Expression of Interest Guidelines
for Private Practitioners
Introduction
The Family Reconciliation Mediation Program (FRMP) is calling for Expressions of Interest (EOI) from
suitably qualified Psychologists, Counsellors, Family Therapists / Mediators, and Art Therapists who are
interested in being placed on a Private Practitioner Register accessed by community sector workers
assisting young people who are homeless, for the purpose of brokering short term therapeutic services for
their clients.
Many case managers do not have the capacity to provide mediation, reconciliation and counselling services
for young people. FRMP Brokerage was allocated by DHS to fill these service gaps. To ensure that FRMP
funds are available to as many young people as possible, funds are allocated to young people to access ten
sessions of therapeutic support to address their specific goals in relation to family reconciliation/mediation
and recovery.
Whilst FRMP is respectful of the skills and training of those practitioners wishing to support these young
people, FRMP would also ask that practitioners are mindful of the limitations of FRMP funding by agreeing
not to charge young people in excess of their normal fees.
EOI applications
Practitioners wishing to express interest in inclusion on the Private Practitioner Register should complete
the attached EOI registration form (Appendix 1)
Applications must fulfil the following requirements. All costs below are GST exclusive. Please be advised
the fee for service may change subject to service funding agreements between Melbourne City Mission
(FRMP) and DHS. Please refer to Invoicing Guidelines (Appendix 2) for more information on payment.
Acceptable Association
Minimum level
Max cost
per
session
Associate Member (Assoc
MAPS)
$155.00
Full Membership
$155.00
Level 3
$110.00
Clinical Membership
$110.00
ARCAP (The Australian Register of Counsellors
and Psychotherapists)
Division
A:
Clinical
Registrants, or Division B:
Level 2
$110.00
Family Therapists
VAFT (The Victorian Association of
Therapies)
Clinical Membership
$120.00
Family Mediators
AMA (The Australian Mediation Association)
Registered under the
National
Mediator
Accreditation System
$120.00
Professional category
$120.00
Professional category
$120.00
Psychologists
Counsellors and
Psychotherapists
Arts Therapists
APS (Australian Psychological Society)
AHPRA (Australian Health Practitioner Regulation
Agency) & Psychology Board of Australia
ACA (Australian Counselling Association)
PACFA (Psychotherapy & Counselling Federation
of Australia)
Family
ACAA (The Australian Creative Art Therapies
Association)
ANZATA (Australian & New Zealand Arts Therapy
Association)
Music Therapists
AMTA (Australian Music Therapy Association)
Professional registration
as a practicing member
$120.00
Mental
Health
Social Worker
AASW (Australian Association of Social Workers)
Accredited Mental Health
Social Worker registered
with Medicare
$130.00
Essential criteria used to assess expressions of interest include:
-
-
Proof of registration to the applicable Board / Association in relevant area of practice
-
Evidence of relevant experience in field of practice including experience in working with
vulnerable young people who may engage in high risk behaviours such as substance use,
self-harm and suicidal ideation.
-
Professional Indemnity Insurance
-
Statement of philosophy / approach
-
Current Police Check
Current Working with Children Check
Desirable criteria:
-
Medicare Registered / Approved
Link to website / brochure
Please note
Inclusion on the Private Practitioner Register does not give rise to an employment relationship
between the contractor/practitioner and Melbourne City Mission. Inclusion on the Private
Practitioner Register is not an exclusivity agreement and there is no minimum work offered or
guaranteed.
Applications should be forwarded to:
Family Reconciliation Mediation Program
Frontyard Youth Services
Melbourne City Mission
19 King Street, Melbourne 3000
Or email to frmp@mcm.org.au
Applicants must include a current CV, certified copy of professional accreditation and a covering
letter briefly addressing the selection criteria as outlined in the Expression of Interest
guidelines.
Family Reconciliation Mediation Program (FRMP)
Expression of Interest Form for Private Practitioners
Note: this form is designed to be filled in electronically.
FRMP USE ONLY
Date received:
Part 1: Contact Details
1a. Please provide your contact details below:
Name
Practice Address
Postal Address
Contact Numbers
Office Number:
Mobile:
Fax:
Email
Website
Outcome:
Part 2: Professional Accreditation
In completing the information below, please ensure you have read the guidelines for brokerage, noting the minimum
qualification and accreditation requirements to be listed as a private practitioner with FRMP.
2a. What is your current accreditation, level, and indemnity insurance amount?
Accreditation
Acceptable
Associations
Your
accreditation
Max cost per
session
(please provide
your registration
number and/ or
provide a scanned
certificate of
registration))
(GST exclusive)
Minimum level
APS
(Australian
Psychological
Society)
Associate
Member (Assoc
MAPS)
AHPRA
(Australian
Health
Practitioner
Regulation
Agency) &
Psychology
Board of
Australia
Full Membership
Counsellors
ACA
(Australian
Counselling
Association)
Level 3
Psychotherapists
PACFA
(Psychotherap
y&
Counselling
Federation of
Australia)
Clinical
Membership
Psychologists
Your level
VAFT (The
Victorian
Association of
Family
Therapies)
Clinical
Membership
AMA (The
Australian
Mediation
Association)
Registered under
the National
Mediator
Accreditation
System
ACAA (The
Australian
Creative Art
Therapies
Association)
Professional
category
ANZATA
(Australian &
New Zealand
Arts Therapy
Association)
Professional
category
Music
Therapists
AMTA
(Australian
Music Therapy
Association)
Professional
registration as a
practicing
member
Mental Health
Social Worker
AASW
(Australian
Association of
Social
Workers)
Accredited
Mental Health
Social Worker
registered with
Medicare
Family
Therapists
Family
Mediators
Arts
Therapists
2b. Please provide your Working with Children Check and police check details below:
Working With
Children Check
Number:
Or Receipt number:
(Please notify FRMP of Working with Children Check
number on receipt of your card)
Police Check
Yes (please attach a copy of it)
No
Part 3: Business Details and Availability
In completing the information below, please ensure you have read the guidelines for brokerage, noting
maximum rates for sessions, outreach criteria, etc.
3A. Please provide the following details:
ABN
Business name
Are you the business owner?
Medicare Registered Provider under the
Mental Health Care Plan Scheme
Medicare Gap payment (if client moves
onto a mental health care plan following
brokerage sessions what gap amount will
be charged)?
Yes
No
$
Business Insurer
(please attach a copy of your insurance certificate)
Insurance Amount
$
Rate per session
$
Cost of unattended/cancelled session
$
Outreach (FRMP funding only available in
rural areas. Practitioners can submit for the
mileage costs of outreach through the
taxation system)
Yes
No
Home Visits
Yes
No
Do you have access to alternative office
I have access to alternative office space
space or would you require a support
worker to organise a venue?
I need a support worker to organise a venue
Travel Cost (if not provided we refer to the
standard rate as per taxation)
Availability
Areas Covered
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please provide any additional information
I only work across the following suburbs
Metro East
Metro South
Metro West, including Melbourne CBD
Metro North
Barwon South West
Loddon Mallee
Hume
Grampians
Gippsland
Grampians
Please provide any additional information
Part 4: Practice Approach and experience
4a. Please list up to 8 of your speciality areas (eg: relationships, trauma, family conflict).
1.
2.
3.
4.
5.
6.
7.
8.
4b. Is your practice targeted specifically to adolescents or to the general public?
4c. Please briefly list details of your experience working with young people and their families (eg: past
and current work places, year, duration, position etc):
4c. Please share your understanding of issues that homeless young people and their families experience:
4d. Experience with diverse client groups
Culturally and linguistically diverse young people (CALD)
Indigenous – Aboriginal
Indigenous – Torres Strait Islander
Indigenous – both Aboriginal and Torres Strait Islander
Gay, lesbian, bisexual and transgender
Other, please specify below
4e. Other language spoken
Part 5: Other Specialty Areas
Presenting at Public Forums
Details:
Group-work Facilitation
Details:
Training and/ or reflective practice sessions for other practitioners/ students
Details:
I am interested in presenting aspects of my work (e.g. best practices, approaches to family
reconciliation amongst homeless youth) at the FRMP yearly conference
Details:
Part 6: FRMP Website
Please note that your contact details and the details contained in this EOI pertaining to your practice will
be listed publicly on the Practitioner Database on the MCM and FRMP websites.
Yes, and I understand it is my responsibility to ensure my contact details are up to date
Yes, but I do not want the following information to be put on the website:
Part 7: Checklist
I have read the FRMP Brokerage guidelines and agree to the rates for sessions, expectations for
practitioners, and invoicing requirements
I have attached to this application form my WW Children Check number, Police Check Certificate, and
professional accreditation registration number or certificate
I acknowledge that the above is true and correct
I will inform FRMP by writing of any changes to any details I supplied in this application
Name
Date
Thank you for taking time to complete this form
Please send this form to FRMP by
Email: frmp@mcm.org.au
The FRMP Team will contact you within two weeks to advise whether or not your services will be included
in the Practitioner Register on the FRMP website.
Kind Regards,
The FRMP Team