Coordinated Veterans’ Care (CVC) Program
The CVC Program provides proactive care coordination for eligible Veteran Card holders with chronic conditions and complex care needs. Providers and participants work as a team to improve the participant’s health care, wellbeing and reduce hospitalisations.
Back to topInformation for providers
The CVC Program supports eligible Veteran Card holders with chronic health conditions and complex care needs through care coordination. It requires is a proactive approach coordinated care program. It aims to improve participant health, wellbeing and reduce quality of life and decrease the risk of unplanned hospitalisations.
Within a general practice setting, the GP works collaboratively with the participant, their general practitioner (GP) and a care coordinator work as a team to develop a comprehensive care plan that addresses to:
- meet the participants health goals, treatment needs and supports the ongoing needs of the participant
- management of their the participant's ongoing care.
- The GP oversees the delivery of this care plan, supported by a Care Coordinator (usually a practice nurse), who manages the day-to-day coordination of services included in the plan and maintains regular contact with the participant.
The CVC Program promotes:
- health literacy,
- self-management and
- best practice coordination of care through a person-centred approach.
Who can participate
Veteran Gold Card holders with a chronic health condition may access the CVC Program if they meet the full program eligibility criteria.
Veteran White Card holders with a DVA- accepted mental health condition that is chronic may also access the program. A DVA-accepted mental health condition is one that DVA has formally accepted as being related to the veteran’s military service.
To be eligible, all Veteran Card holders must:
- be Australian residents
- be living in the community (not in residential aged care)
- have complex care needs, and
- be at risk of hospitalisation.
The full program eligibility criteria can be found in the Notes for the CVC Program.
Who is not eligible
Veteran White Card holders who do not have a DVA-accepted mental health condition are not eligible for the CVC Program. They may still be able to access mental health treatment through Non-Liability Health Care.
Veteran Card holders who are permanent residents of an aged care facility are not eligible for the CVC Program. This does not apply to those receiving short term respite care.
Veteran Card holders recovering from a hospital stay and enrolled in the Department of Health and Aged Care’s Transition Care Programme are not eligible to access the CVC Program until their period of transition care has concluded.
Veteran Card holders who have been diagnosed with a terminal condition and are not expected to live beyond 12 months are not eligible to access the CVC Program.
Back to topNotes for the CVC Program
Before delivering the CVC Program, GPs and Care Coordinators must review the Notes for the CVC Program (Notes) to ensure compliance with program requirements.
The Notes set out the legal requirements for those delivering the CVC Program, including:
- GPs
- Care Coordinators, who can be either the GP themselves or a:
- Practice Nurse
- DVA-contracted Community Nursing Provider
- Aboriginal and/or Torres Strait Islander Primary Health Worker
View the Notes:
Back to topCVC Toolbox
DVA provides a range of tools and resources to support providers in delivering the CVC Program. The CVC Toolbox includes:
- an eligibility tool
- optional care plan templates for Veteran Gold and White Card holders
- information about when and how to claim
- a claim calculator
How to claim
The CVC Program must be delivered by participants usual GP who provides the majority of their care and understands their health goals and treatment needs.
To claim for the CVC Program, the GP must have formally enrolled the participant into the program. Payments that usual GPs can claim are shown in the table below.
Claims for the CVC Program are submitted through Medicare and are checked against eligibility criteria prior to payment. Additional details about how to claim CVC payments are available in the CVC Toolbox
Payments usual GPs can claim
| Usual GP Type | In-person initial assessment and program enrolment | Item number | Completion of 90 day period of care — in-person review of care plan and eligibility | Item number | Total amount year 1 (includes initial assessment) | Total amount for subsequent years |
|---|---|---|---|---|---|---|
| GP with practice nurse | $502.45 | UP01 | $524.35 | UP03 | $2599.85 | $2097.40 |
| GP without practice nurse | $314.10 | UP02 | $235.65 | UP04 | $1256.70 | $942.60 |
Date of service
A period of care under the CVC Program is 90 days
Claims for payment cannot be submitted to Medicare until the period of care is complete.
The date of service is day 1 of the 90-day period of care.
To help calculate when to submit your claim based on the correct date of service, please use either the:
Back to topThe role of a Community Nurse in the CVC Program
GP's who do not have access to a practice nurse, they may choose to work with a DVA-contracted Community Nursing provider to support them to deliver of the CVC Program. In this partnership, the Community Nurse plays a central role in coordinating care for the CVC Program participant.
The Community Nurse will work closely with the participant and GP, maintaining regular communication with the GP to ensure the care plan is effectively implemented.
For more information, including details on the payments DVA-contracted Community Nurses can claim, please refer to Information for DVA contracted Community Nursing Providers.
Back to topCVC Social Assistance
CVC social assistance is a short-term service of up to 12-week service available to CVC Program participants who are socially isolated or are at risk of social isolation.
It aims to help participants connect with their community by building confidence, independence and sustainable social networks through:
- community based programs
- connecting with an ex-services organisation
- social groups
- assistance making social contacts, or
- other social activity or course.
Refer a participant for CVC Social Assistance
To refer a participant for Social Assistance, the GP must contact the Veterans’ Home Care (VHC) Assessment Agency on 1300 550 450 to arrange an assessment.
The referral should include the participants details, the nature of their social isolation and the intended goals of the assistance.
The GP and Care Coordinator are responsible for monitoring the progress and impact of the support provided.
Back to topContact the CVC Program team
If you have questions about the CVC Program, you can contact us by calling 1800 VETERAN (1800 550 457) or send an email to CVCProgram@dva.gov.au