DVA community nursing: eligibility and referrals

You can get DVA community nursing if you hold a Veteran Card and have an assessed clinical need for nursing or personal care at home. With a Veteran Card (All Conditions), long known as the Gold Card, the need can relate to any condition. With a Veteran Card (Specific Conditions), the White Card, it must relate to a condition DVA has accepted as service related. Either way, you need a written referral from a GP, a hospital doctor, a hospital discharge planner or a community nursing nurse practitioner, sent to a DVA contracted provider.

That is the short version, taken from the DVA Community Nursing page. The rest of this guide covers the detail families most often ask us about.

What DVA community nursing covers

The program funds clinically required nursing and personal care in your home. Registered nurses, enrolled nurses and personal care workers deliver it. DVA's examples include help with medication, wound care, showering and hygiene, dressing, and palliative care.

The key words are "clinically required". Community nursing is for care linked to an assessed health need. Help with cleaning, gardening or shopping is not part of it; DVA handles that through other programs with their own assessments.

DVA also notes that your GP keeps ongoing clinical oversight of your care. The nursing provider works with your doctor rather than replacing them.

Who is eligible

There are two parts to eligibility, and you need both.

1. The right Veteran Card

DVA now uses these card names:

• Veteran Card (All Conditions). This is the card many people still call the Gold Card. It is held by some veterans and by eligible war widows and widowers.
• Veteran Card (Specific Conditions). This is the card many people still call the White Card. It covers treatment for conditions DVA has accepted as related to your service.

If you hold the Specific Conditions card, the nursing provider must contact DVA to confirm you can receive community nursing before care starts. That check looks at whether the care you need is for an accepted condition. A White Card holder recovering from surgery on an accepted knee injury might qualify; the same person needing wound care for an unrelated condition might not.

If you are not sure which card you hold, or what your accepted conditions are, call DVA on 1800 VETERAN (1800 838 372).

2. An assessed clinical need

Holding the card is not enough on its own. A registered nurse from the provider assesses what nursing and personal care you need. Services are based on that assessment, and the care is reviewed regularly with you.

How the referral works

The referral is the step that most often holds things up, so it is worth getting right.

Who can write it

According to DVA, a written referral can come from:

• your general practitioner (GP)
• a treating medical practitioner in hospital
• a hospital discharge planner
• a nurse practitioner specialising in a community nursing field.

Family members, carers and veterans themselves cannot refer directly. You can, however, ask your GP for a referral, or ask the hospital team before discharge.

What form it takes

DVA accepts the D9389 Community Nursing Referral form, the referrer's own letterhead or referral document, or the provider's own referral form. The referral should set out the services you need for your nursing needs and medical conditions.

Where it goes

The referral goes straight to a DVA contracted community nursing provider, not to DVA. DVA publishes a Panel of Community Nursing providers for each state and territory. Only providers on that panel are funded to deliver DVA community nursing.

Trailblazer Community Care is on this panel for community nursing and personal care, in set areas across Brisbane, Logan, Moreton Bay and the Redlands. The areas are listed on our DVA services page.

How long a referral lasts

• A referral from your GP or a nurse practitioner lasts 12 months.
• A referral from a hospital lasts six weeks. After that, you need a new one from your GP.

You also need a new referral if you have been out of care for more than 28 days, or if you want to change providers. A common gap is the hospital referral quietly running out at the six-week mark. If you are coming home from hospital, it helps to book a GP appointment within those six weeks so care does not stop.

What happens after the referral

Once the provider receives a valid referral, a registered nurse visits you at home. DVA says the nurse will:

1. Contact DVA to confirm eligibility if you hold the Specific Conditions card.
2. Assess your clinical nursing and personal care needs.
3. Write a nursing care plan and give you a copy.

From there, services start in line with the plan. The amount and type of care is reviewed by a registered nurse, with you, over time.

Costs and paying

DVA states that if you are eligible, it funds services delivered by a DVA contracted community nursing provider and there is no cost to you. It also says that if a provider asks you to pay for community nursing services, you should not pay the account and should contact DVA instead.

Trailblazer is a DVA contracted community nursing provider. If you're eligible and DVA has approved your care, we bill DVA directly and you won't be asked to pay.

Tell your provider when things change

DVA asks you to let your nursing provider know if you go into hospital, your care needs change, you plan a holiday or a move, or you are moving into residential aged care. Tell them too if you are unhappy with the service. If your concern is not resolved, you can call DVA on 1800 VETERAN or use DVA's online feedback form.

Where Trailblazer fits

Trailblazer Community Care provides DVA community nursing and DVA personal care across Brisbane, Logan, Moreton Bay and the Redlands. Our clinical lead is Exavier Rikonda, a Registered Nurse with 14 years of nursing experience.

If you or your GP would like to talk about a referral, you can send it through our referral page or call 1300 822 333. We reply within 12 to 24 hours. You can read about our clinical governance on our quality and safeguarding page.