Upcoming changes for this guidance
This content will be strengthened so it more completely reflects our commitment to practice framed by te Tiriti o Waitangi, based on a mana-enhancing paradigm for practice, and drawing from Te Ao Māori principles of oranga to support mana tamaiti, whakapapa and whanaungatanga. We each need to consider how we can apply these principles to our practice when reading this guidance. The following resources provide support:
Practice for working effectively with Māori
Our practice shift
Collaborating with other agencies to meet the support needs of tamariki and whānau or family
We support disabled tamariki, rangatahi, whānau, family or caregivers to access supports and services that can:
- help tamariki to flourish
- support whānau, families or caregivers with their oranga (wellbeing)
- support whānau, families or caregivers to care for their disabled tamariki.
We work with disability and health practitioners, teachers and educators, and other supports to align assessments and plans to meet the needs and enhance the oranga of tamariki and their whānau or family.
Regional Disability Advisors
Regional Disability Advisors provide support to understand the purpose, eligibility criteria and language used by the following organisations, and to navigate the way to interagency plans.
Needs Assessment and Service Coordination
Needs Assessment and Service Coordination (NASC) is currently the entry point to most Ministry of Health funded supports and services for people with an intellectual, physical or sensory impairment, or autism.
1 Make a referral to NASC
We talk with the guardian and gain their agreement and consent to a referral to a NASC. A referral can be made by a:
- social worker
- whānau or family member
- health care provider such as their GP or Well Child Tamariki Ora nurse.
The initial referral must include evidence that te tamaiti is eligible for Ministry of Health funded disability services. This is an assessment that is usually undertaken by a clinical psychologist, paediatrician or other health professional recognised by the NASC.
Contact your Regional Disability Advisor or NASC for more information on eligibility assessments.
2 NASC needs assessment for te tamaiti
If the referral is accepted, a NASC assessor will meet with te tamaiti and their whānau or family to discuss the needs and goals of te tamaiti and what supports are needed. Before the assessment, we make sure that the NASC assessor understands the reason the referral was made – for example, to support the current care arrangement or a transition out of care, or for alignment with or follow-on from a youth justice plan. This will enable the right people to be involved in the assessment process.
If te tamaiti is in care, their social worker should be present at the assessment.
If te tamaiti chooses not to engage in the process, the assessment can be based on information given by the social worker, whānau or family or caregiver. In this case we talk to te tamaiti and ask for their views and any information we can convey to the NASC assessor on their behalf.
3 NASC support plan for te tamaiti
A service coordinator will work with the whānau or family or caregiver to establish a support plan to meet the prioritised needs and goals of te tamaiti and, where appropriate, their whānau, family or caregivers.
The range of supports available includes personal care, respite care, carer support, behaviour support and child development services, equipment and building modifications. Other options are:
- individualised funding packages so whānau, family or caregivers can purchase disability support services directly
- Intensive Wraparound Support (IWS) for tamariki 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).
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 when there is a change in needs or for transition
Contact NASC if the needs of te tamaiti change. NASC may reassess or review the disability supports.
Otherwise, supports are reviewed once a year, usually by phone call with the caregiver, to ensure they are meeting the needs of te tamaiti. Every 3 years, a full reassessment is arranged.
When rangatahi are leaving care, we work with NASC to update the needs assessment and support transition planning. This should happen well before the change happens. NASC should be an integral part of the planning process and participate in the transition family group conference.
Enabling Good Lives (EGL)
EGL is a new approach that is underpinned by principles developed by disabled people and whānau or family. EGL will eventually replace all NASCs as the entry point to disability support services.
EGL is for people with an intellectual, physical or sensory impairment, or autism. With the guardian’s consent, social workers can make a referral to EGL.
Three EGL prototypes are in place: in Waikato and Christchurch, both EGL and NASC are operating, and Mana Whaikaha (EGL) is the single agency for the Mid Central DHB area.
ACC can help tamariki 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
Tamariki who have been sexually abused should have an ACC claim registered. If this hasn’t happened, the social worker should talk to te tamaiti and, with their consent, seek registration using information Oranga Tamariki holds.
If te tamaiti 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 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 your Regional Disability Advisor.
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 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 is discharged.
To understand what ACC can provide, talk to the ACC case manager, recovery team or claims team (0800 101 996). If there is significant need, te tamaiti 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 whose parents have died of an injury. We may need to assist tamariki and whānau or family to get this support.
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) who 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.
Contact CDS or your Regional Disability Advisor for more information.
Educational, learning and behavioural support
Individual Education Plans (IEPs)
Find out if the school has an Individual Education Plan (IEP) for te tamaiti and what contribution we can make. Where an IEP is in place, we support the whānau, family or caregivers to be part of developing the plan and 6-monthly reviews.
We ensure the IEP is incorporated into and attached to the All About Me plan.
Stand-downs, suspension or expulsion from school
When a disabled tamaiti is stood-down or suspended from school, the pressure on their whānau or family or caregiver can significantly increase. If te tamaiti or rangatahi is in, or likely to be in, a suspension or expulsion process we are concerned about the implications for their care or living arrangement.
At these times it is critical to check that supports are in place to ensure te tamaiti can stay in school to continue their learning and be part of the school community. We:
- support and may advocate for the whānau or family or caregiver with the school
- ensure that all disability needs have been identified, and that the school is exploring all options to assist te tamaiti at school
- collaborate with the Ministry of Education, Needs Assessment and Service Coordination (NASC), Enabling Good Lives (EGL), ACC or other services, to get supports into both the school and home
- consider making a referral to HCN.
If an alternative schooling option is offered, the learning and behaviour support needs of te tamaiti still need to be considered, including how they will continue to participate in a school community. Collaboration to build supports into the home is also required.
Contact the Regional Disability Advisor for advice if needed.
Forensic Coordination Service (Intellectual Disability)
Social workers cannot refer to this national service – referrals are made through Family Court pathways under the Criminal Procedures (Mentally Impaired Persons) Act 2003 for disposition options under the Intellectual Disability Compulsory Care and Rehabilitation Act 2003.
The service is managed by Capital and Coast DHB. It:
- undertakes high and complex needs assessment, service coordination and case management
- assists Needs Assessment and Service Coordination (NASC) 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.
Contact the Regional Disability Advisor for advice if needed.
Disabled tamariki and rangatahi who are not eligible for disability support or ACC
While disabled tamariki can receive support from schools and the Ministry of Education up to the age of at least 16, many disabled tamariki will not be eligible for Needs Assessment and Service Coordination (NASC), Enabling Good Lives, or ACC services.
For these tamariki we bring community and Whānau Ora supports and services together to assist whānau, family and caregivers to create plans to help tamariki and whānau, family and caregivers achieve and thrive.
We also check if tamariki with complex needs can access High and Complex Needs (HCN) support and make referrals as appropriate.