The Intellectual Disability Health Assessment (MBS Items 718 and 719)
Two new Medicare items for general practitioners for the health assessment of people with intellectual disability came into effect in July 2007. Items 718 and 719 will remunerate GPs $204.00 and $226.95 for clinic and home assessments respectively. These items recognise the health vulnerabilities of this group and the proven benefit of having systematic review of the health problems and also allow GPs to work with practice nurses.
Health Check form for people with intellectual disability (pdf, 115kb)
Information about these new items is also on the Department of Health and Ageing website:
http://www.health.gov.au/internet/main/publishing.nsf/Content/pacd-intellectual-disability-assessment
Our research has shown that this group sees their GP about 5 times a year but usually for immunisation or medication review. Doctors need more time to fully assess and manage some of the complex issues found in this patient group.
These new health assessment items will encourage GPs to review health problems in people with intellectual disability identified in the consensus statement available at:
http://www.iassid.org/pdf/healthguidelines-2002.pdf.
Areas to be covered in the item include dental health, hearing, vision, nutrition, bladder and bowel function, medications, immunisations, daily living skills, breast, testicular examinations and PAP smears (when these apply), dysphagia, vitamin D deficiency, mental health review , epilepsy status, thyroid (in Down syndrome), sexual health and review for signs of abuse. Resources like the Comprehensive Health Assessment Program (CHAP) (Lennox et al,) are currently being used by government and non government agencies to collect health information and can be used in conjunction with these new items. At the Centre for Developmental Disability Health Victoria we are already working with practice nurses and GPs to develop training packages and resource materials to support general practitioners and practice nurses in the roll out of this new item. Useful materials including information packages on the different causes of intellectual disability and blank sheets for patient held records are available on the CDDHV website.
The NSW Council for Intellectual Disability has prepared information for general practitioners about medical and allied health services for people with intellectual disabilities.
