Submission to the Inquiry into the Thriving Kids Initiative

About Access Health and Community

Access Health and Community (AccessHC) is a registered, independent community health service operating in Melbourne’s North-East for more than 150 years. We work alongside the wider community health sector to meet the health and wellbeing needs of Victorians, through Community Health First.

From 18 service locations we offer 50+ unique services spanning medical, dental, early childhood, allied health, mental health, alcohol and other drug, community services, and health promotion. In the last year we supported more than 70,000 people.

Our work is underpinned by our Service Principles, co-designed with clients:

• We remove barriers to health and wellbeing
• We are embedded within communities
• We champion health and wellbeing for everyone
• We are holistic and integrated
• We are effective and efficient.

Submission Summary

AccessHC welcomes the opportunity to contribute to the design of services that will make a meaningful difference in the lives of hundreds of thousands of Australian children and their families. AccessHC has identified three key challenges currently limiting the effectiveness and equity of early childhood services under the NDIS:

1. Fragmented and Delayed Services: Families face confusion and long wait times due to complex, overlapping funding systems and a lack of coordinated support, delaying critical early intervention.
2. Evidence-Based Services Not Supported: Current funding models, particularly under the NDIS, fail to support service delivery in natural settings like homes and schools. Recent pricing changes have made travel to these settings financially unsustainable, reducing access and effectiveness.
3. Access and Outcomes Are Not Equitable: The system does not adequately respond to non-clinical factors such as trauma, cultural background, or social disadvantage.

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Families with fewer resources or support networks often struggle to access the services they need.

To address these challenges, AccessHC recommends the Thriving Kids initiative implement four key reforms:

1. Leverage Existing Community Health Capability: Build on the trusted, local infrastructure and expertise of Victoria’s registered community health services to deliver scalable, integrated early childhood care.
2. Make Early Intervention Early: Create clear, supported pathways from universal services like Maternal and Child Health to early intervention, and embed supports within everyday settings to reduce stigma and increase engagement.
3. Focus on Outcomes, Not Hours: Redesign funding models to incentivise timely, capacity-building support that reduces long-term dependence, rather than rewarding high-volume, transactional service delivery.
4. Prioritise Equity in System Design: Ensure eligibility and service delivery models address broader vulnerabilities and support assertive outreach to reach families who are most at risk of being left behind.

These reforms are critical to building a responsive, inclusive, and effective early childhood system that delivers better outcomes for all children.

For more information about our submission please contact -

Anna Robinson

redacted

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Our Specialist Early Childhood Services

AccessHC has been delivering specialist early childhood services for over forty years. Over that time, we have developed a highly skilled specialist workforce and implemented evidence-based models of care that deliver outcomes for children and their families.

Early Childhood Model-of-Care

Our model-of-care establishes a ‘Team Around the Child’ approach (see Diagram 1) that embeds evidence-based approaches that are designed to progressively reduce dependence on supports over time through:

• Wrap-around supports that move in and out as needed
• Capacity building and active parent engagement in services
• Focus on building the child and family’s skills in context, particularly within natural settings such as the home, child-care and schools
• Strengths-based approach that celebrates every child
• Connecting families with their communities to enable and build strong support networks.

Specialist Multi-Disciplinary Workforce

AccessHC currently employs 30 Full-Time Equivalent specialist early childhood clinicians to deliver services. This includes:

• Occupational Therapists
• Speech Pathologists
• Psychologists
• Physiotherapists
• Dietitians
• Music Therapists
• Allied Health Assistants.

Our team all have a pediatric scope of practice, with specialist training in delivering services as a ‘Key Worker’, parent coaching, trauma informed care, key word sign and home visit safety. In

addition, across the team we have specialist skills including autism assessment, aquatic therapy, language devices, literacy and numeracy, feeding, sleep, continence and wheelchair.

From Early Intervention Support to Ongoing Support

AccessHC works with children and families from the moment that developmental delays are identified. Through a strong focus on early intervention, our approach is proven to reduce system dependence and progression onto the NDIS for children where this is not needed.

In 2024-25 AccessHC provided short-term, early intervention support for 1,188 children with developmental delay or emerging disabilities through the Victorian Government’s Community Health Program or Home and Community Care Program for Younger People.

These children are referred to AccessHC by local child-care services, Preschool Field Officers or Maternal and Child Health Nurses after being identified as not meeting developmental goals such as not walking at 18 months or not using functional language at 4-year-old kindergarten. Our team provides short-term support that includes participation in supported playgroups, skill-development based groups or up to six one-on-one therapy sessions.

This support is enough for most children to address their needs and ensure that they are on track to meet their development goals. However, 10 per cent of these children will progress to a multi-disciplinary team assessment due to persistent delays in two or more areas. Last year, AccesSHC facilitated 144 assessments funded through the Victorian Government Home and Community Care Program for Younger People. This is a two-hour assessment with at least two allied health clinicians to identify ongoing support needs.

As a result of these assessments children are usually supported to access the National Disability Insurance Scheme. AccessHC often continues to support children under the NDIS,

up until the age of nine. We currently support 267 children with NDIS plans and delivered 8,897 hours of services in the last year.

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Integrated Care Across Multiple Funding Streams

As a registered community health service AccessHC delivers services to children and families across multiple funding streams from both the Victorian and Australian Government. This model allows us to work flexibly to support children and families from early intervention, through to assessment and ongoing support where needed. It also allows us to leverage complementary funding that can support the family to meet their broader social and health needs, adding significant value to the early childhood services and making these more effective.

The funding model diagram (left) sets out the wide range of funding streams that we use to meet the needs of children and families.

Real Impact for Children and Families

AccessHC has implemented an evidence-based Impact Measurement Framework across our organisation, using the Personal Wellbeing Index and tailored questions to identify our impact. Our early childhood services have demonstrated exceptional impact in 2024-25:

• 92% Of families say they are able to understand the information provided to them by us
• 92% Of families say they are involved in decisions about the care or support their child
• 85% Of families say because of our service they feel more confident to manage their own health and wellbeing
• 85% Of families say that we work with them to understand what is important to them
• 92% Of families feel cared for when they access our services
• 77% Of families say because of us they have better opportunities to access other services or supports they need

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In addition, through our annual ‘Have Your Say’ survey we have heard directly from families the real difference our services make for them:

Our child has developed confidence to speak up and engage in the classroom. We also understand what he wants and needs.

My son has increased awareness of the people around him as well as his surroundings. He is now good at taking turns and sharing.

My son is now confident to navigate his world.

After the school readiness group, my son’s social skills have improved, and he has made some friends.

Quality therapy has enabled my son to catch up with his peers and relieve stress for both him and myself.

It helped me to understand my daughter and I understand how to help her.

We were so worried but now feel comfortable that our daughter is ready to start primary school.

Key System Challenges

Delivering sustainable, scalable outcomes for children and families has become increasingly difficult, particularly under the NDIS. The key challenges in the system that the Thriving Kids initiative must resolve are:

1. Fragmented, Delayed Services

Families seeking support for their children often face significant challenges due to the complexity and fragmentation of the current service system. Multiple, overlapping funding streams create confusion and make it difficult for families to understand what assistance is available or how to access it. This lack of coordination can lead to inconsistent service delivery and missed opportunities for timely intervention.

Long waiting lists for early intervention services delivered through Victorian State Government funded programs are common, caused by demand for services far outstripping available funding. Waiting lists for services often exceed six months which can make a critical difference in the trajectory for children. Where children do need to progress onto the NDIS due to the ongoing and complex nature of their child’s needs delays of six or more months to access the scheme are routine, further delaying supports.

Compounding the issue is the absence of dedicated support to help families navigate the system. Without guidance, many experience delays in accessing early care, which is critical for

achieving positive long-term outcomes for children. The overall complexity of the system not only hinders access but can also discourage families from seeking the support they need.

2. Evidence-based Services Not Supported

The current approach to service delivery under the NDIS tends to prioritise individual, transactional support rather than investing in building the capacity of families and their broader support networks. This narrow focus often leads to passive, long-term engagement with the system, rather than empowering families to take an active role in supporting their child’s development and independence.

Additionally, the NDIS does not adequately support the costs associated with delivering services in natural settings such as homes, schools, and community spaces. This has been made extremely challenging with the changes to the NDIS Price Guide announced in June 2025 that reduced the pricing for time spent travelling to deliver these services to half of the previous price. This change has meant that early childhood providers under the NDIS have had to significantly curtail travel in order to remain financially viable.

This limitation restricts the effectiveness of interventions, as support delivered in familiar environments is often more impactful and sustainable for children and their families. It also risks compounding inequity in the system as those who are least able to travel to access services because of cost, lack of public transport, or inability to take time away from work are often those who are most vulnerable.

3. Access and Outcomes Are Not Equitable

The service system often fails to recognise or respond to complexities that exist beyond clinical needs related to the child’s developmental delay or disability, such as social, cultural, or environmental factors. These significantly curtail a family’s ability to access support and can also impact on the outcomes of the child. These non-clinical challenges are not well understood or accommodated within a fragmented service system, resulting in gaps in service provision for families who may face additional barriers.

Access to services is increasingly dependent on a family’s capacity to self-advocate and navigate a complex system. Those with greater knowledge, resources, or confidence are more likely to receive timely and appropriate support, while others may be left behind, further entrenching inequity within the system.

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Recommendations for Reform

Thriving Kids has a significant opportunity to change the trajectory for hundreds of thousands of Australian children. Thriving Kids can build a sustainable, impactful service system for children by implementing the following recommendations.

1. Leverage Existing Community Health Capability in Victoria

The new Thriving Kids program presents a significant opportunity to leverage the existing relationships, infrastructure, expertise, and reach of Victoria’s registered community health services. These services already deliver care to 1 in 10 Victorians, offering a trusted, local presence embedded within communities across metropolitan, regional, and rural areas. With established community partnerships and a proven ability to deliver state-wide programs, community health services are well-positioned to form the backbone of an integrated, scalable platform for delivering early intervention and support to children and families.

Community health services bring to the table evidence-based models of care, a specialist multidisciplinary workforce, and decades of experience addressing the health and developmental needs of children within the broader context of family and community. Their holistic, wraparound approach aligns closely with the goals of the Thriving Kids program—particularly in addressing the social and environmental factors that influence child development. By building on this foundation, the program can avoid duplication, accelerate implementation, and ensure equitable access to care for children across the state.

2. Make Early Intervention Early

To improve outcomes for children and families, it is essential that Thriving Kids builds clear, supported pathways from mainstream services—such as Maternal and Child Health (MCH) services—into early intervention supports. These universal contact points are uniquely placed to identify developmental concerns early but currently lack the system integration and resourcing to facilitate timely referral and access to care. Embedding a model that prioritises rapid access to appropriate services from their first contact with the system ensures families receive the help they need without unnecessary delay or complexity. Service design should be aligned to the new Australian Government National Best Practice Framework for Early Childhood Intervention.

Embedding early supports within universal services—such as playgroups, childcare, and MCH services—also reduces stigma, increases engagement, and meets families where they are. This proactive, community-based approach allows for earlier identification and intervention, which is not only more effective for children’s development but also significantly reduces the need for

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more intensive and costly services later in life. Early investment in accessible, integrated care pathways represents both a strategic and fiscally responsible approach to delivering outcomes.

3. Focus on Outcomes Not Hours

A sustainable and effective Thriving Kids program must incentivise reduced long-term service dependency where appropriate, by focusing on early intervention and support that enables families to thrive independently. Rather than fostering ongoing reliance, the system should be designed to empower families through timely, targeted supports that address immediate needs while building long-term resilience.

Central to this is a strengths-based approach that invests in the capacity of families, their support networks, and the broader service system. This requires flexible funding models that can be used to strengthen coordination and build meaningful linkages between services—ensuring that families receive holistic, well-integrated care. By shifting focus from transactional service delivery to capacity-building and collaboration, we can create a system that is more responsive, equitable, and ultimately more effective.

4. Prioritise Equity in System Design

Effective Thriving Kids service delivery for children must go beyond a diagnosis to recognise the broader complexity and vulnerability many families experience, including factors such as trauma, intergenerational disadvantage, and social isolation. Eligibility and support should not be solely determined by clinical criteria but should take into account the full context of a child’s life to ensure that those most in need are not excluded.

To reach the most vulnerable, the system must support assertive outreach and active engagement, ensuring families who may be disconnected or overwhelmed are not left behind. Programs such as Pathways to Good Health in Victoria have demonstrated the value of targeted, trauma-informed approaches that meet families where they are and help them navigate complex systems. Building on these successful models will be key to enabling equitable access and improving outcomes for children experiencing the highest levels of vulnerability.

Case Studies

Names and identifying details in all case studies have been changed to protect privacy.

CASE STUDY #1

Introducing Noah

Noah is 6 years old and lives with his Mum and 8-year-old brother. Noah enjoys stacking boxes and pushing them over to watch them tumble. Noah attends a local primary school where an integration aide helps him to participate in daily learning and play activities.

Challenges faced

Noah and his brother were referred to Access Health and Community when Noah was 18 months old. Mum and the boys are victims of family violence and following a period where the boys were placed in state care, secured social housing. Mum was suffering significant and acute mental ill-health including extreme agoraphobia. Noah’s father was subject to a non-contact IVO with multiple breaches reported at the time of referral.

Child protection initiated the referral, and an Integrated Family Service worker commenced engagement. With significant trauma background, Mum feared contact with strangers and had a profound distrust of professionals.

Reaching Noah

The Integrated Family Services worker referred Noah to the AccessHC Child and Family team and supported a warm handover and initial appointment. A Speech Pathologist and Physiotherapist attended the family home with the IFS worker and completed a Team Screen, with a focus on rapport building and understanding Noah’s strengths.

At the time of this assessment Noah spent all day in a cot set up in the lounge room in front of the family TV. As Mum was not able to leave the home, and to manage challenging behaviours, Noah would rarely leave the cot. At 18 months, Noah was not yet walking and had less than 10 words. He preferred to be spoon-fed and refused food unless it was pureed.

Expanded Supports

With a history of family violence, Noah qualified for priority access community health supports. The Speech Pathologist and Physiotherapist attended home (joint visits for safety) over a series of appointments to complete a comprehensive assessment and commence early intervention.

The allied health staff supported goals around gross motor function (Physiotherapist) and communication (Speech Pathologist). In addition, as transdisciplinary practitioners and specialists in Early Intervention, the team supported Mum in parenting strategies such building Noah’s play skills, supporting safety around the home, facilitating sibling interactions and creating positive family mealtimes.

As Mum’s trust grew, the team were able to introduce a dietician to support progression to solid food and optimise nutrition, and a psychologist to support the formal diagnosis of Autism. Noah’s team also made a referral to AccessHC Mental Health for Mum to access her

own support and secured taxi vouchers to enable centre-based appointments with a psychologist.

Outcomes for Noah

Noah is now walking, running and participating in active play. He attends a mainstream primary school with the support of an integration aide who helps him communicate with his peers and educators and facilitates his participation in classroom learning. Noah’s early intervention team continue to support Noah by coaching and training the integration aides and working alongside the classroom teacher. The strategies they develop together enable Noah’s inclusion into all the activities of the day.

Noah would qualify to attend a school for children with Autism and for some children this may be a good option. Early intervention has empowered Noah, his family and his educators, and Noah is thriving in a mainstream school, close to the family home and with his local community.

Outcomes for Noah’s family

The outcomes for Noah’s family are profound. Mum has been empowered to understand her children. She regularly attends meetings with the educators at school to discuss progress and adapt support strategies as Noah’s needs change. For the first few years of engagement, Child Protection would call care team meetings with the Integrated Family Services worker, a housing officer and the allied health team. Mum now calls her own care team meetings, bringing together the support people in Noah’s life to coordinate services.

Mum reports a complete turnaround in her parenting experience: from fear and hopelessness, to being able to enjoy her children and to see them for the strengths they bring. Mum is proud to share with others that Noah has Autism and provides support and advice to other parents.

Conclusion

Early Childhood Early Intervention teams care for the most vulnerable in our community, working closely with other providers to deliver holistic, family-centred support. The teams empower families by building skills in advocacy and service navigation.

CASE STUDY #2

Introducing James

James was born prematurely. James’s mum does not speak English, is mildly cognitively impaired and was in temporary housing at the time of James’s birth. The maternity service identified significant risks for James and referred the family to the Enhanced Maternal and Child Health Nurse. The Enhanced Nurse assessed that James was not meeting early developmental milestones and referred James to Access Health and Community at 5 months old.

Challenges faced

James’s mum lacked basic parenting skills and struggled with significant isolation and anxiety. Without the skills to navigate public transport, James’s mum was only able to access outreach supports or those close to home.

Early Supports

James’s Enhanced Maternal Nurse coordinated a series of initial home-based appointments for James with a Speech Pathologist, an Interpreter and the Nurse present. As rapport built over time, the Speech Pathologist completed a comprehensive assessment providing information around James’s progress in all domains of development. The results formed part of several discussions with Mum to help her understand typical childhood development, the role of the parent to support development and specific strategies for James. The interpreter played a critical role in early intervention and a key to success was requesting the same interpreter for each session.

Expanded Supports

With growing confidence, Mum started being able to take James out of the house. James was internally referred to a SMALL TALK supported play group which he attended from 8 months old. James’s Mum had access to her interpreter, however several other families attending the playgroup spoke the same language.

James and his Mum stayed connected with the paediatric allied health team to address various development challenges as they arose including support from an Occupational Therapist to support toileting and dressing, and a Psychologist to support separation anxiety. The team connected Mum with information to enrol James in Childcare and supported her to share strategies with the educators.

At one stage James’s mum was particularly distressed that James was refusing to eat a wide range of foods that he had previously enjoyed. Mealtimes had become a battleground. James was internally referred to the Feeding Clinic where a Speech Pathologist (feeding specialist) and Dietician supported the family with assessment and strategies for managing fussy eating.

After two terms at the SMALL TALK playgroup, James and his Mum were supported to attend a mainstream playgroup with other families from the same language background.

Outcomes for James

James attends 3-year-old kinder now and enjoys construction play and climbing. As James progresses through 3 and 4-year-old kinder the demands will grow and James will likely need support to develop progressive skills like attention during group times, fine motor skills for drawing and writing, and skills to manage snack and lunch time routines. The allied health team work with the family and educators to provide strategies as the needs change.

Outcomes for James’ Family

James and his Mum continue to attend a mainstream playgroup and meet some of the families in a local park on weekends. The social connections mum has made during these gatherings is profound and helps to build her confidence and enjoyment in parenting.

Conclusion

Early Childhood Early Intervention teams are positioned to provide culturally sensitive supports, responsive to the changing needs of children. By building a parent’s confidence, skills and social connection, these teams deliver life-long positive impacts.