Compensation Act 1988 (the Act), Comcare can both:

This form is to be used by a person applying to renew their approval as a rehabilitation program provider.

IMPORTANT INFORMATION FOR APPLICANTS

Comcare has made two legislative instruments important to any person seeking to have their approval as a rehabilitation program provider renewed. These are:

These instruments will commence operation from 1 January and 1 July 2020 respectively, and can be accessed by applicants prior to these dates in order to complete this application.

There is also the Criteria and Operational Standards for Workplace Rehabilitation provider 2015 (Criteria and Operational standards 2015). This instrument will be entirely repealed on 1 July 2020 and is relevant to the extent a person must demonstrate compliance with the operational standards in force under s 34E since they were initially approved. These instruments are available on the Comcare website. They are also available on the Federal Register of Legislation (www.legislation.gov.au).

The Criteria sets out the matters that a person must meet in order to have their approval to provide rehabilitation services renewed. The Operational Standards sets out the matters that a person must comply with while they are approved to be a rehabilitation program provider.

For approval as a rehabilitation program provider to be renewed, Comcare must be satisfied that the applicant:

If Comcare is not satisfied of these things, it must refuse to renew the person’s approval as a rehabilitation program provider.

Comcare can also request additional information from applicants as part of this process.

 

Comcare is authorised by the Safety, Rehabilitation and Compensation Act 1988 and the Privacy Act 1988 to collect, use and disclose personal information.  If Comcare is unable to collect, use and disclose your personal information, we may not be able to determine or approve your application. Comcare is unlikely to disclose personal information collected to an overseas recipient.

 

For a copy of Comcare’s Privacy Policy, to request a change of your personal information or to make a privacy complaint please refer to comcare.gov.au/privacy. You can also contact us on 1300 366 979 or email us at privacy@comcare.gov.au.

If Comcare decides to renew the person’s approval as a rehabilitation program provider, it can also impose additional conditions on that person’s approval beyond what is in the Operational Standards (the conditions of approval).

Comcare will notify the person in writing whether it has decided to renew the person’s approval or not. It will also provide reasons for its decision.

The Administrative Appeals Tribunal can review a decision by Comcare to refuse to renew a person’s approval as a rehabilitation program provider.

During the approval period, the rehabilitation program provider must participate in evaluations as required by Comcare in order to determine whether the provider is complying with the applicable conditions of approval.

 

HOW TO MAKE AN APPLICATION FOR RENEWAL OF APPROVAL

A person seeking to have their approval to provide rehabilitation services renewed must ensure that their application contains sufficient information to allow Comcare to assess the application appropriately, and is accompanied by the required fee (as prescribed by the Safety, Rehabilitation and Compensation Regulations 2019 Part 3)

If an application is complete and accompanied by the required fee, Comcare must process it within six months of receiving it. If Comcare requires the person to provide additional information in connection with their application, it will not process the application until the person provides that additional information.

An application must be submitted by 31 December unless otherwise advised by Comcare.

 


PART A –APPLICANT DETAILS

     

 

 

 

Organisation details

Full name of organisation:     

Business or Trading name of organisation:      

Nature of Organisation:      

(e.g. Company, Partnership, Sole trader,)

Name and title of Principal/s:

ABN/ ACN (if applicable):     

 (Attach copy of the ABN record from the Australian Business Registry):      

Organisation address:     

State:     

Postcode:     

Postal address:     

State:     

Postcode:     

Phone:      

Mobile:      

Email:     

Name of holding company if applicable:     

Address of holding company:     

State:     

Postcode:     

Name and position of person/s authorised to sign this application on behalf of the organisation:

Name:                                                                                                             Title:     

Name:                                                                                                             Title:     

 

 

Name:      

Title:     

Phone:      

Mobile:      

Email:      

 

Previous applications

Have you ever been refused approval, or had your approval withdrawn, to provide workplace rehabilitation services by Comcare or any other Australian workers compensation authority?

 

o Yes

 

o No

If you answer yes, please provide details of the reasons for refusal or withdrawal of approval

 

Please also detail any steps you have taken since being refused approval to address the identified issue or issues.

 

 

 

Do you have, or are you likely to have any actual or perceived conflict of interest between your role as an approved program provider and any other interest?

 

o Yes

o No

If ‘yes’, what are the details of this conflict?

What steps will you take to manage this conflict?

 

 

Professional misconduct or criminal proceedings

Have any professional misconduct, discipline, criminal or civil proceedings ever been commenced against you, or anyone engaged or caused to be engaged by you, in relation to your work as a rehabilitation program provider?

 

If ‘yes’, please provide details of any charges or complaints and the results of any proceedings.

 

Please also provide reasons why Comcare should not reject your application.

 

 

Insurance currency

Please provide the following documentation and details

  • Professional Indemnity Insurance
  • Public Liability Insurance
  • Workers Compensation Insurance

(For each State or Territory of operation as applicable, if you have an exemption please indicate for which State/Territory)

 

 

 

PART B – CONFORMING TO THE CRITERIA AND ANY CONDITIONS OF APPROVAL

 

Note. This part refers to a person being ‘relevantly qualified’. This is an important concept that is defined in subsection 6(4) of the Criteria. Please ensure that you understand this concept before completing this section.

 

Person in senior management to be relevantly qualified

If you are approved to provide rehabilitation services, you will be required to have at least one person as part of your senior management who is:

  • ‘relevantly qualified’, and
  • has at least five years’ experience providing workplace rehabilitation services as a ‘relevantly qualified’ person.

Please provide the details in relation to that person:

Name:     

Title:     

Qualifications demonstrating that the person is ‘relevantly qualified’:     

  • Relevant qualifications
  • Professional registration number/professional membership number/accreditation number (as applicable)
  • Comcare identification number (if applicable)

Details of that person’s experience providing workplace rehabilitation services as a ‘relevantly qualified person’:

  • Please attach a resume

 

Relevantly qualified

 

Please provide the following details for any person engaged, or who would be engaged, by you to provide rehabilitation program services should your application be approved:

  • Name
  • Comcare identification number (if applicable)
  • Relevant qualifications
  • Professional registration number/professional membership number/accreditation number (as applicable)
  • Has the consultant attended Comcare training for approved rehabilitation program providers?
  • If yes, month and year of attendance
  • Has the consultant had more than 12 months experience providing workplace rehabilitation services?
  • If no, identify the name and contact details of the relevantly qualified consultant responsible for supervision

 

Policies and practices - Induction, supervision and professional development-

 

Please outline how your organisation:

-          inducts new consultants

-          ensures there is appropriate supervision

-          ensures there is compliance with professional codes of conduct

-          provides for learning and development

 

 

Policies and practices - Evaluation

 

Please outline how your organisation:

-          monitors quality of service delivery, including service standards

-          monitors outcomes of service delivery, including performance benchmarks

 

 

Rehabilitation Management

 

Under subsection 8(2) of the Criteria, a person applying for renewal of their approval as a rehabilitation program provider must be able to satisfy Comcare that it has appropriately managed at least five cases under any of the following Acts for the 12 months prior to making this application:

  • the Safety, Rehabilitation and Compensation Act 1988
  • the Military Rehabilitation and Compensation Act 2004
  • the Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988
  • the Seafarers Rehabilitation and Compensation Act 1992.

 

Please provide the data at Appendix A to establish you satisfy this requirement.

 

Return to work rate

 

If you are approved as a rehabilitation program provider, Comcare may require you to meet performance benchmarks as published in the performance monitoring framework.  The published benchmarks for the assessment of the renewal period are as follows:

Same Employer – 90% RTW

New Employer – 60%

Durable RTW – 85% at 13 weeks from program closure

Please provide the data at Appendix A to establish you satisfy this requirement.

 

 

 

 

Referees

 

Provide the contact details of two referees who can attest to your organization’s suitability as a rehabilitation program provider including statements as to the professional integrity, due diligence and quality of service delivery.

 

Name                                                                                     Organisation

Position                                                                                  Phone number

 

Range of services

 

Comcare publishes the services offered by each provider on Comcare’s website.  Should you wish to update your information please complete the following:

 

Workplace Rehabilitation Services

-          initial needs assessment

-          workplace assessment

-          return to work plan/rehabilitation program management

-          functional assessment

-          cognitive assessment

-          vocational assessment

-          job search activities

-          work readiness activities

 

Please also list the range of other services offered by your organisation

 

Location of services

 

Comcare publishes the States/Territories that you have been approved to operate.

Please identify the State(s)/Territories in which you are seeking to operate.

 

Please ensure the application includes:

-          the requisite insurance documentation

-          details for any person engaged, or who would be engaged, by you to provide rehabilitation program services to establish that they are ‘relevantly qualified’

 

 

Appendix A

 

Where a rehabilitation program commenced in the period 1 June 2018 to 1 October 2019, please provide:

-          Claim ID number

-          Scheme (Comcare/ Military/ Seacare)

-          Outcome of service where concluded (no RTW/ at work)

-          Outcome of service 13 weeks post closure (no RTW/at work/not available)

-          Employer (New/ Same)

Cost – total of fees charged for rehabilitation program(s)

 

 

 

 

 

Agreement and Authorisation

Organisation name:      

On behalf of the applicant:

1)  I/We certify that the information provided in this application and in support of the application is true and correct. I understand that giving false or misleading information is a serious offence under the Criminal Code;

2)  I/We agree to advise Comcare as soon as possible of any changes to the information provided in this application; and

3)  I/We certify that persons engaged or employed by the applicant have authorised the collection, use and disclosure of their personal information, by Comcare, in relation to this application and for the purposes of enabling Comcare to determine whether the applicant, a relevant principal or employee of the applicant is complying with the criteria and operational standards for workplace rehabilitation providers determined under sections 34D and 34E of the SRC Act. In particular, I/We understand that this authorises Comcare to collect, use and disclose the personal information in order to seek confirmation of the qualifications, probity and financial standing of the applicant, relevant principals and any workplace rehabilitation provider engaged or employed and the likely effectiveness, availability and cost of the rehabilitation programs which may be provided by the applicant.

4)  I/We consent or certify that persons engaged or employed by the applicant have authorised the collection, use and disclosure of their personal information by Comcare as part of this application or otherwise during the approval as a rehabilitation program provider for any purpose necessary to consider this application or otherwise determine whether I am/we are complying with any requirement or conditions imposed in relation to the approval as a rehabilitation program provider.  

5) I/we declare to Comcare that I/we have undertaken the required self-evaluations and have a remediation plan in place to address any identified issues

If the applicant is approved as a workplace rehabilitation provider:

6)  I/ We understand that the approval as a rehabilitation program provider may be subject to conditions imposed by Comcare as it sees fit. I am/We are aware of the requirements of the Conditions of Approval and I understand and accept the I/we must meet and continue to conform to the Conditions of Approval.

7) I/We understand that failure to comply with the Criteria and Operational Standards may lead to Comcare revoking the approval;

8) I/We understand that failure to comply with any condition(s) specified in the instrument of approval may result in the revocation of approval under section 34Q of the SRC Act;

9)  I/We agree to advise Comcare of any changes in workplace rehabilitation providers employed or engaged by the applicant to manage return to work plans under the SRC Act, including evidence of qualifications, experience/supervision arrangements and attendance at Comcare approved training; and

10)  I/We agree to Comcare listing the applicant’s name, service delivery description and contact details on Comcare’s website.

            This statement should be signed by the person authorised to make this application on behalf of an organisation.

Name and title of authorised signatory:

     

Signature of authorised signatory:

                                                                                                                                           Date:       /       /      

 

Name and title of authorised signatory:

     

Signature of authorised signatory:

                                                                                                                                           Date:       /       /      

 

 

[1] A reference to a rehabilitation program provider has the same meaning as a Workplace Rehabilitation Provider