The VIP operates under a model of service integration between BIRP teams and VR providers.  Successful service integration requires effective communication, co-operation and the blending of expertise to support client vocational goals. Vocational rehabilitation goals should beaddressed concurrently with other rehabilitation goals, not sequentially, to facilitate engagement in vocational rehabilitation and improve vocational outcomes.

At the core of the program is the partnership between BIRPs and vocational providers.

VIP Partnerships

• BIRP clinicians have expertise in the impact of the client’s brain injury, facilitating goal identification and assessing work readiness.

• Vocational providers have expertise in completing work options assessments, work skills assessments, developing RTW programs and identifying and providing RTW supports.

• They work in collaboration to deliver RTW outcomes for clients.

ROLES

BIRP clinicians

• Support the client to identify if they have a vocational goal. Some clients may need guidance to understand (and sometimes accept) when they are ready (and when they are not yet ready) to commence a vocational goal.

• Refer the client to a partner vocational rehabilitation provider once the client is ready to commence vocational services.

• Complete the Client Summary Report (provide link)

• Meet with the vocational rehabilitation provider (usually with the client) and talk about specific aspects of their functioning that may need to be considered as part of their employment program.

• Provide the vocational rehabilitation provider with further training and information to assist their understanding of brain injury.

• Join the vocational rehabilitation provider in working with the employer if needed.

• Participate in joint case reviews and decision-making about the client’s employment program.  

Vocational Rehabilitation (VR) Service Providers

• Ensure at least one member of staff is trained to work with people with brain injury.

• Review information provided by the referring BIRP clinician and initiate discussions regarding employment pathways and program options for the client.

• Meet with the client and BIRP clinician to discuss details and to seek clarification regarding the injury impairments and contextual factors which impact employment.

• Select and commence Same Employer or New Employer pathway with the client.

• Provide regular feedback to the BIRP clinician about the client’s progress. This may be through joint case reviews.

Locations of 12 adult BIRP teams:

BIRP site	Office location/s	Major towns/suburbs serviced
Ryde	Royal Rehab	Sydney city Northern Sydney Eastern suburbs Inner western Sydney
Liverpool	Liverpool Hospital	Southern Sydney South-western Sydney Southern Highlands
Westmead	Westmead Hospital	Western Sydney Nepean Blue Mountains North-western Sydney
Northern NSW	Ballina	Ballina, Byron Bay, Casino, Grafton, Lismore, Maclean, Mullumbimby, Murwillumbah, Tweed Heads, Yamba.
Mid North Coast	Coffs Harbour Port Macquarie	Coffs Harbour, Bellingen, Bowraville, Coramba, Dorrigo, Macksville, Nambucca Heads, Nana Glen, Sawtell, Urunga, Woolgoolga, Crescent Head, Kempsey, Laurieton, Port Macquarie, South West Rocks, Wauchope.
New England	Tamworth	Armidale, Barraba, Bingara, Boggabri, Glen Innes, Gunnedah, Inverell, Manilla, Moree, Narrabri, Quirindi, Tamworth, Tenterfield, Walcha, Warialda, Wee Waa.
Hunter	Newcastle	Cessnock, Gosford and surrounds, Maitland, Merriwa, Murrurundi, Muswellbrook, Newcastle, Scone, Singleton, Taree
Southern NSW	Goulburn	Bateman’s Bay, Bega, Bombala, Braidwood, Cooma, Crookwell, Eden, Goulburn, Moruya, Murrumburrah-Harden, Pambula, Queanbeyan, Young, Yass, Jindabyne
Mid Western NSW	Bathurst	Lithgow, Wallerawang, Portland, Kandos, Rylstone, Oberon, Bathurst, Hill End, Blayney, Orange,  Molong, Yeoval, Cowra, Canowindra, Grenfell, Forbes, Parkes, Peak Hill, Condobolin, Trundle, Tullamore, Tottenham,
Dubbo	Dubbo	Barradine, Bourke, Brewarrina, Cobar, Coonabarabran, Coonamble, Dubbo, Dunedoo, Gilgandra, Goodooga, Gulgong, Lightening Ridge, Mudgee, Narromine, Nyngan, Trangie, Walgett, Warren, Wellington.
South Western NSW	Albury Wagga Wagga	Albury, Ardlethan, Batlow / Adelong, Berrigan, Boorowa, Coolamon, Cootamundra, Corowa, Culcairn, Deniliquin, Finley, Ganmain, Griffith, Gundagai, Hay, Henty, Hillston, Holbrook, Jerilderie, Leeton, Lockhart, Harden, Narrandera, Temora, Tocumwal, Tumbarumba, Tumut, Wagga Wagga, West Wyalong, Wyalong, Young
Illawarra	Port Kembla Nowra	Stanwell Park, Wollongong, Port Kembla, Kiama, Nowra, Jervis Bay, Milton, Ulladulla

The two VIP pathways are Same Employer and New Employer.  

Same Employer is an early intervention for clients with the opportunity and capacity to resume work with their pre-injury employer.

New Employer is for clients seeking new employment, focused on intensive job seeking. There is provision for pre-vocational activities if they are not ready for open employment.

This pathway is for clients with the opportunity and work capacity to return to their pre-injury employer.  The ‘pre-injury employer’ is defined as the employer engaged in a contract of employment with the client at the time of injury.
Return to Work programs:

• Follow a graduated approach tailored to the needs of the client and employer.

• May include commencing on reduced hours and days with gradual upgrades as indicated.

• The plan ncludes strategies to manage physical and cognitive effects of brain injury.

• Clients may RTW on suitable duties within their pre-injury position. If this position is not available, all familiar roles within the organisation should be considered.

Criteria
Employment circumstances

• The client has an employer ready to engage with the return to work program
  

Diagnosis

• The client has the capacity to return to their pre-injury role (or part of)

Readiness for RTW

• The client identifies return to work as a goal and is clinically ready to commence the program

CASE STUDY

Link to FT video on ACI website: (Phillip Duncum)

 

 

This pathway is for clients with brain injury who do not have the opportunity to resume employment with their pre-injury employer or were not working at the time of their injury. They require assistance to identify new opportunities and pathways to work.  The goal of the New Employer program is to obtain paid work with a new employer.  However, individual goals, services and support will vary. Some clients may have identified job goals, but others will need support to generate new job goals, and require job seeking assistance and/or retraining.
New Employer pathway may involve supporting clients commence a prevocational activity if their capacity to work is not clear.  Prevocational activities may include voluntary work, participating in work skills groups and work trials.  Pre-vocational activities along with vocational counselling can assist to clarify a client’s work capacity, explore realistic employment opportunities and determine future employment pathways.

Criteria

Employment circumstances

• The client is unable to return to their pre-injury employer or was not working at the time of their injury

Diagnosis

• The client has capacity to work towards a work goal

Readiness for work

• The client identifies work as a goal and is clinically ready to commence the program

Case study – Video from ACI website (Julian and Antony)

In Australia, provision of employment services is the responsibility of the Commonwealth Government, whilst provision of health, rehabilitation and accident compensation reside with state governments.

People with brain injury may interact with state health, rehabilitation and insurance bodies, and Commonwealth employment agencies, depending on their needs and how their injury was sustained.

VIP services are funded through existing funding schemes.  Existing funding schemes responsible for funding vocational rehabilitation for clients with a brain injury include:

 Disability Employment Services (DES)

is the Australian Government’s employment service that helps people with disability find work and keep a job. DES is delivered by a mix of large, medium and small, for-profit and not-for-profit organisations that support people with disability.

DES have eligibility criteria for persons returning to work with their same employer or needing support to return to work with a new employer.

 Insurance funded providers

People with TBI in NSW may have compensation claims if their brain injury resulted from an accident at work or in a motor vehicle accident. Or a client may have their own income protection policy that includes rehabilitation services.

The schemes concerned with the provision of rehabilitation services for people with TBI include:

Lifetime Care

• No-fault scheme that funds treatment, rehabilitation and care services for people severely injured in a motor accident in NSW
• Lifetime Care’s legislation and guidelines do not require a client to return to work but acknowledges that returning to work is an important part of rehabilitation. • Does not pay income support to clients.
• Clients may be receiving additional benefits, such as through compulsory third party (CTP), workers compensation insurance, or Centrelink entitlements, all of which may have RTW obligations. There may be RTW obligations and an existing RTW program initiated by the CTP insurer. These clients may be able to access SIRA vocational programs

Workers Care

Workers Care funds treatment, rehabilitation and care for people severely injured at work, and is managed within the Lifetime Schemes • Workers receive income support from the workers compensation insurer. They are required to have a certificate of work capacity with obligations to return to work

Workers Insurance

Workers Insurance provides insurance and care services for people injured at work (excluding severe injury). They receive income support. They are required to have a certificate of work capacity with obligations to return to work Vocational programs for Workers Care and Workers Insurance clients may include work trials, funding for workplace equipment and modifications, training to develop new skills and qualifications, financial support to remove barriers for clients, and financial incentives via the Job Cover Placement Program.

Vocational providers for NSW Workers Care and Workers Insurance programs need to be approved by SIRA to provide return-to-work services.

Compulsory Third Party (CTP) scheme

CTP insurance provides support including treatment and care for anyone injured in a motor vehicle accident in NSW.  SIRA regulates the Compulsory Third Party (CTP) insurance scheme.

Following scheme reforms, for injuries sustained after 1 December 2017:

• All injured people regardless of fault are entitled to up to six months of weekly income payments, medical and treatment expenses.
• Medical treatment and care benefits can continue as required, regardless of fault

• Weekly income benefits can continue for up to 3 years (from the date of the accident). •

CTP clients may be receiving benefits through workers compensation insurance, or Centrelink entitlements, which may have RTW obligations. CTP vocational support programs provide funding and support to help eligible people recovering from a motor accident return to work when assistance is required.
Treatment, rehabilitation and care for people with severe brain injury is managed under Lifetime Care, though they may have a CTP claim related to economic and non-economic loss, depending on eligibility.

Income Protection

• Insurance policies purchased by an individual to protect their income if they are unable to work due to illness or injury.
• Some income protection policies may fund rehabilitation to support returning to work.

 National Disability Insurance Scheme (NDIS)

• The (NDIS) provides reasonable and necessary funding for Australians  with a  disability to support their independence and social and economic participation.   
• The NDIS funds employment supports that include employment related skill building, employment related assessments, and on the job assistance for clients who need ongoing support in the workplace to obtain and retain employment.
• The School Leaver Employment Service (SLES) provides individualised support to help participants transition from school to employment to prepare, look for and gain employment.
• NDIS supports can assist clients become ready to commence a DES program

NDIS have developed an information booklet for clients to assist start the conversation about work.  The booklet, Let’s Talk About Work is on the NDIS site.Note : Some clients may be eligible for more than one funding source, e.g., if they were injured in motor vehicle accident, while also receiving income support payments through Centrelink.