Undertake a priority response for an unborn child

The purpose of undertaking a priority response before the birth of a child is to: 

• assess the likelihood that the unborn child will need protection after their birth 
• offer the pregnant person help and support to reduce the likelihood the unborn child will be in need of protection.

Any action taken by Child Safety to assess the safety of an unborn child after their birth must not interfere with the rights and liberties of the pregnant person. 

Before commencing the assessment

Before commencing an assessment for an unborn child:

• plan the assessment (Refer to Plan the priority assessment.)
• consider whether there would be increased risk for the unborn child after their birth, if the pregnant person were alerted to the concerns. (Refer to Delay having contact with the pregnant person.)

Delay having contact with the pregnant person

Before having contact with the pregnant person, the senior team leader will decide if it is necessary to delay contact with the pregnant person until after the child is born.

The decision to delay having contact with the pregnant person until after the child’s birth will only occur if there is a high probability that, if alerted to the concerns, the pregnant person would relocate or cease engaging with medical support and intervention to avoid Child Safety intervention at the time of the birth, placing the newborn baby at increased risk of harm.

When the decision is made to delay contact with the pregnant person:

• The senior team leader will record the rationale and date of the decision to delay contact with the pregnant person in the assessment case in Unify.
• Complete a HRA Form 1 unborn child high risk alert (HRA Form 1) in Unify. (Refer to Complete an unborn child high risk alert.)
• Close the priority response with the outcome of no assessment completed. 

Commence the priority response 

A priority response for an unborn child can only have a 72 hour timeframe. Take one of the following actions to commence a priority response within the allocated response timeframe: 

• contact the pregnant person
• seek and receive new, relevant information that informs the assessment about the safety of the unborn child after they are born from an external agency, including
  • a government or non-government agency
  • a service provider, including National Disability Insurance Agency (NDIA) and National Disability Insurance Scheme (NDIS) providers
  • a health professional, such as a general practitioner.

In Unify:

• record the date the action is taken as the date of commencement
• record what action was taken to commence the priority response.

Do not proceed with a priority response if, at the outset:

• the pregnant person states that they were never pregnant or are no longer pregnant, due to a miscarriage or termination
• it has been confirmed with their medical practitioner (or reasonable attempts have been made to do so).

Assess the concerns

Contact the pregnant person to:

• advise that a notification has been recorded and Child Safety needs to meet with them to assess the likelihood that the unborn child will be in need of protection after the child’s birth, and what help and support they might require to keep their child safe after the child’s birth
• ask if they consent to having a person from another agency be a part of the assessment with Child Safety, if a co-response is being considered
• advise them that they are able to have a support person 
• respond to any question the pregnant person may have about the process
• make a time to visit and interview with the pregnant person.

Once the pregnant person has agreed to engage with Child Safety, assess the likelihood that the unborn child will be in need of protection after the child’s birth, including:

• the level and type of risk to the child after the birth
• the services that may assist the pregnant person, where relevant, her partner or the father of the unborn child, to reduce the likelihood the child will be in need of protection.

Use the following to inform the assessment:

• the risk and protective factors relating to children, and in particular, those for high-risk infants. (Refer to the practice guide Infants at high-risk.) 
• relevant information about cultural factors for Aboriginal and Torres Strait Islander children, gathered during the assessment.

Assess concerns about an Aboriginal or Torres Strait Islander unborn child

For a priority response in relation to an Aboriginal or Torres Strait Islander unborn child, arrange an independent person to help the pregnant person and the child’s family to participate in the assessment, if the pregnant person consents to this (Child Protection Act 1999, section 22(3)).

If the pregnant person consents to having an independent person, arrange for the independent person’s involvement and record relevant information in the independent person tab in Unify. (Refer to Procedure 5 Arrange for an independent person to facilitate the child’s and family’s participation.)

If the Family Participation Program has not accompanied Child Safety on the initial home visit during an assessment about an Aboriginal or Torres Strait Islander unborn child:

• give the pregnant person the brochure Aboriginal and Torres Strait Islander Family Participation Program – Strengthening your family's voice during child protection decisions and the contact details of the local Family Participation Program
• seek the pregnant person’s agreement for the Family Participation Program to contact them to discuss their service and how it may support and assist them and the unborn child’s family during any future contact with Child Safety. 

Refer to Work with the Family Participation Program.

Safety assessment

Do not complete a safety assessment for an unborn child unless the child is born before assessment is approved.

Consider a Suspected Child Abuse and Neglect team referral

Consider a referral to a SCAN team, if coordination of multi-agency actions and/or expert advice from more than one core member representative is required to effectively assess and respond to the protection needs of the unborn child. (Refer to the Consider a Suspected Child Abuse and Neglect team referral.)

Assess concerns about an unborn child and their siblings

If an unborn child and their siblings are listed as subject children in a notification, assess the concerns specific to the unborn child, in addition to those relating to the siblings. 

If it becomes apparent during an assessment for a child that a parent is pregnant, decide whether the unborn child will be recorded as a 'subject child' or an 'other child' in Unify. If it is decided that the unborn child is a subject child, assess the needs of the subject children, as well as those for the unborn child after they are born.

Take action when a pregnant person cannot be engaged in the assessment

If the pregnant person exercises their right not to participate in the assessment regarding the unborn child, they cannot be compelled to participate in the process.

In this circumstance:

• Speak to the pregnant person and explain that the assessment will be finalised with a no assessment completed outcome, and that Child Safety may need to assess the child’s safety at birth if they do not participate. 
• Use the template Engagement letter—Aboriginal or Torres Strait Islander unborn child or Engagement letter—non-indigenous unborn child to provide written advice to the pregnant person about
  • the assessment process, including Child Safety’s obligation to assess whether the unborn child will be in need of protection after the child is born
  • the pregnant person’s rights
  • help and support the pregnant person may access during pregnancy to decrease the likelihood the unborn child will be in need of protection after the child is born.
• Consider using the differential pathway Contact with other professional. (Refer to Consider the differential pathway.)

If after reasonable attempts, a pregnant person remains unwilling to engage in the assessment and:

• the differential pathway cannot be used
  or
• the differential pathway was used, but the information provided by the other professional suggests increased risk to the unborn child after the child’s birth
  
  take the following action
• Complete an HRA Form 1 in Unify. (Refer to Complete an unborn child high risk alert.)
• Close the priority response with a no assessment completed outcome.

Take action when a pregnant person cannot be located

If the pregnant person cannot be located after reasonable attempts have been made to locate them:

• Seek information from external agencies to inform the assessment, if possible.
• Complete an unborn child high risk alert HRA Form 1 in Unify. (Refer to Complete an unborn child high risk alert.)
• Close the priority assessment in Unify with an outcome of No assessment completed.

Complete an unborn child high risk alert

Complete an HRA Form 1 in Unify when:

• a decision has been made by a senior team leader to delay contact with a pregnant person
• a pregnant person cannot be located after reasonable attempts have been made to locate them
• the pregnant person did not engage with Child Safety or another professional using the differential pathway during the assessment.

To complete the alert:

• Complete and forward
  • an HRA Form 1 in Unify by selecting the New unborn child HRA button in the planning tab in the assessment case in in Unify and
    • select the hospital/s where the pregnant person is likely to give birth. (Refer to the Queensland Health Unborn child high risk alert contact list)
    • record details of the nominated RIS, who will be notified upon the birth of the child by Queensland Health
    • submit the form for approval prior to sending it via email
      and/or
  • forward a letter to the private or interstate hospital/s where the pregnant person is likely to give birth.
• In exceptional circumstances only, where the pregnant person is highly mobile and it is not possible to identify the hospitals where the pregnant person is likely to give birth
  • complete the HRA Form 1 in Unify and select the email group Statewide_HRA@csyw.qld.gov.au (this will ensure that the email will be sent to public hospital child protection staff throughout Queensland, and to the Mater Hospital).
    and
  • send a letter to the private or interstate hospital/s where the pregnant person may be likely to give birth (see note below).
• Telephone the hospitals to confirm receipt of the HRA Form 1 or letter and attach the letter to the ongoing intervention case in Unify
• Provide the CSAHSC with a Child Safety After Hours Service Centre: After hours referral and all relevant information, including a link to the HRA Form 1 and the letter.
• Record details of all actions taken in an Unborn child—risk at birth case note in the assessment case in Unify.
• Record a member of a mobile family alert on all relevant person profiles in Unify, where there is information to suggest the pregnant person is highly mobile.
• Contact the pregnant person's medical practitioner (if known) to
  • discuss the concerns identified
  • request that information be shared with relevant health professionals, such as the midwife or hospital social work services
  • ask that Child Safety be advised when the child is born.

When the HRA Form 2 is received, the following actions will occur:

• If the assessment case was closed (No assessment completed), refer to No assessment completed outcome.
• If the Assessment case was closed (Child not in need of protection outcome), the RIS will determine whether any further action is required.
• If the Assessment case was closed (Child in need of protection outcome) due to non-engagement by the pregnant person, the RIS will notify the CSSC who closed the case of the HRA Form 2. The CSSC will decide appropriate action to take to ensure the safety of the child. (Refer to Child in need of protection outcome.)
• if there is an open support service case with the pregnant person, the RIS will notify the CSSC that the HRA Form 2 has been received. The CSSC will decide appropriate action to take to ensure the safety of the child.

Decide the outcome of a priority response for an unborn child

The outcome of a priority response for an unborn child, will be either: 

• Child in need of protection
• Child not in need of protection
• Ongoing intervention continues
• No assessment completed.

Refer to Decide the outcome of the priority response.

When a decision is made to record the assessment outcome as ‘Child in need of protection’, consider whether to complete an HRA Form 1 in Unify, based on:

• whether the pregnant person has consented to a support service case (Refer to Support service case with a pregnant person.)
• whether there are concerns for the immediate safety of the unborn child following their birth. (Refer to Immediate safety concerns for a newborn child.)

If an unborn child high risk alert is required to ensure Child Safety is immediately notified that a pregnant person has presented to hospital for delivery, refer to Complete an unborn child high risk alert.

Take action after the child’s birth  

Take action following the birth of the child, depending on the case circumstances.

Open assessment case

If there is an open assessment case in Unify at the time the child is born:

• Complete a safety assessment to determine whether the child is at immediate risk of harm. (Refer to Carry out a safety assessment.)
• Proceed with other outstanding actions to complete the priority response where it was not finalised during pregnancy.

Child in need of protection outcome

If a priority response for an unborn child was finalised prior to the birth of the child with a Child in need of protection outcome, but the pregnant person either did not consent to a support service case, or withdrew her consent for the support service case, refer to Procedure 4 Take action when a pregnant woman does not consent:

• Queensland Health will send an HRA Form 2 Unborn child high risk alert to the RIS nominated on the HRA Form 1.
• The CSSC will decide the appropriate action to take to ensure the safety of the child.

No assessment completed outcome

If a priority response for an unborn child was as finalised prior to the birth of the child with an outcome of No assessment completed, and an unborn child High risk alert was recorded:

• Queensland Health will send an HRA Form 2 to the RIS nominated in the HRA Form 1.
• The RIS will assess the information, including:
  • the concerns received that formed the basis for the original notification
  • any concerns received since the original notification 
  • any information gathered since the original notification
• The RIS will decide the appropriate response to the advice that the pregnant person has presented for delivery. 

Complete an HRA Form 3 to cease an alert

Complete an HRA Form 3 cessation of unborn child high risk alert (HRA Form 3) in Unify when either:

• an HRA Form 1 has previously been sent to multiple hospitals and, following the baby's birth, the remaining hospitals need to be notified that an alert is no longer required
  or
• Child Safety has been informed that the pregnant person has had a miscarriage or termination and the relevant hospitals need to be notified that an alert is no longer required.

To cease an unborn child high risk alert in Unify:

• select the cease alert button in Unify and send the HRA Form 3 to all relevant hospitals.
• notify any private or interstate hospitals informed of the alert when the alert is no longer required.

In circumstances where a statewide alert to Queensland Health’s maternity hospitals was required before the baby’s birth and the HRA Form 1 was sent to all public hospitals and the Mater Hospital, complete an HRA Form 3 and forward it to the email address  Statewide_HRA@csyw.qld.gov.au when the alert is no longer required.

Also notify any private or interstate hospitals informed of the alert when the alert is no longer required. 

Determine which Child Safety Service Centre will be responsible for case management 

After a priority response with a Child in need of protection outcome is finalised, as outlined in Finalise a priority response, case management responsibility will be accepted by:

• the CSSC in the geographical area where the child is living
  or
• for a child with siblings in care, refer to Procedure 5 Determine who is responsible for case management
  or 
• for a pregnant person, the CSSC in the geographical area where the pregnant person is living, to ensure they have access to local support prior to the birth of the child.

If a child is living in a different geographical area to the parents, the CSSC with case management responsibility will request case work support from the CSSC in the geographical area where the parents live if required, to meet the case plan goals.

If a child is to be placed in a care arrangement with a provisionally approved carer in another geographical area during a priority response, the CSSC manager of the team undertaking the priority response is responsible for the provisional approval and the initial approval of the carer. (Refer to Procedure 6 Decide the outcome of the application.)

Request that a Child Safety Service Centre accepts case management

Prior to requesting that a CSSC accept case management for ongoing intervention:

• finalise the assessment (Refer to Finalise a priority assessment.)
• complete a child strengths and needs assessment tool for each child in need of protection and a parental strengths and needs assessment tool 
• if an application for a child protection order is being recommended
  • complete an initiating affidavit and provide a copy to the OCFOS lawyer for the DCPL, including any amendments requested by the DCPL
  • serve the respondents and complete an affidavit of service (for the initiating affidavit only)
  • provide the affidavit to the ongoing intervention team as soon as possible
• complete a referral for a family group meeting―unless a case plan was developed for an Aboriginal or Torres Strait Islander child at a family-led decision making process during the assessment. (Refer to Consider family-led decision making.)

To request that a CSSC accepts case management for ongoing intervention, the senior team leader responsible for the assessment will:

• ensure the assessment case is closed in Unify
• email the senior team leader of the relevant CSSC
• provide the Unify assessment case identification (ID)
• ask the CSSC to accept case management responsibility.

Timeframes for accepting case management

The ongoing intervention senior team leader will accept case management responsibility in writing within 5 business days of receiving the request, to ensure continuous service delivery to the child. 
If geographically possible, the CSO responsible for the priority response will facilitate a warm handover for the child and family with the CSO responsible for ongoing intervention.

Resolve issues

The CSSC managers responsible for the team completing the priority response and the ongoing intervention team will:
resolve any issues regarding the handover of case management 
address any impediments to timely service delivery to a child and family.
in line with the case transfer guidelines. (Refer to Transfer a case to another Child Safety Service Centre.)