17 August 2005

The National Travel Assistance (NTA) policy

The National Travel Assistance (NTA) policy is now available on the Ministry’s website. Over the next six months more information will become available online for patients and their families at www.health.govt.nz/travelassistance and for health practitioners and administrators at www.moh.govt.nz/travelassistance. Travel assistance will continue to apply to travel to a publicly funded specialist service on referral from a publicly funded specialist.

Summary of new policy

The eligibility criteria for adults has been extended to include: adults who have a Community Services Card (CSC) and travel 80 km but for less than six visits in a year adults who travel 50 km for six visits in six months regardless of whether they have a CSC adults who travel for 25 visits in two months regardless of whether they have a CSC and what distance they travel adults who travel more than 350 km regardless of how often they travel and whether they have a CSC.

The eligibility criteria for children has been extended to include 16 and 17 year olds. all children and young people under 18 years will be eligible if they travel 80 km regardless of how often they travel. children that have to travel more than 25 km will be eligible if their family has a CSC or if they have to make six visits in six months. children who travel for 25 visits in two months will be eligible regardless of distance.

Reimbursement will still be a contribution towards the costs of travel of 20 cents per km for private mileage, the cost of public transport and/or accommodation when appropriate. All eligible children and young people and some adults will also be able to claim assistance towards a support person’s costs. Distance measurement will be much more accurate.

How does the new National Travel Assistance (NTA) policy compare to the current regional policies?

Northern Region

Northern Region – current policy

To qualify for assistance currently, adults in the Northland and Auckland DHB regions have to make six or more visits in a year to appointments at least 80 km from their homes and must have a Community Services Card. Children under 16 years are eligible if they travel 80 km to treatment six or more times in a year. Children with disabilities are eligible for assistance when travelling shorter distances.

Northern region – examples

Currently a woman recovering from a heart attack who has to travel from Paihia to specialist medical outpatient appointments at Whangarei Hospital would not receive assistance because the distance is less than 80 km. Under the new policy she will be eligible for assistance if she has to make six or more trips in six months because the distance is more than 50 km. In addition she would not need a Community Services Card to access the assistance.

Currently people with Community Services cards travelling to Auckland Hospital from Wellsford (over 80 km) would need to travel at least six times in a year before they would be eligible for assistance. Under the new policy people with CSCs travelling over this distance will be eligible for assistance even if they make just one trip.

The new policy is not only targeted at people living long distances away from services. Distance thresholds are much lower for children (as in the current policy) and for people having to travel very frequently. A man who lives in the central Auckland area with cancer that requires a high dose of radiation therapy might have to travel to the hospital five times a week for five to seven weeks for treatment. Although the distance travelled is not large the burden of travel is significant because it is so frequent. In recognition of this he would be able to claim assistance with travel costs under the new policy regardless of distance and even though he does not have a CSC.

Midland Region

Midland Region (Waikato, Bay of Plenty, Lakes, Taranaki)- current policy

There is some variation within the Midland region in how the policy is applied. Your DHB or HealthPAC will be able to provide more information. Currently children (under 16 years) have to travel 80 km, and adults must have a CSC and travel 80 km to qualify for assistance. In addition, eligibility may be measured based on the distance between the local hospital and the treating hospital rather than between the patient’s home and the treating hospital, before people are eligible for assistance

Midland Region – examples Currently a child travelling from Turangi who has to see a specialist at Waikato Hospital would only be able to claim the distance between Taupo (their local hospital which is around 50 km away) and Waikato. Under the new policy they will be able to claim the full distance.

The new policy recognises that travel is a greater burden for people on lower incomes and for people who have to travel frequently. Children from families who have a CSC or children who have to travel to a specialist six or more times in six months will be eligible for assistance if they live just 25 km from the service. This will cover children travelling to Waikato Hospital from places like Raglan or Te Awamutu. It will also cover children travelling to Rotorua Hospital from Reporoa and further south and to Taupo Hospital from Turangi.

Some adults who do not have a CSC will be eligible for assistance under the new policy. For example if someone from Paeroa (or any place more than 50 km from the specialist), has to travel to see a specialist in Hamilton for six outpatient appointments in six months they will be able to claim assistance.

In addition people with very high health needs who live less than 50 km from the specialist will be eligible for assistance if they have to travel to specialist treatment 25 or more times in two months. This will mostly cover people receiving haemodialysis or frequent cancer treatments even if they live in the urban area of the service.

Central Region

Central Region- (excluding Nelson Marlborough) - current policy

There is some variation within the Central region in how the policy is applied. Your DHB or HealthPAC will be able to provide more information. Currently children (under 16 years) are eligible if they travel more than 50 km or if they travel more than 25 km more than six times in a year. Currently adults in the Central region are eligible if they hold a CSC and travel 50 km or if they travel more than 25 km more than six times in a year.

In addition there are variations in practice in terms of measurement of distance. Sometimes the distance is measured between the main DHB centres rather than from a person’s home. For example, because Hutt Hospital and Wellington Hospital are less than 25 km apart people from the Hutt DHB region (even if they live in Upper Hutt) are not eligible for assistance when travelling to Wellington Hospital. In some places only the distance and/or trips beyond the threshold level are reimbursed.

Central Region (excluding Nelson Marlborough) – examples

Everyone in the Central region who needs to travel to the spinal unit at Burwood Hospital in Christchurch will be eligible for assistance whereas now they would need a CSC or to make six trips in a year. Most people from the region who have to travel to Auckland will also be eligible (Ohakune is around 350 km from Auckland hospital).

Families will be recognised as having higher needs if they have a CSC. A family from Stokes Valley will be able to claim assistance with travel costs if they have a CSC and a child in the family has to travel to Wellington Hospital. Currently they would not be eligible because they live less than 50 km from the service.

Central Region (Nelson Marlborough) - current policy

There is currently some variation within the Central region in how the policy is applied. Your DHB or HealthPAC will be able to provide more information. Currently children (under 16 years) are eligible if they travel more than 50 km or if they travel more than 25 km more than six times in a year. Currently adults in the Central region are eligible if they hold a CSC and travel 50 km or if they travel more than 25 km more than six times in a year.

Central Region (Nelson Marlborough) – examples

All people from Nelson (cut off point around Havelock) who have to travel to Christchurch will be eligible for assistance even if they make only one trip and regardless of whether they have a CSC.

Patients who have to travel to specialist services very frequently, such as for haemodialysis or some cancer treatments will be eligible for assistance regardless of the distance they travel and without requiring a CSC. This will benefit those who live in relatively central urban areas as well.

Families will be recognised as having higher needs if they have a CSC. A family from Motueka will be able to claim assistance with travel costs if they have a CSC and a child in the family has to travel to Nelson Hospital. Currently they would not be eligible because they live less than 50 km from the service.

Southern Region

Southern Region - current policy

Currently children (under 16 years) in the Southern region (boundary stretches from between Inangahua and Murchison on the West Coast to between Ward and Kekerengu on the East Coast) are eligible if they travel 90 mins or more one way or if they travel more than 10 km six or more times in three months, or if they attend a continuous course of treatment for 21 days 10 km away.

Adults with a CSC in the Southern region are eligible if they travel 90 mins or more one way or if they travel more than 10 km six or more times in three months, or if they attend a continuous course of treatment for 21 days 10 km away. Adults with a High User Health Card are eligible if they travel more than 10 km six or more times in three months, or if they attend a continuous course of treatment for 21 days 10 km away. Adults without a CSC or HUHC are eligible if they travel more than five hours.

When accommodation is required the maximum cost reimbursed is only $75 despite the fact that people from other parts of the country receive more, and accommodation is more expensive in places like Auckland.

Southern Region - examples

Patients who have to travel to specialist services very frequently, such as for haemodialysis or some cancer treatments will be eligible for assistance regardless of the distance they travel and without requiring a CSC. This will benefit those who live in relatively central urban areas as well.

Families will be recognised as having higher needs if they have a CSC. A family from Rangiora will be able to claim assistance with travel costs if they have a CSC and a child in the family has to travel to Christchurch hospital without meeting any frequent travel criteria.

ENDS

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