On this page
Information on how education and care services support children and young people with health needs.
This information is regularly reviewed and updated. To make sure you have the most current information and forms, access them from this page.
Children and young people recovering from an illness
Education and care services cannot support children and young people who are ill or recovering from an illness.
Education and care services need children and young people to have stable health and clear support plans.
Children or young people who recently contracted an illness, are infectious or need rest and recuperation must stay home.
Children and young people with physical, personal and mental health care needs
Education and care service must follow 3 stages to anticipate, plan and manage health support:
- develop and implement
- observation and review.
Health support planning must include:
- communication and consultation
- risk minimisation strategies
- emergency management
- post-incident and near-miss management.
There are many ways health support needs in education and care services can be identified, and many people that may identify this.
How do you identify health support needs?
On enrolment, education and care services should ask if a child or young person has any physical, mental or personal health care needs. Parents or guardians can provide education and care with the following:
- health profile (DOC 123KB) to give a summary of health support needs for their child or young person
- health care plan completed by a treating health professional
- health support agreement (DOC 131KB) and safety and risk management plan (DOC 143KB) (education and care staff can also start these).
A health support need may also be identified when:
- the parent or guardian says there is a support need but there is no health care plan
- a medical incident has occurred in the education and care service
- there is a change in health or support needs
- planning for excursions and camps
- there is increasing non-attendance.
Who can identify health support needs?
Health support needs can be identified by any person who has responsibility of care for the child or young person, including:
- the child or young person
- treating health professional
- education staff (including leadership, educators, support staff, student support services).
A health care plan, completed by a treating health professional, is not needed to develop strategies to support a child or young person with health needs in education and care.
The site leader must arrange a meeting with the child or young person, their parent or guardian, and relevant staff to discuss and develop health support and risk minimisation strategies. This must be done as soon as a need is identified.
Where there’s a delay between identifying the health need and developing a plan, the education and care service will support the child or young person to attend. Health needs can be managed with standard first aid, for example calling an ambulance. This must be communicated to the child and young person and their parent or guardian.
Health support agreement and safety and risk management plan
The health support agreement (DOC 131KB) and safety and risk management plan (DOC 143KB) are developed together by the child or young person (where possible), parent or guardian and education and care staff.
If health support needs are identified but there’s no health care plan, a health support agreement and safety and risk management plan must be completed.
In preschool, family day care and OSHC services a health support agreement and safety and risk management plan must be completed for all children and young people with health support needs.
In schools, it’s recommended that a health support agreement and safety and risk management plan is completed for children and young people with health support needs.
Strategies developed and documented in the agreement and plan must be agreed on by everyone involved. Discussions must include any risk minimisation strategies to implement to support the child or young person’s safety during attendance.
Document control for care plans and agreements
Original copies of care plans and agreements can be photocopied or scanned. Care plans should be colour copied.
Complete the document control for care plans and support agreements (DOC 155KB) to record the number and location of all copies of the care plans and agreements. Replace forms in all locations when they are reviewed and updated.
Old versions of care plans and agreements must be removed. This is to make sure only the current plan is being used. Old versions can be destroyed or kept in the child or young person’s file.
Guide to planning health support
Use the guide to planning health support (DOC 89KB) for help to complete the health support agreement and safety and risk management plan.
Health support folders
Children and young people with complex or multiple health conditions may have a health support folder.
The folder contains copies of all health care plans, management plans, first aid, medication agreements and other health support information.
The folder remains with the child or young person at all times and can be used by education and care, respite and out of school hours care staff.
Managing health in education and care
For information on specific health concerns go to managing health support in education and care.
For children and young people with complex physical or mental health go to complex or invasive health.
Funding for health support
Education and care services can apply for funding for health support if extra support is needed for the child or young person to access and participate in preschool or school.
The education and care service will need to provide evidence of the functional needs and adjustments.
Observation needs vary depending on the condition (go to managing health in education and care for specific health conditions).
Observation may include:
- the child or young person having 1 on 1 nursing support to monitor their health constantly while they attend education and care services
- the child or young person having intermittent support and monitoring for the health needs, by a nurse or health support officer
- education and care staff completing observation logs or other plans
- identifying signs of changing needs or that show health is deteriorating.
Health care plans include the date of next review. A review date is not an expiry date. If a review date has passed, the care plan can still be used until an updated plan is received. Contact the parent or guardian for an updated plan.
How often you review health care plans depends on the condition and is determined by the treating health professional. Go to managing health in education and care for health conditions.
At a minimum, the plan should be reviewed and updated when:
- symptoms increase
- there’s been a medical emergency related to that health condition
- day to day needs change.
- when the health care plan has been reviewed and updated
- as soon as possible after a medical emergency incident at the education and care service
- before the child or young person goes on camps or excursions or onsite special events (for example class parties, cultural days, fetes, sports or swimming events, incursions) where the safety and risk management plan has not addressed risk minimisation strategies for these activities
- when there’s a new medical diagnosis.
Regular and timely communication helps achieve the best outcomes for children and young people with health support needs. Communicate regularly with:
- the child or young person
- other education staff
- the parent or guardian.
Do not assume their needs are the same as others with the same condition. Recognise needs may change to day to day or month to month.
You can identify known symptoms, triggers, risk minimisation strategies and cultural, spiritual and language needs by communicating early. You can them make sure they’re clearly documented in the health support agreement (DOC 131KB) and safety and risk management plan (DOC 143KB).
General communication strategies
General communication strategies include:
- involving the child or young person in conversations about their health needs wherever possible
- letting parents or guardians know when there’s a change in support, for example when the usual support person is absent and there will be a different support person
- reminding staff of their duty of care and role in training for and responding to a medical emergency or incident
- promoting awareness of specific health conditions, and safe medication management in education and care services to parents or guardians and the wider school community
- giving regular reminders of the department’s process to manage medical emergencies.
Go to managing health in education and care for communication strategies for specific health conditions.
Education and care services must provide a safe environment and supervision to allow all children and young people to take part in and benefit from their educational experiences.
Where a child or young person attending an education and care service has a known personal, physical or mental health condition, everyone’s responsible for minimising their risk.
Risk minimisation strategies are documented in a safety and risk management plan (DOC 143KB).
The off-site safety and risk management plan (DOC 134KB) can be used to record risk minimisation strategies for camps and excursions if they haven’t been included in the safety and risk management plan.
Risk minimisation strategies should be considered for all in-school and out-of-school settings including:
- during classroom activities
- between classes and other breaks
- in canteens
- during recess and lunch
- before and after schools
- on camps and excursion
- special events
- home based care environments.
Go to managing health in education and care for risk minimisation strategies for specific health conditions.
Every education and care service must plan for a medical emergency incident.
Emergency management plan
Include the response to a medical emergency in the emergency management plan.
This should include:
- coordination and responsibilities of staff
- location of first aid kits and emergency medications
- what will happen during situations such as swimming, excursions, camps, out of school hours care and on other special occasions
- who will follow up incidents
- training and updates for education and care staff including emergency response training exercises.
Emergency response training
Education and care services undertake emergency response training from time to time to measure the response to a medical emergency across various locations and scenarios.
Emergency response training should:
- include scenarios such as emergencies during an excursion, special event or school camp
- include scenarios specific to a child or young person’s health support agreement (DOC 131KB) and safety and risk management plan (DOC 143KB)
- include as many education and care staff as possible, including out of school hours care, temporary staff, canteen and kitchen staff, sports staff and volunteers
- measure the time taken to get a first aid kit and emergency medication and administer first aid (be across various locations including the on-site location furthest from a first aid kit or emergency medication)
- measure the time taken for emergency services to arrive on location (including discussion with local emergency services providers to determine best and worst case scenarios for arrival)
- encourage improvements and updates to individual health support agreements and the local emergency plan for the response a medical emergency or incident where delays are identified.
An emergency incident or a near-miss incident involving a child or young person can be traumatic for the child or young person involved, staff, parents, peers and other people who witnessed the incident.
Education and care services should offer a post-incident debrief to everyone involved, with post-incident counselling available on an individual basis.
Department staff can access the Employee Assistance Program for confidential face-to-face or phone counselling sessions at any time.
First aid kit and emergency medication
Restock the first aid kit and emergency medications as soon as possible.
Care and support plans
Where the child or young person has an existing health care plan, encourage the parent or guardian to review this with the treating health professional.
Post-incident or near-miss management must include a review of all aspects of the emergency response process to manage a medical emergency.
The review will identify any emergency response actions for improvement.
All medication incidents and near-miss events must be reported on the incident and response management system (IRMS).
They must also be documented on the medication advice form and forwarded to the parent or guardian as soon as possible after the event. Keep a copy in the child or young person’s file.
Reporting incidents and near miss
All medical incidents that require medical treatment and all near miss medication administration incidents must be reported on the incident and response management system (IRMS) within 24 hours of the event.
Education and care staff are required to provide first aid measures following any care plan or support agreement and contacting emergency services if required. A health professional will complete an individual first aid plan (DOC 134KB) where the response isn’t standard first aid for that health condition.
For information on standard first aid response for each health conditions go to managing health in education and care.
Education and care services must have at least 1 designated first aider trained in HLTAID004 Emergency First Aid Response in an Education and Care Setting in attendance at all times. This person must be immediately available to administer first aid and emergency response medication.
Go to medication management to safely manage medication in education and care services.
You must follow standard precautions for the control and prevention of the spread of infection, and follow instructions from health authorities.
No child or young person should be treated differently. You must not compromise the confidentiality and respect for the child or young person where they have a known infectious disease.
Go to infection control and disease prevention for more information including standard precautions and exclusion periods.
Develop an environmental exposure plan (DOC 142KB), with the parent or guardian, for children and young people that need modified support to manage environmental conditions.
We’re committed to making sure children and young people with complex or invasive health needs can attend and be engaged in education.
We do not expect education and care staff to provide complex or invasive health support.
Where children and young people have complex or invasive physical or mental health or a disability, make a referral to the:
- Access Assistant Program (AAP)
- Registered Nurse Delegation of Care Program (RNDCP)
- Health Education Interface (HEI).
AAP, RNDCP and HEI do not replace existing health services but work in partnership with the child or young person, parent or guardians, education and care services and other health professionals to support the child or young person’s attendance and engagement in education.
How to access support for complex or invasive health
Where a child needs complex or invasive physical, personal or mental health support a WCHN Disability Services referral form is needed.
The referral is completed by the education or care service and parent or guardian and gives consent for AAP, RNDCP or HEI to get information about the child or young person’s health and medical needs.
Where it’s unclear if a child or young person meets the criteria for these services, the education and care service, parent or guardian can contact a referral coordinator by phone 8159 9400 or email Health.WCHNDisabilityServices@sa.gov.au.
Assessment for complex or invasive health
After accepting the referral, a health professional from AAP, RNDCP or HEI will contact the education and care service and parent or guardian to complete an assessment.
The assessment includes visits to the education and care service and home, and meetings with health professionals that work with the child or young person.
The assessment determines the level of support, model of care and resources to support the child or young person in education and care.
Level of support complex or invasive health
The Department for Communities and Social Inclusion (DCSI) Direct Health Support of People with Disability Guideline (PDF, 364KB) describes the 3 levels of health support given to people with a disability as:
Level 3 health plan
AAP or RNDCP may develop a level 3 health plan where the person supporting the child or young person needs skills outside of the standard training for their role.
Where a Level 3 health plan is in place an RN will train, assess and staff.
AAP, RNDCP and HEI staff
Resources are allocated to the child or young person depending on the level of support needed and the complexity of their health. This may include a Registered Nurse, Enrolled Nurse, Health Support Officer or further training and support for education and care staff.
Registered Nurses, Enrolled Nurses and Health Support Officers are employees of the Department for Health and Wellbeing.
There is a Memorandum of Administrative Arrangement between the Minister for Education and the Women’s and Children’s Health Network for AAP and HEI to give support in education and care services.
There any many external providers that can support children and young people requiring health support in education and care. Support can include face-to-face consultancy service, online training, and awareness packages.
See health support services and programs for information on services and programs.
Education and care staff must maintain confidentiality of all health care information for children and young people in their care.
Health information cannot be released without the permission of the parent or guardian or the child or young person where possible.
Any information sharing must meet the information sharing guidelines (PDF, 14MB).
Go to the information sharing guidelines for promoting safety and wellbeing procedure for more information.
Education and care staff
Duty of care is the responsibility to avoid acts or omissions that could potentially injure or harm others. Education and care staff must anticipate risks for children and young people and take care to prevent them coming to harm.
Harm includes both physical and emotional harm.
Consider what precautions the education and care service could reasonably be expected to take to prevent harm. Ask:
- Was the risk identified?
- What is the degree of harm that may occur?
- Did the education and care service know, or should they have known, about the risk?
Where a health support need is identified, education and care services must help develop a health support agreement (DOC 131KB) and maintain open and ongoing communication with the child or young person where possible and their parent or guardian.
Go to the duty of care policy (PDF, 648KB) for more information.
Parents or guardians
Parents or guardians have a duty of care to give correct health information for their child or young person.
Education and care services do not need a full medical history for all children and young people. They only need information that will safely support the child or young person in the education and care service.
Where health supports are needed, parents or guardians must:
- get a health care plan completed by a health professional
- help develop a health support agreement (DOC 131KB) and safety and risk management plan (DOC 143KB)
- keep open and ongoing communication with the education and care service.
Check managing health in education and care to see if you need a health care plan.
Poorly or unmanaged physical and mental health can affect a child or young person’s ability to attend and be positively engaged in education.
A large amount of school absenteeism is because of chronic illness. Up to 35% of school absences are attributed to asthma-related symptoms (Moonie et al, 2006), but other conditions such as diabetes, cerebral palsy, epilepsy, cystic fibrosis and musculoskeletal disorders also impact attendance and cognitive functioning.
A study on chronic illness and developmental vulnerability at school (PDF, 665KB) shows children and young people with a chronic illness have a 20%–35% increased risk of being developmentally vulnerable, with greater disengagement from school.
The National Mental Health Commission reports children and young people with major depressive disorder have highest average number of days absent from school per year, followed by anxiety, conduct disorder and ADHD. Children and young people with ADHD are 3 times more likely to repeat a year level, and almost 3 times more likely to drop out of school before completing their secondary schooling.
There is an increasing number of children and young people affected by medical emergencies such as anaphylaxis, seizures and asthma attacks. ASCIA (PDF, 738KB) reports hospital admissions for anaphylaxis have increased 4 fold in the last 20 years. Asthma Australia reports South Australian children have the highest hospitalisation rate across Australia.
Children and young people with physical and mental health conditions require extra supports for meaningful engagement in their education.
Health can impact how children and young people learn.
Some health conditions are life-long and require consistent strategies for support, others are unpredictable.
Health conditions can impact learning in the following ways:
- poor attendance or non-attendance
- inability to concentrate and pay attention
- inability to retain information
- lack of stamina and physical limitations
- difficulty handling time pressures and multiple tasks
- difficulty interacting with others
- side effects of some medications can include hyperactivity, irritability, aggression, drowsiness, dizziness, memory problems, problems concentrating and mood swings.
Refer managing health in education and care for specific health conditions and how they impact a child or young person’s learning.
Australian Aboriginal culture is the oldest living culture in the world, yet Aboriginal people currently experience the poorest health and education outcomes when compared to non-Aboriginal Australians. [The National Aboriginal and Torres Strait Islander Social Survey 2014-2015 shows poor education and literacy are linked to poor health status.]
The cumulative effects of forced removal of Aboriginal children, poverty, exposure to violence, historical and transgenerational trauma, the ongoing effects of past and present systemic racism, culturally unsafe and discriminatory services are all major contributors to the disparities in Aboriginal education outcomes.
To achieve the best Aboriginal education outcomes, education and care services have a responsibility to provide a culturally safe environment allowing Aboriginal children and families to draw strength in their identity, community and culture.
Aboriginal children are born into strong kinship structures where roles and responsibilities are integral and woven into the social fabric of Aboriginal societies. The primary caregiver for Aboriginal children is not always the parent or guardian. Education and care staff should consider engaging members of the extended family in the absence of parent or guardians where appropriate.
Education and care staff can secure positive long term education and wellbeing outcomes for our Aboriginal children and young people by making well informed decisions in consultation with families, based on cultural considerations.
Health support agreements (DOC 131KB) must be developed in partnership with parents or guardians. The opportunity to identify cultural needs is paramount. Education and care staff should be aware that parents or guardians may request the input of Aboriginal Community Education Officers (ACEOs) or Aboriginal Health Workers (AHW) in the development of their child’s health support agreement. The use of an Aboriginal languages interpreter or translator (PDF 191KB) should also be considered.
The Department for Education acknowledge and give thanks to the Women’s and Children’s Health Network Aboriginal Focus Group for their time and commitment to developing this Aboriginal cultural context statement for the health support planning procedure.
Note: The term ‘Aboriginal’ is used to refer to people who identify as Aboriginal, Torres Strait Islanders, or both Aboriginal and Torres Strait Islander. This is done because the people indigenous to South Australia are Aboriginal and we respect that many Aboriginal people prefer the term ‘Aboriginal’. We also acknowledge and respect that many Aboriginal South Australians prefer to be known by their specific language group(s).
What is disability?
From the Disability Discrimination Act 1992, disability is broadly summarised to include loss of bodily function, damage to bodily function, disease or illness, and disorders of thought processes, emotions, judgement or behaviour.
The Disability Standards for Education 2005 (PDF, 214KB) apply to all children and young people with a disability. They support the child or young person’s right to apply for enrolment in their local school and to provide adjustments to allow for changing needs over time.
Disability in education
The 2018 Enrolment Census of South Australian Government schools reports the number of full time equivalent students with a verified disability was over 16,000.
93.7% of students with disability in state education attend mainstream schools (mainstream class, special class or special unit) and 6.3% attend a special school.
Vulnerability in health
Children and young people with disability generally have more health needs than those without disability.
Some common conditions affecting children and young people with disability are gait abnormalities, flexibility, strength, and balance problems, eye disease, untreated tooth decay, blocked ear canals, and hearing issues.
Children and young people with disability may not present with typical signs or symptoms when they are unwell. They may have differences in the way they express pain and distress, respond to medications and behave when feeling sick.
The Australian Early Development Census (AEDC) names five domains as predictors of health and wellbeing:
- physical health
- social competence
- emotional maturity
- language and cognitive skills
Having a disability increases the chance of being vulnerable in more than one domain.
The opportunity to understand health conditions for students with disability and the way they impact on learning is one of the ways we can value people with disabilities and work towards their wellbeing and longevity.
We support the development of culturally respectful health support planning in education and care services.
We consider the political, cultural, spiritual, emotional, environmental, structural, economic and biological factors impacting the wellbeing of all children and young people.
Health support agreements (DOC 131KB) are completed in consultation with parent or guardians. We make sure they understand the content and underlying values in the Australian context. They have the opportunity to discuss their cultural perspective and needs.
The English as an Additional Language or Dialect (EALD) program supports children and young people from culturally and linguistically diverse backgrounds, and provides access to interpreter services and Community Liaison Officers (CLOs).
The Preschool Bilingual program may assist preschools to access interpreter services to support children and their families from culturally and linguistically diverse backgrounds.
Family members and friends should not be used as interpreters.
Go to health support training for links to training providers for specific health conditions and professional development opportunities.
Each health condition has information of specific training requirements identified on the webpage. Go to managing health in education and care.
Department for Education
Provide safe and healthy work environments.
Take all reasonable measures to eliminate risk of harm.
Provide access to first aid training.
Provide a process to plan for and provide health support that will enable all children and young people to have equitable and safe access to education and care services.
Provide opportunities for collaboration in the development of health support processes that involves parent/guardians and health professionals.
Site leaders (includes principals, directors, Family Day Care and Respite Care Program leaders)
Assurance that staff and families are aware of and follow the Department for Education health support planning procedures.
Ensure appropriate health support provision to enable all children and young people to participate in and benefit from their educational experience including the allocation of trained staff and specific duties related to the required level of support and supervision.
Ensure all staff complete and are up-to-date with an appropriate level of first aid training i.e. HLTAID004 Emergency First Aid Response in and Education and Care Setting for designated first aiders.
Ensure relevant staff are able to access specialised training to support individual children with health support needs.
Ensure the development and rehearsal of a medical emergency response plan.
Ensure all medications are stored appropriately, securely and are readily accessible (refer medication management).
Ensure communication strategies are implemented.
Ensure risk minimisation strategies are implemented.
Support a range of curriculum access options for children and young people requiring health support (ie distance, hospital school).
Ensure all relevant education and care staff, including out of school hours care and temporary staff, canteen/kitchen staff, sports staff and volunteers are informed of emergency response and management strategies for medical incidents.
Facilitate post-incident support (eg counselling) for any person affected by a medical emergency incident (staff, children or young people, peers, parents or parent/guardians).
Education and care staff (includes teachers, support staff, volunteers)
Have completed, and are up-to-date with first aid training and have completed additional training as required.
Know the education and care service general first aid and emergency response procedures, participate in emergency response rehearsals and understand their role in responding to a medical emergency.
Participate in the development of health support agreements (DOC 131KB) and safety and risk management plans (DOC 143KB) for children and young people in their care.
Support children and young people to become independent in the management of their health (in line with their age, stage of development and capabilities).
Plan ahead in consultation with parent/guardians of the child or young person with health support needs for high-risk curricular activities and all extracurricular activities such as excursions, camps, swimming and aquatics, class celebrations.
Regular communication with parent/guardians of children and young people in their care with health support needs, including changes to behaviour and management of the health condition.
Raise awareness about health conditions and the role others can play in minimising risk and contributing to the safety of their peers.
Identify and manage incidents of bullying of children and young people with health support needs.
Complete an IRMS report for any medical incident or near-miss (if required).
Parents and guardians
Educate the child or young person about their health condition (ie how to recognise and describe symptoms, who to alert if they have concerns).
Inform the education and care service of their child or young person’s health support needs.
Obtain a care plan from the treating health professional as required.
Participate in the development and regular review of the child or young person’s health support agreement (DOC 131KB) and safety and risk management plan (DOC 143KB).
Provide the education and care service with:
- a copy of the care plan, action plan and/or medication agreement (where required)
- all medications or equipment that are current, clearly labelled and not expired (where required).
Replace the child or young person’s medication or equipment needed, before the expiry date or when used.
Immediately inform the education and care service on changes to the medical condition or management where this impacts on attendance, engagement or where additional health support needs are required, provide an updated plan if necessary.
Notify of any changes to emergency contact details.
Work with staff and their child or young person (if appropriate) to develop strategies to minimise risks and identify roles and responsibilities of staff and families and arrangements for camps and excursions.
Assist staff in planning ahead for curricular and extracurricular activities such as excursions, camps, swimming and aquatics, class celebrations.
Child and young person (where age appropriate)
Notify another person (education and care staff, peer) when there are concerns about their health status.
Avoid exposure to known triggers (where these are identified).
Participate in development and review of the health support agreement (DOC 127KB) (if required).
Where identified to be able to self-administer medication participate in the completion of a carrying and/or self-administration of medication decision making tool (DOC 160KB) in consultation with parent/guardian and education and care staff.
Take responsibility (where appropriate) for their medication, including administration, storage, and safety.
Health support agreement
Incident and emergency management
Planning and management tools
- HSP123 Environmental exposure plan (DOC 142KB)
- HSP126 Health support plan folder cover (DOC 127KB)
- HSP127 Health support plan folder guide (DOC 135KB)
- HSP130 Document control for health care plans and support agreements (DOC 122KB)
- HSP128 Health profile (DOC 126KB)
- WCHN Disability Services referral form (DOC 284KB)
Disability and complex needs team
Phone: 8226 0515
Email: education.health [at] sa.gov.au