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ResidentialTreatmentWorkingGroup-July20173
CONTENTS
MESSAGEFROMTHECHAIR.........................................................................................................................4INTRODUCTION............................................................................................................................................6DEFININGRESIDENTIALTREATMENT...........................................................................................................7MANDATEOFTHERESIDENTIALWORKINGGROUP....................................................................................7METHODOLOGY...........................................................................................................................................7REVIEWANDDISTRIBUTIONPROECSS.......................................................................................................10
DevelopaLexiconwithCommonDefinitions(SeeAppendix4)............................................................11UnderstandingtheCurrentDemand......................................................................................................12CurrentAgency-levelCapacitytoRespondEffectively..........................................................................12
EMERGINGTRENDS....................................................................................................................................13GapsandStrengths................................................................................................................................13Waitlists..................................................................................................................................................14
VISIONOFTHEFUTURESYSTEM................................................................................................................14GuidingPrinciples...................................................................................................................................14DriversofSuccess...................................................................................................................................15
RECOMMENDEDAREASFORACTION........................................................................................................15Establishabroad-basedcross-sectoralsystemplanningtable..............................................................15YoungParents/Infants,ChildrenYouthandtheirFamiliesShouldHaveAccesstotheFullContinuumofServiceIncludingAfterCare/TransitionalSupport.................................................................................16CentralizedAccess,AssessmentandIntegratedServicePlanningforClients........................................17DataandInformationCollection............................................................................................................19SystemSustainabilityandAdvocacy......................................................................................................20
WORKINGGROUPMEMBERS.....................................................................................................................21APPENDIXES...............................................................................................................................................22
ResidentialTreatmentWorkingGroup-July20174
MESSAGEFROMTHECHAIR
Inearly2016,theleadagencymandatedtheResidentialTreatmentWorkingGroup(RWG)toreportonthecurrentstateofresidentialtreatmentinTorontotoinformevidencebaseddecisionmakingandplanning.Themandateincluded:developinganinventoryofexistingservices,servicedemand,systemcapacity,emergingneeds/trends,clientprofiles,occupancyrates,lengthsofstayandservicegaps.Themandatewasfurtherextendedthrough2016/2017toallowtheRWGtheopportunitytoreviewtheMinistryofChildrenandYouthServices(MCYS)PanelofExpertReportandtocompletetheworkinitiatedinPhase1.
Residentialtreatmentishistoricallyunderfunded.AgenciesacrosstheCityreportrunningdeficitsbetween$80,000-$120,000annually.Themajoritymustfundraiseorsupplementresidentialtreatmentbudgetsthroughotheravenues.TheRWGacknowledgesthecurrentsystemwithexistingfundingisnotsustainable.ThereisalsorecognitionthatdespitethestrengthsthatC.A.R.S.bringstothesystem,wearenotcurrentlyfunctioningasasystem.Decisionsare,forthemostpart,beingmadeatindividualagencylevelswithoutthebenefitofsystemdataandknowingadecision’simpactonthesystemofservices.
Overthecourseofthelastfiveyears,thesystemhaslost26transferpaymentbeds(Thisteltown,LOFT,CDIandHDCclosures)and80perdiembeds(Oolagen,EMYSx2,HDC,Delisle,LOFT,Casatta,Enterphase,KennedyandStorey).CentralizedAccesstoResidentialServices(C.A.R.S.)bedshavereducedfrom204bedsin2005to152in2016.Therewasarecognitionthatifactionwasnottakenquickly,residentialtreatmentserviceswillbefurthereroded.TheRWGfeltstronglythatweneedtomovetoaplacewhereindividualagenciesarenolongermakingdecisionsinisolationbutwherethereisasystem-wideapproachtoplanning.
TheRWGisrecommendingathoughtfuldatadrivenresponsetosystemschanges.Therearelessonstobelearnedfromlatencyagechangeswhichhaveledtoincreasedaccesstoevidenceinformedinhomeintensiveserviceswhileleavingagapinresidentialtreatmentservicesforchildrenages6-12.
WhileC.A.R.S.hascollectedrichdataonbehalfofthesystem,therearegapsininformationthatneedtobefilledbeforeconcreterecommendationscanbemadeabouthowmanybedsareneededandforwhichclientneeds.Althoughsystemsgapswereidentified,moredataisrequiredtodetermineprioritiesandhowgapsinoneareacanbefilledwithoutcreatingothers.
TherewasaconsensusamongsttheRWGthatC.A.R.S.isastrengthofthesystemandcouldbeexpandedtoprovideacentralaccesspointforallintensiveservice,therebyprovidingfamilieswithoneaccesspointtothefullcontinuumofintensiveservices.TheRWGalsostronglysupportedtherecommendationsofChildren’sMentalHealthOntario(CMHO)andKinarkthatwedevelopasysteminTorontowheretiersoftreatmentareprovidedandclientsreceiveanappropriateleveloftreatmentsupports(psychiatry,psychology,OT,etc.)basedonastructuredassessmentofneeds.TheRWGheardfromyouthandfamilieswhoinformedusthatthesystemisunwieldyanddaunting.Thereisanimperativeonthesystemthatwemoveforwardinatimelyfashiontomeettheneedsoffamiliesbeforefurtherresourcesarelost.
ResidentialTreatmentWorkingGroup-July20175
MembersoftheRWGrepresentedcoreserviceproviders.TheRWGfeltstronglythatthevoicesofservicerecipientsandotherstakeholdersareneededtoinformsystemschangesgoingforwardandweneedtopartnerwiththemindeterminingpriorities.TheRWGisthereforerecommendingamulti-sectoradvisorycommittee(partneringwitheducation,childwelfare,youthjusticeandhealth-possiblycaregivers).Thefirstphaseofworkwouldbetocollectandanalyzemoredatawiththegoalofrecommendingsystemschanges.
IcannotthankthemembersoftheRWGenoughfortheircommitmentandthethoughtfulclientcenteredapproachtheytooktothework.AttendanceatmeetingsamongthehighestIhaveseen.Everymembertookinitiativetoworkbetweenmeetingssowecouldkeeptheprocessmovingforward.Weareallcommittedtosystemsimprovementandchangeandwouldbehappytoprovideleadershipandpartnerwiththeleadagencyandourcommunitypartnerstoimplementourrecommendations.
DebbieSchatia,M.S.W.ExecutiveDirectorTurningPointYouthServices
ResidentialTreatmentWorkingGroup-July20176
INTRODUCTIONMovingonMentalHealth(MOMH)isanimportantpartofOntario’sComprehensiveMentalHealthandAddictionsStrategy.Theplanensuresinfants,children,youthandfamiliescangetmentalhealthservicesintheircommunitiesthatareaccessible,responsiveandbasedontheexperiencesofthechildrenandyouthwhoneedhelp.ThegoalofMOMHistoensureallchildren,youthandfamiliesinOntariohaveeasyaccessto:
• Mentalhealthservicesintheircommunities,and• Mentalhealthservicesandsupportsthatmeettheirneeds
Strengtheningthecommunity-basedsystemfordeliveringmentalhealthserviceswillbringpeopleandorganizationsclosertogetherlocallyandbenefiteveryone.EastMetro,LeadAgencyTorontoServiceAreaCollectiveImpactFramework–ACollaborativeApproachCollectiveImpactFrameworkisbasedonthebeliefthatnosingleorganizationcantackleorsolvetheincreasinglycomplexsocialproblemswefaceasasociety.Theframeworkbasedonthepremisethatmultipleorganizationsneedtojointoworktowardacommonagenda.JohnKaniaandMarkKramerfirstwroteaboutcollectiveimpactintheStanfordSocialInnovationReviewin2011andidentifiedfivekeyelementsforCollectiveImpacttosucceed.EMYShasadoptedtheseelementstoguideandshapeourworkinleadingthetransformationofthecommunity-basedchildandyouthmentalhealthsectorinthiscity.
1. AcommonagendaComingtogethertodefineaproblemandcreateasharevisiontosolveit
2. SharedmeasurementAgreeingtotrackprogressinthesameway,whichallowsforcontinuousimprovement
3. Mutuallyre-enforcingactivitiesCo-ordinatingcollectiveeffortstomaximizetheresult
4. ContinuouscommunicationsBuildingtrustandrelationshipsamongallparticipants
5. Backbonesupport–EastMetroYouthServicesDedicatedstafftocoordinate,supportandfacilitatekeyactivitiesandprocesses
RoleofWorkingGroupsThesheernumberoforganizationsbothinsideandoutsidethecommunity-basedchildmentalhealthsectorrequiresamoreintentionalfocusonrelationshipbuildingandcoordinatingopportunitiestosimplyengageandbuildaspiritofcollaboration.Thesetimeintensiveactivitiesarefoundationaltobuildingasustainablesystemchange.TohelplaythefoundationsforToronto’ssystemtransformation,workinggroupswereestablishedtoleveragetheexpertiseofthecoreserviceproviders.Inadditiontoprovidingtheinvaluableresearch,analysisandrecommendationswhichhelptoinformthedevelopmentandongoingadaptationoftheCoreServicesDeliveryPlanandCommunityMentalHealthPlan,nearlyallagenciesprovidingcoreservicesparticipatedasworkinggroupmembers,contributinggreatlytothespiritofCollectiveImpactandformingemergingrelationshipsacrossagencies.Theanalysis,recommendationsandresearch
ResidentialTreatmentWorkingGroup-July20177
resultsprovidedbytheworkinggroupswillcontinuetobeincorporatedintothelargeranalysisandplanningprocessaswemoveforward.DEFININGRESIDENTIALTREATMENTTheCMHOreportResidentialTreatment:Workingtowardsanewsystemframeworkforchildrenandyouthwithseverementalhealthneeds2016,clearlyidentifiesthedistinctionofresidentialtreatmentfromresidentialcare.Residentialcaredoesnotprovidetreatmentastheprimaryfocusoftheplacement.ThisdistinctionandtheimportanceofprovidingcontextandpurposebetweenresidentialtreatmentandresidentialcareincreasedafterthereleaseoftheResidentialServicesPanelReport.ResidentialTreatment,asdefinedbyMCYS,ispartofthecoreservicesclassified“IntensiveOut-of-HomeService”intheCommunity-BasedChildandYouthMentalHealthProgramGuidelinesandRequirements#1:CoreServicesandKeyProcesses,2015.InitsreportStrengtheningChildren’sMentalHealthResidentialTreatmentthroughEvidenceandExperience(Oct2015),KinarkChildandFamilyServicesfurtherdefinesresidentialtreatmentprogramsas“24-hourout-of-homefacilitiesthatprovidementalhealthtreatmentusinganinter-professional,multi-disciplinaryteamapproachthatmakestherapeuticuseofthedailylivingmilieu.”Asoutlinedintheanalysisandrecommendationsofthisreport,theRWGconcludesthatresidentialtreatmentisakeypartoftheIntensiveServicescontinuumoftreatmentwhichoftenlooksdifferentwitheachchildoryouthreceivingcare.MANDATEOFTHERESIDENTIALWORKINGGROUPTheRWGwasestablishedFebruary2016andendeditsmandateinFebruary2017.Theirmandatewastodevelopacomprehensivemapoftheresidentialtreatmentserviceslandscapeandproviderecommendationsformovingforward.METHODOLOGYWorkingGroupMeetings(SeeAppendix1forWorkingGroupmembershiplist)MembershipoftheRWGrepresentedaselectionofagenciesprovidingresidentialtreatmentservicesinToronto.Meetingonregularbasis,theChairledtheworkinggroupthroughdiscussionandanalysisofkeyissues,challengesandopportunitiesbroughtforwardfrommembers’professionalexperience,aswellasfromtheworkinggroup’sinvestigativeandresearchactivities.KeyInformantConsultationsandPresentationsSylAppsYouthCentre:SylAppsYouthCentreisasecureresidentialtreatmentcentreinOakville,ON.DebbieSchatia,RWGChair,spokewithSylAppsabouttheirprogramsastheyidentifiedaneedforyouthtobeabletotransitionfromSAYCtoresidentialtreatmentprogramsinToronto.PineRiver:DebbieSchatiawentouttothefacilityinlateMayforatourandinformalinformationalmeetingabouttheirprogramandtoidentifyareasrelevanttotheTorontoResidentialTreatmentsystem.
ResidentialTreatmentWorkingGroup-July20178
LynwoodCharltonCentre,Hamilton:DebbieSchatiandDarrenFisher,leadagency,ProjectManager,spoketoMaggieInrig,DirectorofSystemPlanningatLynwoodCharltonCentre,abouttheircentralizedIntakeandassessmentprocessaswellastheworktheyaredoingasacommunitytoenhanceandrealigntheirresidentialtreatmentbeds.LatencyAgeWorkingGroup(LAW)(SeeAppendix6fortheLAWFinalReport):Thismulti-sectoralworkinggroupwasestablishedinJune2015andconcludedinJune2016.SeveralmembersoftheRWG,includingtheCo-ChairfromC.A.R.S.,werealsomembersoftheLAW.TheanalysisandrecommendationsoftheLAWwerebroughtforwardfordiscussionandanalysisastheyrelatetoresidentialtreatment.Adraftofthisgroup’sfinalreportwaspresentedtotheRWG.CentralizedAccesstoResidentialServices(C.A.R.S.)–(SeeAppendix2forinformationandreportspresentedbyC.A.R.S.)-SkylarkChildrenandYouthServicesoperatesC.A.R.S.programonbehalfoftheTorontoofficeofMCYS.Providingasinglepointofentryforresidentialplacement,C.A.R.S.playedauniqueroleasamemberoftheworkinggrouppresentinginformationanddataforreviewandanalysis.ReviewofRelevantReports(SeeAppendix3foracompletelistofreportsreviewed)Therehasbeenanincreasedinterestinresidentialmentalhealthtreatmentinrecentyears.Severalreportshavebeenproducedlookingatthestrengths,gapsandchallengesofdesigning,implementingandeffectivelyintegratingresidentialprogramsintothecontinuumofcareforchildrenandyouthaswellasintegratingwithothersectorssuchashealth,socialservicesandeducation.TheworkinggroupreviewedseveralofthesereportswhichrelatetotheirmandateofresidentialtreatmentundertheMCYScoreservicesfundingenvelope.Inadditiontothereportsandinformationpresentedthroughoutthetermoftheworkinggroup,theworkinggroupreviewedanddiscussedanadditionalthreekeyreportsrecentlyreleased.CMHO:ResidentialTreatment:Workingtowardsanewsystemframeworkforchildrenandyouthwithseverementalhealthneeds2016.AccordingtoCMHO),“serviceprovidersnoteresidentialtreatmentischronicallyunderfundedandthatcurrentfundingmodelsdonotmatchthecomplexneedsofthechildren,youthandfamilieswhorequiretheseservices.Serviceproviderscannolongerkeepupwithincreasingdemandandmanyarebeingforcedtoreducetheirtreatmentbedsand/orclosetheirresidentialprogramsaltogether.”(CMHO,ResidentialTreatment:Workingtowardsanewsystemframeworkforchildrenandyouthwithseverementalhealthneeds,2016).AssessingthecurrentagencycapacitytorespondeffectivelytothechallengesinprovidingqualityresidentialcareinTorontowasbasedontwoquestions:
• Whatevidence-basedtreatmentsupportsareofferedtochildren/youthinresidentialtreatment?
• Whatothersupportsareofferedtochildren/youthinresidentialtreatment?
TheworkinggroupreviewedtheCMHOreport,anddeterminedthatmanyofthereportrecommendationsarebeyondtheresponsibilityofleadagencywiththeexceptionsofthefollowing:
• AdopttheCMHOreportrecommendationsaroundtiersystem• Supportingauniversalassessmentaspartoftheintakeprocesstohelpdefinewhatservices
children/youth/familiesaredirectedto
ResidentialTreatmentWorkingGroup-July20179
ProvincialAdvocateReportIn2016,TheOntario’sProvincialAdvocate’sforChildrenandYouthissuedareport:SearchingforHome,ReimaginingResidentialcare.
• OverallthegroupfelttherewereissuesofrelevancyandscopeandwhethertherecommendationspertaintoCYMHresidentialtreatment(manyapplytoothertypesofresidencesordonotreflecttherealityofresidentialtreatmentservices)
• Thegroupagreedissuesaroundlicensingandperdiems,aswellasexitinterviewsandengagement,areworthfurtherexploration
• Buildingrelationshipswithfamily(orequivalent)shouldbeembeddedintothephilosophyofcare
• Thegroupsupportstherecommendationsforprovidingfunding/capacityforrecruitmentandtraining
• ManyoftherecommendationswerenotrelevanttoTorontoagenciesorhavealreadybeingapplied
• Discussionaroundlicensingandaccreditationo i.e.licensedversusunlicensedperdiemhomeso Licensingcouldbeimprovedtofocusmoreonqualityandimprovedoutcomes
• Buildingrelationshipswithfamily(orequivalent)shouldbeembeddedintothephilosophyofcare
PanelofExpertReportMCYScommissionedapanelofexpertstoreviewallresidentialcareintheProvinceofOntario.In2016,theypublished:BecauseYoungPeopleMatter,ReportoftheResidentialServicesReviewPanel.
• ThegroupdisagreeswiththefundingrecommendationaboutperdiemfundingandrecommendscontinuationoftransferpaymentsystemwithadditionalfundingbeingprovidedthroughSTEPS-basedfundingasacentralizedmodel
• Therewasnotsupporttheremovaloftheterms“treatment”and“specialized”o Revieweddefinitionof“effectivetreatment”(changedto“residentialtreatment”)
and“contextofresidentialtreatment”• Supportfortherecommendationtocreateanadvisorycouncilofparentsandyouthinthe
buildingofthesystem(beyondresidentialbutallintensive)• SupportthecontinuationofC.A.R.S.dataandtrackingofchildrenandyouthreceiving
servicesinToronto.ItwasnotedthatagapexistswithChildWelfareclientsastheymovein/outofToronto.
• Developapubliclyaccessibledirectoryoflicensedservices,includingarangeofelementso Requiresadedicatedresourcetohelpparentsnavigateandmakeappropriate
decisionsAnalysisanddiscussionsstemmingfromthereview:
• Thereisaneedforbaselinedataandcontextualinformationaroundcontinuityofcare,lengthofplacements,therelationshipofwhereyouliveversusreceivingtreatment(betterunderstandingofsuccessfactors,pathwaysbetweenservicesetc.)
• Thesystemdoessomecaseconferencingbutthereshouldbestructurestoensurecaseconferencingformatswithalloftherelevantparticipantsoccurateverytransitionpoint(warmhandoffsandsystemnavigation)
ResidentialTreatmentWorkingGroup-July201710
• Section23needstobereviewedtoincreaseaccess.ItwasnotedthatattimestherecanbebarriersfromtheMinistryofEducationtoensurechildrenandyouthlivinginresidentialsettingsgetafulleducation(ratherthanlimitedcourses)
• Thereneedstobeaneedsassessmentofspecialized/underservedpopulationstobetteridentifyhowthesystemcanadapt
o Thereshouldbeaprocessformoreproactiveworkwhenservicingthesepopulations(i.e.ARAOplans)
o ItwasnotedthatFrenchservicesisamajorgap• Supportforafeedbacksystemofclientsatisfaction(couldbepartoftheroleofthe
child/youth/familyadvisorycommittee?)
ConsultationwithOtherWorkingGroupsandTablesOneofthekeylearningsfromYear1wastheneedtobetterfacilitateknowledgesharingamongthegroupsestablishedtoresearch,analyzeanddeveloprecommendationsfortheleadagencytoconsiderinitssystemplanning.Toaddressthis,DebbieSchatiaasChairoftheRWGattendedregularmeetingsoftheYear2Chairswherekeyareasofanalysisanddraftrecommendationsweresharedanddiscussed.YouthandFamilyEngagementRecognizingthesize,diversity,andcomplexityoftheTorontoserviceareatheleadagencyhasfocusedtheiryouthandfamilyengagementworkontwofronts:along-termframeworkandstrategydevelopmentinvolvingbuildingcapacitywithinthesystemtoengagefamiliesandyouthandimmediateeffortstowardsembeddingengagementprocessesandcommitmentsintheoperationsoforganizationsandsystems.Toinformthisworkandprovidealenstoviewtheworkinggrouprecommendations,theleadagencydevelopedandimplemented,inpartnershipwiththeworkinggroups,peer-ledconsultations.Inthisproject,youthandfamilymembersweretrainedtoleadconsultationsandtookpartinformingquestionsandinterpretingresults.Intotal,sevenconsultationswereheldand51youthandfamilymembersparticipated.REVIEWANDDISTRIBUTIONPROECSSInreviewingthemandate,availablecapacityandterm,theRWGorganizedthepreliminaryworkplan(March–June2016)intosixcategoriestobetterfocusthediscussionandanalysis:
• Developalexiconwithcommondefinitions• Identifyexitinginformation• Lookatcurrentdemand• Lookatcurrentagencycapacitytorespondeffectively• Identifyprogramrequirementsareneededtoprovidegoodqualitycare• EmergingTrends
Althoughthecategorieswereseparatedintodiscretediscussiontopics,itrecognizedtheyareinterrelatedandintegrated.Inadditiontothesesixdiscussioncategories,theworkinggroupengagedinafulsomereviewanddiscussionaroundwaitlists.Thisworkformedthefoundationofknowledgeandanalysiswhichinformedthesecondphaseofwork(September2016–February2017)duringwhichthegroupidentifiedkeydriversofsuccessandfinalrecommendations.
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DevelopaLexiconwithCommonDefinitions(SeeAppendix4)Informaldiscussionofexperiencesamongtheworkinggroupparticipantsidentifiedinconsistentuseandunderstandingofcommontermsamongreports,peers,funders,mediaandthepublic.Specifically,therewasaneedtoreinforcetheinterconnectivityoftheissues(clientprofile,effectivetreatment,capacityetc.)andtermssuchasoccupancyandwaitlists.Tobeginthisprocess,theworkinggroupdevelopedalistofcommondefinitionstoprovidecontextandconsistencytotheworkinggroupdiscussions.Notcomprehensive,thelistisastartingpoint,designedtobea“livingdocument”whichcanbeaddedtoandamendedasnecessary.IdentifytheInformationthatAlreadyExistsWithintheMCYSresidentialtreatmentsystemthereisanabundanceofinformationavailable.Thechallengeistonotonlyidentifywhatinformationexistswhere,butalsohowtoeffectivelyaccessandextractthisinformationinausefulformat.Theworkinggroupidentifiedseveraltopicareasandsources,aswellasflaggedthosewhichweredeterminedtobeuseful,butbeyondtheworkinggroupmandateordeemedtoocomplextoacquire.Theworkinggroupalsoidentifiedtheneedtobetterinterpretthedataandidentifywhatismissingandneededtomakeinformedsystemdecisions.Areasofreviewfordataandinformationincluded:
• Inventoryofbeds,clientprofile,lengthofstay,occupancyrates,waitlists(C.A.R.S.)• DatarelatedtothequickeraccessprotocolbetweenC.A.R.S.andserviceprovidersandhowlong
bedsarevacantasaresult• Gapsinthesystem(SeeAppendix2)
o Examples-language(Frenchetc.),disability,culture,gender,GLBTQ,medicallyfragilewithpsychiatricissues,newcomers/refugees,FASD,ASD,sextrafficking,eatingdisorder
• InformationaboutinfantandyoungparentresidentialprogramsanddaytreatmentProgramsforfrancophonestudents(SeeAppendix5)
TheCentralizedaccesstoresidentialservices(FormoreinformationaboutthereportsanddatapresentedbyC.A.R.S.totheworkinggroup,pleasecontactBrianO'Hara,Director,C.A.R.S.,SkylarkChildrenYouth&Families)C.A.R.S.programwasidentifiedasacentralpointfordatacollectionandreporting.SkylarkChildren,YouthandFamilyServicesoperatesC.A.R.S.onbehalfoftheTorontoofficeoftheMCYS.C.A.R.S.providesasinglepointofentryforresidentialplacement,eliminatingtheneedforparentsandcasemanagerstocallmultipleresidencestofindopenings.C.A.R.S.’databasecontainsup-to-datedataforeverymentalhealthresidentialprograminToronto,makingiteasiertomatchachild'sneedswiththeappropriatefacility.C.A.R.S.providesavarietyofimportantservicessuchas:
• ManagingreferralstoallmentalhealthresidentialbedsforchildrenandyouthinToronto• Matchingindividualrequestsforresidentialtreatmentwiththemostappropriateproviders• Monitoringresponsetimesandconfirmingadmissions• Trackingclientsinplacement• Recordingdischarges• Monitoringavailableresources• Providingaccurateoverallsystem-basedinformationforresidentialservices
EveryyearC.A.R.S.processesreferralsfor400-500clientsaged6-18,makingapproximately1,300requestsforresidentialplacement,typicallyleadingtoactualplacementforabout200clients.Othersourcesofdataandinformation
ResidentialTreatmentWorkingGroup-July201712
Inidentifyingexistingavailabledataandinformationsources,theworkinggroupidentifiedseveraldatasourceslistedbelow.
• Specializedassessmentandconsultation–C.A.R.S.• Children’sServicesSystemReview&Consultation(CSSRC)report–C.A.R.S.• Communitytabledata–C.A.R.S.• STEPS/UDSS-C.A.R.S.• Whateverittakes(WIT)-EMYS/Griffin(SeeAppendix5foradescriptionoftheWITprogram)
Inadditiontothesourceslisted,theworkinggroupidentifiedothersaspromising,butbeyondthescopeand/orcapacityoftheworkinggrouptogatherandanalyze,orweretoocomplexandinconsistenttobeusefulatthisstage.
• Datacollectiontools/screenerswhichcouldhelpdefinecomplexity(CAFASetc.)wasdeterminedtobebeyondthecurrentscopeoftheworkinggroup
• Policereports,hospitaletc.weredeemedtoocomplexfortheworkinggrouptocompile• Seriousoccurrencereportsarecomplexandinconsistentevenwhenrolledup,inagencyannual
reports,andnotnecessarilyrelatedtoresidentialtreatmentprograms
UnderstandingtheCurrentDemandTobetterunderstandandclarifythecurrentdemand,theworkinggroupidentifiedkeyelementswhichcouldhelpprovideabetterunderstandingofthecurrentdemandontheresidentialsystem.Asthesinglepointofentryforresidentialplacement,C.A.R.S.providedinformationtotheworkinggrouponseveraloftheseelements:
• Basedontheagreeddefinitionofwaittimes,identificationofthedemand• Numberofyouthcomingfromhospitalintoresidentialtreatment• Regionalissues/outofcatchment(meetingtheneedsofTorontochildrenand/orthoseoutsideof
Toronto,outsideoftheprovinceo Inreviewingthedata,C.A.R.S.hasdeterminedthattherearenothighnumbersofoutofthe
regionplacementshoweveranoutofcatchmentprotocolisinplace
Someelementswerebeyondthecurrentscopeoftheworkinggroupmandate:• Placementhistoryandinstability(hardtoaccess)–howmanytimesyouthmovewithinand
outsidethesystem• Transferwithinthetransferpaymentagencies• Outcomedata
CurrentAgency-levelCapacitytoRespondEffectivelyOneofthefirsttasksofRWGwastodevelopacomprehensiveinventoryofexistingresidentialprogramsinToronto.C.A.R.S.providedadetailedresidentialprogramsummaryforToronto(typeofprogram,specializations,clientprofiles,numberofbeds,staffinglevels,lengthofstay,psychiatricandmedicalservicesandsupport,typesoftherapy,assessmenttoolsetc.)Theworkinggroupreviewedandrequestedadditionaldatathatwouldassisttheminformulatingrecommendationsaswellasstrengthenfuturesystemplanning.
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EMERGINGTRENDSGapsandStrengthsPartofthereviewofexistingreportswasananalysisthroughalensoncapacitytoidentifystrengthsandgapswhichcurrentlyexistinthesystem.AfullspreadsheetanalysiswasprovidedbyC.A.R.S.whichprovidedasnapshotofthecurrentstateofthesystemincluding:Inventoryofbeds,clientprofile,lengthofstay,occupancyrates,waitlists,treatmentoptionsavailableetc.TheRWGalsofeltitimportanttohighlightexistingsystemstrengthsasidentifiedbytheworkinggroupmembers.Theintentwastoensurethataswerecommendandimplementchangeweareabletobuildonthesestrengthswithoutlosingexistingcapacity.Strengthsidentifiedbytheworkinggroupinclude:
• Awidevarietyofprogramsorages0(infants)–18years• Continuumofserviceandage• Fluidityoftransitions(upuntiladult)• C.A.R.S.-systemnavigation,centralintake• AccesstoSTEPSflexfunding• Willingnessofagenciestobeadaptableandaccommodatetochild’sneedseventhoughthechild
maynotfitstrictlyintotheprogram• CommunityTableswhereabroadrangeofserviceprovidersworktogethertoresolveaclient’s
servicechallenges• Sector-wideconsensustoimprovethesystem• Asenseofcommunity,inclusionofchildandfamily• Afocusonthewelfareoftheclient• Arichnessofknowledge,expertiseandtrainingofstaff• Thesystemfocusesonhavingqualifiedpeopleinthedifferentpositions• Thesystemandagenciesoperatewellbeyondwhatthelicensingrequiresandresources
provided• AwillingnesstoworkwithChildWelfareandaddictionorganizations,CSSRC,hospitals,colleges
anduniversitiestotakestudentplacements• AccesstomultipleservicesofferedinallCYMHagencies–accesstocommunity-basedservices
wealloffer• Involvementoffamilies(broaddefinitions)inresidentialtreatmentascoreservicepartnersand
workhardtoengagethemandtoincludesystemsofsupport• Clientswithcomplexneedsandavarietyofdiagnosis/diversityareserved• AccesstotheYouthdalewaitlistmanagementprogram• AccesstoSection23programs
C.A.R.S.providedadetailedanalysisofgapsinthesystemhavingrevieweddatafrom:communitytables,WIT,STEPSandCSRC.Somegeneralthemesrelatedtosystemgapsidentifiedbytheworkinggroupinclude:
• Psychiatric/medicationmanagementrepresentsahighneedbutisnotnecessarilywidelyavailableinourprograms
• Thereneedstobebetteridentificationofdemographicdataonwho’saccessingthesystem(culture,newcomers,languageetc.)
• Thereisalackoftransitionalageresidentialoptions• Thereneedstobeadeeperlooktoidentifypriorities
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• Lackofcross-ministerialcoordination• Needforadaptiveassessments• Thereisalackofcrash,admissionassessmentandrespiteoptions• Thereisaneedforfurtherreviewofthegapsandoptionstobetterquantifythe
WaitlistsTheconceptofwaitlistsisIncludedinthe“Definitions”document.Theworkinggrouphoweverengagedinfurtherdiscussiontobetterdescribethecontextualenvironmentsurroundingthisimportantissue.
• Forresidentialtreatment,waitlistsaremediatedthroughtheprocessesatC.A.R.S.• ItwasnotedthatMCYScollectsdatabydefiningwaitlistsstartingfromwhentheystartthe
serviceatanagencyandarenotnecessarilyaccurateindefiningthenecessaryservicesdeliveredorneed
o Waitlistsshouldnotbetreatedinthetheoryofhotels/hospitalswhereanemptybedcanbefilledrightawaywithoutconsiderationoftheneedsoftheclientsonthewaitlistsorexistingclientsintheresidences
o Thisisanopportunitytorecommendwhattoconsiderwhendiscussing/definingwaitlists
o Thesystemshouldlookatclientwaitingtimesv.waitinglistsandmatchingthetwotoensurepropercareandservice
VISIONOFTHEFUTURESYSTEMWiththeassistanceofPeterO’Donnell,theRWGparticipatedinavisioningexercise.Thepurposewastocreateavisionforresidentialserviceswhichwouldformthefoundationofrecommendations.Theresultwasthedevelopmentofguidingprinciplesandalistofdriversforsuccess.Thefinalrecommendationswereformulatedbyexploringthesystemchangesandthestructuresthatwouldneedtobeinplaceachievethedriversofsuccess.GuidingPrinciplesAresidentialtreatmentsystemthat:
• Prioritizestheneedsofinfants,children,youthandyoungparents• Strivestomeettheneedsofdiversepopulationsandworkstoeliminateoppressionand
promoteequity• Supportsandincludesfamilies/caregivers• Isresponsiveandaccessible• Strivesforseamlesstransitions.• Promotescontinuityofcareandreducesduplicationforclients• Buildsonexistingstrengths• Matchesintensityofresourcestotreatmentneedsandprovidesacontinuumofservice(in
homeintensive,respiteandtiersofresidentialtreatment)whichincludesaccesstoamultidisciplinaryteam
• Isdatadriven,basedonevidenceinformedpracticesanddemonstrateseffectiveness.• Istransparentandaccountabletostakeholders• Supportssystemwideplanninganddecisionmakingwhereagenciesworkaspartofthesystem
andmakecollectivedecisionsratherthanthosebasedonindividualagencyneed• Infants,childrenandyouthareconsideredasharedresponsibilityofthesystem
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• Isflexibleandadaptablealwaysstrivingtoidentifyandfillgaps• Utilizebestpracticeswithinavailableresources
DriversofSuccess
• Eligibilitycriteriaareclearlydefined• Centralizedaccess,assessmentandintegratedserviceplanningforclients• Commonassessmentprocessincludingtool(s)• Commondatacollection• Keyperformanceindicators• Thesystemprovidesyoungparents/infants,childrenyouthandtheirfamilies’accesstothefull
continuumofserviceincludingaftercare• Accesstocentralizedresources• Resourcesarematchedtointensityofneed(forexample:child/youthidentifiedas“tier4”has
greateraccesstoresources/multidisciplinaryteam;resourcesareprovidedtomeetdiverseneedsandincreaseaccessibility)
• Systemisintegratedwithothersectors• Crosssectoralsystemplanningtablestoaddresssystemissues• Treatmentbasedonassessment• Traininganddevelopmentforstaff• Strengthsbasedandcollaborative(youthandfamilyengagementisfundamentalandrequired)• Allprogramsareevidenceinformed,focusonqualityimprovementandcontributetothe
developmentofevidence(includinglongitudinalevaluation)whilesupportinginnovation• Properlyandadequatelyfundedandsustainable
RECOMMENDEDAREASFORACTIONEstablishabroad-basedcross-sectoralsystemplanningtableTheworkinggroupstronglyrecommendsestablishingacross-sectoralsystemplanningtableasthefoundationofmovingforward.ItisintendedthatthistablewouldreporttotheleadagencyandshouldhaverepresentationfromCoreserviceproviders(withrepresentationfromtheadolescent/latencyandyoungparentgroups)aswellasfromotherrelatedsectorssuchaschildwelfare,educationandhealthThemandateforthisgroupwouldbeto:
• Reviewdatatodeterminegapsandtrendsandcommunicatethisinformationtothesystem• Provideaforumatwhichchangestoagencyprogramsincludingprogramclosuresor
reallocationofresourcesfromresidentialtreatmenttoinhomeintensiveservice,forexample,couldbediscussedandconsideredfromtheperspectiveofthepotentialimpactonthesystem
• DiscussandmakerecommendationsreissuesthatimpactandareofconcerntotheentireintensiveservicessysteminToronto.e.g.Howcanthesystembecomemoreresponsivetochangingneeds,thecreationofcentralizedresourcese.g.psychiatry,psychology,etc.;whatisthebestuseandaccesstoSTEPSfunding;whatistheappropriatelevelofresourcesforeachprogram“tier”(levelofintensity);etc.Evaluatethesysteme.g.intheareasofeffectiveness,efficiency,accessibility,etc.
• Themandateoftheplanningtablemustalsoincludethevoiceofyouthandparents/caregivers.Thetermsofreferenceoftheplanningtableshouldincludeasectionwhichdelineateshowyouthandfamilyvoicewillbeincluded
ResidentialTreatmentWorkingGroup-July201716
Theworkinggroupalsorecommends,eventually,thistablewouldoverseeallintensiveservices(Ex:Thisgroupwouldbethetabletoprovidetheanalysisandrecommendationsforconsiderationssuchasconvertingaresidentialtreatmentprogramintoanin-homeintensiveserviceetc.).Giventhecomplexity,a“phased”uptakeapproachcouldbeconsidered,startedmoreeasilybyhavingthegroupaddressresidentialservicesfirst.YoungParents/Infants,ChildrenYouthandtheirFamiliesShouldHaveAccesstotheFullContinuumofServiceIncludingAfterCare/TransitionalSupportThecontinuumwould,atminimum,includeallintensiveservices:daytreatment,in-homeintensiveservices,residentialtreatment.Asystem-wideprocessshouldbedevelopedbywhichaclient’slevelofneedisappropriatelymatchedtotheneededlevelofsupportprovidedbytheprogrami.e.program“tiers”.Clientswhoseneedsrequirethemostintensivelevelofservicesshouldhaveaccesstothewidestanddeepestrangeofsupportsandthesesupportsshouldbewellcoordinatedandseamlesslyintegrated.
DeterminewhatservicescomprisethefullcontinuumofservicesandidentifywhichservicesandwhatlevelofintensityoftheseservicesisassociatedwitheachtierWerecommendthefullcontinuumincludethefollowing:• Respite• Daytreatment• In-homeintensivetreatment• Short-termassessmentandstabilizationhomes• Residentialtreatment(includingtiers2-4whichwouldalsoincludeprogramsthattreat
anywherefrom2-8clientsatonetime)• Homesfortransitionalageyouth• Psychiatry,psychology,etc.• Aftercare/transitionalsupport
Priortochanging,addingorremovinganyexistingservices,thecross-sectoralsystemplanningtablewouldneedtoknowhowmanyofwhattypesofservicesareneeded.TheworkforthishasalreadystartedthroughagapsanalysiswhichhasbeencompletedbytheRWG.Theinitialyearofplanninghowever,needstofocusonabroaderunderstandingofneed.Furtherweneedtoidentifygapsinthecontinuumandhowtobestaddressthem.Anexampleisthecurrentgapinlatencyagedresidentialtreatmentbedsforchildrenaged10-13.Adeterminationwillneedtobemadeaboutwhichagencymightbeinthebestpositiontofillthisgapwithoutinadvertentlycreatinggapsinotherareas.• Gapsinservicesintransitionalageclients-10-13and18+needstobeprioritized• Ideallydaytreatmentshouldbeaccessedaspartofthecontinuumofcentralized
intensiveservices.Todeterminehowthiscanbestbeaccomplished,implicationsandconsiderationsshouldbereferredtoandaddressedattheEducationTable
• Weneedfurtherexplorationoftherolethatcanbeplayedby:WIT,familynavigators,tele-psychiatryandhowtheycanbeconnectedtotheIntensiveServicescontinuum?Explorecloserconnection/coordinationbetweenWITandC.A.R.S.andwrap-aroundservices
ResidentialTreatmentWorkingGroup-July201717
Determinewhichservicesandatwhatlevelofintensitycompriseeach“tier”(forexample:child/youthidentifiedasneeding“tier4”levelofserviceshasgreateraccesstoresources/multidisciplinaryteamthanachild/youthneeding“tier2”).• Resourcesshouldalsobeprovidedtomeetdiverseneedsandtoremovebarrierswhich
limitaccesstoservices• Formalizefunding/resourceallocationtotiers(funding/investmentshouldfollowthe
needsoftheclient–flexibilityofthesystemtomaximizeinvestmentforgreatestimpact)
• Inventoryofexistingresourcesandfundingconnectedwithspecializedserviceso Whopaysforservices?o Partnerwithhealth?o Crisisteammoreaccessibletothesystem
CentralizedAccess,AssessmentandIntegratedServicePlanningforClientsClientstellusthatourintakeprocessesareintrusiveandcumbersomeandthattheyareregularlyrequiredtorepeattheirstories.Currentlyeachagencyhasitsownassessmentprocessandoftenfamiliesareassessedbymorethanoneagencywithoutaclearunderstandingoftheeligibilitycriteriaorthetreatmentmodelthatwouldbestmeettheirneeds.Acentralizedassessmentprocessfoundedoncleareligibilitycriteriaandintegratedserviceplanning(accesstothefullcontinuumofintensiveservices)willimprovethesystemforinfants,children,youthandfamilies(similartothecurrentpilotforlatencyagedchildren).
Determineaprocessbywhichaclient’slevelofneedwillbematchedtotheappropriate“tier”(SeeAppendix7forthedefinitionsofthetiers)ThisprocesscanbefacilitatedbytheCrossSectoralSystemPlanningTable.Somekeyactivities:• EligibilitycriteriaforIntensiveServicesneedtobedeveloped,documentedandposted
onwebsites• Screeningtoolsandprocesstobedeterminedandimplemented,including
determinationoftierofservicerequiredbasedonclientneed• Processandtoolsdevelopedtodeterminewhichintensiveserviceorcombinationof
intensiveserviceswillbeofferedtomeettheneedsoftheclient.Intensiveservicesshouldbedividedintoappropriategroupingse.g.YoungParentResourceServices,latencyagedservices,adolescentservicesetc.Communitytables,triagingofclientsanddeterminationofthetypesandtiersofintensiveservicesthatwillbestmeettheclients’needsshouldbeorganizedwithserviceprovidersfromthesegrouping
• Developacommonassessmenttodetermineyouthandfamilyreadinessforintensiveservices
• DeterminecommonKPIs.TherewillalsoneedtobeprogramorclientspecificKPIs.Strengthsbasedandcollaborative(youthandfamilyengagementisfundamentalandrequired)isacriticalsuccessfactorandshouldbeevaluated
• Developaprocesstoaddressparticularlychallengingtoserveclientneedse.g.bringcommunitytablestogetherforspecificclientneeds
• Treatment-basedassessmentisacriticalsuccessfactor.ThiscanbeaddressedafterthesystemissetupandwouldberootedintheKPIs
ResidentialTreatmentWorkingGroup-July201718
Eligibilitycriteriaareclearlydefined• EligibilitycriteriaforIntensiveServicesneedtobedeveloped,documentedandposted
onwebsites.(Crosssectoralplanningtablerole)• Adeterminationneedstobemadethroughthescreeningprocesswhethertheclient
meetseligibilitycriteriaforIntensiveServices.AllclientswillbescreenedatanindividualagencyusingtheInterRai/Latencyagetool/YoungParentsscreener.Thistool,aswellasaseriesofquestionstobeaskedbyallIntakeWorkerswillbeusedtodetermineeligibilityforintensiveservices
• Adeterminationwillneedtobemadeaboutwhichtierofintensiveservicetheclientrequires:tier2,3,4)
Commonassessmentprocessesandtool(s)• TheInterRaiscreenerisusedinotherjurisdictionsaspartoftheassessmentprocess.
Currentlyeachagencyhasitsownassessmenttools.Ideallyforfamilies,agencieswithinstreams(latency,adolescent,youngparents)wouldusethesameassessmenttools
• Parentsprogramsalreadyhaveacommonscreeningtool.Asmallworkgroupwillneedtodeterminewhatothercommonassessmenttoolsorquestionswillbeused.Ascreeningtoolneedstoberecommendedforlatencyagechildren
Centralorientationforintensiveservices• Clientswillbeinvolvedintheentireprocessbeginningwithanorientationtointensive
servicesviae.g.video,afterwhichdiscussionwouldoccurwithC.A.R.S.astowhichservice(s)theyneed
Buildingonexistingcapacityforcentralizedaccessandcoordination–ExpansionoftheroleandcapacityofC.A.R.S.• ToaidC.A.R.S.’sinitialdecision-making,specificeligibilitycriteriawillbedeterminedfor
eachgroupingofserviceproviders• Informedconsentfromtheclienttobeobtainedattheoutsetsothatinformationcan
besharedwithinthesystem• Currentcommunitytables,facilitatedbyC.A.R.S.,tocontinueforclientswithcomplex
needsthatthesystemmayfindchallengingtomeet• C.A.R.S.tocontinuetoprovidedatatotheleadagencyandserviceprovidersregarding
clientprofilesandsystemutilization• C.A.R.S.willcontinueinitsroletocollectdataonbehalfofthesystem.(See“Dataand
InformationCollection”section)Ontopofwhatisalreadycollected,thefollowingdatashouldalsobeincluded:
o InterRai/Screenerscoreso Moredetailedinformationaboutthepresentingproblem(s)o GeographicmappingofclientsforallIntensiveserviceso Quantifygaps/needs-howmanyofwhattypesofclientswasthesystem
servingandnotabletoserveo AnalysisofwhoisNOTbeingadmittedandwhy?o Whathappenstoclientspostdischarge-someoutcomedataincluding
wheretheclientgoespostdischargeandlengthsofstay
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• Considerationshouldbegiventoseekinginputfromeithertheevaluator’sgrouporaUniversityresearcherabouthowtocollectandanalyzethedatainordertomaximizetheinformationwecollectinyear1
• C.A.R.S.,inanexpandedrole,wouldcontinuetoprovidecentralizedtriagetoresidentialservicesandpotentiallyallintensiveservices(residentialtreatment,inhomeintensiveservices,respiteanddaytreatment).AllintensiveservicesshouldformpartofthecontinuumofservicesofferedtoclientsonceitisdeterminedtheymeeteligibilityforIntensiveServices.C.A.R.S.willlikelyneedanewnametoreflectitsexpandedrole
• C.A.R.S.wouldpresentappropriatereferralstotheappropriategroupingofserviceproviderswhowouldcollaborativelydecidewhichserviceproviderwillprovidetheassessmentofthechild/familyonbehalfofthesystemprovidedithasnotbeencompletedpriortothereferraltoC.A.R.S.
• OnceC.A.R.S.determineswhichagencywillleadtheassessment,thatagencywillcompletetheassessment.Ifitisdeterminedtheirservicesarenotthemostappropriatethatagencywillmakesureallinformationistransferredtothemostappropriateserviceprovidersothefamilyrepeatsaslittleinformationaspossible.Theagencyreceivingtheassessmentwillnotre-doorrestarttheassessmentbutmayaddinformationwhichwillhelpdeterminetheirabilitytomeetthetreatmentneedsoftheclient
DataandInformationCollectionWhileC.A.R.S.hasgatheredrichdataaboutthecurrentsystem,thegroupidentifiedsomeimportantgapsininformation.Theworkinggroupisrecommendingthat,overthecourseoftheupcomingyear,thisdatabecollectedandanalyzedwithaviewtomakingrecommendationsforsystemschange(programchangestoaddressservicegaps,possibleconversionofresidentialprogramstoinhomeintensiveorextendeddaytreatmentprogramsetc.).Theworkinggroupfeltstronglythatnosystemwidedecisionsshouldbemadewithoutathoroughdataanalysisofneedandgaps.Therewasconcernthatwithoutasystemapproach,programsmaybeconvertedorclosedwithalaterrealization(aswasseeninthelatencysystem)thatanactiontorespondtoonegapmaycreateanotherunforeseengapinanotherareaofthesystem.
• Weneedaninventoryofin-homeintensiveservicescurrentlyavailableinthecity.Theworkinggrouphasdraftedasurveyandcancompilethedatafortheleadagency,C.A.R.S.andthesystem.Thissurveytobeincludedintotheleadagencydatastrategyandactivities
• Ananalysisneedstobecompletedaboutthenumberandtypeofrespitebedsrequired• Considerationshouldbegiventoreviewingexistingdata(year1servicemapping,year2
surveysetc.)• Leadagencyshouldpartnerwithauniversitytoconductalongitudinalresearchprojectonthe
outcomesofresidentialtreatmentservices.Thisisacriticalsuccessfactor,howeveritcanbeaddressedafterthesystemissetupandwouldberootedintheKPIs
• Thereneedstobeacomprehensiveenvironmentalscanofbestpractices(withinoursystemandinotherjurisdictions)
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SystemSustainabilityandAdvocacyTheworkinggrouprecognizedthatsustainabilityneedstobeaprioritywhenmakingsystemchanges.Therealityhowever,isthatthesystemisstretchedandunderresourced.Asaresult,theworkinggroupisrecommendingadvocacywithgovernmentoncedataiscollectedandwehaveabetterunderstandingofneedandsystemspressures.Theeffectivenessandefficiencyofthesystemisdependentonadequateresourcing:
• Respitebedsareneededwithinthesystem–advocacywillbeneededtoremovelicensingbarriersthatcurrentlyprohibitresidentialtreatmentprogramsfromusingtheirbedsforrespite
• Flexibilityreagelimitationsonbedsisneededtorespondbettertoclients’needs–advocacyneededtoremoveanypotentiallicencingbarriers
• Isthereawaytoaccessfundingandresourcesfromothersources:MinistryofHealth,MinstoryofEducation,MCYS-YJ,MCYSFASDstrategy?Oncedataiscollectedanalyzedbytheadvisory,othersourcesoffundingcouldbeprioritized
• ThefutureroleofHDCanditsmergerwithSickKidsneedstobebetterunderstood.CanSickKidsresourcesbeleveragedforthesystem?
• Afundedsystemneedstoincludefundingfortrainingandincludefundingfortheimplementationofevidenceinformedtreatmentmodalities.Backfillcostsforstafftoattendtrainingareprohibitive.Agenciesdonothaveresourcestopayrelief/parttimestafftoattendtrainingyetreliefstaffareavitalpartofthetreatmentteam.Fundingneedstobeallocatedtosupporttraining
• Thiswillrequireadvocacyataministrylevel.Thismayalsorequireconversionofsomeresidentialtreatmentprogramstoinhomeintensiveorextendeddaytreatmentprogramsetc.basedonneedandutilizationrates
• Theworkinggroupisrecommendingthatresourcesnotbereallocatedorprogramsclosedorconverteduntilatleastoneyearofdataiscollectedandanalyzedtobetterunderstandclientneeds.Atthisstage,wedonotknowhowmuchin-homeintensive,residentialtreatmentorextendeddaytreatmentisrequireduntilgreateranalysisincompleted
ResidentialTreatmentWorkingGroup-July201721
WORKINGGROUPMEMBERS
Thankyoutoourdedicatedworkinggroupmemberswhomadethisreportpossible:
• DebbieSchatia,TurningPointYouthServices(WorkinggroupChair)
• PaulAllen,YouthdaleTreatmentCentres
• EkuaAsabeaBlair,MasseyCentreforWomen
• SusanChamberlain,GeorgeHullCentreforChildrenandFamilies
• CarolynClark,HinksDellcrest
• DeannaDannell,GriffinCentreMentalHealthServices
• ZelFellegi,AislingDiscoveriesChildandFamilyCentre
• DarrenFisher,EastMetroYouthServices,TorontoLeadAgency(LeadAgencyliaison)
• SteveGregory,YouthdaleTreatmentCentres
• BrianO’Hara,DelisleYouthServicesCARS
• ShirleyShedletsky,DelisleYouthServicesCARS
• KarenProsper,ArrabonHouse
• LydiaSai-Chew,SkylarkChildren,Youth&Families
• DeliaSmith,CentreFrancophonedeToronto
APPENDIXES
Appendix1 WorkingGroupMembers
Appendix2 InformationandReportsPresentedbyC.A.R.
Appendix3 ListingofReportsReviewedbytheResidentialTreatmentWorkingGroup
Appendix4 LexiconofDefinitionsProposedbytheResidentialTreatmentWorkingGroup
Appendix5 InformationaboutSpecializedPrograms
• WIT(Whateverittakes)Programs-EMYS/Griffin• InfantandYoungParentResidentialPrograms• DayTreatmentProgramsforfrancophonestudents
Appendix6 LatencyAgedWorkinggroup:FinalReport(2016)
Appendix7 DefinitionofTiersforIntensiveServices
EastMetroYouthServices|LeadAgencyforMovingonMentalHealth–TorontoHeadOffice:1200MarkhamRoad,Suite200,Scarborough,OntarioM1H3C3
LeadAgencyDowntownOffice:365BloorStreetEast,Suite1010,Toronto,OntarioM4W3L4Tel:416-438-3697|Fax:416-438-7424|Email:[email protected]
www.emys.on.ca
RegisteredCharity#130563166RR0001|AccreditedbytheCanadianCentreforAccreditationSupported by The Government of Ontario