Submitted by: Margo Russell-Bird, Manager, Quinte Children’s Treatment Centre, November 24, 2014
Since our community stakeholder meeting in August, there has been some activity related to the Special Needs Strategy.
The four ministries that are engaged in the special needs strategy sent invites out to key signatory agencies that must be involved in the Special Needs Strategy proposal development. Only invited agencies identified by the ministries attended the information session which occurred on October 17, 2014 for our region service area.
For Service Coordination (proposal due March 5, 2015 with planned implementation by summer 2015) key signatory agencies invited included:
- Applied Behavior Analysis (ABA) Based Lead Agencies
- Children’s Treatment Centres (CTC)
- Children’s Access Mechanisms
- Autism Intervention Programs
- Local Health Integration Networks (LHIN)
- Community Care Access Centres (CCAC)
- District School Boards/School Authorities
For Integrated Delivery of Rehabilitation Services (proposal due June 1, 2015 with planned implementation by January 2016) key signatory agencies invited included:
- Preschool Speech and Language Services
- Children’s Treatment Centres
- Community Care Access Centres
- District School Boards – Public, Catholic, French and English
Representatives from all four ministries were in attendance at this information session. Information shared included: (from my notes so not carved in stone)
- Emphasis on working towards seamless service for children with complex special needs, keeping families at the centre of the services.
- Families should only tell their stories once.
- Removal of barriers. Lots of examples of opportunities to work together in the Speech and Language Pilot sites and CTC pilots in Full Day Learning Programs.
- Emphasized that this work is NOT cost savings-no intent to decrease funding, reduce agencies or decrease jobs. Delivery of quality services is intended to build on strengths.
- Strong emphasis on the seamless delivery of occupational therapy, physiotherapy and speech and language services across service areas and from birth to school leaving age.
- Single waitlist for each of occupational therapy, physiotherapy and speech and language pathology across the service area and age mandate.
- Services to address home, school and community needs of clients and families
- Delivered where it makes the most sense to families.
- Looking for creative use of human and financial resources to meet the needs of children/youth with complex special needs.
- Needs of families are to be put ahead of needs of organizations and individuals.
- Emphasis that the needs of children/youth and families are not based on diagnosis but based on needs.
- Local planning tables are to plan with children/youth and families at the forefront and are to assume no barriers related to mandate, policy etc. but are to identify to ministry any barriers that could impact on role out of any plans.
- Ministries are to determine any realignment of funding if needed based on the proposals –this is not something local planning tables are to address.
- Developmental screen. There is a provincial consultation group that is developing this and will determine the implementation plans. It will build on processes already happening for 0-6 children. Will be a standardized tool that determines if a child needs further assessment. Child would then be directed to service coordination. There was not a lot of detail provided at the meeting related to the developmental screen.
- Ministry staff will not be part of the proposal development at the local level.
- There are scheduled ‘check points’ between local co-chairs and the ministries. First one to occur on December 5, 2014. The ministries will be monitoring the work at the local level through this mechanism.
- Input from families and youth and other community agencies is expected to be part of the process and input is to be utilized in the planning.
- Proposals are to identify one agency responsible for service coordination for children with complex special needs across the service area.
- Service coordination is broader than complex special needs funding; i.e., Children’s Case Resolution. Children that are part of Case Resolution are also eligible for Service Coordination.
- Service Coordination is also not a service resolution function nor is it a Developmental Services Ontario model or gatekeeper model.
- Service Coordination is intended to ensure that families are linked to the services they require AND service coordinators will be responsible for developing, monitoring and updating a single plan of care across those agencies involved with the child/youth/family. Goals must be aligned across providers and in line with families identified needs. This is specific to children with complex special needs which at this point we are still trying to define.
- Service Coordination is also to include mental health services and therefore there is a strong link between the coordinating agency and the Lead Mental Health Agency going forward. (Our service area has yet to identify the lead agency for Children’s Mental Health as part of the Mental Health Transformation).
- Service Coordination will not replace existing transition planning. It could be part of Service Coordination if transition planning does not already exist or it can identify that transition planning is required as part of coordinating services. In the latter case, the single plan of care would potentially identify the need for transition planning but the actual planning would occur through already existing processes.
- Both proposals must be creative in inclusion of Aboriginal and Francophone populations.
- Integrated rehab are asking us to challenge the status quo
- Families must be able to self-refer.
- One waitlist per services, one number to call. Waitlist to be transparent.
- May include funding alignment, who does what, who is funded for what; identify barriers and flag policies and regional barriers that are creating challenges in integrated services.
- Children/youth should be able to get into the system of rehab regardless of age/acuity. (Children/youth must still have complex special needs – does not include children/youth with acute injuries such as fractures requiring physiotherapy which is short-term.)
- Services are to be continuous from birth to school-leaving-age.
Each community is now tasked with starting the planning process and determining how other partner agencies will be involved.
At the present time, there are 25 people at the table because we are crossing two main service areas, Hastings and Prince Edward Counties and Northumberland County. This means that we have representatives from: six school boards, (public, Catholic and French/English), two Children’s Treatment Centres, two Preschool Speech and Language programs, two Community Care Access Centres – central and southeast, three Autism Intervention and Applied Behaviour Analysis agencies, and many have more than one representative at this stage as each signatory agency tries to understand the overall impact on this planning. We still need to get representation from the LHIN’s in both areas as part of the required signatories for Service Coordination. The membership is primarily senior level staff.
Where are we in the planning process? Since the information session, we have had one meeting intended to complete the tasks that we were required to report to the ministries on by November 19. These included:
- Determining Co-chairs of the committees. The group determined that the existing table would be a ‘steering committee’ for the two proposal developments. This role will be shared by June Rogers, Superintendent of Special Education Hastings Prince Edward District School Board and Margo Russell-Bird, Manager, Quinte Children’s Treatment Centre and Preschool Speech and Language program.
- Completion of a funding request to the ministry to support the development of the two proposals. Forty thousand dollars has been allocated to each region for each of the two proposals to assist in the proposal development. This was the decision of the group for those funds:
- Hire a facilitator that will assist the group in planning AND in determining a stakeholder engagement process that will allow involvement of all community stakeholders including other agencies, parents and youth.
- The role of the facilitator has been defined and a request for proposals has been sent out to some key contacts to obtain applications that include mandatory elements, a business case and an outline of the costs involved in delivering the services we are requesting.
- The budget request was submitted to the ministry on November 19.
- Applications for the facilitator will close on November 27 and we hope to have a decision the following week.
- We will not be able to proceed with hiring until funding approval from the ministry is received.
- Some costs have also been allocated for stakeholder engagement; i.e., focus groups, child care; translation; backfill; and administrative support (minute-taker, preparation/set-up for meetings, etc.)
- We also discussed at the first meeting the involvement of other agencies that were not part of the signatory group that were invited to the initial information session. It was determined that at this stage we need some further time with the existing group to get a good understanding of the tasks before us. This includes clearly defining what population is included in “children with complex special needs” and being clear on what is in scope and what is not in scope for these proposals. For example, it is clear that the needs of Aboriginal children with complex needs must be considered in the planning but services at federally funded schools like Quinte Mohawk are out of scope. The facilitator will be assisting in developing a stakeholder engagement process.
For more information on the Special Needs Strategy please visit the Resources section of the CYSN website.