5. Children in care

• Key steps
  • 1. Place a child in care
  • 2. Support a child in care
  • 3. Decision-making for the child
  • 4. Conclude a care placement
• What ifs
• Resources

You are here:

1. Home
2. Chapters
   • Framework for practice and maps
   • Introduction
   • Practice papers
   • Quicklinks
   • Resources
   • Structured Decision Making
3. 5. Children in care
   • 1. Intake
   • 10. General
   • 2. Investigation and assessment
   • 3. Ongoing intervention
   • 4. Case planning
   • 6. Intervention with parental agreement
   • 7. Support service cases
   • 8. Regulation of care
   • 9. Standards of care
4. Key steps
   • Resources
   • What ifs
5. 2. Support a child in care

Research indicates that children in contact with the child protection system experience poorer outcomes across a range of well-being indicators.

This is especially so for Aboriginal and Torres Strait Islander children, who continue to be overrepresented in the child protection system, and whose life chances can be greatly assisted by the provision of culturally appropriate placements, services and supports. This includes providing opportunities for the child and family to be consulted and involved in all aspects of decision-making regarding significant decisions for Aboriginal and Torres Strait Islander children, making arrangements for an independent person to help facilitate their participation in decision making.

Research also shows that children entering care are presenting with increasingly complex levels of need. Children who are assessed as having complex or extreme support levels particularly demonstrate poor social functioning, poor levels of behavioural and emotional functioning, high levels of attachment problem behaviors and significant levels of clinical depression and anxiety. Children with histories of sexual abuse or sexualised behaviours are also a particularly vulnerable group in terms of their likely support needs.

Timely and targeted provision of services that match a child's assessed needs will assist to improve their life chances, both now and in the future. For evidence-based information about the support needs of children in care, refer to Support needs and placement matching in care A Literature Review (PDF, 522 KB) and the practice resource Complex/extreme support needs and placement matching (PDF, 189 KB).

The provision of case management and case work in conjunction with specialised or structured support services enables a holistic response to a child's assessed needs across a range of areas including:

• physical health (including dental)
• emotional and behavioural stability
• child development and intellectual ability
• cultural identity
• social relationships including relationships with the family of origin, the carer family or residential care staff, and the community
• education, vocation and employment
• independent living skills
• alcohol and drug use.

Kicbox 

Kicbox is a digital, standard practice tool that must be utilised for all children in care, regardless of their age, length of time in care and location. This application (app) supports the undertaking of life story work and allows for the recording and accumulation of information throughout a child’s time in care, which is critical for their eventual transition to independence.

All children in care experience disconnection from their family and community and placement disruptions may result in the loss of personal possessions, photos and memories. Life story work supports the development of a strong foundation for a young person’s independence and will assist a child create a coherent understanding of their family relationships and connections, increase their self-knowledge and self-esteem and promote an understanding of what has happened to them during their time in care.

All training and support material including practice guidelines are found on the ‘Support’ tab within kicbox or by searching for kicbox on the Child Safety intranet.

Child subject to a long-term guardianship order to a suitable person

While a child subject to a long-term guardianship order to a suitable person is no longer placed using the authority of the Child Protection Act 1999, section 82(1), the child or long-term guardian may contact Child Safety to request support. For further information, refer to the Supporting children in the care of long-term guardians (PDF) and Child related costs - Long-term guardian support (PDF) policies, and Chapter 3, 1. What if a suitable person has long-term guardianship?

2.1 Obtain a birth certificate for a child

When a child is subject to a child protection order and placed in care, obtain at least two original birth certificates for the child. One original birth certificate is to be retained on the child's file, and a second original is to be provided to the child as part of their transition to independence planning (or at other times at the child’s request) - for further information see 2.10  Plan and support the young person’s transition from care to adulthood. A certified copy is to be provided to the carer.

To obtain birth certificate/s, complete and email the Request for Birth Certificate form to DMS. DMS will process the request, liaise with Births, Deaths and Marriages, verify the child’s birth details on ICMS and post the certificate/s to the CSSC. A copy of the original child protection order must be attached for all applications for interstate, overseas and late registration birth and death certificates.

In addition:

• provide a certified copy to the carer
• upload a copy to ‘Important Documents’ in the child’s kicbox.

[ Return to top ]

2.2 Obtain Medicare and Health care card details

Medicare cards When a child is placed in care, arrange for the child to have their own Medicare card to use while they are in care.

Where a child is subject to a child protection order granting custody or guardianship to the chief executive, it is a Medicare Australia requirement that these children be issued with their own Medicare card. Only Child Safety can apply for the Medicare card for a child in this circumstance, unless the child is over 15 years of age, in which case they can apply for their own card.

Where the child has an existing Medicare number, obtain the number from either:

• the child’s parents, where possible, or
• Medicare Australia
• where the child does not have an existing Medicare number, enrol the child in Medicare.

Obtain Medicare details for the child

Medicare enrolment details are provided to the carer of a child in the completed Child information form. Where Medicare information is not provided at the time of the placement:

• obtain Medicare information from the parents or from Medicare Australia as soon as possible
• update the Child information form
• provide a copy of the updated form to the carer.

It is not necessary to obtain the Medicare card from the child’s parents. The child continues to be listed on the parent’s card, even where Child Safety applies for an individual card for the child.

If the child's Medicare number is not able to be obtained from the parents, a direct request can be made to Medicare Australia by Child Safety in accordance with the Information Sharing Protocol between the Commonwealth and Child Protection Agencies.

Actions required where a child is not enrolled with Medicare Australia

If a child has never been enrolled with Medicare Australia and does not have a Medicare card number, bulk billing by medical practitioners and subsidised medication from pharmacies is not available, and full fees or charges will have to be paid.

Medicare Australia will reimburse the rebate when the child has been issued with a Medicare card. In this circumstance, advise the carer to keep all receipts (both medical and pharmaceutical), and obtain the rebate once the Medicare number is issued.

Only Child Safety can apply for the Medicare card for a child in this circumstance, unless the child is over 15 years of age, in which case they can apply for their own card.

A doctor or pharmacist is able to directly request a child’s Medicare number from Medicare Australia, which may be necessary in emergent situations. If medical care or pharmaceuticals are required by a child for whom an existing Medicare card number is not available, the carer must have accurate information about the personal details of the mother and the child in order to assist the doctor or pharmacist to make a request for the Medicare card number.

Request information from Medicare Australia

To request a Medicare number for a child under 15 years of age, send an email to DMS via the email group CSDMS_Req_MedicareNo@communities.qld.gov.au with the subject heading of ‘Request for Medicare Number for [Child’s Name]’ and include the following details:

• the full name of child
• the child’s date of birth
• any alias details for child
• the mother’s name, if known.

DMS will send a return email with the Medicare number requested.

Apply for a Medicare card - custody or guardianship to the chief executive

Once a child is subject to a child protection order to the chief executive (interim, custody or guardianship) the CSO will either:

• enrol the child in Medicare, or
• request a new Medicare number for the child to use.

To enrol a child in Medicare or request a new Medicare number for a child:

• complete the Medicare enrolment or new Medicare number request (online) form (PDF)or Medicare enrolment or new Medicare number request (printable) form (PDF)
• record the postal address for the CSSC as the child’s address
• attach copies of the required supporting documents (the proof of birth document must be a certified copy)
• return the completed form and supporting documents, either:
  • by email to MPS.Eligibility@humanservices.gov.au – in the subject line of the email include Queensland, Child Protection and [the name of the child or young person], or
  • by post to - Department of Human Services, Medicare, PO Box 7856. Canberra BC, ACT 2610.

Email is the preferred and most time efficient way to return the form.

Young people aged 15 or older can choose whether they want Medicare Australia to send their new Medicare number to Child Safety. If so, the young person must sign the declaration on the form. Alternatively, a young person can request their own Medicare number by completing an Application to copy or transfer from one Medicare card to another form (MS011). This means their Medicare record will list their address and contact details, and their own bank account details if they wish. Medicare Australia will nor link the young person’s new Medicare number to Child Safety or to their existing Medicare number with their parents.

Aboriginal or Torres Strait Islander children

In circumstances where an Aboriginal or Torres Strait Islander child does not have a birth certificate or other identity documents, use the Aboriginal and Torres Strait Islander Medicare enrolment and amendment form (MS018) to enrol them in Medicare.

A Child Safety staff member can act as a referee, confirm the child’s identity on the form and sign it on behalf of Child Safety. The birth parent’s signature is not required to submit this form.

Send the form, not to the address details on the form, but either:

• by email to MPS.Eligibility@humanservices.gov.au  – in the subject line of the email include Queensland, Child Protection and [the name of the child or young person], or
• by post to - Department of Human Services, Medicare, PO Box 7856. Canberra BC, ACT 2610.

Receive the Medicare card and record relevant information 

Once issued, the Medicare card will be sent directly to the CSSC with case responsibility for the child. When the card is received:

• attach a copy of the Medicare card to the health care file - refer to 2.4 Develop a child health passport
• upload the details or a scanned copy to the child’s kicbox ‘Important Documents’ category
• record the Medicare card details in the ‘Child information form’ and provide a copy of this form to the carer for the child health passport folder
• update ‘Health cards’ on the child’s health tab in ICMS with the Medicare card details
• provide the Medicare card to either:
  • the young person, where they are listed as the cardholder
• the child's carer.

Action other Medicare card requirements

While the child is in care:

• each time a child changes placement obtain the Medicare card from the existing carer and provide it to the new carer
• update a child address with Medicare Australia if the child’s case is transferred to another CSSC.

When a child is returned to their parents care, notify Medicare Australia using the Letter to Medicare - change of address and either:

• obtain the child’s Medicare card from the carer and place the card on the child’s health care file – do not provide the card to a parent
• ensure the young person retains their Medicare card, where they are listed as the cardholder.

Request a replacement card for a child under 15 years

When a Medicare card is lost for a child under 15 years of age, request a replacement Medicare number by sending an email to DMS via the email group CSDMS_Req_MedicareNo@communities.qld.gov.au with the subject heading of ‘Request for replacement Medicare card for [Child’s Name]’ and include the following details:

• the number of the child’s lost Medicare card (if known)
• the name of child
• the child’s date of birth
• the postal address where the replacement card is to be sent to

DMS will contact Medicare Australia and request a replacement card for the child to be sent to the relevant CSSC.

Lost Medicare cards – child over 15 years 

A young person aged 15 years and over and listed as the cardholder, may request a replacement card either:

• by calling Medicare Australia on telephone 1300 660 035, and correctly answering the security questions
• by having Child Safety write a letter and including:
  • the type of request – ‘request for a replacement Medicare card’
  • the young person’s full name and date of birth
  • the current Medicare number
  • the signature of the CSO and the young person.
• sending the letter to Medicare Australia, either: 
• by email to MPS.Eligibility@humanservices.gov.au – in the subject line of the email include Queensland, Child Protection and [the name of the child or young person], or
• by post to - Department of Human Services, Medicare, PO Box 7856. Canberra BC, ACT 2610.

When a young person turns 18 years

A young person who turns 18 years can keep their existing Medicare card, however, they will need to update their contact and address details with Medicare Australia, if required. To do this the young person can call the general enquiries line on telephone 132 011 or visit a Medicare Australia service centre.

To advise Medicare Australia that Child Safety is still receiving mail for a young person who is no longer in care:

• call 1300 660 035, or
• write a letter on agency letterhead and either:
  • by email to MPS.Eligibility@humanservices.gov.au – in the subject line of the email include Queensland, Child Protection and [the name of the child or young person], or
  • by post to - Department of Human Services, Medicare, PO Box 7856. Canberra BC, ACT 2610
• in all these communications provide:
• the Medicare number of the young person
• the name and date of birth of the young persona
• advice that the young person is 18 years or older and no longer in Child Safety’s care. 

Advise carer to apply for Health care card

All children in care are entitled to a health care card in their own name. The card remains with the child even if they change placement and it is automatically renewed every six months, as long as the child remains eligible. Health care cards for Children in care are exempt from income and asset testing.

When a child is placed with a foster or kinship carer, only the carer can make the application for a Health care card. When making an application for the Health care card, the carer will need to complete a claim form, and provide documents to prove that they are legally caring for the child, for example, the Authority to care form and proof of identity for the carer and child in care. Refer carers to their local Centrelink office for full details, or to the Centrelink website.

When a child is placed in care other than with a foster or kinship carer (for example a licensed residential care service), apply for a low income health care card by completing the health care card claim form (do not tick that you are claiming a health care card for a “foster child”).

When a child with a health care card changes placement, advise Centrelink of the child’s new address and carer’s name. 

Support the child to apply for a low income health care card

 To be eligible for a low income card the child:

• must be subject to a child protection order granting custody to the chief executive and residing in an approved placement
• be an Australian resident and residing in Australia at the time the claim is submitted
• have income below $543.00 per week.

When a child is placed in care other than with a foster or kinship carer (for example a licensed residential care service), assist the child to apply for a low income health care card in their own right. There is no age limit for the low income card and, as the child is the applicant, only the child’s name will appear on the card.

The card needs to be applied for annually, to ensure the child meets the income test. For more information refer to the Human services website.

Provide information about related Centrelink benefits

When the child is placed in care with an approved foster or kinship carer, or a provisionally approved carer, inform the carer that they may:

• be eligible for the lower threshold of the Medicare Safety Net, Child Care Subsidy (child welbeing), Rent Assistance or Remote Area Allowance
• be eligible for Family Tax Benefit (if claimed with health care card, carer must contact Centrelink)
• be eligible for low or no cost approved kindergarten programs for the child in their care - refer to 2.5 Respond to the child's education needs

[ Return to top ]

2.3 Maintain the child's immunisation schedule

Child Safety considers childhood immunisation an essential part of a child’s health care needs and will arrange for children, who are in need of protection and subject to a child protection care agreement or a child protection order granting custody or guardianship to the chief executive to receive immunisations in accordance with the recommended schedule of immunisations, unless a doctor advises there is a medical reason for not proceeding.

When a child is the subject of an investigation and assessment, the focus of Child Safety’s intervention is assessing their need for protection, and as such Child Safety will not routinely seek to arrange immunisations for children taken into custody during the investigation and assessment. In circumstances where the child’s immunisation is relevant to the investigation and assessment or where there is need for an emergent vaccination, active attempts to obtain the consent of a parent will be made. If consent cannot be obtained, Child Safety may request a medical practitioner to administer the relevant vaccination by exercising their authority under the Child Protection Act 1999, section 97. 

When a child is subject to a child protection care agreement, the parents remain responsible for their child’s vaccinations and Child Safety will seek the parent’s consent for scheduled vaccinations in the first instance. Where a parent objects to their child being immunised, the grounds for the objection will be discussed with a doctor. Where a parent is unable to be located, does not give consent or is otherwise unable to consent, Child Safety will seek medical treatment and ask the doctor to consider providing the vaccination under the authority of the Child Protection Act 1999, section 97.

Children who enter care may have missed one or more of their routine childhood vaccinations, leaving them at risk of significant health consequences - refer to the Immunisation of Children in care policy (PDF, 337 KB).

Vaccinations on the National Immunisation Program Schedule are provided free if a child is eligible for Medicare. The Immunisation Schedule Queensland is accessible via the Department of Health website.

When a child is placed into care it is important to establish their immunisation history as early as possible, to identify any due or overdue immunisations. Most vaccinations need to be given several times to build a child’s long lasting protection. A child’s parents are a vital source of information about the child’s immunisation history, including information about serious adverse reactions to previous vaccinations. Document this in the Child information form and provide a copy to the carer.

Obtaining the child’s immunisation history

The Australian Immunisation Register (AIR) is a national register recording the vaccination details of everyone in Australia. An AIR immunisation history statement provides details of when and what vaccines have been given to a child.

Child Safety can request a record of a child’s immunisations from the AIR Wards of State Skill Group using the AIR request immunisation letter. This request can be emailed to AIR@humanservices.gov.au or faxed to AIR on 08 9254 4810 . The AIR Wards of State Skill Group can be contacted on 1800 037 723 if required. Immunisation history statements should be kept on the child’s Child Safety Health Care file, uploaded to the child’s kicbox account in ‘Important Documents’ and a copy provided to the carer for filing with the child health passport folder. The child’s health tab should reflect the information provided in the immunisation history statement.

If a child is to be enrolled in an early childhood service, proof of their up-to-date immunisation status is required. A delay in providing the Immunisation History Statement may lead to delays in the child commencing at the child care or kindergarten. If a child is not immunised in accordance with the National Immunisation Program Schedule, they may not be eligible to attend a kindergarten program or will be precluded at times when a communicable disease is present in the centre.

Children of all ages must meet immunisation requirements in order for some of the family payments available through the Australian Government – Family Tax Benefit (FBT) Part A end of year supplement, Child Care Benefit and Child Care Rebate.

The AIR automatically generates an Immunisation History Statement to parents/carers upon completion of the childhood vaccination schedule (usually around four years of age). If a child’s immunisation is not up to date, Immunisation History Statements are also automatically generated and sent to parents/carers at key vaccination milestones.

Consent forms

There are two types of forms that can be used to provide consent for a child’s immunisation:

• the Parental consent for childhood immunisation form
• the individual immunisation consent forms of clinics operated by local councils and community health centres, which require the parent or legal guardian’s signature - these forms may be available to download from the immunisation provider.

Children in year seven and attending a Queensland high school are provided with information about their forthcoming vaccinations through the School Immunisation Program, usually at the beginning of the school year. This includes a consent form for the parents or legal guardian’s signature.

Clinics operated by local councils and community health centres require the parent or legal guardian to sign an immunisation consent form. These forms may be available to download from the immunisation provider.

Obtain the parents’ consent to their child’s immunisation

Where the parents retain legal guardianship of a child in out of home care, their consent is required to commence and/or maintain the immunisation of the child. Child Safety staff, approved carers or care services staff do not have authority to sign the immunisation consent form. 

When a child is subject to a child protection order granting custody to the chief executive (including interim and procedural orders), seek to obtain the consent of the parents and work with the parents to understand their views about immunisations, prior to arranging a vaccination.

Seek the parents’ views on commencing and/or maintaining their child’s immunisation schedule while they are in care. Where the child’s parents express concern about immunisation:

• discuss the ‘Information Sheet – Comparison of the effects of diseases and the side effects of NIP vaccines’
• encourage the parent to phone 13 HEALTH (13 43 25 48) for a discussion with a professional health advisor about the risks and benefits of immunisation
• inform them where to access additional relevant information about immunisation - available from Queensland Health Vaccination Matters website or the Immunise Australia Program website
• consider whether it is appropriate for the parent to accompany the child at the immunisation appointment, where they can discuss their concerns directly with the immunisation provider.

Where the parents consent to immunisation:

• advise the parents they can revoke their consent at any time
• have them sign the Parental consent for childhood immunisation form, or the local council clinic or child health centre consent form, if required
• provide a copy of the form to the carer, as this provides proof of parental consent for the immunisation provider – the carer can attach the signed Parental consent for childhood immunisation form to the immunisation providers consent form.

Where the local council clinic or child health centre consent form is used, a new form would be required each time the child is due to receive a vaccination by that clinic.

Where the parent is unable to be located, does not give consent or is otherwise unable to consent, seek medical treatment and ask the doctor to consider providing the vaccination under the authority of the Child Protection Act 1999, section 97. Where a parent has objected to their child being immunised, discuss the grounds for the objection with the doctor.

Obtain consent for the child’s immunisation from another person

For children subject to a child protection order granting guardianship to the chief executive, approved carers and care services are authorised to make immunisation arrangements and the parents’ consent to immunisation is not required. Where the immunisation provider requires a signed consent form, the carer or care service staff will attach the Authority to Care - Guardianship to the Chief Executive form as this provides their authority to arrange for the child’s immunisation.

Emergent vaccination

In all cases where an emergent vaccination is required for a child in the care, the delegated officer will either consent to the vaccination or seek medical treatment and ask the medical practitioner to exercise the authority of the Child Protection Act 1999, section 97, depending on the intervention to which the child is subject.

Request the carer to make immunisation arrangements

Where due or overdue immunisations are identified, request the carer to facilitate the child’s immunisation or catch up immunisation. Vaccinations can be obtained from:

• a general practitioner (a consultation fee may apply)
• an Aboriginal Medical Service
• the local council immunisation clinics (in some areas)
• some local child health centres
• the school immunisation program (year seven and eight vaccinations only).

A catch-up program can be individually tailored for children with overdue vaccinations. The immunisation provider will electronically check the child’s immunisation status through the Australia Immunisation Register. In rare circumstances a child may be exempt from vaccinations, but only where this is verified by a General Practitioner and recorded on the Australian Immunisation Register.

When the child has received a vaccination:

• ask the carer to confirm the vaccination/s has been provided to the child, and to also provide any information from the immunisation provider that may have an impact on future vaccinations
• request the carer update the child health passport to reflect the particular vaccination/s received - refer to 2.4 Develop a child health passport
• update the new vaccination information in the child’s ICMS health profile and the ‘important information’ category in their kicbox account.  

[ Return to top ]

2. 4 Develop a child health passport

Many children who enter care do so with higher rates of significant health issues than children in the general population. A number of factors can contribute to this including poor diet, poor prenatal care, exposure to parental substance use and inadequate past medical care. This can result in children entering care with previously unknown or undiagnosed illnesses, developmental delays or dental problems.

Finding and dealing with health problems early reduces the risk that they become entrenched and chronic. The child health passport aims to ensure that children receive effective and coordinated health care on entering care.

The child health passport contains the information the carer requires to meet the day-to-day health needs of the child. A child health passport is required for a child in care subject to:

• a child protection care agreement that has been extended beyond 30 days
• a CAO that has been extended beyond 30 days
• an interim order granting custody to the chief executive
• a child protection order granting custody or guardianship to the chief executive.

The child health passport framework aligns with the National Clinical Assessment Framework for Children and Young People in care (the Framework) developed by the Australian Government as a guide for health practitioners to assess and respond to the health needs of Children in care.

More information on the Framework can be located at National Clinical Assessment Framework for Children and Young People in care (OOHC) - March 2011.

Gather essential health information

When a child is to be placed in care, obtain information from the child, parents and where necessary, relatives or other health professionals, about:

• the child’s immediate health needs (details of general practitioner, health specialist and outstanding appointments) and essential medical history
• whether the child has recently received a health or dental service and if so, by whom
• any medication the child may be taking, including the dosage and who prescribed the medication
• whether the child has recently been seen by a dentist or the Child and Adolescent Oral Health Service
• whether the child has a diagnosed or suspected disability and who they are involved with to meet their support needs
• the child’s immunisation details, - refer to 2.3 Maintain a child's immunisation schedule
• Medicare and if applicable, health care card - refer to 2.2 Obtain Medicare and Health care card details
• who should complete the health assessment, where necessary.

For more information about gathering a child’s essential health information, refer to the practice resource Child health passports.

Record the essential health and dental information in the Child information form and:

• provide a copy to the carer at the beginning of the child’s placement 
• attach the ‘Child information form’ to the relevant event in ICMS 
• file the original on the child’s health care file.

Record all attempts to obtain the child's health history as case notes in ICMS.

Commencement of a child health passport

A child health passport is commenced when the department makes a request in writing for a health and dental professional to complete an appraisal or undertake an assessment of a child's health and dental needs, or when confirmation of a medical appointment has been received.

It must begin 30 days and no later than 60 days after a child enters care.

The child health passport process is not to be implemented as an isolated event, but is to be linked to the child's strength and needs assessment and the development and ongoing review of the child's case plan and case work. For further information, refer to the practice resources Child health passports and Child health passports flowchart.

All persons involved in the child health passport process are to be made aware of their responsibility to maintain the confidentiality of health related information in accordance with the requirements of the Child Protection Act 1999, section 187 and 188.

The child health passport folder must move with the child whenever the child moves to a new placement.

Definitions

Relevant health professional means a health professional who has seen the child, in a professional capacity, within the last 12 months, usually the child's general practitioner, and can comment on:

• the child's general health status, any significant health issues
• the day-to-day health needs of the child
• any follow up treatment required.

A health appraisal is appropriate if a child has seen a health professional within the last 12 months and the health professional has enough information about the child to provide a comprehensive report in relation to the child's day to day health needs, health status and any medical follow up or treatment that may be required.

A health assessment is required when the child has not seen a health professional in the last 12 months or if the health professional is unable to provide a comprehensive report about the child's health status without seeing the child.

Prepare the Child Safety health care file

When commencing the child health passport process, arrange for the creation of a Child Safety health care file by completing a CSSC file creation request and forwarding it to the CSSC Records Officer. File all original documents relating to the child's health on the health care file and copies of the originals in the child health passport folder.

Decide if a health assessment or health appraisal is required

Essential health information obtained from the child's parent, carer or other sources will inform whether a health assessment or health appraisal is required. To determine this:

• establish whether the child is currently receiving a health service
• contact the child's carer or parent to find out whether the child has been seen by any health professional or has accessed any other health services in the last 12 months, for example:
  • a dentist or the Child and Adolescent Oral Health Service
  • a medical examination conducted as part of an investigation and assessment.

A health appraisal is appropriate where a child is currently receiving a health or dental service, or has been seen by a health professional in the last 12 months, for example:

• a dentist or the Child and Adolescent Oral Health Service
• a medical examination conducted as part of an investigation and assessment.

Note: Early Childhood Caries (Infant Tooth Decay) can occur soon after the baby teeth erupt, usually between nine months and two years. The need for infant dental treatment may be guided by the medical assessment.

Arrange a health appraisal

Where a health professional may have enough information to provide a comprehensive report about the child's health needs, forward a Health appraisal letter and any available information or outcomes of recent assessments to the child's health professional and request:

• whether they have assessed the child's health (as outlined in the letter), within the last 12 month period
• an updated summary of the child's health needs and health assessments, including any prescribed medication for the child.

Where the health professional indicates that the child does not require a health assessment:

• the information they provide is the health summary and forms the basis of the child health passport - record this in the child's case plan at the next review under the heading 'Child Information'
• negotiate with the child's carer during the development of the placement agreement to maintain scheduled appointments with the identified health professional, if applicable
• prepare the child health passport (see below)
• place the health summary on the health care file, and a copy in the child health passport folder.

If the health professional's reply indicates that the child needs to be seen to complete a health assessment, or a child has not seen a health professional in the previous 12 month period, arrange a health assessment.

For a dental assessment, where the child has previously received dental services, contact the service provider to obtain details, including any recommended follow-up. Where the child has not received any dental services in the past 12 months, or recommended treatment has not occurred, arrange an appointment with a dentist or dental service. For school age children, this may occur through the Child and Adolescent Oral Health Service.

Provide the carer with the Letter re: Custody (Medical) or Letter re: Custody and guardianship (Medical) to inform the dentist of who can provide consent for any proposed dental treatment.

For further information, refer to Queensland Health, Child and Adolescent Oral Health Services.

Where a child has mental health issues that require intervention and treatment by Child and Youth Mental Health Services, refer to the Interim Memorandum of Understanding between State of Queensland (through the department Child Safety, Youth and Families) and State of Queensland (through Queensland Health Child and Youth Mental health Services) 2010-2013

Decide which health professional will conduct the health assessment, if applicable

The child's general practitioner (GP) should complete the health assessment where possible. Where the child has not seen a GP, to decide the most appropriate professional to conduct the health assessment, consider the child's age, Indigenous status and current living arrangements. For further information, refer to the practice resource Child health passport.

When there are limited services available to conduct a health assessment, or where a specific service is required for the assessment, contact the CPLO to:

• negotiate a health assessment by a Queensland Health service
• obtain advice about local services or processes.

Involve the child, parents and the carer in the health assessment

Where it is determined that a child requires a health assessment:

• discuss the requirement for a health assessment with the child's parents and carer, and explain the assessment process
• speak with the child, where age and developmentally appropriate, to explain the assessment process, answer any questions they may have and obtain their agreement to attending an appointment with the GP, or a dentist
• ask the child who they would like to attend the appointment with them
• advise the parents and the carer that they may be required to provide health information or history, if requested by the health professional
• consider parental involvement in the appointment
• advise the parents, where they retain guardianship of the child, that their consent may be required for certain procedures or treatment for the child.

If a child refuses to attend a health assessment appointment, record this in a case note in ICMS and continue to work with the child to address their concerns about attending the appointment.

Where a child does not want anyone to attend the appointment with them, and a doctor deems the child as 'Gillick competent', consider their right to privacy and discuss with them whether information can be shared between the health professional and Child Safety following the assessment. In addition, consider the views of the child prior to informing the child's parents and carer of the outcome of the health assessment and any further actions required.

A decision will be made on a case-by-case basis as to whether the parents attend the health assessment appointment. When reunification is the goal of the child's case plan, parents should be involved in attending medical and dental appointments. When deciding about parental attendance, consider the views of the child and ensure the decision is consistent with the child's case plan.

Arrange the health assessment appointment, if required

To initiate a health assessment, ask the carer to make an appointment with the preferred health professional or service and request a long consultation.

Prepare the following documentation for the carer to provide to the health or dental professional:

• the Child information form
• the Health summary letter
• copies of assessments or reports that may inform the health assessment.

In addition, advise the carer to take a copy of the completed 'Letter re: Custody (Medical)' or 'Letter re: Custody and guardianship (Medical)' to the appointment, to inform decision-making about custody and guardianship matters, if required - refer to 1.11 Place the child in care.

Negotiate payment processes with the health professional

A large number of Medicare items are appropriate for when various aspects of the health needs of children in care are being assessed. For example, for an Aboriginal or Torres Strait Islander child, the health professional has the discretion to bulk bill the cost of a health assessment. For further information on eligible items for Medicare refer to the practice resource Child health passports.

For a non-Indigenous child, there is no single Medicare item number for a health assessment and full payment may be necessary.

Where full payment for the health assessment is required, the following options are available for payment:

• the carer pays for the health assessment and then claims the gap through Medicare. Child Safety reimburses the carer for the ‘gap fee’ associated with the health assessment
• the health professional directly invoices Child Safety - this option must be agreed to by the health professional prior to the appointment. For an Aboriginal or Torres Strait Islander child, Child Safety can arrange for a Medicare rebate using the child’s Medicare number.

Use the child health passport account code 54355 to cover the initial health assessment and any follow up health assessments. This code excludes all other costs associated with meeting the child's health care needs met by the carer in accordance with the Expenses - Fortnightly Caring Allowance and Inter-state foster payments (PDF) policy.

When a child is referred to other health providers for follow up, for example, a dietician, a respiratory specialist or speech therapist, the carer will pay for one appointment only and Child Safety will meet the cost of the other appointments, using the relevant Child Related Cost account code.

In relation to dental assessments, school age children can be assessed through the Child and Adolescent Oral Health Service, at no cost. For teenagers, the Medicare Teen Dental Plan provides annual vouchers that cover the initial costs of a dental examination.

Prepare the child health passport

When the health summary from the health and dental professional is received:

• obtain a child health passport folder from the records officer and print the cover sheet Child Health Passport - Private and confidential for the front of the folder
• attach a self-adhesive alert on the inside cover of the folder for any child with a medical condition - this sticker is available from the records officer
• place a copy of the following documentation in the child health passport folder:
  • the Child information form
  • information about any medical alerts (see note below for what may constitute a medical alert)
  • the child's Medicare card and if applicable, health care card
  • the Health appraisal letter or Health summary letter
  • the Letter re: Custody (Medical) or Letter re: Custody and guardianship (Medical)
  • the letter from the health professional summarising the child's health needs (this constitutes the health assessment)
  • information relating to the specific health needs of the child, including a diagnosed disability or any other health related information that would assist the carer to meet the child's health needs
  • information about any prescribed medications.

The Child information form will be added to the child health passport, excluding section C, which relates to the parental health history information that is not relevant to meeting the child's medical needs, after non-essential information is gathered (see below).

Note: All medical alerts for the child, including adverse drug reaction, sensitivity/allergies of significance, significant mental health alerts, prescribed psychotropic medications and infections of significance, require the self-adhesive alert to be placed on the inside cover of the child health passport folder.

In addition, where an alert relates to a life threatening medical condition, record the medical condition as a 'serious health condition' alert on the child's person record in ICMS.

Provide the child health passport to the carer

Provide the child health passport folder to the carer at the commencement of the child's placement, or as soon as possible following the commencement of the placement. At this time, the child's carer must be informed that it contains confidential information and must be kept in a secure location.

Do not include information pertaining to other family members in the child health passport folder.

Register the provision of the folder to the carer on the Child Safety record management system, eDOCS.

Inform relevant parties of the health assessment or health appraisal outcome

The health summary from the health and dental professional will include:

• significant findings from the health assessment
• a recommended health plan
• recommended follow-up, including timeframes.

When the health summary is received:

• register receipt of the health assessment letter on eDOCS
• discuss the outcome with the child, where age and developmentally appropriate, the parents and the carer
• provide a copy of the letter to the carer, for the child health passport folder
• place the original letter on the health care file
• arrange any recommended follow up appointments.

Note: Where a medical practitioner reports that a child under 16 years has a sexually transmitted disease or is pregnant, inform the QPS according to the Child Protection Act 1999, section 14(2) and (3) using a Police referral, and, where the information meets the threshold for recording a notification, record a notification in accordance with Chapter 1. Intake.

Arrange health follow up

When the health assessment recommends further action:

• negotiate responsibility for meeting related costs (see below)
• organise health services or specialist appointments in consultation with the child and the carer
• ensure necessary documentation is provided when the child attends specialist or other appointments
• consider additional referrals that may assist in meeting the child's identified needs, for example, an Evolve or NDIS referral may be appropriate to the child's mental health or disability needs -refer to 2.9 Refer the child to Evolve, if required and 2.11 Respond to a child disability support needs
• either:
  • incorporate the follow up actions in the next review of the case plan and placement agreement, or
  • consider whether a review of the child's case plan and placement agreement is required, where the health findings and required actions are significant.

If during the health assessment or follow up appointments, consent is required for medical tests or procedures, for example, immunisation or pathology tests, ensure that the person able to provide consent, either the child if 'Gillick competent' or the child's guardian*, has:

• information about the procedure or test
• the opportunity to discuss concerns about the procedure or test with a health professional, before providing consent.

*Please note, while immunisations and blood tests are a guardianship decision, for a child subject to an order granting guardianship to the chief executive, approved carers and care services are authorised to arrange blood tests (excluding the approval of DNA testing of a child) and make the necessary immunisation arrangements for the child on behalf of the chief executive using the Authority to Care – Guardianship to the Chief Executive as their authority.

The health professional will decide if the child is able to provide consent for medical procedures based on the concept of 'Gillick competency'. For further information, refer to 3. Decision-making for the child.

Where a child has mental health issues that require intervention and treatment by Child and Youth Mental Health Services, refer to the Interim Memorandum of Understanding between State of Queensland (through the Department Child Safety, Youth and Families) and State of Queensland (through Queensland Health Child and Youth Mental health Services) 2010-2013

Negotiate responsibility for follow up costs

In relation to follow up health appointments:

• access public health services as the first option
• access state and federal health schemes, where available and appropriate.

Specific health schemes which may be of assistance include:

• Medicare Teen Dental Plan
• Better access to psychiatrists, psychologists and general practitioners through the Medicare Benefits Schedule (MBS).

Where necessary, seek appropriate approvals with respect to child related costs expenditure for required appointments, for example, if the required health service is not available publicly.

Gather 'non-essential' health information

Within 12 months of the child's placement in care, or as required due to case circumstances, obtain information about:

• any childhood illnesses and hospitalisations experienced by the child
• the child's developmental progress - refer to the resource Physical and Cognitive Developmental Milestones (PDF, 24 KB)
• the pregnancy history of the child's mother
• the child's family's health history.

Specific circumstances prompting the collection of 'non-essential' health history are outlined in the practice resource Child health passports

Where it is identified that a child or parent has an infectious or communicable disease, refer to 11. What if a child or parent has an infectious or communicable disease?

Record the 'non-essential' health information in the Child information form and:

• provide a copy to the child's carer, excluding parental health history information that is not relevant to meeting the child's medical needs, for inclusion in the child health passport folder
• attach the 'Child information form' to the relevant event in ICMS
• consider uploading items that will be useful for a child when leaving care, to the child’s kicbox ‘Important Documents’ category
• file the original on the child's health care file.

Arrange a subsequent health assessment

If the child has ongoing health issues, a health issue arises or the child has not had a health assessment for a significant period of time, arrange a subsequent health assessment, as outlined above.

Where possible, arrange for the health professional who conducted the previous health assessment, to complete this health assessment.

Once the health professional has completed the assessment and revised the child's health status, they will prepare a letter to Child Safety outlining the child's health needs and any required follow up. This letter constitutes an updated health assessment.

Manage the location of the child health passport

When a child commences a new out-of home care placement:

• provide the new carer with the child health passport, with the possible exception of a respite placement (see below)
• inform the carer about any medical alerts for the child, including any life threatening medical condition
• advise Medicare Australia of the child's new address
• update the location of the child health passport on eDOCS.

When a child commences a respite placement:

• advise the respite carer of the child's health needs, including all medical alerts and any appointments or treatment required during the placement period
• depending on the length or frequency of the respite placement, arrange for the primary carer to provide the respite carer with the child health passport, for the duration of the respite placement.

When a child returns to the care of parents:

• provide the parents with the child health passport
• ensure all useful items within the child health passport have been uploaded to the child’s kicbox ‘Important Documents’
• inform the parents about relevant medical information and any follow up appointments
• update eDOCS
• advise Medicare Australia of the child's new address using the Letter to Medicare - change of address 

When a young person transitions from care to independence:

• provide them with the child health passport
• update eDOCS
• advise them to inform Medicare Australia of any new address.

Management of psychotropic medication

Psychotropic medications are used to treat psychiatric disorders. They are not disorder specific, but provide clinical benefit for a range of psychiatric disorders and symptoms. Some medications, such as some anticonvulsants, which are primarily used to treat medical and neurological conditions, are also used to treat psychiatric disorders.

The most common types of psychotropic medications used to treat psychiatric disorders are:

• antidepressants
• antipsychotics
• anxiolytics
• mood stabilisers
• hypnotics
• stimulants
• cognitive enhancers.

Given the significance of a decision to prescribe or alter a psychotropic medication for a child in care:

• gather sufficient information to make informed decisions
• consult with the child, the parents and the carers and facilitate their participation in decision-making, as appropriate – where applicable, arrange for an independent person to help facilitate the child’s and family’s participation in the decision – refer to 10.1 Decision-making about Aboriginal and Torres Strait Islander children
• document all actions and decision including completing relevant sections in the Child information form, the education support plan, the case plan and the child strengths and needs assessment.

Gather information and consult

When a medical practitioner seeks consent for a child in care to be prescribed a psychotropic medication or to change the type of psychotropic medication prescribed for the child, obtain the following information from the medical practitioner:

• the child's diagnosis and the behaviours or symptoms the medication is intended to modify or alleviate
• the name of the medication, the dosage and the anticipated period of time that the child would be required to take the medication
• the possible short and long term side effects that may be experienced by the child
• the anticipated date when the use of this medication will be reviewed by the medical practitioner.

As soon as possible after the use of a psychotropic medication is recommended:

• upload all relevant information regarding medication, recommended dosage and review dates to the child’s kicbox ‘Important Documents’
• consult with the child, the parents and the carers, as appropriate, to ensure that all the relevant persons:
  • have information about the diagnosed medical condition requiring treatment with psychotropic medication
  • are clear about the specific type of medication and the possible side effects
  • understand when the use of this medication will be reviewed by the medical practitioner.

Obtain consent

To obtain consent for the use of psychotropic medication for a child in care:

• complete the Consent form - Psychotropic medication and obtain the guardian's consent, either:
  • the parents when the parents retain guardianship of the child
  • the CSSC manager or CSAHSC manager or senior team leader or, when the chief executive has guardianship of the child
• forward the signed consent form to the medical practitioner
• place a copy of the signed consent form on the child health file
• provide a copy of the signed consent form to the carer for inclusion in the child health passport.

Participate in review of medication

When a child in care is prescribed psychotropic medication:

• request that the medical practitioner provide advice about the outcome of any scheduled review of the medication
• facilitate the participation of the child, the parents and the carers, as appropriate, in this review
• include discussion of the psychotropic medication in any review of the case plan or review of the child health passport.

Share information with relevant professionals

When a child in care is prescribed psychotropic medication, relevant information about the medication and the possible impacts on the child's behaviour and functioning can be provided to:

• staff from the Department of Education - information can be provided to staff at the child's school and during the education support planning process
• a youth justice caseworker - where the child is subject to youth justice intervention by Youth Justice Services
• staff from a youth detention centre - where the child is subject to a detention order or remanded in custody.

[ Return to top ]

 2.5 Respond to the child's education needs

A good education gives children the best possible start in life, leading to greater opportunities in adulthood. Children in care generally start with a level of disadvantage when compared with their peers and it is the responsibility of both the Child Safety and the Department of Education to provide them with opportunities to overcome their adversity and help them achieve.

For additional guidance in responding to the education needs of children, refer to the practice paper Valuing and improving educational outcomes for Children in care (PDF, 278 KB) Valuing and improving educational outcomes for Children in care (RTF, 115 KB) and the related practice resource Education outcomes for Children in care (PDF, 37 KB) Education outcomes for Children in care (RTF, 20 KB).

Children involved in the child protection system also continue to experience higher levels of school disciplinary absences  across Queensland compared to those in the general population play an important role in supporting children through their education and working closely with the educational facility to share the right information at the right time. For information on the school disciplinary absence process, refer to the resource School disciplinary absence (PDF, 210 KB) School disciplinary absence (RTF, 692 KB).

While a child is in care, ensure the following details are uploaded or recorded in a child’s kicbox account:

• where the child attends school and when,
• relevant and important teachers’ names
• any report cards
• any awards received by the child.

Education for pre-school aged children

Kindergarten plays a key role in laying the foundation for children’s future learning and lifetime outcomes. Effective learning involves ideas and concepts that build on each other. If children do not acquire crucial skills and knowledge, and develop positive attitudes to learning early on, it can become increasingly difficult for them to learn as they get older.

Under the Queensland kindergarten funding scheme offered by the Office of Early Childhood Education and Care, all children in care, who are aged at least four years old by 30 June in the year they participate, are entitled to low or no cost approved kindergarten programs. This initiative encourages the participation of disadvantaged children in quality early childhood education. Eligibility for the program is on the basis of the child holding a health care card, to which all children in care are entitled – refer to 2.2 Obtain Medicare and Health care card details.

Approved kindergarten programs are delivered in a range of settings, including: C&K, Independent Schools Qld, Queensland Catholic Education Commission, Queensland Lutheran Early Childhood Services, Lady Gowrie and approved long day care services.

The ‘Early childhood education and care participation minimum gap payment’ policy assists foster and kinship carers to meet the costs arising from the child’s attendance at an approved kindergarten program. Unlike child related costs, this is not a discretionary payment requiring pre-approval by the CSSC manager. For more information, refer to the Early childhood education and care participation minimum gap payment (PDF) policy.

If a child is not immunised in accordance with the National Immunisation Program Schedule, they may not be eligible to attend a kindergarten program or will be precluded at times when a communicable disease is present in the centre.

Foster and kinship carers may also be eligible for reimbursement, through child related costs, for out-of-pocket expenses.

Children who are attending kindergarten do not require an education support plan.

Ensure the development of an education support plan

The education support plan (ESP) is a joint initiative of Child Safety and the Department of Education. It aims to ensure that a child in care is enrolled and participating in an educational program that meets their individual learning needs, maximises their educational potential and improves their well-being. The ESP is the key process to plan and document the child’s educational goals and outcomes and strategies to achieve identified outcomes.

The Department of Education will complete an ESP for each child enrolled in a Queensland educational facility (Prep to Year 12), under 18 years of age and either:

• subject to an interim or final child protection order granting custody or guardianship to the chief executive OR
• subject to a final interstate child protection order granting custody or guardianship to the chief executive of that state and:
  • residing in care in Queensland
  • not accessing equivalent funding interstate.

The Department of Education is responsible for the development and annual review of the ESP. Child Safety is responsible for advising the Department of Education of the child's eligibility, participating in the development and review of the ESP and monitoring that the ESP process occurs.

The Department of Education has a separate agreement with the Independent and Catholic schooling sectors, requiring these schools to establish the same process as State schools for completing an ESP.

A child will not be eligible for an ESP when the child:

• is subject to an interim or finalised child protection order but no longer resides in care. For example, the child has returned home as part of a planned reunification process and the child protection order has not yet been varied or revoked
• is being cared for under a private care arrangement between family members
• is subject to an order made by the Family Court of Australia
• is involved with Child Safety under an intervention with parental agreement case, a TCO, TAO or CAO 
• is subject to any of the following child protection orders:
  • an order granted by a court in another Australian state which has not been transferred to Child Safety
  • an interim child protection order except in the circumstances noted above
  • a  supervision or directive child protection order
  • an order granting custody or long term guardianship to a suitable person who may be a member of the child’s family or a person nominated by Child Safety
• has turned 18 years of age – young people who are turning 18 years of age should consult with their CSO about their transition to adulthood plan which should incorporate education support.

If the Department of Education or Child Safety identifies that a child would benefit from education planning but is not eligible for education support through the 'Memorandum of Understanding between Department of Education and Department of Communities (Child Safety Services)', the child will be supported to access the range of other programs and support options available through the Department of Education.

Where eligible, support will be documented in the child’s case plan and discussed as part of the transition to adulthood planning process.

For further information about ESPs and educational outcomes, refer to the Memorandum of Understanding between Department of Education and Training and Department of Communities (Child Safety Services)

Inform the school principal of the child's eligibility

Prior to the enrolment of a child who may require special consideration in accessing an educational program, contact the local the Department of Education regional office to identify schools in the area with support services to best meet the child’s needs. This may be appropriate, for example, for a child who has disabilities or is subject to school disciplinary absences.

Where a child is eligible for an ESP, notify the school principal of the child's eligibility by completing and providing the Letter to school - education support plan to the school's principal, within the following timeframes:

• before, or at the time of, the child's enrolment with the school
• where the child is already enrolled in a school and residing in an care placement, within one month of the commencement of the child protection order (interim or final) granting custody or guardianship to the chief executive.

If the school has not contacted Child Safety within five working days following the notification of the child's eligibility, contact the principal to make arrangements for an ESP planning meeting.

The school principal is responsible for finalising the child's ESP within one month of being notified of the child's eligibility.

Prepare for the education support planning meeting

Prior to attending the school to participate in the development of the ESP:

• consult with the child about the development of the ESP and discuss and encourage their attendance at the meeting, where appropriate - refer to the practice resource Participation of children and young people in decision-making (PDF, 342 KB) and the Children and young people's participation strategy
• determine the appropriate level of involvement for the child's carer and parents
• in collaboration with the principal, identify and engage other agencies that may provide services to support the educational participation, retention and achievement of the child
• liaise with Queensland Transport to identify school transport arrangements that enable the child to attend the nominated school, where applicable
• inform the child's carer of the availability of financial support through Child Safety, including child related costs as outlined in the Child related costs - Education support (PDF, File not found) policy, and the school, to enable the participation of the child in any learning support opportunities
• cooperate with the principal and related staff to ensure the development of the ESP within specified timeframes.

Note: Any expenditure by Child Safety is subject to approval by the CSSC manager and will be recorded in both the child's ESP and case plan.

Attend the education support planning meeting

The carer and where considered appropriate, the child and the child's parents will attend education support planning meetings. The CSO with case responsibility is required to actively participate in the meeting, which will include discussion of:

• any health or well-being risks related to the child, other children or staff
• strategies to address identified risks
• educational services that may assist the child
• the potential impacts of any prescribed medications, including psychotropic medications, on the child's achievement and functioning - refer to 2.4 Develop a child health passport
• any planned placement changes, including respite, or reunification that may impact on school attendance and participation, and/or a change of school
• strategies and goals to maximise the child's academic potential and school engagement.

Where a child chooses not to attend the meeting, their views and educational goals should still be communicated at the meeting, where possible. This may occur by either the CSO or the carer ascertaining their views prior to the meeting.

If a child is truanting or refusing to attend, discuss the risks to the child and associated management strategies at the meeting, and request that school staff advise the child's carer or, where not contactable, the CSSC, whenever this occurs.

Where necessary, take a copy of the Letter re: Custody (Schools) or Letter re: Custody and guardianship (Schools) to the education support planning meeting, to inform decision-making about custody and guardianship matters. For further information refer to 3.8 Make education decisions

The Department of Education will require all parties who attend the education support planning meeting, or annual review, to sign the ESP.

Obtain and file a copy of the education support plan

The Department of Education will distribute a copy of the final education support plan to the key parties involved in the development or review of the plan.

Upon receipt of the ESP from the school:

• ensure a copy of the ESP has been provided to the child and clarify any questions they may have
• attach the ESP to the relevant event in ICMS.

Attend the review of an education support plan

The Department of Education is responsible for reviewing the ESP, at a minimum, every 12 months. An earlier review may be organised if the child's circumstances change, for example, if the child is to transfer to another school or existing goals have been met and new goals need to be established.

If a CSO has not been contacted by the school within 12 months of the date of the current ESP, contact the principal to make arrangements for the review.

The CSO is required to attend each review of the child's ESP.

Inform the school principal about changes in circumstances, including changes in eligibility

For the duration of the child's placement in care, inform the principal in a timely way of any changes in a child's legal status, care placement or change in school enrolment. This includes providing the completed Letter to school - education support plan (change in eligibility) when a child is no longer eligible for an education support plan, for example, where a child protection order is made granting long-term guardianship to a suitable person or the child returns to the care of the parents.

Education support funding program

Funding is available through the Education Support Funding Program, which is initiated and administered by the school. This funding can be utilised for a child who has a completed ESP which identifies individualised needs and strategies which require funding to meet the specified educational goals.

[ Return to top ]

2.6 Facilitate and monitor family contact

Continuity of relationships with family, friends and other significant people, and connections to familiar environments and activities can help children in care to better cope with the difficulties of transition. Family contact promotes the child's sense of identity, assists towards achieving reunification and ensures ongoing relationships and support following the child's transition to adulthood. Maintaining sibling relationships is positively associated with child well-being and adult functioning.

For Aboriginal and Torres Strait Islander children, family contact should also include other people of significance to the child under Aboriginal tradition or Island custom.

Family contact activities, such as taking photographs during the contact and then sharing them with the participants can proactively support a child’s self-identity formation, relationship development and life story narrative while in care. Upload photos of positive family contact experiences to the child’s kicbox, to ensure the child maintains access to their memories and experiences.

When a child is placed in care:

• provide opportunity for contact between the child, the child's parents and appropriate members of the child's family as often as is appropriate (the Child Protection Act 1999, section 87)
• ensure that an appropriate level of contact occurs between a child and their siblings, particularly where siblings are not in the same care placement or where there are siblings who continue to reside with their parents
• ensure that the child's view about contact is considered and accurately recorded in the decision-making process - refer to the Safe Contact Tool, practice resource Participation of children and young people in decision-making (PDF, 342 KB) and the Children and young people's participation strategy
• the CSO maintains responsibility for the child having appropriate family contact, where the child resides in a non-family based placement.

Where a contact decision is made that is contrary to the child's wishes, ensure that the reason for the decision is explained to the child.

Family contact visits will only be held in a CSSC where there are legitimate reasons for doing so, such as threats of violence or risk of abduction.

When deciding the location of family contact, work with the child and family to identify a location that the family can easily access, will be safe and will maximise the child and family’s ability to enjoy and participate in the visit.

If a decision is made to refuse to allow, restrict or impose conditions on family contact, each person affected by the decision, including the child, where age and developmentally appropriate, must be provided with written notice of the decision.

Decide the level and nature of family contact

The level and nature of family contact is decided within the case planning process, using an inclusive decision-making process. The decisions made must reflect the goal and outcomes of the case plan, be in the best interests of the child and not place the child at further risk of harm.

A senior team leader or CSSC manager are the delegated officers to decide the level and nature of family contact within Queensland. When the family contact is in another jurisdiction, only the CSSC manager can approve the contact - refer to 3.14 Make family contact decisions. A team leader or CSSC manager may also decide to refuse, restrict or impose conditions on contact.

To inform decisions about the level and nature of family contact, consider requesting information about any criminal or domestic violence history about the parents or adult household members. QPS may provide a written report of criminal history and a summary of domestic violence protection orders and their conditions on:

• a parent of the subject child
• an adult member of the parent's household
• an adult who may be a person responsible for alleged harm.

Under the authority of the Child Protection Act 1999, section 95(3), a request can be made to the QPS at any time a decision is being made in relation to a child. The request can be used in circumstances such as:

• a parent or household member refuses to disclose their criminal or domestic violence history, and reliable information cannot be gathered from other sources to inform the family contact decision
• it is assessed that a parent or household member has not fully disclosed any history
• it is alleged that a parent or household member has a history of offences against children, but the full history is not available.

In most instances these requests will not be urgent. For further information about making a non-urgent request to the QPS for a written report on criminal and domestic violence history refer to Chapter 2, 2.7 Gather information from other sources.

For further information information to guide decisions about family contact, refer to the practice resource Facilitating family contact (PDF, 44 KB), the Practice guide: The assessment of harm and risk of harm (PDF, 886 KB) and the practice papers Family contact for children and young people in care (PDF, 193 KB) and Supporting children and young people in care through transitions (PDF, 154 KB).

Note: A CSO must comply with contact arrangements directed by the Childrens Court and the Family Court of Australia, however, orders made under the Child Protection Act 1999 take precedence over Family Court of Australia directives (Family Law Act 1975, section 69ZK (2)).

If a child is at risk of harm during contact that has been directed by the Family Court of Australia, and the parent with whom the child is having contact refuses to suspend contact arrangements, a CSO must take action to ensure the child's safety. For further information, refer to Chapter 10.21 Family courts.

When a child's parent, family member or other significant person is in custody in a correctional facility, refer to 4. What if family contact needs to occur in a correctional facility?

When a child’s parents are residing in the same carer household, consider the capacity of the carer to provide care in accordance with the case plan and the placement agreement, including arrangements for contact between the parent and child in relation to daily care matters.

Family contact where there is history of domestic violence

Where domestic violence is identified in a parental relationship, assess whether:

• family contact may be used by the perpetrator to further harm the child and as a means to continue the abuse of the non-violent parent or extended family members
• family contact between the child and the perpetrator or extended family members is in the child's best interests
• the child's behaviour is significantly affected before, during or following family contact.

When a child is placed with a kinship carer who is a member of the perpetrator's family, assess:

• whether the carers are able to meet the child's protective and care needs during family contact with the perpetrator
• the level of fear of the perpetrator held by family members and the level of control the perpetrator has over them.

When a child is placed with a kinship carer who is kin of the non-violent parent, assess whether there are safety concerns for the child or any members of the household, when decisions are being made about contact between the child and the perpetrator.

Where there is a concern about a child's safety during contact, ensure safety planning has occurred with the child, family and network and action steps are clear and have been agreed to, that only agreed family contact is occurring and that kinship carers and parents are not making their own arrangements. Changes to agreed family contact arrangements must occur in accordance with 3.14 Make family contact decisions.

For further information, refer to the practice resource Facilitating family contact (PDF, 44 KB) and the practice paper Domestic and family violence and its relationship to child protection (PDF, 1.3 MB) Domestic and family violence and its relationship to child protection (DOCX, 3.2 MB).

Supervise family contact

A Child Safety officer is required to supervise family contact when:

• there are significant safety concerns for the child, and a high level of control and oversight of the parents or other persons participating in contact with the child is required
• there are legitimate concerns that the child may be abducted or harmed during contact
• the child or family requests that a Child Safety officer be present
• a qualified professional working with the child or family recommends that contact be supervised, based on legitimate concerns.

A Child Safety officer may also be present during family contact when:

• there is a need to assess interactions between the child and family, to check the progress
  of the case plan or to assist with court processes
• the Child Safety officer is working in a therapeutic capacity with the child and family.

Negotiate carer participation in family contact

Carers may participate in family contact arrangements where both of the following apply:

• cases are reasonably straight forward and do not require a high level of control and oversight of the parents or other persons participating in contact with the child
• the factors considered prior to the provision of placement information to parents do not identify significant safety concerns, such as:
  • recent threats of removal or abduction of the child
  • aggressive behaviour by the parents during the removal of the child, which resulted in harm to others.

Negotiate the carer's involvement in family contact, and document the agreed arrangements in the case plan and placement agreement.

Outsourcing transport or supervision of family contact

An external party may be contracted to provide transport or to supervise family contact in accordance with a child’s approved case plan. Expenditure in relation to this contracted service needs to be pre-approved as detailed in Child related costs - Client support and family contact (PDF, File not found) policy.

Prepare participants for family contact

When the family contact arrangements have been decided:

• inform all participants about the date, time and venue
• inform all participants of their responsibilities during family contact
• discuss whether strategies or supports are required to assist the child, their carer or family members to effectively manage family contact arrangements
• discuss appropriate strategies and interventions to be implemented when the contact involves a child who has been sexually abused and/or has engaged in sexually abusive behaviour, if applicable - refer to the practice resource Children with sexual abuse histories (PDF, 52 KB)
• ensure suitable transport arrangements are made for the child
• arrange appropriate supervision for the family contact, if required
• ensure that appropriate information and advice is provided with respect to safety issues and associated management strategies, including the use of standard infection control precautions if a child or parent has an infectious disease.

Change family contact arrangements

The CSO or the child's carer can negotiate to change family contact arrangements where the changes are minor and consistent with the case plan goal and outcomes. Reasonable requests by the child or family for additional family contact may are to be accommodated, where possible, if they are consistent with case plan goal and outcomes.

When engaging the child, family and carers in contact discussions, consider using the Safe Contact Tool. When changes are made, inform all participants and record relevant information in a case note in ICMS.

When requests are made for additional contact or changes to family contact that are substantially in conflict with the agreed case plan, or are likely to result in significant issues for the child or their family members, the child's guardian (team leader or CSSC manager) must make the decision - refer to 3.14 Make family contact decisions.

Should the contact arrangements in the case plan no longer be in the best interests of the child, initiate a case plan review, in accordance with Chapter 4, 5. Review and revise the case plan.

For further information, refer to the practice resource Facilitating family contact (PDF, 44 KB).

Monitor the progress of family contact

Family contact arrangements are to be monitored on an ongoing basis, in order to:

• obtain information from the child about their experience of the contact
• gather information about the progress and suitability of the family contact from all other parties, including the parents, family members, carers and Child Safety officers
• assess parental progress in meeting the child's protection and care needs during family contact, if applicable
• address any concerns identified, as they arise
• assist and support the child, their family and the carer and their family, in maximising positive family contact.

Respond to child protection concerns related to family contact

Where information is received about harm or risk of harm to a child by their parent during family contact refer to Chapter 3, 2. What if new child protection concerns are received?

Respond to disruptive family contact

When family contact is assessed as not meeting the needs of the child, or when issues arise about the actions or behaviours of family members during contact, engage the relevant parties to resolve the identified issues. Consider possible strategies to address disruptive contact, including:

• discussions with parents and other family members regarding Child Safey's expectations during family contact, and the establishment of clear boundaries
• support and therapeutic intervention for the child and parents or family members.

If the issues persist or escalate, consult the team leader to consider changing the contact arrangements to meet the needs and best interests of the child, and initiate a case plan review.

If issues relating to the carer's role or responsibilities arise during family contact, discuss the matter with the carer and consider strategies for resolving the issues. 

Record family contact arrangements and outcomes

Record specific family contact arrangements in the child's case plan and placement agreement. The Safe Contact Tool may be attached to, or information and decisions about family contact recorded in, a case note, including:

• the child's views
• observations about the progress or outcomes of family contact
• disruptive family contact and response strategies.

Refuse, restrict or impose conditions on family contact 

A senior team leader or CSSC manager may decide to refuse, restrict or impose conditions on contact, when either:

• family contact is not in the child's best interests
• it is not practical for the parents or family member to have contact.

When a decision is made to refuse, restrict or impose conditions on family contact:

• inform all affected persons of the decision, the reason for the decision and how to have the decision reviewed
• ensure the child's understanding of review processes and support options
• provide written notice of the decision, as soon as practicable after the decision is made, as follows:
  • for the child, develop a letter on a case-by-case basis, that reflects the child's age, maturity and capacity to understand
  • for other persons affected by the decision, complete the Letter re: Refusal or restriction of family contact.

Attach a copy of each written notice to the relevant event in ICMS.

The senior team leader or CSSC manager is responsible for ensuring compliance with the legislative requirement to provide written notice of a decision to refuse, restrict or impose conditions on family contact.

When a child is no longer in the care of their long-term guardian and is subject to an assessment order, TCO or interim custody order, the long-term guardian has the same rights as parents. Advise the long-term guardian of the decision to refuse, restrict or impose conditions on family contact as per the requirements for a parent.

Note: Under the Public Guardian Act 2014, section 133, the Public Guardian has the ability to apply to the Queensland Civil and Administrative Tribunal for a review of the decision by a team leader or CSSC manager, not to refuse, restrict or impose conditions on a child's contact in accordance with the Child Protection Act 1999, section 87(2). Before requesting a review, the Public Guardian must attempt to resolve the concern with Child Safety.

Decide the nature of overnight contact with kin

When it is planned that a child will stay overnight with kin, either in Queensland or in another state, territory or New Zealand, (for example, during school holidays), the CSSC manager has the discretion to determine whether the arrangement constitutes a placement that will be subject to regulation of care requirements.

Alternatively, the CSSC manager may decide that the arrangement constitutes family contact or a holiday, not requiring the child's kin to be approved as a kinship carer. In this case however, an assessment for the purpose of family contact or holiday is still necessary.

Provide the CSSC manager with the following information to inform the above decision:

• the goal and outcomes of the case plan
• the level of risk to the child posed by the contact
• the child's views about the contact
• the child's age and vulnerability
• the history of previous contact between the child and the child's kin
• the length of stay, location and circumstances of contact
• whether the fortnightly caring allowance is required.

Note: Where the child's kin requests financial support for the placement, the fortnightly caring allowance can only be paid if the kinship member is approved as a kinship carer.

Where the CSSC manager decides that the placement will be subject to regulation of care requirements, approach the child's kin about submitting an application to become an approved kinship carer. For further information about the assessment and approval of a carer applicant, refer to Chapter 8. Regulation of care.

Where the CSSC manager decides that the placement will not be subject to regulation of care requirements, the Child Safety officer will conduct an assessment for the purpose of family contact or holiday.

Conduct an assessment - family contact or holiday within Queensland

To undertake an assessment where the child's kin resides in Queensland:

• ensure the the kin are willing to care for the child
• discuss any relevant issues regarding the placement and the child's safety during the proposed visit
• arrange a time to visit them and conduct the assessment
• check Child Safety records for any child protection history on the child's kin and other household members - their consent is not required, but they are to be advised that the checks will be undertaken
• conduct an assessment interview with the kinship member and complete the Assessment for the purpose of family contact/holiday
• consider approval delegations required for intrastate travel - refer to 3.11 Make travel decisions - intrastate or interstate

No other personal history checks may be undertaken. Should further checks be assessed as necessary, consideration must be given to formally assessing them as a kinship carer.

Where the kinship member lives in another geographical area from the child and the CSSC and there is a significant geographical distance, complete the Assessment for the purpose of family contact/holiday and forward the request to the appropriate CSSC for actioning. Following the assessment, the CSSC responsible for the child must approve the contact decision.

Facilitate an assessment - family contact or holiday in another jurisdiction

To facilitate an assessment where the child's kin resides in another state, territory or New Zealand:

• ensure there is a sufficient period of time before the intended contact, to complete the assessment - allow eight to nine weeks
• ensure the child's kin is aware of the proposed visit and is willing to care for the child
• discuss any relevant issues regarding the proposed visit and the child's safety during the visit
• conduct interstate or New Zealand child protection history checks on the kinship member and all other household members, through DMS - email CPIS_Checks@communties.qld.gov.au
• contact the Queensland ILO, Court Services and obtain the Request for Interstate Assessment - Holiday Placement/Respite care template
• complete the 'Request for Interstate Assessment - Holiday Placement/Respite care' template and attach appropriate supporting documentation, for example, medical and psychological reports on the child
• ensure the request outlines the dates for the intended visit
• have the request signed by the CSO with case responsibility and their team leader
• fax or post the form and supporting documentation to the ILO at least eight weeks before the intended holiday, to allow the other jurisdiction sufficient time to complete the assessment.

The completed assessment is returned to the Queensland ILO, who forwards the assessment to the CSSC. The CSSC manager decides whether the family contact or holiday is to proceed, regardless of the recommendation by the other jurisdiction.

Additional approval decisions will be required for interstate or international travel, or if a passport application is required - refer to 3.11 Make travel decisions - intrastate or interstate, 3.12 Make overseas travel decisions and 3.13 Apply for a passport.

Where the family contact or holiday is to proceed:

• obtain approval for the interstate or international travel, and where applicable, a passport application
• advise the ILO of the:
  • decision to proceed with the family contact or holiday
  • proposed dates for the child's family contact or holiday
  • details of the child's kin, including name, relationship to the child and phone number.

The ILO will advise the ILO in the other jurisdiction of the child's intended holiday visit and:

• request the details of the local office in the jurisdiction that covers the kinship member's home
• provide the CSSC with the contact details for the local office.

If another state, territory or New Zealand (jurisdiction) requests a carer assessment for the purpose of family contact or a holiday, refer to 12. What if another jurisdiction requests an assessment?

[ Return to top ]

2.7 Provide regular respite for the child

Respite is defined as a service intended to provide support to a child in care and their primary carer.

The aim of respite is to enhance the child’s quality of life, support the carer’s ability to continue in their role as a primary carer and sustain the caring relationship. Respite will always occur with an approved foster or kinship carer or provisionally approved carer, who is not their primary carer.

Respite is to be offered for any child in care where the child is subject to:

• a care agreement
• an assessment order granting custody
• a child protection order granting custody
• a child protection order granting guardianship to the chief executive.

A respite carer will be paid the same carer allowances for the duration of the child’s respite placement, as the primary carer usually receives.

If the child’s primary carer also requires payment for the duration of the respite placement, obtain CSSC manager or regional director approval for the dual payment of carer allowances. For more information, refer to the Dual payment of carer allowances (PDF) policy

Note: If another state, territory or New Zealand (jurisdiction) requests a carer assessment for the purpose of respite, refer to 12. What if another jurisdiction requests an assessment?

Incorporate respite arrangements in the case plan

Respite options are to be negotiated within the context of the family group meeting and case planning and review process. This includes identifying possible respite placement options and resourcing alternative respite activities, based on:

• the need for a timely response to the child's changing needs and circumstances
• changes to family relationships and connections over time
• the support needs of the carer.

Record respite arrangements in the case plan and the placement agreement.

Support participatory and collaborative working relationships

When exploring respite options, support participatory and collaborative working relationships, as follows:

• mobilise the child's family and cultural and community connections whenever possible, to resource and facilitate respite arrangements
• actively work with the child and engage with families and carers to gain an understanding of their views about respite options
• prepare the child and their primary and respite carers for a respite placement.

In some instances, respite care may not be in the immediate best interests of the child, for example, an infant's need for attachment and bonding or a child who has experienced significant placement disruption, may need stability as a priority. When considering a respite placement under these circumstances, discuss the child's need for security and the carer's expectations regarding respite arrangements. Where there is conflict between the interests of the child and the carer, the child's needs are to be prioritised in negotiation with the carer. This may result in the respite not going ahead or being delayed, to enable the child's security and attachment needs to stabilise.

Identify and decide respite options

When developing respite options to be included in the case plan for the child:

• plan and decide respite options, including frequency and duration, in accordance with the needs of the individual child, their carer and the case plan goal and outcomes
• identify and deliver flexible and diverse respite options that are likely to improve and enhance the child's quality of life - refer to the practice resource Respite options (PDF, 29 KB)
• provide a combination of respite options for an individual child, for example, a couple of hours of respite per week, attendance at a recreational camp and planned respite placements
• identify respite options within the child's community that sustain their connection with their family, culture and social support networks.

Where respite incorporates a care placement, seek a placement that:

• is consistent with the child placement principle for an Aboriginal or Torres Strait Islander child
• is consistent with the cultural needs of a culturally or linguistically diverse child
• enhances sibling contact, particularly where siblings reside in separate placements
• enhances contact with extended family and other persons of significance to the child
• as far as practicable, occurs with a consistent carer and ideally, a person with whom the child has an existing relationship.

When planning and deciding on a respite placement for an Aboriginal or Torres Strait Islander child, ensure that:

• the child is placed in accordance with the hierarchy of placements specified in the Child Protection Act 1999, section 83 (the child placement principle)
• the carer is committed to meeting the child's cultural needs as outlined in the cultural support plan, particularly when the carer is not an Aboriginal or Torres Strait Islander person
• the carer is committed to meeting all of the requirements in the Child Protection Act 1999, section 83(7), when the carer is not an Aboriginal or Torres Strait Islander person - refer to 1.2 Gather information to inform placement matching.

Where necessary, seek approval with respect to child related costs expenditure.

Review respite options when reviewing the child's case plan, or the placement agreement, having regard to the changing individual needs of the child and their carers.

Decide the nature of overnight respite with kin

When a child is to stay overnight with kin, either in Queensland or in another state, territory or New Zealand, (for example, during school holidays), the CSSC manager has the discretion to determine whether the respite arrangement will be considered a placement, subject to regulation of care requirements, or a family contact visit or holiday.

For further information, refer to 2.6 Facilitate and monitor family contact.

Manage differing views about suitable respite options

Where there are differing views about the most suitable respite option, make the final decision based on what is in the child's best interests, having considered:

• the views of the child, their family and the carer
• the maintenance of family relationships, individual rights and ethnic, religious and cultural identity or values.

Provide placement information to the parents and the child

When a child, subject to a child protection order granting custody or guardianship to the chief executive, will have regular and ongoing respite with a carer for more than seven days for the duration of the current case plan, the decisions about in whose care to place the child, or to withhold full or partial placement information from parents, are reviewable decisions.

For further information, refer to 1.10 Provide placement information to parents.

[ Return to top ]

2.8 Facilitate positive behaviour support for the child

Positive behaviour support is targeted to address the developmental needs of Children in care who have experienced trauma. Positive behaviour support assists a child to learn acceptable behaviours through the implementation of positive strategies by the carers, such as:

• role-modelling
• positive reinforcement
• skill development
• collaborative and inclusive approaches.

At the earliest point possible, using information in the Placement risk assessment tool, identify children who display or are at risk of displaying behaviours that may have a negative effect on themselves or others in order to plan effectively to meet their behavioural needs.

Where the child strengths and needs assessment has identified significant needs in the behaviour or emotional stability domains:

• make a referral to Evolve and/or Disability Services or, if unavailable, to a psychologist - refer to 2.9 Refer the child to Evolve, if required and to 2.11 Respond to a child's disability support needs
• develop a behaviour support plan (unless this has been developed by a clinician) as part of the case plan - refer to the practice resource Guide to supporting positive behaviour (PDF, 384 KB)
• regularly review the effectiveness of the support plan in line with the review of the case plan and the placement agreement.

The plan may include case work support for carers and assistance with planning and implementing strategies to de-escalate behaviours through positive responses such as:

• redirection
• changing the environment
• removal of privileges or attention for a period of time
• organisation of referrals to therapeutic services.

Where carer learning and support needs are identified through case planning, these needs will be responded to and recorded in either:

• the foster carer agreement, for a foster carer
• the placement agreement, for a kinship carer.

When placing a child in care, carers will be informed that positive behaviour support must be consistent with the statement of standards, the Charter of rights for children and the Positive Behaviour Support (PDF, File not found) policy.

Where age and developmentally appropriate, engage the child as an active participant in the development of the behaviour support plan. Refer to the practice resource Participation of children and young people in decision-making (PDF, 342 KB) and the Children and young people's participation strategy for additional information about the involvement of children in planning and decision-making processes that impact on them.

Record the positive behaviour support plan

There are no specific fields in the case plan for the positive behaviour support plan. Record the support plan in a Word document and attach it to the ongoing intervention event in ICMS.

[ Return to top ]

2.9 Refer the child to Evolve, if required

Evolve Interagency Services (Evolve) is a collaborative partnership across Child Safety, Queensland Health and the Department of Education. Evolve comprises teams of both mental health professionals from Hospital and Health Services (Evolve Therapeutic Services) and psychologists, speech and language pathologists and occupational therapists (Evolve Behaviour Support Services).

These teams work in collaboration with school guidance officers and the CSO with case responsibility to provide therapeutic and behaviour support for children in care who have severe and complex behavioural and psychological issues. Evolve allows an intensity of service provision consistent with the level of need of the child and their support network to:

• reduce frequency and intensity of challenging behaviour
• form secure attachments and positive peer relationships
• increase placement stability
• increase participation in educational programs and improve educational outcomes
• increase participation in community activities to facilitate their wellbeing
• enhance communication with the key people involved with their care
• promote greater understanding of their behaviour and the best way to respond to their needs
• build capacity of their support network.

Determine eligibility for a referral to Evolve

The eligibility criteria for the Evolve Interagency Services are as follows:

• the child is under the age of 18 and
• the child presents with severe and complex psychological and/or behavioural problems and
• the child is in care and under an interim or finalised child protection order granting custody or guardianship to the chief executive of Child Safety.

Additional eligibility criteria exist for an intensive mental health therapeutic intervention. This includes:

• the presence of multiple, intense and persistent emotional and/or behavioural problems
• a high level of risk
• severe functional impairment across a variety of domains
• the presence of additional risk factors.

If a child has a disability and does not meet the above Evolve eligibility criteria, refer to 2.11 Respond to a child’s disability support needs.

Information from the completed child strengths and needs assessment and other case planning activities will assist in determining whether specialist therapeutic and behaviour support services will be sought for the child.

For further information about Evolve services, refer to the Evolve Interagency Services Manual and the practice resource Evolve interagency services (PDF, 38 KB).

Make a referral to Evolve

Where it is assessed that an Evolve referral is necessary:

• obtain the informed consent of the child's guardian and wherever possible, the consent of the child, for the referral to Evolve and the release and sharing of relevant information - for further information about obtaining consents, refer to 3.1 Determine who may decide a custody or guardianship matter
• complete the Evolve Referral form
• consult with any member of the Interagency Panel, if required
• record the decision to make a referral and any related interventions as actions in the case plan
• submit the referral form to the Evolve administration officer and/or panel chair
• attend the panel meeting to discuss the referral and engage in an interagency case presentation, if requested.

Once the referral is received, the interagency panel will determine the appropriate service response.

Monitor the intervention

As part of the ongoing implementation of the child's case plan and Evolve plan, if applicable:

• maintain close links with the Evolve service providers and participate in regular stakeholder meetings to develop and review the Evolve plan
• monitor the effectiveness of the intervention to ensure the goals are being achieved
• participate in panel activities, such as reviews and case closure
• action appropriate recommendations from the panel and stakeholder meetings.

Maintain file records

Ensure that the following documentation is filed on the child's case file:

• a copy of the 'Evolve Referral' form
• a copy of assessments and information provided by Evolve.

Case notes are recorded in accordance with usual record keeping processes.

Specialist disability support and early intervention

If a child has a disability, you may seek support from the NDIS. Refer to 2.11 Respond to a child’s disability support needs.

[ Return to top ]

2.10 Plan and support the young person's transition from care to adulthood

The years leading into adulthood are a time of opportunity and great change. As young people learn to take greater control of their own lives, their relationships change and the connections with friends, family and community begin to alter to reflect their growing maturity. The transition into adulthood can be exciting and daunting, particularly for young people who have experienced trauma in their lives and who have lived in care. These young people are often insufficiently prepared, emotionally and materially, for the responsibilities of independent adult life.

Young people leaving care are often confronted by issues such as reconnecting with their families and communities, coming to terms with the reasons why they came into care or finding themselves alone without the security of a family or community to fall back on. A well-planned, gradual and flexible process for transitioning young people to independence is therefore critical, including the potential provision of post-care support, if necessary.

Kicbox can assist this process by providing the young person with convenient digital access on their mobile phone or any other device, to photos and memories about their time in care and their interactions with family and other important people during that time. They can comment on photos and memories and upload more. They can exercise a degree of control over their own information and experience competence as a young adult by having access to essential identification and other formal documents in ‘Important Documents. They can communicate securely and conveniently with their Child Safety team via ‘Private Messaging’ sharing their views and wishes. They can engage in review and make goals for their future in' My Goals' category of kicbox.

Working with young people can be challenging. There may be high-risk behaviours, instability of placements and young people not wanting to engage Child Safety. The key to every young person having the opportunity to transition from care well is regular communication, information provision, early planning, active involvement and participation of the young person and other significant persons in their lives, which may include the staff of services who have been engaged with the young person.

For further information about the participation of children and young people in decision-making, refer to the practice resource Participation of children and young people in decision-making (PDF, 342 KB) and the Children and young people's participation strategy.

What is transition to adulthood?

All young people subject to a child protection order granting custody or guardianship to the chief executive have the right to receive appropriate assistance and support with their transition from care to independence, in order to maximise their life opportunities and choices.

Transition to adulthood is the planning process that occurs as part of the ongoing case work and review process with a young person from the year they turn 15. Transition to adulthood planning is the opportunity for young people to identify their future goals and needs, and to work towards these with the support of Child Safety and the community.

Transition to adulthood is an ongoing process that is made up of numerous experiences, successes, attempts and challenges. A parallel planning approach will assist young people to meet both their immediate day-to-day needs, as well as short and long-term goals.

Transition to adulthood assistance and support may continue to be provided once a young person leaves care or after they have reached the age of 18 years by way of a support service case - refer to Chapter 7, 1. Provide intervention through a support service case. This can occur when there are existing case planning goals and outcomes still to achieve, or if there are key life events for which the young person may require ongoing support. For example, completing year 12 or making an application to study at university or TAFE.

In addition, Child Safety will assist young people aged from 18 up to 24 years who have been in care to access necessary support and services.

Commence transition to adulthood planning

Transition to adulthood planning commences when a young person turns 15 years. In the year of the young person’s 15th birthday, review the young person’s case plan to include transition to adulthood planning.

To commence this process, initiate discussions with the young person at an appropriate time during case work to introduce the idea of planning for their life after leaving care, and explain the purpose and process of planning for their transition from care to adulthood

• identify potential members of their support network who might participate in the planning process and be an ongoing advocate for the young person, particularly the young person's carer, or staff members if the young person is placed in a residential care service
• discuss the young person's strengths and needs, to inform the revised child strengths and needs assessment and the case plan review - refer to Chapter 4, 1.2 Assessing the child's strengths and needs 
• discuss the kicbox app and encourage them to become interactive kicbox users (if they are not already)
• assist them to identify their goals and dreams for their adult life and to record them in ‘My Goals’ in kicbox
• consider what information the young person currently knows and will need to know to manage their own health care, including where applicable, medication, assessment and treatment, processes to transition to adult health services, management of their own My Health Records
• consider what support and practical assistance they may require to achieve the identified goals
• advise them what financial resources are available from the department and the Australian Government's Transition to Independent Living Allowance (TILA) that will focus on meeting their identified needs and enhance their ability to become an independent adult
• provide the young person with, and discuss, the Info Kit, if not already provided
• where the young person has been a victim of an act of violence, review whether information about support and assistance available from Victim Assist Queensland (VAQ) has been provided and liaise with Legal services about the possibility of an application being made to VAQ for assistance - refer to Chapter 10.20 Victims of Crime and the Role of Victim Assist Queensland 
• where the young person has a disability, involve the transition officer in the process of reviewing their NDIS plan
• discuss the way the young person would like to engage in the planning process and encourage a sense of ownership for their future planning.

Work with the young person using the CREATE resource Go your own way, as a guide to identifying the actions required to assist in their development of skills as they transition to adulthood.

When beginning to discuss transition to adulthood with a young person, meet with the young person's carer or staff members in the residential care service to:

• discuss and reflect upon the relationship between the young person and the carer or staff members
• encourage them to ensure photos of positive experiences are uploaded to the young person’s kicbox
• ensure that they will support the young person’s use of kicbox by providing wifi access for that purpose
• consider what support and practical assistance they may be able to offer to the young person to meet their goals for adult life
• acknowledge the change in the relationship between the carer and the young person once the young person turns 18 years.

Following discussions with the young person about their goals and plans for the future and what to expect as they begin the transition to adulthood process, provide them with a completed Letter to young person at 15 years. The purpose of this letter is to provide the young person with written information about the transition to adulthood planning process. The letter should confirm information that you have already discussed. The receipt of this letter must not be the first time that a young person becomes aware of the transition to adulthood process.

Complete assessment activities to inform the case plan review

Prior to the case plan review, complete the necessary assessments and reassessments, as outlined in Chapter 4, 5. Review and revise the case plan.

Ensure the young person's health needs are identified and effective health care is received during their transition to adulthood by arranging a subsequent health assessment where the young person has:

• ongoing physical, dental or mental health issues
• a physical or mental health issue that arises
• the young person has not had a health assessment for a significant period of time.

For further information about arranging a subsequent health assessment and the child health passport process, refer to 2.4. Develop a child health passport.

A case plan that incorporates the transition goals for the young person requires a parallel planning approach to ensure that both the immediate needs of the young person and their future transition goals are addressed.

To enable holistic and thorough transition to adulthood planning, eight key life areas have been identified to discuss in detail with the young person. These key life areas cover the main areas of a young person's life and are interconnected with each other and the child strengths and needs assessment. The eight key life areas and their corresponding child strengths and needs domains are:

For further information about discussing these key life areas and domains with the young person and considering the identified needs into the case plan review process, refer to the practice resource Transition to Adulthood - planning checklist, the practice resource Transition from care (PDF, 59 KB) and the definitions in SDM: Child strengths and needs assessment and appendix B: Case Plan Guidance in the SDM Manual.

For particular groups of young people who are considered to be most at risk of experiencing social discrimination, isolation or exclusion, provide additional, intensive support in planning for, and in the lead-up to, their transition.

For further information about engaging with young people who have been hurt and traumatised by adults and are now behaving in ways that are likely to hurt themselves or others, refer to the practice paper A framework for practice with 'high risk' young people (12-17 years) (PDF, 1.1 MB).

When a young person has a disability

When a young person has a verified disability and is likely to require increased disability supports from the NDIS following their eighteenth birthday, involve a transition officer and request a review of their NDIS plan, refer to 2.11 Respond to the child’s disability support needs.

When a young person has impaired decision-making capacity

When a young person with impaired decision-making capacity will require their interests to be protected and their needs met after they turn 18 years of age:

• consider applying to have a guardian or administrator appointed by the Queensland Civil and Administrative Tribunal (the tribunal) - application forms and related brochures and fact sheets are available on the Queensland Civil and Administration Tribunal website
• consider the circumstances outlined in the QCAT information Administration for adults and Guardianship for adults
• consult with a team leader or senior practitioner about whether to apply to the tribunal and obtain CSSC manager approval to submit the application
• consider applying to the Public Trustee for management of payments for a young person who is subject to a guardianship order - application forms and related fact sheets are available on the Public Trustee website.

Where the young person is receiving transition support from the NDIS, consult the transition officer during case planning or review processes, as to whether an application to the Guardianship and Administration Tribunal may be appropriate.

Where it is considered necessary to apply for a guardian or administrator, complete an application as soon as possible after the young person turns seventeen and a half years. This allows adequate time for the investigation and hearing by the tribunal.

Make a referral to the Child Advocate (PDF), Office of the Public Guardian with a view to seeking their representation of the young person in any tribunal proceedings.

When a young person requires housing assistance

Determine if the young person will require assistance with securing housing when they exit care and continue to explore and revisit the young person's housing needs throughout transition planning with the young person.

Where a young person requires assistance with securing housing, the Department of Housing and Public Works can assist by providing:

• access to social housing when the young person would find it difficult to sustain a tenancy in the private rental market
• advice regarding other housing options and products.

Facilitate and support a young person to begin the process of applying for public housing from 15 years of age. Housing and Homelessness Services begin formal Joint Action Planning when a young person reaches the age of 16, however a referral from Child Safety will be accepted for a young person aged 15 years if it is part of their transition to adulthood needs identified in their case plan.

For procedural information about referring a young person for housing assistance, links to an overview of the referral and planning process and the referral form, refer to Chapter 3, 4. What if assistance is required with social housing?

For information about the framework for Housing and Homelessness Services and Child Safety to provide housing assistance to young people transitioning from care, refer to Schedule 2 of the Memorandum of Understanding (MOU) between The State of Queensland through the Department of Child Safety and The State of Queensland through the Department of Housing 2007

Where a young person is homeless or at risk of homelessness, consider a referral to Youth Housing and Reintegration Services (YHARS). YHARS assists young people who are homeless or at risk of becoming homeless by providing support and access to a range of accommodation options. YHARS also provides an additional service, The After Care Service, which is specifically for young people aged 18 to 20 years old who have recently left the care of Child Safety. The After Care Service can provide case management and financial support to assist young people to establish and maintain independent accommodation. For further information, refer to Young person after care flyer (PDF, 85 KB), After Care Service for young people exiting care - Factsheet (PDF, 113 KB) and YHARS service guidelines (PDF, 913 KB).

Ensure compulsory education and training requirements for 15 to 17 year olds

A young person's case plan and transition to adulthood goals must comply with the Department of Education in relation to compulsory schooling. It must also take into account eligibility criteria for Commonwealth benefits.

All young people must participate in 'learning or earning':

• for two years after they complete compulsory schooling (that is, have completed year 10 or turned 16 years of age), or
• until they turn 17 years of age, or
• until they complete a Queensland Certificate of Education or a Certificate III (or higher level) vocational qualification.

The Department of Education will develop a Senior Education and Training (SET) Plan during year 10, or in the year prior to the young person's sixteenth birthday (whichever comes first), for any young person attending a state, independent or Catholic school. The SET plan is created by the young person working with the school and their carer to identify career goals.

The young person will be registered with the Queensland Studies Authority and given a learning account to enable any achievements to be accrued and monitored.

The existing education support plan should be congruent with the SET plan.

In recognition of some of the difficulties young people leaving care may face in completing tertiary education, the Australian Government has standards for justifying the withdrawal from study, without accruing penalties. A letter of support from Child Safety may enable a young person to continue their study at a later time.

If the young person does not have a SET Plan developed during year 10, or in the year prior to the young person's sixteenth birthday, contact the school principal to request the development of the plan.

For further information about SET plans and how to ensure that a young person's case plan goals comply with the requirements of the Department of Education, refer to the practice resource Transition from care (PDF, 59 KB).

Schedule a case plan review

Following the completion of case plan review assessment activities in accordance with Chapter 4, 5. Review and revise the case plan:

• encourage the young person to have ownership of this planning process and let them be involved in the preparation for the case plan review
• decide with the young person whether a family group meeting or other processes will be used for the case plan review
• talk to the young person to identify all of the relevant people to attend the case plan review meeting, and invite them to participate in the development of the case plan
• discuss the case plan review process with the young person's carer and invite them to attend the case plan review
• provide an opportunity for the young person and their family to be supported by an independent person in the transition to adulthood planning process for an Aboriginal or Torres Strait Islander young person – refer 10.1 Decision-making about Aboriginal and Torres Strait Islander children
• determine whether a transition officer, representative from  Specialist Services or Housing and Homelessness Services will participate in, or provide written information for, the case plan review.

Develop a new case plan which includes transition to adulthood planning

Engage the young person to develop a case plan that:

• reflects the young person's goals for their future
• focuses on the young person's strengths and needs
• addresses the young person's needs in relation to the eight key life areas
• identifies strategies and timeframes to meet the stated goals of the young person
• states who is responsible for implementing each action
• details the resources required to achieve each outcome
• includes information about kicbox and ensuring that if a young person is not currently an interactive kicbox user, they are supported to access and use kicbox so that life story work and important documents are attended to in preparation for the young person’s exit from care
• includes contingency planning for changes in the young person's life and future goals.

If a young person is placed in a care environment that provides intensive levels of support, such as intensive foster care or therapeutic residential care, the case plan will include strategies to improve the young person's behaviour, skills and functioning, with the aim of preparing them for a less intensive care environment following their transition to independence.

When developing the case plan, adopt a longer-term view of the young person's needs. It is critical that the planning process builds an enduring support network around the young person. The young person needs to know who they can approach for assistance or advice once they have left care. This will involve identifying adult services that may be useful to the young person in the future, as well as family, friends and community members.

When the case plan relates to an Aboriginal or Torres Strait Islander young person, ensure the cultural support plan supports the young person's connections to family, community, culture and country. For further information, refer to the practice resource Developing a cultural support plan for an Aboriginal or Torres Strait Islander child (PDF, 249 KB).

The development of a case plan, which includes transition to adulthood planning, may take some time. The young person may require support to develop an understanding of how their life may change as a result of leaving care. The young person may also require support to develop an understanding of adult roles and responsibilities before they are able to make informed decisions about their goals and support options.

Obtain approval for funding

Departmental funding is available to support and resource transition to adulthood goals which are based on the assessed needs of the young person. All expenditure is to be included as part of an endorsed case plan, with transition to adulthood actions and outcomes.

Transition to adulthood funding from Child Safety is not an 'exit' payment upon the young person leaving care. Rather, it is subject to ongoing review in accordance with the changing needs of the young person within the context of the case planning and review process or support service planning process.

All requests for financial support are to be consistent with the eligibility criteria outlined in the Child related costs - Client support and family contact (PDF, File not found) policy, are to be recorded in the young person's case plan and are subject to the CSSC manager's approval. Obtain approval by submitting a Child related costs approval form to the CSSC manager.

Note: Funds may be expended on a young person who has already left care and previously been subject to a child protection order granting custody or guardianship to the chief executive.

Consider, and assist the young person to access, other specific programs in the local community, or educational facility that may provide financial assistance to the young person leaving care.

For examples of financial support and service options for young people transitioning from care, refer to the practice resource Transition from care (PDF, 59 KB).

Transition to Independent Living Allowance funding for the young person

Assist the young person to access the Australian Government's Transition to Independent Living Allowance (TILA) funding. This one-off payment of $1,500 is available to all young people aged between 15 and 25 years of age who are preparing to exit, or have exited, care.

Applications for TILA must be made by a CSO through a Regional Intake Service or CSSC. Once a young person has been assessed as eligible for TILA and approval has been granted by the TILA Program Office for the expenditure, the application for TILA can be made in the Department of Human Services Unified Government Gateway (UGG). CSSCs are responsible for registering staff access to the UGG. For information on TILA UGG registration refer to Appendix 3 of the Transition to Independent Living Allowance (TILA) Operational Guidelines. 

For further information on eligibility and the application process, refer to the Transition to Independent Living Allowance (TILA) Operational Guidelines on the Australian Government Department of Social Services website.

Record and distribute the case plan outlining the goals for the future

When recording the revised case plan for the young person:

• use language that can be easily understood by all parties, especially the young person
• document the young person's goals, along with the roles and responsibilities of the young person, family, carers, friends and other support persons in achieving these goals
• include any decisions relevant to funding
• provide a copy of the case plan and the list of proposed review dates to the young person, the transition officer or specialist services coordinator where applicable, the young person’s carer, all other persons who participated in the planning process and persons responsible for implementing case plan actions.

While it is essential to record the transition to adulthood goals and actions in the case plan, the information also needs to be meaningful to the young person. Explore creative options with the young person and work with them to create useful and individual ways to record their transition from care goals, in addition to their formal case plan. For example:

• develop a calendar that shows who is doing what, and when
• create a transition to adulthood notebook for the young person and another for their carer or support person - outline different goals on each page and have the young person and carer write down how they are going to meet those goals, and update progress towards achieving the goals
• draw a floor plan of a house or unit and collect pictures or make a list of the things that the young person may need to live in that space
• sit with and support the young person to upload photos and make collages about their goals and aspirations using ‘Goals’ in the young person’s kicbox or do so using a pile of magazines and collage a picture of where the young person would like to be in five years.

Review the case plan

Review the young person’s case plan and their progress towards achieving transition to adulthood goals at each case plan review or at least every six months as outlined in Chapter 4, 5. Review and revise the case plan.

More frequent reviews may be held at the young person's request or if their support needs are complex. In addition, the young person may experience episodes of uncertainty as their order approaches expiry and the frequency of case planning and Child Safety contact with the young person should increase accordingly.

Consider whether the young person has significant life events occurring during the transition stage, for example, completing academic commitments, when scheduling case plan reviews with the young person.

Ongoing assessment of the young person's readiness to leave care will be completed throughout the transition planning process. Young people should not leave care under 18 years of age, unless they are ready to on both a practical and emotional level.

At the last scheduled case review meeting prior to the young person's eighteenth birthday, determine whether ongoing support is to be provided to the young person by Child Safety. If ongoing support is to be provided:

• document the support to be provided to the young person past the age of 18 in the case plan
• open a support service case following the young person's eighteenth birthday - for further information about support service cases, refer to Chapter 7. Support service cases.

Recognise a young person's journey from being a child in care to entering adulthood

Rituals and celebrations are an important part of life and are often long remembered and reflected upon. Consider ways to recognise the young person's journey from being a child in care to entering adulthood.

Consult with people close to the young person such as their carer or nominated advocate about appropriate activities to mark this time of transition. This may range from sending a congratulatory birthday card to a celebratory event. If there are several young people leaving care around the same time, it may be feasible to plan a combined event at a CSSC level or involving more than one CSSC.

If not provided previously, six months prior to the young person turning 18 years of age, provide the young person a copy of Support Service Case: Information for young people transitioning from care (PDF, 313 KB) brochure. Over the next six months ensure that the young person has the following:

• their child health passport folder
• an original birth certificate (one original birth certificate is to be retained on the child’s file and a second original is to be provided to the child as part of their transition from care planning)
• information about how to access the Australian Government's Transition to Independent Living Allowance (TILA) funding if they have not already done so
• information and assistance about enrolling to vote, where required
• their Tax File number
• the 'Go your own way' kit - a resource developed in partnership between CREATE Foundation and Child Safety for Aboriginal or Torres Strait Islander young people, a copy of their Aboriginality Certificate to assist future funding applications for study purposes - for further information, refer to the practice resource Developing a cultural support plan for an Aboriginal or Torres Strait Islander child.
• for Aboriginal or Torres Strait Islander young people, a copy of their Aboriginality Certificate to assist future funding applications for study purposes - for further information, refer to the practice resource Developing a cultural support plan for an Aboriginal or Torres Strait Islander child (PDF, 249 KB).

During this time, ensure all relevant in information is uploaded into ‘Important documents’ in the young person’s kicbox account.

When the young person turns 18 years of age, provide them with the Letter to young person at 18 years, that:

• acknowledges their milestone birthday
• makes reference to the young person's journey and achievements whilst in care
• clearly states that the child protection order has expired
• outlines whether Child Safety will continue to have contact with the young person – whether in a support service case capacity, or by providing Child Safety contact details to support their access to services up until they turn 25 years
• reminds them that they will retain ‘read only’ access to view and download from their kicbox account.

Attach a certified copy of the young person's child protection order to the letter and retain the original copy on the young person's file.

Assist the young person to enrol to vote

Any young person who is 18 years of age and over and an Australian citizen must enrol to vote for federal, state and local government elections. If the young person is 17 years old, they may enrol but are not entitled to vote until they turn 18 years of age.

Assist the young person, where required, to enrol to vote by having them complete an enrolment form that can be can be obtained from any Medicare, Centrelink, Australian Taxation Office, Australia Post outlets, State/Territory Electoral Office or online from the Australian Electoral Commission.

For further information about enrolling to vote, refer to the Australian Electoral Commission's website.

Provide information to a child in care from their Child Safety file

A child in care may request access to their personal information held by the department. Information can be provided to a child in the custody or guardianship of the chief executive by a delegated officer as part of performing their functions under the Child Protection Act 1999. However, this must not include the release of notifier details.

If a child requests specific information, such as details about their placement history or the location of their siblings, this can be provided as part of regular case work. Similarly, if a child requests copies of their personal documents, such as a birth certificate or case plan, these can be provided.

If a child requests detailed information about their personal history, including the circumstances which led to them coming into care, or asks to review their departmental file, consult with a senior team leader to determine how information can be released in a planned, supportive manner. In consultation with the senior team leader:

• consult with the child’s carer about the circumstances that led the child to make the request, and how best to support the child to access the information
• review the information before it is provided to a child
• remove information not relevant to the child
• arrange a time and a space to review information with the child
• meet with the child to discuss the information being released and explain sensitive or confusing information
• refer the child to a support service, such as a counsellor or psychologist, for ongoing assistance, where appropriate.

Leaving Care Report

Young people have the right to be provided with collated information and important documents held by Child Safety in a timely manner, prior to leaving care. To ensure this is a simple process and happens in a timely manner the CSSC will collate and provide relevant information to the young person without them having to make a formal application for the information and documents. A young person should only need to seek information through a formal application to Right to Information in exceptional circumstances and as a last resort.

The Leaving Care Report will assist staff provide this information. The Confirmation of Care letter that is included in the report will be used by the young person for official purposes such as accessing Centrelink payments, obtaining support services or applying for higher education services. The report only includes information about the young person; information about others will only be included only where it relates to the person’s official role, such as carer, teacher or doctor.

Prior to the young person leaving care:

• complete the Leaving Care Report (DOCX, 97 KB), including the Confirmation of Care letter, outlining information about the young person’s care and placement history, including schools attended and health information
• contact the Right To Information, Information Privacy and Screening Unit on 07 3224 2242 or free call1800 809 078 if clarification is needed about what information is suitable to release to the young person
• attach a copy of the Leaving Care Report (DOCX, 97 KB) and Confirmation of Care letter to the young person’s record in ICMS
• provide the Leaving Care Report (DOCX, 97 KB), Confirmation of Care letter and all relevant documents to the young person
• advise the young person that if they require more detailed information about their time in care they may apply to the Time in Care Information Access Service administered by the Right to Information (RTI) Information Privacy and Screening Unit, see details below.

Time in care information access service

A person who was in care, or a child who is transitioning from care, may request their personal information through the Time in Care Information Access Service. This service is an administrative release scheme administered by the Right to Information, Information Privacy and Screening Branch. It is a separate process from requesting documents under the Information Privacy Act 2009 or the Right to Information Act 2009.

The type of information that may be available through the Time in Care Information Access Service includes a Time in Care Report detailing their placement history, family constellation and their experiences in care. They may also be provided with documents on file including the birth certificates, school reports and medical records.

Information about the service, including information sheets and application forms is available on the Right to Information website.

[ Return to top ]

2.11 Respond to a child's disability needs

Identify disability or developmental delay

Up to 16-20% of children in care have a disability or developmental delay as defined by the Disability Services Act 2006. Aboriginal and Torres Strait Islander Australians experience disability at up to twice the rate of non-Indigenous Australians, yet historically have been up to four times less likely to receive a funded disability service.

'Disability’ refers to an intellectual, psychiatric, cognitive, neurological, sensory or physical condition or impairment that has a substantial impact on a child’s ability to learn, communicate, move, participate in social situations or care for themselves. In children aged 0-6, the term ‘developmental delay’ is used to describe when a child is slower to develop skills in these areas.

Developmental delay does not necessarily mean a child will go on to receive a formal disability diagnosis. With the right interventions, a child experiencing developmental delay may receive all the support they need to ‘catch up’ to their peers.

Identifying when a child has a disability can sometimes be difficult, as signs and symptoms of some types of disability can easily be confused with signs and symptoms of neglect, or as a child’s response to past trauma.

To ensure that a child with disability in care can access the disability supports they are entitled to, it is important to challenge your assumptions and beliefs in relation to the presentation of the child. Ask yourself:

• Could these behaviours be a sign of disability or developmental delay?
• Could trauma symptoms or coping strategies be masking this child’s disability?
• Has a health professional thoroughly assessed this child (as outlined in 2.4 Child Health Passports and identified any possible developmental delays?
• Could this child benefit from a further assessment to rule out disability?

Whenever signs or symptoms of possible disability or developmental delay are present or emerge, they must be investigated and responded to in a timely way. Access to early intervention support can be the key to a child achieving their optimal development and well-being, and can dramatically improve their social, emotional, behavioural or mental health outcomes later in life.

The Types of Disability, Impairment and Diagnosis information table (PDF, 242 KB) Types of Disability, Impairment and Diagnosis information table (DOCX, 128 KB) shows categories of impairment and indicates possible ways these impairments may present in children.

Seek disability support from the National Disability Insurance Scheme (NDIS)

Determine who is the child’s representative

The NDIS Act 2013 requires that participants under 18 be represented by a parent or guardian. This person is known as the ‘child’s representative’.

When a child is subject to an order granting guardianship to the chief executive, the senior team leader performs the functions of the ‘child’s representative’ on the chief executive’s behalf. The CSO will carry out most day-to-day NDIS tasks for the child on behalf of the senior team leader.

When the Chief Executive does not hold guardianship for the child, submit the Consent to share information form signed by parents when requesting NDIS access.

The child’s representative is responsible for:

• providing consent for the child to access the NDIS or an Early Childhood Early Intervention (ECEI) service
• coordinating collection of eligibility evidence to support an NDIS access request
• acting as the contact point for the child with the NDIS
• making decisions during the planning process including what to ask for and who takes part
• signing agreements with service providers for supports to be delivered to a child under their NDIS plan.

In certain circumstances, Child Safety may make a request to the National Disability Insurance Agency (NDIA) for Child Safety (the Child Safety senior team leader on behalf of the Chief Executive) to become the child’s representative for a child in the custody of the chief executive for whom the chief executive does not already hold guardianship. Examples of these circumstances may include:

• when requested by the guardian of a child
• when requested by the child
• when the guardian of a child cannot be located or does not have capacity to perform the role of child representative
• when the chief executive has interim custody of a child and has made an application for either short or long-term guardianship.

Make the request to transfer a child’s representative role to Child Safety using the NDIS Child Representative form (DOCX, 69 KB).

Considerations for Aboriginal and Torres Strait Islander families

Disability is a socially constructed concept arising from western culture and society. People from Aboriginal and Torres Strait Islander backgrounds may have a very different understanding or concept of disability, and in many traditional languages there is no word for disability.

Previous negative experiences of discrimination from government services - both mainstream and disability-related - may affect the willingness of Aboriginal and Torres Strait Islander people to self-identify, or identify their family member as having a disability. In addition, Aboriginal and Torres Strait Islander carers may fear that coming forward about disability, or the challenging support needs of a child in their care, may affect the child’s placement.

Child Safety is responsible for ensuring that an Aboriginal and Torres Strait Islander child subject to ongoing intervention gains the full benefits of all the disability supports and services to which they are entitled. Consider the best way to approach discussions about the NDIS for each family, and who else the family may benefit from having involved.

Request NDIS access for a child aged 0-6

For children aged 0-6 years, the NDIS operates in partnership with non-government providers as part of their ECEI approach. A child aged 0-6 years gains access to the NDIS by making an application through these providers.

To access ECEI, the child’s representative must make contact with the Early Childhood Early Intervention provider contracted for their location and complete their application form.

For a child subject to an order granting custody to the chief executive, contact the ECEI provider for an application and then facilitate the signing of the application by the child’s representative.

If a child requires more support than can be delivered directly by the ECEI provider, the ECEI provider will work with the child’s representative to seek access for the child to the NDIS.

Request NDIS access for a child aged 7 and above

The NDIS has age, residency and disability/early intervention requirements.

To request access to the NDIS for a child aged seven years and above, gather eligibility evidence and complete an access request form. To progress this:

• conduct an initial check of a child‘s eligibility using the NDIS Eligibility Checklist
• contact the NDIS by telephone on 1800 800 110 or at an NDIS office to order an Access Request Form
• attach copies of relevant documentation (proof of age, residency and disability) to the Access Request form.

Note: Child Safety has access to electronic versions of the Access Request Form (ARF). These forms may only be used once a form has been requested from the NDIA and are not to be provided externally. The Child Safety-only ARF forms are the NDIS Access Request Form for existing Disability Services Clients (Defined) and the NDIS Access Request Form for new clients (Non-Defined).

Gather evidence of disability and of significant impact of disability

The NDIS requires evidence of disability be provided by a ‘treating doctor or specialist’. Depending on the disability, this may refer to a: 

The Types of Disability, Impairment and Diagnosis information table (PDF, 242 KB) Types of Disability, Impairment and Diagnosis information table (DOCX, 128 KB) provides guidance on which professionals are best suited to provide evidence about different disability types.

Some conditions once diagnosed require no further evidence of significant impact. These conditions are known as List A conditions.

Some conditions will almost always require further evidence of significant impairment. These conditions are known as List B conditions.

A specialist or health professional may use Part F of the NDIS Access Request Form to provide disability evidence. The NDIS defines ‘health professional’ as a physiotherapist, occupational therapist, speech pathologist, psychologist or nurse. Alternatively, you can provide this information as attached letters, assessments or reports. Either the form or the attachments need to include information about any treatments the child has already received or is receiving.

Ensure the specialist or health professional is familiar with the NDIS process and confident in their role within it prior to completing the Access Request form or preparing other NDIS documentation. The following resources clearly explain the role of the specialist or health professional and how they can best provide disability evidence:

• Primary Health Network GP NDIS Toolkit (PDF)
• A GP and Allied Health Professional’s guide to the NDIS
• RACP’s NDIS guide for Physicians

Receive access decision

In response to the access request, the NDIA will advise the child’s representative in writing of whether:

• the request has been accepted
• further information is required in order to make a determination
• access requirements have not been met.

If access requirements have not been met, the NDIA will provide reasons and you may choose to request a ‘Review of the decision’ (refer Request reviews of NDIS decisions). You may also resubmit a new access request at a future date.

Prepare for NDIS planning

Once access to the NDIS is confirmed for a child, an NDIS planner or Local Area Coordinator (LAC) will contact the child’s representative to schedule a time to develop their NDIS plan. This will usually happen at a face-to-face meeting.

Schedule a planning meeting

When a child is subject to an order granting long-term guardianship to the chief executive, the NDIA planner or LAC partner will contact the CSO or senior team leader to schedule a planning meeting. When considering the time and date of the planning meeting, allow enough lead in time to gather information to support the child at the meeting, and consider the availability of:

• the child, where appropriate
• the child’s parents, where appropriate
• the child’s foster or kinship carer or residential care support workers
• the CSO and senior team leader
• a transition officer (where appropriate and available for a child aged 15-18 years).

Communicate with stakeholders and gather information ahead of planning meeting

The NDIS provides disability supports that are specific to a child’s disability or developmental delay and in addition to the needs of children of similar ages in similar care arrangements.

In order to ensure a child receives all the required supports from their NDIS plan, ensure the people attending the planning meeting:

• have a good understanding and are clear about a the child’s support needs
• are well prepared with a list of existing supports and services the child needs covered in their NDIS plan
• are able to link requested supports (especially new supports) clearly to the child’s functional impairments and goals for development.

Use the Child Safety NDIS pre-planning guide print version (DOCX, 25 KB) or NDIS pre-planning guide electronic version (PDF, 712 KB) to collect relevant information about the child ahead of the planning meeting. The guide can be shared with and provided to external parties.

Gather information about the child’s disability needs and supports from all possible sources, for example:

• the child
• family members
• foster and kinship carer or residential care support workers
• kindergarten teachers, school teachers or guidance officers
• child care centre and family day care staff
• doctors/specialists
• CSNA application/CRC-PAS review documentation.

Provide the child’s family and foster or kinship carer with resources to explain the NDIS and the NDIS planning process:

• NDIS information for parents and families of children in care (PDF)
• general NDIS information for foster and kinship carers (PDF)
• NDIS planning factsheet for foster and kinship carers (PDF).

Ask the child’s family and foster or kinship carer or residential care worker to consider and make notes about:

• how the child’s disability or developmental delay affects their
  • ability to undertake the tasks of daily living (for example, showering, dressing, eating meals and getting ready to leave the house)
  • communication
  • relationships
  • behaviour
• the supports and services the child already uses each week and the supports and services that are missing
• the child's goals and aspirations for the next twelve months
• any disability-specific supports that would help them to better understand the child's needs and better care for them.

Where relevant, provide the child with the NDIS factsheet for young people in care (PDF) which contains information about the NDIS process and what they can expect, having regard to the child’s age and ability to understand.

Ask them to imagine and tell someone or write down what would make their life better in 12 months’ time, and what help they might need to get there.

Conduct pre-planning meeting

Once all available information has been gathered and stakeholders have had an opportunity to consider the supports and services they want to seek for the child, invite all stakeholders to attend a pre-planning meeting (or conference call). 

If the child’s parent or guardian is the child’s representative, they will decide who attends the planning meeting with the NDIA and they may choose not to involve the child’s foster or kinship carer or other stakeholders. In these cases, a pre-planning meeting is particularly important in bringing everyone together and agreeing on priorities prior to a planning discussion with the NDIS planner or LAC.

At the pre-planning meeting, ensure all parties are aware of:

• the NDIS planning process and what will happen at the meeting
• the NDIS planning questions that will be asked and how and who will answer them.
• the child’s support needs across all domains
• the child’s existing disability supports (including funded by Disability Services, Medicare, or under Complex Support Needs Allowance, Child Related Costs, / Child Related Costs – Placement and Support or other)
• the child’s goals for the next 12 months
• the department’s choice of agency-management of all NDIS plans for children and young people for whom we are the child’s representative
• the importance of accurately describing the ‘most challenging day’.

Note: Some families and carers may hold fears that if they accurately describe the child’s most challenging day that it may affect the placement of the child with them. Reassure the family or carer that the NDIS planning process is a place in which they may describe any challenges they are facing in a safe and supportive environment.

It may also be beneficial to discuss preferred support coordinators ahead of the NDIS planning meeting. Where this is not possible, support coordination options can be investigated and a support coordinator chosen after the plan is approved. Refer to section Implement the NDIS plan.

Attend NDIS planning meeting to develop NDIS plan

Attend the NDIS planning meeting with the child and other stakeholders

Ensure the following information and documents are available at the meeting as these may be requested:

• the child’s full name and address
• the name, phone number and email address to use to contact the child’s representative (for example, a regional mailbox)
• a copy of the child protection order
• a copy of the child’s birth certificate
• a copy of the Australian Naturalisation certificate, if the child was not born in Australia
• passport or travel documents with valid Australian Permanent Residency Visa or Protected Special Category Visa, if the child is not an Australian citizen
• a copy of originally submitted access request and any additional eligibility documentation or reports providing evidence of the child’s disability support needs
• notes from the pre-planning meeting, including information about the child’s existing supports, support needs, identified gaps in supports and goals
• copies of the completed Child Safety NDIS pre-planning guide.

Provide relevant information to the planning meeting

The meeting is made up of the following parts:

• Introductions: ensure at this point that the NDIS planner is made aware of the child’s custody and guardianship arrangements and who the child’s representative is.
• Assessment questions determining the impact of the child’s disability: ensure each of these questions is answered based on the most challenging day experienced in the past 30 days.
• Questions determining existing service utilisation: ensure all relevant supports are included here from all previous funding sources, for example:
  • transport subsidies
  • medical or disability aids and equipment
  • therapies received, including through Medicare treatment plans, the hospital system or Evolve
  • community activities including hobbies, clubs, after school care and vacation programs
  • disability related training provided to staff or carers
  • other funded disability supports covered by the HSNA, CSNA or CRC-PAS arrangement.
• Questions related to setting of goals: the NDIS planner may help to craft the wording of the goals for the plan: ensure that the goals recorded accurately reflect the discussion and that all required funded supports for the child discussed at the pre-planning meeting are able to be clearly linked to them.
• Questions related to plan management and coordination: ensure that funding for support coordination is requested and that ‘agency management’ is requested for plan funding (or encouraged, where the Child Safety is not the child’s representative). Notify the NDIA of the preferred support coordinator/s for the child if one has been chosen.
• Wrap up and future actions: ensure prior to the meeting closing that the NDIS planner:
  • has been provided with accurate contact details for the CSO and child’s representative
  • summarises the information they have gathered at the meeting so that attendees can confirm their accuracy and ensure nothing discussed is missing.

Most children in care should receive funding for support coordination, with a minimum support coordination amount of 100 hours for a 12-month plan. Refer to the Advocating for support coordination tip sheet to assist in establishing the need for support coordination with the planner at the NDIS planning meeting.

Implement the NDIS plan

Following the planning meeting, the child’s representative will be issued with an NDIS plan by the NDIA.

The plan will show NDIS funding allocated against one or more of three support budgets:

• core budget: for supports related to daily living, community access, and the child’s longer-term goals
• capital budget: for assistive technologies and equipment
• capacity building budget: for supports to build skills and independence, for example, therapies.

Determine whether plan review required

On receiving the plan, check that all the required supports discussed and agreed at the planning meeting have been funded. The NDIS support calculator can assist to check funding amounts. If funding for support coordination had been requested, this will show against the capacity building budget and a Request for Service form will often be included with the plan.

If all required supports have not been included in the plan, the child’s representative has 90 days to lodge a request for a plan review (refer to section 8. Manage NDIS reviews).

Engage a support coordinator

Queensland’s Complex Cohorts Needs Working Arrangements provide for children who are involved with Child Safety to be allocated funding for support coordination in their capacity building budget.

The support coordinator is the first provider engaged as part of the plan. The support coordinator’s role is to help the child and the child’s representative to implement their plan.

It is important to choose a quality support coordinator, and to outline clearly in the service agreement with them what services they will provide and how they will charge for their services. The work of the support coordinator includes:

• researching and providing options for service providers to deliver services under the plan
• preparing service agreements where required with those providers
• providing reports to the child’s representative about utilisation of plan funding once the plan is in action
• coordinating progress reports and other input from service providers ahead of scheduled plan reviews.

A Request for Service form will be included with the child’s plan. Complete and submit the form to your chosen support coordination provider.

A support coordinator can be chosen at the planning meeting or later. If a support coordinator was not chosen at the planning meeting, a Request for Service form may be included with the child’s plan. Complete and submit the form nominating your chosen support coordination provider. Please include the Service agreement addendum and provide the critical incident reporting information sheet when signing the service agreement with the chosen support coordinator, to ensure Child Safety requirements are met by the provider.

Some Child Safety regions have identified preferred Support Coordination providers. In addition, the NDIS can provide a list of registered support coordinators operating in the local area. The NDIS also regularly publish the full list of NDIS-registered providers (providers may or may not be operating locally). Search for support coordinators using the “Provider by Group – QLD” tab and filtering Registration Group on “Assist Life Stage Transition” and “Support Coordination”.

The support coordinator will process the form and make contact with the child’s representative to set up a meeting. It is important that all the key people in the child’s life attend the first meeting with the support coordinator. At the meeting, the support coordinator will explain the plan and gather information which will inform the recommendations they make to the child’s representative about service providers for the child.

If support coordination has not been funded, the LAC can provide support to implement the plan. If you believe support coordination funding has not been included due to NDIA error, you can request a plan review (refer to Request or manage an unscheduled plan review).

The list of LACs is also available on the NDIS website.

Engage service providers

The support coordinator will provide information to the child’s representative about providers in the area that may be a good match to deliver the required services under the child’s plan.

The list of NDIS-registered providers is available on the NDIS website.

NOTE: for agency managed plans, all service providers must be NDIS-registered.

Establish service agreements with all providers delivering services under the plan. The delegation for signing NDIS service agreements is held by the senior team leader.

Most providers have services agreement templates of their own that they request NDIS participants to sign. Review the agreement carefully and add to or amend the agreement where required to ensure all parties are in agreement in relation to:

• confidentiality
• use of the Child Safety critical incident reporting policy and process
• communication with the support coordinator, child’s representative and CSO, including the frequency of feedback and how this will be provided (verbal or written)
• the agreed support being provided to the child
• current agreed fees charged and number of hours of support provided to the child including what happens if a child is unable to attend an appointment
• what happens when one party wishes to end the agreement – explore how much notice is required (generally two weeks) and if there are any exit fees. Include if the service provider is ending the agreement a written report is to be provided outlining support already provided to child.

Review the Placement Agreement including Child Safety-funded supports

The child’s NDIS plan provides funding for reasonable and necessary disability supports.

Review the placement agreement for the child once the NDIS plan is available to ensure the agreement captures roles and responsibilities in relation to the implementation of, and communication about, the plan.

It is important that funding provided to support the child’s placement is reviewed as soon as the child has an NDIS plan to ensure Child Safety is not duplicating NDIS-funded supports. Refer:

• the Complex Support Needs Allowance policy (PDF) and procedure (PDF)
• Child Related Costs – Placement and Support business rules (PDF)

The fortnightly caring allowance and high support needs allowance do not need to be reviewed as a result of the child receiving an NDIS plan.

Record and maintain plan information

Use the NDIS sub-tab located under the Health tab in ICMS to track NDIS-related information for children subject to Child Safety or Youth Justice intervention, including:

• NDIS participant number
• access requests and decisions
• plans
• review decisions
• annual scheduled reviews
• historical information including previous plans.

NDIS information (excluding ECEI details) is shared between Child Safety and Youth Justice. For Youth Justice dual clients, Child Safety will be responsible for the entry of the child’s NDIS information, although Youth Justice staff may assist to maintain it.

Refer to the NDIS ICMS Information Guide for further information on how to use the NDIS sub-tab.

Monitor the NDIS plan

Discuss the child’s NDIS plan and how the services funded in the plan are working for the child in progressing toward their goals at case plan review and placement meetings.  

If areas of improvement are identified, many changes to NDIS supports can be made during the life of the plan by the child’s representative directly with providers without a review by the NDIA, as plan funding can generally be used flexibly within the core and capacity building budgets. The changes may include:

• changes to service providers
• changes to service types
• changes to frequency of a service.

More significant changes may require the NDIA to review the plan (Refer to section 9. Manage an NDIS plan review below).

Manage an NDIS plan review

Request an internal review of an NDIS decision

The majority of decisions made by the NDIA under the NDIS Act are ‘reviewable decisions’. The NDIA must give written notice of a reviewable decision to each person directly affected by the reviewable decision.

Those who may be directly affected by a decision and who are able to request a review of a decision include:

• a prospective participant
• a participant (including participants who are children)
• one or more persons with parental responsibility for a child
• a child's representative, or a person seeking to a be a child's representative
• a child's guardian
• a plan or correspondence nominee, or a person appointed, or seeking to be appointed as a plan or correspondence nominee
• a registered provider of supports, or a person or organisation that applies to be a registered provider of supports
• a person who owes a debt to the NDIA

As a party affected by a decision, the most common scenarios where you may need to request a review of the decision are when:

• the NDIA have determined that a child does not meet NDIS access criteria
• the NDIS has refused a request for participant initiated plan review.

The full list of reviewable decisions is available in the NDIS operational guideline.

To make a request for a review of a decision:

• send or deliver a written request by post or email to the NDIA, or
• make an oral request, in person, by telephone or other means to the NDIA.

The request must be made within 90 days of the decision being made. The decision remains in effect while the decision is reviewed.

The review:

• must be conducted by a staff member who was not involved in making the original decision
• must be conducted ‘as soon as reasonably practicable’
• should include an opportunity for the requestor to explain why a different decision should be made and provide any additional information or evidence.

Following the review, the NDIA is required to advise the requestor of the outcome in writing.

Request an external review of an NDIS decision

There is a further right of external review by application directly to the Administrative Appeals Tribunal (AAT). Seek advice from the senior team leader (who may wish to contact the NDIS Interface Team and/or Legal Services) before preparing to make a request to the AAT.

Further information about applying for an external review is available on the AAT website.

Manage a plan review

A plan review is a process in which the NDIA performs a re-assessment of a participant’s support needs and prepares a new plan on behalf of the participant.

There are three types of review of an NDIS plan:

• unscheduled reviews - participant-initiated (where the participant or representative requests a review and the NDIA delegate agrees to the review)
• unscheduled reviews - delegate-initiated (where the NDIA initiates a review)
• scheduled reviews - scheduled (as part of the NDIS planning cycle).

Request or manage an unscheduled plan review

A participant or their representative may request a review of their plan at any time. The NDIA delegate then decides whether the plan will be reviewed. This decision is a reviewable decision (refer above).

Some examples of when the child’s representative may need to request an unscheduled review include when:

• there is a significant increase or decrease in the child’s support needs
• there is an urgent requirement for an additional service type not already included in the plan
• a key life transition is approaching, such as leaving school or leaving care.

Discuss the request for review with the child’s support coordinator first, as a request for review is unlikely to be accepted without evidence of a change in circumstances or additional information such as an updated functional assessment being provided about the child’s need for support. The NDIA will generally not accept requests for plan reviews within three months of an existing review date.

The NDIA must decide whether to review a plan within 14 days of receiving a request from a participant or their representative. If they do not make a decision, the NDIA are taken to have decided not to review the plan and you can lodge a request for a review of a decision (Refer: Request an internal review of an NDIS decision above).

The review will create a new plan. Record the previous and new plan information in ICMS as outlined in ‘Record plan information’ section above.

The NDIA may also initiate an unscheduled review if they have reason to do so. A delegate of the NDIA may decide it is appropriate to review under the following circumstances:

• a change in the participant’s circumstances
• feedback from the NDIAs monitoring activities
• something has changed in relation to how the child would be assessed under the NDIS Act (for example, the effectiveness of a support to assist a participant to achieve their goals and aspirations, value for money relative to alternative supports, or what it is reasonable to expect family or carers to provide).

Manage a scheduled plan review

The NDIA or LAC partner is likely to make contact up to three months prior to a child’s plan expiry date to set a date and time for a plan review meeting. The plan review meeting is likely to be set well before plan expiry so that a new plan can be approved before the current plan finishes.

It is important not to assume that existing services will be rolled over automatically into a new plan at the review. The NDIA require evidence that each service is delivering benefits to a child, and continuing to contribute to the child achieving their goals.

Facilitate progress reports ahead of a plan review

Work with the support coordinator (or directly with each service provider if no support coordinator has been allocated) to organise for progress reports to be developed and submitted by all funded support providers ahead of the review meeting. 

Progress reports are required for each service accessed during the life of the current plan. The reports should show:

• evidence of benefit of the service to the child
• progress toward the outcomes that the service was funded to achieve in the current plan
• the outcomes for the child that the service will be working towards in the coming year
• any recommendations for increase or decrease in the amount of the service for the child.

The support coordinator is also required to provide a report on how they have been supporting the child over the period of their plan. The NDIA provide support coordinators with a template for this.

Communicate with stakeholders and gather information ahead of a plan review

As with the initial planning meeting, a child is likely to receive a better plan at review if the people attending their review meeting:

• have a good understanding and are clear about what a child’s support needs are
• are well prepared to explain how existing supports and services are benefitting the child and are required to continue
• are able to link any new requested supports clearly to the child’s functional impairments and goals for development.

Gather information to assist the review from all relevant sources, for example:

• the child
• family members
• foster and kinship carer or residential care service staff
• kindergarten/school teachers, guidance officers
• Child Care Centre and Family Day Care staff
• doctors/specialists
• CSNA application / CRC-PAS review documentation
• the pre-planning guide or other pre-planning materials completed prior to the original planning meeting or previous reviews.

Ask them to consider and provide information about whether there have been any changes in:

• how the child’s disability or developmental delay affects their
  • ability to undertake the tasks of daily living (for example, showering, dressing, eating meals, getting ready to leave the house)
  • communication 
  • relationships
  • behaviour
• the supports and services that would benefit the child
• the child’s goals and aspirations for the next 12 months
• the disability-specific supports that would help them to better understand the child’s needs and better care for them.

Where relevant, provide the child with the NDIS general factsheet (PDF) about the NDIS process and what they can expect, having regard to the child’s age and ability to understand.

Ask them to imagine and tell someone/write down what would make their life better in 12 months’ time and what help they might need to get there.

A review will create a new plan. Record the previous and new plan information in ICMS (refer ‘Record plan information’). 

Respond to disability support needs for a child in an emergency or crisis

Action in relation to a child’s NDIS support may be required in an emergency or crisis situation, for example:

• the sudden illness or hospitalisation of the carer
• a sudden or severe escalation of challenging behaviours related to the child’s disability that are unable to be managed within the existing care arrangement
• an immediate and critical need for equipment or equipment repair to sustain the existing care arrangement.

When a child is an NDIS participant, the child’s representative can work with their support coordinator or the LAC to move funds within their NDIS plan to respond to the crisis. This may include purchase of emergency short term accommodation (respite) or another support. The support coordinator or LAC can also assist with a request for an urgent plan review if the child’s circumstances have changed sufficiently to warrant an unscheduled plan review request.

Manage contact with the NDIA

Strict privacy provisions govern who the NDIA will speak to about an NDIS participant. To enable the NDIA to speak with you about a child who is in care, you may be requested to provide:

• a copy of the current child protection order
• a copy of your government ID
• an email from a state government email address (regional NDIS mailboxes are preferred).

Note: For a child subject to Child Safety intervention but who is not in care:

• seek consent from their parent or guardian to speak with the NDIA using the NDIS Information Exchange form (DOCX, 54 KB). 
• to seek information from the NDIA without the consent of the parent or guardian to determine whether a child is in need of protection as part of pre-notification checks or investigation and assessment, use the Data Management NDIA Request Form.

[ Return to top ]

2.12 My Health Record

The Australian Government introduced the My Health Record system to enable health care providers to have immediate digital access to a person’s important health information, at any time and from anywhere in Australia. Health care providers, such as hospitals, doctors, pharmacists, radiologists and other allied health professionals registered with My Health Record, will be able to view the information on a health care recipient’s record, and upload new health information. This will improve information sharing about a person’s the health needs. Learn more about My Health Records.

Continuity of healthcare is a key issue for children in care, particularly when changes to their living arrangements may lead to changes in healthcare providers. Child Safety will support children in the guardianship or custody of the chief executive, by performing the functions of their authorised representative, in accordance with their age and the type of child protection order.

Access the Children in Care portal

The Australian Digital Health Agency has developed the Children in Care portal (the portal) to enable Child Safety staff to be linked to the My Health Record of a child in care as a Care Agency employee, and undertake the functions of the child’s authorised representative. The portal will only be accessed for a child under 14 years of age subject to a child protection order granting:

• guardianship to the chief executive, and
• in specific circumstances, custody to the chief executive.   

Access to the portal is governed by strict requirements as outlined in Policy 642 Managing access to My Health Records using the Children in Care portal and can only be accessed by Child Safety staff who have:

• completed the required training as evidenced in iLearn
• case responsibility for the child, or alternatively have responsibility for overseeing the delivery of services to the above children in care, such as senior team leaders, senior practitioners and CSSC Managers.

Child Safety staff do not have the authority under the My Health Record Act 2012 to access the portal for a child subject to an intake, investigation and assessment, care agreement, assessment order, intervention with parental agreement, support service case, non-custodial child protection order, or a child protection order granting custody or guardianship to a relative or a suitable person.

Link to a child’s My Health Record as an authorised representative

For guidance on how to perform this function in the portal, refer to Linking to a child’s My Health Record as their Authorised Representative.

Child protection order granting guardianship to the chief executive

All children under 14 years of age and subject to a child protection order granting guardianship to the chief executive will have a My Health Record (record). The CSO with case responsibility for the child will access the portal to:

• register as the child’s authorised representative
• restrict the parents access to the child’s record and remove the parent as an authorised representative if they are already linked to the record, if applicable
• create a My Health Record for a child subject to a child protection order granting guardianship to the chief executive, where one does not exist
• update or correct the child’s personal details, as appropriate
• monitor the access history of the child’s record.

Where a record is created for a child because one does not already exist, the CSO will provide the child with information about their record, taking into account the child’s age, maturity and capacity to understand. This will include information about:

• the reason for creating a record on their behalf
• the information provided to the My Health Record system to create the record
• who is able to access and view the information in their record
• the privacy of their information
• how the CSO will use and disclose health information to others such as carers, and
• when they turn 14 years of age, they will be able to take control of their record.

Child protection order granting custody to the chief executive

The CSO with case responsibility for a child under 14 years and subject to a child protection order granting custody or interim custody to the chief executive will only link to the child’s My Health Record as their authorised representative in the following limited circumstances:

• the child has complex health needs and access to their health information will assist in managing and responding to their health needs. In this situation, the child’s parent will not be removed as their authorised representative, or
• there is a need to restrict the parent/s’ access to their child’s record due to a risk of significant risk of harm to the child, their carer or others, should they be able to access the child’s My Health Record (refer information below).

Recording in ICMS

The CSO will use the child’s ICMS health tab, MHR subtab, to record actions taken in the portal including the name of the child’s authorised representative and the date the action was taken.

Restrict parents access to a child’s My Health Record

Although address information is not visible in a child’s My Health Record, a health care provider may include the child's address in the clinical information they upload, or information that can lead to the identification of a child's community or locality or their carer’s identity.

Using the Children in Care portal, a CSO with case responsibility for a child in care who is under 14 years of age, can use the portal to restrict a parents’ access to their child’s record in the following circumstances:

• the child is subject to a child protection order granting custody or guardianship to the chief executive, and
• the life, health or safety of the child, their carer, or another person would be put at risk if the parent were access information in the child’s record which may enable them to determine where the child is living.

The CSO will:

• seek senior team leaders endorsement of the proposal to restrict the parent’s access
• complete the restriction in the portal, which will also automatically link the CSO as the child’s authorised representative
• remove the parent as the child’s authorised representative, if they are already linked to their child’s record
• advise the parent/s of the action to restrict access to the child’s My Health Record and the reasons for the decision
• provide the parent/s with the information sheet, My Health Records and children in care: Information for parents of children in care
• use the child’s ICMS health tab, MHR subtab, to record details of the restriction action and the authorised representative information
• review the restriction decision and where appropriate, remove the restriction when the parent/s no longer poses a significant risk to the child or others.

For guidance on how to perform this function in the portal, refer to Restricting record access and removing parents.

In circumstances where the portal cannot be accessed by the CSO or senior CSSC staff, and the need to restrict the parents’ access to the child’s record is urgent, contact the My Health Record helpline on 1800 723 741, and ask the operator to restrict the child’s record. Provide evidence of your legal authority to take this action (i.e. the child protection order and the expiry date of the order).

Manage a child’s My Health Record

The CSO as the child’s authorised representative will maintain the accuracy of the information in the child’s record and may add, amend or correct personal information. This can include adding information about known allergies or adverse reactions and the child’s Indigenous status.

A CSO will not cancel a child’s record or remove clinical documents.

When a child in care undergoes a health assessment, including for the child health passport process, the CSO can request that the health care provider include this information in the child’s My Health Record. If the health care provider is not registered with the My Health Record system, this report can be added to the child’s record by the CSO, through the ‘Personal Health Notes’ screen.

Monitor the record

It is sound security practice for the child’s authorised representative to regularly log into the portal to monitor who is accessing the record, ensuring that there has not been unauthorised access:

• remove any person with representative access who no longer has the need to access the child’s record, such as a former carer or CSO
• if unauthorised access or suspicion activity is identified, then immediately discuss this with the CSSC Manager, and contact the My Health Record helpline on 1800 723 741
• if a privacy breach is suspected, report the suspicion to the CSSC Manager who will consider whether the concern should be referred to the Information Privacy Team and Legal Services
• if a privacy complaint is received, relating to a breach of Child Safety staff member's obligations under the Information Privacy Act 2009, immediately refer the matter to the Information Privacy Team for assessment.

Invite a nominated representative

In some circumstances it may be appropriate to give the child’s foster or kinship carer access to the child’s record as a nominated representative, to assist in coordinating health care appointments and meeting the child’s health needs. This decision will be made on a case-by-case basis, depending on the child’s needs and circumstances, for example where:

• the child is subject to a child protection order granting guardianship to the chief executive, and the care arrangement is a stable one with the intention to be long-term
• the child has high or complex health needs and access to the child’s record will directly assist the carer in meeting the child’s health needs
• the child’s views about their carer having access to their record has been sought and considered
• the carer agrees to represent the child’s views and preferences, and to using their personal MyGov account to be linked as the nominated representative
• the carer is made aware of and understands the privacy considerations associated with viewing a child’s record, and of the penalties for inappropriate or unauthorised use.

Provide the carer with the Information sheet, My Health Records and children in care: information for foster and kinship carers.  

The CSO will:

• seek the senior team leaders endorsement of the proposed action
• record the rationale for the action in a generic case note with the title of ‘My Health Record’, including a description of the action, such as ‘Carer as nominated representative’
• remove the carer as the nominated representative immediately when the child leaves the care arrangement.

If the CSO who initiated this action in the portal ceases to be the child’s authorised representative, the carer’s access will be deactivated by the My Health Record system. The child’s next CSO will need to re-invite the carer as the child’s nominated representative, if this is applicable and in the child’s interests, after registering as the child’s authorised representative.    

For guidance on how to perform these functions refer to Inviting or removing a Nominated Representative.  

View a child’s My Health Record

Health care providers are not obliged to upload clinical information to a person’s My Health Record, and not all health care providers are registered with the My Health Record system. The CSO cannot assume that the information in the child’s record is comprehensive, and will need to continue to gather information about the child’s health needs from other sources, such as the child, their parent, carer and directly from health care providers.

Information in a child’s record includes personal and sensitive information about the child. Collection, use and disclosure of this information is governed by a range of legislation including the My Health Record Act 2012, the Information Privacy Act 2009 and the Child Protection Act 1999. Information sharing must comply with this legislation. The CSO may:

• collect information from the child’s record that is relevant to meeting the child’s current care needs
• share information to the extent necessary to meeting the child’s health care needs
• use the information in the child’s record to:
  • update the ICMS health tab information
  • inform the child’s strengths and needs assessment
  • develop goals and actions in the child’s case plan
  • identify health services required for the child, and
  • provide information to the carer, as documented in the Child Information Form and the Placement Agreement.

Key sources of health information in the child’s record include:

• the shared health summary, for an overview of the child’s health status at a point in time
• immunisation history records, to show outstanding vaccinations
• prescription history, for information about any current medicines prescribed and dispensed
• known allergies or adverse reactions
• specialist reports
• event summaries and hospital discharge summaries, where appropriate.

For guidance on how to navigate a child’s record, refer to Viewing a child’s health information.

Remove Child Safety staff from a child’s My Health Record

When a CSO is linked to a child’s record as their authorised representative and they cease having case responsibility for the child, the CSO will immediately remove themselves as the child’s authorised representative.

When a child under 14 years is reunified to their parents care, or another child protection order is made granting guardianship to a relative or a suitable person, the CSO will:

• remove themselves as the child’s authorised representative
• remove any restriction that may have been placed on the record, where appropriate
• provide advice to the child and their parent or guardian about linking to the child’s record so that they can assume the responsibility as the child’s authorised representative.

When a child turns 14 years of age, any authorised or nominated representatives on their record, will be automatically removed by the My Health Record system.

Enable a young person to control their My Health Record

A key feature of the My Health system is that once a child is 14 years of age, they can take control of their own record.

The CSO will ensure that a young person has a MyGov account to enable them to sign in and assume control of their My Health Record should they wish to do so, and that they have the information needed to safely manage their record. A young person can choose not to take control of their My Health Record or to suspend or cancel it.

A young person may give other people access to their record as a nominated representative. This might be a parent or family member or their carer. The CSO will not be a young person’s nominated representative.

Information sheets for children and young people about the My Health Record system are available at My Health Record for teens and Information for children in care.

[ Return to top ]