COVID-19 Advice to ADEA Members

Dear members,

The declared COVID-19 pandemic has impacted many organisations, including ADEA. We are continuing to explore options to lessen the impact on our members and people with diabetes. There are many elements of risk to manage and we are working hard with many of our stakeholders to put in place plans that serve the best interests of our members and their clients.

The situation is constantly changing, and we will continue to update this advice. This information will be next updated on Friday 30 October.

 

LATEST UPDATE

24 November, 2020

Face masks mandatory for South Australian CDEs

The South Australian Chief Public Health Officer has confirmed that all CDEs and allied health professionals are to wear face masks at work.

Mask use is also mandatory in aged care facilities where physical distancing cannot be maintained.

Further information on masks is available here:

https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/covid-19/about+covid-19/protecting+yourself+and+others+from+covid-19/face+masks

COVID-19 Safe Plan

All members in private practice are encouraged to have a Voluntary COVID-19 Safe Plan.

See how to create a COVID-19 Safe Plan here:

https://www.covid-19.sa.gov.au/business-and-work/create-a-covid-safe-plan

We will provide further updates as they become available.

19 November, 2020

The South Australian Chief Allied Health Officer has issued new advice that relates to CDEs in South Australia.

In summary:

The South Australian government has now made an official statement around allied health under the Emergency Management (COVID-19) (Stay at Home) Direction 2020. This came into effect from 12.01am today ,Thursday 19 November and ends at 12.01am on 25 November.

The details are below.

Key points:

The details

The South Australian government has now made an official statement around allied health under the Emergency Management (COVID-19) (Stay at Home) Direction 2020. This came into effect from 12.01am today ,Thursday 19 November and ends at 12.01am on 25 November.

Read it here:

https://www.covid-19.sa.gov.au/emergency-declarations/stay-at-home

Read the PDF here:

https://www.covid-19.sa.gov.au/__data/assets/pdf_file/0016/318310/EMA-Stay-at-HomeCOVID-19-Direction-2020.pdf

A person may leave home to receive ‘essential health services.’ (Part 3, 6, 2 (a))

These are defined in Schedule 1 of the direction – Essential health services (pg 7.)

For CDE and allied health services, ‘essential health services’ are:
(a) services provided by  essential workers in hospitals providing critical clinical care or as directed by the hospital;
(b) services provided by CDEs and allied health professionals working in private practice providing care through telehealth and other virtual care options;
(c) students, medical/nursing/midwifery/allied health on placement providing essential care in hospitals or through telehealth;

(Point 10, pg 8.)

Please note: ‘essential workers’ includes people providing ‘essential health services’ but only if they are provided in accordance with Part 3 of the direction.

Frequently asked questions

The below FAQ link outlines the same points around health services during the lockdown period:

https://www.covid-19.sa.gov.au/restrictions-and-responsibilities/stay-at-home#health


18 November, 2020

Catherine Turnbull, the South Australian Chief Allied Health Officer, has provided the following advice regarding allied health practice in the current situation in South Australia – we will advise members if this advice changes:

The SA Government is encouraging people to reduce movement as much as possible. Use telehealth where suitable and consider rescheduling over the next fortnight while they assess if the number of infections stabilises, goes down or increases.

There is currently no specific restriction on CDE / allied health clinics, and they are excluded from the Direction on public activities, as have medical or health services. They do ask that clinicians use good clinical judgment to assess the risk, complete pre-screening, suitable sanitation and social distancing. It is essential that clinics can identify anyone who attended for future tracking if needed.

Masks – There is currently no mandated requirement to use masks within CDE/ allied health services; however, some clinics have their own requirements, and people should be aware of risks.
Masks are required within aged care facilities.

Aged Care Facilities – CDE/ allied health appointments are not being counted towards the “restriction of 2 visitors per resident per day” rules.

Aged Care “limited to working at one site” – allied health who provide casual appointments in aged care are not restricted to one site; however, there is the expectation they will ensure any facility they enter is aware in advance of:

It is important to maintain these details to assist in tracking if needed.

Group therapy – within CDE/ allied health clinics do not fall under the gym/fitness closure/restrictions. It is essential these clinics consider social distancing obligations, pre-screening, sanitation, and risks associated with extra exertion and breathing.

Gyms – If a CDE/ allied health practitioner is co-located within a gym facility, as the facility cannot operate the clinician will need to work elsewhere (such as an allied health clinic) or cease practicing over this period. This may impact Exercise Physiologists and others.


31 October, 2020

National advice: watch Department of Health webinars on-demand

The Department’s most recent COVID-19 Primary Care and Allied Health webinar, 28th October 2020, provided key updates relevant to our members.

On the panel:

This was part of a series. Watch previous webinars (including transcripts) here.

Update on Victorian Restrictions

VIC Industry Restart Guidelines

The latest iteration of the Industry Restart Guidelines for Allied Health and Primary Care has been provided by the Victorian Chief Allied Health Officer:

Read the guidelines here.

These Guidelines have been updated to reflect the easing of restrictions effective as of 11.59pm 27 October 2020. For clarity, the guidelines were further updated today.

Indoor group therapies

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 – the timing of which is subject to Public Health epidemiological modelling and advice
.
The requirements state that indoor groups are currently restricted.
However, indoor therapy groups (in both clinical settings and fitness industry settings) will be allowed to recommence in metro Melbourne from 11.59pm on Sunday 8 November 2020.

Please note the detail below, outlining differences in the requirements for density quotients between these two settings:

Indoor clinical settings

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.

Fitness industry settings

For health professionals, that provide clinical services in a fitness industry setting (ie. 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.

Services from a residential address

In terms of practitioners who operate services from a residential address (i.e. their or another practitioner’s home), Public Health have confirmed the requirement for the premise to have a separate patient/client access point.

New advice from VIC DHHS: residential address-based services

We have received the following additional clarification from DHHS today, about services operating from a residential address.

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:

Updates to Metropolitan Melbourne restrictions

CDEs and allied health practitioners were able to commence routine care from last week.
All other practitioner groups are now able to commence routine care effective 11:59 PM last night (27 October 2020), subject to having a COVID-safe plan.

Exceptions

The only remaining exception / restriction for metropolitan Melbourne is indoor group consultations or activities. These are still not permitted.

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.

For the latest updates to Metropolitan Melbourne restrictions visit the Victorian Government’s restriction summary for Metropolitan Melbourne here.

Regional Victoria

There are some differences between restrictions in regional Victoria and metropolitan Melbourne due to the current rates of local transmission.

If the number of active cases continue to drop then restrictions in metropolitan Melbourne can be eased to align with the restrictions in regional Victoria, in line with public health advice.

Read the restrictions for regional Victoria here.

Personal Protective Equipment for CDEs in Private Practice

The Victorian Government recently updated the Conventional Use of PPE Guide.

This applies to Victoria-based CDEs in private practice settings.

For your convenience, this version has the updated advice highlighted in yellow.


COVID Myths and How to Prevent its Spread

Click here for slides from the COVID-19 Infection Control webinar that outline the myths around COVID-19 and how to prevent its spread.

Complete the University of Melbourne survey to support advocacy for ongoing access to MBS-funded telehealth for diabetes education, beyond 31 March 2021

ADEA has partnered with other health professional organisations to engage the University of Melbourne to conduct a survey on Telehealth by allied health practitioners in Australia during the COVID-19 pandemic. This survey will close on 31 October. To date only a small number of CDEs have completed the survey. We encourage all members to complete this survey, which will be an important element in supporting our advocacy for ongoing access to telehealth for CDEs. The survey has two elements: a clinician survey and a survey for their clients.

Clinician survey here: https://melbourneuni.au1.qualtrics.com/jfe/form/SV_1BVZ27Cy7F5Bg3z 

Client survey here: https://melbourneuni.au1.qualtrics.com/jfe/form/SV_eg1XhYKKhcU0gTj

 

RECAP

‘Heads up on diabetes’ campaign

The theme for National Diabetes Week 2020 (NDW2020) was ‘Heads Up on Diabetes’.

ADEA and our partner diabetes organisations such as Diabetes Australia, Australian Diabetes Society and several state/ territory organisations ran a campaign during National Diabetes Week to raise awareness of diabetes and mental health.
In addition to running several professional development activities for members, ADEA also released videos on our social media channels to highlight the importance of mental well-being in people with diabetes from the perspectives of consumers, their family members and carers, and Credentialled Diabetes Educators. Watch the videos in our playlist.

The 2020 Australasian Diabetes Congress will now be virtual

As the COVID-19 situation unfolds globally, and in alignment with the current restrictions on public gatherings, ADS together with ADEA have made the decision to go virtual.

The Australasian Diabetes Congress 2020 will now be held virtually on 11–13 November 2020.

Moving the Congress online is a necessary and responsible course of action. The health and wellbeing of attendees is of the utmost importance. This decision also recognises that most of the prospective ADC attendees are frontline health workers who are already stretched to capacity at this time and for the foreseeable future.

We sincerely hope that you will be able to join us virtually for the Congress in spring to enjoy the high quality educational and networking experience you have come to expect from ADC.

Registration has reopened so book now before the end of the financial year and save with the early bird rate. Click here to find out more information on costs.

Telehealth for CDEs

Extension of telehealth arrangements

On 18 September the Prime Minister and Minister for Health announced a six month extension to the current telehealth arrangements until 31 March 2021. More information here: https://www.pm.gov.au/media/2-billion-extend-critical-health-services-across-australia

DVA telehealth arrangements extended to 31 March

In line with the extension of Medicare-funded telehealth arrangements, the Department of Veteran Affairs (DVA) has extended its temporary telehealth arrangements to 31 March 2021. Updates on DVA’s COVID-19 arrangements for providers will continue to be communicated on the DVA website. Providers are encouraged to check this webpage regularly. All relevant allied health fee schedules will be updated with the new end date of 31 March 2021 for the telehealth items. These will be published shortly on the DVA website here.

2020 Telehealth Survey results

With the introduction of MBS-funded COVID-19 telehealth arrangements in March 2020, ADEA in collaboration with several Allied Health peak bodies developed two surveys to collect information about telehealth services. One survey was for health professionals and the other for their clients who utilised telehealth services. The Department of Health has requested advice from Allied Health peak bodies about their members’ experiences with telehealth, as well as their clients’ experiences. A summary of the results of the combined Allied Health peak bodies’ surveys will be provided to the Department of Health to inform discussions about the potential continuation of telehealth. The combined survey results are currently being compiled and when these are available we will share these results with members.

A summary of the key results of the survey of ADEA members is provided here.

Podcast on introducing telehealth into a CDE’s practice, and other useful telehealth resources

ADEA has produced a podcast in which a panel of CDEs, who are using telehealth for diabetes education, discuss how CDEs can set up and utilise telehealth in their practice. Access the podcast here.

ADEA has also a range of webinars regarding telehealth and the impacts of COVID-19 on people with diabetes, available on the ADEA Learning Management System (LMS).

Log into the ADEA LMS here

Other useful telehealth resources include:

 

Telehealth software platforms

In late March, after strong advocacy by ADEA and members, new COVID-19 telehealth arrangements for CDEs and other allied health professionals were announced. From 30 March 2020 until 30 September 2020, CDEs can provide Medicare-funded telehealth videoconference and telephone consultations to all people with diabetes. For further details please refer to the latest version of ADEA’s Telehealth Guidelines for CDEs’.

For CDEs exploring technology that enables them to provide telehealth services please refer to the information on technologies provided below.

HealthBank is a digital health and telemedicine company, which helps to connect clients to allied health practitioners allowing them to deliver secured virtual consultations and monitor their health, diet, and lifestyle.

Features include:

Click here for more information.

As KnowDiabetes is a new system which has been pilot-tested on a small scale to date, this free access plan offer is being introduced gradually. A limited number of CDEs will be set up to access the system each day, on a first received – first listed basis. Once set up is complete, CDEs can use the system without restriction.

For more information view the information sheet; visit the KnowDiabetes websitecontact KnowDiabetes or phone KnowDiabetes on 0414 696 250 (Monday-Saturday; 9am-9pm AEST).

ADEA encourages members to select services that best fit their needs. ADEA receives no financial benefit in providing this information to members.

The Department of Health has advised that they will not be providing advice on, or regulating telehealth platforms, and has advised that health professionals must consider their obligations under the Privacy Act and their clinical obligations.

Telehealth advocacy

Following advocacy by ADEA and other organisations, as well as member-initiated campaigns, new COVID-19 telehealth arrangements for CDEs and allied health professionals were announced by the Department of Health on 29 March 2020.

The announcement means all eligible allied health professionals can provide telehealth videoconference and telephone services from 30 March 2020 until 30 September 2020. The definitions section of the legislation defines which allied health professionals can provide services under the new extended telehealth arrangements. An eligible diabetes educator has the meaning given by section 4 of the Health Insurance (Allied Health Services) Determination 2014 – this states A person is an allied health professional in relation to the provision of a diabetes education health service if the person is credentialled by the Australian Diabetes Educators Association as a ‘Credentialled Diabetes Educator’ ’.  Services can be provided under Schedule 3 (Allied Health Services) sub-groups 11 and 12 of the legislation.

The MBS factsheets contain useful information including the Allied Health FactsheetAllied Health Frequently Asked Questions and Provider Frequently Asked Questions. Please refer to the table* below for a quick overview of the existing 13 Chronic Disease Management MBS item numbers, and the new telehealth and telephone MBS Item Numbers.

*Information extracted from page 4 of the Allied Health Factsheet.

ALLIED HEALTH ATTENDANCES

These services need to be bulk-billed, and are for non-admitted patients

Service Existing Items

face to face

Telehealth items

video-conference

Telephone items – for when video-conferencing is not available
Chronic disease management
Allied CDM services (all 13 items) 10950, 10951, 10952, 10953, 10954, 10956, 10958, 10960, 10962, 10964, 10966, 10968, 10970 93000 93013

We are awaiting further information from the Department of Health, which is working on additional MBS factsheets. We will advise members as these become available.

 

Additional information:

 

Telehealth and bulk-billing

The Minister for Health announced changes to bulk-billing arrangements for specified health professionals, including CDEs and allied health professionals, which came into effect on 20 April 2020. The Minister noted that the amended legislation would help ensure the continued viability of specialist and allied health services under Medicare and recognised the advocacy of many groups. ADEA worked closely with allied health professional organisations, through the peak body Allied Health Professions Australia, in advocating for these changes.

The changes in the legislation mean that specified health professionals are no longer required to bulk-bill their clients. These health professionals include CDEs, allied health professionals, nurse practitioners, midwives, specialists, consultant physicians and consultant psychiatrists.

For more information, refer to the MBS Online announcement.

Access to Medicare-funded telehealth arrangements for Australians overseas and visitors to Australia

Medicare does not cover any medical or hospital services provided outside of Australia, however Australian citizens who are overseas may have coverage under a Reciprocal Health Care Agreement between the country they are visiting and Australia.

Australia has Reciprocal Health Care Agreements with BelgiumFinlandItalyMaltaThe NetherlandsNew ZealandNorwayThe Republic of IrelandSloveniaSweden and The United Kingdom.

Visitors from these countries can access Reciprocal Health Care Agreements while in Australia. These Agreements vary by country, but generally provide access to publicly funded medically necessary care, and in some cases they may partly cover the costs of prescribed medicine. Further information about these Agreements is available here.

The provision of non-Medicare funded telehealth services to Australians overseas, or to visitors to Australia, will be dependent on each CDE’s insurance arrangements.

 

Department of Health COVID-19 webinar series for health professionals

The Department of Health COVID-19 webinars for primary care and allied health professionals are available here to watch on-demand. The transcript can be downloaded by clicking the top right of the video player from each webinar.

Diabetes supplies for people with diabetes – PBS and NDSS

  1. Access to diabetes medications and supplies through the PBS and NDSS

ADEA works with ADS, Diabetes Australia, the Australasian Paediatric Endocrine Group and JDRF Australia in an alliance of leading national diabetes organisations. We are encouraging people with diabetes to continue their usual insulin purchasing practices and not stockpile or refill prescriptions more frequently.

The Department of Health has advised there is no national shortage of NDSS products or insulin or other diabetes-related medicines. Read more here.

All diabetes medication and device companies have advised that they have sufficient stock within their warehouses. The spike in March in people accessing diabetes medications and products resulted in some temporary shortages within some warehouses that supply to pharmacies, as the warehouses adapted to the increased demand.

Please be aware that some pharmacies do not stock all insulins, but order on request by people with diabetes.

With the introduction of insulin limits and NDSS product limits, we understand these issues have been resolved; however ADEA members are encouraged to report any incidents of insulin or other medication shortage, or NDSS product shortage.

Insulin Limits – In April, the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia, in consultation with the Department of Health, agreed on new requirements for community pharmacists to enforce new limits on dispensing and sales of prescription and over-the-counter medicines to address excessive purchasing in community pharmacies. Insulin is on the list of medicines that has been limited, and Diabetes Australia is working with stakeholders on behalf of people with diabetes and diabetes organisations, including ADEA, to ensure that these limits do not adversely impact on people with diabetes. Read more here.

Diabetes Australia and the Pharmacy Guild are also encouraging all pharmacies to stop sale of blood ketone monitoring strips for keto diets and reserve these strips for people with diabetes.

NDSS Product limits – In April, Diabetes Australia, in consultation with the Department of Health, advised people with diabetes are advised not to stockpile NDSS supplies. Limits to NDSS product orders are put in place to help ensure there are enough products available for everyone with diabetes who needs them. Read more here.

Diabetes Australia continues to work with the Pharmacy Guild to ensure the medicines and products supply chain is supported and all people with diabetes across Australia can continue to access their medicines and products.

We recommend that you:

The Australian Diabetes Society (ADS) issued advice to their members about COVID-19 and medication usage. You can access a copy here.

Sanofi update on insulin supply during COVID-19

With Lantus being de-listed from the PBS, Sanofi is accelerating availability of Optisulin to support ongoing access to insulin glargine U100. Sanofi has issued a media release to assure health professionals that there is no shortage of insulin glargine U100. Read the media release here.

2. Blood glucose test strips for people with type 2 diabetes not using insulin

Blood glucose test strips are available for people with type 2 diabetes who are not using insulin, under certain circumstances including ‘inter-current illnesses’. The requirement for a Blood Glucose Test Strip (BGTS) Six Month Approval form to be completed has been temporarily suspended. Read more here.

3. Changes to the delivery of continuous glucose monitoring (CGM) starter kits

In response to the COVID-19 pandemic the Australian Government has introduced a temporary change to the Continuous Glucose Monitoring (CGM) Initiative to enable a CGM starter kit to be sent directly to the residential address of the person with diabetes or their carer/guardian. This may be appropriate when access to a face-to-face opportunity for the health professional to provide education and support for the setup and ongoing use of the CGM device is unavailable.

A Continuous and Flash Glucose Monitoring Eligibility Assessment form must have been completed, and an Addendum for home delivery of CGM starter kits must be filled in by the certifying health professional to allow this to happen.

Before the follow-up appointment, the health professional should ensure the person with diabetes has received their CGM starter kit.  

For more details refer to the information sheet.

4. Home delivery of medicines and NDSS products

The Australian Government has announced that it is funding medicine home delivery services to help vulnerable people stay at home and reduce their exposure to COVID-19.

The service means participating pharmacies can offer customers free delivery of under 500 grams of medication using the Australia Post Express Post network.

Vulnerable and at-risk Australians, including those isolating themselves at home, people over 70 and people with chronic health conditions are eligible for the service from participating pharmacies.

Check with your local community pharmacy to see if they are offering this service. Some participating pharmacies may be able to add products subsidised through the NDSS to home delivery of medicines. Read more here. Information is also available through the Coronavirus App and WhatsApp.

NDSS forms

Health professionals can now complete NDSS forms for access to services and diabetes products without the need for co-signing by the person with diabetes.

To ensure your clients who are newly diagnosed with type 1 diabetes are registered with the NDSS as quickly as possible, to have access to blood glucose monitoring strips and other NDSS products, please ensure that you provide their mobile phone number on the NDSS registration form, and email or fax the form to the NDSS team. This will ensure faster processing and will enable the NDSS team to send an SMS to your client with their NDSS registration number.

Validating concessional status for continuing access to CGM or FGM through the NDSS: ADEA has been advised that some people with type 1 diabetes who are accessing CGM or FGM believe they need to re-register with the NDSS every 12 months. ADEA has sought clarification on the process. People who have type 1 diabetes and are over 21 years old can access CGM or FGM through the NDSS if they have concessional status. They are required to re-validate their concessional status every 12 months. One month prior to their concessional status expiring, a reminder NDSS letter/ email is sent requesting the person to contact the NDSS Helpline to validate their concessional status for continued access to CGM/ FGM through the NDSS. Once the person provides this information, their access is extended for a further 12 months. This re-validation process occurs every 12 months. People do not need to complete a new registration form for continuing access to CGM/ FGM.

Changes to certification of NDSS forms from 1 August 2020

The Department of Health is currently undertaking a project to deliver updated NDSS IT systems and simplified business processes to reduce administrative time and costs for NDSS stakeholders. During stakeholder consultation for the project, the Department was advised by GP clinics, that following a diagnosis of diabetes by a GP, it is common practice for a Practice Nurse to complete the certifier section of the NDSS registration form, with the GP subsequently signing to certify the form.

The Department of Health notified health professional associations this week that from 1 August 2020, an administrative efficiency will be introduced with Practice Nurses (registered and enrolled) being able to certify some NDSS forms following written confirmation of the diabetes diagnosis from a Medical Practitioner. The forms that Practice Nurses will be able to certify are:

In introducing this change, the Department has advised health professional associations including the Australian Primary Health Care Nurses Association (APNA) and the RACGP that “Normal referral processes to health professionals such as credentialled diabetes educators, accredited practicing dietitians or other health professionals continue as required.”  The Department has also advised that adopting this new process will be optional for each GP/clinic, and a Practice Nurse would not be required to certify a form unless it was within their scope of practice, knowledge and experience to do so.

Further information and updated NDSS forms reflecting this change are available here.

ADEA thanks all members who contributed to our advocacy on this issue, as well as ADS and Diabetes Australia who supported our advocacy. Unfortunately our efforts were unsuccessful. Over the coming months we will be focusing heavily on working with the RACGP and APNA to promote referral pathways to CDEs, including those newly diagnosed with diabetes, and those transitioning to more frequent blood glucose monitoring or new medications so that they receive the necessary specialist diabetes education, management and care.

NDSS services and programs

All NDSS face-to-face education and support programs and activities have been postponed. These programs are being delivered in alternative ways, including webinars and other online activities.

Diabetes Australia has extended the hours for the NDSS National Helpline 1800 637 700 to be able to give greater support for people with diabetes during the COVID-19 pandemic.

The new hours are:

Monday to Friday – 8:30am to 8:00pm
Saturday – 9:00am to 2:00pm

People with diabetes are encouraged to call the NDSS Helpline to:

Stay up to date with the NDSS COVID-19 advice here.

 

Advice from Health Departments

Australian Government Department of Health

The Department’s website has a range of resources for health professionals regarding COVID-19. This includes an Infection Control training module developed for use by healthcare workers across the health, aged care, disability and childcare sector. The 30-minute online training module is accessible here. The Department also provides regular COVID-19 news and media updates.

The Department of Health COVID-19 webinars for primary care and allied health professionals are available here to watch on-demand. The transcript can be downloaded by clicking the top right of the video player from each webinar.

Department of Health reminders for you and your clients

The Department of Health has advised that allied health professionals should:

State and Territory Health Departments

State and territory jurisdiction health advice on COVID-19 restrictions are available on the relevant jurisdictional website.

Easing of restrictions for allied health and other health care providers in Victoria from 28 September

ADEA today received correspondence from the Victorian Chief Allied Health Officer providing additional guidance about the easing of restrictions as part of the next stage (Step 2) of the Victorian Roadmap to reopening. This guidance is intended to provide further clarification ahead of the release of the full industry roadmap.

The attached guidance outlines which allied health professions can provide services and under what circumstances. 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. We’re pleased to see a recognition of the need to see not only patients with a recognised need for services, but also for the need to be able to undertake assessment and diagnosis as part of the triaging work that allied health professionals are currently undertaking to manage their patient’s health needs.

We encourage all CDEs to continue to use telehealth as the first option for care delivery where appropriate. Routine care and regular monitoring, other than via telehealth, is not permitted during the second step and CDEs should continue to delay services that can safely be delayed until Step 3. When determining whether a service can no longer be delayed, you will need to use your clinical judgement to ensure the service is essential to preventing deterioration and an escalation in care needs.

We have been advised that those allied health professionals providing services within a permitted workplace during stage four (such as a public hospital, aged care or mental health setting) will remain permitted to do so under Step 2 guidelines. However, these allied health professionals should continue to apply clinical reasoning and only see patients face to face to prevent a significant change/deterioration in functional independence which would result in an escalation of care needs.

As a final note, we wish to highlight that while the Chief Allied Health Officer has written to provide guidance around allied health restrictions as part of Step 2, all decisions relating to the easing of restrictions are made independent of the Chief Allied Health Officer and Allied Health Workforce Team. If you have further questions or concerns about specific restrictions, we recommend that you contact Business Victoria – Coronavirus (COVID-19) business support and the Industry Coordination Centre on 13 22 15.

DHHS Victoria: clarification on ‘endorsed care plan’

DHHS in Victoria has confirmed endorsed care plans are listed as:

A standalone GP referral does not constitute an endorsed care plan.

Information for CDEs and their clients regarding COVID-19

Information for CDEs

Rights of people with a disability during COVID-19

The Australian Human Rights Commission has published its guidelines this week on the rights of people with disability in health and disability care during COVID-19. The guidelines are available here.

Supporting our mental health

The National Mental Health Commission has launched its ‘Getting Through this Together’ campaign that provides practical tips to stay connected and mentally well during this time.. More information is available on their website: https://www.mentalhealthcommission.gov.au/GettingThroughThisTogether

Alert published for BYD brand N95 respirators

Safer Care Victoria has published an alert in relation to the use of ‘BYD’ brand N95 respirators. These respirators are at risk of tearing when adjustments are made using the straps. Practitioners are advised to use caution with this brand of respirator.

The Health Advocate journal special COVID-19 edition

The August COVID-19 edition of ‘The Health Advocate’ focuses on key policy issues highlighted by COVID-19, the impacts on Aboriginal and Torres Strait Islander people, telehealth, how the pandemic killed COAG and beyond COVID-19.

COVID-19 Health Professionals Disability Advisory Service extended to 17 November 2020

The COVID-19 Disability Advisory Committee Secretariat has advised that the COVID-19 Health Professionals Disability Advisory Service has been extended to 17 November 2020.

Health professionals can call the service at the new operating times of 8am to 9pm (AEST) Monday to Friday on 1800 131 330.

The COVID-19 Health Professionals Disability Advisory Service is a telephone advisory service established by the Commonwealth Department of Health to provide specialised advice for health professionals involved in the care of people with disability diagnosed with COVID-19 or experiencing COVID-19 symptoms. Healthdirect Australia has been engaged to manage the helpline on behalf of the Commonwealth Department of Health.

As you may be aware, some people with disability may become very anxious in these situations and require reasonable adjustments to their healthcare to ensure they receive either COVID-19 testing or treatment, with minimum distress. Specific support may be required to address communication and management issues, such as behaviours of concern and the reduction of risk to the patient and staff involved in the process.

Calls to the Advisory Service will be answered by health professionals with disability service qualifications and experience working with people with disability.

Australian Commission on Safety and Quality in Health Care (ACSQHC): Precautions for caring for aged care home residents with suspected, probable, or confirmed COVID-19

The ACSQHC has advised that:

For more information, visit the COVID-19 page on the Commission’s website, or contact the Commission at: HAI@safetyandquality.gov.au.

Student clinical placements in Victoria

DHHS in Victoria has updated their guidance on ‘Coronavirus (COVID-19) – Student Clinical Placements (Guidance note as at 12 August 2020)’.

Although this guidance is specific to public health sector entities and aged care providers, it contains a number of general risk management principles related the provision of student clinical placements.

The Continuity of Care Collaboration Free Webinars – Re-engaging with Healthcare; Rural and remote communities forum

The most recent webinar includes discussion on patient and consumer concerns about re-engaging with healthcare, providing a safe environment for care, providing practical advice to support patients and consumers (with a focus on diabetes and HIV) and lessons learnt. The webinar recording will be available soon.

The previous Continuity of Care Collaboration webinar and panel discussion examines how the pandemic has thrown up unique barriers to the delivery of patient care in rural and remote communities. Access the webinar recording here.

An open letter to Victorians: ‘Healthcare does not stop for lockdown, we are here to keep you well’

Through the Continuity of Care Collaboration, ADEA and a range of other organisations issued an open letter to the Victorian media urging Victorians to continue to seek health care, and to maintain their usual health care appointments. Read the letter here.

Please contact ADEA if your clients’ health care is significantly impacted by NSW/ VIC border closures  

Allied Health Professions Australia is working, on behalf of ADEA and other peak bodies, with NSW Health to obtain clarity on the situation regarding cross-border services in NSW/ Victoria. ADEA has also written to the NSW and Victorian Governments noting that although CDEs are able to provide some services via telehealth, there will be gaps where people with diabetes can’t participate by telehealth or where the CDE assesses that providing services by telehealth is not appropriate for the person.

We are seeking the same arrangements as currently apply to medical practitioners. They will allow allied health professionals in a border ‘bubble’ area to provide services across the border as long as they remain within the ‘bubble’ area.  If a Victorian allied health professional provides services outside of the border ‘bubble’ area in Victoria, they will not be allowed into NSW. If a NSW allied health professional provides services outside of the ‘bubble’ area in Victoria, they will be required to self-isolate for 14 days on their return to NSW.

If you believe these arrangements will adversely and significantly impact on the health of your client(s), and there is no alternative arrangement that can be implemented for your client(s), please contact the ADEA team with specific details about the situation as soon as possible by email to inquiries@adea.com.au or phone (02) 6287 4822.

Keep SAFE: a behavioural vaccine for COVID-19

The Medical Journal of Australia’s InSight+ recently published an article on adopting and sustaining a ‘behavioural vaccine’, while we await a medical vaccine. The authors of the article are: Professor Jane Speight, Professor Timothy Skinner, Jessica Hateley-Browne and Professor Charles Abraham. Following the article, the ABC interviewed Professor Speight about the psychology of the second COVID-19 lockdown in Melbourne and this interview is expected to be published on its online platforms in the coming days.

Read the article here.

Fact sheets on the use of face masks in the community to protect against COVID-19

Wearing a face mask is now recommended by Australian health experts in areas where community transmission of COVID-19 is high, and where physical distancing is not possible. The Australian Commission on Safety and Quality in Health Care has developed a fact sheet and answers to frequently asked questions to provide guidance to consumers on the use of face masks to protect against COVID-19 and advice on how to use face masks safely. They support the recommendation of the Australian Government and Victorian Government to wear face masks in areas where there is community transmission of COVID-19. These resources are available here:

For more information, please visit the COVID-19 page on the Commission’s website. Please contact COVID19@safetyandquality.gov.au if you have any questions.

 

Federal Department of Health guidance on the use of face masks and shields by healthcare workers

The Department of Health has published new guidance on the use of face masks and shields by healthcare workers in areas with significant community transmission of COVID-19 (published 30 July 2020).

The guideline can be found on the Department of Health website here

Other guidance on PPE for healthcare workers has also been published or updated (31 July) including:

These and other publications on PPE can be found in the collection of COVID-19 resources for health professionals on the Department of Health website.

PPE advice for CDEs in Victoria

ADEA has received some enquiries about PPE requirements for CDEs in Victoria, and we can advise that the Victorian Government has updated its advice on the use of PPE for health workers. This is available at https://www.dhhs.vic.gov.au/personal-protective-equipment-ppe-covid-19

The Victorian DHHS advises that:

As demand for PPE is high during the pandemic and there is the potential for shortages if it is inappropriately used, DHHS has developed a guide as to when different types of PPE should be used. DHHS advises the use of face shields when a person is at risk or suspected or confirmed to have COVID-19. In these cases, wherever possible face-to-face appointments should be deferred or telehealth services offered. Detailed advice is provided in:

Allied Health Professions Australia (AHPA) has been liaising on our behalf with the Department of Health regarding access to PPE, including surgical masks, in Victoria.

Primary care health professionals should generally access surgical masks from commercial suppliers. Face masks are available from the National Medical Stockpile through your local PHN. PHNs can provide masks and respirators, where there is a demonstrated need, to GPs, Aboriginal Community Controlled Health Organisations and Health Services, and community pharmacies. PHNs can provide masks to CDEs and allied health professionals in certain circumstances including if there is no commercial supply available or if the health professional is working in higher-risk clinical areas with higher risk vulnerable patients.

For more information on how to apply to receive surgical masks from Victorian PHNs, click here.

 

Expansion of Continued Dispensing Arrangements – COVID-19

The Australian Government has extended the temporary Continued Dispensing (Emergency Measures) to 30 September 2020, to assist in managing the demand on the health system during the COVID-19 outbreak.  This means that people who are having difficulty accessing their medical practitioner for a new prescription can obtain a one-off standard quantity of eligible PBS/RPBS medicines subsidised under the PBS without a prescription. The person must previously have been prescribed this medicine and the pharmacist must be satisfied that it is urgently needed and it is not practicable to obtain a new prescription. Read more here.

The Australian response to the COVID-19 pandemic and diabetes

The COVID-19 pandemic has had a significant impact on the economy and health system of most countries in the world. In Australia, there have been important social and health strategies to “flatten” the curve, to reduce infections and to manage those infected. This article was put together by members of several diabetes health organisations including ADEA: Trisha Dunning, Jane Overland, George Barker and Susan Davidson. Read more on how Australia has responded to the COVID-19 pandemic.

COVID-19 and disabilities

 

Assistance for health professionals in registering with the NDIS

Allied Health Professions Australia (AHPA) has developed free resources and guidance to help CDEs and allied health professionals to register with the NDIS and to prepare for the audit process associated with registration. You can access the website here.

Department of Veterans’ Affairs (DVA) COVID-19 update

DVA has updated the fee schedules for allied health providers which have been published on the fee schedules page. Information about additional support for eligible veterans, including mental health support, access to prescriptions and pharmaceuticals, and shopping support, is available from the DVA website.

The Department is encouraging all DVA clients to maintain continuity of health care throughout the pandemic. They also remind allied health providers that the allied health treatment cycle arrangements for DVA clients continue to apply during the pandemic. More information and updates from DVA here.

Updated statement on diagnostic testing for GDM during COVID-19

The Australian Diabetes in Pregnancy Society (ADIPS), ADEA, the Australian Diabetes Society (ADS) and Diabetes Australia have further updated the joint statement on diagnostic testing for gestational diabetes mellitus (GDM) during the COVID-19 pandemic. This update includes the recently revised Queensland Health Clinical Guidelines flowchart, which now includes postnatal follow-up. Please read the statement here.

Break the Chain of Infection poster

The Australian Commission on Safety and Quality in Health Care produced a Break the Chain of Infection poster which illustrates the chain of transmission of COVID-19 and to identify measures that can be implemented to limit its spread. The poster has been developed in collaboration with the New South Wales Clinical Excellence Commission and is targeted at health professionals, their clients and the public. The Break the Chain of Infection poster is available for download on the Commission’s website.

Internet speed boosts available at no extra cost for health professionals who provide telehealth services

Through Allied Health Professions Australia, the Government has confirmed that health professionals who provide telehealth services can access enhanced telehealth services at no extra cost for six months for their clinic location, whether this is the usual clinic location or a remote working clinic location. To access these arrangements, you need to contact your current internet service provider and let them know that you are a health professional providing telehealth services. The NBN will continue to provide updates and has provided some tips for getting the best from your NBN service.00B

National COVID-19 Coordination Commission (NCCC)

The NCCC is working to help minimise and mitigate the impact of COVID-19 on jobs and businesses and to facilitate the fastest possible recovery of lives and livelihoods. Further information and resources are available here.

Flu shots mandatory for health professionals working in or visiting residential aged care facilities

From 1 May 2020, all health professionals working in or visiting residential aged care facilities are required to have a ‘flu shot. There have been reports of some localised shortages of ‘flu vaccinations, and we request that any members who cannot access a ‘flu shot contact us at inquiries@adea.com.au and include the town or suburb and the State/ Territory in which they could not access a ‘flu vaccination. All information provided will be de-identified and summarised, and will assist the Department of Health in managing local shortages.

Australian Clinical Guidelines for COVID-19

The first version of the Australian Clinical Guidelines for COVID-19 are accessible via the Taskforce website. These guidelines will go through a one-month public consultation process before approval by the NHMRC.

Increasing the COVID-19 workforce 
The Australian Government will provide funding for registered nurses to undertake online education to enable them to re-enter the clinical workforce and assist with the national response to the COVID-19 pandemic. Eligible nurses interested in undertaking the training should visit acn.edu.au/refresher or contact the Australian College of Nursing, by email at customerservices@acn.edu.au or by phone on 1800 265 534.

ISPAD

IPSAD has made recommendations regarding COVID-19 and children with diabetes

ADEA Sick Day Management guidelines for health professionals provide guidance for managing illness in people with diabetes.

Cochrane resources and news

The COVID-19 page on the Cochrane website provides information and resources for healthcare workers, researchers, policy and guideline developers and the public and carers. Find out more. This webpage provides readable, clinically-focused, actionable answers to inform point-of-care decision-making for health professionals. Read more here.

NDSS Diabetes in Schools program

The online program (level 1 and level 2 general training) is continuing. Face-to-face delivery of the training (level 3) by clinical treating teams in schools has begun in some states across Australia including Victoria, WA and NSW.  A clinical working group made up of clinicians from Perth Children’s Hospital, Royal Children’s Hospital Melbourne and John Hunter Hospital developing a telehealth service for level 3 training. This will roll out in the coming weeks. Other paediatric diabetes centers and health professionals will progressively come on board to provide Level 3 services across Australia in 2020.

ATTD COVID-19 and Diabetes Management online presentation

Advanced Technologies andTreatments for Diabetes (ATTD) has developed a series of presentations on COVID-19 and diabetes management. You will need to register with ATTD to access these presentations.

JDRF-Beyond Type 1 Alliance Releases Recommendations for People with Diabetes During the COVID-19 Pandemic 

JDRF has been working with Beyond Type 1 on the development of global public health messaging for people with diabetes. The campaign is endorsed by 50 global diabetes- and health-related organisations, including the IDF, Harvard Medical School, the American Diabetes Association, ISPAD, Life for a Child, the T1DExchange, and more. Read more here.

Supporting people with long-term conditions during national emergencies

This article from the Centre for Evidence-Based Medicine highlights that people with cardiovascular disease, diabetes, older people and at socio-economic disadvantage are most at risk during national emergencies. Read more here.

 

Information for your clients

ADEA’s sick day management resources, updated in June 2020,  for health professionals and people with diabetes are available on here our website.

The NDSS information sheets on sick day management complement ADEA’s sick day management resources:

The NDSS has a range of other resources and support for your clients, including:

#DontWaitMate

The Continuity of Care Collaboration (CCC), of which ADEA is a member, has launched the #DontWaitMate campaign encouraging people to continue with appointments with their healthcare professionals during the COVID-19 pandemic. ADEA has included posts from this campaign on our social media channels and would strongly encourage members to share these through their social media and other networks. You can also get involved by visiting the CCC website here: https://continuityofcare.org/

The University of Queensland’s Centre for Online Health has developed a good resource which can be provided to your clients to assist them in preparing for a telehealth consultation. Read more here.

We recommend that you refer your clients to the Department of Health website. Your clients can also contact the Coronavirus Health Information Line (1800 020 080).  The line operates 24 hours a day, seven days a week. COVID-19 resources by the Department of Health include:

The Diabetes Australia website has important information for people with diabetes. Advice on returning to school is available from the Diabetes in Schools website.

JDRF Australia has useful information on COVID-19 for people with type 1 diabetes, and JDRF USA has also published useful advice. Please however also refer your clients to the Department of Health’s website, provided above.

The Consumers Health Forum has issued a Special Bulletin with advice for consumers, that may be useful for your clients.

Curtin University has developed an online diabetes course to which you may wish to refer your clients with diabetes.

ADEA-endorsed programs

Harvard Medical School webinar: World-wide experience on COVID-19 in people living with diabetes

In this webinar, world-wide diabetes experts provide updated and evidence-based information on how COVID-19 has impacted people living with diabetes across the globe and share best practices to improve diabetes care during this difficult time. This is an ADEA-endorsed program that allows members to gain CPD points. Watch the webinar here.

Insulin analogues, COVID-19 and diabetes

During a two-part webinar series, Jayne Lehmann and Kirrily Chambers shared the latest evidence-based information and case studies on insulin analogues, COVID-19 and sick day management. The webinar recording is available for viewing on ADEA LMS. 

This webinar series will provide 2 CPD points towards your credentialling application, in Clinical Practice (Category 1).

Following the webinar on insulin analogues, Jan Alford interviewed Kirrily Chambers and Jayne Lehmann to learn more about insulin analogues, what influences the type of insulin analogue chosen and how Coronavirus can impact people with diabetes.

Listen to the podcast here.

 

CPD points and re-credentialling

Temporary changes to re-credentialling requirements

ADEA would like to thank members for their feedback and advice on how the current situation and uncertainty may impact members’ educational opportunities and continuing professional development.

The Credentialling Committee met in late March to discuss the concerns of members in private practice around cancellations of clinic appointments; the concerns of members in the public health system who are being redeployed; and member concerns about the ability to attend face-to-face CPD activities in light of recent COVID-19 meeting restrictions.

The Credentialling Committee has recommended the following changes be implemented for the six months to 30 September 2020, noting that we will continue to monitor the situation:

Members can apply for a voluntary leave of absence of CDE status where they are they are not practising as a CDE, for example where they are deployed to other areas of work, or for loss of work or temporary clinic closure.

Please contact the credentialling and membership team at cde@adea.com.au if you have any questions about these changes.

To support members’ educational needs over the next six months, ADEA offers a range of educational opportunities on the ADEA Learning Management System, as well as webinars and podcasts. There are no fees attached to ADEA Learning Management System courses and we are continuing to develop online learning for members throughout 2020.

Earn CPD points by supporting student placements in private practice

Many universities are experiencing difficulties in making arrangements for post-graduate student placements in hospital-based diabetes clinics as a result of the current pandemic.

With the new COVID-19 Medicare telehealth item numbers there is an opportunity for CDEs in private practice to gain CPD points and support students in their post-graduate studies by offering them placements.

Students are required to undertake 40 hours of placement with one or more CDEs. CDEs in private practice may be able to offer students the opportunity to observe clinic and/ or telehealth consultations, enhancing their understanding of private practice and telehealth.

Supervision of students on placement can provide a range of benefits for CDEs including earning CPD points and support in developing clinical resources (e.g. hand-outs or resources for your clients). Supervising CDEs are expected to: ensure students can observe consultations and ask questions; ask the student questions; de-brief on case conferences; demonstrate various diabetes management devices; and certify the student’s clinical placement booklet on completion of the placement.

If you are able to provide a student placement in your practice (either within your clinic or for telehealth consultations), please contact education@adea.com.au.

Workplaces must ensure the social distancing rules of 1.5m between people and 4 square metres per person). If these rules are adhered to, as well as the COVID-19 hygiene recommendations, then students can participate in consultations between a health professional and their client. COVID-19 guidelines vary between states and territories, so members should also consult the guidelines for their own state and territory to ensure they comply with local requirements.

 

Let’s support each other

ADEA is made up of a small team of very dedicated staff who are managing this situation, while keeping usual operations flowing as smoothly as possible.

The Board, ADEA staff and I continue to take this situation seriously, while focusing on the best possible outcomes every day for our members and people with diabetes. With information and advice changing frequently, please understand that we are doing everything possible to keep you updated and informed.

Thank you for your understanding and support. Please write to us at inquiries@adea.com.au if you have any questions.

 

Yours sincerely,

Susan Davidson

ADEA CEO

 

*Information last updated 24 November 2020

COVID-19 Advice to ADEA Members

Dear members,

The declared COVID-19 pandemic has impacted many organisations, including ADEA. We are continuing to explore options to lessen the impact on our members and people with diabetes. There are many elements of risk to manage and we are working hard with many of our stakeholders to put in place plans that serve the best interests of our members and their clients.

The situation is constantly changing, and we will continue to update this advice. This information will be next updated on Friday 30 October.

 

LATEST UPDATE

24 November, 2020

Face masks mandatory for South Australian CDEs

The South Australian Chief Public Health Officer has confirmed that all CDEs and allied health professionals are to wear face masks at work.

Mask use is also mandatory in aged care facilities where physical distancing cannot be maintained.

Further information on masks is available here:

https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/covid-19/about+covid-19/protecting+yourself+and+others+from+covid-19/face+masks

COVID-19 Safe Plan

All members in private practice are encouraged to have a Voluntary COVID-19 Safe Plan.

See how to create a COVID-19 Safe Plan here:

https://www.covid-19.sa.gov.au/business-and-work/create-a-covid-safe-plan

We will provide further updates as they become available.

19 November, 2020

The South Australian Chief Allied Health Officer has issued new advice that relates to CDEs in South Australia.

In summary:

The South Australian government has now made an official statement around allied health under the Emergency Management (COVID-19) (Stay at Home) Direction 2020. This came into effect from 12.01am today ,Thursday 19 November and ends at 12.01am on 25 November.

The details are below.

Key points:

  • CDEs and Allied Health Professionals (AHPs) can still go to Residential Aged Care Facilities (RACF).
  • You will need to let each RACF know if you are visiting any other facilities. These details may be registered by the RACF.
  • When visiting a RACF, you need to use infection control and prevention protocols at all times

The details

The South Australian government has now made an official statement around allied health under the Emergency Management (COVID-19) (Stay at Home) Direction 2020. This came into effect from 12.01am today ,Thursday 19 November and ends at 12.01am on 25 November.

Read it here:

https://www.covid-19.sa.gov.au/emergency-declarations/stay-at-home

Read the PDF here:

https://www.covid-19.sa.gov.au/__data/assets/pdf_file/0016/318310/EMA-Stay-at-HomeCOVID-19-Direction-2020.pdf

A person may leave home to receive ‘essential health services.’ (Part 3, 6, 2 (a))

These are defined in Schedule 1 of the direction – Essential health services (pg 7.)

For CDE and allied health services, ‘essential health services’ are:
(a) services provided by  essential workers in hospitals providing critical clinical care or as directed by the hospital;
(b) services provided by CDEs and allied health professionals working in private practice providing care through telehealth and other virtual care options;
(c) students, medical/nursing/midwifery/allied health on placement providing essential care in hospitals or through telehealth;

(Point 10, pg 8.)

Please note: ‘essential workers’ includes people providing ‘essential health services’ but only if they are provided in accordance with Part 3 of the direction.

Frequently asked questions

The below FAQ link outlines the same points around health services during the lockdown period:

https://www.covid-19.sa.gov.au/restrictions-and-responsibilities/stay-at-home#health


18 November, 2020

Catherine Turnbull, the South Australian Chief Allied Health Officer, has provided the following advice regarding allied health practice in the current situation in South Australia – we will advise members if this advice changes:

The SA Government is encouraging people to reduce movement as much as possible. Use telehealth where suitable and consider rescheduling over the next fortnight while they assess if the number of infections stabilises, goes down or increases.

There is currently no specific restriction on CDE / allied health clinics, and they are excluded from the Direction on public activities, as have medical or health services. They do ask that clinicians use good clinical judgment to assess the risk, complete pre-screening, suitable sanitation and social distancing. It is essential that clinics can identify anyone who attended for future tracking if needed.

Masks – There is currently no mandated requirement to use masks within CDE/ allied health services; however, some clinics have their own requirements, and people should be aware of risks.
Masks are required within aged care facilities.

Aged Care Facilities – CDE/ allied health appointments are not being counted towards the “restriction of 2 visitors per resident per day” rules.

Aged Care “limited to working at one site” – allied health who provide casual appointments in aged care are not restricted to one site; however, there is the expectation they will ensure any facility they enter is aware in advance of:

  • their entering other facilities
  • which facilities were visited, and
  • when the facilities were visited.

It is important to maintain these details to assist in tracking if needed.

Group therapy – within CDE/ allied health clinics do not fall under the gym/fitness closure/restrictions. It is essential these clinics consider social distancing obligations, pre-screening, sanitation, and risks associated with extra exertion and breathing.

Gyms – If a CDE/ allied health practitioner is co-located within a gym facility, as the facility cannot operate the clinician will need to work elsewhere (such as an allied health clinic) or cease practicing over this period. This may impact Exercise Physiologists and others.


31 October, 2020

National advice: watch Department of Health webinars on-demand

The Department’s most recent COVID-19 Primary Care and Allied Health webinar, 28th October 2020, provided key updates relevant to our members.

On the panel:

  • Dr Anne-marie Boxall, Chief Allied Health Officer, Department of Health
  • Adjunct Associate Professor Donna Markham, Chief Allied Health Officer for Safer Care Victoria

This was part of a series. Watch previous webinars (including transcripts) here.

Update on Victorian Restrictions

VIC Industry Restart Guidelines

The latest iteration of the Industry Restart Guidelines for Allied Health and Primary Care has been provided by the Victorian Chief Allied Health Officer:

Read the guidelines here.

These Guidelines have been updated to reflect the easing of restrictions effective as of 11.59pm 27 October 2020. For clarity, the guidelines were further updated today.

Indoor group therapies

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 – the timing of which is subject to Public Health epidemiological modelling and advice
.
The requirements state that indoor groups are currently restricted.
However, indoor therapy groups (in both clinical settings and fitness industry settings) will be allowed to recommence in metro Melbourne from 11.59pm on Sunday 8 November 2020.

Please note the detail below, outlining differences in the requirements for density quotients between these two settings:

Indoor clinical settings

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.

Fitness industry settings

For health professionals, that provide clinical services in a fitness industry setting (ie. 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.

Services from a residential address

In terms of practitioners who operate services from a residential address (i.e. their or another practitioner’s home), Public Health have confirmed the requirement for the premise to have a separate patient/client access point.

New advice from VIC DHHS: residential address-based services

We have received the following additional clarification from DHHS today, about services operating from a residential address.

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: Read the exceptions for not wearing a face mask

Updates to Metropolitan Melbourne restrictions

CDEs and allied health practitioners were able to commence routine care from last week.
All other practitioner groups are now able to commence routine care effective 11:59 PM last night (27 October 2020), subject to having a COVID-safe plan.

Exceptions

The only remaining exception / restriction for metropolitan Melbourne is indoor group consultations or activities. These are still not permitted.

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.

For the latest updates to Metropolitan Melbourne restrictions visit the Victorian Government’s restriction summary for Metropolitan Melbourne here.

Regional Victoria

There are some differences between restrictions in regional Victoria and metropolitan Melbourne due to the current rates of local transmission.

If the number of active cases continue to drop then restrictions in metropolitan Melbourne can be eased to align with the restrictions in regional Victoria, in line with public health advice.

Read the restrictions for regional Victoria here.

Personal Protective Equipment for CDEs in Private Practice

The Victorian Government recently updated the Conventional Use of PPE Guide.

This applies to Victoria-based CDEs in private practice settings.

For your convenience, this version has the updated advice highlighted in yellow.


COVID Myths and How to Prevent its Spread

Click here for slides from the COVID-19 Infection Control webinar that outline the myths around COVID-19 and how to prevent its spread.

Complete the University of Melbourne survey to support advocacy for ongoing access to MBS-funded telehealth for diabetes education, beyond 31 March 2021

ADEA has partnered with other health professional organisations to engage the University of Melbourne to conduct a survey on Telehealth by allied health practitioners in Australia during the COVID-19 pandemic. This survey will close on 31 October. To date only a small number of CDEs have completed the survey. We encourage all members to complete this survey, which will be an important element in supporting our advocacy for ongoing access to telehealth for CDEs. The survey has two elements: a clinician survey and a survey for their clients.

Clinician survey here: https://melbourneuni.au1.qualtrics.com/jfe/form/SV_1BVZ27Cy7F5Bg3z 

Client survey here: https://melbourneuni.au1.qualtrics.com/jfe/form/SV_eg1XhYKKhcU0gTj

 

RECAP

‘Heads up on diabetes’ campaign

The theme for National Diabetes Week 2020 (NDW2020) was ‘Heads Up on Diabetes’.

ADEA and our partner diabetes organisations such as Diabetes Australia, Australian Diabetes Society and several state/ territory organisations ran a campaign during National Diabetes Week to raise awareness of diabetes and mental health.
In addition to running several professional development activities for members, ADEA also released videos on our social media channels to highlight the importance of mental well-being in people with diabetes from the perspectives of consumers, their family members and carers, and Credentialled Diabetes Educators. Watch the videos in our playlist.

The 2020 Australasian Diabetes Congress will now be virtual

As the COVID-19 situation unfolds globally, and in alignment with the current restrictions on public gatherings, ADS together with ADEA have made the decision to go virtual.

The Australasian Diabetes Congress 2020 will now be held virtually on 11–13 November 2020.

Moving the Congress online is a necessary and responsible course of action. The health and wellbeing of attendees is of the utmost importance. This decision also recognises that most of the prospective ADC attendees are frontline health workers who are already stretched to capacity at this time and for the foreseeable future.

We sincerely hope that you will be able to join us virtually for the Congress in spring to enjoy the high quality educational and networking experience you have come to expect from ADC.

Registration has reopened so book now before the end of the financial year and save with the early bird rate. Click here to find out more information on costs.

Telehealth for CDEs

Extension of telehealth arrangements

On 18 September the Prime Minister and Minister for Health announced a six month extension to the current telehealth arrangements until 31 March 2021. More information here: https://www.pm.gov.au/media/2-billion-extend-critical-health-services-across-australia

DVA telehealth arrangements extended to 31 March

In line with the extension of Medicare-funded telehealth arrangements, the Department of Veteran Affairs (DVA) has extended its temporary telehealth arrangements to 31 March 2021. Updates on DVA’s COVID-19 arrangements for providers will continue to be communicated on the DVA website. Providers are encouraged to check this webpage regularly. All relevant allied health fee schedules will be updated with the new end date of 31 March 2021 for the telehealth items. These will be published shortly on the DVA website here.

2020 Telehealth Survey results

With the introduction of MBS-funded COVID-19 telehealth arrangements in March 2020, ADEA in collaboration with several Allied Health peak bodies developed two surveys to collect information about telehealth services. One survey was for health professionals and the other for their clients who utilised telehealth services. The Department of Health has requested advice from Allied Health peak bodies about their members’ experiences with telehealth, as well as their clients’ experiences. A summary of the results of the combined Allied Health peak bodies’ surveys will be provided to the Department of Health to inform discussions about the potential continuation of telehealth. The combined survey results are currently being compiled and when these are available we will share these results with members.

A summary of the key results of the survey of ADEA members is provided here.

Podcast on introducing telehealth into a CDE’s practice, and other useful telehealth resources

ADEA has produced a podcast in which a panel of CDEs, who are using telehealth for diabetes education, discuss how CDEs can set up and utilise telehealth in their practice. Access the podcast here.

ADEA has also a range of webinars regarding telehealth and the impacts of COVID-19 on people with diabetes, available on the ADEA Learning Management System (LMS).

Log into the ADEA LMS here

Other useful telehealth resources include:

 

Telehealth software platforms

In late March, after strong advocacy by ADEA and members, new COVID-19 telehealth arrangements for CDEs and other allied health professionals were announced. From 30 March 2020 until 30 September 2020, CDEs can provide Medicare-funded telehealth videoconference and telephone consultations to all people with diabetes. For further details please refer to the latest version of ADEA’s Telehealth Guidelines for CDEs’.

For CDEs exploring technology that enables them to provide telehealth services please refer to the information on technologies provided below.

  • Video-conference software guide
    The University of Queensland’s Centre for Online Health has developed a quick video-conference software guide which compares three cloud-based video conferencing platforms for telehealth
  • HealthBank – a telehealth platform for health professionals – free access plan to 30 September 2020

HealthBank is a digital health and telemedicine company, which helps to connect clients to allied health practitioners allowing them to deliver secured virtual consultations and monitor their health, diet, and lifestyle.

Features include:

    • Search engine and practitioner public listing.
    • Client/practice management, telehealth and a digital health platform
    • Electronic medical records
    • Online bookings, messaging, calendar integration, and billing.
    • Ability to book for face to face consultations also
    • Blog

Click here for more information.

  • KnowDiabetes – a new telehealth platform for CDEs and diabetes education – free access plan to 30 September 2020
    A new Australian-based telehealth provider, KnowDiabetes, has approached ADEA about their free access plan to help CDEs book and deliver private telehealth audio and video consultations. Its new purpose-built platform specifically promotes diabetes education and the role of CDEs. The platform uses a simple and secure Australian telehealth system originally developed by CSIRO (Coviu) and features end-to-end encryption ensuring privacy. KnowDiabetes is currently being pilot tested by a small group of CDEs and their clients.KnowDiabetes is currently offering complimentary access for CDEs to use the platform to deliver bulk-billed telehealth consultations under the new COVID-19 Medicare-funded arrangements until 30 September 2020. KnowDiabetes also offers options for full fee consultations, in which CDEs will receive 100% of the fees paid by clients for web-consultations, until 30 September 2020. The consultation charges are: 20-minute consultation $75; 40-minute consultation $125.

As KnowDiabetes is a new system which has been pilot-tested on a small scale to date, this free access plan offer is being introduced gradually. A limited number of CDEs will be set up to access the system each day, on a first received – first listed basis. Once set up is complete, CDEs can use the system without restriction.

For more information view the information sheet; visit the KnowDiabetes websitecontact KnowDiabetes or phone KnowDiabetes on 0414 696 250 (Monday-Saturday; 9am-9pm AEST).

ADEA encourages members to select services that best fit their needs. ADEA receives no financial benefit in providing this information to members.

The Department of Health has advised that they will not be providing advice on, or regulating telehealth platforms, and has advised that health professionals must consider their obligations under the Privacy Act and their clinical obligations.

Telehealth advocacy

Following advocacy by ADEA and other organisations, as well as member-initiated campaigns, new COVID-19 telehealth arrangements for CDEs and allied health professionals were announced by the Department of Health on 29 March 2020.

The announcement means all eligible allied health professionals can provide telehealth videoconference and telephone services from 30 March 2020 until 30 September 2020. The definitions section of the legislation defines which allied health professionals can provide services under the new extended telehealth arrangements. An eligible diabetes educator has the meaning given by section 4 of the Health Insurance (Allied Health Services) Determination 2014 – this states A person is an allied health professional in relation to the provision of a diabetes education health service if the person is credentialled by the Australian Diabetes Educators Association as a ‘Credentialled Diabetes Educator’ ’.  Services can be provided under Schedule 3 (Allied Health Services) sub-groups 11 and 12 of the legislation.

The MBS factsheets contain useful information including the Allied Health FactsheetAllied Health Frequently Asked Questions and Provider Frequently Asked Questions. Please refer to the table* below for a quick overview of the existing 13 Chronic Disease Management MBS item numbers, and the new telehealth and telephone MBS Item Numbers.

*Information extracted from page 4 of the Allied Health Factsheet.

ALLIED HEALTH ATTENDANCES

These services need to be bulk-billed, and are for non-admitted patients

Service Existing Items

face to face

Telehealth items

video-conference

Telephone items – for when video-conferencing is not available
Chronic disease management
Allied CDM services (all 13 items) 10950, 10951, 10952, 10953, 10954, 10956, 10958, 10960, 10962, 10964, 10966, 10968, 10970 93000 93013

We are awaiting further information from the Department of Health, which is working on additional MBS factsheets. We will advise members as these become available.

 

Additional information:

  • Privately-funded telehealth services are also an option for CDEs and allied health professionals, if included in the health professional’s insurance arrangements. If you wish to provide telehealth services, you should check your insurance arrangements with your insurer.
  • Medicare provider numbers are usually location-specific, however under the COVID-19 arrangements, the provider numbers are mobile and can be used by health professionals for remote working arrangements.
  • ADEA has recently advocated for the inclusion of the group services for people with type 2 diabetes Medicare items via telehealth, and are awaiting department communication.

 

Telehealth and bulk-billing

The Minister for Health announced changes to bulk-billing arrangements for specified health professionals, including CDEs and allied health professionals, which came into effect on 20 April 2020. The Minister noted that the amended legislation would help ensure the continued viability of specialist and allied health services under Medicare and recognised the advocacy of many groups. ADEA worked closely with allied health professional organisations, through the peak body Allied Health Professions Australia, in advocating for these changes.

The changes in the legislation mean that specified health professionals are no longer required to bulk-bill their clients. These health professionals include CDEs, allied health professionals, nurse practitioners, midwives, specialists, consultant physicians and consultant psychiatrists.

For more information, refer to the MBS Online announcement.

Access to Medicare-funded telehealth arrangements for Australians overseas and visitors to Australia

Medicare does not cover any medical or hospital services provided outside of Australia, however Australian citizens who are overseas may have coverage under a Reciprocal Health Care Agreement between the country they are visiting and Australia.

Australia has Reciprocal Health Care Agreements with BelgiumFinlandItalyMaltaThe NetherlandsNew ZealandNorwayThe Republic of IrelandSloveniaSweden and The United Kingdom.

Visitors from these countries can access Reciprocal Health Care Agreements while in Australia. These Agreements vary by country, but generally provide access to publicly funded medically necessary care, and in some cases they may partly cover the costs of prescribed medicine. Further information about these Agreements is available here.

The provision of non-Medicare funded telehealth services to Australians overseas, or to visitors to Australia, will be dependent on each CDE’s insurance arrangements.

 

Department of Health COVID-19 webinar series for health professionals

The Department of Health COVID-19 webinars for primary care and allied health professionals are available here to watch on-demand. The transcript can be downloaded by clicking the top right of the video player from each webinar.

Diabetes supplies for people with diabetes – PBS and NDSS

  1. Access to diabetes medications and supplies through the PBS and NDSS

ADEA works with ADS, Diabetes Australia, the Australasian Paediatric Endocrine Group and JDRF Australia in an alliance of leading national diabetes organisations. We are encouraging people with diabetes to continue their usual insulin purchasing practices and not stockpile or refill prescriptions more frequently.

The Department of Health has advised there is no national shortage of NDSS products or insulin or other diabetes-related medicines. Read more here.

All diabetes medication and device companies have advised that they have sufficient stock within their warehouses. The spike in March in people accessing diabetes medications and products resulted in some temporary shortages within some warehouses that supply to pharmacies, as the warehouses adapted to the increased demand.

Please be aware that some pharmacies do not stock all insulins, but order on request by people with diabetes.

With the introduction of insulin limits and NDSS product limits, we understand these issues have been resolved; however ADEA members are encouraged to report any incidents of insulin or other medication shortage, or NDSS product shortage.

Insulin Limits – In April, the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia, in consultation with the Department of Health, agreed on new requirements for community pharmacists to enforce new limits on dispensing and sales of prescription and over-the-counter medicines to address excessive purchasing in community pharmacies. Insulin is on the list of medicines that has been limited, and Diabetes Australia is working with stakeholders on behalf of people with diabetes and diabetes organisations, including ADEA, to ensure that these limits do not adversely impact on people with diabetes. Read more here.

Diabetes Australia and the Pharmacy Guild are also encouraging all pharmacies to stop sale of blood ketone monitoring strips for keto diets and reserve these strips for people with diabetes.

NDSS Product limits – In April, Diabetes Australia, in consultation with the Department of Health, advised people with diabetes are advised not to stockpile NDSS supplies. Limits to NDSS product orders are put in place to help ensure there are enough products available for everyone with diabetes who needs them. Read more here.

Diabetes Australia continues to work with the Pharmacy Guild to ensure the medicines and products supply chain is supported and all people with diabetes across Australia can continue to access their medicines and products.

We recommend that you:

  • advise your clients to continue their usual diabetes medication and product purchasing patterns, and not to stockpile or refill prescriptions or NDSS products more frequently. If your clients need to access additional supplies for the purpose of managing sick days, please advise them to only access the volume of medication or products they need.
  • advise ADEA if any of your clients experience issues accessing diabetes medications or products, by emailing us at inquiries@adea.com.au or contact the NDSS Helpline on 1800 637 700 if any of your clients experience issues accessing diabetes medications or products. Please include the date your client requested the product at a pharmacy, the pharmacy details and the product details.

The Australian Diabetes Society (ADS) issued advice to their members about COVID-19 and medication usage. You can access a copy here.

Sanofi update on insulin supply during COVID-19

With Lantus being de-listed from the PBS, Sanofi is accelerating availability of Optisulin to support ongoing access to insulin glargine U100. Sanofi has issued a media release to assure health professionals that there is no shortage of insulin glargine U100. Read the media release here.

2. Blood glucose test strips for people with type 2 diabetes not using insulin

Blood glucose test strips are available for people with type 2 diabetes who are not using insulin, under certain circumstances including ‘inter-current illnesses’. The requirement for a Blood Glucose Test Strip (BGTS) Six Month Approval form to be completed has been temporarily suspended. Read more here.

3. Changes to the delivery of continuous glucose monitoring (CGM) starter kits

In response to the COVID-19 pandemic the Australian Government has introduced a temporary change to the Continuous Glucose Monitoring (CGM) Initiative to enable a CGM starter kit to be sent directly to the residential address of the person with diabetes or their carer/guardian. This may be appropriate when access to a face-to-face opportunity for the health professional to provide education and support for the setup and ongoing use of the CGM device is unavailable.

A Continuous and Flash Glucose Monitoring Eligibility Assessment form must have been completed, and an Addendum for home delivery of CGM starter kits must be filled in by the certifying health professional to allow this to happen.

Before the follow-up appointment, the health professional should ensure the person with diabetes has received their CGM starter kit.  

For more details refer to the information sheet.

4. Home delivery of medicines and NDSS products

The Australian Government has announced that it is funding medicine home delivery services to help vulnerable people stay at home and reduce their exposure to COVID-19.

The service means participating pharmacies can offer customers free delivery of under 500 grams of medication using the Australia Post Express Post network.

Vulnerable and at-risk Australians, including those isolating themselves at home, people over 70 and people with chronic health conditions are eligible for the service from participating pharmacies.

Check with your local community pharmacy to see if they are offering this service. Some participating pharmacies may be able to add products subsidised through the NDSS to home delivery of medicines. Read more here. Information is also available through the Coronavirus App and WhatsApp.

NDSS forms

Health professionals can now complete NDSS forms for access to services and diabetes products without the need for co-signing by the person with diabetes.

To ensure your clients who are newly diagnosed with type 1 diabetes are registered with the NDSS as quickly as possible, to have access to blood glucose monitoring strips and other NDSS products, please ensure that you provide their mobile phone number on the NDSS registration form, and email or fax the form to the NDSS team. This will ensure faster processing and will enable the NDSS team to send an SMS to your client with their NDSS registration number.

Validating concessional status for continuing access to CGM or FGM through the NDSS: ADEA has been advised that some people with type 1 diabetes who are accessing CGM or FGM believe they need to re-register with the NDSS every 12 months. ADEA has sought clarification on the process. People who have type 1 diabetes and are over 21 years old can access CGM or FGM through the NDSS if they have concessional status. They are required to re-validate their concessional status every 12 months. One month prior to their concessional status expiring, a reminder NDSS letter/ email is sent requesting the person to contact the NDSS Helpline to validate their concessional status for continued access to CGM/ FGM through the NDSS. Once the person provides this information, their access is extended for a further 12 months. This re-validation process occurs every 12 months. People do not need to complete a new registration form for continuing access to CGM/ FGM.

Changes to certification of NDSS forms from 1 August 2020

The Department of Health is currently undertaking a project to deliver updated NDSS IT systems and simplified business processes to reduce administrative time and costs for NDSS stakeholders. During stakeholder consultation for the project, the Department was advised by GP clinics, that following a diagnosis of diabetes by a GP, it is common practice for a Practice Nurse to complete the certifier section of the NDSS registration form, with the GP subsequently signing to certify the form.

The Department of Health notified health professional associations this week that from 1 August 2020, an administrative efficiency will be introduced with Practice Nurses (registered and enrolled) being able to certify some NDSS forms following written confirmation of the diabetes diagnosis from a Medical Practitioner. The forms that Practice Nurses will be able to certify are:

  • NDSS Registration Form
  • NDSS Blood Glucose Test Strip Six Month Approval Form
  • NDSS Medication Change Form.

In introducing this change, the Department has advised health professional associations including the Australian Primary Health Care Nurses Association (APNA) and the RACGP that “Normal referral processes to health professionals such as credentialled diabetes educators, accredited practicing dietitians or other health professionals continue as required.”  The Department has also advised that adopting this new process will be optional for each GP/clinic, and a Practice Nurse would not be required to certify a form unless it was within their scope of practice, knowledge and experience to do so.

Further information and updated NDSS forms reflecting this change are available here.

ADEA thanks all members who contributed to our advocacy on this issue, as well as ADS and Diabetes Australia who supported our advocacy. Unfortunately our efforts were unsuccessful. Over the coming months we will be focusing heavily on working with the RACGP and APNA to promote referral pathways to CDEs, including those newly diagnosed with diabetes, and those transitioning to more frequent blood glucose monitoring or new medications so that they receive the necessary specialist diabetes education, management and care.

NDSS services and programs

All NDSS face-to-face education and support programs and activities have been postponed. These programs are being delivered in alternative ways, including webinars and other online activities.

Diabetes Australia has extended the hours for the NDSS National Helpline 1800 637 700 to be able to give greater support for people with diabetes during the COVID-19 pandemic.

The new hours are:

Monday to Friday – 8:30am to 8:00pm
Saturday – 9:00am to 2:00pm

People with diabetes are encouraged to call the NDSS Helpline to:

  • talk to a health professional about managing their diabetes
  • get advice about specific diabetes information related to COVID-19
  • find out how to access health services and support during this time
  • discuss access to NDSS products and diabetes medications.

Stay up to date with the NDSS COVID-19 advice here.

 

Advice from Health Departments

Australian Government Department of Health

The Department’s website has a range of resources for health professionals regarding COVID-19. This includes an Infection Control training module developed for use by healthcare workers across the health, aged care, disability and childcare sector. The 30-minute online training module is accessible here. The Department also provides regular COVID-19 news and media updates.

The Department of Health COVID-19 webinars for primary care and allied health professionals are available here to watch on-demand. The transcript can be downloaded by clicking the top right of the video player from each webinar.

Department of Health reminders for you and your clients

The Department of Health has advised that allied health professionals should:

  • reinforce to patients, especially those who are at increased risk if they contract COVID-19, about the importance of wearing masks and about how people can do this safely. Further advice is available at www.health.gov.au;
  • reinforce to patients the importance of being tested for COVID-19 if they have symptoms no matter how mild;
  • encourage patients and friends if they haven’t already done so, to download the COVID safe app onto their phones; and
  • try to source PPE, including eye protection, commercially if possible. Those in Victoria, Brisbane north and south and west Moreton can apply to get eye protection form their PHN.

State and Territory Health Departments

State and territory jurisdiction health advice on COVID-19 restrictions are available on the relevant jurisdictional website.

Easing of restrictions for allied health and other health care providers in Victoria from 28 September

ADEA today received correspondence from the Victorian Chief Allied Health Officer providing additional guidance about the easing of restrictions as part of the next stage (Step 2) of the Victorian Roadmap to reopening. This guidance is intended to provide further clarification ahead of the release of the full industry roadmap.

The attached guidance outlines which allied health professions can provide services and under what circumstances. 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. We’re pleased to see a recognition of the need to see not only patients with a recognised need for services, but also for the need to be able to undertake assessment and diagnosis as part of the triaging work that allied health professionals are currently undertaking to manage their patient’s health needs.

We encourage all CDEs to continue to use telehealth as the first option for care delivery where appropriate. Routine care and regular monitoring, other than via telehealth, is not permitted during the second step and CDEs should continue to delay services that can safely be delayed until Step 3. When determining whether a service can no longer be delayed, you will need to use your clinical judgement to ensure the service is essential to preventing deterioration and an escalation in care needs.

We have been advised that those allied health professionals providing services within a permitted workplace during stage four (such as a public hospital, aged care or mental health setting) will remain permitted to do so under Step 2 guidelines. However, these allied health professionals should continue to apply clinical reasoning and only see patients face to face to prevent a significant change/deterioration in functional independence which would result in an escalation of care needs.

As a final note, we wish to highlight that while the Chief Allied Health Officer has written to provide guidance around allied health restrictions as part of Step 2, all decisions relating to the easing of restrictions are made independent of the Chief Allied Health Officer and Allied Health Workforce Team. If you have further questions or concerns about specific restrictions, we recommend that you contact Business Victoria – Coronavirus (COVID-19) business support and the Industry Coordination Centre on 13 22 15.

DHHS Victoria: clarification on ‘endorsed care plan’

DHHS in Victoria has confirmed endorsed care plans are listed as:

  • Chronic disease management plans – noting that a GP is required to prepare same (more detail here)
  • Endorsed NDIS plans (including self-managed plans)
  • Endorsed TAC plans
  • Endorsed Workcover plans
  • Endorsed DVA plans

A standalone GP referral does not constitute an endorsed care plan.

Information for CDEs and their clients regarding COVID-19

Information for CDEs

Rights of people with a disability during COVID-19

The Australian Human Rights Commission has published its guidelines this week on the rights of people with disability in health and disability care during COVID-19. The guidelines are available here.

Supporting our mental health

The National Mental Health Commission has launched its ‘Getting Through this Together’ campaign that provides practical tips to stay connected and mentally well during this time.. More information is available on their website: https://www.mentalhealthcommission.gov.au/GettingThroughThisTogether

Alert published for BYD brand N95 respirators

Safer Care Victoria has published an alert in relation to the use of ‘BYD’ brand N95 respirators. These respirators are at risk of tearing when adjustments are made using the straps. Practitioners are advised to use caution with this brand of respirator.

The Health Advocate journal special COVID-19 edition

The August COVID-19 edition of ‘The Health Advocate’ focuses on key policy issues highlighted by COVID-19, the impacts on Aboriginal and Torres Strait Islander people, telehealth, how the pandemic killed COAG and beyond COVID-19.

COVID-19 Health Professionals Disability Advisory Service extended to 17 November 2020

The COVID-19 Disability Advisory Committee Secretariat has advised that the COVID-19 Health Professionals Disability Advisory Service has been extended to 17 November 2020.

Health professionals can call the service at the new operating times of 8am to 9pm (AEST) Monday to Friday on 1800 131 330.

The COVID-19 Health Professionals Disability Advisory Service is a telephone advisory service established by the Commonwealth Department of Health to provide specialised advice for health professionals involved in the care of people with disability diagnosed with COVID-19 or experiencing COVID-19 symptoms. Healthdirect Australia has been engaged to manage the helpline on behalf of the Commonwealth Department of Health.

As you may be aware, some people with disability may become very anxious in these situations and require reasonable adjustments to their healthcare to ensure they receive either COVID-19 testing or treatment, with minimum distress. Specific support may be required to address communication and management issues, such as behaviours of concern and the reduction of risk to the patient and staff involved in the process.

Calls to the Advisory Service will be answered by health professionals with disability service qualifications and experience working with people with disability.

Australian Commission on Safety and Quality in Health Care (ACSQHC): Precautions for caring for aged care home residents with suspected, probable, or confirmed COVID-19

The ACSQHC has advised that:

  • when caring for residents with suspected, probable or confirmed COVID-19 in aged care homes, staff must use personal protective equipment (PPE) as recommended in the Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019)and by their state or territory
  • for areas with significant community transmission of COVID-19, the Infection Control Expert Group has provided guidance regarding use of P2/N95 masks and protective eye wear/face shields in aged care homes. Specific national guidance has also been developed to support aged care homes’ response to COVID-19
  • they have developed a poster to support aged care workers with step-by-step instructions on how to put on and remove PPE, and how to fit check P2/N95 respirator masks, where they are required to be used. Using PPE correctly helps to protect residents and staff from the spread of COVID-19.

For more information, visit the COVID-19 page on the Commission’s website, or contact the Commission at: HAI@safetyandquality.gov.au.

Student clinical placements in Victoria

DHHS in Victoria has updated their guidance on ‘Coronavirus (COVID-19) – Student Clinical Placements (Guidance note as at 12 August 2020)’.

Although this guidance is specific to public health sector entities and aged care providers, it contains a number of general risk management principles related the provision of student clinical placements.

The Continuity of Care Collaboration Free Webinars – Re-engaging with Healthcare; Rural and remote communities forum

The most recent webinar includes discussion on patient and consumer concerns about re-engaging with healthcare, providing a safe environment for care, providing practical advice to support patients and consumers (with a focus on diabetes and HIV) and lessons learnt. The webinar recording will be available soon.

The previous Continuity of Care Collaboration webinar and panel discussion examines how the pandemic has thrown up unique barriers to the delivery of patient care in rural and remote communities. Access the webinar recording here.

An open letter to Victorians: ‘Healthcare does not stop for lockdown, we are here to keep you well’

Through the Continuity of Care Collaboration, ADEA and a range of other organisations issued an open letter to the Victorian media urging Victorians to continue to seek health care, and to maintain their usual health care appointments. Read the letter here.

Please contact ADEA if your clients’ health care is significantly impacted by NSW/ VIC border closures  

Allied Health Professions Australia is working, on behalf of ADEA and other peak bodies, with NSW Health to obtain clarity on the situation regarding cross-border services in NSW/ Victoria. ADEA has also written to the NSW and Victorian Governments noting that although CDEs are able to provide some services via telehealth, there will be gaps where people with diabetes can’t participate by telehealth or where the CDE assesses that providing services by telehealth is not appropriate for the person.

We are seeking the same arrangements as currently apply to medical practitioners. They will allow allied health professionals in a border ‘bubble’ area to provide services across the border as long as they remain within the ‘bubble’ area.  If a Victorian allied health professional provides services outside of the border ‘bubble’ area in Victoria, they will not be allowed into NSW. If a NSW allied health professional provides services outside of the ‘bubble’ area in Victoria, they will be required to self-isolate for 14 days on their return to NSW.

If you believe these arrangements will adversely and significantly impact on the health of your client(s), and there is no alternative arrangement that can be implemented for your client(s), please contact the ADEA team with specific details about the situation as soon as possible by email to inquiries@adea.com.au or phone (02) 6287 4822.

Keep SAFE: a behavioural vaccine for COVID-19

The Medical Journal of Australia’s InSight+ recently published an article on adopting and sustaining a ‘behavioural vaccine’, while we await a medical vaccine. The authors of the article are: Professor Jane Speight, Professor Timothy Skinner, Jessica Hateley-Browne and Professor Charles Abraham. Following the article, the ABC interviewed Professor Speight about the psychology of the second COVID-19 lockdown in Melbourne and this interview is expected to be published on its online platforms in the coming days.

Read the article here.

Fact sheets on the use of face masks in the community to protect against COVID-19

Wearing a face mask is now recommended by Australian health experts in areas where community transmission of COVID-19 is high, and where physical distancing is not possible. The Australian Commission on Safety and Quality in Health Care has developed a fact sheet and answers to frequently asked questions to provide guidance to consumers on the use of face masks to protect against COVID-19 and advice on how to use face masks safely. They support the recommendation of the Australian Government and Victorian Government to wear face masks in areas where there is community transmission of COVID-19. These resources are available here:

For more information, please visit the COVID-19 page on the Commission’s website. Please contact COVID19@safetyandquality.gov.au if you have any questions.

 

Federal Department of Health guidance on the use of face masks and shields by healthcare workers

The Department of Health has published new guidance on the use of face masks and shields by healthcare workers in areas with significant community transmission of COVID-19 (published 30 July 2020).

The guideline can be found on the Department of Health website here

Other guidance on PPE for healthcare workers has also been published or updated (31 July) including:

  • Fact sheet on COVID-19 face shields
  • Guidance on use of PPE in hospitals
  • Guidance on use of PPE in non-inpatient healthcare settings

These and other publications on PPE can be found in the collection of COVID-19 resources for health professionals on the Department of Health website.

PPE advice for CDEs in Victoria

ADEA has received some enquiries about PPE requirements for CDEs in Victoria, and we can advise that the Victorian Government has updated its advice on the use of PPE for health workers. This is available at https://www.dhhs.vic.gov.au/personal-protective-equipment-ppe-covid-19

The Victorian DHHS advises that:

  • Health care workers must wear a level 1 or type 1 disposable surgical mask in public-facing areas – particularly where adequate social distancing is not possible.
  • Patients should also wear face masks in these same environments.

As demand for PPE is high during the pandemic and there is the potential for shortages if it is inappropriately used, DHHS has developed a guide as to when different types of PPE should be used. DHHS advises the use of face shields when a person is at risk or suspected or confirmed to have COVID-19. In these cases, wherever possible face-to-face appointments should be deferred or telehealth services offered. Detailed advice is provided in:

Allied Health Professions Australia (AHPA) has been liaising on our behalf with the Department of Health regarding access to PPE, including surgical masks, in Victoria.

Primary care health professionals should generally access surgical masks from commercial suppliers. Face masks are available from the National Medical Stockpile through your local PHN. PHNs can provide masks and respirators, where there is a demonstrated need, to GPs, Aboriginal Community Controlled Health Organisations and Health Services, and community pharmacies. PHNs can provide masks to CDEs and allied health professionals in certain circumstances including if there is no commercial supply available or if the health professional is working in higher-risk clinical areas with higher risk vulnerable patients.

For more information on how to apply to receive surgical masks from Victorian PHNs, click here.

 

Expansion of Continued Dispensing Arrangements – COVID-19

The Australian Government has extended the temporary Continued Dispensing (Emergency Measures) to 30 September 2020, to assist in managing the demand on the health system during the COVID-19 outbreak.  This means that people who are having difficulty accessing their medical practitioner for a new prescription can obtain a one-off standard quantity of eligible PBS/RPBS medicines subsidised under the PBS without a prescription. The person must previously have been prescribed this medicine and the pharmacist must be satisfied that it is urgently needed and it is not practicable to obtain a new prescription. Read more here.

The Australian response to the COVID-19 pandemic and diabetes

The COVID-19 pandemic has had a significant impact on the economy and health system of most countries in the world. In Australia, there have been important social and health strategies to “flatten” the curve, to reduce infections and to manage those infected. This article was put together by members of several diabetes health organisations including ADEA: Trisha Dunning, Jane Overland, George Barker and Susan Davidson. Read more on how Australia has responded to the COVID-19 pandemic.

COVID-19 and disabilities

  • Resources for people with cognitive impairment: The Australian Commission on Safety and Quality in Health Care (the Commission) has developed new resources to support health service organisations to provide safe care for people with cognitive impairment during COVID-19. The resources include a fact sheet for clinicians and a poster, which provide an important reminder of key actions in the National Safety and Quality Health Service (NSQHS) Standards that remain crucial at this time.

 

Assistance for health professionals in registering with the NDIS

Allied Health Professions Australia (AHPA) has developed free resources and guidance to help CDEs and allied health professionals to register with the NDIS and to prepare for the audit process associated with registration. You can access the website here.

Department of Veterans’ Affairs (DVA) COVID-19 update

DVA has updated the fee schedules for allied health providers which have been published on the fee schedules page. Information about additional support for eligible veterans, including mental health support, access to prescriptions and pharmaceuticals, and shopping support, is available from the DVA website.

The Department is encouraging all DVA clients to maintain continuity of health care throughout the pandemic. They also remind allied health providers that the allied health treatment cycle arrangements for DVA clients continue to apply during the pandemic. More information and updates from DVA here.

Updated statement on diagnostic testing for GDM during COVID-19

The Australian Diabetes in Pregnancy Society (ADIPS), ADEA, the Australian Diabetes Society (ADS) and Diabetes Australia have further updated the joint statement on diagnostic testing for gestational diabetes mellitus (GDM) during the COVID-19 pandemic. This update includes the recently revised Queensland Health Clinical Guidelines flowchart, which now includes postnatal follow-up. Please read the statement here.

Break the Chain of Infection poster

The Australian Commission on Safety and Quality in Health Care produced a Break the Chain of Infection poster which illustrates the chain of transmission of COVID-19 and to identify measures that can be implemented to limit its spread. The poster has been developed in collaboration with the New South Wales Clinical Excellence Commission and is targeted at health professionals, their clients and the public. The Break the Chain of Infection poster is available for download on the Commission’s website.

Internet speed boosts available at no extra cost for health professionals who provide telehealth services

Through Allied Health Professions Australia, the Government has confirmed that health professionals who provide telehealth services can access enhanced telehealth services at no extra cost for six months for their clinic location, whether this is the usual clinic location or a remote working clinic location. To access these arrangements, you need to contact your current internet service provider and let them know that you are a health professional providing telehealth services. The NBN will continue to provide updates and has provided some tips for getting the best from your NBN service.00B

National COVID-19 Coordination Commission (NCCC)

The NCCC is working to help minimise and mitigate the impact of COVID-19 on jobs and businesses and to facilitate the fastest possible recovery of lives and livelihoods. Further information and resources are available here.

Flu shots mandatory for health professionals working in or visiting residential aged care facilities

From 1 May 2020, all health professionals working in or visiting residential aged care facilities are required to have a ‘flu shot. There have been reports of some localised shortages of ‘flu vaccinations, and we request that any members who cannot access a ‘flu shot contact us at inquiries@adea.com.au and include the town or suburb and the State/ Territory in which they could not access a ‘flu vaccination. All information provided will be de-identified and summarised, and will assist the Department of Health in managing local shortages.

Australian Clinical Guidelines for COVID-19

The first version of the Australian Clinical Guidelines for COVID-19 are accessible via the Taskforce website. These guidelines will go through a one-month public consultation process before approval by the NHMRC.

Increasing the COVID-19 workforce 
The Australian Government will provide funding for registered nurses to undertake online education to enable them to re-enter the clinical workforce and assist with the national response to the COVID-19 pandemic. Eligible nurses interested in undertaking the training should visit acn.edu.au/refresher or contact the Australian College of Nursing, by email at customerservices@acn.edu.au or by phone on 1800 265 534.

ISPAD

IPSAD has made recommendations regarding COVID-19 and children with diabetes

ADEA Sick Day Management guidelines for health professionals provide guidance for managing illness in people with diabetes.

Cochrane resources and news

The COVID-19 page on the Cochrane website provides information and resources for healthcare workers, researchers, policy and guideline developers and the public and carers. Find out more. This webpage provides readable, clinically-focused, actionable answers to inform point-of-care decision-making for health professionals. Read more here.

NDSS Diabetes in Schools program

The online program (level 1 and level 2 general training) is continuing. Face-to-face delivery of the training (level 3) by clinical treating teams in schools has begun in some states across Australia including Victoria, WA and NSW.  A clinical working group made up of clinicians from Perth Children’s Hospital, Royal Children’s Hospital Melbourne and John Hunter Hospital developing a telehealth service for level 3 training. This will roll out in the coming weeks. Other paediatric diabetes centers and health professionals will progressively come on board to provide Level 3 services across Australia in 2020.

ATTD COVID-19 and Diabetes Management online presentation

Advanced Technologies andTreatments for Diabetes (ATTD) has developed a series of presentations on COVID-19 and diabetes management. You will need to register with ATTD to access these presentations.

JDRF-Beyond Type 1 Alliance Releases Recommendations for People with Diabetes During the COVID-19 Pandemic 

JDRF has been working with Beyond Type 1 on the development of global public health messaging for people with diabetes. The campaign is endorsed by 50 global diabetes- and health-related organisations, including the IDF, Harvard Medical School, the American Diabetes Association, ISPAD, Life for a Child, the T1DExchange, and more. Read more here.

Supporting people with long-term conditions during national emergencies

This article from the Centre for Evidence-Based Medicine highlights that people with cardiovascular disease, diabetes, older people and at socio-economic disadvantage are most at risk during national emergencies. Read more here.

 

Information for your clients

ADEA’s sick day management resources, updated in June 2020,  for health professionals and people with diabetes are available on here our website.

The NDSS information sheets on sick day management complement ADEA’s sick day management resources:

The NDSS has a range of other resources and support for your clients, including:

  • the NDSS website has important information, resources and online programs for people with diabetes including Type 2 Diabetes and Me, GDM resources and specific resources for older people with diabetes.
  • a new fact sheet, ‘Managing worry about COVID-19 and diabetes’. This fact sheet has been developed to support people during this uncertain time, it recognises that things might be a little scary and uncertain at the moment. This fact sheet has been translated into 26 languages. Other NDSS diabetes information sheets have also been translated and are now available in 26 languages too.
  • an updated fact sheet Living with type 2 diabetes and what to do when you are sick
  • a new series of short video clips about gestational diabetes and how it is managed. The Understanding gestational diabetes videos are available on the NDSS website. For health professionals who would like to find out more information about the Understanding gestational diabetes videos, contact Mel Morrison, NDSS Diabetes in Pregnancy National Lead and Advisor.

#DontWaitMate

The Continuity of Care Collaboration (CCC), of which ADEA is a member, has launched the #DontWaitMate campaign encouraging people to continue with appointments with their healthcare professionals during the COVID-19 pandemic. ADEA has included posts from this campaign on our social media channels and would strongly encourage members to share these through their social media and other networks. You can also get involved by visiting the CCC website here: https://continuityofcare.org/

The University of Queensland’s Centre for Online Health has developed a good resource which can be provided to your clients to assist them in preparing for a telehealth consultation. Read more here.

We recommend that you refer your clients to the Department of Health website. Your clients can also contact the Coronavirus Health Information Line (1800 020 080).  The line operates 24 hours a day, seven days a week. COVID-19 resources by the Department of Health include:

The Diabetes Australia website has important information for people with diabetes. Advice on returning to school is available from the Diabetes in Schools website.

JDRF Australia has useful information on COVID-19 for people with type 1 diabetes, and JDRF USA has also published useful advice. Please however also refer your clients to the Department of Health’s website, provided above.

The Consumers Health Forum has issued a Special Bulletin with advice for consumers, that may be useful for your clients.

Curtin University has developed an online diabetes course to which you may wish to refer your clients with diabetes.

ADEA-endorsed programs

Harvard Medical School webinar: World-wide experience on COVID-19 in people living with diabetes

In this webinar, world-wide diabetes experts provide updated and evidence-based information on how COVID-19 has impacted people living with diabetes across the globe and share best practices to improve diabetes care during this difficult time. This is an ADEA-endorsed program that allows members to gain CPD points. Watch the webinar here.

Insulin analogues, COVID-19 and diabetes

During a two-part webinar series, Jayne Lehmann and Kirrily Chambers shared the latest evidence-based information and case studies on insulin analogues, COVID-19 and sick day management. The webinar recording is available for viewing on ADEA LMS. 

This webinar series will provide 2 CPD points towards your credentialling application, in Clinical Practice (Category 1).

Following the webinar on insulin analogues, Jan Alford interviewed Kirrily Chambers and Jayne Lehmann to learn more about insulin analogues, what influences the type of insulin analogue chosen and how Coronavirus can impact people with diabetes.

Listen to the podcast here.

 

CPD points and re-credentialling

Temporary changes to re-credentialling requirements

ADEA would like to thank members for their feedback and advice on how the current situation and uncertainty may impact members’ educational opportunities and continuing professional development.

The Credentialling Committee met in late March to discuss the concerns of members in private practice around cancellations of clinic appointments; the concerns of members in the public health system who are being redeployed; and member concerns about the ability to attend face-to-face CPD activities in light of recent COVID-19 meeting restrictions.

The Credentialling Committee has recommended the following changes be implemented for the six months to 30 September 2020, noting that we will continue to monitor the situation:

  • Initial credentialling requirements will remain unchanged
    We understand people may take longer to achieve the various aspects due to the current uncertain workplace climate, however applicants must meet all criteria to achieve initial credentialling.
  • Re-credentialling requirements will remain as per the usual annual cycle based on a member’s usual membership due date, however some requirements have been relaxed for CDEs who are due for re-credentialling during the period 30 March 2020 until 30 September 2020:
    • 20 CPD points can be obtained across any of the categories, and the requirement for 5 points from ADEA activities will not be compulsory
    • A guide to how the 20 points might be obtained will be provided, including links to various activities and the CPD Guide. Specific examples will be provided for those in private practice
    • ADEA will consider any application for financial hardship and will provide flexibility regarding membership payments for CDEs if required. Please contact inquiries@adea.com.au for an application form.

Members can apply for a voluntary leave of absence of CDE status where they are they are not practising as a CDE, for example where they are deployed to other areas of work, or for loss of work or temporary clinic closure.

Please contact the credentialling and membership team at cde@adea.com.au if you have any questions about these changes.

To support members’ educational needs over the next six months, ADEA offers a range of educational opportunities on the ADEA Learning Management System, as well as webinars and podcasts. There are no fees attached to ADEA Learning Management System courses and we are continuing to develop online learning for members throughout 2020.

Earn CPD points by supporting student placements in private practice

Many universities are experiencing difficulties in making arrangements for post-graduate student placements in hospital-based diabetes clinics as a result of the current pandemic.

With the new COVID-19 Medicare telehealth item numbers there is an opportunity for CDEs in private practice to gain CPD points and support students in their post-graduate studies by offering them placements.

Students are required to undertake 40 hours of placement with one or more CDEs. CDEs in private practice may be able to offer students the opportunity to observe clinic and/ or telehealth consultations, enhancing their understanding of private practice and telehealth.

Supervision of students on placement can provide a range of benefits for CDEs including earning CPD points and support in developing clinical resources (e.g. hand-outs or resources for your clients). Supervising CDEs are expected to: ensure students can observe consultations and ask questions; ask the student questions; de-brief on case conferences; demonstrate various diabetes management devices; and certify the student’s clinical placement booklet on completion of the placement.

If you are able to provide a student placement in your practice (either within your clinic or for telehealth consultations), please contact education@adea.com.au.

Workplaces must ensure the social distancing rules of 1.5m between people and 4 square metres per person). If these rules are adhered to, as well as the COVID-19 hygiene recommendations, then students can participate in consultations between a health professional and their client. COVID-19 guidelines vary between states and territories, so members should also consult the guidelines for their own state and territory to ensure they comply with local requirements.

 

Let’s support each other

ADEA is made up of a small team of very dedicated staff who are managing this situation, while keeping usual operations flowing as smoothly as possible.

The Board, ADEA staff and I continue to take this situation seriously, while focusing on the best possible outcomes every day for our members and people with diabetes. With information and advice changing frequently, please understand that we are doing everything possible to keep you updated and informed.

Thank you for your understanding and support. Please write to us at inquiries@adea.com.au if you have any questions.

 

Yours sincerely,

Susan Davidson

ADEA CEO

 

*Information last updated 24 November 2020