The Jack Brockhoff Foundation Churchill Fellowship to investigate integrated models of care for Aboriginal children in out-of-home care

Aboriginal children are over-represented in the child protection system. They represent more than one third of children in out-of-home care (OoHC), even though they account for only 5.9% of Australia’s children. They are more than ten times more likely to be in care than non-Aboriginal children, and numbers are rising. Aboriginal children in OoHC have high and unmet health, developmental and emotional needs yet few access even the minimum standard of health care in national guidelines.

Dr Kennedy was awarded the 2018 Jack Brockhoff Foundation Churchill Fellowship to investigate models of integrated care to improve the health of Aboriginal children in statutory out-of-home-care. Her study involved site visits to over ten innovative and renowned models of Integrated Care in New Zealand, Canada and the United States of America and interviews with clinical leaders, researchers and policy makers in the fields of child welfare and Indigenous Health.

This report provides details case studies and analysis illustrating how the best of international models could be used to inform the design of accountable policy, programs and services for Aboriginal children in OoHC in Australia.

Key lessons and recommendations include:

·     Increase access to specialised services/ Hubs to address current barriers to navigating a fragmented system:

o  It is crucial to have specialised team-based care through multidisciplinary “Medical Home” Hubs for vulnerable children.

o  One-stop hubs provide a streamlined referral process, a specialised workforce, and a range of integrated medical, allied health and wrap-around social services.

o  Offer services to children and families involved in the child protection system as a form of early intervention and prevention

o  The value of integrating mental health services with medical services

·     Design accountable and equitable policy:

o  The urgent need to have a national strategy or action plan to implement the standards of Australia’s National Clinical Assessment Framework for children and young people in out-of-home care (2011) and to have meaningful statutory regulation, monitoring and oversight of health care

o  The USA’s evidence-based policy interventions led by Bryan Samuels, who was President Obama’s Commissioner for Administration on Children, Youth and Families provides an example of how good policy can support and incentivise best practice and improved health outcomes

·     Self-determination and Aboriginal led solutions

o  ACCHOs who have pioneered integrated care in Australia share many elements with the best international models of integrated care. They are natural settings to deliver such care.

o  ACCHOs must have proportionate investment to build on their strengths.

Niroshini was a 2021 Policy Impact Program participant and featured in the Policy Features publication with her article Safe, Healthy and Thriving. Watch her presentation below. You can also watch all PIP presentations here.