Assessment of participant’s treatment and care needs
23 Assessment of participant’s treatment and care needs
The LTCS commissioner must assess the treatment and care needs of a participant in the LTCS scheme for the injury in relation to which the injured person is a participant in the scheme.
Treatment and care needs, of a participant in the LTCS scheme—see s 9.
The assessment must determine the participant’s treatment and care needs that—
are reasonable and necessary in the circumstances; and
relate to the injury in relation to which the person is a participant in the LTCS scheme.
In deciding whether the participant’s treatment and care needs are reasonable and necessary in the circumstances, the LTCS commissioner must consider the following:
the benefit that a service will have for meeting the participant’s treatment and care needs;
the appropriateness of a service, or request for a service, to meet the participant’s treatment and care needs;
the appropriateness of a provider of a service mentioned in paragraph (b);
the cost benefit of a service mentioned in paragraph (b).
Note The LTCS guidelines may include provisions about which of an injured person’s treatment and care needs are reasonable and necessary in the circumstances (see s 30 (5)).
The assessment must be made in accordance with the LTCS guidelines.
The LTCS guidelines are made under s 93.
The LTCS commissioner must—
certify in writing its assessment of the participant’s treatment and care needs; and
include in the certificate its reasons for the findings on which the assessment is based; and
give a copy of the certificate to the participant.
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