Guidance
Working with disability and learning supports, mental health and ACC
We work in partnership with tamariki and rangatahi and their whānau or family and collaborate with health and disability services to ensure that oranga needs and aspirations are understood and well supported.Ko te raranga o te harakeke ka whakatau i te kaha o te kete.
The weave of the flax determines the strength of the basket.
Updates made to this guidance
Supporting whānau or family to achieve their oranga aspirations (whai oranga)
We develop shared understandings of the strengths and needs of te tamaiti or rangatahi and work closely and relationally with them and their whānau or family to ensure that oranga needs and aspirations are understood and well supported.
We support and advocate for their access to other services, and collaborate with other practitioners, clinicians and services to:
- assess any health, mental health, disability or learning needs affecting te tamaiti or rangatahi
- help whānau, family or caregivers to better understand how to care for and support te tamaiti or rangatahi
- inform plans, including All About Me plans, family group conference plans and court plans
- share appropriate information so that the plans developed by other practitioners and services can align with the All About Me plan.
Specialised assessments and support needs
Supporting tamariki and rangatahi with their health needs
Needs Assessment and Service Coordination (NASC), Enabling Good Lives (EGL) and Whaikaha Ministry of Disabled People
NASC and EGL are the entry point to most Whaikaha-funded supports and services for people with an intellectual, physical or sensory disability, or autism. The NASC and EGL websites tell us which one to contact for our region:
Needs assessment services | Whaikaha Ministry of Disabled People
1 Make a referral to NASC or EGL
Referrals can be made by a social worker, whānau or family member, or health care provider such as their GP or Well Child Tamariki Ora nurse.
If we make the referral, we first talk with the guardian and gain their agreement and consent. The initial referral must include evidence that te tamaiti or rangatahi is eligible for Whaikaha-funded disability services. This requires a specialised assessment and a diagnosis, with the assessor being a psychologist, paediatrician or other health professional recognised by NASC or EGL.
If eligibility is disputed by NASC or EGL, an eligibility assessment can be requested. Contact the Regional Disability Advisor, Clinical Services, NASC or EGL for more information on eligibility assessments.
2 Understanding support needs and developing plans
If the referral is accepted, a NASC service facilitator or EGL connector will meet with te tamaiti or rangatahi and their whānau or family to discuss the needs and goals of te tamaiti or rangatahi and work together to develop a support plan or 'good life plan'. When we make the referral, we make sure that NASC or EGL understands the circumstances of te tamaiti or rangatahi and their whānau or family at that time – for example, where and who they are living with, and if there is an upcoming transition.
If te tamaiti or rangatahi is in care, their social worker should be present at the assessment.
If te tamaiti or rangatahi chooses not to engage in the process, the assessment can go ahead based on information given by the social worker, whānau or family and caregiver. In this case, we talk with te tamaiti or rangatahi and ask for their views and any information we can convey to the NASC assessor or EGL connector on their behalf.
3 Types of support available
The range of supports available includes personal care, respite care, carer support, family-funded support, behaviour support and child development services, equipment and building modifications. Other options are:
- Intensive Wraparound Support (IWS) for tamariki and rangatahi at risk of needing out-of-home care and requiring more intensive support (national contracts are currently held by Open Home Foundation and CCS Disability Action)
- individualised funding packages so whānau, family or caregivers can purchase disability support services directly
- personal budgets (available in EGL regions).
Rangatahi who are transitioning out of care have additional options:
- Choice in Community Living provides individual support for a disabled person who might otherwise need residential services so they can plan for and live more independently in a home of their choice.
- Supported Living is a range of flexible and individually responsive service approaches that are based on an individual support plan.
- Residential Services provide 24-hour support at the level needed for people to have a safe and satisfying home life.
4 Contact NASC or EGL when there is a change in needs or for transition
Contact NASC or EGL if the needs of te tamaiti or rangatahi change.
Otherwise, supports are reviewed once a year, usually by phone call with the caregiver, to ensure they are meeting the needs of te tamaiti or rangatahi. Every 3 years, a full reassessment is arranged.
When tamariki and rangatahi are leaving care, we work with NASC or EGL to update the plan. This should happen well before the change happens. NASC or EGL should be an integral part of the planning process.
Child Development Services (CDS)
CDS focuses on early intervention for pre-school tamariki and some school-age tamariki and rangatahi (it varies in different regions) if they are not achieving developmental milestones or have intellectual, sensory or physical disabilities, or autism.
CDS practitioners include physiotherapists, occupational therapists, neuro-developmental therapists and sometimes psychologists.
Referrals are made by a health care provider, such as their GP, Well Child Tamariki Ora nurse, Māori health provider, child health specialist (including Gateway) or NASC.
Forensic Coordination Service (Intellectual Disability)
Social workers cannot refer to this national service but may suggest to the court that a referral is made, particularly if they are aware that the rangatahi has an intellectual disability.
Referrals are made through Youth Court or Family Court pathways under the Criminal Procedure (Mentally Impaired Persons) Act 2003 for disposition options under the Intellectual Disability Compulsory Care and Rehabilitation Act 2003.
This is a national service managed by Te Whatu Ora Capital, Coast and Hutt Valley. It:
- undertakes high and complex needs assessment, service coordination and case management
- assists NASC and EGL with complex cases
- administers the Intellectual Disability Compulsory Care and Rehabilitation Act 2003, which includes coordinating placements for care recipients under the Act and managing the legal processes for care recipients through the Family Court.
Infant, Child and Adolescent Mental Health Services (ICAMHS)
ICAMHS are a specialist service for tamariki and rangatahi up to their 20th birthday, although some will transfer or be referred to adult services from 18 years.
ICAMHS are for tamariki and rangatahi:
- with, or suspected of, having a mental health or alcohol and other drug problem
- with psychological disorders, including severe emotional and behavioural disturbances
- who are affected by the mental health or addiction problems of a parent or carer.
Social workers and other kaimahi can refer directly to ICAMHS.
Learning and behavioural support
When te tamaiti or rangatahi is well engaged with education, they have the opportunity to be successful in their learning and development and also be part of the school community. Tamariki and rangatahi may require support with their learning and behavioural needs to ensure they are able to participate and engage.
When the school assesses that te tamaiti or rangatahi has learning and behavioural needs, the support options include:
- Special Education Grant (held by the school)
- Special Education and Assistive Equipment Grant
- Resource Teacher Learning and Behaviour
- Ongoing Resource Scheme (ORS) funding
- behaviour management interventions such as the Ministry of Education's Intensive Wraparound Support Te Kahu Tōī
- teacher aide support.
The Interim Response Fund (IRF) may provide initial support while the school is assessing the needs of te tamaiti or rangatahi.
Clinical Services
Clinical Services is part of Oranga Tamariki (previously called Specialist Services Units – SSU). Team members are a combination of psychologists and therapists who offer psychological and therapeutic services. Clinical Services offers consultation, assessment and therapeutic interventions with tamariki and rangatahi engaged with Oranga Tamariki and their whānau or family.
Contact the regional Psychologist Team Leader or the Site Clinician to make a referral.
ACC
ACC can help tamariki or rangatahi with health and disability needs that are caused by injury or accident. This can include:
- injuries caused by everyday accidents
- injuries caused by serious harm events
- sensitive claims that relate to sexual abuse
- traumatic brain injuries.
Sexual abuse
Tamariki and rangatahi who have been sexually abused should have an ACC claim registered. If this hasn't happened, the social worker should talk with te tamaiti or rangatahi and, with their consent, seek registration using information Oranga Tamariki holds.
Brain injury
If te tamaiti or rangatahi was assessed or seen by a health practitioner when their brain injury occurred, their injury is likely to have been registered and they may have an ACC case manager. If not, their GP is usually the best person to follow up with ACC – talk with their GP about this.
If te tamaiti or rangatahi was not assessed or seen by a health practitioner at the time of their injury, they are unlikely to have ACC cover. ACC cover can be difficult to establish after the event, so talk to ACC and seek advice from the Regional Disability Advisor or Clinical Services.
How ACC supports its clients
The types of support that ACC can provide include surgery, medical care, attendant care, equipment, aides, transport, travelling to treatment, rehabilitation (such as physiotherapy, speech language therapy, occupational therapy, psychology), childcare and education (for injured parents), teacher aide, counselling, behaviour support and other support.
If te tamaiti or rangatahi has been hospitalised due to an injury, ensure that an ACC representative is part of the discharge planning processes so that ACC supports are in place when te tamaiti or rangatahi is discharged.
To understand what ACC can provide, talk with the ACC case manager, recovery team or claims team (0800 101 996). If there is significant need, te tamaiti or rangatahi may have a dedicated recovery team member allocated, and there may be a Support Needs Assessment (SNA), which the social worker will need to have input into and be familiar with.
ACC may also provide financial help for tamariki and rangatahi whose parents have died of an injury.
Disabled tamariki and rangatahi who are not eligible for disability support or ACC
Many tamariki and rangatahi will not be eligible for Disability Support Services or ACC services.
For these tamariki and rangatahi, we bring community and Whānau Ora supports and services together to assist whānau, family and caregivers to develop and implement plans.
We also check if tamariki and rangatahi with complex needs can access High and Complex Needs (HCN) support and make referrals as appropriate.