OOHC - Health Pathway - A guide for caseworkers

• DCJ completes the OOHC Health Pathway referral form and emails it to the OOHC   Health Coordinator within 14 days of the child’s entry into statutory care so that their health needs can be identified and addressed as soon as possible.
• If a Service Provider finds that a child or young person was not referred to the   Pathway when they entered care they can complete the OOHC Health referral   form. However, they cannot sign the back, this must be done by a DCJ Manager   Casework or above before it is provided to the OOHC Health Coordinator. The local Child Family District Unit (CFDU) can provide more advice about this to Service Providers and help them access the form if needed via the DCJ internet.
• The caseworker should explain the following to the child/young person as part of the referral process:
• why they are being referred to the Pathway
• how their participation will help to keep them healthy during their time in care
• that if they demonstrate sufficient maturity to make their own decision regarding participation they must give their written consent. The child/young person does this by signing the referral form (note this is generally considered to be from age 14, though in some instances may be younger as advised by a medical practitioner)
• The caseworker should explain the purpose of the Pathway to the carer and make   sure that they understand their role in implementation e.g. taking the  child/young person to appointments, implementing Health Management Plan   recommendations. Provide the carer with the factsheet OOHC Health Pathway: A Carer’s Guide
• The DCJ caseworker should email the referral form to the OOHC Health Coordinator and save in ChildStory.

• The OOHC Health Coordinator and their team will gather relevant information to   undertake a health assessment.

• The 2A or primary health assessment is undertaken for all children/young people in   care by a primary health practitioner e.g. a General Practitioner, Child  and Family Health Nurse, Youth Health Nurse or Aboriginal Medical Service. It should be undertaken within 30 days of the child/young person entering care and will include: physical examination, growth and development check, vision, hearing, mental health, dental screen, immunisation status review and nutrition.
• The OOHC Health Coordinator will organise the 2A or primary health assessment and advise the carer of the details.

There is no need for caseworkers to organise separate – vision, hearing, pediatrician assessments for children/young people

• It is not necessary for caseworkers to organise separate eyesight or hearing tests   for children/young people as their vision and hearing will be assessed through their primary health assessment. The annual or six-monthly health review process   should determine whether there are newly presenting issues with a child/young   person’s vision or hearing.
• If a health professional identifies concerns with a child or young person’s eyesight or hearing during the 2A assessment process they should refer them to an appropriate practitioner for a full assessment.
• A child or young person will be referred to a pediatrician through the OOHC Health Pathway  if required. It is not a requirement for caseworkers to organise an independent pediatrician assessment.

Caseworkers should support the 2A or Primary Health Assessment by:    

• Reminding  the carer to bring the child’s Personal Health Record (Blue Book for 0-5 year old children).
• Attending the appointment with the carer, birth parent (if appropriate) and child or   young person where possible.
• Saving any communication about the primary health assessment provided by the OOHC Health Coordinator into ChildStory or their organisation’s record management system e.g. this could include:
• an email from the Coordinator to indicate that the 2A assessment has occurred
• copy of the 2A/primary assessment report from the health practitioner
• other reports such as prenatal birth summary

OOHC Health Coordinators may not necessarily provide caseworkers with a copy of the 2A primary health assessment or advise that it has occurred. Provision of this depends on how their district implements the Pathway.

• For some children and young people, the primary health assessment will identify   that a 2B or comprehensive assessment should occur. This assessment may   involve a range of health practitioners and appointments for assessment of   physical, development, psychosocial, and/or mental health. The OOHC Health   Coordinator or their team will coordinate the comprehensive health  assessment.

Caseworkers should support the 2B or Comprehensive Health Assessment by:

• Checking with carers to ensure they know about and attend relevant appointments.
• Saving copies of reports from health specialists after an assessment has occurred in ChildStory/their organisation’s record management system.
• Providing the OOHC Health Coordinator with any assessment reports if they have been undertaken in the private health system as the Coordinator will not have   access to these.

• The OOHC Health Coordinator or team member will develop a Health Management Plan for the child/young person. The plan is a record of their health needs identified   through their primary and comprehensive assessments and the services   recommended to address these. The Health Management Plan should be developed within 90 days of the child/young person entering statutory care.

Caseworkers should support the Health Management Planning process by:  

• Participating in the planning process if requested by the OOHC Health Coordinator and encouraging participation by children/young people, carers and birth parents   were appropriate.
• Saving the Health Management Plan in ChildStory/ or the organisation’s record management system.
• Ensuring key recommendations are incorporated into the health domain of the child/young person’s case plan. If the Health Management Plan is not ready in time for integration into the child or young person’s case plan, then incorporate   findings from the Plan into their next case plan review.
• Integrating other aspects of the Health Management Plan into the planning processes that occur for children/young people, this could include their care, cultural and personalised learning and support planning.
• Giving a copy of the Health Management Plan to the child/young person’s carer, birth parent if appropriate and make sure they are aware of the actions they will   need to implement.

Caseworkers are responsible for implementing the Health Management Plan

• Implementation of the Health Management Plan should occur in partnership with the OOHC Health Coordinator, other health practitioners, the carers, birth parents   (were appropriate) and the child or young person.

Obtaining health services for children and young people:

• The health services that children require should be included in their Health   Management Plan. These services could be provided by a general practitioner or health practitioner with a specialisation, for example, a speech therapist, physiotherapist, dentist, optometrist, psychologist or psychiatrist. The caseworker is also responsible for organising access to the   National Disability Scheme or Early Childhood Early Intervention if this is required by the child or young   person.
• The OOHC Health Coordinator can provide the caseworker with more advice about specific health services available through the local health district for children and   young people and how they operate.
• Wherever possible health services should be obtained through a publically-funded health provider. Where extraordinary services or supports are required that cannot be provided through the public health system or provided in a timely fashion, caseworkers should seek these through private providers.

For children in DCJ managed placements, caseworkers should request contingency funds to cover costs. For children/young people in service provider managed placements services would be funded through the Child Needs Package PDF, 243.57 KB, or if the issues the child/young person is experiencing are very complex, through application to the Complex Needs Payment PDF, 351.34 KB.

Obtaining health services for Aboriginal children and young people:

• In some local health districts, elements of the OOHC Health Pathway are delivered by Aboriginal Community Controlled Health Services. This includes access to   Aboriginal Medical Services and Aboriginal Health staff.
• The OOHC Health Coordinator will be able to provide the caseworker with more information about services in their local health district that are available to meet the   needs of Aboriginal children and young people in care. Information about   Aboriginal Health Services operating in NSW can also be found on Australian Indigenous HealthInfoNet.

• A child  or young person in OOHC requires periodic health reviews and assessments in order to ensure that their Health Management Plan is being implemented and that it is effectively addressing their health needs. In addition, new and emerging health issues can also be identified during reviews and incorporated into the HMP.

The caseworker is responsible for ensuring the Health Management Plan is reviewed by the OOHC Health Coordinator or by a health practitioner

• Health Management Plan reviews should occur for:
• Children under the age of five years every six months.
• Children and young people over the age of five every 12 months.
• Health Management Plans should also occur for:
• Children and young people with emerging needs that require a health assessment
• After a child or young person experiences a significant event (e.g. placement change, change in health condition)

The caseworker should undertake the following to have the Health Management Plan reviewed:   

• Contact their local OOHC Health Coordinator and request that they review the Plan.

If the OOHC Health Coordinator advises that they do not have capacity to review the Plan because of resource constraints they will advise the caseworker and provide advice about how to get the plan reviewed.

This advice may include that the caseworker use the relevant 2A Primary Health Assessment Form as a guide for    review of the Health Management Plan. These forms are available on the DCJ website and are age specific. It is important    that caseworker’s do not design their own assessment forms and that the 2A form is always completed by a health    practitioner.

• Save the 2A form on ChildStory or your organisation’s record management system and provide to the OOHC Health Coordinator to update the child/young person’s Health Management Plan.
• Ensure issues identified through the review are investigated and followed up. Request that the GP or health professional who reviewed the Plan organise referral(s) to be made to appropriate follow-up services or ask the OOHC Health Coordinator to make recommendations when they update the Plan.