Funder

The term ‘funder’ is used to mean those who approve the funding of services.
Funders are also commonly known as ‘insurers’.

Funders and service providers both work with client goals.

A greater understanding of the role and use of goals in rehabilitation can facilitate communication between services and funders by providing a common approach to communicating goals.

Funders approve services, not the goals the client has identified.

Services need approval by funders.

Benefits of goal setting for Funders

Increasingly, funders of services require information regarding how the client will benefit from the services provided.

Rehabilitation goals can provide useful information to describe the level of change expected in the client as a result of the services provided or anticipated change when additional services are requested.

 

 

 

 

 

Meeting funding requirements

Funding bodies use the description of the goals, in conjunction with the description of the client’s impairments and functional status, to determine whether the requested services meet funding criteria and are considered reasonable and necessary.

In funding requests its important to show how requested services will help the client to achieve their goals and minimise the impact of their injuries.

Funding for services is provided when requests for funding demonstrate that the services:

• are related to the client’s injury
• directly benefit the client
• meet additional scheme specific criteria, e.g. reasonable and necessary, and LTCSA TRAC (treatment, rehabilitation and care) criteria and within the scope of relevant legislation. These criteria refer to the requested services and equipment, not to the goal itself.

Goals

goals show the benefit to the client.

Ideally, goals should be achievable but challenging.

There is a balance that needs to be aimed for when setting a goal so that it is sufficiently achievable so as not to be intimidating, yet challenging enough to be motivating.

However, in some situations you may want to document the client’s goal, even when it is unrealistic. The ‘gap’ between the current action plan and the client’s goal may need to be explained to funders and can inform ongoing discussions with clients to support the development of insight, particularly if progress towards goal achievement is much slower than the client anticipated.

It can also be useful to document unrealistic goals to highlight service gaps where services are unavailable or inadequate.

 

Questions for funders

1. How do you determine the extent to which goals submitted in reports are meaningful and motivating for the client?

2. Would you give feedback to service providers about whether the goals submitted in reports and plans are meaningful and motivating for the client?

3. What questions do you ask service providers when this is unclear?

4. What support for goal setting can you offer ‘virtual’ teams made up of sole practitioners or clinicians from different services?