Transition Care Program
The Transition Care Program (TCP) is specifically designed for individuals aged 65 years or older (or 50 years or older for Aboriginal or Torres Strait Islander people) who require short-term care and support at the end of a hospital stay to assist in their recovery process.
​Through rehabilitative services and personalised care plans, Transition Care Packages help individuals regain their independence and rebuild their strength to continue to live independently, or alternatively, assists them while their family and carers make appropriate long-term care arrangements.
What we offer
West Wimmera Health Service's Transitional Care Program is available in Nhill and provides short-term support and care for older people for up to 12 weeks.
​
As a goals based program ,TCP can be delivered in:
-
your home (Home based), or
-
the Nhill Hospital (Bed based)
Some people may move from one setting to another as their care needs change, within the same transition care episode.
​
Transition care provides older people with a package of services that can include nursing support, personal care, physiotherapy and other allied health disciplines, medical support, case management and more. The complete list of the specified care and services of TCP can be found in the Transitional Care Program information and client agreement.
​
All TCP recipients work with their case manager and care team to establish their goals and develop their plan of care, which will be regularly reviewed and updated as care needs change.​
How to access
To access TCP, you must be an inpatient in a public or private hospital. When your doctor and multidisciplinary team feel you meet the criteria for TCP, they will send a referral to our TCP Coordinator who will organise to speak with you about the program.
​
If you consent to the program, an ACAS referral will be sent to determine if you are eligible. Once satisfied, a member from the Transition Care Team will meet with you to discuss the program in more depth, including setting goals, which will form your care plan. At this point, a client agreement will also be signed by you or your representative and a TCP staff member.
Cost
TCP is a Commonwealth and State funded program.
​
The majority of the costs of the TCP are covered by the Government however, the Government also require a daily care fee contribution from people who are able to pay.
The maximum fees are calculated based on the single aged pension and are adjusted twice yearly (20 March and 20 September):
-
Community clients - 17.5% of the single aged pension which equates to a daily rate
-
Bed based clients - 85% of the single aged pension which equates to a daily rate.
​​
Service providers may be able to waive care recipient fees in circumstances where a care recipient is experiencing financial disadvantage.
Contact
For more information or to request us to refer you to the program, please ask a nurse or call West Wimmera Health Service's main reception on (03) 5391 4222 and ask to speak with our TCP Manager.