Who is Eligible for Out of Hospital Care?
People of all ages who are either inpatients in a NSW Health Public Hospital or have been referred by a NSW Health Community Health Service or Out-patient Team are eligible for the Out of Hospital Care Program. Eligible people may be suffering from acute or chronic health conditions, functional impairment/s or a life limiting illness that impacts on their ability to manage their activities of daily living and therefore puts them at risk of unnecessary hospitalisation.
To be eligible for the Out of Hospital Care Program:
- The patient or carer consents to participating in the program.
- The patient requires non-clinical case management and home care services to enable that person to be discharged home safely and to prevent avoidable admission.
- The patient has no other programs or services in place that provide the level of care that is required. For example, if the patient is currently receiving the Commonwealth Home Support Program (CHSP), their Service Provider may be asked to temporarily increase their services. If this is not possible OHC may be provided.
- The patient does not require a package of care that is long term or an intensive level of community supports beyond the scope of the program.
- The patient is not living in Residential Care.
To be eligible for ComPacks, the patient:
- Must be discharged from a NSW participating public hospital;
- Has been identified as medically stable by the Local Health District (LHD) in-patient treating team and no longer requires hospitalisation;
- Is at risk of readmission unless ComPacks is utilised; and
- Can be of any age although the packages generally do not cater for the specific needs of children. Instead they are there to support parents in their caring role.
Safe and Supported at Home (SASH) Eligibility
To be eligible for the SASH package, the patient:
- Must be aged between 18 and 64 years;
- Have functional impairments that impact on their ability to manage activities of daily living. This may include a sensory, functional, or psychosocial disability;
- Has limited or no informal supports;
- Has commenced the NDIS application process and has received a reference number; and
- Has had their application to the NDIS rejected or requires support while re-applying for the NDIS or appealing an access decision. In some cases, the SASH package can support people waiting for a NDIS support plan to be implemented or reviewed.
Referrals for SASH packages can be made from either the inpatient or community setting. A risk of hospitalisation tool such as the NSW Chronic Conditions Patient Selection (CCoPS) Tool may be used to identify and prioritise patients at higher risk.
End of Life (EoL) Eligibility
To be eligible for the EoL packages, the patient:
- Must be experiencing functional decline and is in the deteriorating (or terminal) phase of a progressive life limiting illness/condition, – typically this could be 3 months or less before death;
- Can be of any age although the packages generally do not cater for the specific needs of children. Instead, the package could support parents in their caring role;
- Requires non-clinical home care services to be able to manage at home for as long as possible;
- Has a carer or family member that requires non-clinical home care services to support the patient to die at home or to remain at home for as long as possible.
The following categories of patients may be eligible for the Out of Hospital Care Program in certain circumstances provided they meet the program criteria:
Hospital in the Home (HITH)
Hospitals in the Home (HITH) services provide acute or sub-acute care to adults and children as substitution or prevention for in-hospital care. Patients receiving daily care as hospital substitution are eligible for Out of Hospital Care during and after the completion of their HITH episode