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Australians�billeted�in�a�farmhouse�near�Armentières�make�friends�with��local�children�around�a�water�pump,�June�1916.�(AWM�EZ0036)
DEPARTMENT OF VETERANS’ AFFAIRS ANNUAL REPORT 2015–16
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PART 1 PERFORMANCE
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OUTCOME 1: COMPENSATION AND SUPPORT
DVA maintains and enhances the financial wellbeing and self-sufficiency of eligible persons and their dependants through access to income support, compensation and other support services, including advice and information about entitlements.
Rehabilitation servicesIn 2015–16, DVA’s ongoing Rehabilitation Review Project continued to improve the effectiveness and consistency of the delivery of rehabilitation services for veterans. The project’s positive outcomes have been:
�� the promotion and expansion of psychosocial rehabilitation
�� improved sharing of information between all stakeholders
�� collaborative undertakings by DVA, the Department of Defence (Defence) and service providers.
Process improvementsThe Department undertook a number of activities in 2015–16 to improve the delivery of rehabilitation services. In particular:
�� Goal attainment scaling, a method of measuring outcomes from rehabilitation activities, was introduced in August 2015. It will provide important information for DVA and veterans on the effectiveness of programs.
�� New communications and education services were released for staff, rehabilitation service providers, stakeholders and clients. They included a provider newsletter, provider information sessions, rehabilitation success stories and a social media campaign.
Australian National Audit Office recommendationsThe Australian National Audit Office published the report of its audit of the administration of rehabilitation services under the Military Rehabilitation and Compensation Act 2004 (MRCA) in May 2015. The report made five recommendations: two for Defence, two for DVA, and one shared. In response to the recommendations, DVA will:
�� work jointly with Defence to improve the effectiveness and efficiency of transition services for separating members of the Australian Defence Force (ADF)
�� introduce outcome measures and targets to improve the effectiveness of rehabilitation services, including measures to validate the selection of service providers
�� consider using service-level agreements to manage and monitor provider performance.
DVA continues to collaborate with the Australian Defence Force Rehabilitation Program within Joint Health Command through the joint Defence–DVA bi-monthly rehabilitation integration meetings. These meetings discuss and promote joint Defence and DVA efforts to improve services for ADF members transitioning to DVA services.
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Veterans’ Employment Assistance InitiativeThe Department conducted phase two of its enhanced vocational rehabilitation project, the Veterans’ Employment Assistance Initiative, in South Australia and Victoria from November 2015 to June 2016.
The initiative enhanced vocational rehabilitation within DVA’s whole-of-person rehabilitation programs and identified opportunities to better support clients, employers and rehabilitation providers.
The project involved:
�� greater use by rehabilitation providers of employment specialists with experience of working with former ADF members
�� increased focus on transferring and aligning military skills to civilian employment
�� better communication and provision of information about DVA’s rehabilitation program to former members, employers and rehabilitation providers
�� better promotion of the valuable skills that former members bring to employment.
Phase two monitored the progress of around 100 DVA clients—with a mix of genders, ages and locations—in achieving their vocational goals. Another group of 20 clients with only mental health and/or neurological conditions was also monitored, to determine whether they experienced any specific barriers to returning to the workforce and to identify any special requirements.
The project has given the Department greater insight into the support required by all stakeholders to improve employment outcomes for former members undertaking vocational rehabilitation. Information gained through an evaluation of the project will be used to improve DVA’s national approach to vocational rehabilitation.
Timely engagementIn 2015–16, DVA trialled a timely engagement program with the Australian Defence Force Rehabilitation Program in South Australia and Victoria. The timely engagement program allows DVA to engage with members who are separating from the ADF on medical grounds at the earliest possible time before their separation. This allows for a more effective rehabilitation handover from Defence to DVA. It also allows DVA to identify, prior to the discharge, the types of support the member may require.
Engaging early with medically separating members and improving the rehabilitation support to help injured veterans get job-ready and into meaningful and sustainable civilian work are key priorities for the Department.
Compensation claims processingAs part of its commitment to providing services to veterans and their families in a more strategic, sustainable and efficient manner, the Department is determined to improve the efficiency and timeliness of claims processing.
In 2015–16, the Department met the timeliness targets for compensation claims under the Veterans’ Entitlements Act 1986 (VEA), the Safety, Rehabilitation and Compensation Act 1988 (SRCA) and the MRCA.
DVA introduced a new national rehabilitation and compensation business model in 2015–16. The model aims to improve claims processing timeframes, consistency in decision-making and the overall client experience. It has a capability-based structure that consolidates compensation claims processing to fewer sites. Clients will continue to be able to access information about their claims through face-to-face contact at DVA offices in all states and territories, by telephone or mail, online, or via On Base Advisory Services.
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StreamliningStreamlining provides a simplified path to DVA accepting liability for specific conditions where claimants are able to meet minimum evidence requirements. In 2015–16, the Department analysed compensation claims to determine whether there were additional conditions for which acceptance of liability could be streamlined.
As a result of the analysis, on 5 May 2016 the Repatriation Commission and the Military Rehabilitation and Compensation Commission approved the expansion of streamlining provisions to include a further five conditions:
�� for claims under the MRCA only—chondromalacia patella, and internal derangement of the knee
�� for claims under the MRCA and VEA—malignant melanoma of the skin, tinea of the skin, and pterygium.
This decision will be implemented in early 2016–17.
Alternative dispute resolutionCommencing on 1 January 2015, the Veterans’ Review Board (VRB) conducted a 12-month trial of alternative dispute resolution for all VRB appeals in New South Wales and the Australian Capital Territory.
In early 2016, the Department commissioned an independent review of the trial. The review found that the trial had been a resounding success and that 85 per cent of the cases that completed the alternative dispute resolution process were resolved quickly and without the need for a hearing.
A national roll-out of alternative dispute resolution will commence in 2016–17, in tandem with the implementation of a new claims management system for the VRB.
Single pathway for appealsIn the 2015–16 Budget, the Government announced its intention to refine the administrative appeal paths under the MRCA to a single path, as recommended by the Review of Military Compensation Arrangements in 2011. The Parliament considered legislation to effect the necessary amendments to the MRCA in 2015–16, but no amendments were passed before the Parliament was prorogued in April 2016.
Digital transitionDVA’s digital transition project, aligned with the National Archives of Australia Digital Continuity 2020 Policy, aims to move the Department from paper-based practices to digital processes over three to five years. Since 1 July 2015, DVA has been progressively rolling out initiatives to improve business processes by making smarter use of existing tools. This includes ongoing provision of online services under MyAccount.
DVA’s compensation claims process currently relies heavily on a client’s paper file record. In April 2016, claims processing staff began to shift from storing client information on paper to making better use of DVA’s electronic document management system. Existing paper files are being scanned into the system. Over time, the use of paper files will be removed from the claims process.
Veterans’ needsTo ensure that the changing needs of eligible veterans are addressed by appropriate rehabilitation, compensation and support services, the Department works with the veteran community, and investigates issues that may affect the health and wellbeing of veterans and their families.
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Royal Commission into Institutional Responses to Child Sexual AbuseThe Royal Commission into Institutional Responses to Child Sexual Abuse held a public hearing in June 2016 to inquire into the experiences of men and women who were sexually abused as children in certain divisions of the ADF. A DVA representative appeared as a witness at the hearing.
DVA fully supports the commission’s investigations into how institutions have managed and responded to allegations and incidents of child sexual abuse, and how organisations can achieve best practice in reporting, responding to and addressing such incidents.
DVA takes the issue of child sexual abuse very seriously and has arrangements to manage claims for such abuse as sensitively and efficiently as possible while meeting legislative requirements and providing support and treatment to clients. In response to the hearing, DVA is considering issues raised by the commission.
Health issues for firefighters and fuel-exposed workersFormer ADF firefighters and fuel-exposed workers have expressed concerns about possible health effects arising from their exposures to fuel, solvents and other chemicals. DVA and Defence are working together to initiate and monitor relevant research into these groups.
In 2015–16, the Department commissioned an independent review of the case files of fuel-exposed workers to identify any gaps in the claims process with respect to how claims are investigated and how evidence is examined. The review will continue in 2016–17.
The Department also commissioned an independent review of relevant firefighter studies, looking at any causal associations between the occupational hazards of firefighting and adverse health outcomes. The initial review was completed in 2015–16 and further related research is expected to be finalised before the end of 2016.
The fourth study of mortality and cancer incidence in F-111 fuel tank maintenance workers was completed in the first half of 2016. The report is due to be released later in 2016. The study was conducted by the Australian Institute of Health and Welfare and includes a group of former ADF firefighters.
Priorities for 2016–17DVA’s priorities for rehabilitation, compensation and support in the year ahead are to:
�� meet timeliness targets for claims processing
�� improve business practices and enhance the delivery of compensation and rehabilitation services, including by
- continuing to implement outcomes of the Rehabilitation Review Project
- making changes in response to Australian National Audit Office recommendations
- transitioning from paper-based processes to digital processes
�� implement the expanded eligibility provisions introduced as part of the 2016–17 Budget for non-liability health care for certain mental health conditions
�� support the implementation of alternative dispute resolution and the new VRB case management system
�� examine research studies and provide advice to the Government on
- possible occupational health issues for former ADF firefighters and fuel-exposed workers
- mortality and cancer incidence in F-111 fuel tank maintenance workers
�� progress the MRCA Rehabilitation Long-Term Study, which sits across both research and rehabilitation business areas (described in more detail under Outcome 2).
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PROGRAM 1.1: VETERANS’ INCOME SUPPORT AND ALLOWANCES
ObjectiveProgram 1.1 delivers means-tested income support pensions and other allowances to eligible veterans and dependants under the VEA and related legislation.
Income support pensions and allowances include:
�� age service pension and invalidity service pension (similar to age and disability support pensions paid by the Department of Human Services)
�� partner service pension paid to eligible partners of veterans
�� income support supplement paid to eligible war widows and widowers.
Other forms of income support paid to eligible veterans, members and former members of the ADF or peacekeeping forces include:
�� social security age pension paid to eligible disability pensioners and their partners by DVA as an agent of the Department of Human Services
�� Defence Force Income Support Allowance.
OverviewIncome support provides a regular income for eligible veterans and their dependants with limited means.
Income support payments are determined according to eligibility criteria under the VEA or other legislation. Pensions are subject to an income and assets test and are subject to routine reviews.
While the veteran population is reducing in size, the activities undertaken within Program 1.1 are becoming more complex due to the increasing sophistication of veterans’ and their dependants’ personal financial arrangements and circumstances.
Report on performanceNew claims processedA total of 10,110 claims were processed in 2015–16 compared to 11,494 in 2014–15 (a decrease of 12.0 per cent). The number of cases on hand at the end of the year rose marginally from 735 at 30 June 2015 to 743 at 30 June 2016 (up by 1.1 per cent). Intakes decreased from 11,470 in 2014–15 to 10,118 in 2015–16 (down by 11.8 per cent).
New claim intakes have increased in recent years due to the number of veterans with warlike service returning from overseas deployments. This, combined with new technology enabling clients to lodge claims via an online portal, led to an increase in the number of claims from veterans seeking clarification of their qualifying service status. Qualifying service claims tripled over a five-year period, from 1,954 in 2010–11 to a peak of 6,075 in 2014–15. The 2015–16 intake for qualifying service claims was 5,634—7.3 per cent less than 2014–15. This is reflective of Australia’s scaled-down involvement in overseas conflicts.
Card claims intakes were down by 25.7 per cent, from 2,064 in 2014–15 to 1,534 in 2015–16. Pension claims intakes were down by 11.4 per cent, from 3,331 in 2014–15 to 2,950 in 2015–16. These declines correspond with the reducing numbers of eligible veterans (and their partners) who are reaching their relevant income support pension age.
Figure 3 shows new claims intakes, disposals and cases outstanding for the past five years.
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Figure 3: New claims activity 2011–12 to 2015–16
Intakes Disposals Outstanding at 30 June
0
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4,000
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2011–12 2012–13 2013–14 2014–15 2015–16
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Time to process new claimsNew claims were processed in an average of 23 days in 2015–16. This result is well within the 32-day target and is a significant improvement on 2014–15, when claims were processed in an average of 33 days.
The improvement in timeliness was due mostly to the implementation of the new electronic link between DVA and the Department of Defence. The link enables access to information on veterans with post-1997 ADF service, in real time. This has greatly reduced the time taken to process qualifying service claims lodged by this veteran group, which has had a flow-on effect on the overall processing time.
Figure 4 shows the average processing times for new claims against the target over the past five years.
Figure 4: Average processing time for new claims 2011–12 to 2015–16
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Pensioner initiated reviews processedA total of 77,361 pensioner initiated reviews (PIRs) were processed in 2015–16, compared to 86,502 in 2014–15 (a decrease of 10.6 per cent). Intakes decreased by 12.5 per cent (from 86,652 in 2014–15 to 75,820 in 2015–16). This decrease is directly attributable to the cycle of pensioner obligation mail-outs and the declining pensioner population. Mail-outs occur every second year and there was no mail-out in 2015. The mail-out in June 2016 is expected to result in increased intakes in 2016–17. The amount of work on hand at 30 June 2016 was 38.7 per cent lower than at 30 June 2015 (2,438 cases compared to 3,979 cases).
Figure 5 shows PIR intakes, disposals and cases outstanding for the past five years.
Figure 5: Pensioner initiated review activity 2011–12 to 2015–16
Intakes Disposals Outstanding at 30 June
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Outcomes of pensioner initiated reviewsIn 2015–16, the processing of PIRs resulted in pension increases for 27,793 clients (average fortnightly increase of $49.93 per client) and decreases for 24,107 clients (average fortnightly decrease of $46.76 per client). A further 39,710 clients notified the Department of changes to their personal and financial circumstances which required updates to their records through the PIR process.
The processing of a PIR can affect the pension payments of each member of a pensioner household. The client numbers are therefore always higher than the case numbers since a significant number of income support households contain two people (i.e. the veteran and their partner).
Time to process pensioner initiated reviewsThe processing time for PIRs in 2015–16 was 22 days on average (compared to 21 days in 2013–14 and 2014–15). The focus on finalising older outstanding cases affected the timeliness figure. The average age of outstanding cases was 27 days at 30 June 2016 (compared to 29 days at 30 June 2015).
As with the processing of new claims, the increasing complexity of clients’ personal circumstances and sophistication of their financial affairs, as well as the fluctuating economic climate, contributed to a need for a greater level of investigation within PIRs. Additional time taken during the investigation process helps to ensure clients continue to receive their correct entitlements.
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Figure 6 shows the average times to process PIRs against the target over the past five years.
Figure 6: Average processing time for pensioner initiated reviews 2011–12 to 2015–16
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PriceThe cost per income support beneficiary in 2015–16 was $267, compared to $290 in 2014–15.
QualityThe critical error rate of 4.3 per cent for income support processing in 2015–16 was well within the target of 5 per cent.
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PROGRAM 1.2: VETERANS’ DISABILITY SUPPORT
ObjectiveProgram 1.2 delivers disability pensions, allowances and special purpose assistance to eligible veterans and members of the ADF or peacekeeping forces under the VEA and related legislation.
The program provides compensation to eligible veterans (including Australian merchant mariners) and members of the ADF or peacekeeping forces for the tangible effects of war or defence service. Eligible persons receive disability pensions and ancillary benefits.
OverviewCurrent and former serving defence personnel have access to compensation and benefits under the legislation that is in force at the date an injury or disease related to their service was sustained. Under the VEA, fortnightly disability pensions and allowances are determined based on the medical impairment and lifestyle impacts of the service injury or disease on the individual. The effect on the person’s ability to work is also taken into account, and where there is a resulting loss of earnings the higher rates of disability pensions may be paid. The maximum pension, the Special Rate (totally and permanently incapacitated), may be payable to veterans whose ability to work is severely affected by their service-related conditions.
Disability pensions are not taxable and are not subject to an income or assets test. Veterans with service-related amputation or blindness may be entitled to an additional amount, but the total of the disability pension and the adjustment amount cannot exceed the Special Rate. If the veteran receives a disability pension, they may also be entitled to other ancillary benefits, which include a range of targeted allowances.
In 2015–16:
�� 12,981 compensation conditions were determined with an acceptance rate of 62.2 per cent. In addition, 1,467 applications for increases in disability pension were determined with an acceptance rate of 57.9 per cent. The number of cases on hand at 30 June 2016 was 3,323.
�� The mean time taken to process VEA compensation cases (including disability pension cases, applications for increases in disability pension and war widow(er)’s pension cases) was 72 days.
The forecast reduction in the number of disability pensioners continued, with a drop of 4.3 per cent, from 96,493 at 30 June 2015 to 92,374 at 30 June 2016.
Report on performanceDisability claims There were 13,615 primary disability claims (applications for disability pensions, applications for increases in disability pension and assessment/reviews) received in 2015–16, compared with 12,008 claims in 2014–15.
Most frequently determined conditions and acceptance ratesIn determining the majority of liability cases, the Department refers to the Repatriation Medical Authority Statements of Principles (SOPs) for the relevant condition. Table 6 details the 15 most frequently claimed conditions under the VEA, based on SOP usage, in 2015–16. The 15 most frequently used SOPs cover 61.7 per cent of the conditions determined under the VEA.
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Table 6: Top 15 claimed conditions under the VEA (based on Statements of Principles) 2015–16
Disability Claims accepted
Acceptance rate (%)
Claims rejected
Total claims
Osteoarthritis 1,139 72 446 1,585
Sensorineural hearing loss 1,217 99 8 1,225
Tinnitus 1,145 99 9 1,154
Lumbar spondylosis 657 78 179 836
Solar keratosis 488 99 5 493
Posttraumatic stress disorder 324 68 155 479
Non-melanotic malignant neoplasm of the skin 446 99 3 449
Depressive disorder 188 51 182 370
Alcohol use disorder 148 51 141 289
Cervical spondylosis 40 18 183 223
Hypertension 56 27 148 204
Ischaemic heart disease 93 50 92 185
Acquired cataract 176 99 2 178
Rotator cuff syndrome 40 23 133 173
Sprain and strain 100 61 64 164
Total 6,257 78 1,750 8,007
VEA = Veterans’ Entitlements Act 1986
Time to processThe average time taken to process VEA compensation cases (including disability pension cases, applications for increases in disability pension and war widow(er)’s pension cases) in 2015–16 was 72 days, the same as in 2014–15, against a target of 75 days.
PriceThe unit cost in 2015–16 is reported as the program staff and administrative expenses (departmental) per disability pensioner. The average cost of $427 per disability pensioner in 2015–16 was below the estimate of $455.
QualityDVA is working to improve performance by reinforcing policy and procedures and refining and improving staff training.
Merit reviewsThree levels of merit review activity are open to clients under the VEA. These are:
�� section 31—where a reviewable decision is reviewed by a delegate not involved in the original decision-making process
�� section 135—where the Veterans’ Review Board (VRB) reviews a decision and a report is then prepared by DVA under section 137 of the VEA
�� section 175—where a client who is still dissatisfied with the VRB decision can appeal to the Administrative Appeals Tribunal (AAT) on certain grounds. Following receipt of an appeal by the AAT, DVA prepares a report under section 37 of the Administrative Appeals Tribunal Act 1975 (AAT Act).
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Section 31 reviewsThere were 1,116 section 31 reviews decided in 2015–16. The mean time taken to process was 18 days, which is well within the 40-day target.
VRB reportsIn 2015–16, 93 per cent of reports for the VRB were prepared within the target of 42 days, compared with 87 per cent in 2014–15. The number of outstanding reports to be prepared reduced from 242 at 30 June 2015 to 165 at 30 June 2016.
AAT Act reportsIn 2015–16, 83 per cent of reports for the AAT were prepared within the 28-day target, compared with 88 per cent in 2014–15.
Finalised activityMerit review finalised activity consists of cases completed by DVA review officers under section 31 of the VEA, and the preparation of documentation for the VRB in accordance with section 137 of the VEA and for the AAT in accordance with section 37 of the AAT Act. The total number of finalised review activities in 2015–16 was 3,247, compared with 3,414 in 2014–15.
Table 7 shows a breakdown of activity in the three levels of merit reviews under the VEA for the past three years.
Table 7: Merit review activity under the VEA 2013–14 to 2015–16
Activity 2013–14 2014–15 2015–16
Section 31
Applications received 1,347 1,205 1,129
Days taken to process 15 15 18
Decisions 1,335 1,202 1,116
Affirmed 843 817 837
Varied 462 362 255
Withdrawn 30 23 24
On hand 59 62 75
Section 137 (VRB)
Applications received 2,634 2,058 1,939
Proportion of reports completed within target time frame (%) 95 87 93
Reports prepared1 2,588 2,044 2,016
On hand 228 242 165
Section 37 (AAT)
Applications received 245 271 195
Proportion of reports completed within target time frame (%) 90 88 83
Reports completed 251 262 206
On hand 23 32 21
AAT = Administrative Appeals Tribunal, VEA = Veterans’ Entitlements Act 1986, VRB = Veterans’ Review BoardNote: Additional detail on decisions varied by the VRB is available in the Commissions’ annual reports. 1 Includes reports not progressed to the VRB because the applicants withdrew their appeals.
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PROGRAM 1.3: ASSISTANCE TO DEFENCE WIDOW(ER)S AND DEPENDANTS
ObjectiveProgram 1.3 delivers war widow(er)’s pensions and defence pensions, allowances and special purpose assistance to the dependants of veterans under the VEA and related legislation. Program 1.3 also delivers payments of war widows’ and widowers’ claims for compensation.
OverviewThe war widow(er)’s pension is part of a compensation package made in recognition of the special circumstances affecting veterans and their families. The pension is paid fortnightly to compensate a widowed partner of a veteran, where there was a connection between the veteran’s death and service. Eligible children are provided with financial support through a fortnightly orphan’s pension. These pensions are not taxable and are not subject to an income or assets test. War widow(er)’s pension and orphan’s pension are not affected by other income, except income from other compensation payments.
For veterans most affected by their service-related disabilities, a pension may be automatically granted to their widow or widower or eligible dependants following their death. Widows, widowers and dependants who do not qualify automatically for a pension may lodge a claim to have the veteran’s death accepted as service related.
In 2015–16:
�� 1,374 war widow(er)’s pension cases were determined, with an acceptance rate of 60 per cent. The number of cases on hand at 30 June 2016 was 221.
�� The mean time taken to process widow(er)’s pension cases was 49 days, within the target of 75 days.
The number of war widow(er) pensioners continued to reduce, and has dropped by 24 per cent over four years, from 91,925 at 30 June 2012 to 69,960 at 30 June 2016.
Report on performanceWar widow(er)’s claims There were 1,663 claims for war widow(er)’s pension received in 2015–16, compared with 1,799 claims in 2014–15.
Time taken to processThe mean time to process war widow(er)’s pension cases in 2015–16 was 49 days, compared to 45 days in 2014–15. This was within the target of 75 days.
The mean time to process section 31 reviews was eight days in 2015–16, compared to six days in 2014–15 and within the target of 40 days. See Program 1.2 for further information on section 31 reviews.
PriceThe unit cost in 2015–16 is reported as the program staff and administration expenses (departmental) per war widow or widower. The average cost of $157 per war widow or widower in 2015–16 was above the average cost of $151 in 2014–15.
QualityDVA is working to improve performance by reinforcing policy and procedures and refining and improving staff training.
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PROGRAM 1.4: ASSISTANCE AND OTHER COMPENSATION FOR
VETERANS AND DEPENDANTS
ObjectiveProgram 1.4 delivers other allowances and assistance to eligible veterans and dependants under the VEA and related legislation. Allowances and assistance include subsidised housing loans, home support loans, funeral benefits, prisoner of war ex gratia payments and payments on behalf of Commonwealth and allied countries. The Department also provides assistance to the ex-service community and ex-service organisations through Building Excellence in Support and Training (BEST) grants and the Training and Information Program (TIP).
OverviewUnder the VEA, a one-off payment of up to $2,000 is available to assist with the funeral costs of an eligible Australian veteran or dependant. Assistance may also be provided with transport costs from the place of death to the normal place of residence. (Funeral assistance available under the MRCA and SRCA is reported under Program 1.6.)
In 2015–16, the Defence Service Homes loan scheme continued to provide quality services to veterans and ADF personnel. Under the scheme, individuals may access subsidised housing loans of up to $25,000 and/or home support loans of up to $10,000, depending on their eligibility. Due to the ongoing decline in the client base, the number of housing loans has decreased. This decline is in line with projections, as the scheme membership is limited to those who first enlisted in the ADF before 15 May 1985.
The Defence Service Homes Insurance Scheme (DSHIS) offers home building insurance and, in partnership with QBE Australia, provides a range of other personal insurance products to eligible members of the veteran and ADF communities.
In 2015–16, DSHIS had a surplus of $7.03 million. This result was driven by below budget claims expenses, as the number of claims received arising from catastrophes or significant weather events was less than predicted.
Report on performanceFuneral benefitsTable 8 shows the number of VEA funeral benefits by type paid to eligible people over the past five years.
Table 8: Number of funeral benefits paid by type 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Dependant 235 193 180 138 152
EDA 1,709 1,605 1,445 1,426 1,347
Former POW 113 104 75 61 66
Medical institution 4,225 3,769 3,190 2,746 2,391
Needy circumstances 46 46 36 34 31
Service related 167 141 146 77 79
Special rate/SDA 768 736 673 761 659
Transport 43 34 33 21 29
Total 7,306 6,628 5,778 5,264 4,754
EDA = extreme disablement adjustment, POW = prisoner of war, SDA = Special Disability Allowance
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Funeral benefits processedThe total amount paid reduced from $10.42 million in 2014–15 to $9.40 million in 2015–16. This amount was above the budget estimate of $9.02 million. Figure 7 shows the trend in the cost of funeral benefits over the past five years.
Figure 7: Cost of funeral benefits 2011–12 to 2015–16
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The intake of funeral benefit claims decreased by 11.5 per cent over the past two years, from 6,043 in 2014–15 to 5,346 in 2015–16. This decrease is consistent with the declines in expenditure and in the veteran population in recent years. There were 35 outstanding funeral benefit claims at 30 June 2016.
Figure 8 shows the outcomes for funeral benefit intake, disposal and cases outstanding for the past five years.
Figure 8: Funeral benefits activity 2011–12 to 2015–16
Intakes Disposals Outstanding at 30 June
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Time taken to process funeral benefits claimsThe average time taken to process funeral benefit claims decreased by two days to eight days in 2015–16, which is within the target processing time of 10 days.
Figure 9 shows the average processing times against the target over the past five years.
Figure 9: Average processing time for funeral benefits claims 2011–12 to 2015–16
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QualityThe 1.5 per cent critical error rate in 2015–16 was well within the target of less than 5 per cent.
Table 9 shows the critical error rate for this activity over the past five years.
Table 9: Critical error rate in processing funeral benefit claims 2011–12 to 2015–16 (%)
2011–12 2012–13 2013–14 2014–15 2015–16
Critical error rate 0.5 2.4 3.3 0.0 1.5
Defence Service Homes loans
Subsidy paidDefence Service Homes loans are provided by Westpac Banking Corporation, which is subsidised each month under the Defence Service Homes Act 1918 to offer discounted interest rates to Defence Service Homes clients. The rate is set at 1.5 per cent below the average standard variable home loan rate but is capped at 6.85 per cent a year.
The Westpac interest subsidy totalled approximately $1.030 million in 2015–16, which was less than the previous year’s total of $1.36 million. The benchmark interest rate on which the subsidy amount is based fell during the year, in line with general interest rate changes.
Number of housing loansThe number of housing loans on which the subsidy was paid fell to 8,322 in 2015–16, down 19 per cent on the previous year’s total of 10,296.
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Figure 10 shows the reduction over the past five years in the number of housing loans maintained.
Figure 10: Number of housing loans maintained 2011–12 to 2015–16
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Certificates of entitlement issued There were 332 applications for certificates of entitlement received in 2015–16, 12 less than the 344 received in 2014–15. A total of 281 certificates were issued, comprising 13 for additional advances, 63 for housing support loans and 205 for other forms of assistance.
Timeliness and qualityIn 2015–16, 95 per cent of certificates were issued within 18 days. This was in line with the target of 95 per cent.
No critical errors were identified during 2015–16.
Defence Service Homes Insurance SchemeThe total number of building policies at 30 June 2016 was 58,825, compared with 62,127 in 2014–15. There was a continued decline in the number of policies held by older veterans, partially offset by an increase in policies held by veterans from recent campaigns and ADF members who are eligible under the Defence Home Ownership Assistance Scheme.
ClaimsA total of 7,376 claims were received from DSHIS clients during 2015–16, compared with 9,113 during 2014–15. Claims for damage totalled more than $27.63 million. Major loss events during the year included the bushfires in Western Australia and a number of storms across Australia.
Table 10 shows the percentage of DSHIS insurance claims settled within the settlement targets of three and six months.
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Table 10: Proportion of DSHIS claims settled within targets 2011–12 to 2015–16 (%)
Three-month target Result Six-month target Result
2011–12 80 64 95 81
2012–13 80 75 95 91
2013–14 80 76 95 91
2014–15 80 80 95 94
2015–16 80 72 95 89
DSHIS = Defence Service Homes Insurance Scheme
QualityDSHIS conducts regular surveys of settled claims for quality-assurance purposes. During 2015–16, 1,200 claims were reviewed. Feedback indicated that 97 per cent of clients surveyed were satisfied with the way in which their claim had been handled.
During 2015–16, eight matters were referred to the Financial Ombudsman Service for resolution. This represented less than 0.5 per cent of claims received.
Veterans’ access through community agenciesDVA provides information services and community support through more than 150 contracted agents across regional Australia. Agencies include the Department of Human Services (DHS), Service Tasmania, the Queensland Government Agent Program, and Community Resource Centres in Western Australia.
Following a review in 2014, arrangements with DHS were streamlined in 2015. A new payment model was agreed, the schedule under the memorandum of understanding with DHS for access to information services was updated, and contracts with other providers were simplified.
Table 11 shows the number of contacts made through agencies and their costs from 2011–12 to 2015–16.
Table 11: Number and cost of contacts through agencies 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Contacts (no.) 21,194 23,805 18,743 14,537 10,073
Expenditure ($) 873,784 965,725 934,632 686,581 262,738
Building Excellence in Support and TrainingEligible people often receive advice on DVA services from veterans’ pensions and welfare officers who work, in many cases voluntarily, for ex-service organisations. Those officers are generally themselves veterans or family members of veterans, which allows them to bring their experiences and knowledge of service life to their work and reflects the principle that veterans prefer to speak to other veterans when they need help or advice.
BEST is an annual grants program that supports pensions and welfare officers by assisting ex-service organisations to cover a range of administrative costs.
In recent years, the Department has made changes to the program to better meet the needs of veterans and ex-service organisations. The reforms were implemented following detailed discussions with the ex-service community, in particular with its peak body, the Ex-Service Organisation Round Table.
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In the 2015–16 funding round, a total of $3.778 million was provided to 126 ex-service organisations under BEST. This compares with $3.772 million provided to a total of 141 organisations in 2014–15. The amount included $1 million restored to the program in 2014–15.
The workload funding formula continued to be refined. The formula takes into account the complexity and time involved in the claims and welfare work undertaken by ex-service organisations and recognises an organisation’s entire contribution by including the work done by both paid and volunteer officers.
Table 12 shows the total allocation and numbers of grants made under BEST in the past four financial years, along with allocations for future years.
Table 12: Building Excellence in Support and Training allocations and grants 2012–13 to 2017–18
2012–13 2013–14 2014–15 2015–16 2016–17 2017–18
Total allocation ($m) 2.673 2.788 3.772 3.778 3.848 3.885
No. of grants approved 155 135 141 126 – –
Training and Information ProgramTIP training is provided to welfare and pension practitioners to enable them to deliver advocacy services to assist current and former serving members of the ADF and their dependants with accessing their entitlements from DVA and other organisations. Specialised training is also provided to advocates who assist with appeals from claimants that are referred to the Veterans’ Review Board and the Administrative Appeals Tribunal.
In 2015–16, 139 TIP courses were conducted for 1,753 participants.
The Advocacy Training and Development Program will replace TIP from 1 July 2016. The new program will place greater emphasis on a training model that is nationally consistent, has competency and accreditation standards and further utilises e-learning tools.
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PROGRAM 1.5: VETERANS’ CHILDREN EDUCATION SCHEME
ObjectiveProgram 1.5 provides financial assistance to eligible students under the VEA Veterans’ Children Education Scheme (VCES) and the MRCA Education and Training Scheme (MRCAETS) to assist with their education needs.
OverviewUnder the VCES and MRCAETS schemes, education allowances are paid to eligible children of ADF members who died or were severely injured as a result of service.
The schemes also provide for special assistance, student support services, guidance and counselling for eligible children to help them achieve their full potential in education and career training. The schemes cater for children undertaking primary, secondary and tertiary study and are normally provided only for full-time study within Australia.
Report on performanceThe number of eligible students receiving education allowance increased from 2,484 students at 30 June 2015 to 2,491 students at 30 June 2016.
In 2015–16, the Department conducted a formal survey to assess the quality of its education schemes. A high percentage of respondents rated the level of service as good or very good and there was also a high satisfaction rating with the time taken to receive benefits. The Department also took a number of actions to improve awareness of the schemes’ benefits, including writing to all education scheme recipients to provide information about the range of services available.
The key performance indicator of a critical error rate of less than 5 per cent was not met. Only a small sample of cases (60) was examined, all errors were administrative in nature and only one error had any financial impact. The case-sampling criteria are under review to ensure that more aspects of the scheme are reviewed.
Long Tan Bursary SchemeThe Long Tan Bursary Scheme was established in 2000 in response to the findings of the Vietnam Veterans Health Study. Since then, bursaries have been available to Vietnam veterans’ children who have Australian residency status and who are enrolled or plan to enrol in post-secondary education in Australia.
The scheme is administered by the Australian Veterans’ Children Assistance Trust on behalf of DVA.
Bursaries of up to $9,000 each are awarded over a three-year period. Students receive their first bursary payment once acceptance of the award is notified, usually in March, and monthly payments thereafter.
In 2015–16, 50 applications were received from eligible children. From this group, 34 bursaries were awarded for courses as diverse as science, architectural design, law and nursing.
Further information about the scheme is available on the DVA website at www.dva.gov.au/consultation-and-grants/grants.
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PROGRAM 1.6: MILITARY REHABILITATION AND COMPENSATION ACTS
PAYMENTS—INCOME SUPPORT AND COMPENSATION
ObjectiveProgram 1.6 provides compensation to current and former members of the ADF and their dependants under the SRCA, the MRCA and related legislation.
OverviewThe SRCA and MRCA provide injured ADF members with economic and non-economic benefits to support their return to health, work and independence.
The compensation component provides injured persons with payments for permanent medical impairment. Members and former members with an inability to work or reduced capacity to work because of injury or disease connected with service may access incapacity payments to cover their loss of earnings. The objective is to improve the wellbeing and social and economic participation of injured service personnel.
Compensation is also available for eligible dependants. Widowed partners and eligible children may receive financial support, and the MRCA also provides health care and other ancillary benefits.
In 2015–16:
�� 5,920 compensation conditions were determined under the SRCA, with an acceptance rate of 60.9 per cent, and the mean time taken to process SRCA liability cases was 118 days.
�� 14,527 compensation conditions were determined under the MRCA, with an acceptance rate of 71.4 per cent, and the mean time taken to process MRCA liability cases was 117 days.
Report on performanceSafety, Rehabilitation and Compensation Act
LiabilityThere were 7,343 SRCA liability claims received in 2015–16.
In 2015–16, 5,920 compensation conditions were determined, with an acceptance rate of 60.9 per cent.
The number of cases on hand at 30 June 2016 was 2,133.
Permanent impairment There were 4,385 SRCA permanent impairment claims received in 2015–16, compared to 3,837 claims in 2014–15.
In 2015–16, 3,159 permanent impairment cases were determined, with an acceptance rate of 31.6 per cent.
A total of 1,055 SRCA one-off lump-sum payments for compensation for permanent impairment were made to clients in 2015–16, compared to 1,260 in 2014–15.
The number of cases on hand at 30 June 3016 was 1,938.
IncapacityIn 2015–16, a total of $72.8 million in SRCA incapacity compensation was paid to 2,160 payees, compared to $72.7 million and 2,273 payees in 2014–15. This represents a 0.3 per cent increase in expenditure and a 5.0 per cent reduction in the number of payees.
Incapacity payees receive benefits during the year for differing periods according to the length of time they are unfit for service or work and whether or not they are on a current rehabilitation program.
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Compensation for dependants In 2015–16, 79 dependants of seriously injured or deceased former or serving ADF members received lump-sum compensation payments totalling $20.5 million, compared to 62 dependants and $14.3 million in 2014–15.
TimelinessAgainst a target of 120 days, the mean processing time for SRCA liability cases was 118 days in 2015–16, a 15.7 per cent decrease when compared to 140 days in 2014–15. The improvement reflects the success of ongoing DVA initiatives to improve case management practices, business processes and communication with clients.
QualityDVA is working to improve performance by reinforcing policy and procedures and refining and improving staff training. The funding in the 2016–17 Budget for improving processing systems will include incapacity payments processing and is expected to improve the quality of transactions.
Military Rehabilitation and Compensation Act
LiabilityThere were 8,472 MRCA liability claims received in 2015–16, with 6,448 claims in 2014–15.
In 2015–16, 14,526 compensation conditions were determined, with an acceptance rate of 71.4 per cent. In previous years MRCA liability acceptance rates were based on claims accepted as a percentage of claims determined. Therefore a claim with multiple conditions was deemed to be accepted if liability for one or more of the claimed conditions was accepted.
The number of cases on hand at 30 June 2016 was 2,584.
Permanent impairmentThere were 4,231 MRCA permanent impairment claims received in 2015–16, compared to 4,315 claims in 2014–15.
In 2015–16, 3,629 cases were determined, with an acceptance rate of 58.9 per cent.
A total of 1,846 MRCA one-off lump-sum payments for compensation for permanent impairment were made to clients in 2015–16, compared to 1,580 payments in 2014–15.
The number of cases on hand at 30 June 2016 was 2,008.
IncapacityIn 2015–16, a total of $112.5 million was paid to 3,629 payees for MRCA incapacity compensation, compared to $102.2 million to 3,419 payees in 2014–15. This represents a 10.1 per cent increase in expenditure and a 6.1 per cent increase in payees. It continues the forecasted steady growth of the MRCA as potential MRCA payee numbers increase.
Compensation for dependants In 2015–16, 54 dependants of seriously injured or deceased former or serving ADF members received lump-sum compensation payments totalling $9.3 million, compared to 53 dependants and $8.8 million in 2014–15.
TimelinessAgainst a target of 120 days, the mean processing time for MRCA liability cases was 117 days in 2015–16.
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QualityDVA is working to improve performance by reinforcing policy and procedures and refining and improving staff training. The funding in the 2016–17 Budget for improving processing systems will include incapacity payments processing and is expected to improve the quality of transactions.
Most frequently determined conditions and acceptance ratesIn determining the majority of liability cases, the Department refers to the Repatriation Medical Authority SOPs for the relevant condition. Table 13 details the 15 most frequently claimed conditions under the MRCA, based on SOP usage, in 2015–16. The 15 most frequently used SOPs cover 58.1 per cent of the conditions determined under the MRCA.
Table 13: Top 15 claimed conditions under the MRCA (based on Statements of Principles) 2015–16
Condition Claims accepted
Acceptance rate (%)
Claims rejected
Total claims
Sprain and strain 1,303 89 167 1,470
Osteoarthritis 866 84 169 1,035
Tinnitus 781 98 20 801
Depressive disorder 588 89 69 657
Fracture 554 86 92 646
Lumbar spondylosis 523 84 99 622
Sensorineural hearing loss 428 71 176 604
Rotator cuff syndrome 458 89 58 516
Posttraumatic stress disorder 395 84 77 472
Joint instability 264 84 50 314
Labral tear 217 77 65 282
Chondromalacia patella 258 98 5 263
Intervertebral disc prolapse 157 60 106 263
Shin splints 219 85 39 258
Acute meniscal tear of the knee 83 34 159 242
Total 7,094 84 1,351 8,445
MRCA = Military Rehabilitation and Compensation Act 2004
Merit reviewsTwo levels of merit review activity are available to clients under the SRCA and the MRCA: reconsiderations and appeals. When a SRCA or MRCA client requests a reconsideration of a decision, a merit review is conducted by a delegate not involved in the original decision-making process.
Alternatively, an MRCA client may choose to have their original determination reviewed by the Veterans’ Review Board. (Further information about merit reviews through the Veterans’ Review Board is contained in the board’s annual report.)
Clients who are dissatisfied with the outcomes of reviews by the Department or the Veterans’ Review Board may appeal to the Administrative Appeals Tribunal.
Table 14 summarises SRCA and MRCA merit review activity over the past three years. More information on decisions of the Administrative Appeals Tribunal is provided in the ‘External scrutiny’ section in Part 2 of the annual report.
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Table 14: SRCA and MRCA merit reviews and outcomes 2013–14 to 2015–16
Activity 2013–14 2014–15 2015–16
SRCA
Requests for reconsideration received 810 913 845
Requests for reconsideration decided 718 850 976
Decisions affirmed at reconsideration 437 520 682
Applications to the AAT 145 118 155
MRCA
Requests for reconsideration received 427 485 554
Requests for reconsideration decided 432 518 569
Decisions affirmed at reconsideration 148 178 222
Applications to the VRB (s.137) 482 582 601
Applications to the AAT 76 71 97
AAT = Administrative Appeals Tribunal, MRCA = Military Rehabilitation and Compensation Act 2004, SRCA = Safety, Rehabilitation and Compensation Act 1988, VRB = Veterans’ Review Board
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PROGRAM 1.7: ADJUSTMENT TO THE MILITARY REHABILITATION AND COMPENSATION
ACTS LIABILITY PROVISION—INCOME SUPPORT AND COMPENSATION
Objective Program 1.7 provides an updated actuarial assessment of the movement in the liability for income support and compensation under the SRCA and the MRCA.
OverviewThis program represents the movement in the long-term liability based on the advice of the Australian Government Actuary. The movement is recognised as an expense in DVA’s financial statements. Due to the nature of the provision, significant adjustments can occur between years. Movement for the liability for the past two years is shown in Table 15.
Table 15: Movement in SRCA and MRCA liability under Outcome 1 for 2014–15 and 2015–16
2014–15 2015–16
SRCA($m)
MRCA($m)
Total($m)
SRCA($m)
MRCA($m)
Total($m)
Opening balance adjustment 346.0 343.4 689.4 –12.8 125.2 112.4
Permanent impairment –30.1 –6.4 –36.5 –33.5 275.3 241.8
Benefits for eligible dependants –13.5 3.6 –9.9 –14.4 3.2 –11.2
Income maintenance payments 0.0 199.6 199.6 –50.7 237.3 186.6
Incapacity payments –44.9 0.0 –44.9 –3.2 0.0 –3.2
Medical exams –3.0 9.6 6.6 –0.2 11.9 11.7
Other –2.1 3.1 1.0 –2.3 3.3 1.0
Interest rate 140.1 295.3 435.4 237.7 627.8 865.5
Total expenses 392.5 848.2 1,240.7 120.6 1,284.0 1,404.6
MRCA = Military Rehabilitation and Compensation Act 2004, SRCA = Safety, Rehabilitation and Compensation Act 1988
Report on performance The Department’s provision for compensation-related payments increased from $5.3 billion in 2014–15 to $6.7 billion in 2015–16.
This provision recognises the obligations that the Department has to veterans and current serving military personnel for benefit payments that will occur in the future.
After a long period of predominantly peacetime service, the ADF has undertaken a range of extensive and intensive operations since 1999 that have involved significant numbers of servicemen and servicewomen. Deployments of both permanent and reserve forces have exposed an increasing number of ADF personnel to risks of injury and death, and the Government to an increasing liability for future costs of rehabilitation, health care and compensation.
It is important to note that the provision takes into account personal benefits and health care for clients over the next 80 years. It is expected that the estimate will be adjusted each year as claims are received and additional information about claims patterns becomes available.
The increase in 2015–16 resulted from a number of factors, including an opening balance adjustment of $112.4 million due to modelling lower than expected exit rates for people in incapacity payments, and growth in the numbers and average costs of permanent impairment claims and income maintenance payments. The change in interest rates also contributed to the increase.
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OUTCOME 2: HEALTH
The Department works with public and private providers to ensure that eligible people have access to high-quality health and other care services, with an emphasis on early intervention, prevention and treatment. DVA’s approach is informed by targeted research on the health and wellbeing of members and their families.
Mental healthFor the past five years, DVA has strongly focused on supporting the mental health of the ex-service community. This reflects the high operational intensity of service in the ADF since 1999.
DVA spends around $187 million a year on a range of services and treatments to provide mental health support. This includes online information and support tools; GP services; psychology and social work services; psychiatric services; pharmaceuticals; and hospital services, including trauma recovery programs for posttraumatic stress disorder (PTSD). Funding for mental health treatment is demand-driven and not capped.
In addition to compensation arrangements for service-related conditions, DVA can pay for certain mental health treatments for eligible current and ex-serving members of the ADF whatever the cause. From July 2016, eligibility for these arrangements will be extended to all current and ex-serving permanent members of the ADF. These non-liability arrangements support early intervention and cover anxiety disorder, depressive disorder, PTSD, alcohol use disorder and substance use disorder.
ClientsTable 16 shows the numbers of veterans living with accepted mental health conditions, under service-related compensation arrangements (by different cohorts) and under non-liability arrangements. The table also shows how the numbers in each group changed over the five years from 2011 to 2016.
Table 16: Veterans with accepted mental health conditions, June 2011 and June 2016
Category June 2011 June 2016 Change (%)
Service-related disabilities
Pre-Vietnam conflicts 15,181 7,418 –51
Vietnam War 26,380 25,474 –3
1972–99 conflicts 1,049 1,397 +33
Post-1999 conflicts 1,480 3,981 +169
Peacetime service only 5,921 8,802 +49
Total service-related disabilities 48,462 45,236 –7
Non-liability conditions 12,984 18,636 +44
Net total veterans 51,224 50,794 –1
Note: ‘Veterans’ includes anyone with service in the Australian Defence Force. Some veterans have both service-related disabilities and non-liability conditions. The ‘Net total veterans’ includes veterans in both categories.
The net total number of members and former members of the ADF with service-related mental health disabilities declined over the five years, from 48,462 to 45,236, due mainly to the decline in the number of veterans from conflicts prior to the Vietnam War. The Vietnam War cohort continues to have the highest number of mental health disabilities. Numbers increased among those who served in conflicts since the Vietnam War and those with peacetime service only. DVA expects that this type of growth will continue over the next five years.
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The increase in the number of people covered by non-liability mental health arrangements, from 12,984 to 18,636, is partly due to the widening of eligibility and addition of alcohol use disorder and substance use disorder for those arrangements in July 2014. DVA has also encouraged early access to mental health care, including through these non-liability arrangements.
A major theme of DVA’s approach to mental health is early intervention: if anyone is worried about how they are feeling or coping, DVA encourages them to seek help as soon as possible. This can lead to earlier and more successful recovery.
E-mental healthRecognising that contemporary veterans use the internet and mobile devices to source information, DVA uses online resources to encourage them to take action to address any mental health concerns. In 2015–16:
�� The website High Res, which complements the High Res app, was released to help veterans manage stress and build resilience.
�� The Operation Life app, which complements the website Operation Life Online, was released to help those at risk deal with suicidal thoughts. It is recommended to be used with the support of a clinician.
�� The website The Right Mix, which complements the On Track with The Right Mix app, was rebuilt to reflect the latest research into the effects of alcohol consumption and to offer goal-setting tools based on motivational interviewing principles. The Right Mix helps veterans to find the right balance of alcohol, diet and exercise.
DVA also released e-mental health resources for health professionals to facilitate the delivery of quality care to veterans. This included:
�� the PTSD Psychological Interventions e-learning program
�� an update of the Understanding the Military Experience e-learning program
�� updated assessment measures in the Veteran Mental Health Consultation Companion app
�� a guide to using the Operation Life app as an adjunct to professional treatment.
CounsellingThe Veterans and Veterans Families Counselling Service (VVCS) provides free, confidential, 24/7 counselling and support for eligible current and former ADF members and their families.
VVCS’s client numbers are increasing and its demographics are changing. To ensure that future client needs will be met, VVCS has undertaken continuous quality improvement processes to enhance its national service delivery system.
In 2015–16, VVCS further embedded its secure records management system, updated internal clinical and governance policies, and strengthened its workforce capability to further embed evidence-based therapies and practices into its service offering. To improve client access, the service delivery model was changed in some locations and a trial of online counselling commenced for clients who are unable to visit a counsellor in person.
Peer supportIn another innovative approach to delivering mental health support, DVA commenced a pilot of the Peer to Peer Support Network program in 2015–16. The program aims to assist the recovery of clients with a mental health condition by matching individual clients with peer support mentors. The pilot locations are Townsville and Sydney. Training workshops were conducted for mentors, followed by the matching of peers with mentors. An evaluation of the pilot will start in late 2016.
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Mental and social health policyIn October 2015, on World Mental Health Day, the Government released the Social Health Strategy 2015–2023 for the Veteran and Ex-Service Community and the Mental and Social Health Action Plan 2015 and 2016. The social health strategy aims to improve quality of life among the veteran community by preventing illness, fostering social connectedness and enhancing health and wellbeing. The new strategy and plan complement the Veteran Mental Health Strategy 2013–2023, which continues to be implemented.
In March 2016, the Senate Foreign Affairs, Defence and Trade References Committee delivered the report of its inquiry into the mental health of ADF members and veterans. DVA’s submissions to the inquiry are available from the committee’s website.
Dental and allied healthAs part of a 2015–16 Budget measure that paused the indexation of fees for items on DVA’s dental and allied health schedules, the Department commenced a review of these arrangements to ensure that they continue to support appropriate, high-quality and effective services for the veteran community. The review will complement a review of the Medicare Benefits Schedule being undertaken by the Department of Health.
In late 2015, DVA invited peak associations representing dental and allied health providers to make submissions to the review and nominate clinicians to participate in working groups. The working groups also include representatives from the veteran community, nominated by members of the Ex-Service Organisation Round Table.
The working groups met for the first time in March 2016. The review will continue in 2016–17.
Research and developmentDVA strategically invests in research to inform and improve the effectiveness of the health care and related services available to veterans.
Transition and Wellbeing Research ProgrammeDVA and Defence have invested in the Transition and Wellbeing Research Programme to examine the impact of military service on the mental, physical and social health of serving and ex-serving ADF members who have deployed to contemporary conflicts. The research is also investigating the impact of military service on the health and wellbeing of families. The program comprises three major studies: the Mental Health and Wellbeing Transition Study, the Impact of Combat Study, and the Family Wellbeing Study.
Data collection for the program commenced in June 2015 and ended in February 2016. Almost 12,000 current and ex-serving ADF personnel and reservists participated in the Mental Health and Wellbeing Transition Study and the Impact of Combat Study. More than 1,400 of their family members participated in the Family Wellbeing Study.
The program is expected to deliver eight reports progressively, commencing in mid-2017.
MRCA Rehabilitation Long-Term StudyThe MRCA Rehabilitation Long-Term Study is a joint DVA–Defence project to examine the long-term effectiveness of rehabilitation offered under the MRCA.
In February 2016, DVA engaged a consortium to develop a framework containing potential models for the study. The consortium is led by researchers from the Sax Institute and the Social Policy Research Centre (University of New South Wales). DVA and Defence will select the preferred model in late 2016. There will be a procurement process in 2017 for the study itself.
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Comparison of post-1990 outcomes in the United States and AustraliaIn 2015–16, researchers in the United States and Australia collaborated to conduct a comparative literature review of health and social outcomes among veterans of post-1990 conflicts. The study found that rates of PTSD were generally similar among veterans in the two countries, and that rates of traumatic brain injury among veterans who served in Afghanistan and/or Iraq were relatively low in Australia compared to those reported in the United States.
Research on PTSD treatmentIn 2015–16, the National Health and Medical Research Council awarded a four-year grant to enable Phoenix Australia—Centre for Posttraumatic Mental Health to work with DVA and Defence on research to improve the treatment of PTSD through a trial of intensive prolonged exposure therapy.
Prolonged exposure therapy is the gold standard, evidence-based treatment for PTSD. In its current form it requires weekly treatment for 10 weeks, which can pose significant barriers to access and uptake for serving and former ADF members. This trial will assess whether an intensive delivery of prolonged exposure therapy, involving 10 sessions over a two-week period, will deliver outcomes comparable to those of standard prolonged exposure.
Research on suicideDVA is working with Defence and the Australian Institute of Health and Welfare on a study to achieve a more definitive understanding of the incidence of suicide among former members of the ADF, including how it compares with the incidence of suicide in the general Australian population. Preliminary results are expected by the end of 2016.
To complement the study, DVA commissioned a literature review of international veteran experiences with the aim of providing a comparison point for suicidal behaviour and ideation among Australian ex-serving personnel. The review found that there has been no research that would allow a comparison between the Australian ex-serving population and the general Australian community, and that international studies have limited applicability to Australian veterans.
Research on homelessnessIn 2015–16, DVA contracted the Australian Housing and Urban Research Institute to develop a research study that will lead to a clearer understanding of the scale, location and nature of homelessness among Australian veterans. This will include working towards collecting data on histories of ADF service among people who are homeless, and integrating veteran-specific support services with the support offered by mainstream and specialist providers of services for the homeless.
ProcurementOver the past decade, DVA has developed a number of methods to improve the way it contracts service providers. One example is the ‘statutory registration’ model used for engaging doctors and allied health professionals, which involves minimal paperwork. However, DVA still procures services from certain industries through a traditional tender process, which is necessary where competition is used to achieve value for money.
The traditional tender process is not efficient when DVA seeks to engage with all providers within an industry who accept DVA’s terms and conditions. To reduce the administrative burden on those providers, DVA introduced a simplified tender model in September 2015. It allows all qualified providers to apply using a standard contract, as long as they are willing to accept DVA’s terms and conditions.
DVA has used the simplified model to procure private hospital, community nursing and medical-grade footwear services. The model has been well received by providers.
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Priorities for 2016–17DVA’s priorities for health in the year ahead are to:
�� implement 2016–17 Budget measures in relation to
- veteran suicide awareness and prevention programs, including continuation of Operation Life
- support services for children of veterans
�� implement government election commitments to establish the Phoenix Australia institute on veteran mental health care, further extend access to VVCS, and help homeless veterans
�� finalise, disseminate and implement the veterans’ mental and social health action plan for 2017–18
�� continue to support implementation of whole-of-government reform activities, such as aged care reforms and the National Disability Insurance Scheme
�� continue to improve the use of data and evidence in the development and review of policy, in program design, and in compliance and assurance activities
�� progress the dental and allied health review
�� manage the Applied Research Program and ongoing major research studies, including
- releasing the report of the fourth study of mortality and cancer incidence in aircraft maintenance personnel
- continuing the Transition and Wellbeing Research Programme
- progressing the MRCA Rehabilitation Long-Term Study.
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PROGRAM 2.1: GENERAL MEDICAL CONSULTATIONS AND SERVICES
ObjectiveProgram 2.1 provides access to general and specialist medical and dental services to entitled DVA clients. The Department has arrangements in place with medical and dental practitioners to deliver a comprehensive range of services throughout Australia.
OverviewThe Department provides access to a wide range of clinically relevant medical and dental services to enhance the physical wellbeing and quality of life of DVA clients. This program utilises DVA health treatment cards: the Gold Card for ‘All conditions within Australia’ and ‘Totally and permanently incapacitated’, and the White Card for ‘Specific conditions’. The cards are broadly accepted by health care providers for the provision of general medical consultations and services throughout Australia.
At 30 June 2016, 200,245 DVA clients were eligible to receive treatment via a Gold Card or a White Card. During 2015–16, around 185,300 DVA clients collectively accessed an estimated 9.9 million medical and dental services.
The majority of payments to medical providers are made by DHS on behalf of DVA.
Report on performanceMedical services
Number of medical servicesAt the time of reporting, 9.0 million medical services had been provided and billed for 2015–16, compared to 9.4 million at the time of reporting in 2014–15. Current estimates are for 9.2 million services for the full year, a 4.2 per cent decrease compared to 9.6 million for 2014–15.
Percentage of veteran population using medical servicesIn 2015–16, 92.4 per cent of the veteran population used medical services, compared to 93.4 per cent in 2014–15.
PriceAt the time of reporting, the average cost per medical service was $80.08 in 2015–16 compared with $80.20 in 2014–15.
Table 17 shows the number of medical services provided and the average cost over the past five years, as reflected in current data.
Table 17: Number of medical services provided and average cost 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Number of services 10,971,769 10,481,504 10,035,901 9,611,653 8,979,773
Average cost per service ($) 73.94 76.68 78.85 80.20 80.08
Proportion of treatment population1 (%) 95.2 94.9 93.5 93.4 92.4
Note: Figures for previous years have been updated to reflect latest available claims data.1 Treatment population is measured at 30 June for each financial year.
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Dental servicesAt the time of reporting, 679,065 dental services had been provided and billed for 2015–16, compared to 704,385 at the time of reporting in 2014–15. Current estimates are for 692,495 services for the full year, a 3.6 per cent decrease compared to 718,316 for 2014–15.
Table 18 shows the number of dental services provided and average cost over the past five years.
Table 18: Number of dental services provided and average cost 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Number of services 778, 934 784, 576 759,159 718,316 679,065
Average cost per service ($) 128.65 132.76 136.38 136.64 135.04
Proportion of treatment population1 (%) 38.5 38.7 37.7 37.3 36.6
Note: Figures for previous years have been updated to reflect latest available claims data.1 Treatment population is measured at 30 June for each financial year.
Service items processed by the Department of Human ServicesDHS processes payments on behalf of DVA to providers of medical, allied health, community nursing and hospital services (see Program 2.2 for a full report on hospital services, Program 2.4 for details of community nursing services and Program 2.5 for allied health services).
A total of $2.05 billion was paid by DHS to DVA providers in 2015–16, compared to $2.09 billion in 2014–15.
Table 19 compares the number of items processed with the treatment population and average age at 30 June for the past five years.
Table 19: Health services items and treatment population 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Items processed (millions) 21.2 20.6 20.0 19.0 18.3
Treatment population 233,800 223,181 217,562 208,181 200,245
Average age of clients (years) 76.2 75.8 74.8 74.1 73.4
Services per client 91 92 92 91 91
Business activity
Coordinated Veterans’ Care programThe Coordinated Veterans’ Care (CVC) program is in its sixth year of operation. At 30 June 2016, 33,298 Gold Card holders had been enrolled since the program commenced. Approximately 23,000 are currently enrolled.
Participants report feeling more confident to manage their chronic disease through health literacy, support and coordination of their health conditions. In a survey of general practices conducted in 2015–16, 90 per cent of respondents indicated a high level of satisfaction with CVC and their intent to continue to provide CVC services.
A number of evaluations were undertaken on the program objectives and performance. The reviews confirmed that the overall implementation of CVC has been successful and the data from the reports show that the program design reflects evidence-based best practice for chronic disease management.
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TelemonitoringDVA’s In-Home Telemonitoring for Veterans Trial has been running for over two years. The trial is a technology-based extension to the CVC program, and is being piloted in more than 50 general practices across four trial sites (the North Coast and New England regions of New South Wales, Darling Downs in Queensland and Bayside in Victoria).
The trial aims to test the effectiveness of telemonitoring as a complement to conventional health care for chronically ill veterans and war widows. Trial participants take their vital signs with the telemonitoring equipment installed in their homes and can use it for video consultations with their GP or nurse.
At its peak, there were over 250 veterans and war widows participating in the trial. More than 80 per cent of participants chose to continue on the trial extension, attesting to its popularity and perceived benefit.
There have been a number of potentially life-saving interventions from the trial. Early findings indicate greater understanding and involvement for many veterans in managing their own health conditions and increased peace of mind. The trial runs until the end of 2016.
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PROGRAM 2.2: VETERANS’ HOSPITAL SERVICES
ObjectiveProgram 2.2 provides access to hospital services for entitled clients through arrangements with hospitals in both the private and the public sectors.
OverviewDVA clients have access to a broad range of quality inpatient and outpatient services in private hospitals, day procedure centres and mental health hospitals, along with all public hospitals operated by state and territory governments.
During 2015–16, DVA completed a procurement process for private hospital and mental health services beyond 30 June 2016. As part of this procurement, proposals for innovative models of care were actively encouraged, particularly those demonstrating a strong evidence base for improving clinical outcomes, preventing unplanned readmissions and avoiding premature admissions to permanent care. DVA aimed to purchase hospital-based services that are closely matched to the diverse and changing needs of its clients.
Negotiations on new arrangements with state and territory health departments were ongoing during 2015–16. DVA’s new public hospital arrangements are based on the pricing framework of the Independent Hospital Pricing Authority and will provide a consistent, national framework, resulting in reduced administration for DVA and the jurisdictions.
Private hospital performance is monitored annually against a set of clinical indicators as well as feedback provided through the DVA Patient Satisfaction Survey.
In 2015–16, the total expenditure for hospital services continued to decrease, again reflecting decreases in the size of the treatment population, the total number of hospital separations, total occupied bed days and average length of stay.
Report on performanceThe number of DVA clients accessing hospital services fell during 2015–16. In total, 67,900 clients accessed private hospital services (all services), with an estimated total of 180,339 separations. In the public hospital sector, an estimated 36,640 clients accessed services (admissions only), with an estimated total of 87,110 separations.
In 2015–16, the total administered expenditure for public and private hospitals was $1.528 billion. This represented a decrease of 6.2 per cent compared to $1.629 billion spent in 2014–15.
Private and public hospital separationsTable 20 shows the number of private and public hospital separations over the past five years.
Table 20: Number of private and public hospital separations 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Private hospital separations 209,706 200,937 195,298 187,570 180,339
Public hospital separations 109,945 103,326 96,461 91,001 87,110
Note: Reconciliation of public hospital data is usually completed 12 months in arrears. Private hospital data are considered complete three months in arrears. Therefore, the number of hospital separations for 2015–16 is an estimate only, and earlier years’ separations have been updated.
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Average cost per private and public hospital separationThe estimated average cost per separation, for combined private and public hospital separations, was $5,807 in 2015–16, compared to the estimate of $5,522 in 2014–15. The increase was due to the price increases that were implemented during the year, reflecting increases in costs categories such as hospital staffing and general increases in the cost of medical technology.
Administered expenditure is an aggregate of payments made in the year rather than payment for services provided in the year. Therefore, it has not been used to determine average cost per separation. Public hospital expenditure includes payments for non-inpatient services and is an estimate because payments to state health departments for 2015–16 public hospital services have not been finalised.
Percentage of treatment population using private and public hospital servicesDuring the year, approximately 33.9 per cent of the treatment population used private hospital services and an estimated 18.3 per cent of the treatment population used public hospital services (admissions only), as reflected in current data.
Table 21 shows the proportion of the treatment population using private and public hospital services over the past five years. The measure records the percentage of the treatment population using private and public hospitals, not the percentage of total hospital separations.
Table 21: Proportion of treatment population using private and public hospitals 2011–12 to 2015–16 (%)
2011–12 2012–13 2013–14 2014–15 2015–16
Private hospitals 36.0 36.0 35.0 34.6 33.9
Public hospitals 19.8 19.5 18.9 18.6 18.3
Business activityDVA continued to undertake significant contracting and negotiation activities during the year, to ensure clients continue to have access to quality health care through Australia’s hospital network.
Private hospitalsDuring 2015–16, DVA successfully implemented an invitation process for new arrangements for private hospital services beyond 30 June 2016. The new process led to a significant reduction in administrative requirements for both the Department and providers and was received well by the industry. The new arrangements include changes to DVA’s purchasing model and contracting procedures, resulting in a more efficient and streamlined process for engaging providers. In addition, the mental health private hospital purchasing framework was amalgamated with the general private hospital arrangements, to reduce the work required for major purchasing exercises. DVA will commence work on aligning its purchasing arrangements for private day procedure centres in 2016–17.
Public hospitalsDuring 2015–16, significant consultations and negotiations took place with state and territory health departments on DVA’s new arrangements for public hospital services. The changes will result in a reduction in administration for both DVA and the jurisdictions. Work also continued on the development of new systems capabilities in accepting and analysing public hospital data, consistent with the new model. As a result of these changes, and the resultant lags to data supply, the figures for public hospitals in the tables in this report represent estimated activity based on the previous financial year. It is expected that the total number of services will be reduced, as was the case in previous reporting periods.
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PROGRAM 2.3: VETERANS’ PHARMACEUTICAL BENEFITS
ObjectiveUnder Program 2.3, the Repatriation Pharmaceutical Benefits Scheme (RPBS) provides entitled beneficiaries with access to a comprehensive array of pharmaceuticals and wound dressings for the treatment of their health care needs, including items available to the broader Australian community under the Pharmaceutical Benefits Scheme (PBS).
OverviewIn 2015–16, the Department continued to maintain a comprehensive schedule that meets the health care needs of DVA clients and maintains consistency with trends in the delivery of health care services.
DVA continued to support programs to enhance DVA clients’ access to quality pharmaceutical care. This includes the transfer of some over-the-counter items from the PBS to the RPBS, the signing of a new three-year agreement for the provision of the Veterans’ Medicines Advice and Therapeutics Education Services (Veterans’ MATES) program, and annual remuneration under the Veterans’ Pharmaceutical Reimbursement Scheme to eligible DVA clients to provide relief in meeting the costs of pharmaceuticals.
Payments to pharmacy providers are made by DHS on behalf of DVA.
Report on performanceThe Repatriation Pharmaceutical Reference Committee advises the Repatriation Commission and the Military Rehabilitation and Compensation Commission on the clinical appropriateness of items in the RPBS and their conditions of supply, along with other matters relating to the RPBS. The committee comprises experts nominated by medical and pharmaceutical associations and veteran community groups. Under the committee’s guidelines, departmental pharmacists may authorise access to drugs outside the PBS and RPBS schedules, as well as approve the prescribing of ‘authority required’ drugs on the schedule.
DVA’s Quality Use of Medicines program is designed to encourage best practice in the prescribing, dispensing and use of medications for DVA clients. In 2015–16, DVA signed a new three-year agreement for the continued promotion of education and intervention programs to assist DVA clients and health service providers to better manage specific health problems, and reduce unnecessary risks in medication use.
A range of medication reviews are available to eligible DVA clients through broader health arrangements. The reviews assess eligible recipients’ use of prescription and over-the-counter items to assist them with medication management and include collaboration between general practitioners and pharmacists.
As a flow-on from the Sixth Community Pharmacy Agreement, some over-the-counter medicines were transferred from the PBS to the RPBS to ensure that eligible DVA clients have continued access to medication to meet their clinical needs. In addition, the annual Veterans’ Pharmaceutical Reimbursement Scheme payment system was updated to include provision for the pharmacy discount budget measure. The scheme continues to provide financial relief for eligible clients in relation to their medication costs.
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Administered expenditure for pharmaceutical items (cash basis)In 2015–16, expenditure under the RPBS was $337.07 million, which is a 5.14 per cent decrease compared to 2014–15. The decrease was due to the continuing decline in the treatment population and price decreases under the PBS price disclosure arrangements that flowed through to the RPBS.
Number of pharmaceutical claims paidDHA paid 10.55 million claims for RPBS-listed items in 2015–16, a decrease of 9.5 per cent compared to 2014–15.
Percentage of treatment population using the Repatriation Pharmaceutical Benefits SchemeIn 2015–16, 89 per cent of the treatment population accessed the RPBS, a decrease of one percentage point compared to 2014–15.
Veterans’ Pharmaceutical Reimbursement SchemeThe Veterans’ Pharmaceutical Reimbursement Scheme reimburses eligible DVA clients for out-of-pocket costs associated with the concessional pharmaceutical co-payment.
In March 2016, payments under the scheme were made to approximately 35,000 eligible DVA clients. The total payment was approximately $4.3 million, with an average payment of $125 per eligible client.
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PROGRAM 2.4: VETERANS’ COMMUNITY CARE AND SUPPORT
ObjectiveProgram 2.4 manages community support and residential care programs for veterans and war widows and widowers. This includes developing and reviewing policy and operational guidelines and procedures, and assessing program effectiveness. The program also provides the Australian Government subsidy for clients living in residential care facilities.
Community care and support programs include the Veterans’ Home Care (VHC) program and the Community Nursing program, which aim to support people to remain independent in their homes and improve their quality of life and health.
The veteran community is ageing and requires increased services. The provision of these services helps to delay entry into residential aged care and maximises independence.
OverviewVeterans’ Home CareThe VHC program assists entitled DVA clients who wish to continue to remain in their homes by providing a small amount of practical help. The program is part of a broader government strategy to ensure that DVA clients maintain optimal health, wellbeing and independence.
In 2015–16, the procedures for VHC assessment agencies and service providers were updated to incorporate the aged care reform changes that commenced on 1 July 2015. Changes included references to the My Aged Care Gateway, Commonwealth Home Support Program, Home and Community Care (in Victoria and Western Australia), My Aged Care Regional Assessment Service, and consumer-directed care arrangements for all home care packages.
DVA also reviewed the VHC fees. This was in response to concerns raised by assessment agencies and service providers that the fees did not cover the costs of delivering services. As a result of the review, DVA adjusted VHC fees to better align with changes to the Fair Work system modern awards, including penalty rates, superannuation guarantee, travel costs, and workers compensation and payroll tax under state and territory law.
Community NursingThe Community Nursing program assists DVA clients to continue living in their own homes with their clinical and personal care needs being met.
The program assists DVA clients to avoid early admission to hospital or residential care by providing access to high-quality services, such as clinical care, personal care, medication administration and palliative care.
The Department has agreements with organisations to provide community nursing services to around 23,000 DVA clients nationally.
DVA approached the market in February 2016 through AusTender to establish new agreements with community nursing providers. Implementation of the new arrangements will commence on 1 July 2016.
Residential careThe number of DVA clients in residential aged care continued to decrease in 2015–16. However, the care needs of those clients increased in both level and complexity.
DVA is continuing its discussions with the Department of Health on the future home and community care needs of DVA clients and how they can best be supported as part of the Government’s aged care reforms.
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Report on performanceHome care
Assessment and coordination In 2015–16, DVA spent $8.8 million on assessment and coordination of clients’ needs for VHC and other community care services, which was around the same as in 2014–15.
DVA also spent $91.8 million on the delivery of domestic assistance, personal care and safety-related home and garden maintenance services. This was an increase of $9.3 million compared to 2014–15. Another $10.8 million was spent on the delivery of in-home respite services, compared to $10.6 million in 2014–15.
Table 22 shows expenditure on these services for the past five years.
Table 22: Veterans’ Home Care expenditure 2011–12 to 2015–16 ($m)
2011–12 2012–13 2013–14 2014–15 2015–16
Assessment and coordination 10.1 9.2 8.9 8.8 8.8
Domestic assistance, personal care and safety-related home and garden maintenance 76.2 76.2 78.5 81.8 91.1
In-home respite 18.9 15.5 10.4 10.6 10.8
Clients approved for servicesAround 52,550 DVA clients were assessed for VHC services in 2015–16, compared to approximately 57,170 in 2014–15. Of those approved to receive VHC services during 2015–16:
�� 89.4 per cent were approved for domestic assistance
�� 32.0 per cent were approved for safety-related home and garden maintenance services
�� 5.7 per cent were approved for personal care
�� 13.6 per cent were approved for respite care
�� less than 0.1 per cent were approved for social assistance services under the CVC program.
These figures total more than 100 per cent as DVA clients may be approved for more than one service type.
Table 23 shows the approvals for one or more VHC services for the past five years as a percentage of the total number of DVA clients approved to receive VHC services.
These figures do not include social assistance services under the CVC program that are delivered through the VHC program, as those services are not available to DVA clients.
Table 23: Approvals for one or more services as a percentage of the total number of DVA clients approved to receive Veterans’ Home Care services 2011–12 to 2015–16 (%)
Number of services 2011–12 2012–13 2013–14 2014–15 2015–16
One 63.4 65.9 65.3 63.4 63.7
Two 28.6 30.5 30.8 32.2 32.1
Three 3.1 3.3 3.2 4.0 3.8
Four 0.2 0.2 0.2 0.4 0.3
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Community Nursing In 2015–16, DVA spent $135.7 million on community nursing services, an increase of 9 per cent compared to $124.5 million in 2014–15. This increase in nursing services reflects DVA clients choosing to remain as independent as possible in their own homes.
The majority (99 per cent) of DVA community nursing services are paid through a set schedule of item numbers and fees. The remainder are paid through the process managed by DVA’s Exceptional Case Unit, which contracts specialist clinical nurse consultants who have a range of expertise in generalist nursing, wound management, palliative care and gerontology to process applications for exceptional case status.
Carer and Volunteer Support programThe Carer and Volunteer Support program improves the health and wellbeing of DVA clients and their carers by supporting a range of social health activities.
DVA engages community support advisers to provide services through the program, focusing on day clubs for frail and aged veterans, health promotion, men’s health peer education and other community, recreational and social health initiatives.
Grants-in-Aid programThe Grants-in-Aid program assists national ex-service organisations with administration costs such as travel for representational business, office equipment and advocacy undertaken on behalf of the veteran community. To be eligible, an organisation must be an effective national representative body, have direct links to the ex-service community and have objectives that aim to benefit the welfare of its members.
The Grants-in-Aid program has an annual allocation of $145,000. During 2015–16, 12 national ex-service organisations received funding under the program, totalling $112,635.
Veteran and Community Grants programThe Veteran and Community Grants program provides funding for projects that support a healthy, quality lifestyle for members of the veteran community and assist them to keep living independently in their own homes. Grants are also available for initiatives that reduce social isolation, support carers and improve access to community care services.
In 2015–16, a total of $2.095 million was provided to 122 applicants under the program. The program includes community care seeding grants, joint venture grants and joint venture day club grants.
Funding is available for projects that will become sustainable and financially viable, or for one-off projects that have an ongoing health benefit for the veteran community. The grants are not intended to provide for ongoing financial assistance. Projects funded in 2015–16 included bus trips to reduce social isolation, equipment for men’s sheds and day clubs, and facility upgrades to support the veteran community. To receive funding under the program, an applicant must be an ex-service organisation, community-based organisation or private organisation that can demonstrate the ability to contribute to the welfare of members of the veteran community through the project.
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PROGRAM 2.5: VETERANS’ COUNSELLING AND OTHER HEALTH SERVICES
ObjectiveProgram 2.5 provides a wide range of mental and allied health care services—including counselling and referral services—for veterans, war widows and widowers, serving members, former ADF members, and their families. The program also supports DVA clients with funding for aids and appliances, and travel for treatment.
OverviewIn 2015–16, DVA delivered a range of initiatives for the prevention, early intervention and treatment of mental health conditions in the veteran community and to support social wellbeing.
The Veteran Mental Health Strategy 2013–2023 and the Social Health Strategy 2015–2023 for the Veteran and Ex-Service Community provide the strategic framework for DVA’s work in this area.
Both strategies commit to the release of a supporting action plan. DVA fulfilled this commitment in October 2015 when it released the Veterans’ Mental and Social Health Action Plan 2015 and 2016. The plan details the practical steps DVA will take to achieve the objectives for effective, best practice mental and social health care.
There was continued strong demand for allied health services in 2015–16. DVA remains committed to meeting the needs of DVA clients by ensuring that they can access clinically appropriate allied health services. Payments to allied health providers for services provided to eligible clients are made by DHS on behalf of DVA.
Arranged travel through the Booked Car with Driver scheme is an important DVA service for the veteran community. For clients who are not eligible for the additional assistance through the scheme, DVA may reimburse costs incurred for privately arranged travel, including costs of meals and accommodation for longer distance travel.
Report on performanceVeterans and Veterans Families Counselling ServiceThe VVCS helps members of the veteran and ex-serving community, and members of their families, who are experiencing service-related mental health and wellbeing conditions.
This service is free and confidential and offers a wide range of therapeutic options and programs for war- and service-related mental health conditions, including posttraumatic stress disorder, anxiety, depression, sleep disturbance and anger. VVCS also offers relationship and family counselling to address issues that can arise due to the unique nature of military service.
All VVCS counsellors, whether centre-based counsellors, outreach providers or telephone line counsellors, have an understanding of military culture and work with clients to find effective solutions for improved mental health and wellbeing.
Through its national, integrated, 24-hour service delivery system, VVCS provides:
�� counselling for individuals, couples and families, and support for those with more complex needs
�� group programs to develop skills and enhance support
�� an after-hours veterans telephone counselling line
�� information, education and self-help resources, including a Facebook page and a website
�� referrals to other services or specialist treatment programs.
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VVCS is undergoing a period of change, with increasing client numbers, and changing client demographics due to ADF deployments to the Middle East Area of Operations and an ageing Vietnam-era client cohort. In 2015–16, business improvements were underpinned by a highly secure electronic records system, updates to internal clinical and governance policies, strengthening of the quality management framework, and the introduction of changes to the service delivery model to improve client accessibility. In addition, VVCS continued to enhance workforce capability, focusing on embedding cognitive processing therapy and family-inclusive practice into its evidence-based service mix.
In 2014, DVA commissioned an independent functional review of VVCS to identify opportunities to further enhance administrative and clinical efficacy and efficiency. The review found that the VVCS service delivery model is sound. It made 14 recommendations to improve or enhance some back-end activities so that VVCS remains a flexible and responsive service that continues to deliver positive client outcomes into the future. Actions identified in the review are in addition to planned service improvements and quality activities that VVCS undertakes as a result of its external accreditation.
Number of clients receiving servicesIn total, 15,154 unique clients received VVCS counselling during 2015–16, up 3.6 per cent on the 14,627 clients in the preceding year. A further 4,783 clients received intake support and had their concerns resolved during their initial contact with VVCS or were referred to other appropriate services, and 1,182 clients participated in VVCS group programs. Veterans Line also supported clients after hours (6,269 calls answered). Table 24 shows numbers of client contacts for each stream for the past five years (centre and outreach combined).
Table 24: Number of clients receiving VVCS services by support stream 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Counselling (centre and outreach) 10,314 11,687 14,136 14,627 15,154
Intake assessment not leading to counselling (including referral to alternative service) 3,354 4,232 5,526 5,350 4,783
Group programs 2,897 2,488 2,074 1,610 1,182
Veterans Line 5,497 5,306 7,050 6,571 6,269
VVCS = Veterans and Veterans Families Counselling Service
TimelinessVVCS aims to ensure that all clients in crisis receive clinical intervention and/or referral to specialist services at the point of initial contact with VVCS (i.e. as part of the clinical intake process). The intake process, which is undertaken by a qualified centre-based counsellor, includes an initial assessment, support and advice, and a determination of the most appropriate ongoing support (or referral) for each client.
Allocation to VVCS counselling or group programs is arranged for clients who need ongoing support. Allocation depends on the clinical needs of the individual client. VVCS seeks to have the majority of client needs identified and support systems in place within a fortnight of the initial intake.
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Table 25 shows the timeliness of the first counselling session in the past five years.
Table 25: Timeliness of first counselling session 2011–12 to 2015–16 (%)
2011–12 2012–13 2013–14 2014–15 2015–16
Within 14 days
Centre-based 76.7 76.5 82.0 84.0 77.3
Outreach 64.8 66.1 69.0 73.0 66.3
Within 21 days
Centre-based 87.0 86.8 97.0 92.0 89.0
Outreach 79.0 81.3 82.0 86.0 81.3
QualityThe quality of service provision was high across centre-based and outreach counselling delivered during 2015–16, as measured by client satisfaction levels. This result was derived from 587 returned satisfaction surveys, which showed that 70.9 per cent of clients were very satisfied and 21.5 per cent were moderately satisfied (i.e. a total of 92.4 per cent of clients were satisfied or very satisfied). A new client satisfaction feedback form was rolled out in 2015–16.
Complaints and complimentsVVCS records all formal complaints and compliments received in the VVCS complaints and feedback management system. This information provides a valuable tool to identify inconsistencies in service delivery and is used to target improvement activities.
In 2015–16, VVCS received 69 items of feedback (complaints and compliments) from clients and other stakeholders. This is separate from feedback received though the client satisfaction survey. Of the 69 items of feedback, 35 per cent were compliments. Complaints centred primarily on the responsiveness of VVCS services. Table 26 shows the total number of complaints and compliments in 2015–16, compared to previous years.
Table 26: VVCS complaints and compliments 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Complaints 45 24 30 35 45
Compliments 35 36 25 18 24
Total 80 60 55 53 69
VVCS = Veterans and Veterans Families Counselling Service
Centre counsellingThe 74 full-time equivalent VVCS staff counsellors (including program managers) provided 25,114 counselling sessions to 4,697 clients in 2015–16, compared to 22,161 sessions for 4,073 clients in 2014–15. The average number of sessions per client was 5.3.
In addition, centre counsellors provided intake counselling, case management for clients with complex needs, and coordination and clinical oversight of outreach program clients.
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Outreach counsellingAt the end of June 2016, VVCS had a network of 1,101 outreach counsellors located throughout Australia, of whom 813 had provided services to VVCS clients in 2015–16. Outreach counsellors are qualified psychologists (83 per cent) and mental health accredited social workers (17 per cent), with an understanding of military culture and the veteran experience. VVCS outreach counsellors deliver services to clients who are unable to access a VVCS centre.
During 2015–16, VVCS outreach counsellors delivered 72,661 counselling sessions to 11,181 clients. This compares with 70,700 counselling sessions for 11,196 clients in 2014–15. The average number of outreach sessions per client was 6.5.
Group programsIn 2015–16, VVCS facilitated 148 group treatment and psycho-educational programs, to 1,182 clients nationally (detailed in Table 27). This was a decrease from 2014–15, when 1,610 clients participated in 192 group programs.
Table 27: Group programs delivered in 2015–16
Group program Active groups
Health and wellbeing (including anxiety, depression and sleep programs) 33
Australian Defence Force transition (Stepping Out Program) 23
Operation Life 17
Residential lifestyle 12
Pain management 3
Anger management 19
Stress management 14
Posttraumatic stress disorder transition 5
Relationships and communication 9
Couples 9
Other (including grief and loss, parenting and resilience groups) 4
Total 148
Case management VVCS supports a number of clients in complex situations who find it difficult to engage and manage the range of health and social care services they require. In 2015–16, the service managed 293 cases nationally, compared to 227 in 2014–15.
Veterans Line Veterans Line is a telephone-based counselling service designed to assist veterans and their families outside VVCS office hours. It is delivered through a national contracted provider, On the Line Pty Ltd.
During 2015–16, Veterans Line provided counselling support on 6,269 calls, compared to 6,571 calls in 2014–15.
Veterans Line also provided a call-back service for clients at risk of suicide or self-harm, which allowed for systematic risk assessment, management and referral for after-hours, weekend and public holiday periods.
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Australian Defence Force services Client referrals under the Agreement between the Department of Defence and the Department of Veterans’ Affairs for the Provision of Mental Health Support Services by the Veterans and Veterans Families Counselling Service (VVCS) to Australian Defence Force Personnel increased during the period, particularly in states with a large Defence presence, such as Queensland.
In 2015–16, 1,451 referrals were made to VVCS under this agreement, compared to 1,135 in 2014–15. In addition, 2,968 currently serving members self-referred to VVCS for assistance during 2015–16, compared to 2,966 self-referrals in 2014–15.
VVCS also continued to deliver the two-day Stepping Out Program for members separating from the ADF. This program aims to increase awareness of psychosocial skills and behaviours that may assist during the transition from military to civilian life. In 2015–16, 23 programs were run nationally with a total of 236 participants, the majority of whom were current serving members, from all ranks and services.
Supporting sons and daughters VVCS seeks to support mental health and reduce suicide risk among the sons and daughters of Australian veterans by establishing partnerships with local services to ensure that sons and daughters receive appropriate care and by supporting self-help initiatives and projects that aim to increase their personal strength, resilience and coping skills.
VVCS services are available to Vietnam veterans’ children of any age, and the other veterans’ dependent children up to the age of 26. Services include intake and assessment, counselling, referral, psychiatric assessments (for the children of Vietnam veterans), group programs and information sessions.
In 2015–16, 2,615 children of veterans received counselling support (a total of 18,173 counselling sessions) and 51 children of Vietnam veterans were referred for psychiatric assessment.
Operation Life workshops Operation Life provides a framework for action to prevent suicide and promote mental health and resilience across the veteran community. Its major components include a set of three suicide prevention workshops, along with support services for the veteran community.
The following workshops were delivered in 2015–16:
�� two Safe Talk half-day introductory workshops, with a total of 17 attendees (two workshops and 16 attendees in 2014–15)
�� 15 Applied Suicide Intervention Skills Training two-day workshops, with 142 attendees (six workshops and 50 attendees in 2014–15)
No Tune Up workshops were requested in 2015–16 (one workshop and seven attendees in 2014–15).
Noting the continued decline in participation rates, VVCS will work to identify opportunities to expand this program’s reach.
Crisis Assistance Program In addition to counselling support, VVCS delivers the Crisis Assistance (Time Out) Program, which provides short-term emergency accommodation for eligible Vietnam veterans (five nights maximum). The program aims to help reduce stress that might lead to family violence or family break-up. It links the client with VVCS services such as counselling, case management, and group programs that assist with managing stress.
In 2015–16, two clients accessed this program (five clients in 2014–15).
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Communication and marketing VVCS continued to facilitate clear, regular communication with its clients and stakeholders throughout 2015–16. The VVCS Facebook page community continued to grow and act as a complement to the VVCS website. These online tools provided VVCS with an opportunity to improve community mental health literacy, assist members with self-management and provide contact information and an additional referral pathway for those in need. VVCS centres also continued to hold a range of regional consultative forums and meetings to capture the views of clients, stakeholders and advocacy groups.
Allied health servicesAllied health services are accessed by eligible clients from a range of health providers, including chiropractors, dieticians, exercise physiologists, occupational therapists, physiotherapists, podiatrists, optometrists, psychologists, social workers and speech pathologists.
During 2015–16, an estimated 3.19 million allied health services were provided to eligible clients, a 1 per cent increase compared to 3.15 million for the same period in 2014–15. The proportion of the veteran population accessing allied health services decreased to 66.0 per cent in 2015–16 from 67.8 per cent in 2014–15.
The average cost per allied health service increased slightly, to $68.25 in 2015–16 from $67.76 in 2014–15. With a continuing pause on indexation of DVA health services in place there is expected to be little change in cost per service in coming years.
Administered expenditure for the provision of allied health services in 2015–16 was $225 million, compared to $231 million in 2014–15, a decrease of 2.6 per cent.
Table 28 shows the number of allied health services provided and the average cost over the past five years.
Table 28: Number of, and average cost for, allied health services 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Number of services 3,134,135 3,209,759 3,216,661 3,154,553 3,086,684
Average cost per service ($) 63.62 65.47 66.96 67.81 68.25
Proportion of treatment population1 (%) 69.7 69.4 68.4 67.8 66.0
Note: Figures for previous years have been updated to reflect latest available claims data.1 Treatment population is measured at 30 June each financial year.
Mental and social health supportDVA continues to make significant progress in implementing the Veteran Mental Health Strategy 2013–2023 and the Social Health Strategy 2015–2023 for the Veteran and Ex-Service Community. Key outcomes achieved in 2015–16 included innovative digital resources for veterans and health providers and a range of social health programs focused on promoting good mental, social and physical health.
Innovative e-mental health resources DVA worked in close collaboration with the Department of Defence to develop and promote the High Res website, which provides information and self-help tools for serving and ex-serving ADF members to manage stress and build resilience. The website, released in August 2015, is based on Defence’s BattleSMART (self-management and resilience training) program.
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An online advertising campaign ran from 17 April 2016 to 7 May 2016 to raise awareness of the High Res website and app. The promotion resulted in more than 9,800 interactions with the advertising material, including likes, shares and clicks through. This led to a substantial increase in the number of website sessions (3,962) and a 150 per cent increase in the number of app downloads (575) compared to the previous three-week period.
In September 2015, DVA relaunched the alcohol management website The Right Mix after it underwent improvements to make it more user-friendly and to reflect the latest research on alcohol consumption. The website has as its centrepiece a self-help program, using a range of interactive tools, including self-assessment, to identify motivational priorities and goals and peer supports. Personalised information automatically generates a self-help treatment plan. The website is mobile-enabled so users can access their plans on multiple platforms. It also comes with an accompanying app, On Track with The Right Mix, to assist users to track their alcohol consumption and spending habits.
Support for health providersAdditional digital resources were released for health providers to support the delivery of quality veterans’ mental health care, including a new mobile app, Operation Life, to support clinicians treating those at risk of suicide, and an updated e-learning program, Understanding the Military Experience. The program’s content was amended to accurately reflect the military experience of contemporary veteran clients and give health providers a greater understanding of patients who have served.
PTSD Psychological Interventions, a new e-learning program designed to increase clinicians’ understanding of evidence-based treatments for PTSD, was launched during the year. The program uses a veteran case study to demonstrate the three primary treatment methods for PTSD and to explain the ongoing impact of military experience on a veteran’s mental health.
In 2015, the transition to the international treatment standard Diagnostic Statistical Manual-5 affected the way in which a number of common mental health conditions are diagnosed and treated. DVA reviewed and updated clinical professional development resources to ensure they remain consistent with international best practice.
Social health and wellbeingFrom 10–18 October 2015, DVA partnered with ex-service and community organisations to hold the annual Veterans’ Health Week. The event aims to increase health awareness among current and ex-service members and their families, and to encourage behavioural change leading to improved health outcomes. This year, the theme was mental wellness and approximately 18,000 people attended 230 events. DVA provided $100,000 to support the events.
During 2015–16, DVA provided support to 127 day clubs around Australia to help improve the quality of life for veterans and their families. The day clubs create a setting for members of the veteran and general communities to forge friendships and create social support networks, and to be involved in activities that enhance health and wellbeing. The support is provided through Community Support Advisory Services and Veteran and Community Grants.
At 30 June 2016, there were 262 active volunteers providing health information to members of the veteran and ex-service community throughout Australia as part of DVA’s Men’s Health Peer Education program. The initiative raises awareness about men’s health issues by encouraging all members of the veteran and ex-service community to share the responsibility for managing their own health and wellbeing. The program trains volunteers from all age groups to help promote positive health messages to their peers.
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In 2015–16, DVA’s Heart Health program achieved a significant increase in enrolments and completion rates. Following an extensive mail-out program, enrolments quadrupled and 1,474 participants (95.5 per cent) completed the program during the year. The 52-week program aims to help participants increase their physical health and wellbeing through practical exercise, nutrition and lifestyle management support. The program includes two physical activity sessions per week that are tailored to meet participants’ individual needs, as well as 12 health education seminars.
Travel for treatmentIn 2015–16, DVA processed 146,537 travel for treatment reimbursement claims under the Repatriation Transport Scheme, a decrease of 2.9 per cent compared to 2014–15. Processing times reduced slightly—97.2 per cent of claims were processed within 28 days, compared to 98 per cent in 2014–15.
The ability for clients to lodge travel claims online through MyAccount continued to make it easier for clients do business with DVA and has increased acceptance of online travel reimbursement under all three Acts. The number of online claims submitted to DVA in 2015–16 was 84,414, a 12.9 per cent increase compared to 2014–15.
Arranged travel through the Booked Car with Driver scheme continued to be an important service for the aged and frail veteran community, as evidenced by the 1,211,805 person trips completed in 2015–16. This represents a 4.8 per cent decrease compared to 1,273,128 trips in 2014–15.
Table 29 shows activity under the two travel schemes over the past five years.
Table 29: Claims for reimbursement and arranged transport processed by DVA 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Claims for reimbursement 145,880 165,137 159,905 150,871 146,537
Arranged transport trips (Booked Car with Driver) 877,521 955,954 1,002,844 1,273,1281 1,211,805
1 Results for the current reporting period are estimates based on provisional data available at the time of reporting. This result has been revised upward from the estimate of 956,369 shown in the 2014–15 annual report, based on final data.
Aids and appliancesExpenditure for aids and appliances totalled $145.7 million in 2015–16 (including Rehabilitation Appliances Program expenditure of $142.7 million and Medical Grade Footwear program expenditure of $2.98 million). Approximately 105,404 DVA clients received aids and appliances in 2015–16.
Medical Grade Footwear The Medical Grade Footwear program provides eligible DVA clients with clinically approved modified footwear. In 2015–16, the program assisted 5,954 clients with 5,943 pairs of ready-made medical-grade footwear and 1,761 pairs of custom-made medical-grade footwear.
Essential Medical Equipment Payment The Essential Medical Equipment Payment covers the additional costs of running essential medical equipment or medically required heating and cooling. In 2015–16, approximately 3,090 claims were paid, with total expenditure of $527,256.
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PROGRAM 2.6: MILITARY REHABILITATION AND COMPENSATION ACTS—
HEALTH AND OTHER CARE SERVICES
ObjectiveProgram 2.6 arranges for the provision of rehabilitation, medical and other related services under the SRCA, the MRCA and related legislation. The services include payment for medical treatment, rehabilitation services, attendant care and household services.
OverviewDVA’s rehabilitation approach is holistic and focuses on all the elements of a person’s life that could improve functioning, wellbeing and quality of life. It aims to assist people to adapt to, and recover from, an injury or illness that is related to their ADF service.
Report on performanceSafety, Rehabilitation and Compensation Act
RehabilitationIn 2015–16, 881 rehabilitation assessments were conducted, compared to 927 in 2014–15. Of the clients assessed, 56 per cent were placed on non–return to work programs, compared to 49 per cent in 2014–15. Eighteen per cent were placed on return to work programs, compared to 22 per cent in 2014–15.
Attendant care and household servicesIn 2015–16, 121 clients received a total of $1.8 million in compensation for attendant care, compared to 124 clients and $2.2 million in 2014–15. A further 1,700 clients received a total of $6.5 million for household services assistance, compared to 1,636 clients and $5.4 million in 2014–15.
Medical and treatment accounts paidMedical and treatment accounts cover general and specialist medical services, household services and attendant care services. This does not include medico-legal services. Most medical treatments for SRCA clients are paid for via health treatment cards, but 36,430 accounts in 2015–16 were paid for by clients and reimbursed by the Department (37,911 in 2014–15).
QualityDVA is working to improve performance by reinforcing policy and procedures and refining and improving staff training.
Military Rehabilitation and Compensation Act
RehabilitationIn 2015–16, 1,349 rehabilitation assessments were conducted, compared to 1,536 in 2014–15. Of those assessed, 26 per cent were placed on non–return to work programs, compared to 24 per cent in 2014–15. Forty-six per cent were placed on return to work programs, the same as in 2014–15.
Attendant care and household servicesIn 2015–16, 47 clients received a total of $589,263 in compensation for attendant care, compared to 48 clients and $516,488 in 2014–15. A further 854 clients received a total of $2.1 million for household services assistance, compared to 721 clients and $1.7 million in 2014–15.
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Medical and treatment accounts paidMedical and treatment accounts cover general and specialist medical services, household services and attendant care services. This does not include medico-legal services. Most medical treatments for MRCA clients are paid for via health treatment cards, but 12,941 accounts in 2015–16 were paid by clients who were subsequently reimbursed by the Department (11,872 in 2014–15).
QualityDVA is working to improve performance by reinforcing policy and procedures and refining and improving staff training.
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PROGRAM 2.7: ADJUSTMENT TO THE MILITARY REHABILITATION AND COMPENSATION
ACTS LIABILITY PROVISION—HEALTH AND OTHER CARE SERVICES
ObjectiveProgram 2.7 provides an updated actuarial assessment of the movement in the liability for health and other care services under the SRCA and the MRCA.
OverviewThis program represents the movement in long-term liability based on the advice of the Australian Government Actuary. The movement is recognised as an expense in DVA’s financial statements. Due to the nature of the provision, significant adjustments can occur between years. Movement for the liability for the past two years is shown in Table 30.
Table 30: Movement in SRCA and MRCA liability under Outcome 2 for 2014–15 and 2015–16
2014–15 2015–16
SRCA($m)
MRCA($m)
Total($m)
SRCA($m)
MRCA($m)
Total($m)
Opening balance adjustment –126.6 281.1 154.5 –15.6 249.0 233.4
Hospitals –2.3 16.5 14.2 –2.9 22.9 20.0
LMO consultations –3.1 2.2 –0.9 –4.6 2.9 –1.7
Specialist consultations –1.5 6.8 5.3 –1.3 8.9 7.6
Medical services 0.0 26.7 26.7 0.0 273.3 273.3
Non-institutional care –3.5 0.0 –3.5 –4.3 0.0 –4.3
Pharmaceuticals –0.9 4.5 3.6 –1.3 6.0 4.7
Rehabilitation services –2.6 5.4 2.8 –3.6 9.7 6.1
Other –4.5 10.1 5.6 –4.7 9.5 4.8
Interest rate 95.0 150.0 245.0 172.0 364.2 536.2
Total expenses –50.0 503.3 453.3 133.7 946.4 1,080.1
MRCA = Military Rehabilitation and Compensation Act 2004, SRCA = Safety, Rehabilitation and Compensation Act 1988
Report on performance The Department’s provision for health care and other services increased from $2.1 billion in 2014–15 to $3.2 billion in 2015–16.
This provision recognises the obligations that the Department has to veterans and current serving military personnel for benefit payments that will occur in the future.
After a long period of predominantly peacetime service, the ADF has undertaken a range of extensive and intensive operations since 1999 that have involved significant numbers of servicemen and servicewomen. Deployments of both permanent and reserve forces have exposed an increasing number of ADF personnel to risks of injury and death, and the Government to an increasing liability for future costs of rehabilitation, health care and compensation.
It is important to note that the provision takes into account personal benefits and health care for clients over the next 80 years. It is expected that the estimate will be adjusted each year as claims are received and additional information about claims patterns becomes available.
The increase in 2015–16 resulted from a number of factors, including an opening balance adjustment of $233.4 million due to modelling increased usage of medical services that is associated with higher take-up of health treatment cards. The change in interest rates has also contributed to the increase.
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OUTCOME 3: COMMEMORATIONS
Commemorative activities provide opportunities for the Australian community to appreciate and acknowledge the role played by Australians in wars and conflicts since federation.
The Department’s commemorations program aims to increase the community’s understanding of and regard for the service and sacrifice of veterans, to ensure that veterans are afforded the respect and recognition they deserve. The Department also acknowledges the service of eligible war dead by maintaining graves, cemeteries and gardens of remembrance in Australia and Australian memorials overseas.
Commemorative activitiesThe Anzac Centenary Program 2014–2018 acknowledges significant military anniversaries for veterans of the First World War and all subsequent conflicts, through its two themes: Centenary of the First World War and Century of Service.
Among the program’s achievements in 2015–16:
�� A centenary service was delivered at Gallipoli in Turkey in August 2015, marking the 100th anniversary of the August Offensive at Lone Pine.
�� The Department contributed to national ceremonies conducted at memorials on Anzac Parade, Canberra, to commemorate the 75th anniversaries of the Siege of Tobruk, the Battle of Greece and the Battle of Crete.
�� The Gallipoli Symphony, which was commissioned by the Department, premiered in Istanbul, Turkey, in August 2015 and in Brisbane in November 2015. The production was nominated in the Best New Australian Work category of the Helpmann Awards, which recognise distinguished artistic achievement and excellence in live performance, for 2016.
�� Audacity: Stories of heroic Australians in wartime, the second book in the Department’s Century of Service series, received an award from the Children’s Book Council of Australia in the Eve Pownall Award for Information Books category for 2015. The third book in the series, Ancestry: Stories of multicultural Anzacs, has been nominated in the same category of the awards for 2016.
Since the launch of the program’s flagship community event, the Spirit of Anzac Centenary Experience, in September 2014, the exhibition has visited 11 locations across the country and been attended by 170,000 visitors. The Department is delivering the Spirit of Anzac Centenary Experience in partnership with the Australian War Memorial, Telstra Corporation and Commonwealth Bank of Australia.
War graves and memorialsThe repatriation of the remains of Australians buried in Malaysia and Singapore was a significant achievement for the Department in 2015–16. The decision to repatriate was taken in response to concerns about the accessibility of the Terendak Military Cemetery in Malaysia, which is located on an operational Malaysian Army base. In all, 33 Australians were returned, including 25 soldiers who were casualties of the Malayan Emergency or the Vietnam War and eight civilian dependants.
The Australian Memorial in Wellington, New Zealand, which was formally dedicated in April 2015, received an award in the Small Project Architecture category of the Australian Institute of Architects’ International Chapter Architecture Awards for 2016.
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Other significant achievementsThe Department’s achievements under Outcome 3 during 2015–16 included:
�� managing the Anzac Day services at Gallipoli in Turkey and Villers-Bretonneux in France
�� conducting veterans’ commemorative missions to mark key anniversaries of Australia’s military heritage
�� promoting community involvement in commemorative programs, in conjunction with ex-service organisations and other community organisations, particularly through the Saluting Their Service grants program
�� acknowledging the 50th anniversary of the Battle of Long Tan and Australia’s involvement in the Vietnam War by providing funding to assist veterans to hold events promoting camaraderie
�� updating the website Anzac Portal: Education and Community Awareness for the Anzac Centenary 2014–2018, to inform and educate the community on Anzac Centenary initiatives leading up to the 2016–18 program of events
�� supporting community awareness and preservation of Australia’s wartime and service heritage, and veterans’ experiences, through the production of innovative online educational resources and commemorative publications
�� administering the Anzac Centenary Public Fund and its board, which distributed $19.65 million to a number of iconic state government Anzac Centenary projects, including
- redevelopment of Anzac Square in Brisbane and the Shrine of Remembrance in Melbourne
- construction of the Anzac Centenary Memorial Walk in Adelaide
- development of a pedestrian walkway in Hobart
�� completing architectural and interpretive designs for the Sir John Monash Centre, which is located at the Australian National Memorial at Villers-Bretonneux in France
�� working in partnership with French and Belgian authorities to develop Australian content for museums, interpretive centres and walking trails at key battlefield sites along the Western Front.
Priorities for 2016–17DVA’s priorities for commemorations in the year ahead are to:
�� deliver significant commemorative events, in Australia and overseas, as part of the Anzac Centenary Program
�� progress the development of the Sir John Monash Centre
�� refurbish the Hellfire Pass Memorial Museum in Thailand
�� refurbish ageing war graves in Papua New Guinea.
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PROGRAM 3.1: WAR GRAVES AND COMMEMORATIONS
ObjectiveProgram 3.1 acknowledges and commemorates the service and sacrifice of the men and women who served Australia and its allies in wars, conflicts and peace operations.
OverviewPublic interest in commemorative activities and war graves has been heightened by the significant wartime anniversaries occurring during the Anzac Centenary and Century of Service period, 2014–2018; the ageing of the veteran population; and the ongoing deployment overseas of ADF personnel. There is continuing interest in funding under the commemorations grant program, Saluting Their Service, and an increased demand for community awareness, education and online resources.
The Office of Australian War Graves (OAWG) delivers the program of official commemoration and constructs and maintains national memorials overseas. Official commemorations have been provided since 1922. As the average age of the commemorations increases, significant future works are identified to maintain them at approved standards.
Projects in progress include the Sir John Monash Centre near Villers-Bretonneux in France, the Australian Remembrance Trail in France and Belgium, and the Australian contribution to the Vietnam Veterans’ Education Center in the United States, also known as The Education Center at The Wall.
The OAWG led the multi-agency arrangements for the June 2016 repatriation of the remains of Australian service personnel and civilian dependants previously reinterred in the Terendak Military Cemetery in Malaysia.
The Department conducts annual Anzac Day services at Villers-Bretonneux in France and Isurava in Papua New Guinea, while supporting Anzac Day services at other locations, including at Hellfire Pass in Thailand, Sandakan in Malaysia, and Port Moresby (Bomana) War Cemetery in Papua New Guinea.
The Department is the lead agency for preparing and managing the Australian Government’s arrangements for the Anzac Centenary Program 2014–2018.
A number of significant anniversaries occurred in 2015–16, including the 25th anniversary of the end of the First Gulf War and the 75th anniversaries of the Siege of Tobruk, the Battle of Greece and the Battle of Crete.
Report on performanceAnzac Centenary Program
Century of Service programDuring 2015–16, the Century of Service program commemorated a number of anniversaries of battles and events of particular significance to the Australian community.
The 75th anniversary of the Siege of Tobruk was commemorated by a service at the Rats of Tobruk Memorial on Anzac Parade in Canberra. It was attended by 25 surviving ‘Rats’ who travelled from all over Australia to remember their comrades and reflect on their wartime experiences. Shortly thereafter, the 75th anniversaries of the Battle of Greece and the Battle of Crete were commemorated at the Australian Hellenic Memorial, also on Anzac Parade in Canberra.
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Anzac Day services in FranceThe Department successfully delivered an Anzac Day Dawn Service at the Australian National Memorial, Villers-Bretonneux, and a later Anzac Day service at the Digger Memorial, Bullecourt. The Dawn Service at Villers-Bretonneux was broadcast live to Australia by the ABC.
In 2016, 3,100 visitors braved the chilly morning to attend the Anzac Day Dawn Service, and around 900 attended the Digger Memorial service later in the day. Feedback through the visitor survey indicated a very high level of visitor satisfaction, with those attending enjoying a memorable experience.
Local French authorities provided police, security, medical and first aid facilities for visitors at the site. The Australian Government is grateful for the assistance of our French hosts.
Anzac Centenary national programImplementation of the Australian Government’s Anzac Centenary national program continued in 2015–16, with a focus beyond the anniversary of the Gallipoli landings.
A number of Anzac Centenary projects were delivered in 2015–16, including:
�� the opening in Albury–Wodonga, Victoria, of the Spirit of Anzac Centenary Experience travelling exhibition, which later visited another 10 locations
�� the performance of the Gallipoli Symphony in Turkey and Australia.
In total, the Australian Government has committed approximately $312 million to the Anzac Centenary national program over a 10-year period. This funding has contributed to a range of projects in the areas of education and research, commemorations, and arts and culture as recommended by the Anzac Centenary Advisory Board.
More information about the Anzac Centenary national program is available at www.anzaccentenary.gov.au.
Anzac Centenary Public FundThe Anzac Centenary Public Fund was established in June 2013 to enable the Australian business community and the public to donate to Anzac Centenary initiatives. The fund is open for donations until 1 May 2019. The fund was granted deductible gift recipient status to enable donations over $2 to be tax deductible.
At 30 June 2016, almost $43 million had been donated to the fund, mostly by Australian companies. A number of Australian companies have committed to donate by instalment over the period of the Anzac Centenary and have commenced their donations. Taking into account current donations and written commitments, it is estimated that a total of $67 million will be donated before the fund closes.
The Anzac Centenary Public Fund Board assesses Anzac Centenary projects and makes recommendations to the Government for project disbursements from the fund. The board met once in 2015–16 and made a series of recommendations to the Minister for Veterans’ Affairs. All recommendations were agreed to by the Government and publicly announced.
More information about the Anzac Centenary Public Fund is available at www.anzaccentenary.gov.au/get-involved/anzac-centenary-public-fund.
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Spirit of Anzac Centenary ExperienceThe Spirit of Anzac Centenary Experience travelling exhibition is the flagship community event of the Anzac Centenary national program. The exhibition brings together more than 200 artefacts from the Australian War Memorial and interactive multimedia technology to tell the story of Australia’s involvement in the First World War and the subsequent century of service of Australia’s armed forces.
The exhibition was launched on 4 September 2015 in Albury–Wodonga by the then Prime Minister, the Hon. Tony Abbott MP, and has since travelled to Launceston, Hobart, Ballarat, Bendigo, Wollongong, Melbourne, Adelaide, Tamworth, Toowoomba and Brisbane. As of 30 June 2016, 170,000 people had visited the exhibition. The exhibition will visit another 12 locations in 2016–17 to complete its 23-location itinerary. It will conclude its run in Sydney in April 2017.
More information about the Spirit of Anzac Centenary Experience is available at www.spiritofanzac.gov.au.
Commemorative missionsIn 2015–16, veterans of the Second World War travelled to Papua New Guinea to mark the 70th anniversary of Victory in the Pacific. The Department managed and provided support for a number of solemn, dignified and moving commemorative services in Papua New Guinea. Significant support was provided to DVA’s commemorative mission by the Department of Foreign Affairs and Trade and the Australian Defence Force.
Community involvement and awarenessIn 2015–16, DVA continued to effectively engage the general community, teachers and students on Australian wartime history and raise awareness and appreciation of the service and sacrifice of our servicemen and servicewomen in war, conflicts and peace operations. During the year, the Department produced a range of educational resources and awareness-raising information and materials and activities, including commemorative war history websites, a calendar, commemorative posters, a school competition and oral histories. DVA also supported Australian War Memorial outreach initiatives.
The website Anzac Portal: Education and Community Awareness for the Anzac Centenary 2014–2018 continues to be a highly successful means of connecting with the community. The Anzac Portal holds a wide range of online publications, links to e-books, education and history resources, and event information. Information on the Anzac Centenary, veterans’ stories and curriculum units are all innovative additions to the portal.
Saluting Their Service grants The Saluting Their Service grants support projects and activities that directly commemorate Australia’s servicemen and servicewomen in wars, conflicts and peace operations, and are provided to ex-service organisations, local government authorities, museums and schools.
There were three categories of grants in 2015–16: Major Commemorative Grants, Community Commemorative Grants and Vietnam War Commemorative Grants. Community Commemorative Grants are available for small projects that are locally significant, and Major Commemorative Grants are available for projects with significance at the national, state or territory level. The Vietnam War Commemorative Grants were provided in a one-off round to commemorate the 50th anniversary of the Battle of Long Tan and Australia’s involvement in the Vietnam War.
In 2015–16, 16 Major Commemorative Grants were approved to the value of $546,119; 246 Community Commemorative Grants were approved to the value of $591,660; and 83 Vietnam War Commemorative Grants were approved to the value of $399,053.
A list of approved grants can be found on the DVA website, www.dva.gov.au.
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Commemorating our war dead and those who have died as a result of war
Maintenance of war cemeteries, memorials and gravesIn 2015–16, preventative and reactive maintenance was undertaken at war cemeteries and individual official commemorations within general cemeteries throughout Australia and the region. Remoteness, resource availability and environmental conditions precluded work being undertaken at some of the more than 2,300 sites where official commemorations are located. A risk-based approach continued to be applied to the deteriorating asset inventory and improved use of technology continued to assist in the management of assets.
Graves of Our BravestThe Graves of Our Bravest program provides for the maintenance of private memorials of Australian recipients of the Victoria Cross, the George Cross or the Cross of Valour that are not included in the program of official commemoration. These private memorials are to be maintained in perpetuity. The program also provides for the maintenance of the private memorials in Australia of recipients of the Victoria Cross from other Commonwealth countries.
New commemorations The OAWG completed 2,951 new official commemorations. These consisted of 302 interments in crematoriums, 148 commemorations in lawn cemeteries, the construction of 211 monumental graves and placement of 2,290 plaques in the OAWG Gardens of Remembrance. A further 134 offers of official commemoration were declined. Table 31 details post-war commemoration activity.
The number of war graves maintained during 2015–16 increased after the Commonwealth War Graves Commission accepted commemoration for a number of Australians who died in Australia between 1914 and 1921 or 1939 and 1947 who had not been officially commemorated as war dead of the two world wars. These cases were brought to the OAWG’s attention by members of the public and researchers and, after investigation, were accepted for commemoration.
Table 31: Post-war commemoration activity 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Notification of eligibility for commemoration 4,596 4,811 3,805 3,389 3,106
Acceptance by families 3,182 4,238 3,142 2,684 2,561
Completed memorials 3,733 4,903 4,394 3,418 2,951
Cemetery and memorial informationTable 32 shows the extent of community contact with the office over the past five years in relation to the quality of the work undertaken or advice provided.
Table 32: Contacts relating to quality of OAWG services 2011–12 to 2015–16
2011–12 2012–13 2013–14 2014–15 2015–16
Letters and emails 343 325 287 454 305
Telephone calls 97 52 73 84 49
Total 440 377 360 538 354
OAWG = Office of Australian War Graves
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Overseas memorials and projects
Operation Reunite—Terendak repatriation On 2 June 2016, 24 Australian service personnel and eight civilian dependants interred in the Terendak Military Cemetery, Malaysia, and the single remaining casualty of the Vietnam War interred overseas, in the Kranji War Cemetery, Singapore, were repatriated to Australia in the largest repatriation of its kind in our nation’s history. Reinterments of the returning Australians took place in every state and territory except Tasmania. The OAWG led the multi-agency initiative, working collaboratively with Defence and in cooperation with the governments of Malaysia and Singapore. The families of three soldiers declined the offer of repatriation. Their wishes were honoured and the graves of their loved ones will be maintained in perpetuity.
Hellfire Pass Memorial Museum and Sandakan Memorial ParkVisitation to the Hellfire Pass Memorial Museum in Thailand and the Sandakan Memorial Park in Malaysia continued to be strong in 2015–16. The Hellfire Pass Memorial Museum and walking trail was awarded the 2016 certificate of excellence by Trip Advisor, and among its more than 158,000 visitors was the Crown Princess of Thailand Her Excellency Maha Chakri Sirindhorn. Sandakan Memorial Park had more than 13,500 visitors during the year.
Overseas Privately Constructed Memorial Restoration Program The Overseas Privately Constructed Memorial Restoration Program provides grants to assist Australian veterans and others in the restoration and preservation of existing privately constructed military unit and battle memorials located overseas. In 2015–16, five grants totalling $46,879.75 funded several such projects; they are detailed on the DVA website at www.dva.gov.au.
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PROGRAM 3.2: GALLIPOLI-RELATED ACTIVITIES
ObjectiveProgram 3.2 coordinates and manages the delivery of annual commemorative and related activities at Gallipoli.
OverviewThe Department has direct responsibility for planning Anzac Day and other significant commemorations at Gallipoli. The Department works cooperatively with other Australian agencies, New Zealand agencies and Turkish authorities, both directly and through its contract provider.
Report on performanceThe Department conducted a solemn and dignified commemorative ceremony for the 100th anniversary of the August Offensive at the Lone Pine Cemetery on 6 August 2015. There were 750 people in attendance.
The service in August was attended by the Governors-General of Australia and New Zealand, His Excellency General the Hon. Sir Peter Cosgrove AK MC (Retd) and Lieutenant General the Rt Hon. Sir Jerry Mateparae, along with the New Zealand Minister of Veterans’ Affairs, the Hon. Craig Foss MP, and senior Turkish officials.
Preceding the Lone Pine commemoration, the Department jointly hosted the world premiere of the Gallipoli Symphony at the Hagia Irene inside the Topkapi Palace in Istanbul. With an exclusive guest list of 300 guests, including the Governors-General and the Speaker of the Turkish Grand National Assembly, Mr Ismet Yilmaz MP, the event was the culmination of a 10-year project. Soloists from Turkey, New Zealand and Australia were supported by the Istanbul State Symphony Orchestra, conducted by Australian maestra Ms Jessica Cottis. This symphonic piece forms a fitting tribute to the memories of those who fought in 1915, and will form a lasting legacy of the Anzac Centenary.
Both the Lone Pine service and the Gallipoli Symphony were televised by the ABC. A DVD of the Istanbul premiere of the symphony was released by the ABC and reached a high of number 2 on the ARIA DVD charts.
The 101st anniversary of Anzac Day was commemorated at the Anzac Commemorative Site in Gallipoli, Turkey, on 25 April 2016. A total of 1,224 people attended the Dawn Service. The Dawn Service was televised by the ABC and other networks to viewers in Australia and other countries.
Throughout 2015, the Turkish Government provided significant support to DVA’s commemorative activities. Significant logistics, security, medical and first aid activities were provided by the Turkish authorities to support our visitors. The Australian Government is very grateful for the assistance provided by our Turkish hosts.
The Australian premiere of the Gallipoli Symphony was jointly hosted by DVA at the Queensland Performing Arts Centre on the evening of 24 November 2015. Again, maestra Ms Jessica Cottis conducted talented soloists, supported by the Queensland Symphony Orchestra. The performance in Brisbane was open to the paying public, with 1,300 guests and VIPs in attendance, including the Queensland Governor, His Excellency the Hon. Paul de Jersey AC; the Premier of Queensland, the Hon. Annastacia Palaszczuk MP; and the then Minister for Veterans’ Affairs, the Hon. Stuart Robert MP.
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Sister Ada Smith, Australian Army Nursing Service, stands outside her tented quarters at the 2nd Australian Casualty Clearing Station at Trois Arbres, France, in 1916. (AWM P00156.058)
