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The Mental Health Nurse Incentive Program

Information for General Practices

Summary

General practices can now engage or retain a mental health nurse to assist in managing community based patients with a severe mental disorder The minimum case load for the mental health nurse is at least two individual patients with a severe mental disorder and being treated in the community per 3.5 hr session (minimum 1 session per week). A payment of $240 (GST inclusive) per session is available in urban areas, and $300 (GST inclusive) in very remote, remote, and outer regional areas (defined by the Australian Standard Geographic Classification scheme). Establishment funding is available under this Program of up to $10,000 (GST free). From 31 December 2008, eligible mental health nurses need to be credentialed by the Australian College of Mental Health Nurses. Until this time, interim arrangements will apply to enable mental health nurses that are not yet credentialed to be engaged. Practices choosing not to engage or retain a nurse may still have access to services through nurses employed by a division or other eligible organisation. Definitions of eligible practices, and patients with 'severe mental disorder' are included within program guidelines available from www.medicareaustralia.gov.au or at www.health.gov.au/coagmentalhealth Advice on recruiting mental health nurses can be obtained from the Australian College of Mental Health Nurses at www.acmhn.org

Background

The Mental Health Nurse Incentive Program provides a non-MBS incentive payment to community based general practices, private psychiatrist services and other appropriate organisations (such as Divisions of General Practice) that engage or retain mental health nurses to assist in the provision of coordinated clinical care for people with severe mental disorders in the community.

What services are provided?

Mental health nurses engaged under this initiative will support general practitioners (GPs) in managing patients with severe mental disorders in the community and provide a package of services that are tailored to the person's needs, which could include

• periodic review of the patient's mental state
• medication monitoring and management
• providing information on physical health care to patients
• integrating services from GPs, psychiatrists and allied health workers (such as psychologists) including arranging access to interventions from other health professionals when these are required
• undertaking home visits (including family interventions if needed)

What are the benefits for general practices/practitioners?

General practices that engage or retain a mental health nurse under this initiative will have increased capacity to directly provide and coordinate services for people with severe mental disorders in the community. Services provided by the mental health nurse may also reduce workloads for GPs and other practice staff.

General practices choosing not to participate directly may still be able to access mental health nurse services for their eligible patients through other organisations, such as divisions of general practice, who have engaged a mental health nurse under the initiative.

The RACGP strongly recommends that general practices considering involvement carefully review the guidelines for this initiative in light of their local patient, practice and mental health services profile. Practices are also advised to review the obligations incurred through different models of participation in this initiative. For example, insurance obligations on practices may vary depending on whether mental health nurses are employees or independent contractors.

What are the benefits for patients?

• Access to clinical care by a mental health nurse in the community
• Continuity of care
• Provision of multdisciplinary, community based care through one practice
• Additional assistance with medications
• A single person coordinating both clinical care and coordination with other agencies and service providers

Establishment payments

Participating organisations are now able to apply for establishment funding under this Program of up to $10,000 (GST free). Establishment payments will be triggered by evidence of engagement of a mental health nurse and would be available to an organisation once only, irrespective of the number of nurses engaged. Organisations that have already registered under the Program are also eligible for the establishment payment. Payment amounts will be tied to the number of sessions being undertaken by the nurse. Organisations that engage a mental health nurse five or more sessions a week qualify for a $10,000 establishment payment. Organisations that engage a mental health nurse for less than five sessions qualify for a $5,000 payment.

The payment will be made to the entity that registered to be part of the Program. For example, a Division of General Practice might engage the nurse for use by local general practices. In this scenario, the Division of General Practice would incur the establishment costs of engaging the nurse and therefore qualify for the establishment payment.

Medicare Australia will be in contact with all organisations which have applied to the Program to provide further information about the establishment payment.

How are these services funded?

The Australian Government has provided funding of $191.6 million over 5 years from July 2007 through the Mental Health Nurse Incentive Program. Payments to eligible organisations will be administered by Medicare Australia.

For more information, including detailed program guidelines, definitions of eligibility criteria for organisations (including general practices), mental health nurses and patients, visit the Medicare Australia website or the COAG mental health section at the Department of Health and Ageing website.

Publication Date: 7 May 2007
Authorised By: Mental Health