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 1, 2 January 2019.

Introduction

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 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.

Procedure

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, NDIA plan (where applicable) 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.

Where an NDIS plan for the child already exists:

  • Consult with the NDIS Support Coordinator (if funded in the NDIS plan) or the Local Area Coordinator (children aged 7 – 18) or local Early Childhood Partner (children aged 0 – 6) to identify all NDIS funded supports and any other medical services involved with the child if this is not already complete. If the Local Area Coordinator or Early Childhood Partner are unable to assist, contact the National Disability Insurance Agency (NDIA) on 1800 800 110 to clarify if a plan is in place for the child and what supports are funded. 

Local Area Coordinators (children aged 7 – 18), and local Early Childhood Partners (children aged 0 – 6)  are local NDIS services that support people access the NDIS and help NDIS participants develop and implement their NDIS plans. The NDIS website has contact information for all Local Area Coordinators and Early Childhood Partners in Victoria.

  • Gather specific information regarding the child’s disability and/or complex medical needs and update the LAC records in CRIS. For more information on recoding disability and/or complex medical needs information in LAC, 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.
  • 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) 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:

  • 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 the LAC records 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 to commence the access process
  • support or arrange for another service to support the parent/carer prepare for their planning meeting with the NDIS. This includes advocating to the NDIS for the child to receive NDIS funded Support Coordination.  
  • Record the outcome of the NDIS planning meeting on CRIS, and upload information about the child’s disability in LAC on CRIS.

Support coordination is a funded NDIS service that provides people with more intensive support to implement NDIS plans . Support coordination should be requested for vulnerable children and families with complex needs associated with their disability and for children in out-of-home care. Where support coordination is not funded, you may engage with an agency delivering Local Area Coordination – however where possible, have an active role in obtaining funded support coordination for the child during the NDIS planning process.

If the child has an NDIS plan and is placed in out-of-home 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.
  • 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

Protection order

Where an NDIS plan for the child is in place:

  • Where the Secretary of the Department of Health and Human Services (the Secretary) has parental responsibility (either exclusive or shared) for a child, provide the NDIA with a copy of the child’s court order and clearly articulate in writing what change in parental responsibility has taken place. 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) should also be notified and may be able to assist in advising the NDIA in writing of the change in parental responsibility. If the Local Area Coordinator or Early Childhood Partner are unable to assist, contact the National Disability Insurance Agency (NDIA) on 1800 800 110 to advise of the change in parental responsibility.
  • Advise the NDIA in writing 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 where the Secretary of the department has exclusive parental responsibility.
  • 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 OOHC the child’s care team to have Support Coordination and the following supports funded in the child’s NDIS 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 (if funded in the NDIS plan), or Local Area Coordinator (children aged 7 – 18), or local Early Childhood Partner (children aged 0 – 6) 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.
  • 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 out-of-home care with NDIS plans:

  • Follow the Leaving care procedure and advice.
  • Refer to leaving care programs as required.
  • 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  
  • Engage the care team to determine the best future housing arrangements for the young person.
  • 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’s17th 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 Specialist Disability Accommodation (SDA) if required.
  • Engage with the Support Coordinator to identify appropriate disability supports for the young person’s transition to adult accommodation.

Supervisor tasks

  • Provide ongoing support and supervision.
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