Health Pathway

As a foster, relative or kinship carer you play a crucial role in the health of the children in your care. Find out more on this page or download a copy of this information in the Out-of-Home Care (OOHC) Health Pathway: A Guide for Carers factsheet (PDF 443.6KB).

Why are the health needs of children in care important?

As a carer, you play a key role in making sure that children are provided with the support they need to access services and maintain good health. 

Children and young people in OOHC tend to be more disadvantaged and vulnerable than other children. Hence, your role as a carer can help to give these children and young people better opportunity to overcome their often high and unmet health and developmental needs, giving them the most equally opportunistic and high-quality start to life as possible.

What is the OOHC Health Pathway? 

The OOHC Health Pathway is a joint initiative between NSW Health and the Department of Communities and Justice (DCJ).

The Pathway aims to ensure children in statutory OOHC receive:

• assessment and identification of their health and development needs
• a Health Management Plan (HMP) that documents their needs and the actionable steps required to meet those needs
• regular monitoring and review of their health
• priority access to health support and services (where possible)
• continuity of health services through changing circumstances.

What is an OOHC Health Coordinator?

Each local health district has an OOHC Health Coordinator who is responsible for the coordination of the Pathways processes, including the assessments, and development and review of the HMP. 

The OOHC Health Pathway Team is available for you to contact with questions about the Pathway. 

You can find your OOHC Health Coordinator on the DCJ website.  

When are children referred to the OOHC Health Pathway?

Children aged 0-17 in statutory OOHC are referred to the Pathway when they are expected to remain in care for longer than 90 days. This occurs whether parental responsibility is interim or final.

Mature minors must consent to be referred to the Health Pathway. Their caseworker is responsible for discussing their participation and obtaining their consent. 

Steps of the OOHC Health Pathway

1. Referral

DCJ will complete an OOHC Health Pathway Referral form within 14 days of a child entering statutory care. DCJ will send the referral form to the local OOHC Health Pathway Team to place the child or young person onto the Pathway. 

2. Preparing for Health Assessment

The OOHC Health Pathway Team will collate the child’s health information. They may contact you for more information and ask you to complete a questionnaire to help identify the child’s strengths and where they need support.

3. Health Assessments

a) Primary Health Assessment

The primary health assessment (also known as a 2A assessment) will assess the child’s physical health, growth and development, immunisation, vision, hearing, oral health, nutrition, and psychosocial and mental health needs. 

It can be conducted by a General Practitioner (GP), Child and Family Nurse or Aboriginal Medical Service (AMS).

The OOHC Health Pathway Team will contact you to organise a primary health assessment for the child within 30 days of receiving a correct referral. You are encouraged to attend the appointment with the child. If your circumstances change and you can no longer attend the appointment, contact the OOHC Health Pathway Team so they can reschedule. 

b) Comprehensive Health Assessment

If complex needs are identified in the child’s 2A primary health assessment, a comprehensive health assessment (also called a 2B assessment) will be completed. This may involve a range of clinicians and may occur over several appointments. 

4. Developing Health Management Plan (HMP)

All children on the Pathway will receive a HMP, which is a record of their health needs and the services required to meet these needs. The HMP facilitates health coordination and care continuity.

The HMP will be developed by the OOHC Health Pathway Team. You may be requested to be involved in developing the plan along with the caseworker and the child.  

You will receive a copy of the HMP. Contact your caseworker if you have not received the HMP. 

5. Implementing the Health Management Plan

You will work with the child, OOHC Health Pathway Team and your caseworker to implement the HMP and ensure the child receives health services.

Where possible, services should be obtained through the public health system. If services cannot be obtained through the public health system or in a timely manner, talk to your caseworker about accessing private providers and funds to cover the costs. 

Remember:

• You and your caseworker are responsible for ensuring the HMP is implemented.
• If you need help accessing a service for a child, reach out to your local OOHC Health Pathway Team. They can help you advocate for access to services.

6. Reviewing the Health Management Plan

All children need regular health reviews which will occur as indicated in their HMP. 

The review ensures that the HMP is being implemented and is effectively addressing the child’s health needs. It also allows for any emerging health issues to be identified and addressed. 

At a minimum, reviews should occur every 6 months for a child under 5 years old and annually for a child aged 5 and older. The child’s caseworker will initiate the review.

If the child has not had their HMP reviewed, talk to your caseworker. They will contact the local OOHC Health Pathway Team to schedule a review.  

Leaving Care – Transitioning to Adulthood

The Pathway supports young people aged 15-18 years old who are preparing to leave care and transition to adulthood. The leaving care assessment and planning process helps young people to be responsible for their own health needs. Their HMP will include strategies to develop their health literacy and build their capacity to access services in the adult health care system.

Young people will receive a copy of their HMP and OOHC Health Pathway teams are also a point of contact for young people until they leave care.

How can you support the young person to manage their health needs?

• Talk to the young person about their health needs.
• Explain the different health services they may need and how to access these. For example, general practitioners, mental health services, sexual health services, Aboriginal Medical Services, and culturally appropriate health services.
• Help the young person apply for their own Medicare and Health Care Card.
• Check in with the young person about strategies to maintain a happy and healthy lifestyle.
• Encourage the young person to learn more about the OOHC Health Pathway.

Questions commonly asked by carers

Who can consent to medical and dental treatment for children in care?

Children in care can consent to their own medical and dental treatments if they are assessed by a medical practitioner as having sufficient level of understanding and maturity to fully understand the proposed medical treatment.

When a child lacks the capacity to consent for themselves, carers can consent to most day-to-day medical and dental treatments. You MUST keep caseworkers informed of serious accidents, injuries, or illnesses. 

To determine who has authority to provide consent for specific medical and dental treatments, refer to the Medical and Dental Consent Tool. For more information see the accompanying factsheet. 

Are carers expected to pay for health services?

The carer allowance should cover day-to-day or general medical and dental costs including visits to the doctor, and prescription and non-prescription medications. 

Health services should be accessed through the public system where possible. If this is not possible, you can access services through the private health system after you have obtained agreement from your caseworker.

You are entitled to receive benefits from Medicare and will be reimbursed for your out-of-pocket expenses if you obtain health services through the private health system. Your caseworker can support you with this process.

What other help is there for carers to access dental services?

The Australian Government provides financial support for basic dental services to children and young people aged 0-17 who receive both Medicare and a government payment such as the Family Tax Benefit Part Aor Youth Allowance, either directly or through their carer.

Benefits for basic dental services are capped at $1,052 per child over two consecutive calendar years and cover a range of services. 

For more information about dental benefits go to the Services Australia website.

What should I do if I am having trouble accessing health services?

If you are struggling to get a child access to a health service due to long waiting lists or lack of services in a particular location, reach out to your local OOHC Health Pathway Team. By making them aware of the child’s needs, they can help advocate and try to get them access to the service if possible. You can also talk to your caseworker to see what support they can provide. 

Who can I speak to if I have concerns about the health of the child or if I need more information?

If you have concerns about the development or health of the child in your care, speak to your caseworker or your OOHC Health Pathway Team. There is more support available if you require, so reach out! There are also some great websites for carers, for example, check out emerging minds which is dedicated to advancing the mental health of children and their families.   

For more information on the OOHC Health Pathway

Carers, watch this video developed specifically for you for more information on the OOHC Health Pathway for carers.

Encourage young people to watch this video developed specifically for them for more information on the OOHC Health Pathway for children and young people.

Self-care is important – remember to look after your own health needs as well. See this pamphlet for some helpful self-care tips.