2016-17 Core Services Delivery Plan for Children and Youth ... · without the involvement ... child/ adolescent psychiatrists, psychologists, ... Adolescent Alcohol and Drug Inventory

Ministry of Children and Youth Services 2016-17 Core Services Delivery Plan Instructions and Guidelines

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2016-17 Core Services Delivery Plan for Children and Youth Section A - Executive Summary: Children’s Mental Health of Leeds and Grenville have actively been working with Open Doors for Lanark Children and Youth on six priorities and our engagement efforts have been focused in these areas. The six priorities are: family engagement, youth engagement, service coordination, crisis coordination, youth addictions and continuous quality improvement. Over the upcoming year the two agencies will be working on further clarify the pathways to care between education, health, youth justice and CYMH. As a region we have focused our community engagement efforts on our priorities but have maintained communication through various planning tables to ensure that the broader community of Lanark, Leeds and Grenville are apprised of System Transformation- Moving on Mental Health work. Over the next year we will be working with our Core Service Delivery Partners to look at the 2016 census data and population health statistics to better understand the socio-economic and health conditions of families living in the service area. This will help to further identify areas that are facing barriers to CYMH services. Both agencies have made significant changes in support of family and youth engagement over the past year. We will be continuing to focus on Family Engagement and Youth Engagement programming and development over the next year. Both agencies will be working with the Centre of Excellence to further develop their engagement plans and will be working to ensure there is a regional aspect incorporated into the plans. The three priorities identified last year on our Core Service Delivery Plan are on track to meet completion as of March 2018 and will remain priorities however, some have moved to the Community Mental Health Plan. Service coordination, which was also an engagement priority, has also been relocated to the Community Mental Health Plan as an ongoing priority. Continuous Quality Improvement will remain a priority on the Core Service Delivery Plan and targets are on track to be met. As we have worked on this priority over the last year we have identified a second priority that has surfaced through this work, specifically developing a Performance Management Plan for the service area in collaboration with our Core Service Delivery partners. We will be continuing to work on ensuring our data has integrity and can be compared across the entire service area. Our last priority for the 2017-18 fiscal year, was identified through our Crisis Coordination work, is to develop a plan where CMHLG will act as a triage for Hotel Dieu for all youth psychiatry consult referrals for Leeds and Grenville and Open Doors for Lanark County.


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Section B: Core Services Summary Core Service and Key Processes (Based on PGR #01)

Agency Delivering Service (Lead agency of other MCYS-funded child and youth mental health core service provider)

Description of Program Budget MCYS funding allocation for core service deliver

Service Commitment Per Year (e.g., service targets and service specifics (Per the service contract))

Method to assess service quality (e.g., CANS, Client Satisfaction Survey)

Brief Description Geographic coverage in service area

Age group served

Target population if applicable (e.g., Aboriginal, Francophone, South Asian)

TARGETED PREVENTION (A356) Focus is on increasing child, youth or family`s capacity to understand MH issues, identify problems early, change perspectives, enhance resiliency; avenue to promote early identification of MH problems, provide timely effective early intervention and develop skills in a specific population.

CMHLG

Some targeted prevention community and school presentations on an as needed basis including ASIST trainings.

All of Leeds and Grenville

0-18 $91, 421 250 Presentation review surveys, client satisfaction forms, training evaluation forms

EKIOC coordinator’s salary falls under this detail code

Making Play Possible, a program that removes barriers to recreational activities for children and youth

Open Doors Community Presentations to target groups specifically at risk youth

All of Lanark

0-18 $72,593 500 Presentation review surveys, client satisfaction forms, training evaluation forms

Youth engagement activity – youth presenting presentations to


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E.g., MH literacy, resiliency/early prevention groups, stigma reduction activities, prevention programs at specific populations such as youth with anxiety

youth on mental health within the high-schools – NEW MENTALITY

Participate in Screening Clinics

CHEO Youth Net – By youth for youth mental health promotion program

Strive to reduce the stigma surrounding mental health and illness through prevention and intervention activities, education, research, and advocacy.

All programs led by trained facilitators aged 20 - 30 and are supported by clinical back-up resources.

Champlain LHIN – Parts

of North Grenville

and North Lanark

13-18 Satisfaction Measures; Total Clinical Outcomes Management (TCOM) # of participants in sessions/ workshops/ trainings

BRIEF SERVICES (A348) Focus is “quick access” therapeutic encounters to address the immediate or presenting needs of a child or youth

CMHLG Brief Services

Clinical intake screen

Single Session Consult

School Single Session Consult

Brief Intervention (4 additional sessions following SSC)

School Brief


0-18 965,097 830 Outcome measurements, ministry stats and client satisfaction surveys


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provided through a service delivery mechanism that allows more effective service. Brief services are episodic and time limited. E.g., walk-in clinics, single session model, brief consultation

Intervention (4 additional sessions following School SSC)

Walk-In a single session

brief services use solution focused and narrative therapy modalities

All staff are trained in ASIST suicide risk planning

Open Doors Face to face consultation

Brief intervention 4 additional sessions

Same day clinics

All staff are trained in ASIST suicide risk planning and FIT Feedback informed treatment

All of Lanark County

0-18 $366,769 850 Outcome measurements, client satisfaction surveys and ministry stats

COUNSELLING AND THERAPY (A349) Focus is on reducing the severity of, and/or remedying, the emotional, social and behavioural problems of children and youth. Services includes a series of

CMHLG • Individual-, narrative therapy, CBT, solution focused, attachment therapy, EMDR, ITTM, mindfulness • Family- family counseling and support in school based setting, family therapy in office based services • FRIENDS anxiety group


6-18 $ 1, 011, 404

475 Outcome measurements, client satisfaction surveys and ministry stats and CANS


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planned, interrelated interventions based on an assessment of the child, youth and family’s multiple risks, needs and strengths. Can include a range of modalities (e.g.., individual, group, family, play-based) as well as clinical practices (e.g., CBT) E.g., individual counselling & therapy, family counselling and therapy

and Go Goddess group All staff are trained in ASIST suicide risk planning and VTRA

Open Doors Individual-, narrative therapy, CBT, solution focused, attachment therapy, EMDR, ITTM, mindfulness • Family- family counseling and support in school based setting, family therapy in office based services All staff are trained in ASIST suicide risk planning and FIT Feedback informed treatment


0-18 $920,058 350 Outcome measurements, client satisfaction surveys and ministry stats and CANS

FAMILY/CAREGIVER CAPACITY BUILDING AND SUPPORT (A351)

CMHLG Triple P Level 2-5 and standard Group and individual modalities


0-18 $92, 441 40 Triple P Outcome measurements, client outcome measurements, client satisfaction


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Focus is to enhance parent, caregiver or guardian capacity to understand, support and adaptively respond to the MH needs of the children and youth. Could include changing attitudes and behaviours, support to adjust to new diagnoses, building skills and competencies, and/or creating awareness and resiliency, provision of effective parenting strategies. E.g., family support, groups, system navigation support, peer supports

and ministry stats

Open Doors Parent consultations without the involvement of the child or youth Working in home on the development or parenting skills that support the intensive treatment recommendations made to children and youth


0-18 $34, 794 75 Outcome measurements, client satisfaction and ministry stats

Lanark Renfrew Health and Community Services

Lanark Community Programs Respite

Lanark County

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SPECIALIZED CONSULTATION AND ASSESSMENTS (A355) Focus is clinical consultations and/or diagnostic assessment services designed to provide advice or direction in the diagnosis, prognosis and/or treatment of a child or youth.

CMHLG Contracted Services with Child Psychiatrist Dr. Khan from Hotel Dieu Contracted Services with Dr. van Stralen Consulting Pediatrician Minimum number of psychological assessments per year

Leeds and Grenville

0-18 $46, 245 120

Open Doors Contracted Services with Dr. Child Psychiatrist from Hotel Dieu Minimum number of psychological assessments per year

Lanark 0-18 $49, 154 80

Children’s Specialized Consultation Champlain Mood $1,916,174 # of Individuals ABC Data Sheet (


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E.g., psychological or psychiatric consultations/assess-ments, psycho-educational assessments

Hospital of Eastern Ontario

& Assessment

CHEO has a number of speciality teams which provide the outpatient and outreach services. Services include specialized consultation/assessment and intervention

Teams include: mood and anxiety; ADHD/ADD/Disruptive Behaviours; Abuse/Trauma; Dual Diagnosis

Teams composed of child/ adolescent psychiatrists, psychologists, psychological associates, nurses, social workers, occupational therapists, speech language pathologist

Referrals through CY-SPMHS intake (by health professional)

Care plans established for each child/youth

Linkages with other service providers: CYMH agencies, school boards, CAS, adult mental health services for youth who are transitioning, adult developmental services sector

OTN is utilized by members of CHEO’s

LHIN (ERO plus North Lanark and

North Grenville)

and Anxiety – under 16 years

ADHD/ ADD/ Disruptive Behaviours –under 16 years

Abuse/ Trauma – up to age 18

Dual Diagnosis – up to age 18

Served 3,070 # of Client Consultations 3,070 # of Education Sessions 12 # of Days Children/Youth Waited for Service 162,300 # of Children/Youth with Assessed Psychiatric Needs 3,070 # of Children/ Youth with Complex Assessed Needs

Functional Behavioral

Assessment Measure)

Adaptive Behavior Assessment

System(ABAS II) Connors 3 ( parent

and Teacher Forms)

Behavior Assessment System for Children (BASC

2) Sensory Profile

Crisis Intervention/Safety Plan Questionnaire Clinical Evaluation

of Language Fundamentals-4

(CELF -4) and other Speech and

Language assessment measures

Behavior Inventory of Executive

Functions ( BRIEF) parent and teacher Autism Diagnostic

Observation Schedule (ADOS)

Childrens Depression

Inventory (CDI) Revised Childrens Manifest Anxiety

Scale (RCMAS) Other

Psychological


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clinical teams to provide consultation assessment and short term intervention

Measure depending of the referral questions

Outreach Services

OTN is utilized to provide the essential link to consultative and collaborative partnerships for children and youth suffering from major psychiatric disorders who are living in the counties of Renfrew, Prescott-Russell, Stormont-Dundas-Glengarry, North Lanark and North Grenville

Interdisciplinary mental health team works in collaboration with the community in which the child/youth lives to ensure that specialized psychiatric services are available to him/her

The Royal Ottawa Health

Group

Outpatient Services

Intensive and specialized mental health services to youth with emerging and early onset psychiatric disorders and /or complex psychiatric illnesses

The Royal’s outpatient program

Champlain LHIN (ERO plus North Lanark and

North Grenville)

16-18

$984,391

Beck Depression Inventory (BDI) Multidimensional Anxiety Scale for Children (MASC) Youth Self Report (YSR) Youth Quality of Life (YQOL) Adolescent Alcohol and Drug Inventory Scale (AADIS)


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team is composed of psychiatry, psychology, nursing, social work, occupational therapist, addiction counsellor and a recreation therapist.

Referrals through CY-SPMHS intake (by health professionals) Urgency or severity of need determines the priority for treatment

Specialized team responds to the Individual needs of the youth through individual and group interventions.

Linkages to other service providers: CYMH agencies as well as transitioning to adult mental health services.

ANSA-T Client Satisfaction Questionnaire 8 item version (CSQ-8)

Outreach Services

OTN is utilized to provide the essential link to consultative and collaborative partnerships for youth suffering from major psychiatric disorders who are living in the

16-18


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counties of Renfrew, Prescott-Russell, Stormont-Dundas-Glengarry, North Lanark and North Grenville

Interdisciplinary mental health team works in collaboration with the community in which the youth lives to ensure that specialized psychiatric services are available to him/her

CRISIS SUPPORT SERVICES (A350) Focus is immediate, time-limited services, delivered in response to an identified child or youth who is experiencing an imminent mental health crisis or an urgent crisis situation that places the child/youth or others at serious risk. Services actively work to stabilize situation, ensure urgent access to services and may facilitate access to longer-term resources and supports. E.g., mobile crisis

CMHLG

Crisis Support in and out of office when needed during regular working hours

Leeds and Grenville

0-18

$56, 110 25

Open Doors

Crisis Support in and out of office when needed during regular working hours

Lanark 0-18

$82, 819 80


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services, crisis lines

INTENSIVE TREATMENT SERVICES (A353) Focus are for those who require intensive intervention for defined period of time or who require intensive intervention periodically throughout their life span, to maintain functioning in their home, school or community. Can be provided in variety of settings, matching the child, youth or family’s level of need with most appropriate intensity of service. E.g., in-home intensive services, day treatment program/section 23, out of home respite, residential services

CMHLG

Early Years, Middle Years and Adolescent Years In Home intensive treatment services Tap C also available

Leeds and Grenville

0-18

$956, 616 200 Outcome measurements, client satisfaction, ministry stats and CANS

Open Doors

Intensive in home service for children and youth Lanark 0-18

$464, 499 250 Outcome measurements, client satisfaction, ministry stats and CANS

Royal Ottawa Health Group

Partial Hospitalization Unit • Day hospital services or youth with serious psychiatric disorders • For youth stable enough not to require inpatient hospitalization • Unit does have the ability to step-up or step-down interventions • Team includes psychiatrist, psychologist, psychologist associate, social worker, C/Y counsellors, recreation therapist, an addictions counsellor,OT and education specialist.

Champ-lain LHIN (ERO plus North Lanark and North Grenville)

16-18

-BDI (Beck Depression Inventory) -MASC (Multi-dimensional Anxiety Scale for children) -YSR (Youth self -report) -YQOL (Youth Quality of Life) -AADIS (Adolescent alcohol and drug inventory scale) -CSQ-8 (Client satisfaction questionnaire)

SERVICE COORDINATION (A354) Focus is staff specifically

CMHLG Case Management functions of all services except Brief

Leeds Grenville

0-18 $83, 230 1110 Not used

Open Doors Case Management functions of all services except brief

Lanark 0-18 $92, 567 1200 Not used


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dedicated to providing case management and service coordination services. E.g., case managers, system navigators

CHEO •For the children, youth and families receiving specialized Consultation/ Assessment/ Intervention (A355) and Intensive Service Day Treatment/Section 23 (A353) at CHEO, •Activities include developing a service plan, monitoring progress and adjusting services, planning discharge and transitions • Safety plan to re-connect with CHEO clinical services should deterioration in functioning occur post discharge

Champ-lain LHIN (ERO plus North Lanark and

North Grenville)

0-18 years $107,300 Perception of care

Royal Ottawa Health Group (CSP)

•For the youth and families receiving intensive residential, intensive services day treatment, specialized Consultation/ Assessment/ Intervention, and Intensive Service Day Treatment/Section 23 at the Royal •Activities include developing a service plan, monitoring progress and adjusting services, planning discharge and transitions


North Grenville)

16-18 years $66,329 Not Used

ACCESS INTAKE CMHLG Demographic Collection Leeds and 0-18 $36, 612 1300 Modified CANS and


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SERVICE PLANNING (A352) Focus is staff specifically dedicated to providing intake services E.g., intake coordinators

and crisis assessment Grenville BCFPI questions

Open Doors Demographics and crisis assessment

Lanark 0-18 $220, 454 1275 FIT

Children’s Hospital of

Eastern Ontario

Intake

Referral to the Youth Psychiatry Program at The Royal and the Psychiatric and Mental Health Services at CHEO are initiated through the Centralized Intake service at CHEO

A referral from a physician is required for outpatient services at CHEO and The Royal

The Intake workers triage referrals based on urgency and appropriateness for specialized care

The Intake workers will provide information about community services for referrals which are redirected


North Grenville)

0-18 years

$283,259 Modified Cans at intake

The Royal Ottawa Health

Care Group

Intake Services

Referral to the Youth Psychiatry Program at The Royal and the Psychiatric and Mental Health Services at CHEO are initiated through the Centralized Intake service at CHEO

A referral from a


North Grenville)

16 – 18 years

$40,769 Modified Cans at intake


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physician is required for outpatient services at CHEO and The Royal

The Intake workers triage referrals based on urgency and appropriateness for specialized care

The Intake workers will provide information about community services for referrals which are redirected

Organizations/ Partners

Relationship (e.g. MOU, Contract)

Description Intended Purpose (e.g. Core Service Delivery, referrals, program, pathway)

UCDSB, CDSBEO and CMHLG

School Mental Health Worker in the Schools MOU

Leeds and Grenville MOU for the provision of services within high school environment also builds capacity with the school by increasing the awareness and knowledge of teachers

Quick Referral process and pathway to care within the high school environments to remove the need for transportation

Hotel Dieu Psychiatry and CMLHG

Contract for services The contract provides psychiatric services to Leeds and Grenville clients through Dr. Khan

Ensures that the core service specialized consultations and assessments is being provided

Dr. van Stralen Consulting Pediatrician and CMHLG

Contract for services

The contract provides consulting pedantic services to Leeds and Grenville

Ensures that the core services specialized consultations and assessments is being provided


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DSLG and CMHLG Contract for Psychology Assessments

To provide assessments and consultations to clients and staff. (Core service delivery). These assessments and consultations can provide direction for further service delivery or referrals to appropriate services.

Ensures that the core services specialized consultations and assessments is being provided

Catholic District School Board of Eastern Ontario

l'éducation, Conseil scolaire de district catholique de l'Est ontarien

l'éducation, Conseil des écoles publiques de l'Est de l'Ontario

l'éducation et secrétaire-trésorier, Conseil des écoles catholiques du Centre-Est

Upper Canada

VTRA Protocol Violence Treat Risk Assessment protocol

Risk mitigation and crisis support


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District School Board

Ontario Provincial Police

Brockville Police Service

Cornwall Community Police Service

Gananoque Police Service

Perth Police Service

Smith Falls Police Service

Family and Children’s Services of Lanark, Leeds and Grenville

Children’s Aid Society of the United Counties of Stormont, Dundas and Glengarry

Valoris for Children and Adults of Prescott-Russell


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Cornwall Community Hospital

Children’s Mental Health of Leeds and Grenville

Open Doors for Lanark Children and Youth

RNJ Youth Services

Laurencrest Youth Services Inc.

Probation, Ministry of Children and Youth Services, Youth Justice Services


Upper Canada District School Board

Champlain Community Care Access

Suicide Prevention Protocol

Suicide prevention processes including the adoption of ASIST training on a regional level

Risk Mitigation and Crisis Support


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Centre

South East Community Care Access Centre



Valoris for Children and Adults of Prescott-Russell

Almonte General Hospital

Brockville General Hospital

Children’s Hospital of Eastern Ontario

Carleton Place and District Memorial Hospital

Cornwall


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Community Hospital

Glengarry Memorial Hospital

Hawkesbury and District Community Hospital

Hotel Dieu Hospital Kingston

Kemptville District Hospital

Perth and Smiths Falls District Hospital

The Royal

Winchester Memorial District Hospital

Children’s Aid Society of the United Counties of Stormont, Dundas and Glengarry

Family and Children’s Services of


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Lanark, Leeds and Grenville


Cornwall Community Police Service


Ontario Provincial Police

Smith Falls Police Service



Pathways for Children and Youth

Children’s Mental Health Hastings Prince Edward Counties

Youthabilitations Quinte Inc.

Staff or Board requiring CMH Services Protocol

Staff members or board members of an agency can work with their agency to make a referral to a sister agency but received services in their own community

Access to Services and Referrals


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OTN Network Tele-Mental Health Agreements

Specialized consultations and assessments

Child and Youth Psychiatry assessments and consultations over video conferencing using OTN network



O.P.P. (Ontario Provincial Police)

Smiths Falls Police Service


DSLG (Developmental Services of Leeds and Grenville)


RNJ Youth Services

TriCounty Addiction Services

Intersections Protocol

Access to services and referrals


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camh (Centre for Addiction and Mental Health)

Smiths Falls Police Service

Lanark County Ontario Provincial Police

Lanark County Mental Health

Lanark County Paramedic Service

Perth and Smiths Falls District Hospital

Carleton Place & District Memorial Hospital

Almonte General Hospital

Brockville General Hospital

Open Doors For Lanark Children & Youth

Lanark County LEAD Protocol

The L.E.A.D. Team has been established to better serve this community and, specifically, emotionally disturbed persons in crisis. The purpose will be attained through increased training of the L.E.A.D. Team Members and a partnership with local mental health care professionals and advocacy/support groups. Peer Support Group located at The Link. Family to Family Support Group to support families with persons experiencing mental health disorders of concerns.

Access to services and referrals and crisis support


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Lanark Leeds & Grenville Addiction and Mental Health

Distress Centre Lanark Leeds & Grenville

CMHLG and LLG Mental Health and Addictions

Transitional Aged Youth Memorandum of Understanding LG

The purpose of this MOU is to confirm agreement between agencies regarding methods and resources available to complete an individualized, coordinated transition plan for youth with moderate to serious mental health and/or substance use issues who require ongoing mental health and/or addictions supports and links to other community resources.

Transition services from youth mental health services to adult mental health services

Children’s Mental Health of Leeds & Grenville

Lanark County Mental Health

Lanark Leeds and Grenville Addictions and Mental Health

Open Doors for

Transitional Aged Youth Protocol LLG

The purpose of this protocol is to confirm agreement between agencies regarding methods and resources available to complete an individualized, coordinated transition plan for youth with moderate to serious mental health and/or substance use issues who require ongoing mental health and/or addictions supports and links to other

Transition services from youth mental health services to adult mental health services


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Lanark Children and Youth

Youth Habilitation Quinte Inc.

Brockville General Hospital – Mental Health Services


Hotel Dieu – Early Intervention in Psychosis

Perth and Smiths Falls Hospital

RNJ Youth Services

Upper Canada District School Board

Victims Services of Lanark, Leeds and Grenville

community resources.

Various private psychologists and

Contract for services psychological

Limited resource – pay for psychology assessments on an


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Open Doors assessments Lanark as needed basis based on client treatment need

Hotel Dieu Psychiatry Open Doors

Contract for services The contract provides psychiatric services to Lanark Clients through Dr. Jones

Ensures that the core service specialized consultations and assessments is being provided

CHEO, ROH and CMHLG

Partnership Agreement and Memorandum of Understanding

Serves as an overall framework that defines the relationship, roles and functions of CHEP, and ROMHC and the mental health providers in Leeds and Grenville with respect to the specialized mental health outreach services for children and youth in Leeds and Grenville

Specialized Services and Intensive Services

Open Doors and CMHLG

School Based Program for Leeds Grenville students attending Lanark High Schools partnership agreement

An agreement that allows border children and youth attending school in Lanark County to receive services from Open Doors as this is more convenient and requires less transportation support

Access to services

Open Doors, CMHLG and Family and Children’s Services of Lanark Leeds and Grenville

PATH Memorandum of understanding

Parent assisted treatment homes – a partnership where youth can be removed for a limited amount of time from the family home to receive treatment and case management while in a foster home environment

Alternative to Residential Services

Family and Partnership to Representative sits on the Support to a Section 23 program provided by


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Children’s Services of Lanark, Leeds and Grenville, CDSBEO and CMHLG

support the Section 23 Program at St. John Bosco

admissions committee and all clients have an active clinician and services with CMHLG

education partners

Tumbling Together

MOU A program for 3 to 6 year olds with special needs in the areas of language, sensorimotor, self-regulation and school readiness. CMHLG staff work as part of a team to provide intensive therapies and strategies in a fun, movement oriented environment of a community gymnastics club.

Program

Triple P Community Working Group

Contract The Triple P Working Group provides leadership and coordination for the provision and evaluation of Triple P in Leeds and Grenville. Triple P is an evidence- based, collaborative and regional parenting support strategy.

Core Service Delivery

Connections MOU We provide one day a week of support to the connections program with a brief services clinician The clinician works with the staff at connections as part of the team and also sees youth individually for intake SSC and brief services.

Core Service Delivery


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Creating Pathways Classroom (Leeds Grenville) And Partners Program (Lanark)

MOU between CDSBEO and CMHLG and Open Doors

Provide Mental Health Workers to the CDSBEO to provide attachment

based Section 23 mental health support. The CDSBEO provides the funding for the positions. 0.5FTE Leeds and Grenville and 1.0FTE

Lanark

Pathways to Care between CDSBEO and CYMH

Section C: Population Profile Summary Lanark, Leeds & Grenville Counties is a considerably rural and homogenous population. Due to the rural nature of our population, services are provided to children, youth and families in either their homes or community offices. With respect to geographic region we are a fairly homogeneous community when it comes to language and ethnic culture. The geographic region of Lanark, Leeds and Grenville is not designated a French Speaking region. All of Lanark County is considered at risk for socio-economic disparity. Regions of Leeds and Grenville Counties are also considered at risk, specifically: Edwardsburg-Cardinal, Gananoque, Prescott and North Leeds. Much of Lanark, Leeds and Grenville is still classified as agricultural. Families who work outside the home travel to Kingston, Brockville, Ottawa or Kemptville for work opportunities. Throughout the tri-county region tourism is a growing industry with peak season being from June to late September. Transportation and isolation continue to be a barrier for youth to participate in recreational activities and gain consistent access to services and support. Both CMHLG and Open Doors work hard to remove transportation barriers but experience higher than average transportation costs. According to material provided by the Ministry of Child and Youth Services in December 2015:

Between 2015 and 2025, the population of children and youth aged 0-18 years in the province of Ontario is expected to increase at an average annual rate of 0.7%.

All three age subgroups are projected to increase between 2015 and 2025. The population aged 0-5 will increase at an average annual rate of 1.2%, the population aged 6-11 at 0.8%, and the population aged 12-18 at 0.3%. The 0-5 years age group is expected to have the largest increase among the three subgroups.

Lanark, Leeds and Grenville are seeing significant population growth in the areas of North Lanark and North Grenville, specifically Almonte, Carleton Place and Kemptville. Much of this growth is young families who are looking to raise a family outside of the city


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but still work in cities. The hospitals in these areas are seeing an increase in presentations at their Emergency including youth presenting with mental health concerns. According to the last census in 2011 Lanark Leeds and Grenville had a population of 164, 973 with 33, 720 individuals 18 years of age or younger. 3% of the population identified French being their first language, 35 individuals identified as aboriginal and an additional 3% identified as ethnically diverse. Next Steps: The 2016 census data will be released this coming spring. As a service area CMHLG will be working with Open Doors to further understand the growth regions of the counties, as well as the socio-economic depressed communities. We will also be looking at population health statistics with help from the local Health Unit and the Data Analysis Coordinators of both Lanark and Leeds and Grenville. We will be incorporating this data into the development of our performance management framework and our processes that are developed to make fiscal recommendations to the Ministry of Child and Youth Services regarding service area funding. Section D: Engagement Activities Family Engagement: Open Doors: Open Doors worked with PLEO in early 2016 to develop and implement a parent support group in North Lanark. This year they have worked with PLEO to further develop the framework of the parent support group by implementing short informational sessions regarding CYMH at the start of the parent group sessions. Open Doors have also been working diligently to ensure that there are parents with lived experience of the children’s mental health sector on their Board of Directors. CMHLG: CMHLG is currently working with PLEO and Kemptville District Hospital to develop and implement a parent support group in North Grenville. They will be following the new framework that Open Doors have found advantageous to getting parents out to the group. CMHLG has also been working with a selection of parents when revising printed materials such as brochures, orientation pamphlets and service letters including closing treatment letters. Next Steps:


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Staff Training from the Centre of Excellence

Working with Parents for Children’s Mental Health to develop a parent support group in South Lanark, Leeds and South Grenville.

Work with the Centre of Excellence to develop a Parent Engagement Plan for Open Doors that has regional aspects in collaboration with CMHLG

Work with the Centre of Excellence to develop a Parent Engagement Plan for CMHLG that has regional aspects in collaboration with Open Doors

Youth Engagement Open Doors: Open Doors are working on revitalizing their Youth Engagement programming at Open Doors. One of their clinicians acts as a youth engagement coordinator and has made progress on reconnecting youth to the program. CMHLG: CMHLG started a youth engagement program in October 2016 and successfully received a Dare to Dream Grant from the Centre of Excellence to create a video and present to community partners and schools. The small group has continued to grow to where their weekly meetings are experiencing a participant level of 15 to 20 individual youth. Transportation is continuing to be a challenge that we are addressing as barriers are identified. The youth will be presenting their video to local schools sharing the message that Counselling Works and that stigma associated with Mental Health needs to shift. The youth will also be talking to community partners on how services can be approached to make services and spaces more youth friendly. We are looking forward to seeing how the Dare to Dream Grant Activities impacts the community. In June 2016 Centre of Excellence presented a training to all staff at CMHLG on the importance of developing a Youth Engagement Program that meets the needs of the youth participating and we have used these principles as we have rolled out our programming. Both Open Doors and CMHLG youth engagement staff participated in training provided by the Centre of Excellence and attended a youth forum where various organizations with youth engagement programs came together and youth had the opportunity to plan civic engagement projects. CMHLG also has been working closely with the Centre of Excellence throughout the process of developing their youth Engagement programming including providing training to the entire staff body. Next Steps:

Staff Training at Open Doors on Youth Engagement

Centre of Excellence will continue to work with both agencies on their youth engagement plans

Presentations and video launch of CMHLG’s Youth Engagement Program Real ; Talk

Regional Youth Engagement Opportunities


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Service Coordination: CMHLG and Open Doors partnered with the Special Needs Strategy Committee to develop training and forms that will help support further integration of service planning and coordination of services for clients who are working with more than on community agency. Training was delivered in February and March and will be held again in a few months for those partners who were unable to attend. This will remain as a community priority for the upcoming year. Next Steps:

Work on ensuring that service coordination is a priority for services that go beyond Brief – cultural shift

Develop best practices for how to engage service partners and create collaborative service coordination and treatment opportunities.

Core Service Delivery Partner Engagement: We have two Core Service Delivery Partners in Lanark Leeds and Grenville. Open Doors for Lanark Children and Youth, an agency that offered the full continuum of core services and key processes and Lanark Community Programs who are allotted a small amount of dollars to support their respite program under the core service Family Caregiving and Support. We have focused our engagement efforts on working with Open Doors for Lanark Children and Youth. Open Doors has been a full partner from the beginning participating equally in gap analysis of the service area. Some of the lead agency budget has been used to second a member of the Open Doors management team on a part time basis to support the work on the priorities. This allows a member of the Open Doors Management team to act as co-lead on the priorities that we have been working on as a region specifically Youth Engagement, Family Engagement, Service Coordination, Crisis Coordination, Youth Addictions and Continuous Quality Improvement. In addition, our Quality Assurance Manager position was hired as a regional position offering support to both Open Doors and CMHLG equally. This has allowed each agency to develop Quality Management Plans that meet both individual needs as well as provide the opportunity to work towards the development of a regional plan. Next Steps:

Engage Lanark Community Programs in further discussions regarding their small allotment of funds

Working towards a performance management framework and funding allocations recommendations process for the service area (Outlined as Core Service Delivery Plan Priority)


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Continuous Quality Improvement Regional Work (remaining as a priority on the Core Service Delivery Plan) Section E: Priority Report Summary:

Priority Identified Crisis Coordination Partners involved Stage one Partners: Almont Hospital, Kemptville District Hospital, Carleton Place and District Memorial Hospital, Open Doors

for Lanark Children and Youth, Children’s Mental Health of Leeds and Grenville, CHEO and Centre of Excellence Stage Two Partners: Brockville General Hospital, Smith Falls Hospital, Perth Hospital, Hotel Dieu Hospital

Status this period

Red – considerable slippage and a significant risk that the completion date will not be met Amber – a possibility of some slippage but the issues are being dealt with Green – on track and should be completed by the target date

Project Description

[Very brief details of background, objectives, rationale, scope, etc.]

Youth who were presenting at hospitals in the service area were not being referred back to their community mental health agency

Youth would continue to present in crisis but not always admitted to in-patient services at tertiary hospital CHEO or Hotel Dieu

Crisis would continue until elevation in need resulted in in-patient services or disenfranchised youth

Progress Against Key Milestones

Deliverable (as identified in the 2014-15 CSDP)

Date of Completion Demonstrable Progress Next Steps

Community Engagement December 2016 for Phase One and December 2017 for Phase Two

Met with areas hospitals and CHEO to engage them in discussions on working towards a framework and got them on board to actively participate

Develop framework

Develop a framework for crisis coordination for youth presenting at local emergency rooms in the Champlain LHINS

June 2017 The framework has been developed and we are working on final edits to prepare for training with local emergency rooms doctors and nurses

Meeting on April 3 to finalize framework and determine areas where training will be required

G A R


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Communicate Framework and train hospital staff on how to implement protocol

Summer 2017 We have identified areas where training will be required

Complete training

Evaluate implementation and then use lessons learned to repeat planning process with South East LHINS Partners

Fiscal Year 2017-18 N/A N/A

Pre and Post Evaluation of Emergency Rooms to see how well the framework meets the needs of youth presenting with mental health concerns

Throughout the Project Hoping to work with the Centre of Excellence on this piece of work

Meet with Centre Representative for System Planning

Achievements over this period

What activities did you complete as you worked towards addressing this identified priority?

Collaboratively developed framework and decision tree to use at local ER rooms and a rapid referral form for hospitals to use to ensure community mental health agency is aware of youth requiring service

Challenges and Issues

Issue that arose Issue mitigation

Scheduling meetings that worked for all partners as everyone is busy with their own priorities and demands

As much as possible we would plan future meetings at the end of the current meeting

Priority Identified Youth Addictions Partners involved Phase One Partners: Lanark Leeds and Grenville Mental Health and Addictions, Open Doors for Children and Youth, Lanark

County Mental Health, Children’s Mental Health of Leeds and Grenville Phase Two Partners: Education, Youth Justice

Status this period

Red – considerable slippage and a significant risk that the completion date will not be met

G A R


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Amber – a possibility of some slippage but the issues are being dealt with Green – on track and should be completed by the target date

Project Description


Youth Addictions has increased across the service area and has been identified as a priority for education to create clearer pathways to care

Services for Youth Addictions in the past have been done separately from mental health treatment for youth and there is a desire to work towards concurrent treatment options

Service coordination and joint treatment planning between addiction and children’s mental health partners




Community Engagement September 2016 Phase One September 2017 Phase Two

We have engaged all Phase One Partners

Phase two partners

Identify barriers, concerns and opportunities regarding concurrent treatment opportunities in the service area

March 2017 This stage of work has been completed and we are now working on creating a service framework for coordinated services

Framework development and training

Identify areas where training is required to ensure that clients with addition concerns are comfortable self-identifying their needs

Complete – Addiction Staff require training on how to engage families in treatment Children’s Mental Health Staff require training in identifying addiction concerns Both agencies require training in concurrent disorder treatment with youth

Training has been identified Internal and external training is being explored

Training

Develop framework and partnership agreement with respect to service coordination between agencies

By March 2018 Meeting scheduled for April 3 to start looking at decision making process map

Training


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Training of Service Agreement and Clinical Training

by March 2018 N/A N/A



Community Engagement Efforts

We have identified the barriers faced by clients and the concerns with regards to human resources to create a service agreement that will work

We have identified areas where clinical training is required

WE have a working committee comprised of management and frontline staff participating in the project



Both Children’s Mental Health and Adult Mental Health Sectors are currently undergoing transformation at a systems level making it difficult to ensure that meetings are attended. The Mental Health and Addictions Redesign is a priority for LLG Mental Health and Addictions and while they are dedicated to working with us on this priority there will be times they will be unable to support our deadlines.

We are now working with administration at each location to ensure that the booking procedure is smoother

Youth Addictions is a priority of Catholic District School Board of Eastern Ontario and possible the Upper Canada District School Board through their education priorities in CYMH – however it has been difficult to explain that there is work to be completed with respect to treatment coordination prior to determining the pathways to are from Education to CYMH and LLMHA regarding youth Addictions. It has also been a challenge to determine what CYMH priorities both school board are working on and how they interact with our priorities.

Continue to work on relationships with CDSBEO and UCDSB and ensure that we are an active participant in the development of the Youth Addictions Protocol for UCDSB and CDSBEO


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Priority Identified Continuous Quality Improvement Partners involved Children’s Mental Health of Leeds and Grenville and Open Doors for Lanark Children and Youth

Status this period

Red – considerable slippage and a significant risk that the completion date will not be met Amber – a possibility of some slippage but the issues are being dealt with Green – on track and should be completed by the target date

Project Description


Family and Youth Engagement efforts in March of 2016 identified a number of clinical service concerns and needs

Both CMHLG and Open Doors felt that a strong Continuous Quality Improvement Plan with regional aspects would help positively influence service

Data integrity and comparability across the region was imperative as we start to compare regional services




Identify data integrity concerns and determine how to compare service data across the region

March 2018 A multitude of concerns have been identified at both CMHLG and Open Doors and corrections have been made this is an ongoing process as we continue to strengthen our data’s integrity

Continued identification and corrections

Develop Risk Management and Quality Assurance/ Improvement Plans at both CMHLG and Open Doors and incorporate aspects of Regional Comparisons

March 2018 Work is ongoing the Quality Assurance Manager has worked extensively with the management teams at both CMHLG and Open Doors in the development of these plans and has worked with the Centre of Excellence to determine best practices and frameworks that best meet the needs of both agencies

Continued work and completion of plans

G A R


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Performance Management Aspects for Lead Agency work for the Service Area

March 2018 Beginning discussions have occurred with our Core Service Delivery Partners and we will be proceeding with a collaborative approach to develop a solid performance management framework

Ongoing development of aspects at governance, management and staff levels



Core Service Delivery Partner Engagement

Staff Engagement at both agencies

Research and understanding of best practices

Training in Quality Assurance

Identification of data integrity concerns



Perceived power imbalance between Lead Agencies and core service delivery partners

Transparency in communications

Section F: 2016-17 Priorities Name of Priority #1: Triage Coordination for Hotel Dieu Psychiatry for Lanark, Leeds and Grenville

Rationale: In our community engagement process an area for enhanced service improvement was identified between LLG and Hotel Dieu hospital. Currently family DR. within our area refer directly to HDH for psychiatric consults. While some of these families may also be referred to us this is not always the case. We have embarked upon a triage process with HDH in which our agencies will now be the sole recipient of referrals for psych consult in LLG. We will triage the referral based on a developed algorithm. Families who do not require the level of specialization provided at HDH will be triaged to our respective agencies. They may also be seen by tele psychiatry. This will decrease the number of inappropriate referrals to HDH and thereby decrease the wait time for appropriate referrals.

Objective – describe in as much detail as possible the desired results of addressing the priority, include indicators and/or targets where


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possible (e.g. waitlists, protocol developed): CMHLG will act as the triage for all psychiatry referrals to Hotel Dieu from Leeds and Grenville and Open Doors for Lanark Children and Youth will act as triage for all psychiatry referrals to Hotel Dieu in Lanark County made by local physicians

Deliverable(s) Task(s) Estimated Timelines

Proposed Activity 1 (e.g. engagement, mapping, client engagement):

Identify Champion from the physicians to support transition of triage from Hotel Dieu to the local children’s mental health agency

March 2016

Work collaboratively with local physicians to develop pathways document and triage process using process already in use in border service area

October 2017

Proposed Activity 2: Launch process and community training of doctors throughout the summer

October 2017

Name of Priority #2: Performance Management Framework for the Service Area and Data Integrity and Comparability

Rationale: Note: Rationale should be supported by evidence such as the core services summary (Section B), the CMHP template, client feedback, previous evaluations and/or other evidence.

Lead Agencies are responsible for ensuring performance of the entire service area is supporting children and youth in Lanark Leeds and Grenville equitably.

Data needs to be comparable across the service area and integrity of data must be achieved

The performance management framework will have better success if it is developed in collaboration with our core service delivery partner

Objective – describe in as much detail as possible the desired results of addressing the priority, include indicators and/or targets where possible (e.g. waitlists, protocol developed):

Data Integrity and comparability across the service area

Performance Management Framework for the region that will produce data that can support service area planning and funding recommendations

Conflict Resolution Process with levels of elevation clearly defined



Working Committee with representation from Open Doors and CMHLG to compare data and targets to identify how services truly compare across the service area

Initial development of the committee has been completed and a meeting I is scheduled for May 2017

Funding conversations and identification of areas of concern Late 2017 – Early 2018


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that are under resourced

Proposed Activity 2: Collaborate on aspects of a regional performance management plan including a communication plan to disseminate information to staff

Late 2017 – Early March 2018

Name of Priority #3: Continuous Quality Improvement

Rationale: Note: Rationale should be supported by evidence such as the core services summary (Section B), the CMHP template, client feedback, previous evaluations and/or other evidence. • Family and Youth Engagement efforts in March of 2016 identified a number of clinical service concerns and needs • Both CMHLG and Open Doors felt that a strong Continuous Quality Improvement Plan with regional aspects would help positively influence service • Data integrity and comparability across the region was imperative as we start to compare regional services

Objective – describe in as much detail as possible the desired results of addressing the priority, include indicators and/or targets where possible (e.g. waitlists, protocol developed): A Quality Assurance Program that includes a Continuous Quality Improvement Plan and Risk Management Plan at both CMHLG and Open Doors for Lanark Children and Youth that supports regional comparison of data and services



Develop Risk Management and Quality Assurance/ Improvement Plans at both CMHLG and Open Doors and incorporate aspects of Regional Comparisons

March 2018

Regional CQI Committee By March 2018

Proposed Activity 2: Regional Score Cards outlining each agencies successes By March 2018

Section H – French Language System Partners Lanark Leeds and Grenville is not a French designated service area. Should we have clients refer to services and ask for French services we

either work with a translator or we work with a partner from a French Designated service area to help provide services to the child or youth. We

do have a French Speaking Catholic School Board with 3 schools in the region. We will be working on an engagement project with this schools in

2017-18 fiscal year to determine how we can best partner to ensure that their students and families are aware of services and how to access

services within their own communities.


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Section I – Approvals Children’s Mental Health of Leeds and Grenville approved the priorities for the Community Mental Health Plan on March 22, 2017.

Documents

2016-17 Core Services Delivery Plan for Children and Youth ... · without the involvement ... child/ adolescent psychiatrists, psychologists, ... Adolescent Alcohol and Drug Inventory