1. Key changes:  Raising threshold to Risk Of Significant Harm (ROSH)  Mandatory Reporters Guide (MRG) – a tool to determine risk  Child Well-Being Units (CWU) - 4 govt based structures to address risk to those under threshold  Information exchange (Chapter 16a)  Pilot projects – Family Referral services; family case management etc Keep Them Safe

2.  CP Helpline (5 000 reports per week across NSW) 99 283 were ROSH reports  ¾ of all reports are from mandatory reporters, Police, Health and Education  Children under 5 continue to be over- represented in reports  Most prevalent ROSH reports: Physical abuse, neglect, domestic violence, emotional abuse, carer drug and alcohol, sexual abuse, carer mental health  Physical abuse, neglect, emotional abuse and domestic violence remain the top 4 forms of abuse reported over past 3 years  Where face to face assessment is done, 70.2% of children are found to have experienced actual harm (neglect and emotional harm most common)  Face to face assessment rates have improved by 12% over past 3 years CS Annual Statistics 2012 NSW Context

3. 7 (1) This section applies to: (a) a person who, in the course of his or her professional work or other paid employment delivers health care, welfare, education, children’s services, residential services, or law enforcement, wholly or partly, to children, and (b) a person who holds a management position in an organisation the duties of which include direct responsibility for, or direct supervision of, the provision of health care, welfare, education, children’s services, residential services, or law enforcement, wholly or partly, to children. (Source: Children and Young Persons (Care and Protection) Act, 1998) Mandatory Reporters

4. Access via Community Services, Medicare Local, Google Categories: Physical Abuse Neglect (Shelter/ Environment; Food; Hygiene/Clothing; Medical Care; Mental Health Care; Education – Not enrolled; Education – Habitual Absence) Sexual Abuse: Child; Young Person; Problematic Sexual Behaviour Towards Others Psychological Harm Child / Young Person is a Danger to Self and / or Others Relinquishing Care Carer Concern: Substance Abuse: Mental Health: Domestic Violence Unborn Child Mandatory Reporters Guide - MRG

5. Physical abuse occurs if a child or young person sustains a non-accidental injury or is being treated in a way that may have or is likely to cause injury. The injury may be inflicted by a parent, carer, other adult or child or young person. It is often a particularly visible form of child maltreatment. (NSW Child Protection Interagency Guidelines 2011) Physical Abuse

6.  Sexual abuse is any sexual act or threat to a child or young person that causes them harm, or to be frightened or fearful.* It covers a continuum from:  non-contact forms of harm, such as flashing, having a child or young person pose or perform in a sexual manner, exposure to sexually explicit material or acts (including pornographic material), communication of graphic sexual matters (including by email and SMS)  a range of contact behaviours, such as kissing, touching or fondling the child or young person in a sexual manner, penetration of the vagina or anus either by digital, penile or any other object or coercing the child to perform any such act on themselves or anyone else. Sexual Abuse

7. The child or young person’s psychological state has been, or is at risk of, being harmed, because of the parent or carer’s behaviour or attitude. This could be due to domestic violence, mental health, drug and alcohol use, criminal or corrupting behaviour or deliberate exposure to traumatic events. (NSW Child Protection Interagency Guidelines 2011) Psychological Harm

8. The child or young person’s basic needs (e.g. supervision, medical care, nutrition, shelter and education) have not been met, or are at risk of not being met, to such an extent that it can reasonably be expected to have a significant adverse impact on the child or young person’s safety, welfare or well-being. This lack of care could be constituted by a single act or omission or a pattern of acts or omissions. (NSW Child Protection Interagency Guidelines 2011) Neglect

9. Domestic and family violence is any abusive behaviour used by a person in a relationship to gain and maintain control over their partner or ex- partner. It can include a broad range of behaviour that causes fear and physical and/or psychological harm. If a child or young person is living in a household where there have been incidents of domestic violence, then they may be at risk of serious physical and/or psychological harm. (NSW Child Protection Interagency Guidelines 2011) Domestic Violence

10. wThe preferred term in many Aboriginal communities is ‘family violence’. wFamily violence describes all forms of violence-including physical, emotional, psychological, sexual, sociological, economic and spiritual – in intimate, family and other relationships of mutual obligation and support (Aboriginal Child Sexual Assault Taskforce, 2006) wFamily violence takes place within the extended nature of Aboriginal families. Aboriginal Family Violence

11.  Issues of loyalty - To whom am I responsible?  A family focus? A primary Client? A child focus?  ‘That’s not why they came to me’  Issues of being time poor  Loss of Patients / Clients  Responsibilities at law, and for health and well-being  Practice Issues

12.  Provisions  Prescribed Bodies  Consent Information Exchange – 16A

14. Prescribed Body A prescribed body is any organisation specified in section 248(6) of the Act or in clause 7 of the Children and Young Persons (Care and Protection) Regulation 2000. Generally prescribed bodies are: NSW Police Force a State government department or a public authority a government school or a registered non-government school or a TAFE a public health organisation or a private health facility an accredited adoption service provider a designated agency a registered agency a children’s service any other organisation the duties of which include direct responsibility for, or direct supervision of, the provision of health care, welfare, education, children’s services, residential services, or law enforcement, wholly or partly to children. (Source: Child Wellbeing and Child Protection: NSW Interagency Guidelines)

15.  Consent is not necessary for exchange of information under Chapter 16A and there are some specific occasions when it should not be sought. However, as it is a principle of the Act that a child or young person should be given an opportunity to express views on personal matters, consent should be sought where possible.  Best practice recommends that consent is sought from parents and/or carers before information relating to them, is exchanged. (Exception – risk)  For many services working on a voluntary basis with families the decision to act without the family’s consent may be significant to the continuing relationship.

16. Questions for you to consider  Who with, what and when to exchange  Requesting information yourself  Agreeing/ responding to an information request  Providing information  Declining a request  Is it appropriate to gain consent of the parent/s and/or child or young person? If so, how would you go about it?  What is the purpose of the exchange in this instance?

17.  Overall, the intent of the legislation and requirements are about asking you and your colleagues to notice your concerns and act, when sometimes you may feel its not their business. When families are needing assistance, it is all of our business to support them broadly and to protect children specifically when there are concerns. 

18.  The Child Protection Helpline eReporting is an internet based system used to make child protection reports to Community Services if you have concerns about the safety, welfare or wellbeing of a child or young person.  eReporting will only be made available for mandatory reporters at this stage and is currently being used by selected government agencies. Extended to remaining govt orgs and key non govt orgs mid this year.  eReporting will be available via a link on the Medicare Local Pathways directory that will take you through to the eReport on the Community Services Website.  eReports are delivered securely and automatically to the Child Protection Helpline for review and assessment.  Helpline eReporting must only be used for non-imminent suspected Risk of Significant Harm reports. ALL urgent reports must still be made by phone to the Helpline.  The user will be provided with an instant receipt upon submission of the report along with a full transcript of the report submitted to Community Services. The CS Reference Number is also displayed on the eReport transcript. E-reporting Pilot

19. Case study:  On a home visit to assess for home modifications for a dad following an accident, the OT is told by Merridy, 8 years old, that she and her brother and sister have been left unsupervised at home on a number of occasions whilst her parents were at a neighbours drinking alcohol and smoking Marijuana. Merridy has a baby sister Verity, 6 months, and brother Thomas, 4 years old. On the same visit mum asked if the OT knew who could give them money for food. Merridy attends the Smith St Primary School and Thomas goes to the Smith St Preschool 2 days a week. Case study:  The father of a 16 year old boy with a developmental delay asks you, at the end of his session / appointment for some ideas for where he can take his son for some help, as he has been exposing himself to his 10 year old sister. This behaviour had previously been occurring at school, but they seemed to stop it. He hasn’t talked to the school about it because he thought they were very judgmental, but he is worried now about his daughter. Case Examples

20.  Would you run an MRG?  If ROSH – report  If not – options? Would you seek information under 16A? From whom? Do you need to provide information to anyone? Would you discuss this with the family? Referrals / Support options Case Example Questions