Form A: package administration arrangements
Name of document1
Used for submission of proposals and variations to the existing packages. This form is populated by community service organisations (CSOs).
Where document refers to ‘Aboriginal’, this is inclusive of Aboriginal and Torres Strait Islander people.
A1. Child / young person details
Full nameCRIS identifier
D.O.B
Division / <indicate the Division that the child/young person is allocated to, i.e. North, South, East, West>
A2. Organisation details
OrganisationContact person
Full Name
Position
Phone
Key worker details
Organisation
Full Name
Position
Phone
Case management details (must align with the case planning decision)
Will the key worker also be the child’s contracted case manager? / Yes
No, please provide details:
N/A, please provide details:
A3. Partnership arrangements (where applicable)
OrganisationContact details
Please outline the key aspects of the partnership and describe how the roles and responsibilities of each organisation will be managed effectively.
A4. Placement type / living arrangement details:
Reunification / homeIndependent living
Kinship
Foster care
Semi-independent living / lead tenant
Other, please specify:
Child / young person location (local government area – LGA) / <for the proposed living arrangement, provide the local government area of the proposed accommodation>
Placement with siblings / Yes, please provide details:
No
N/A
Number of other children / adults in the proposed household
Further information relating to the placement / living arrangement:
A5. Proposed duration of the package
Package duration (in number of months)A6. Package start date
Package start datePackage end date
A7. Carer details (where applicable)
Full nameRelationship
Is the carer registered? (where applicable) / Yes, registration number:
No, please explain why this carer has been nominated
N/A
Existing relationship with the child / young person / Yes, please provide details:
No
A8. Respite carer (where applicable)
RelationshipRegistration number (where applicable)
Contact hours with child / young person
A9. Annualised TCP funding required to achieve goals (excluding G.S.T.)
Total TCP funding amount $A10. Other non-TCP funding child / young person is receiving / will receive (excluding G.S.T.; annualised)
Program / source / Amount $<nominate the program or source, for example, disability Individual Support Package.
<nominate the program or source>
Total other funding
A11. Care allowance
Care allowance (where applicable) is assessed by the department in consultation with CSOs based on the individual needs of each child of the placement and is regularly reviewed. Only assessed and approved foster carers are eligible to receive a care allowance.
Care allowance level soughtReasons
In exceptional circumstances a “non-standard” care allowance rate for kinship care is possible, please outline the reasons for this and why this is essential in enabling the success of the placement (in line with the Care allowance adjustments – kinship policy for TCPs).
A12. Key worker role
What qualifications, experience and skills does the key worker bring tothe role?Please provide details on contact hours for the following activities (hours per week):
Face to face contact with the child / young person
Face to face contact with the carer
Face to face direct service activities* (eg. Attendance at care team meetings, student support group meetings, etc)
Note: The key worker hourly rates represent fully costed face to face direct care services. Salary on-costs and non-wage items are included.
*Direct service activities are defined as hours spent by the Key Worker providing casework to clients, including a range of service activities such as assessment, active engagement, and telephone consultations.
A13. Package benefits
What are the key package benefits for the child / young person and their carer? How will the child / young person’s needs be better met via provision of a package?A14. Consultation with the child / young person
Has the child / young person been consulted to inform the content of this package? Please provide details:A15. Risks and challenges
Identify any risks, issues and/or challenges that the organisation may experience associated with the delivery of the TCP and explain how these will be managed (e.g. impacts on organisational resources and performance):A16. Additional information
Other information considered relevant:Name of document1