Submission 266 — Community Health First — Inquiry into the Thriving Kids initiative | External submission

House Standing Committee on Health, Aged Care and Disability
Parliament House
Canberra ACT 2600

3 October 2025

Community Health First submission to the\

Inquiry into the Thriving Kids initiative

About Community Health First

Community Health First is an initiative led by all 22 registered independent community health services in Victoria united by one shared goal – improving the health, wellbeing and quality of life for all Victorians.

Registered independent community health services play a unique and important role within the Victorian health and social service systems to support people at every age and stage of life. To do this, community health works at multiple levels – with individuals and families, communities and systems – to achieve improved health outcomes and lasting community impact. Community Health First partners are listed in Appendix 2.

Submission summary

Community Health First welcomes the opportunity to provide a submission to the Inquiry into the Thriving Kids initiative to contribute to the design of the system and services that will support children under 8 and their parents and families.

To inform system design that truly builds on existing community services, we encourage the inquiry to examine what can be learnt from the current model of care being delivered through Victoria’s registered independent community health sector that is making a tangible difference to lives of children statewide.

Registered community health organisations in Victoria are among the largest providers of paediatric allied health in Victoria, delivering speech pathology, occupational therapy, physiotherapy and psychology at scale alongside developmental assessments and autism diagnostic.

Our large, multi-disciplinary workforces spans occupational therapy, speech pathology, physiotherapy, psychology, dietetics, music therapy, nursing, general practice, counselling and support workers who deliver trauma informed, wrap around care that supports not just the child but their parents, families and carers to get the best outcomes possible.

Delivering a team around the child model of care
Ensuring integration with universal services and delivering services is familiar setting
A ‘one-stop-shop’ approach to support seamless transitions
Prioritising early intervention
Being trusted local providers embedded in communities

With over 250 locations statewide community health organisations already have a trusted brand, deep community relationships, robust governance, clinical expertise, and integration with universal services that families already use such as maternal child health and early childhood education. Examples of the support and services offered is provided in the case studies in Appendix 1.

Against this backdrop, registered community health organisations are well positioned to deliver a statewide platform of support for young children across Victoria and partner with government to deliver on the objectives of the Thriving Kids initiative.

Community Health First also makes the following recommendations for reform in the roll out of Thriving Kids:

Implement funding flexibility
Embed early intervention as a core principle
Invest in system navigation
Prioritise equity in system design

Partners of Community Health First would welcome the opportunity to discuss this submission and the current capabilities of our sector with the committee should further information be required.

For questions or further information please contact:
Sam Blake
Strategic Advisor, Community Health First
redacted

Community Health in Victoria

First established in 1974 by the Whitlam government, when Community Health was introduced citing a need to shift the focus in healthcare from treatment to prevention, reduce hospital demand, and present a cost-effective alternative to private general practice.

For over 50 years Victorian community health organisations have been responding to the needs of Victorian families and communities, supporting millions of people through provision of high quality and high impact services.

Registered community health services are uniquely positioned within the health system to work across the full spectrum of healthcare prevention and early intervention (Figure 3), improving long-term health outcomes and avoiding escalating healthcare costs. The ultimate goal is to reduce overall contact with health services by promoting healthier environments and behaviours, delivering evidence-based prevention programs, and intervening early to stop health conditions escalating.

Registered community health deliver support and services to over 600,000 Victorians every year, employing over 10,000 staff across over 250 sites in metropolitan, regional and rural Victoria.

The Community Health Model

Community health is built on a model of care that recognises health and wellbeing issues do not exist in isolation.

To truly meet the needs of our communities, we move beyond single-issue responses and embrace the full context of each person’s life.

This personalised and person-centred approach results in improved health and wellbeing outcomes in our communities and over 90% of our current clients reporting that the support they get from community health is personalised to their needs and the support they get from community health helps them better manage their health and wellbeing.

Community Health Services and Support

Community health provides a wide range of support and services to address the diverse needs of all Victorians. Offerings significant clinical capabilities and well-established clinical governance frameworks, alongside multidisciplinary and social models of care.

All community health organisations provide the core services that form the foundation of community health.

Each organisation then builds on the core services offering a range of additional health and social support tailored to local needs.

This unique service model allows community health organisations to deliver holistic, wrap-around support for clients.

Community Health Governance

Registered community health services are independent, locally embedded stand-alone organisations, registered under the Victorian Health Services Act 1988 (the Act) and incorporated under the Corporations Act 2001. Registration provides a framework for governance and quality standards aligned with the rest of the public health system.

While independence ensures flexibility to provide services tailored to their local communities. Community health organisations are uniquely able to attract multiple, alternative State and Federal funding sources to drive holistic, wrap around care.

Supporting Victorian Children

While community health supports people at all stages of their life, our sector is proven to be effective in supporting Victorian children and their families. These services are delivered through a number of Victorian Government funding streams including the Community Health Program, Home and Community Care for Younger People, and Pathways to Good Health. In addition, many community health organisations also deliver early childhood and paediatric services under the National Disability Insurance Scheme.

In Victoria, one in five children begins school developmentally vulnerable. In rural and regional Victoria, the rates are higher, with one in ten children experiencing significant developmental vulnerability¹. These vulnerabilities, if left unaddressed, have lifelong consequences, including poorer educational attainment, reduced employment opportunities, and increased use of health and social services throughout the lifespan.

The Victorian community health model has already proven effective in working with young children and their families to deliver targeted and effective early interventions, while also reducing long term system dependencies. This is a platform that is ready and able to scale statewide to reach more families under the new Thriving Kids initiative.

Delivering a ‘team around the child’ model of care

The community health approach is grounded in the social model of health, which recognises that factors such as economic stability, living conditions and access to education all influence a person’s health and wellbeing² ³. There is no one-size-fits-all approach; our services are designed to reflect the unique needs of each child and their families. Services are delivered a “team around the child”⁴ ⁵ model of care that provides:

Holistic wrap around support that moves in and out as needs change and concerns are addressed.

1 Victorian Government 2020, Trends from the Australian Early Development Census. Available from: https://www.vic.gov.au/trends-from-aedc 2 World Health Organisation, Social determinants of health. Available from: https://www.who.int/health-topics/social-determinants-of-health 3 Australian Institute of Health and Welfare 2024, Social determinants of health. Available from: https://www.aihw.gov.au/reports/australias-health/social-determinants-of-health 4 Luscombe, D. (2009). Team around the child: building the capacity of all. Intellectual Disability Australasia, 2009 5 Fukkink R, Lalihatu ES. A Realist Synthesis of Interprofessional Collaboration in the Early Years; 2020

Capacity building and active parent engagement to help families feel confident, connected and capable.
A focus on building skills and providing support in place and in context for the child.
Strengths based approach to care and support.
Connects families with their communities and peers.

Ensuring integration with universal services and delivering services is familiar setting

Community health organisations are embedded within the everyday platforms families already know and use, including:

Maternal and Child Health services.
Early childhood education and care.
Local schools and school health programs.
Sports club

This integration means families do not need to navigate new systems or re-tell their story and services and support is often delivered in a setting that is already known, familiar and comfortable for the child.

A ‘one-stop-shop’ approach to support seamless transitions

By combining expert clinical care with a range of social services and population health programs together in one place, we address both health and social factors simultaneously, delivering better outcomes – immediately and over the long term for children and their families.

Co-location provides a single point of entry into the health system. It simplifies the journey for the child and their family, improves referrals between practitioners and supports doctors, nurses, allied health professionals and social support teams to collaborate more effectively, which is critical for early intervention. It also means practitioners can work holistically, addressing not just developmental concerns but the broader circumstances affecting a child’s wellbeing.

Prioritising early intervention

For children and families facing new or complex challenges, early intervention is critical. Community health prioritises early intervention through building clear and easy to navigate pathways from mainstream services into family and children services within community health. These models emphasise and take proactive steps to deliver timely access, fast referrals, and connected care.

Supporting parents to support their children

Community health works with both the child and their families to ensure they are equipped with practical strategies, stronger confidence, and supportive peer networks. Community health runs evidence-based parent support programs alongside child focused supports that empower parents as the primary agents of change in their child’s daily life.

Trusted local providers embedded in communities

Community health services are deeply embedded within communities, with connections across the health and social services sector, and ensure communities are engaged within their governance and co-design and delivery of services.

Community health organisations are whole-of-life hubs, delivering services across the lifespan: from sexual and reproductive health to chronic disease management, mental health, family violence support and palliative care. This breadth means families view community health as a safe, trusted entry point where all their biopsychosocial needs are understood. This embedded presence and trust are crucial for engaging families early, particularly those who are reluctant or unable to access private providers.

Community health organisations have a core mandate to prioritise and provide accessible, culturally safe care to vulnerable populations, including those with the poorest health and greatest economic and social needs. Community health organisations have longstanding relationships with First Nations and culturally and linguistically diverse communities in their local areas and provide a range of services and support that recognise equity and intersectional issues that impact health and wellbeing across the lifespan, including with young children.

A model ready and able to scale

Community Health First has developed a detailed funding proposal and methodology for the delivery of Thriving Kids across the state, based on the recommendations from the NDIS Review. At its heart is:

Family Capacity Building support which is generally available to all families with children with developmental concerns and disability, regardless of NDIS status, and
Targeted Intensive Early Supports for children that are not eligible for the NDIS, but with needs that cannot be addressed by mainstream services alone.

The Alliance of Rural and Regional Community Health organisations (all of who are members of Community Health First) have partnered with Murdoch Children’s Research Institute to support robust research and evaluation.

Community Health First would welcome the opportunity to work in partnership with government to develop a statewide delivery platform for Thriving Kids in Victoria.

Recommendations

Based on the research and learnings of our current model and service delivery to children and families in Victoria, we make the following recommendations to the inquiry regarding broader system design:

Implement funding flexibility to support system and services linkages and improve wrap around service options for children.
Embed early intervention as a core principle of the new system design to ensure the most impactful outcomes for children and to incentivize reducing system dependency (where appropriate).
Invest in system navigation to support early intervention and seamless transitions to cut down wait times and improve the experiences of children and their families.
Prioritise equity in system design that recognises the value of diagnosis complexities, supports assertive outreach and builds on the successes of existing integrated service models such as those developed and delivered through community health in Victoria.

APPENDIX 1: Case Studies

The following case studies have been provided by a number of Community Health First partners to demonstrate the work of community health in Victoria.

Names and identifying details have been changed to protect privacy.

CASE STUDY ONE: Holstep Health

Isla*, a 2-year-old referred to Holstep Health’s Integrated Family Services, reflected this need. She showed developmental concerns in speech and feeding and experienced anxiety when separating from her mother.

Isla’s family environment was complex, shaped by trauma and intellectual disability. While the team’s initial goal was to understand her developmental needs and identify the best pathway forward, they also recognised the likely need for ongoing support for Isla and her family.

An Integrated Family Services practitioner and a Complex Disability Practitioner worked collaboratively to visit Isla’s family at home. Meeting in a familiar environment helped reduce stress and build trust. By listening to the family’s concerns and taking a culturally sensitive approach, trust grew stronger. Holding the visits at home also gave the team flexibility to adapt to challenges like sleep difficulties, which had previously caused cancelled appointments.

After the first assessment, Holstep Health made timely referrals to audiology and dietetics, and supported access to a tailored NDIS plan. Over several months, the team worked with Isla’s mother, modelling child-led play, communication strategies, and routines to support her development.

Isla was successfully enrolled in a local childcare centre, encouraging socialisation and long-term developmental progress.

CASE STUDY TWO: Bendigo Community Health Services’ Loddon Children’s Health and Wellbeing Local

Mum was concerned about her 5 year old daughter Sarah. She was worried about her behaviours, her not attending kindergarten and her transition to school. Mum also described her own health and wellbeing needs and signs of carer burnout. The family was referred to Bendigo Community Health Services’ Loddon Children’s Health and Wellbeing Local (LCHLW).

The LCHWL was able to support the family by taking some initial time to really understand the needs of Sarah, and her family. The family lived in a small regional town, and some of the appointments were able to take place in the family home and via telehealth.

Sarah was connected with mental health clinicians in the LCHWL who completed a comprehensive assessment, and the multi-disciplinary team of allied health, mental health, paediatrics and family services reviewed together the support needs and developed a family focused, wrap around plan.

A Care Coordinator was allocated to assist the family along each step of the process, and the Occupational Therapist visited the child’s school to complete an assessment and obtain further evidence for diagnosis. Some broader family support needs around parent health and wellbeing were also supported by the Family Services Practitioner in the team.

The LCHWL care team were able to complete a secondary consult with the Paediatrician at the Bendigo Community Health Services’ LCHWL, leading on to a referral being made. Sarah needed some pathology tests completed however due to her anxiety required sedation to support this process. The LCHWL nurse and care coordinator were able to support the family through this process. Sarah has now been referred through to the NDIS for ECIS, and the family has been connected with broader supports.

CASE STUDY THREE: IPC Health Brimbank Melton Children’s Health and Wellbeing Local

When Rachel and Adam sought out IPC Health for help for their daughter, Trinity, they were already familiar with the challenges of navigating the health system. Years earlier, their eldest son’s epilepsy and autism diagnoses had required countless appointments across multiple locations, extensive paperwork, and long delays.

Trinity was experiencing anxiety and handwriting difficulties. The family needed timely assessments and practical support – but with both parents working and another child at home, the prospect of repeating the exhausting process was overwhelming.

Through the IPC Health Brimbank Melton Children’s Health and Wellbeing Local, the family accessed a coordinated, multidisciplinary team under one roof. Within a week of their first call, Trinity had an intake appointment and soon after received an autism diagnosis, occupational therapy and mental health support, all delivered in the same location.

Everyone’s in the same place, talking to each other. I don’t have to tell our story 100 times, and all the different practitioners can share info on what the best care plan would be. − Rachel

The family also connected with a lived experience worker, who provided guidance on building independence, future employment pathways, and navigating housing challenges. The empathy and compassion from someone with lived experience of these challenges was invaluable.

When your child has complex needs, you need a lot of support. Having it all in one place makes a huge difference. Not just for my daughter, but for the whole family. − Adam

CASE STUDY FOUR: Access Health and Community

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.

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.

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 these sessions and a key to success was requesting the same interpreter for each session.

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. The social connections Mum made during these weekly gatherings were profound, helping her to build confidence to meet James’s needs. James and his Mum stayed connected with the paediatric allied health team to address various development challenges as they arose and have received blocks of support from an Occupational Therapist to support toileting and dressing, and a Psychologist to support separation anxiety. The Access Health and Community 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.

James attends 3-year-old kinder now and enjoys construction play and climbing. The family still attend playgroup and meet some of the families in a local park on weekends. James is not currently receiving active support from Access Health and Community, however, it would not be uncommon for James to need additional support when demands change, for example, when he needs to participate in more structured learning at 4-year-old kinder or when he transitions to school. James’s Mum knows to reach out if concerns arise in the future.

CASE STUDY FIVE: Bellarine Community Health

When Sam noticed her 2 year old son Gable struggling to hold his head up and sit properly, she initially sought help through hospital physiotherapy. While this addressed some concerns, Sam had additional worries about Gable’s head tilt and other developmental signs that needed attention. Everything changed when their maternal health nurse referred them to Bellarine Community Health.

“I felt listened to and got immediate answers,” – Sam

The Bellarine Community Health physiotherapist began working intensively on Gable’s neck muscles through targeted stretching exercises. As the physiotherapist worked with Gable on his delayed physical milestones, they began observing other developmental areas. When language delays became apparent, other specialists would “pop into sessions” to observe and assess Gable’s needs. This integrated approach led to speech therapy referrals and a transformative six-week parent group program explains. She learnt practical tools and strategies around speech and sound to support Gable at home and help him continue to develop skills.

“It was like gold because as a first-time parent you have no idea what you’re doing” – Sam

For Sam, it’s the holistic approach at Bellarine Community Health that she values the most.

“You don’t experience that in most places, you see one person usually…it’s one dimensional, that service in and out, but here it is completely different.” – Sam

Gable is now accessing occupational therapy sessions. Sam says this wrap-around approach, addressing Gables immediate needs, planning for the future and supporting the family, makes Bellarine Community Health ’s Child Hub exceptional.

“It’s not just delivering a service. It’s, how you deliver that, it just feels like you’ve just come to a safe, supportive place where everybody is his cheerleader and it’s just a wonderful place to be. It’s so positive.” – Sam

CASE STUDY SIX: Bendigo Community Health Services’ Loddon Children’s Health and Wellbeing Local

Katie is a 2 year old from a small town in Loddon Shire, She was initially referred to the Bendigo Community Health Services’ Loddon Children’s Health and Wellbeing Local (LCHWL) by a Maternal Childcare Nurse with concerns of speech, behaviour and physical developmental delays.

When the referral was received, the Care Coordinator, based in her local community, supported mum to participate in an Intake Phone Call, to establish if Katie’s referral to the LCHWL service was the appropriate next step. The first outreach appointment was organised for Katie in her nearest town in Central Victoria. The appointment was with a LCHWL allied health clinician and a family services practitioner for some initial engagement and observations. The Loddon Care Coordinator organised the dates, time and space for the outreach visit to occur, which was a relief to Mum to not have to travel into Bendigo for an appointment with Katie, and for the meeting to happen in a familiar space.

The Allied Health professional collated observations into a report, and the Care Coordinator also accessed additional clinical observations from clinicians outside of the Local (Speech Therapist from RFDS) to support the initial assessment. Approximately three weeks after this consultation and review by the LCHWL multi-disciplinary team, Mum was contacted by the LCHWL Paediatric Nurse to book in Katie to see the paediatrician. After the paediatric appointment Mum contacted Care Coordinator to share Katie’s ASD diagnosis, and the relief she felt.

The Care Coordinator is now supporting Mum to collate diagnostic information to secure NDIS funding and Carer’s Allowance, and has linked her in with some Parenting Group sessions in a nearby town facilitated by the mental health team at the LCHWL, and has Mum in touch with a local playgroup. In the course of the engagement, Mum also expressed her concerns about Katie’s older sibling, and the Care Coordinator facilitated a referral to the LCHWL for a Mental health assessment. The sister is now also being supported by a Mental Health Clinician through the LCHWL.

“I can’t imagine how long this would have taken to get him seen without your help, I really appreciate it. I think with extra support Katie will be able to thrive once she gets to Kinder and then school’.” – Katie’s mum

Bypassing long waiting lists, early diagnosis means early intervention, wrap around support for the whole family including connecting with local groups outside of the Locals for ongoing support. The local knowledge and networks supported effective service linkages to be made for the family, close to home.

APPENDIX 2: Partners

Community Health First is an initiative led by all 22 registered independent community health organisations in Victoria.