Complex Case Resolution ProcessChildren’s Case Resolution

Complex Case Resolution Process• Need in the community:o The complex case resolution process came into existence when

the provincial government realized that the only way a family with a child with very complex needs could get all of his/her needs met was to have them placed in care

• To address this, MCYS developed the Complex Case Resolution Process, which takes the following form:o Regional, e.g., Leeds and Grenville, Complex Case Resolution

Committee’s (currently composed of MCYS supervisors, Executive Directors from Community Living, North Grenville, BDACI, DSLG, CMHLG, FCSLLG, and an invite to CCAC)

o Other community stakeholders involved in case resolution are the school boards and health sectors such as CCAC, LHINs, etc.

o Current chair is Allan Hogan, Executive Director, FCSLLG

Process• All funding requests submitted to the regional committee• Committee meets a minimum of once a year and when an

application has been submitted• Final approval for funding rests with the Ministry• Once approved, each case are reviewed at a minimum of once

a year, and more frequently as needed• Funding is provided on a fiscal, year to year basis

In the past 2 years• 8 Complex Special Needs cases applications were reviewedo 2 were approved for fundingo The costs range between $65,000 and $186,000 o Both cases were funded to receive residential services

Criteria for applications: • With the understanding that the child/youth’s needs span

multiple sectors and care providers, clearly documented evidence is required to show that significant work and collaboration has already been undertaken to try to meet their needs

• Meeting the child/youth’s needs clearly go beyond the scope and resources of the referring agen(cies).

• There is increased likelihood of the child/youth coming into care if further intervention is not provided

• Family must be engaged in and aware of the application process

Where are children/youth placed:

• With adequate supports, a number of children/youth who are funded through the Complex Case Resolution process are able to continue to live with their families

• Some youth, who need a residential placement, unfortunately are placed outside of Leeds and Grenville

• Why is this?• Children’s treatment beds were available to Leeds and Grenville- 1970’s—

1990, e.g. Sunnyside Children’s Centre in located in Kingston• In the early to mid 1990’s—children’s residential services dismantled into

local/regional services- LLG/ Hastings/ Frontenac/etc• Treatment beds were available through Sampson House (Child and Youth

Wellness Centre), but closed around 2001 due to changes in funding models and a desire by MCYS to look at a different residential treatment format

• Goal for the future: to look at developing residential placements within Leeds and Grenville that can meet the youth’s needs with community supports

What are the Issues that Result in Someone’s Story Being Told to the CCSN Case Resolution Committee?

What are the Issues that Result in Someone’s Story Being Told to the CCSN Case Resolution Committee?

• Children with severe disabilities such as Autism who have one or more additional issueso Severe behaviour problemso Communication difficultieso Seizure disorderso Medical conditions such as diabetes

• Children with severe intellectual disabilities, physical disabilities and medical issues which result in them being considered medically fragile

• Children with mental health Issues, including addictions, and intellectual

disabilities who fall “between the cracks” • Children with any combination of the above who

o live in poverty which reduces their parents’ ability to copeo don’t sleep well which reduces their parents’ ability to copeo face challenges in the education system

Case StudyChildren’s Case Resolution

The situation• Received a call from a parent who was requesting

assistance for his son • Son was currently hospitalized at CHE0- to be discharged

March 15

Diagnosis and Behaviour• Child (currently 13 yrs) diagnosed at 2 yrs. 7 mo. ASD

with global developmental delays• Hospitalized for serious development issues, also

demonstrating violent behavior. Discharge information from CHEO indicated an additional Dx Anxiety Disorder NOS• School attendance at risk; police involvement

Interventions from multiple sectors and care providers• CLNG immediate response: case management, • behavior supports (DSLG), • respite (talked with BDACI), •MCSS contacted to negotiate immediate increase to ACSD • referral to Children’s Case Resolution• two well credentialed workers who were scheduled in

home daily with behavioural backup• ASD respite committee approved contingency funds

(2,500.00)• Several SORs reported, staff were becoming increasingly

concerned about safety, school board decided to send child to school in Smiths Falls.

Interventions from multiple sectors and care providers• Summer camp experience did not have the structure the child

needed, placed in a more secure setting• Psychologist recommended in house treatment for 6 – 9

months• Worked with school board for an alternative school placement

which later broke down. Child charged by police• Medical issues addressed – gastro, dental and medication

change• Dietary changes needed

The Request

•MCYS requires additional funding to stabilize child• Family is asking for change, would like child to return

home, requesting MCYS provide funding• Current behavioral profile includes extreme aggression

(biting, poking others with sharp objects, incontinence, fecal smearing, destruction of property)