Case management: NDIS and children with a disability and/or complex medical needs
This procedure should be used by child protection practitioners and contracted case managers who are working clients of child protection who also have a disability and/or complex medical need.
Document ID number 1706, version 4, 6 May 2021.
Disability and complex medical needs can significantly increase a child’s vulnerability. When risk of harm issues are evident, thorough consultation and information sharing with all specialist disability and/or medical services involved with a child is required. This includes NDIS funded supports where the child has, or may require, a NDIS plan.
See Disability and complex medical needs- advice for additional information regarding this procedure.
See Practice guidelines for Child FIRST, The Orange Door, Integrated Family Services, Child Protection and Out-of-Home Care for further information about working with children with a disability who require NDIS supports.
Case practitioner tasks
Investigation and protective intervention
- Consult with services involved with the child to understand how the child communicates in order to obtain their views or complete an investigative interview where a child is non-verbal or has significant communication needs. It may be appropriate for a support person to be present with the child during an investigative interview.
- Gather information from relevant hospital staff and other medical professionals where a child is residing in hospital due to complex medical needs about the reported protective concerns, including parental capacity to meet the child’s medical needs.
- Confirm if the child has a disability and/or complex medical need in CRIS following completion of the first home visit. The disability and complex medical needs fields are mandatory at the Investigation and Assessment phase where a first visit has been recorded. For more information on recording disability and/or complex medical needs in the investigation and assessment phase, see the Recording Disability and Complex Medical Needs Information CRIS Guide.
- When a case involving a young person with a significant or complex disability or complex medical needs is recommended for closure who is 16 years 9 months or more (but will not be 18 when the case closes), seek the endorsement of the Principal Practitioner to close the case. This applies when an investigation has been completed, whether substantiated or not, and at any phase following investigation.
If direct child protection involvement with a young person with a significant or complex disability or complex medical needs is ceasing at or after 16 years 9 months but before 18 years of age, it is critical that appropriate arrangements are in place to provide continued support. This will increase safeguarding for vulnerable young people who are close to, or are 17, where thereafter Child Protection no longer has statutory authority to intervene.
Where an NDIS plan already exists:
- Confirm with the family what funded supports are being accessed, including any support coordination services, and contact the service providers directly to obtain information about the child’s disability/complex medical needs, engagement with services and their views about the child and family circumstances.
Support coordination is a funded NDIS service that provides NDIS participant with more intensive support to implement NDIS plans. Support Coordinators will be able to access information about a parent or child’s NDIS plan, including what services being accessed and how frequently.
- Where families consent to you contacting the NDIA to gather information about the families circumstances or communicate the with the NDIA on their behalf, request the parent complete a Consent to Exchange Information Form. Consent to Exchange Information forms can be used where a participant or NDIS representative of a child agrees for the NDIA to share and receive information about them to third parties, such as child protection.
- Where a NDIS plan is place and the family will not consent to you accessing their information and you do not have access to information about funded NDIS supports, complete a NDIS Information Request Form. The NDIS Information Request Form can be used to seek information from the NDIS without consent of the participant or their representative. Part 4E of the form must refer to why this information is required to formulate a risk assessment for a child.
- When completing the form, include information about:
- why consent cannot be obtained
- why the NDIS registered providers working with the family are not known and therefore cannot contacted directly for information.
- specific details regarding what information is required from the NDIA, this may include:
- copies of the NDIS plan or a medical or disability assessment.
- the names of current and past funded supports.
- current funding allocation and how frequently it is being utilised.
- Record specific information regarding the child’s disability and/or complex medical needs in CRIS. For more information, see the Recording Disability and Complex Medical Needs Information CRIS Guide.
- Inform disability and medical services involved about the protective concerns being investigated and the outcome of the investigation, inclusive of the NDIS Support Coordinator (if funded in the NDIS plan), Local Area Coordinator (children aged 7 – 18) or local Early Childhood Partner (children aged 0 – 6). Consider a case conferencing approach as required.
- Where appropriate, support the parents/carers to engage with their NDIS Support Coordinator (if funded in the NDIS plan), Local Area Coordinator (children aged 7 – 18) or local Early Childhood Partner (children aged 0 – 6) to request a NDIS plan review where the child’s NDIS plan does not contain adequate supports to meet the child’s disability related needs.
Where an NDIS plan does not exist and the child is likely to be eligible:
- Identify all disability and medical services involved with the family if this is not already complete.
- Gather specific information regarding the child’s disability and/or complex medical needs from all disability and medical services involved with the family and update in CRIS.
- Refer to the Practice guidelines for Child FIRST, The Orange Door, Integrated Family Services, Child Protection and Out-of-Home Care if you believe a child may be eligible for the NDIS. Support the parent/carer to access the NDIS for the child. This may include:
- Gathering evidence about the child’s disability, including funding assessments to obtain a diagnoses.
- Obtaining information from the parent/carer and other professionals about the child’s day to day disability needs.
- Contacting or supporting the parent/carer to contact the NDIA’s National Access Team on 1800 800 110 or the Local Area Coordinator to commence the access process.
- Planning meeting with the NDIS.
- Record the outcome of the NDIS planning meeting on CRIS, and upload information about the child’s disability in LAC on CRIS.
- Where appropriate, undertake a referral to Family Services to support the family access the NDIS or request and NDIS plan review to address unmet disability support needs.
- Consult the Child Protection Litigation Office (CPLO) where a child with a disability and subject to an IAO requires an NDIS access request and parents will not consent.
Where support coordination is not funded, Child Protection or Family Services should play an active role in supporting the family obtain funded support coordination during the NDIS planning process.
If the child has an NDIS plan and is placed in care on an interim accommodation order (IAO):
- Contact the Support Coordinator (if funded in the NDIS plan) or the Local Area Coordinator (children aged 7 – 18), or the local Early Childhood Partner (children aged 0 – 6) to advise if the child’s placement has changed.
- Provide a copy of the IAO to the NDIA.
- Liaise with the Support Coordinator (if funded in the NDIS plan), or Local Area Coordinator (children aged 7 – 18), or local Early Childhood Partner (children aged 0 – 6) about the child’s disability needs in their new placement.
- Regularly review the adequacy of the child's disability and medical supports with the care team and during the case plan review process
Where an NDIS plan for the child is in place:
- Provide the NDIA with a copy of the court order.
- Where the Secretary of the department has sole parental responsibility, advise the NDIA in writing that the Secretary is now the Child’s Representative for their NDIS plan and the allocated child protection practitioner is authorised to act as a delegate of the Secretary.
- Advise the NDIA of any other persons involved in the child’s life who has day to day decision making responsibilities for the child, for example, a contracted case manager or carer and advise the NDIA if this person is authorised to assist in the day to day implementation of the child’s NDIS plan.
- Sign any service agreements to enable the delivery of any new disability supports when developing a new NDIS plan or as a result of a plan review.
- Sign any invoices for NDIS funded supports where the NDIS plan is managed by a financial intermediary the Secretary is the Child’s Representative.
A Service Agreement is a contract between the Secretary as the Child’s Representative and the disability service provider which will outline how they will deliver the supports the child’s NDIS plan. As a delegate of the Secretary you may be required to sign a Service Agreement the chosen service provider/s for the child’s supports to begin. The support coordinator can arrange for the Service Agreement to be developed for you to sign.
- Work collaboratively with the family and all services involved or, where a child is in care the child’s care team, to have the following supports funded in the child’s NDIS plan:
- Support Coordination – Support Coordination must be funded in all plans. Many families involved with child protection or children in care will be eligible for Specialist Support Coordination. Children and young people in care with complex needs, or who are turning 17 years and will be transitioning to adult supports should have Specialist Support Coordination included in their plan.
- Development of daily living and life skills – where the child, or the child’s family or carer require support specifically related to the functional impairment to live as autonomously as possible, including, skills in daily life activities, communication and social skills, problem solving and managing funding of supports.
- Participation in community, social and civic activities - to assist children and young people participate in community activities. These activities can also assist to sustain caring arrangements as an alternative to previous supports funded as in-home/facility based care.
- Disability - specific parenting training programs which are designed for the child’s needs and are not available as a mainstream service. This can include intensive training such as one-on-one or in-home training for parents and carers.
- Behaviour support – a plan aimed at limiting the likelihood of behaviours of concern developing or increasing
- Additional needs – where a child is in out-of-home care and requires supports specific to the child’s disability that are additional to the needs of children of similar ages, including assistance with daily personal activities, aids and equipment, community participation and home modifications.
Children with a disability and behaviours of concern:
- Engage relevant professionals to complete a behavioural assessment where a child has behaviours of concern related to their disability. This may include working with the Support Coordinator to engage a behaviour support practitioner.
- Regularly review the effectiveness of the behaviour support plan with the care team and establish responsibilities and timeframes for the ongoing review of the behaviour support plan.
- Request the NDIA consider the child’s eligibility for the Complex Support Needs Pathway if this has not already taken place.
- Update the child’s case plan with information about behaviour support planning as required.
- Coordinate any other specialist assessments required to meet the safety and wellbeing needs of the child and those around them.
- Refer to the Positive practice framework: A guide for behaviour support practitioners for further information about behaviour support planning for children with a disability.
Leaving care for young people in care with NDIS plans:
- Follow the Leaving care procedure and advice.
- Contact with Centrelink to commence a Disability Support Pension application at 16 years.
- Commence early planning with the NDIA as part of the 15+ Care and Transition plan including referrals to the Better Futures program.
- Contact the Office of the Public Advocate (OPA), Advocate Guardian Program for young people with cognitive disability who will require a guardian or administrator upon turning 18. Refer to the department’s MOU with the Public Advocate for further information.
- Engage in consultation with the NDIA Support Coordinator to inform leaving care planning prior to the child’s 17th birthday.
Consultations with the NDIA must begin prior to the child’s 17th birthday and should aim to identify potential living options in accordance with the child’s disability support needs, developmental needs, and potential vulnerabilities.
- Work with the Support Coordinator to gather evidence to support an application for Supported Independent Living (SIL) Specialist Disability Accommodation (SDA) if required.
- Engage with the Support Coordinator and care team to identify appropriate disability supports for the young person’s transition to adult accommodation.
- If the young person has a significant or complex disability or complex medical needs and is 16 years 9 months or more but will not be 18 years of age when the case is closed, seek endorsement of the Principal Practitioner to close the case.
- Provide ongoing support and supervision.
Principle practitioner tasks
- Disability and complex medical needs - advice
- MOU with the Public Advocate
- Leaving care - advice
- NDIS website
- Positive practice framework: A guide for behaviour support practitioners
- Recording Disability and Complex Medical Needs Information CRIS guide
- Practice guidelines for Child FIRST, The Orange Door, Integrated Family Services, Child Protection and Out-of-Home Care
- NDIS consent to exchange information - form
- NDIS information request - form
- Information Sharing Protocol between NDIA and Australian State and Territory Agencies