Summary Of Recommendations
The Restructuring Committee conducted its analysis of social services for children, youth and their families in Sarnia-Lambton based on several values it considered to be important to the community:
Recommendations
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STARR Recommendations.doc - 455 k
STARR Recommendations.zip - 146 kMeeting the needs of children, youth and their families is the most important goal of the service system and of any changes to the service system.
Only a multi-sectoral approach, including social services but not limited to social services can meet the needs of children, youth and their families.
Change should be well planned and well implemented. For that reason, this report proposes further careful study and design of several initiatives suggested in the report, before the changes are implemented. If further planning suggests that any of the report’s suggestions should be modified or abandoned altogether, the Restructuring Committee is prepared to make those changes.
The Committee believes the community’s values should pervade the future of services in Sarnia-Lambton, through development of a community mission statement.
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TOPThe Restructuring Committee should develop a single community mission statement for the delivery of services to children, youth and their families in Sarnia-Lambton.
Based on its local principles, the Committee then used the policy guidelines contained in the Ministry of Community and Social Services document Making Services Work for People as a tool to determine whether Sarnia-Lambton could make better use of the resources currently provided to it by MCSS.
The Committee determined that a number of systems improvements could be introduced, and it proposes the creation of a new interagency/community entity called "Simplify The Access to Resources and Residences" (STARR) to provide four of these systems improvements:
providing access to the system for people who do not know how to approach the system
serving as the access point for residential services and for complex service packages, through its Community Team
developing common risk/assessment tools
developing information systems.
STARR is neither a building nor an agency. It is a community and interagency process, and one of its key features is a Community Team which will act as a central point of access for a number of services.
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TOPA central system component called "Simplify The Access to Resources and Residences" (STARR) should be created in Sarnia-Lambton, to carry out the following system functions:
providing access to the system for people who do not know how to approach the system
serving as the access point for residential services and for complex service packages through its Community Team
developing common risk/assessment tools developing information systems
developing information systems
The Committee makes the following recommendations for improving access and creating central access for residential placement and for complex cases:
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TOPAccess to service packages for the prevention of residential placement, and access to child and family intervention beds, out-of-home respite beds, and developmental service beds for children should be through the Community Team of STARR. Access to crisis response beds should be through the Community Team unless the urgency of the problem makes this inadvisable. Possible roles for the Community Team of STARR STARR in placements into child protection beds and young offenders’ beds need should be further explored. to be explored further.
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TOPSTARR’s Community Team should play the lead role in developing non-residential service strategies for children and youth with complex problems, particularly in instances in which the alternative to these strategies would be admission to a residential bed.
To avoid duplication, the Committee recommends that the role of STARR’s Community Team and the role of the tri-county Residential Placement Advisory Committee (which reviews residential placements) should be reconciled so that both functions can be carried out for Sarnia Lambton by STARR’s Community Team if possible.
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TOPThe Restructuring Committee should negotiate with MCSS to achieve the reconciliation of the role of RPAC with the role of the Community Team.
The Committee also believes that STARR’s Community Team should have access to a special pool of resources, to fund innovative service options for children, youth and their families.
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TOPThe Restructuring Committee should explore with the Ministry of Community and Social Services the possibility of creating a pool of resources on which the Community Team of STARR can draw, to fund "host family" respite beds and innovative services not available through another funding source other respite beds in Sarnia-Lambton.
To make a restructured system work better while avoiding costly and intrusive residential placements for children and youth, the Committee believes that innovative models such as the Wraparound model and the Family Preservation model should be introduced into Sarnia-Lambton.
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TOPThe Restructuring Committee should develop a strategy for the introduction of the Wraparound model and the Family Preservation model into the service system in Sarnia-Lambton, so these models can be used by the Community Team in putting together service strategies for children and youth with complex problems.
The Committee also believes that the introduction of single service agreements into Sarnia-Lambton will provide a tool which allows STARR and other agencies to put together service strategies early enough, and comprehensively enough, to help avoid residential placements at times, and to make co-ordinated use of available resources.
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TOPThe Community Team of STARR should coordinate the development of single service agreements with individuals and families whose problems are particularly complex or who require the involvement of a range of supports.
The Community Team of STARR needs enough authority to allot it to make decisions on reductions in resources to certain clients, when it is in the best interest of those clients.
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TOPThe Community Team of STARR should be empowered to authorize reductions in service, or substitution of less resource-intensive services, more supportive services.
STARR has a major role to play in the development of common risk/assessment tools. STARR’s Community Team would use these tools itself in assessing complex cases, but other agencies would also use the tools in cases which continue to go directly to these agencies.
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TOPSTARR should facilitate develop the development and use of common risk/assessment tools , by providers in Sarnia-Lambton, and the Community Team of STARR. refine, disseminate and encourage agency use of common risk/assessment tools in Sarnia-Lambton, and STARR should administer and use these common risk/assessment tools itself when it is assisting children, youth and families with complex needs
The development of service agreements requires concerted community effort to ensure they are designed and used by agencies in the community.
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TOPService agreements negotiated between individuals and families, and those programs and agencies who will serve them, should form the basis of service.
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TOPThe Restructuring Committee should create a subcommittee, with members drawn from the Committee and from other resources in the community, to develop:
a model or prototype service agreement
a model process for using service agreements,
and the model service agreement should incorporate any prototypes developed by the Ministry of Community and Social Services.
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TOPAgencies with a legislated or judicial mandate and obligation to provide certain services - the Children’s Aid Society, Community Homes Inc. and the John Howard Society in particular - should be involved in development of the single service agreement model, to increase the utility of this agreement for all parties.
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TOPAll relevant agencies and programs serving children, youth and their families - both those within the social service system and those within related systems - should be urged to use the model service agreement.
STARR also has a major role to play in developing, maintaining and sharing information bases on services, and (with appropriate confidentiality safeguards) on the people who use them.
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TOPSTARR should develop, maintain and manage an accessible information base on social service resources, and services for children, youth and their families.
The Committee recognizes that STARR’s access and information activities will only make a difference if most or all agencies serving children, youth and their families fall within the scope of STARR’s activities.
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TOPAll agencies serving children, youth and their families should participate in the access and information components of STARR.
In addition to the system components which STARR can perform, there are a number of other system components which the Restructuring Committee can design or can carry out. One of these components is a central support component, providing pool support services on behalf of a number of agencies.
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TOPThe Restructuring Committee should examine the feasibility of developing a STARR should become the site of operation of selected central support component functions on behalf of MCSS-funded agencies serving children, youth and their families in Sarnia-Lambton. The specific support functions will be determined after further analysis of whether savings can actually be made by centralizing the support function, without a decrease in the effectiveness of the support function.
Another system component could be a pool of highly specialized staff to be made available to all agencies in Sarnia-Lambton. In some cases, no single agency may be able to afford to keep these resources "in-house."
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TOPThe Restructuring Committee STARR should examine develop the feasibility of developing a shared specialized human resources component, to be used by service providers agencies in Sarnia-Lambton to provide specialized resources to children, youth and their families
Another systems component would be consistent quality assurance practices across the whole system.
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TOPThe Restructuring CommitteeSTARR should ensure the development of consistent quality assurance practices across service system, and the Restructuring Committee should identify system level characteristics to which quality assurance practices can be applied.
As well, the Restructuring Committee could play a systems role in providing planning and system-level problem resolution services in Sarnia-Lambton.
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TOPThe Restructuring CommitteeSTARR should include within its mandate a role in helping to resolve system problems.
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TOPThe Restructuring CommitteeSTARR should include within its mandate the role of take on a role as planner for the future of social services for children, youth and their families in Sarnia-Lambton, possibly in partnership with planning bodies in other sectors.
The Restructuring Committee recognizes that not all services helping people in Sarnia-Lambton are actually located in Sarnia-Lambton. The Committee can play a key role in ensuring that these services are either relocated into Sarnia-Lambton, or provided their services in response to Sarnia-Lambton’s community voice and in response to actual service patterns.
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TOPThe Restructuring Committee should explore repatriation of specialized services to Sarnia-Lambton and the creation of outreach teams to serve Sarnia-Lambton, when quality and efficiency of service would not be seriously compromised by such initiatives.
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TOPThe Restructuring Committee should develop links with services within Sarnia-Lambton and with specialized services beyond Sarnia-Lambton, so STARR can negotiate with those specialized services to integrate them as fully as possible into the range of services available within Sarnia-Lambton.
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TOPFunds available in Windsor to serve residents of Sarnia-Lambton should be allocated to Sarnia-Lambton or to London, to be used to serve Sarnia-Lambton in more geographically appropriate ways which are negotiated with the Restructuring Committee.
In examining the goals for restructuring contained in the MCSS document Making Services Work for People, the Restructuring Committee identified a number of changes which can be made to help achieve those goals. The Committee believes, for instance, that an emphasis on prevention and early intervention makes sense, provided it does not rule out certain age groups which might benefit from these services.
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TOPWhile children under the age of six may be the most promising target population for prevention, early intervention and developmental support, children and youth of other ages should not be excluded from receiving early support based on age alone.
The Committee also believes that new initiatives introduced into the community, regardless of source, should be introduced in a co-ordinated way.
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TOPThe Restructuring Committee, should work closely with other partners, both within the social services field and within related fields, to jointly develop and introduce processes to ensure that new initiatives in Sarnia-Lambton are introduced in a coordinated way.
One of Sarnia-Lambton’s most valuable resources is its pool of volunteers. This is a community asset which should be augmented if Sarnia-Lambton is to depend less on government-funded services in future.
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TOPThe Restructuring Committee, in conjunction with the volunteer components of service providers serving children, youth and their families, and in conjunction with Neighbourlink Sarnia, Sarnia and District Senior Volunteer Community Services, and the Volunteer Co-ordinators’ Association of Sarnia-Lambton, should explore ways to augment the volunteer component.
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TOPThe Restructuring Committee should convene one or more meetings with representatives of other community sectors (particularly volunteer organizations, charitable foundations, religious institutions and businesses), to begin an exploration of the ways they can further contribute further to the well-being of children, youth and their families in Sarnia-Lambton.
But co-ordination at the local level is not enough. Each ministry which funds agencies in Sarnia-Lambton should co-ordinate itself internally, and should co-ordinate its efforts with the efforts of other ministries.
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TOPCo-ordination within each ministry responsible for children, youth and their families, and co-ordination among these ministries, should be considered an absolute requirement if local systems are expected to function in a co-ordinated way.
The Committee suggests that as a pilot project in co-ordination between the Ministry of Health and the Ministry Community and Social Services, the needs of medically fragile and technologically dependent children should be addressed jointly by the two ministries.
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TOPThe Ministry of Community and Social Services and the Ministry of Health should work with Community Concerns for the Medically Fragile, to determine how the ministries can support the development of a residential option in Sarnia-Lambton for medically fragile and technologically dependent children.
The Restructuring Committee examined residential services in Sarnia-Lambton in particular, developing a vision for those services which sees them as the resource to be used only when no other resources will work. The Committee also developed a hierarchy of services which could help prevent use of residential resources.
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TOPResidential assessment and treatment beds should be reserved for children and youth who are, generally speaking, more seriously troubled than is presently the case.
The Committee believes it may be possible in Sarnia-Lambton to reduce the number of assessment and treatment beds, to increase the resources applied to the remaining beds so they can serve more acute or complex cases, and to also invest some of the savings from bed reductions into those services most likely to make a number of residential placements unnecessary.
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TOPThe total number of assessment and treatment beds in Sarnia-Lambton should be gradually reduced to 34 beds (17 male, and 17 female) over a 4 to 5 year period.
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TOPThe Child Protection residential beds currently operated by Sarnia Therapeutic Adolescent Residential Treatment (START) should be integrated with assessment and treatment beds, and a defined number of these beds be assigned to the Sarnia-Lambton Children's Aid Society.
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TOPThe transitional beds currently provided through the Inn of the Good Shepherd should be retained as part of the residential services spectrum, using the current separate funding mechanism.
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TOPThe desired age range to be served by residential placements should be considered by the Restructuring Committee, which should articulate a position on the issue.
Before changes are made to the residential service system, two factors in particular will need further analysis:
the optimal size of residential facilities
the possibility of co-locating male and female young people in the same facilities.
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TOPAn analysis should be conducted on the optimal size (number and age range/problem type) of beds in residential facilities, with attention paid to the relative merits of co-educational facilities.
The Restructuring Committee also proposes the addition of four respite beds for young people with behavioural and emotional disorders, in addition to those respite beds already available for children with developmental disabilities and for medically fragile children.
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TOPFour Child and Family Intervention beds should be created to serve a behaviourally/emotionally troubled population, as an alternative to longer residential placements.
A reduction in beds will likely produce savings which can be used to:
increase the per diems for the remaining residential beds so they can help children and youth with more acute or complex problems
provide funding to implement concepts like the Wraparound and Family Preservation models, which may reduce the demand for residential placements.
Further analysis is needed before the Committee can determine how much of the savings should be spent on each of these initiatives.
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TOPA thorough analysis of per diem rates required to support more intensive assessment and treatment beds should be conducted as soon as possible.
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TOPAny savings resulting from the overall reduction in beds, after higher per diem for the remaining beds has been allocated, should be reinvested in services designed to prevent the need for residential placement.
The Committee is aware that in future, residential services in Sarnia-Lambton may be reconfigured in ways which involved capital costs for facility renovation. It believes that MCSS has a role to play in funding these capital projects.
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TOPThe Ministry of Community and Social Services (MCSS) should provide major capital support for any future reconfiguration of residential facilities in Sarnia-Lambton.
The Restructuring Committee is aware that restructuring studies across Ontario will provide information which can be used to produce a much improved information base on services. This information, as well as benchmarks for service levels which MCSS should develop, will improve the capacity of communities to plan for their future.
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TOPThe Ministry of Community and Social Services should initiate a process to develop benchmarks for service volumes and for balance among services, beginning with benchmarks for residential services.
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TOPThe Ministry of Community and Social Services should use the data from restructuring studies as the starting point for a provincial data base on social services for children, youth and their families.
The Restructuring Committee touched on its deliberations on a number of possible ways to make savings within the system, but neither time nor resources allowed the Committee to explore these possibilities in detail. However, the Ministry of Community and Social Services has made additional funding available which will help the committee to conduct an immediate analysis of these cost saving measures - particularly the possibility of agency amalgamation or the creation of a central support service for agencies.