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Understanding care arrangements in Australia


When seeing young people, it is important to recognize that their support person/s may vary from that of the typical ‘nuclear family’ which we are accustomed to thinking of. Having an understanding of the types of care arrangements is important to help develop our relationship with the young person and implement realistic management plans (both in the short and long term).

Out of home care is the care of children 0 – 17 years who are unable to live with their primary caregivers. This placement of care may be short or long term and may have been arranged formally or informally. It may be voluntary or involuntary.

Regardless of the care arrangement, the goal is to provide the index child/children with stability, safety and a sense of security


Important definitions

  • Residential care – placement in a building where the purpose is to provide placements for children and there are paid staff eg. Mercy Community
  • Family group homes – placement in a provided home with live-in carers who are reimbursed/subsidized for provision of care
  • Home-based care – placement is in the home of the carer who is reimbursed for the care of the child; subcategories include:
    • Relative/kinship
    • Foster care
    • Third-party parental care arrangements
    • Other home-based out of home care
  • Independent living


Relative/kinship: placement with relatives or persons well known to the child. This is particularly common within the Indigenous communities as an informal arrangement.

Foster care: A form of out-of-home care where the caregiver is authorized and reimbursed (or was offered but declined reimbursement) by the state/territory for the care of the child

Third-party parental care: transfer of all duties, powers, responsibilities, and authority to which parents are entitled by law to a nominated person(s) whom the court considers appropriate. The nominated person may be an individual such as a relative or an officer of the state or territory department.

Other: boarding schools, hospitals, hotel/motel, defense forces


What does out of home care look like in Australia?

In Australia, there are ~48 000 children in out of home care, with children 1 – 4-year old being the most heavily represented age group. These numbers are rising. The majority of children are in home-based care arrangements (93%) with kinship/relative care being the most common.


Out of home care arrangements


The majority of children have been in care for >12 months.

Up to 40% of individuals will have experienced 2 to 5 different care arrangements.

1/3 of children reported having 5 or more caseworkers during their time in out of home care

Although out of home care is not the preferred arrangement, for a number of young persons in Australia, this is currently their safest and most secure option. Having a good understanding of these arrangements and the difficulties experienced by these young people will allow optimization and coordination of care to better support them.


Selected resources






  • Mary is an advanced trainee in General Paediatrics/Community and Developmental Paediatrics. Has called Townsville home for the last decade. Outside of work, she enjoys eating and Crossfit (one of 'those people'!)

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