Gateway to
better education
and health care
Information for stakeholders
Services for Children in Care
Budget 2011 provided government funding for services to address the
needs of children and young people in care. The package includes:
> Gateway Assessments
(health assessments and
education profiles).
> The establishment of primary
mental health services for
children and young people in
care.
> Funding for early childhood
education for children in care,
aged 18 months to three
years.
Gateway Assessments - Overview
Gateway Assessments are an interagency initiative between Child,
Youth and Family, Health and Education, for children and young people in
care. Their aim is to:
> identify health and education
needs early
> ensure interagency agreement
on how best to address needs
> facilitate access to appropriate
services
> ensure children and young
people get the support they
need at home and at school.
Who is a Gateway Assessment for?
Children and young people entering CYF care must be referred for a
Gateway Assessment.
A social worker may form the belief
that a Gateway Assessment would
help identify and clarify ways to
address health and education
needs.
So a referral may also be made
when a child or young person is in
care already or is being referred for
an Family Group Conference
(FGC).
Health needs of children in care
Emotional, behavioural, mental health
51%
Incomplete immunisation
20%
Developmental delays
15%
Dental
26%
Hearing
19%
Speech and Language
13%
Skin
14%
Vision
9%
Parental alcohol and other drug
26%
Referrals are made to specialist services to address the identified needs.
Examples of outcomes
Condition
Age of child
Outcome
Enlarged kidney
3 months
Referred for x-ray and specialist assessment. Major illness identified.
Undergoing treatment
Jaundice with arching
back
4 months
Referred to specialist paediatric service. Major concern about permanent
brain injury
Tongue tie – feeding
problems
4 months
Surgery the following day. Excellent progress and now thriving
Cleft palate
18 months
Referred to plastic surgery for repair, speech progressing
Club foot
2 years
Orthopaedic surgery corrected deformity. Able to walk 12 months later
Squint
3 years
Eye surgery to correct muscle problems, coordination improved and building
towers
Disruptive behaviour
5 years
Incredible Years Programme to help caregivers understand and manage
behaviour positively – child now participating well at school
Needle stick injury
11 years
Investigated for HIV infection, Hepatitis
Acute psychosis
14 years
Referred for psychiatric assessment, now under specialist mental health
care
Epilepsy
15 years
Commenced treatment. Able to progress well at school once treatment
established
Child or young person Identified by CYF to have a Gateway Assessment
Urgent health
appointment if required
•
•
•
Social Worker
Engages with family and gains consents
Refers for health assessment & education profile
Provides information regarding child or young person’s history
•
•
•
•
Gateway Assessment Coordinator
Collates information from CYF, Health and Education
Collects existing health information
Collects family health history
Determines appropriate assessment
•
•
•
Health Assessor
Reviews history
Undertakes comprehensive health assessment of child or young person
Writes health report and recommendations
Social Worker
Family
Health (NHIS)
Well Child Provider/
Tamariki Ora
ACC
GP
NGO
Health
Gateway Assessment Coordinator
Drafts Interagency Services Agreement (ISA) recommendations in consultation with
Health, CYF and Education
• Coordinates Multi-disciplinary Clinical Meeting
• Follows-up on referrals and recommendations at 3 months
•
Education
Social Worker
Teacher/Principal/
RTLB Cluster
Manager ( or School
or Early Childhood
Education centre)
• Completes education
profile
• Identifies issues
affecting education
• Engage with SWiS,
MASSiSS &YSWiS
Health Referrals
•Immunisations
•Primary Care
engagement
ICSS
CAMHS
Primary MH Services
Paediatric Services
•
•
•
•
•
Social Worker
ISA recommendations are discussed with child/young person and their
family/caregiver
SW assists to get parent/s consent for any follow up referrals
Agreed recommendations are included in the child/young persons Plan and
appropriate FGC/whānau hui/court review or case consult.
Support, review, monitor and give feedback to GAC and School/ECE
Record on CYRAS
Adult AoD and MH
Services
Roles and responsibilities –
The CYF social worker
The social worker is responsible for:
>
engaging with the child, young person and their family/whānau to inform them of the process of a
Gateway Assessment and obtain consent
>
requesting the education profile and making the referral to the Gateway Assessment coordinator
>
supporting the child or young person and their parents/caregiver to attend the appointment
>
attending the health assessment with the child/youth and their family/whānau
>
>
>
>
>
assisting with the development of the Interagency
Services Agreement (ISA)
participating in the Multi-disciplinary Clinical Meeting
discussing the completed report with the child or young
person and family/whānau or caregivers
developing the plan with the child/young person and their
family/whānau
on-going monitoring and reviewing of the child or young
person’s progress.
Teachers and the Education Profile
>
Teachers information is important: they know how children and young people learn and
socialise at school
>
Exchanging information with teachers is part of the social work role and improves the
knowledge all professionals have about children and young people
>
Social workers request the education profile and draft the
Gateway Assessment referral
>
Interagency collaboration means teachers, CYF and
health all contribute to the Interagency Services Agreement
(ISA).
>
>
>
Interagency Service Agreements (ISA’s) are a commitment
to provide services to address the educational needs
for children and young people.
Gateway Assessment coordinator
>
The Gateway Assessment Coordinator is employed by the DHB and is
responsible for:
> collecting existing health information about the child or young
person from other agencies
> collecting the mental health, drug and alcohol
history and status of the parents (where there
is consent)
> ensuring the education profile information is
considered in the assessment
> drafting the Interagency Services Agreement,
with the social worker and teacher
> arranging Multi-disciplinary Clinical Meetings.
The health assessment
> The type of assessment depends on the age, development status, and health needs
of the child or young person.
> Health assessments look at:
> current physical health
> current mental/emotional health
> behaviour, development and learning
> skin, dental, eyes, vision, hearing, and
> sexual health.
The assessing health practitioner may also:
> offer immunisation if there is specific consent
> request additional services or interventions to
complete the assessment.
> provide treatment for current conditions
Multi-disciplinary clinical meeting



Organised by the Gateway Assessment Coordinator
Determines what services each agency will contribute to meeting the needs of the
child or young person
Confirms the Interagency Services Agreement which is a:
• summary of needs identified
• the recommended interventions and
services to meet the needs
• who will make the referral and when
• who will pay for the interventions
• how it will be monitored
 Once finalised, each agency is responsible for
implementing the services that they have
agreed to provide.
Gateway Report and Interagency
Services Agreement (ISA)
>
The health assessor prepares a Gateway report
about the child/young person’s current health and
wellbeing.
>
It draws on information and findings from
information that has been collated, the health
assessment, education profile and information from
the social worker.
>
The ISA outlines the recommended services to
address the needs that have been identified.
>
Once the document is agreed by each agency that
agency is responsible for providing and funding the
services to the child, young person and their
family/whanau to meet their needs.
Timeframes
Health and education information needs to be available within time frames, so
their needs can be addressed in a timely manner.
The Gateway Assessment process therefore needs to be undertaken within the
following timeframes:
Social worker
> requests the education profile and drafts the
referral for the health assessment
Within 10 working days of entering care or identifying the need
for an assessment
Teacher
>Attends RTLB led meeting (within 4 days) and
completes the education profile
Within 7 working days of receiving the request
Health assessor
Completes the health assessment
Within 6 weeks of receiving referral
(4 weeks for children under 5 years old)
Gateway Assessment Coordinator
Distributes Gateway report and recommendations
Within 10 working days of the assessment
Drafts the Interagency Services Agreement
Arranges Multi-disciplinary Clinical Meeting
Within 10 working days of the assessment
New CYF Funded Mental Health Services
We have new funding for mental health services to meet the needs of
children and young people identified through Gateway Assessment.
New primary services
> Mild to Moderate
mental health =
emotional and
behavioural needs
> 1,600 children per year
> Average $1,550 per
child
> Evidence-based family
focused services
> Starting very soon
Acute
ICSS
CAMHS
Primary Mental
Health Service
Universal services
Extension of Intensive
Clinical Support
Services
> Complex mental health
and behaviour
> 175 young people per
year
> Average cost of $14,300
> Evidence-based, family
focused services
Primary services – CYF will fund evidence
based interventions
Group
– Infants (aged 0-4)
Primary Mental
Health Services
0-17 year olds
Intensive Mental
Health Services
10-17 year olds
- Children & young people
(aged 3 or older)
- Young People
Names of evidence based interventions
– Watch, Wait and Wonder™
– Parent Child Interaction Therapy
– Trauma and Abuse focused
Cognitive Behavioural Therapy
– Primary care or level 4 and 5
Triple P
– Incredible Years
– Functional Family Therapy
– Multi-systemic Therapy
These rely on good social worker engagement & case management
Early Childhood Education – why is it
important?
High quality early childhood education
=
positive long term effects AND immediate returns for children
Early Childhood Education funding
>
Child, Youth and Family funding is available to
enable children in the custody of the Child, Youth
and Family aged 18 months - three years, to access
early childhood education
>
Funding covers up to 20 hours per week, or $600
per month.
>
The funding continues if a child progresses to a
‘home for life’ until they are three, provided it is set
up before the court order is legally secured.
>
Beyond three years, all children benefit from the
MoE’s 20 hours free ECE.
More information
>
>
You will find more information about these initiatives on the Child, Youth and Family
website www.cyf.govt.nz
You can also contact your local Child, Youth and Family site if you have specific
enquiries about how this might affect you.