1.1 The LSA considers treatment, care & support needs for ambulance transportation to be necessary and reasonable when the transportation is:
1.1.1 not otherwise funded by the LSA;
1.1.2 required to provide assistance for a participant to access, enter or be positioned in a vehicle, and the physical assistance required is greater than that expected to be provided by a taxi driver, attendant care worker or family member;
1.1.3 for the purpose of receiving medical or hospital services related to the motor vehicle injury, or for receiving other services to meet the participant’s treatment, care and support needs under these Rules; and
1.1.4 the only suitable means of transport for the participant.
1.2 The reasonable expenses in relation to the participant’s assessed treatment, care and support needs in relation to ambulance transportation will not generally include:
1.2.1 ambulance transportation provided under an existing fee agreement;
1.2.2 attendance-only charges for ambulance services; or
1.2.3 active 'waiting time' for an outpatient driver service, on request from the hospital or facility, unless there is a clinical need for active management or supervision. Active waiting time will only be paid for the time the outpatient driver has provided it for the participant.
2.1 To determine whether a participant’s need for ambulance transportation is necessary and reasonable in the circumstances, the following factors are relevant:
2.1.1 the circumstances where the ambulance transportation is required, such as: between hospitals; from a hospital to the participant’s residence after a stay in hospital as an in-patient; or for other medical treatment or therapy services;
2.1.2 consideration of whether other services have been provided, such as vehicle modifications, that will eliminate the need for ambulance transportation;
2.1.3 whether supervision for behavioural management is required by an ambulance officer; and
2.1.4 consideration of the period of time for which ambulance transportation is required.