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SERVICES FOR CHILDREN AND YOUNG PEOPLE –
Health Services for Children and Young People in Child
Youth and Family (CYF) Care and Protection and Youth
Justice Residences
TIER LEVEL TWO
SERVICE SPECIFICATION
STATUS:
MANDATORY 
For the nationwide minimum description of
services to be provided.
Review History
Date
First Published on NSFL
July 2012
Updated:
August 2015
Amended: Reporting added word ‘directly”
September 2015
Consideration for next Service Specification
Review
Within five years
Note: Contact the Service Specification Programme Manager, National Health Board
Business Unit, Ministry of Health to discuss the process and guidance available in
developing new or updating and revising existing service specifications.
Nationwide Service Framework Library website: http://www.nsfl.health.govt.nz/
SERVICES FOR CHILDREN AND YOUNG PEOPLE –
HEALTH SERVICES FOR CHILDREN AND YOUNG PEOPLE IN CHILD YOUTH AND
FAMILY (CYF) CARE AND PROTECTION AND YOUTH JUSTICE RESIDENCES
TIER TWO
SERVICE SPECIFICATION
COCH0026
This tier two service specification for Children and Young People in Child Youth and Family (CYF)
Care and Protection and Youth Justice Residences (the Services) must be read in conjunction with
the overarching tier one Services for Children and Young People Service Specification.
Refer to the tier one Services for Children and Young People Services service specification for
generic requirements that are applicable to all service delivery.
The Services are linked to other District Health Board (DHB) funded service specifications such as:
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Services for Children and Young People
Mental Health and Addiction Services - for children, adolescents and youth
Oral Health Services
Specialist Medical and Surgical Services.
Access to the above services for Service Users is determined clinically, based on principles of
levels of need and ability to benefit. This list is not exhaustive.
Background
Services in CYF Residences1
Child, Youth & Family (CYF) is a service line within the Ministry of Social Development (MSD) with
statutory duties and powers to provide care and protection for children and young people. As part
of these responsibilities, CYF provides residential care for children and young people who either:

have behaviour such that they are placing themselves or others at risk and a secure
environment is required to keep them (or others) safe (Care and Protection Residence), or
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have a history of offending serious enough to warrant secure placement, or have been
charged with a criminal offence(s) or face charges, or have been sentenced to a term of
imprisonment which they are serving in a Youth Justice residence because they have been
deemed too vulnerable to serve the sentence in prison (Youth Justice Residence).
Children and young people may not always be placed in a CYF Residence close to where they
live. Following admission, they are provided with a range of programmes to meet their individual
needs. Planning is undertaken for their transition back to the community or other facility when the
placement is complete.
Children and young people (the “Service User / Service Users”) who enter a Residence often have
high levels of unmet health needs particularly in the areas of mental health and developmental
disability, and often have not had active contact with primary health services and subsequent
referral for specialist care.
1
Section 364, Children, Young Persons and Their Families Act, 1989
Health Services for Children and Young People in CYF Care and Protection and Youth Justice
Residences tier two service specification September 2015
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1.
Service Definition
This service specification applies to the following Residences (each a “Residence” and together
the “Residences”):
Table 1: Applicable Residences
Residence
Whakatakapokai
Korowai Manaaki
Te Ao Rere a te Tonga
Epuni
Te Puna Wai o Tuhinapo
Te Oranga
Puketai
Te Maioha o Parekarangi
DHB
Counties Manukau
Counties Manukau
MidCentral
Hutt Valley
Canterbury
Canterbury
Southern
Lakes
Care & Protection or Youth Justice
C&P
YJ
YJ
C&P
YJ
C&P
C&P
YJ
The health services provider funded by a DHB to deliver the services specified in this service
specification (“the Provider”) will deliver and coordinate the delivery of a comprehensive range of
health services to meet Service Users’ needs.
Health services (“the Services”) will:
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comprise of personal, mental, and population health based approaches to support the
attainment and maintenance of the Service Users’ optimal health and development
be user-friendly, culturally-appropriate and driven by the needs of the Service User
be delivered by the Provider in the best interests of the child or young person2 with the
consent of the child or young person and their family and whānau are involved, whenever
practicable.
2.
Exclusions
Children and young people not currently resident in a CYF Care & Protection or Youth Justice
Residence and staff in the Residences are excluded from these Services.
3.
Service Objectives
3.1
General
The objectives of the Services are to:
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identify and address the Service Users’ presenting health conditions and ensure a
comprehensive range of health services are provided to meet their needs
work within the constraints of the Residence environment to facilitate a positive caring and
therapeutic approach that promotes positive health, wellbeing and development
utilise strength-based approaches3 to build resilience in Service Users
assist Service Users to develop knowledge, skills and confidence to adopt healthier
behaviours that contribute to their physical, mental and social wellbeing, and skills that are
able to be taken back into the community upon discharge
create sustainable health outcomes for Service Users while they are in the Residence and
establish a platform for ongoing engagement with health services after discharge.
The Services:
2
Children, Young Persons, and Their Families Act 1989 section 6.
3A treatment approach, that focuses on and helps develop the Service user’s strengths. This approach combines both
provision of direct services and treatment, along with helping people define or priorities their needs, navigate the system
and link into community resources.
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take into account the particular needs of culturally diverse communities and other ethnic
groups
strive to minimise barriers to access to, or communication with, the Services
ensure there is no discrimination in any practice, and that the Services are safe for all
Service Users.
3.2
Māori health objectives
Refer to the tier One Services for Children and Young People service specification for the
overarching objectives for Māori Health.
In addition, the Provider will provide Services that are responsive to the unique needs of Māori
Service Users who make up a significant proportion of their clients and contribute to a reduction of
health inequalities for their Māori Service Users, and understanding and meeting their needs.
Māori Service Users are to be supported by the Provider to help achieve their maximum health and
wellbeing consistent with the directions set in key strategic documents, such as He Korowai
Oranga4–(Ministry of Health, 2014).
Providers must recognise the cultural values and beliefs that influence the effectiveness of services
for Māori and must consult and include Māori in service design and delivery. Services must build
on the current investment and innovation in Māori programmes and services and develop effective
models of service delivery that are responsive to Māori and contribute to whānau ora.
Providers must offer an integrated service that includes developing and maintaining relationships
with other primary and specialist health, education and social services that influence Māori health
outcomes.
3.3
Pacific health objectives
The Services will work to encourage Pacific Service Users to make healthy choices and facilitate
access to health and social services.
The Provider is expected to provide health services that will contribute to the improvement of
health outcomes and reduction in health inequalities for Pacific people’s children and young people
under their care.
The Provider will support initiatives that build upon current investment and innovation in Pacific
peoples’ programmes and services and develop effective models of service delivery that is
responsive and aligned to Ala Mo'ui: Pathways to Pacific health and wellbeing' 2014-2018.5
3.4
Agreement on strategies to achieve the objectives
Within three months of signing a Service Agreement and on an annual basis after that, the
Provider will consult with the manager of the Residence to develop and agree a Memorandum of
Understanding that sets out for the following 12-month period the approach to delivering the
Services to achieve the objectives set out in this clause 2, and includes:
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the parties’ and the Service Users’ priorities with regard to the Services
the Provider’s staffing plan for the Services (refer clause 5.4)
the Provider’s approach to delivering the Services and working with Residence staff to:
-
meet Service Users’ health service needs
deliver the components of the Services described in clause 5
achieve the quality requirements described in clause 8.
The New Zealand’s Māori Health Strategy, He Korowai Oranga strategy was updated with input from
across the sector during 2013/14 to ensure its relevance for the future http://www.health.govt.nz/ourwork/populations/maori-health/he-korowai-oranga
5 Ala Mo'ui: Pathways to Pacific health and wellbeing' 2014-2018. http://www.health.govt.nz/publication/alamoui-pathways-pacific-health-and-wellbeing-2014-2018
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4.
Access
4.1. Hours of operation
The Services are provided during agreed business hours6. The Services are not provided after
hours, or on weekends or public holidays.
Primary Health Care Services will be provided during agreed business hours.
4.2
Entry
The Services will commence when a child or young person enters a CYF Care and Protection or a
Youth Justice Residence.
Each Service User in a Residence is eligible to receive the Services and to be referred to receive
DHB funded health services, where access for Service Users is determined clinically, based on
principles of levels of need and ability to benefit.
DHB funded services are to be accessed wherever possible. Where private service providers
need to be accessed, or co-payments apply for publicly funded services, CYF will consider funding
the service as appropriate to their role (refer to Appendix One Table 7).
4.3
Exit criteria and transfer
The Services described within this service specification will be discontinued following discharge of
the Service User from the Residence, or transfer to another Residence of facility. Refer to 5.1.7 –
Discharge Planning.
5.
Service Components
5.1
Processes
Consent:
No Service User will be required to undergo any medical or dental examination or treatment
without the Service Users consent, except where another person is authorised to make that
decision on behalf of the Service User7. Where the Service User is assessed as not being
competent to grant consent8, their guardians must be involved in decisions about health services.
Parents, guardians and caregivers will be informed about decisions that significantly affect the
Service User9.
The Service Users will receive the following assessments and clinical services:
5.1.1
Assessment
Assessment will support multi-disciplinary review, discussion with the Service User and their
health care planning.
Following triage assessment on admission (see 5.1.1.1 below) and medical assessment (see
5.1.1.3 below), a comprehensive Health Care Plan (Medical and Nursing) will be developed
and updated during the Service User’s stay in the Residence. The Services will be delivered
in accordance with the Service User’s Health Care Plan.
5.1.1.1
Triage assessment on admission
Each Service User will receive a triage assessment within 24-4810 hours of entry to the
Residence to identify and prioritise their immediate health needs and the appropriate
action or treatment required. The assessment will usually be undertaken by a nurse
6
These hours are negotiated between the Provider and the Residence, and the DHB of Service.
Regulation 14 (3) – Children, Young Persons and their Families (Residential Care) Regulations, 1996.
8 A Service User who is competent to give consent will be young persons aged 16 years or older and those who are
assessed as able to understand the explanations given about procedures/treatment/consequences and assessed as
able to make informed decisions.
9 Section 8 – Children, Young Persons and Their Families Act, 1989.
10 This timeframe excludes weekends and public holidays.
7
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and include communicable diseases, infection, immunisation status, fractures,
lacerations, infestations, suicide and self-harm risk and medication (to ensure the
Service User has access to their regular medication).
Where a Gateway Assessment11 has been completed in the community this
assessment should be sent to the Residence and be available on admission to the
Provider.
5.1.1.2
Nursing assessment
Triage assessment on admission is followed up by a comprehensive nurse-led age and
development assessment using the HEADSS assessment12 or equivalent tool at the
clinically determined time. Ongoing, clinically indicated nursing assessment will be
undertaken.
5.1.1.3
Medical assessment
The Service User will be examined by a registered medical practitioner within one week
of being admitted to the Residence, as indicated in the CYF Regulations13.
A registered medical practitioner will undertake ongoing medical assessment, as
appropriate.
5.1.2
Primary Health Care Services
Primary health care Services will be provided as part of the Services during agreed business
hours14. As part of a comprehensive and holistic approach, with the Service User’s consent,
family and whānau may be involved in decisions about the Service User’s health care.
The Services’ primary health care services will include:
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referral for laboratory screening and diagnostic services and pharmacy services,
including pharmaceuticals
sexual health screening and treatment
provision of, or referral to, vision and hearing screening
dental services as required
alcohol and drug assessment and treatment
mental health assessment and treatment
immunisation services (where standing orders are in place, the nurse is an
authorised non-medical vaccinator and oxygen and emergency drugs are available)
primary mental health services, and services for children and young people with mild
to moderate mental health and / or addiction issues which may include behavioural
disorders.
These services will operate in conjunction with the medical and service coordination
processes, and will build in comprehensive, proactive transition planning when the Service
User leaves the Residence (Refer to Section 5.1.6 - Discharge Planning).
The Service User will be referred to Accident and Medical Services for out-of-hours urgent or
acute care, as appropriate.
5.1.3
Service coordination/navigation
Refer to Section 6 – Service Linkages
11
A Gateway Assessment is the assessment currently being piloted by several DHBs in conjunction with MOH and CYF,
which may be rolled out nationally
12 The assessment tool Home, Education/employment, peer group Activities, Drugs, Sexuality, and
Suicide/depression (HEADSS) is a psychosocial interview tool for adolescents.
13 Regulation 14 (2), Children, Young Persons, and Their Families (Residential Care) Regulations, 1996.
14 Services delivered by the Provider will not necessarily be full time, 5 days a week. Agreed working hours will be
negotiated between the Provider and the Residence and the DHB of Service.
Health Services for Children and Young People in CYF Care and Protection and Youth Justice
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Service coordination will generally be provided by nursing or allied health clinicians who have
service coordination experience. Service coordination will be supported by the appropriate
multi-agency, multidisciplinary team, including CYF, Provider and DHB staff, and other
agencies/sectors as appropriate (eg, ACC).
Following assessment, timely access for the Service User to the primary and specialist health
care services is important because of the limited time Service Users are in the Residence
and the need for their discharge planning.
The Service Coordinator/Navigator has responsibility for ensuring referrals recognise the high
health needs of the Service Users, that they are appropriately prioritised as facilitated
between the Provider and the DHB, and that this process occurs efficiently and effectively.
Refer also to clause 6 – Service Linkages.
5.1.4
Health education/promotion
The Provider will support the health and wellbeing of Service Users by providing health
education services, advice on nutrition and physical activity and delivery or referral to
relevant services such as smoking cessation.
The Provider will work collaboratively with other agencies to develop and deliver
appropriately prioritised health promotion initiatives within the Residence.
5.1.5
Intersectoral collaboration
The Provider will work as part of a strong effective multi-disciplinary / multi-agency team to
support both the Service User and effective discharge planning. This includes participation in
multi-agency planning meetings and liaison with CYF staff, special education providers, and
other relevant agencies as and when appropriate.
5.1.6
Discharge planning
Prior to discharge the Provider will use its best endeavours to ensure appropriate health
referrals are in place, and if discharged to the community that the Service User is linked back
to a primary health care provider. As appropriate, the primary health care provider or the
CYF Social Worker will be asked to follow up and encourage and assist the Service User to
engage with any health service provider to which he/she has been referred.
If the Service User does not have a primary health care provider, the CYF Social Worker will
be asked to encourage the Service User to link back with a primary health care provider.
The Provider will work collaboratively with staff in the residence to document discharge plans
in the Service User’s Transition Plan, and these plans will also be recorded in the medical
record in the Residence’s patient management system.
The discharge plans will be sent to the Service User’s CYF social worker, the nominated
Primary Care Provider, Prison Medical Officer and/or clinical staff in the subsequent
residential placement. Staff will make themselves available to talk about the Service User
with relevant staff in the new placement, and will be involved in a case conference, or
facilitate this, when appropriate.
5.2
Settings
Clinical services and coordination services (where possible) will be based within the Residence.
Considerations in determining these settings should include (but are not limited to) accessibility,
cultural appropriateness, workplace and physical safety of the practitioner and Service User, and
the effective and efficient use of resources.
Health services will be provided on site where this is able to be negotiated. When this is not
possible, consultations / appointments will be made at offsite facilities. The Provider will request
timely access for the appointment because of the limited time Service Users are in the Residence.
Health Services for Children and Young People in CYF Care and Protection and Youth Justice
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Service Users will attend offsite appointments with CYF escorts who are responsible for the
Service User.
5.3
Support Services
Interpreting services (including sign language), if required, will be provided by CYF.
5.4
Key Inputs
Service provision will be guided by multi-disciplinary teams. Team members should be people with
skills and experience in clinical assessment, diagnosis, treatment, investigation, referral and followup services, and who belong in one of the following categories:
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registered health professionals regulated by the Health Practitioners Competence
Assurance Act 2003
practitioners who are regulated by a health or social service professional body
practitioners who interact with Service Users and who are not subjected to regulatory
requirements under legislation or by any other means.
The staff providing the Services must:
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be appropriately screened as required by the Vulnerable Children Act 2014
be appropriately trained and skilled in child and adolescent health and development
have training in cultural safety
provide care within their authorised scope of practice and competence
use recognised tools and processes (eg, HEADSS assessment)
have a profile acceptable to CYF that enables them to work on site in the Residence.
Providers and CYF should discuss this before any appointments are made.
Staff providing the Services will be provided with professional support and supervision, and
operate in a team environment. Where necessary, standing order arrangements will be in place
and regularly reviewed.
5.5
Equipment
The Provider is responsible for:
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providing clinical equipment that enable the provision of the Services and complies with
current clinical standards and codes of practice, for use by the health staff
consumables used in the Residence.
There are a range of circumstances where CYF is expected to contribute to or fund the cost of
equipment for Service Users as outlined in Appendix One Table seven.
The medical room will contain relevant agreed office and clinical equipment which are maintained,
serviced and calibrated to the required standards by the Provider and paid for by CYF. A
reasonable set of relevant clinical equipment will be negotiated with each health provider.
5.6
Facilities
CYF will provide safe, confidential and clinically appropriate health facilities for the provision of
Services within the Residence. This will include office and medical rooms equipped with
appropriate furniture including a computer with broadband internet connection, a printer, a scanner,
and a fax.
CYF will ensure the computer hardware and software (i.e. the electronic patient management
system) are maintained and supported (Staff training in the patient management system is the
responsibility of the Provider).
6.
Service Linkages
The Services will work to develop effective working relationships with services / agencies that
reflect the size and scope of the relationship they have with each organisation and the degree of
cooperation required between them. These linkages will facilitate open communication, continuity
Health Services for Children and Young People in CYF Care and Protection and Youth Justice
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of care, smooth referral, follow - up and discharge processes to ensure that the following principles
are acknowledged:
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a continuum of care from primary health care services through to secondary / tertiary and
back to primary health care services, including those services funded via other funding
streams
safety for at-risk children through linkages with Police, CYF, and DHB Memorandum of
Understanding for Care and Protection of Abused Children in Hospital
intersectoral linkages with social, education and voluntary services involved in the care and
support of the child or young person and their family and whānau
clinical consultation and referral services that support clinical pathways
linkages with other funders and providers, including community and social services, support
seamless service delivery and continuity care is maintained.
Appropriate linkages will be made with some or all of the following agencies in Tables two and
three.
The costs of liaison and linkage with these services are included within this Service price. The
costs of the services delivered by other providers are included in their agreements, and not this
Agreement.
Table 2: Service Linkages with Health Services/Agencies
Service Need
Provider(s)
After Hours Services / Accident & Medical Services
Oral health
Any after hours medical centre
Mobile Dental Services or School Dental Clinic
Any DHB contracted community dental practice
[Service Agreement for the provision of Oral Health
Services for Adolescents and Special Dental Services
for Children and Adolescents]
Services for dental trauma are funded by ACC
Private dentist
Any DHB contracted community pharmacy
Any DHB contracted community laboratory/diagnostic
provider
DHB funded specialist mental health provider
DHB funded Sexual Health Services
DHB Alcohol and other Drug (AOD) Services
DHB Hospital specialist services
Pharmaceuticals
Laboratory tests and other diagnostic services
Moderate to severe mental health problems
Sexual health
Drug & Alcohol issues
Other specialist secondary and tertiary services (e.g.
medical / surgical services)
Maternity Services
Immunisation
Well Child / Tamariki Ora Services
Māori Health Service, Whānau Ora Service
Māori support and advocacy services
Pacific Health Service
Population health services
e.g. smoking cessation, nutrition & physical activity
Disability Services
Lead Maternity Carer, DHB Community Midwives or
Secondary Maternity services
Authorised non-medical vaccinator
Providers who are publicly funded by the MOH
Services funded by the DHB, MOH or other
Government Agency
Services funded by the DHB
Services funded by the DHB or MOH
Needs Assessment Service Coordination (NASC) or
other relevant disability service funded by MOH
Health Services for Children and Young People in CYF Care and Protection and Youth Justice
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Table 3: Service Linkages with Non-Health Agencies
Agency
Nature of the Linkage
Accountabilities
Child, Youth & Family
(CYF)
Liaise and work with CYF
Residence and Community
social work staff
Schools, and Special
Education providers,
including organisations
responsible for assessing
learning disabilities
Interagency Co-ordination
(Strengthening Families;
Home Interactions
Programme for Parents
and Youngsters Families)
Refer or liaise re individual
Service Users as appropriate
Work as part of an effective
multidisciplinary/multi-agency team with
respect to Service Users and provide
information, education, advice and support to
Residence and community staff including
support for discharge planning
Work with other relevant professionals
whenever there are concerns relating to a
particular Service User
Attend or instigate interagency
co-ordination meetings as
appropriate
8.
Quality Requirements
8.1
General
Work as part of a multidisciplinary/multi
agency team with respect to Service Users
and provide information, education, advice
and support including support for discharge
planning
The Provider must comply with the Provider Quality Standards described in the Operational Policy
Framework 15or Crown Funding Agreements, contracts or service level agreements, as applicable.
The Services will be delivered in full compliance with relevant legislation including:
•
•
•
•
New Zealand Public Health and Disability Act 2000
Health and Disability Services (Safety) Act 2001
Health Practitioners Competence Assurance Act 2003
Vulnerable Children Act 2014.
8.2
Acceptability
The Services must meet the following:
8.2.1
Confidentiality of Personal Health Information
Under Part 6 of the Children, Young Persons, and Their Families (Residential Care)
Regulations 1996 (the Regulations), CYF has a duty to maintain certain records including
certain health information in relation to Service Users. Subject to any legal reason for
withholding the information the Provider must provide to CYF information required under
Part 6 of the Regulations to be on the Service User’s record.
Staff providing the Services will work in accordance with the Health Act 1956 and the
Health Information Privacy Code 1994 and the Regulations.
All Service Users’ personal health information will be kept securely and confidentially in the
CYF Residence. Access levels will be managed by the Provider according to nationally
consistent protocols (agreed with Providers, clinicians and CYF) that meet legislative and
regulatory requirements. Such protocols will be clearly described, practised and auditable.
In consultation with the Provider and Privacy Commissioner, and in accordance with the
Health Act 1956 and Health Information Privacy Code, CYF is responsible for developing
and maintaining policies and procedures that ensure health information contained in the
patient management system and not required for the records required to be kept under Part
15
The Operational Policy Framework is updated annually by the Ministry of Health and is published on
http://nsfl.health.govt.nz/accountability/operational-policy-framework-0
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6 of the Regulations, is kept confidential to the Provider, and is not available to any CYF
staff unless there is a legal or safety obligation for this to occur.
8.2.2
Effective Communication and Informed Consent
Wherever possible and practicable, when clinical information about a Service User is to be
transferred to a third party, the Service User should be involved in the consent process.
(See also regulation 58 of the Regulations.)
8.2.3
Maintenance of Clinical and Medication Records
All the Provider’s health practitioners will maintain appropriate clinical records using the
electronic patient management system (MedTech) provided by the Ministry of Social
Development and make these records available to other health practitioners caring for the
Service User at the Residence. Appropriate summary records will be available for
Residence staff.
Subject to the legal obligations information will be shared to enable health services
appropriate to the Service User’s needs to be delivered. This will include the maintenance
of a timely report to Residence staff on active health issues that impact on the daily
management of the Service Users.
8.2.4
Compliance with Legislation and Standards
Services provided will be delivered in compliance with appropriate health and disability
sector standards including the Health and Disability Sector (Safety) Standards Act, the
Health and Disability Commissioner’s Code of Patient Rights, and the Health Information
Privacy Code.
8.2.5
Audit
The Provider may be included in audits conducted in conjunction with the Residence audit
processes. The Provider will also be subject to audits conducted by the DHB.
8.3
Communication and Reporting Lines
Staff providing the Services will report to their own management. Similarly Residence staff are
CYF employees and will report to the Residence Manager.
Any disputes are to be resolved through local negotiations in the first instance, acting in good faith
and DHBs and CYF National Office are to be advised of any problems in writing within 10 working
days if the dispute is unable to be resolved through these reporting lines.
9.
Purchase Units and Reporting Requirements
Purchase Units are defined in the joint DHB and Ministry’s Nationwide Service Framework
Purchase Unit Data Dictionary. The following Purchase Unit applies to this Service.
Table 4: Purchase Units
PU Code
PU
Description
PU Definition
PU
Measure
PU Measure Definition
COCH0026
Service for
children and
young people
entering CYF
Care &
Protection or
Youth Justice
residences
First health assessment for
children and young people
entering Child Youth & Family
(CYF) and youth justice
residences. Includes the
coordination of a range of health
services to meet the service
users’ needs. The service is
provided by Doctors, nurses or
allied health clinicians.
Service
Service purchased in a
block arrangement or
uniquely agreed at a local
level.
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9.1
National Data Collections and Additional Reporting Requirements (Minimum Data Set)
Table 5: Data Collections
National
Each Service User must have an accurate NHI* number.
Health Index
NHI level data will be reported in the quarterly and annual reports in a non(NHI) level
identifiable way to show the range of residents in the facility based on:
data
 Age
 Gender
 Ethnicity to Level 2
 Domicile by DHB on admission
 Average length of resident stay.
DHBs will not have access to Service User’s identifiable NHI data.
*Note: Service utilisation information at National Health Index (NHI) level (or its subsequent
equivalent) is required to assist with health service utilisation reviews for the purpose of service
monitoring, planning and development. The information is used for statistical and analytical
purposes in a form in which the Service Users are not identified. As this Service forms part of a
national initiative comprising similar services in other districts the DHB may provide summarised
reporting information to all DHBs, the Ministry of Health and CYF to assist with future service
planning and funding.
9.2
Quarterly Reporting
The Provider will provide Quarterly reporting as described in table six directly to the DHB, at the
following time points:
Reporting Period
1 July – 30 September
1 October – 31 December
1 January – 31 March
1 April – 30 June
Report Due
20 October
20 January
20 April
20 July
DHBs are requested to forward a copy of the Provider’s quarterly report to CYF.
Health Services for Children and Young People in CYF Care and Protection and Youth Justice
Residences tier two service specification September 2015
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Table 6: Quarterly Report Requirements
Quarterly Report
Quarterly Summary
Narrative Report
Number of admissions
Number of discharges
Admissions by age, gender and ethnicity (Level 2)
Admissions with a Nurse Assessment within 48 hours of admission
(Number and %) [Reasons for exception to 100% completion and the
mitigation strategy to be reported in the Narrative Report]
Admissions with a Medical Assessment within one week of being admitted
(Number and %) [Reasons for exceptions to 100% completion and the
mitigation strategy to be reported in the Narrative Report]
Number of Nurse Consultations16
Number of Medical Consultations
Consultations by other members of the health care team
Referrals by Service Type
- Publicly funded specialist services – specified by type e.g. Allied
Health, Medical, Surgical, Paediatric, Mental Health, Sexual Health,
Alcohol and Other Drugs, Other
- Dental
- Vision Hearing Testing
- Disability Services
- Privately-funded health services (identify what services were
funded)
- Other.
Summary for the quarter:
- Exception Reporting and mitigation strategy for nursing or medical
assessments outside the required admission timeframes
- Human resources [number, FTE, and designation of Provider staff
for the Services]
- Successes, initiatives, opportunities, issues, risks, barriers,
emergent trends, lessons learnt in delivering the service.
16
Person working within a nursing scope of practice
Health Services for Children and Young People in CYF Care and Protection and Youth Justice
Residences tier two service specification September 2015
Nationwide Service Framework
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Appendix One: Funding
Allocation of Funding
DHB funded services will be available to Service Users on an appropriately prioritised basis, and it
would only be for exceptional reasons that additional funding would be provided from this funding
pool e.g. specialist mental health services that can not be met within the current provider arm
capacity.
Funding Responsibility
Table seven itemises funding responsibility for various aspects of care. CYF is responsible for
private consultations and co-payment charges.
Table 7: Funding Responsibility
Service
GP/nurse
consultations
After hours visits
(when the
GP/nurse is not
normally present
at the residence)
Consultations with
Specialists,
including mental
health services
Example
CYF
funding
No
Primary health care services delivered by the
contracted health provider (including services by
the contracted GP) do not incur a charge.
After hours medical
consultation
Yes
CYF is responsible for full charges associated with
visiting a primary care provider who is not the
Provider contracted by the DHB to provide services
in the Residence – i.e. is treated as a casual
patient.
DHB outpatient
services
No
There is no charge for public hospital outpatient
visits or services as an inpatient.
Private clinic
consultation
Yes
Unless specified and agreed in the contract
between the DHB and provider, CYF is responsible
for specialist consultations in the private sector.
ACC will fully subsidise a consultation with a
specialist if the health issue is covered by ACC.
ACC part charges
Part
ACC covers the costs for approved sexual abuse
counselling.
Private counselling
Yes
Publicly-funded primary or specialist mental health
services are covered by DHBs. CYF is responsible
for the cost of private counselling.
Prescription part
charges
Part
CYF is responsible for prescription co-payments
and any part charges.
CYF is responsible for medicines that are not listed
on the Pharmaceutical Schedule.
OTC medications for
use by residents–
e.g. paracetomol,
acne and sun block
cream, vitamin and
mineral supplements
Yes
CYF is responsible for over the counter medications
provided to or used by Service Users.
Blister packaging
Yes
CYF is responsible for the costs of compliance
packaging.
No
Consumables used by the Provider are the
responsibility of the Provider.
ACC will cover the costs of equipment for wound
dressings (up to a certain level). The Provider can
claim on this from ACC (refer to the ACC
Guidelines).
Part charges
Counselling
Medications
Consumables
Explanations
Wound care,
examination and
chronic illness
consumables
Health Services for Children and Young People in CYF Care and Protection and Youth Justice
Residences tier two service specification September 2015
Nationwide Service Framework
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Service
Example
First aid equipment
eg, slings, dressings,
saline
Equipment to help
people manage
Medical
conditions
Physiotherapy,
Chiropractic,
Osteopathy,
Acupuncture ,
Podiatry
CYF
funding
Explanations
Yes
CYF is responsible for the cost of general first aid
equipment used by staff.
Orthotics, asthma
spacer, crutches
Part
Public health funding (refer to the Service Coverage
Schedule) or ACC meets the cost of some devices.
CYF is liable for part-charges. CYF is responsible
for co-payments and any part charges.
If crutches are supplied by the DHB they are at no
cost. CYF is responsible for any additional costs
outside of this.
ACC part charges
Part
CYF is responsible for any part charges.
Non ACC
Yes
CYF is responsible for services that are not
publicly-funded.
See
explanation
Publicly-funded services provided by a DHB
dietitian do not incur a charge
CYF is responsible for private services.
Dietitian
Face to face or telephone interpreting services.
Interpreting
For interpreting in
languages other than
English.
Yes
Laboratory
Part charges
Part
CYF is responsible for part charges (if any).
ACC part charges
Part
CYF is responsible for part charges for private
diagnostic imaging if the injury is covered by ACC.
Non ACC
Yes
Diagnostic Imaging services undertaken in a
publicly-funded DHB service are at no cost. CYF is
responsible for services in the private sector.
See
explanation
Up to 18 years of age there is no charge to access
a DHB funded service – either the Community Oral
Health Services for Children and some Adolescents
dental service or a dentist for a range of services
under the Service Agreement for the Provision of
Oral Health Services for Adolescents and Special
Dental Services for Children and Adolescents
(commonly known as the ‘Combined Dental
Agreement’ or CDA
Publicly-funded hospital dental services normally do
not incur a charge, but some services may have
small co-payment depending on eligibility criteria
(eg, removal of wisdom teeth).
Diagnostic
Imaging
Routine dental
Dental
ACC part charges
Orthodontic care
Part
See
explanation
ACC meets the cost of dental consultations
associated with injuries, but there may be a part
charge.
Requires prior approval by CYF. Some services
are available under the Combined Dental
Agreement or Hospital dental services. Hospital
Dental Services are provided free to children and
adolescents aged 0 up to their 18th birthday:
- that are covered in the scope of the CDA, and
- orthodontic treatment for the correction of severe
Health Services for Children and Young People in CYF Care and Protection and Youth Justice
Residences tier two service specification September 2015
Nationwide Service Framework
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Service
Example
CYF
funding
Explanations
congenital craniofacial abnormalities and
malocclusions.
Optometry
(glasses)
Vision Hearing
Testing (VHT)
Audiology
(hearing)
Charges over
health’s limit
Part charges
See
explanation
Refer to the Service Coverage Schedule or Ministry
guidelines for subsidies for children’s glasses and
vision tests. http://www.health.govt.nz/yourhealth/conditions-and-treatments/disabilities/visionloss/subsidy-childrens-glasses-and-vision-tests
See
explanation
DHBs provide publicly funded VHT and audiology
services. CYF is responsible for private services.
Refer to the Service Coverage Schedule and
Ministry’s Guidelines on Hearing Aid Funding
Scheme.
http://www.health.govt.nz/publication/guide-gettinghearing-aids-hearing-aid-funding-scheme
Health Services for Children and Young People in CYF Care and Protection and Youth Justice
Residences tier two service specification September 2015
Nationwide Service Framework
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