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3.4.12 Health care planning

Last Modified: 18-Mar-2024 Review Date: 04-Jan-2021

 ‭(Hidden)‬ Legislation

Overview

The term 'health plan' refers to the planning decisions and steps required to meet the child's identified health needs that are documented in the care plan (or provisional care plan).  

Within the health care planning pathway, when a child first comes into the CEO's care, they must have an initial medical assessment followed by a more comprehensive health and development assessment. A health and development assessment review must be carried out on an annual basis, before the care plan (or provisional care plan) is due for review.

Health assessments identify any problems early to reduce the potential impact later in the child's life. For example, if a hearing problem is not identified and treated, the child may develop difficulties with speech or experience learning problems.

Under s.10 of the Children and Community Services Act 2004, child protection workers also need to emphasise the importance of child participation, particularly in relation to significant events and times of intense planning for the child:

When a decision is being made that is likely to have a significant impact on a child's life, to make sure the child is able to participate in the decision-making process, the child must be given:

  • adequate information about the decision being made, in accessible language and in a way the child can understand.
  • an explanation on why the Department is making this decision.
  • an opportunity to express their wishes and views freely, according to their ability
  • any help they need to express their views and wishes
  • information on how their views and wishes will be documented, and
  • a chance to respond and to challenge the decision made.

In terms of the extent of a child's participation, you must give due regard to the child's age and level of understanding. 

 You should provide the carer and parent with a copy of the Health Care Planning for Children in Care - Information Sheet for Foster Carers (in related resources).

The Health Care Planning Tracking Sheet is a useful tool for tracking and recording the relevant health care processes completed for a child in the CEO's care (in related resources).

Note:  CEO refers to the Chief Executive Officer of the Department of Communities (the Department).

Rules
  
Process Maps

Refer to the following flowcharts available in related resources:

  • Health Care Planning Pathway for Children New to Care
  • Health Care Planning Pathway for Children Already in Care
  • Processing Medical Expenses from Public Providers and Private Practitioners.

 

Information and Instructions

  • Power of the CEO to give consent on behalf of a child in the CEO's care
  • Obtaining access to medical records for children in the CEO's care
  • The Child Health Passport
  • Considerations before referring a child to a health assessment
  • The initial medical assessment
  • The comprehensive health and development assessment
  • The health assessment for a young person in detention or on remand
  • My Health Record - Australian Government
  • Medicare cards
  • Medical costs and processing medical accounts
  • Health Care Cards
  • Strengths and Difficulties Questionnaire
  • Dental health
  • Ambulance cover
  • Filing and recording
  • Developing the health plan
  • Power of the CEO to give consent on behalf of a child in the CEO's care

    Section 127 of the Act gives the CEO the power to provide consent in lieu of a parent where the CEO has parental responsibility. Refer to the table below:

    Child subject to (section of th eAct)Child in the CEO's care?

    Does CEO have parental responsibility?

    s.29

    Provisional protection & care and under s.29(2) subject to an interim order

    Yes​Yes (to limited extent)

    Subject to any interim order in respect of the child, the CEO has responsibility for the day to day care, welfare and development of the child, including responsibility for making decisions about any medical or dental examination, treatment or procedure in respect of the child. Responsibility for the long-term care, welfare and development of the child otherwise remains with the parents.

    s.47-53

    Protection order (supervision)

    ​NoNo

    Parental responsibility remains with the parents. Conditions placed on parents by the Court.

    ​s.54-56

    Protection order (time limited)

    ​YesYes
    s.57-59

    Protection order (until 18)

    ​Yes​Yes

    s.60-66        

    Protection order (special guardianship)

    ​No​​No                 Parental responsibility is transferred to the special guardian; where SGO granted with an order for payment, a carer subsidy is replaced with SGO payment; may be considered for Special Needs Loading payments – assessed on a case-by-case basis; Department involvement is limited to the review of financial arrangements, or where the Department has deemed it necessary to provide social or additional financial services.
    ​s.74-77

    Negotiated placement agreement (NPA)

    ​YesNo

    Parental responsibility essentially remains with the parents EXCEPT where the NPA specifically authorises the CEO to do so and is signed by the CEO and the parents. Cannot be used where there are child protection concerns​ ​

    ​s.32(1)(a)

    Placement service

    ​YesNo

    Parental responsibility remains with the parents. (Note: It is Department policy that a placement service must not be used where there are child protection concerns). ​ ​

    Where a child is the subject of a NPA, parental responsibility essentially remains with the child’s parents, except as determined by the agreement. If agreed to and included in the NPA, you can provide consent on behalf of the CEO for the child to have any medical or dental examination, treatment or procedure required.  

    Where a young person is provided with a placement service under s.32(1)(a) of the Act, parental responsibility remains with the young person’s parents. Therefore, you will need to discuss health care planning processes with the child's parents and the young person and obtain their consent.  Where it is assessed that the young person has sufficient understanding and maturity to make decisions, they can provide consent for services and sharing of relevant information – refer to the Gillick Principle in related resources.

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    Obtaining access to medical records for children in the CEO's care

    When a child enters care and is under the CEO's parental responsibility, the Child Documents Team (CDT) commence the process to obtain access to the child's My Health Record, access to the child's immunisation records, and a new Medicare Care. 

    If you have any queries, contact the CDT by email: bsc-childdocs@communities.wa.gov.au

    All children in the CEO's care must also have all required vaccinations according to the WA Health Childhood Immunisation Schedule, unless there are contraindications on medical advice.  

    To obtain immunisation records for a child new to the CEO's care, please contact the Central Documents team by email  bsc-childdocs@communities.wa.gov.au

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    The Child Health Passport

    Each child in the CEO's care must be provided with a Child Health Passport (Passport), unless a young child has a Department of Health ‘all about me’ purple folder (rather than duplicate records). However, once a child reaches school age, they must be provided with a Passport.

    Important information must be entered in the Passport before, or when the child is placed with the carer. This includes the child’s name, date of birth, emergency contact name and telephone number, Medicare number (if known), medic alerts, the child protection worker’s name and district, and information about known medications, allergies, health conditions and immunisation records. Refer to the WA Vaccination Schedule.

    The Passport provides the carer (or residential care staff) with immediate knowledge of the child’s health needs, for example, if the child uses an asthma inhaler or requires other medication. You should assist in keeping the Passport up-to-date and encourage the carer to take it along to health appointments. Taking the Passport to appointments provides health professionals with information so the child receives appropriate care and treatment.

    The Passport must accompany the child if there is a change of care arrangement, be given to the parents if the child returns home or be given to a young person when they transition from care.

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    Considerations before referring a child to a health assessment

    There may be matters to consider before making a referral for a child to have a medical assessment and/or a more comprehensive health assessment. For example, the child may wish to have someone else other than the carer present at the appointment.

    The child's cultural needs are an important consideration, potentially informing the decision about the most appropriate health professional to undertake an assessment. 

    There are a range of factors that need to be considered to meeting the health needs of a child from a culturally and linguistically diverse (CaLD) background. This includes whether an interpreter service is required, the gender of the health assessment provider, and an understanding of the trauma experienced prior to (such as war) or since moving to Australia (for example, social isolation).

    If the child migrated to Australia under the Humanitarian Program, you should advise the health professional undertaking the assessment to consult with a community migrant health nurse, the Migrant Health Unit or the Perth Children's Hospital Refugee Health Service. This is to determine whether the child has undergone a recent health check and to obtain refugee specific health information. In some circumstances, they may be the best provider to undertake the health assessment rather than involve another health professional.

    Additional consideration may also be required to meet the specific needs of Aboriginal children before they are referred for a health assessment. The Aboriginal practice leader or other relevant Aboriginal officer in the district should be consulted before you make a referral. It may be more appropriate for the health assessment to be undertaken by an Aboriginal Medical Service or other Aboriginal health service.

    Where a child is already engaged with several health professionals, or is being seen by a General Practitioner (GP) on a regular basis for a health condition, more health assessments may not be warranted. This may be the case for a child with a disability. In this instance, you should discuss this with the relevant health professionals.

    Similarly, if a child has a diagnosed disability they may already be engaged with disability specific services. Although a child may already be under the care of a health team, you should discuss health care planning assessments with current health providers to check that all aspects of the child’s health care are being addressed, such as immunisation or oral health care.

    A standardised information sharing template has been created for districts to use when working with WACHS in the context of Health Care Planning. Districts should use the template in related resources to provide WACHS with the most current information relevant for issuing reminders for health care assessments for children in care. 

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    The initial medical assessment

    When a child comes into the CEO's care, they must have an initial medical assessment as soon as practicable. but within 20 working days, unless an assessment has already occurred (for example, through the Perth Children's Hospital Child Protection Unit).

    Consult with the carer and child, where age appropriate, before making the appointment. 

     

    Access to a private psychologist / practitioners

    If a child requires ongoing treatment and the waiting time for access to our Psychology Services is considered too great given the presenting issues, it is possible to access services via a private practitioner. You should follow the guidelines outlined in Chapter 4.2: Engaging with private practitioners for treatment/therapeutic services.

    Deciding on the most appropriate GP or other health professional to conduct the health assessment requires professional judgment, having regard to the views of the child, parents and carer.

    You should book a 30 minute appointment with a GP or other health professional, and advise the carer of the day and time. When making the appointment, advise the GP, surgery or health provider that a Department form will be sent with the child that provides information about the health assessment request and includes Medical Benefit Schedule item numbers that may be used, such as the '4 year old Healthy Kids Check'.

    Before the appointment, you must:

    • complete pages 2 and 3 of the Form 513 - Initial Medical Assessment Form - Health Care Planning for Children in Care (In Related Resources Forms List), and
    • update the Child Health Passport as required, including the child’s immunisation records. 

    Aboriginal children and young people who attend an Aboriginal Medical Service are often assessed using the Aboriginal Medical Service's Form 715. To avoid delays in subsequent health assessments for Aboriginal children and young people, Aboriginal Medical Service Form 715 may be used in lieu of the Department's form 513 – Initial Medical Assessment Form (Health Care Planning for Children in Care).

    Information on obtaining immunisation records can be found in Chapter 3.2: Medical or dental treatment - including immunisations. Refer also to the Australian Childhood Immunisation Register (ACIR).

    Remind the carer to take the Child Health Passport to the appointment if they are attending.

    Form 513 advises the health professional to return it (or their clinical notes) to you at the district office once the assessment is completed. Once received, you must scan Form 513 (or clinical notes) to the Child History File in Objective and place the original in the Child History Folder.

    If you assess that the child is already seeing a doctor (or several),  and we have a thorough understanding of the child's existing health needs, attach the most recent medical assessment and record that the child has undergone a medical assessment.

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    The comprehensive health and development assessment

    A child who is new to care must be referred for a more comprehensive health assessment once the initial medical assessment has occurred, unless he or she is already seeing a health professional for ongoing management of their health.

    A child already in care must be referred for a health and development assessment on an annual basis before their care plan (or provisional care plan) is due for review, unless he or she is already seeing a health professional for ongoing management and monitoring of their health. You should discuss this with the health professional.

    Aim for continuity of care wherever possible. You should allow enough time for the assessment to be completed before the care plan review date.  If the child is continuing to see regular medical providers, make sure the GP or specialist has covered off on all the aspects of health care planning and record this as an Annual Plan.

    A child diagnosed with a disability is usually seen by specific services and may be under the care of a health team. In this instance, a comprehensive health assessment may not be required. However, the child may require other health checks, such as a dental check-up.  You must record that the child is under the care of a health team in the Health dimension of the Quarterly Care Review in Assist under ‘Health Assessment’.

    You must discuss the comprehensive health assessment process with the carer and child (where age appropriate), and provide a copy of the Health Care Planning for Children in Care - Information Sheet for Foster Carers (Refer Related Resources).

    Deciding on the most appropriate health professional to conduct the health assessment requires:

    • professional judgment
    • regard for the views of the child, parents and carer, and
    • the specific health and medical needs of the child.

    Refer to the procedure above - ‘Considerations before making a referral for a child to have an initial medical assessment and/or comprehensive health assessment’.

    Complete Form 510 Comprehensive Health Assessment - Health Care Planning for Children in Care to provide information about the child and his or her family to the health provider undertaking the assessment.

    If a young person declines to have a health assessment, record this in a case note. You should continue to work with the young person to address their concerns and encourage them to have a health assessment. The young person may wish to see a youth friendly doctor who is trained in adolescent health issues. A list of medical practitioners (by suburb and regional town) who have undertaken this specific training is available on the Australian Medical Association 'Youth Friendly Doctor' website.

    Requests for a medical assessment by foster or family carers

    All requests by foster and family carers (carers) for medical assessment must be considered and a decision to proceed and/or fund the request must be made within 20 working days.

    In instances where a decision cannot be made within this timeframe, for example, if further information is required, you must inform the carers. 

    Carers should be given information and provided with an opportunity to discuss the outcome of their request and any suggested next steps.

    Where a request for assessment will not be supported, a clearly documented rationale, endorsed by the District Director, must be provided to the carer, unless it is already included in the child's care plan or modified care plan. Carers should be provided the opportunity to discuss the decision to ensure transparency and development of a shared understanding of the rationale.

    Decisions that involve the child remaining on a waitlist for public services should also outline additional supports for the child and carer during the interim period. Where significant wait times apply for assessment or services, decisions to fund private services should consider the need to support and maintain the care arrangement and the significant cost, and potential further impact on the child, of this care arrangement breaking down.

    Where the health assessment will be carried out by a community health nurse

    If the decision is to have the comprehensive health assessment undertaken by a community health nurse, you must inform the carer and the child (where age appropriate) before sending the referral.

    If the assessment is for a child already in care, the referral should be made two to three months before the care plan review meeting. This will allow time for the health assessment to be completed and the report provided to you.

    You should gather relevant medical information about the child and any significant family history to complete the Form 510 Comprehensive Health Assessment - Health Care Planning for Children in Care.

    Information about the child’s previous addresses should be provided so that the nurse conducting the assessment can access the child’s previous health records where available. It is also important to indicate in the Form 510 if the child is new to care, and if you and the nurse need to discuss anything before the health assessment.

    Send the completed Form 510 and other supporting documents to DOH.CICreferrals@health.wa.gov.au 

    Copy your team leader into the email and attach any other relevant information about the child’s history to the email.

    This may include a copy of the completed Form 513 Initial Medical Assessment Form - Health Care Planning for Children in Care (for a child new to care) or a previous health plan.  The more information you can provide for the nurse, the better the health assessment and identification of health needs.

    You must not send multiple referrals in the one email.

    The Department of Health central intake team will check the referral form and, if complete, will forward it and any attached documents to the key contact (senior manager) for the health region where the child resides or attends school. The referral may be returned to you if the child does not attend the appointment or declines to have the assessment.

    The nurse will schedule the appointment with the carer for children under school age, while school age children will be seen while they are at school.

    If a child indicates that they do not wish to have their health assessment at school, they can have it with their GP instead.

    The nurse will aim to schedule the assessment appointment within 30 working days from receipt of the completed referral form, with priority given to a child who is new to care.  There can be delays however, in getting an assessment appointment during school holidays for school-aged children, especially during December and January, as the school health services do not operate during these periods. In addition, the child and/or carer may not be available to attend an appointment during these times. If an assessment is required during these times, you should arrange for this to be undertaken by a GP instead.

    If the carer will be attending the assessment appointment, remind them to take the Child Health Passport to the appointment.

    Use the 11 Month Care Planning Guide in related resources to plan for the annual health assessment.

    The nurse assessment for children under school age (0 - 4 years)

    The nurse will undertake an oral health inspection and assess the child’s emotional and developmental status using the Ages and Stages Questionnaire (ASQ) as part of the health assessment. Where the nurse considers there may be mental or emotional development issues, the Ages and Stages Questionnaire - Social and Emotional (ASQSE) may be used to assess the child and to recommend appropriate services for referral if required. However, in some instances, the nurse may need to use another assessment tool with the carer such as the parent’s evaluation of developmental status (PEDS).

    Where the nurse assesses that there are mental health concerns, you should consult the district psychologist to discuss the child’s mental health needs and services to which the child can be referred.

    Health Improvement Plan and recommended referrals from the health nurse

    The nurse will complete the Health Improvement Plan (on last page of Form 510), and return this and any referral documents to you within five working days of completing the health assessment.

    The Health Improvement Plan must include the significant findings from the health assessment, any recommended referrals and other actions the nurse suggests need to be taken and by whom, including if a follow-up appointment is required.

    Sexually transmitted infections (STIs)

    A community health nurse does not routinely ‘screen’ for STIs but if a need is indicated, the nurse generally refers to a GP. For more information on STI notifications refer to Chapter 2.2 Sexually transmitted infection notifications.

    Blood-borne viruses (BBVs)

    Blood-borne viruses include Human Immunodeficiency Virus (HIV), hepatitis B and hepatitis C.  If a child in the care of the CEO has an infection or is at risk of infection, ongoing and close consultation with medical personnel as well as the Department of Health, the Western Australian AIDS Council and/or Hepatitis WA should occur.

    Information relating to a child’s infection should be disclosed on a need to know basis only, preferably with consent of the child. In the case of a child, disclosure of any infection must be made to:

    • the child’s primary carer, including carer and residential care staff when the child is in the CEO’s care

    • the case manager and team leader

    • the child’s parents, unless this is considered not in the child's best interests. In this case the decision should be endorsed by the district director and documented

    • medical personnel involved in, or consulted about, the management and treatment of the infection

    • the relevant Executive Director and Assistant Director General where the child is placed in out of home or alternative care and the infected person’s behaviour constitutes a risk to others, or where a recommendation is made for testing.

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    The health assessment for a young person in detention or on remand

    A nurse will review the young person upon admission to the center, and any urgent health needs will be addressed. If the young person requires a doctor’s review, an appointment must be made for the next available clinic. A physical assessment of the young person must be carried out by a GP within 28 days of admission.

    If you require copies of the health assessment reports for a young person, you can make a request on Department letterhead and email it to Central Medical Records – InformationRelease@justice.wa.gov.au.  

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    My Health Record - Australian Government

    New Commonwealth privacy laws implemented in 2019 provide stronger privacy protection for young people aged 14-17 years.  All existing authorised representatives for young people over the age of 14 were removed from their My Health Records. 

    When young people turn 14 years of age, they can manage their own My Health Record.  The Department has no access to these records unless the young person authorises it.

    The My Health Record includes Medicare information on doctor's visits, prescribed medication under the Pharmaceutical Benefits Scheme (PBS) and immunisations.  It may also hold medical documents uploaded by a doctor, nurse or hospital, hospital and pathology test results, and medicine dispense records uploaded by a pharmacist.  At age 14, the young person manages all this information, and can choose to remove these records, or set additional privacy controls to restrict who can see them. The CDT can assist with restricting records – contact by email:  bsc-childdocs@communities.wa.gov.au

    If the young person wants a parent or person with parental authority (the CEO or delegate) to have access to their record, the young person must invite them to be their nominated representative

    The young person drives this process through their MyGov account and can set the level of access including removing access from the nominated representative.

    If the young person does not have a My Health Record, they can register for one at any time.

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    Medicare cards

    A child in the CEO's care does not need a Medicare Card to access medical treatment or to claim reimbursement for a Medicare service.

    The claimant (person who paid for the service, such as the carer) can be paid a Medicare benefit for the service even if the patient (child in care) is not enrolled on their Medicare Card.

     A range of Medical Benefit Schedule (MBS) services provided by GPs are suitable for each stage of the health assessment of children in the CEO's care:

    • GP general consultations
    • a range of health services, and
    • chronic disease management services assessed through Chronic Disease Management Plans or Mental Health Treatment Plans.

    Refer to the table on the Commonwealth Department of Health website regarding MBS items available for the primary health care needs of children in out-of-home-care.

    Where the CEO does not have parental responsibility

    The Department obtains a duplicate of the parents' Medicare Card if they are in a care arrangement for longer than one month.  Refer to the table above under 'Power of the CEO to give consent on behalf of a child in the CEO's care' above to identify if the CEO has parental responsibility.

    Children in care 15 years and older

    When a young person in care turns 15 years of age, he or she can request a Medicare Card in their own right.  You must discuss this with the young person as part of leaving care planning.

    Provision of a Medicare Card to a carer

    When the Department receives the child's Medicare Care, you should give to the carer for convenience of use, although the card remains the property of the Department on behalf of the child.

    The carer is authorised to make claims from Medicare on behalf of the child.

    Where a child is in the CEO's care for less than one month, only provide the child's Medicare number to the carer (not a duplicate card).  

    If a child requires a medicine on the PBS, under the Act the child's Medicare Card number must be given to the pharmacist to determine the child's eligibility. However, if this is not possible, (for example, the card has been lost or stolen), a pharmacist can use a pharmacy only 'Special Medicare Number'.  With consent of the carer or child, the pharmacist can also telephone the Medicare Australia PBS enquiry line to obtain the child's Medicare Card number.  

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    Medical costs and processing medical accounts

    The fortnightly subsidy paid to carers incudes an amount intended to cover basic general expenses for the child in the CEO's care.  These include expenses for personal hygiene items and basic general medical treatments (Panadol or Bandaids, etc.), and non-prescription medication when a child has a short-term illness (e.g. cough or cold medicine). 

    Health assessments as part of the Health Care Planning pathway and ongoing medical treatment, diagnostic tests and specialist health services' costs are not covered by the basic subsidy payment.

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

    • The carer pays for the health assessment and then claims the Medicare Benefit.  We reimburse the carer for the 'gap fee' for the health assessment.  Carers must provide receipts to child protection workers in a timely manner to enable reimbursement of the gap. 

    • The health professional directly invoices the carer – the health professional must agree to this before the appointment.

    Children in residential care under 15 years of age

    If you take a child to a medical practitioner that does not bulk bill or accept deferred payment, the Department cannot claim a Medicare Benefit.  This includes children in a residential care service younger than 15 years of age.

    All young people in care over the age of 15 years who have their own bank account and Medicare Card can claim Medicare Benefits if they cannot use a service provider that bulk bills.  If the service provider has the facility, they can process the Medicare Benefit at the time, and the young person pays the balance. 

    If the child is in a residential group home and does not have a bank account or Medicare Card, you must arrange payment from case support costs for the service and cannot claim a Medicare Benefit.

    Payment processes for medical accounts

    Refer to the flowchart Processing medical expenses from public providers and private practitioners (also access via related resources).

    The five options for paying medical accounts in order of preference are:

    1. GP or service provider who bulk bills for services.

    2. GP or service provider who does not bulk bill or accept deferred payment, but the carer can meet the upfront cost for the service.

    3. GP or service provider has a HICAPS machine for processing private health insurance rebates for carers who have the child in care on their private health cover.

    4. GP or service provider accepts deferred payment.

    5. GP or service provider does not bulk bill or accept deferred payment and the carer is unable to meet upfront costs.

    Carers can claim Medicare Benefits for a child who is not listed on their Medicare Card, but claims must be submitted by mail to Medicare. Claims cannot be processed through the surgery at the time of payment, or online. 

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    Health Care Cards

    ​A Health Care Card (HCC) assists with the cost of prescription medications under the PBS and Commonwealth Government funded medical services. It also provides access to various concessions from government and private organisations. These include education and public transport concessions.  The CDT can assist with accessing required documentation. Contact via bsc-childdocs@communities.wa.gov.au.  Complete Form 024 - Centrelink Placement Notification Letter to notify Centrelink of the child's care arrangement.

    Carer's and child's eligibility for a HCC

    A carer and/or child are eligible for a HHC in the following ways:

    1.  A carer who receives the maximum rate of Family Tax Benefit (FTB) Part A or receives a specific Centrelink payment, such as Newstart Allowance or Parenting Payment, is eligible for a HCC.  The card is issued automatically, but the carer should inform Services Australia that they are carers for the child, and the child's name will be added to the carer's HCC as a dependent.  

    The carers and/or child's HCC must be used on all occasions where available.

     2.  Carers who are not eligible for a HCC can claim a Foster Child Health Care Card (FCHCC) on behalf of the child. The FCHCC is not means tested and is issued in the name of the child for a period of 52 weeks. It is automatically re-issued until a notifiable event causes cessation of the card e.g. the child leaves care or receives an income support payment. The carer can only obtain concessions and services for the child.

    Carers who wish to claim a FCHCC must do this through their own MyGov account.  If they don't have one, they need to create one.  Carers must collate their supporting documents in preparation for making their claim.  Refer to the Centrelink process for claims

    Supporting documents:

    Protection order (special guardianship) – child's eligibility for a FCHCC

    Under the current Guide to Social Security Law (section 3.9.1.45), a child is considered to be in care when:

    1. the child is not the natural or adopted child of the carer, and 

    2. the carer is responsible for the day-to-day care, welfare and development of the child. 

    Therefore, a child subject to a protection order (special guardianship) is eligible for a FCHCC. 

    You must inform the child and/or the special guardian of his or her eligibility.

    The special guardian must provide a copy of the court order and the child's birth certificate when submitting a claim for a FCHCC through MyGov.  If the guardian does not have a MyGov account they must create one to claim FCHCC.

    Obtaining a HCC for a child in a residential care arrangement

    An Approved Care Organisation (ACO) such as the Department cannot qualify for a HCC for a child in the CEO's care.  However, a child in the care of an ACO may qualify for a Low Income Health Care Card in their own right, provided their parent does not receive the Family Tax Benefit (FTB) for them).

    Child protection or residential care workers must assist the child to complete Form SS050 Claim for a Health Care Card

    Process:

    1. Answer questions from the perspective of the child - the child is the applicant.

    2. Where the claim form asks if the applicant wants another person or organisation to act on his or her behalf when dealing with Centrelink, answer 'Yes'.

    3. Complete and attach Form SS313 Authorising a person or organisation to act or enquire on your behalf (link also in related resources).

    4. Where the claim form asks if a parent or guardian, or any other person is financially supporting the applicant, answer 'No'.  Centrelink will check whether FTB is being claimed on behalf of the applicant and, if it is, will liaise with relevant parties on the most appropriate course of action (this may depend on the expected length of placement in the residential care facility).

    5. Attach child's birth certificate and the Department letter stating that the child is in the CEO's care to the SS050 Claim Form. 

    6. Submit the form and supporting documents: 

      1. Online (excluding identity documents) using the child's MyGov account.  For more information go to www.humanservices.gov.au/submitdocumentsonline.

      2. In person at a Centrelink office if you are not able to use your MyGov account.

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    Strengths and Difficulties Questionnaire

    The Strengths and Difficulties Questionnaire (SDQ) is an important tool for assessing children's psycho-social needs and targeting interventions to address them.  The process involves collecting information from an adult who knows the child, such as a carer or teacher, or by young people themselves if they're 11 years of age or older (depending on their understanding). 

    Where any child or young person has a total score above 13 in any of the questionnaires, you should request a psychologist consult. Refer to the SDQ Scoring Pyramid in related resources.

    For more information on SDQ's and Viewpoint, refer to Chapter 3.4 Viewpoint.

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    Dental health

    Children under school age (0 – 4 years)

    If the child has a comprehensive health assessment completed by a child health nurse, the assessment will include an oral health inspection.

    If the nurse finds that the child has oral health issues, she/he will complete a ‘Lift the Lip’ referral form. The referral form will be sent to you along with the completed Health Improvement Plan. Once received, you must make an appointment for the child at the local public dental clinic for a dental check and treatment to be completed – refer below for details on this process.

    If another health professional conducted the comprehensive health assessment, you should make an appointment at the child’s local public dental clinic for a dental check – refer below for details on this process.

    Children of school age

    All children from kindergarten to Year 11 (that is, children who turn 5 in the first year of enrolment at school and until they turn 17 years old) are eligible for enrolment in the School Dental Service (SDS). Children in the CEO's care who attend Education Support Schools are also eligible for enrolment in the SDS until they reach 18 years old.

    All children in the CEO's care who are school age and attend a school or facility recognised by the Department of Education should be enrolled in the SDS.

    You must complete Form 500 - Dental Treatment Notification and Consent (which includes the child’s medical history information) and forward to the General Manager, Dental Health Services (address details are provided on the form). Dental Health Services will then forward the Form 500 to the appropriate dental therapy centre to follow up. You must advise the carer (and parents if appropriate) of the child’s enrolment in the SDS program. 

    Dental Health Services will check the child’s clinical records and enrolment status, and will contact the carer and you to advise where the child is going to be seen for the dental check and any treatment required.

    Dental checks and treatment via a public dental clinic

    If a child requires a dental check or treatment, you can call Dental Health Services on (08) 9313 0555 for information on the closest public dental clinic to the child or refer to the Dental Health Services website (www.dental.wa.gov.au) under the Adult Dental Service heading and choose clinic locations.

    Dental Health Services will prioritise a child in care and apply the full subsidy rate. The following forms need to be completed and provided at the appointment:

    If the carer is attending the appointment with the child, you should remind the carer to take the Child Health Passport.

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    Ambulance cover

    You should consider ambulance cover (insurance) where it has been identified as reasonably foreseeable that the child or young person in care may require an ambulance, at least, once a year. 

    There are primarily two types of ambulance cover – 'emergency/urgent' and 'non-emergency/premium' cover. Urgent ambulance cover does not cover all ambulance services and may not cover air services or scheduled hospital appointments that require an ambulance. Non-emergency cover must be considered for children and young people who are known to regularly require/ or request ambulance services or who have complicated physical and/or mental health needs with the potential for frequent ambulance support and/or ambulance transport between hospitals.

    You should ensure that all ambulance insurance membership details are saved in Objective for future ambulance invoices.   Ambulance cover is typically taken out on an annual basis and should be considered as a health dimension within care planning.

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    Filing and recording

    You should place health assessment reports and other relevant documentation from the health checks in the Child History Folder, after they have been scanned to Objective by the Business Administration Team at their district.   The scanned documents are added to the Child History File in Objective by the Records Management Quality Assurance Team (refer to Chapter 4.1 Recording Obligations). 

    Note: forensic health reports, psychology assessment reports and any context relating to neglect or abuse are not placed in the Child History Folders or Files (refer to Chapter 3.4 Child history folder and child history file and Government and Business Manual entries (links in related resources):

    • Administrative files, client files and carer files (hard copy) - retention, storage, and
    • Disposal, and Administrative files, client files and carer files (hard copy) – transfer.

    You must update the health dimension in the child’s Child Information Portal (CIP) in Assist to record the status of each relevant health care planning process being undertaken or completed. The ‘Requirement Type’ values and corresponding status in the CIP are: 

    • Initial Medical Assessment – completed before the child enters care; in process; completed; or unable to complete.

    • Health and Development Assessment – under the care of a health team; in process; completed; or unable to complete (if recorded as ‘under the care of a health team’ or ‘unable to complete’, the child’s health needs must be reviewed quarterly).

    • SDQ – in process; sent to psychology services; or completed.

    • Mental Health Practitioner involvement – active involvement; or inactive.

    • Oral Health – enrolled in SDS; or attending public dental.

    You must record: 

    • the reasons for any ‘Requirement Type’ with a status of ‘unable to complete’ in the CIP

    • details of the child’s overall health, and

    • any referrals that need to be actioned must also be recorded.

    You must also link the latest health assessment reports in Objective  to the CIP in Assist.

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    Developing the health plan

    The health plan is based on the findings and recommendations outlined in the relevant health assessment reports. 

    The health plan should list the identified health needs of the child and the planning decisions and steps to meet those needs for the next 12 months. If required, you should consult with relevant health professionals when developing the health plan. Where the child has several different health needs, a discussion may help prioritise which issues need to be addressed first.

    You may use a 'file note' to document the health plan for the child, and this can be taken to the care plan meeting for discussion with all parties. The health care planning decisions and actions must be documented in the health dimension in the child’s CIP.  These will auto-populate into the provisional care plan or care plan - these may be edited and amended as required before approval.  

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