Transfer Payment Reporting Standards

Transfer Payment Reporting Standards
Developmental Services Dec 2011

Detail Codes and Data Elements Key objectives of the project: Streamline current detail codes and clarify definitions to align with Transfer Payment service delivery, the Services and Supports to Promote the Social Inclusion of Persons with Disabilities Act (SIPDDA) and regulations Improve the Ministry’s capacity to capture true and accurate costs of services Introduce well-defined, measureable service outputs that enable the Ministry to meaningfully assess service capacity and value for money Address concerns raised by the Auditor General

Detail Codes and Data Elements Streamlining detail codes and standardizing service data results in: Simplified reporting requirements for agencies Clarified service functions and activities Improved reporting accuracy, and Meaningful measurement of services

Consultation Process The standards development process has occurred over the past four years and consisted of the following steps: Internal survey on Ministry information needs, current data elements and new elements Ministry working group discussions to refine the proposed elements and definitions Focus groups and consultations with Transfer Payment agencies Policy approval of proposed service data standards for implementation, and Implementation planning including training and budget package changes

What Is Included in Detail Code Definitions? Detail codes inform stakeholders of the core activities and functions provided by a service.Although the definitions include a range of activities, all specified activities are not necessarily provided by every TPA reporting in the detail code. The definitions, can however be used to clarify service expectations to TPAs. Detail code structures should be similar to the way TPAs are organized to provide services. Detail codes are also structured to comply with funding controls and external reporting requirements (e.g. reporting obligations to other levels of government). New detail code definitions do not typically convey information about specific funding initiatives. This is a change from current practice. As a result, we recommend that new detail codes not be created simply to track new funding announcements for an existing service. Specific outputs can be measured using service data elements to account for the new funding within existing detail codes.

Detail Code Definition Components A Detail Code definition includes the following components:

Streamlined Detail Codes The details codes have been reduced from over 30 to 16 including: 1. DS Supported Group Living Residences 2. DS Intensive Support Residences 3. DS Host Family Residences 4. DS Specialized Accommodation 5. DS Supported Independent Living 6. DS Caregiver Respite Services and Supports 7. DS Community Participation Services and Supports 8. DS Specialized Services – Adult Protective Services

Streamlined Detail Codes cont’d 9. DS Professional and Specialized Services 10. DS Employment Supports 11. DS Coordination Processes 12. DS Application Entity 13. DS Funding Entity 14. DS Direct Funding Budgets 15. DS Community Networks of Specialized Care (CNSC) 16. Broader Public Sector – Other Developmental Services

What is not changing Detail codes for Children’s Developmental Services Dedicated Supportive Housing Small Water Works ODSP Employment Supports 8915 – Partner Facility Renewal – Capital 8868 – Vocational Alternative Supports Other MCSS Programs

Mapping to Streamlined Detail Codes New DS detail codes are consistent with legislation and with TPA staffing structures for service delivery. As a result, in many cases these may not represent a simple consolidation of previous detail codes to new ones. The new codes are also not likely to be consistent with past funding initiatives. In some cases funding from previous detail codes will need to be split between multiple new codes. The standards include mapping from previous to new detail codes in its appendices. However, the recommended approach is to consider the new definitions and determine applicable detail codes based on services and organizational structure within agencies. Rationale: Variations exist between TPAs in their use of old detail codes. Therefore, although there is a mapping from previous to new detail code, it is expected that mappings for specific agencies will vary to provide accurate reporting using the new detail codes. 10

Mapping of Detail CodesThis mapping is provided as a general guideline, agencies should review the detail codes to determine the best fit for each of the services they offer. DS Supported Group Living Residences 8847 (SIPDD Act) Adult Community Living-Group Living Supports 8847 (SIPDD Act) Community Living Supports – Individualized Residential Model 8844 (SIPDD Act) Adult Community Living-Group Living Supports 8847 (SIPDD Act) DS Intensive Support Residences XXXX (SIPDD Act) Adult Community Living-Associate Living Support 8845 (SIPDD Act) Community Living Supports – Individualized Residential Model 8844 (SIPDD Act) Current New DS Host Family Residences XXXX (SIPDD Act)

Mapping of Detail Codes DS Specialized Accommodation 8886 (SIPDD Act) Specialized Accommodation 8886 (SIPDD Act) Community Living Supports-Adult-Individual Living Supports 8846 (SIPDD Act) Community Living Supports – Individualized Residential Model 8844 (SIPDD Act) DS Supported Independent Living XXXX (SIPDD Act) Adult Respite Supports- In Home Supports 8855 (SIPDD Act) Adult Respite Supports-Out of Home Supports 8856 (SIPDD Act) DS Caregiver Respite Services and Supports XXXX (SIPDD Act) Community Participation Supports-Adult-Community Access Supports 8860 (SIPDD Act) Passport - Transfer Payment Agency 8885 (SIPDD Act) Specialized Community Supports – Adult - Foundations 8865 (SIPDD Act) Specialized Community Supports-Adults-Other 8861 (SIPDD Act) Current New DS Community Participation Services and Supports XXXX (SIPDD Act)

Mapping of Detail Codes Adult Protective Services Supports 8888 (SIPDD Act) DS Specialized Services - Adult Protective Services 8888 (SIPDD Act) Intensive Case Management Dual Diagnosis 8884 (SIPDD Act) Specialized Community Supports-Adult-Behaviour Intervention 8859 (SIPDD Act) Specialized Community Supports-Adult-Speech & Language 8858 (SIPDD Act) SCS - Adults-Other 8861 (SIPDD Act) SCS – Adult-Video Conferencing 8863 (SIPDD Act) Psychological Assessments 8880 (MCSS Act) DS Professional and Specialized Services XXXX (SIPDD Act) DS Employment Supports 8871 (SIPDD Act) CPS – DSB – Employment Supports (Transition) 8871 (SIPDD Act) Specialized Community Supports-Adult-Assessment & Counselling 8857 (SIPDD Act) Access Mechanism – Developmental Services 8864 (MCSS Act) Passport - Designated Agency/Local Access Mechanism 8883 (MCSS Act) Current New DS Coordination Processes XXXX (MCSS Act)

Mapping of Detail Codes Application Entity 8882 (SIPDD Act) DS Application Entity 8882 (SIPDD Act) 8883 Passport – Designated Agency/ Local Access Mechanism 8875 Special Needs – Phase II – Adults with a Developmental Disability (Adult SSAH only) DS Direct Funding Budgets (XXXX) Specialized Resources - Community Networks of Specialized Care 8887 (SIPDD Act) SCS – Adult-Video Conferencing 8863 (SIPDD Act) DS Community Networks of Specialized Care (CNSC) 8887 (SIPDD Act) Current New Broader Public Sector – Other Developmental Services 8876 (MCSS Act) Broader Public Sector – Other Developmental Services 8876 (MCSS Act)

DS Supported Group Living Residences (8847) Adult Community Living-Group Living Supports 8847 (SIPDD Act) DS Supported Group Living Residences 8847 (SIPDD Act) Note: There may also be circumstances where a current enhanced supported independent living model or Individualized Residential Model better fits Group Living under the new definitions.

DS Supported Group Living Residences (8847) A supported group living residence is a staff – supported residence operated by a service agency and include: 24/7 staffing support is available for residents Accommodations are for groups of three or more residents Includes support for activities of daily living and development and implementation of individuals support plans Includes supports for participation in community activities are provided by residential staff

DS Supported Group Living Residence Scenarios Scenario 1 Four individuals ( Bob, Sally, Mike and Sarah) live in a group home that is owned by your agency. All four of these individuals go to the day program during the week. Even though all four individuals attend a day program and a couple of them go away to visit their families, the prime responsibility for their care remains with your agency and therefore they would be counted as being in a supported group living residence.

Scenario 2 Beth, Ron, and Mary live together. Beth attends Day program but Ron and Mary are now retired and they do activities in the community with the residential staff. They live in a co-operative housing unit in a three bedroom apartment. Although they rent the apartment, the agency is still responsible for maintenance and furnishing of the apartment. They have staffing for twenty four hours per day to assist them in the activities of daily living.

Scenario 3 Kevin, Ron, Keith, Stan and Jason all live in a residence. Staffing costs for this home are higher than in other residential homes due to the need for increased staffing to deal with behaviours. Kevin has a number of behavioural protocols in place. At times his behaviour escalates to the point where he needs to be put in a mechanical restraint and five staff are required to be present to carry out this procedure. Although the number of incidents have decreased since he moved to the agency and there is no longer a requirement for five staff in the home at all times, there is a need for call-in staff to be close to the home and there are days when there are five staff present to deal with the issues. Ron has a dual diagnosis. He threatens staff and others in the home. He has a history of running away and he often has been taken into custody for short periods of time. There are a number of behavioural protocols in place. The other residents also have behavioural protocols in place but their incidents are not as frequent as Kevin and Ron.

DS Intensive Support Residences (XXXX) Community Living Supports – Individualized Residential Model 8844 (SIPDD Act) Adult Community Living-Group Living Supports 8847 (SIPDD Act) DS Intensive Support Residences XXXX (SIPDD Act)

DS Intensive Support Residences (XXXX) An intensive support residence is a staff – supported residence operated by a service agency and includes: 24/7 staffing support is available for residents Accommodations for one or two individuals May include provision of specialized behaviour and/or medical supports under clearly defined/prescribed clinical supervision Supports for participation in community activities provided by residential staff

DS Intensive Support Residence Scenarios Scenario 4 Suzie and Kyle both have very high medical needs. They live together in a home and they require total care with all of their activities of daily living. Suzie is diabetic and requires insulin. Staff must feed her a prescribed diabetic diet and are required to administer insulin and check her blood sugars. She is blind and she has oxygen therapy for congestive heart failure. Her legs often become ulcerated and staff must do dressings. Suzie is unable to walk. She can no longer feed herself or do any of her personal care.

Kyle requires total care. He is blind. He is fed through a G-Tube on a continuous feed. He requires suctioning and oxygen therapy. He needs to be constantly monitored because he stops breathing at intervals. He has had numerous episodes of aspiration pneumonia. He requires postural drainage and range of motion exercises at least three times a day. He receives sensory stimulation daily. Scenario 5 Kathy and Margo live in an apartment. During their person directed plans it was determined that a quieter setting with fewer individuals would be the best option for these two ladies. They require assistance 24 hours a day. Kathy attends the day program on a regular basis but Margo only attends two days a week due to health issues. She has a dual diagnosis but seldom has any severe behavioral outbursts.

Scenario 6 Linda and Ruth live in a residence owned by the association. They have single adjoining apartments in the home. Linda has a dual diagnosis and she requires intensive behavioural supports. In the past she has been extremely agitated and may do extensive damage to the home in which she resides. The home has had major alterations to ensure her safety and the safety of the staff who are supporting her. She has weekly appointments at the mental health center for treatments and this requires two staff to assist with the hour transport. She has multiple behavioural protocols in place . Ruth has been diagnosed with Prader Willi Syndrome and also requires constant monitoring both of her behaviours and her diet. In both of these cases there is a higher expectation of staffing costs. There are higher costs related to staff training because of the interventions from behavioural therapists and other clinical professionals. Staff working in these homes have a higher than average staff burn out rate and therefore there are usually higher replacement costs than in other residential settings.

DS Host Family Residences (XXXX) Adult Community Living-Associate Living Support 8845 (SIPDD Act) Community Living Supports – Individualized Residential Model 8844 (SIPDD Act) DS Host Family Residences XXXX (SIPDD Act)

DS Host Family Residences (XXXX) A host family residence is when a person with a developmental disability, who is not a member of the family, is placed by a service agency in a family residence to reside and receive care, support and supervision from the host family, in exchange for remuneration. It also includes: Screening, recruitment and training Home visits Case management, and Inspection and compliance with requirements for host living

DS Host Family Residences Scenarios Scenario 7 Jennifer would like to live with a family. She has been residing in a group residence but feels that she would like to be part of a family. The agency worker, Sarah, has been interviewing families who are interested in becoming a host family. Once the family has been chosen there will be a number of visits between Jennifer and the family. It may start with meeting for coffee, or going on an outing. Jennifer may be introduced to more than one family at this stage. When Jennifer chooses the family with whom she wants to live, she will do some placement visits and then will eventually move into the home.

The family is paid a daily rate for their services. Sarah continues to do home visits on a regular basis. She would coordinate services for the family and the individual. Most host families receive respite and Sarah would arrange this respite.

DS Specialized Accommodation (8886) Specialized Accommodation 8886 (SIPDD Act) DS Specialized Accommodation 8886 (SIPDD Act)

DS Specialized Accommodation (8886) These are the beds that are commonly connected to the Networks of Specialized Care. They are transitional short term accommodations for specific treatment goals. Services are provided in a staff supported residence to individuals with a developmental disability who have a co-existing mental illness (dual diagnosis) or behavioural challenges that requires specialized supports to meet their support needs. Mental illness will include mood/anxiety/personality disorders and depression. Challenging behaviours may include physical aggression, inappropriate sexual behaviour, and self-injurious behaviour

An agency operated, staff-supported residence with either: Permanent spaces for adults with persistent, high-risk behaviour who need ongoing specialized support; or Temporary, transitional spaces to provide crisis and specialized respite support for adults who needs exceed their caregivers’ ability to keep them safe from self-harm and/or harm to others Supports may include: 24/7 staffing Professional assessment Transitional short-term accommodations to achieve specific treatment goals Staff implementation of any clinical behavioural intensive treatment services/plans to stabilize mental health/behavioural functioning Staff providing services have the required training or experience in specialized/clinical services (eg. psychologist, behavioural therapist, psychiatric nursing).

DS Specialized AccommodationScenarios Scenario 8 Richard was part of a group residence in the community. He has a dual diagnosis. His behaviours have escalated to the point where he is a danger to the other individuals in the home. He has been destroying his clothes, putting holes in the wall, and throwing furniture. Staff have been working closely with the behavioural support team to monitor medications and to implement all of the behaviour protocols that have been established for him but nothing has worked. Staff and residents are unable to cope and therefore, the agency has asked that Richard be sent to the specialized accommodation treatment home temporarily for an assessment and that he receive more intensive supports from a clinical team. Once his treatment goals are reached he will return to his residence.

DS Supported Independent Living (XXXX) Community Living Supports-Adult-Individual Living Supports 8846 (SIPDD Act) Community Living Supports – Individualized Residential Model 8844 (SIPDD Act) DS Supported Independent Living XXXX (SIPDD Act)

DS Supported Independent Living (XXXX) Services and supports are provided to one or more persons with developmental disabilities who: Reside alone or with others but independently of family members or of a caregiver, and Receive services and supports from the service agency including activities of daily living Individuals are living in housing not operated by a Developmental Services agency, an individual’s own home or where an agency leases or owns the homes and then sub-leases to individuals they support

DS Supported Independent Living Scenarios Scenario 9 Aaron lives in an apartment in the community. He pays his own rent, his utilities and buys his own groceries and incidentals. Aaron receives six hours of support each week. His worker has been assisting him with transportation but he now needs to learn to take the bus to work. They have been putting the schedule for the bus on the calendar so that Aaron knows when he needs to be at the bus stop.

Aaron is learning skills to enable him to get to work and back home on his own. The other area that Aaron requires assistance with at present is managing his finances. His worker has been helping him to set up a budget which will include a set amount of money for entertainment. Aaron’s needs can change and some weeks he may need more support because he has appointments or other issues that need to be addressed. The S.I.L. worker may need to add hours one week and provide less hours another week depending on the needs of the individuals that she is supporting.

Scenario 10 George, Connie, and Karen are individuals who reside in a home that is owned by the agency but has been renovated into apartments. Connie and Karen share a two bedroom apartment and George lives by himself in a one bedroom apartment. They lease the apartment from the agency. They buy their own food and they pay all of their own bills. The S.I.L. worker assist them with cooking skills and has found a community co-operative cooking program that assists individuals to plan meals for the week, buy groceries together, cook the meals and share them.

Connie and Karen are also working on budgeting skills and housekeeping skills. George has been working on transportation skills since he has a job that requires him to take a bus. George receives eight hours of service from the S.I.L. worker each week and Connie and Karen are each receiving six hours of support.

DS Caregiver Respite Services and Supports (XXXX) Adult Respite Supports- In Home Supports 8855 (SIPDD Act) Adult Respite Supports-Out of Home Supports 8856 (SIPDD Act) DS Caregiver Respite Services and Supports XXXX (SIPDD Act)

DS Caregiver Respite Services and Supports (XXXX) Respite services are provided by a person other than the primary caregiver for the purpose of providing a temporary relief to the primary caregiver Services may be provided as follows: In the individual’s place of residence in the absence of the usual caregiver; In a setting other than their place of residence Supports may be provided hourly or for short-term overnight stays in dedicate group homes for respite, summer camps, respite family homes

DS Caregiver Respite Services and Supports Scenarios Scenario 11 Dan lives with his aging parents. His parents are not ready to refer Dan to adult DS residential services, but they need to have some time away from Dan. The agency recruited families and individuals who would care for individuals on a short term basis to give their primary caregiver a break. Dan goes to stay with Sue and Greg one weekend every month. In the summer he attends camp for a week as a means of respite for the family and it is also an outing that he looks forward to each year.

Scenario 12 Jane lives at home and attends a day program. Her parents would like to go to Europe this summer for their fortieth anniversary. They have never used adult respite services before because Jane has a number of siblings who often invite her to stay for the weekend. They have been able to find a home within the organization where she attends the day program that has spaces for individuals who need respite services. Jane is excited about going to the home. She will stay for the three weeks while her parents are on holidays.

Scenario 13 Edward is 19 and lives at home. His parents have three other children and they are very busy taking everyone to activities. Edward does not like to go to his sibling’s activities so his parents have been able to get some respite for three hours, three times a week to enable them to spend time with their other children. Edward’s respite provider spends time with Edward doing puzzles and doing some baking. These are activities that Edward likes to do and he appreciates the one to one attention he receives from the respite provider.

DS Community Participation Services and Supports (XXXX) Community Participation Supports-Adult-Community Access Supports 8860 (SIPDD Act) Passport - Transfer Payment Agency 8885 (SIPDD Act) Specialized Community Supports – Adult - Foundations 8865 (SIPDD Act) Specialized Community Supports-Adults-Other 8861 (SIPDD Act) DS Community Participation Services and Supports XXXX (SIPDD Act) Note: There may also be circumstances where current Individualized Residential Models 8844 or case management functions that are currently funded under 8857 better fits Community Participation Services and Supports under the new definitions.

DS Community Participation Services and Supports (XXXX) Services and supports include: Facilitate and support participation in community – based activities Develop skills in utilizing community infrastructures such as transportation services, shopping, libraries and recreational opportunities Promote activities of community inclusion for individuals transitioning from the education system Structured learning and education to enhance functional independence and community participation Development of person-directed planning Transitional supports for school-aged youth including passport mentoring

DS Community Participation Services and Supports Scenario 14 Quinn lives at home but attends a day program in an agency. While at the day support program, she has been learning cooking skills, attending curling, and accessing a variety of community sites such as the library and the sports complex. The staff are attempting to teach her to use the public transportation system so that she will have access to a number of facilities.

Scenario 15 Sonia lives in a group home run by one agency. During the day she attends the day program at another agency. She goes to the day program five days a week and she is involved in the recreation program, the cooking program. Scenario 16 Cameron is attending high school but he will soon be graduating. He attends the youth transition program where he is being introduced to different opportunities in the community that he will be able to access once his formal education has been completed. He has been working with Anita, the transition worker, to identify his interests and to set goals for his future.

DS Specialized Services – Adult Protective Services (8888) Adult Protective Services Supports 8888 (SIPDD Act) DS Specialized Services - Adult Protective Services 8888 (SIPDD Act)

DS Specialized Services – Adult Protective Services (8888) Only agencies currently funded for APSW services will utilize this detail code. Services and supports include: Advocacy to understand and exercise their rights, prevent abuse, disservice, or exploitation, access and maintain mainstream community supports and government funded services and supports Support with problem-solving, life skills counselling, guidance, or group facilitation Coordination and case management of community resources, service plans, mediation and liaison with other service providers Assisting or arranging for appropriate accommodation/housing, legal, health, social, financial, family or counselling supports

DS Specialized Services- Adult Protective Services Scenarios Scenario 17 Michelle lives in the community in an apartment. She is not part of any residential programs being offered by the local agencies for DS services. Michelle has been having difficulties paying all of her bills and she needs assistance with some budgeting skills. She was referred to the A.P.S.W. for some support. Angie, the APSW, realized that Michelle needed more intensive assistance than she was able to provide so she made an appointment for her at the local credit counseling service and took her to her first appointment.

Michelle did very well with support from the credit counseling, but they identified that Michelle was spending too much money going out for dinner. In order to help her stay within budget Michelle would need some assistance with shopping and preparing meals. Angie asked Michelle if she would like to attend the Community Kitchens program. This program involves preparing meals and doing shopping as a group. The group plans meals for the week and then they buy the ingredients, cook the meals and prepare them for the freezer.

Michelle met some people at the local coffee shop. She thought that they were her friends and she invited them to her apartment. One of the individuals said that she had no place to stay so Michelle let her sleep on the couch. When she woke up her stereo, her T.V. and some of her DVD’s were missing. She phoned Angie in tears. Angie assisted her to contact the police and report her stolen items. Angie realized that Michelle had very few friends and she assisted her to apply to the local agency to take part in their community participation recreation programs.

Angie also assisted Michelle to find a part time job in the community and worked with her to learn about the bus system in town so that she could get to work and back home. Angie took her to the O.D.S.P. office and helped her by ensuring that she was getting the proper funding and by researching any other programs or supports that might be beneficial for Michelle.

DS Professional and Specialized Services (XXXX) Intensive Case Management Dual Diagnosis 8884 (SIPDD Act) Specialized Community Supports-Adult-Behaviour Intervention 8859 (SIPDD Act) Specialized Community Supports-Adult-Speech & Language 8858 (SIPDD Act) SCS - Adults-Other 8861 (SIPDD Act) SCS – Adult-Video Conferencing 8863 (SIPDD Act) Psychological Assessments 8880 (MCSS Act) DS Professional and Specialized Services XXXX (SIPDD Act)

DS Professional and Specialized Services (XXXX) Services and supports may include: Psychological and/or other professional specialized assessments; Intensive case management for individuals with dual diagnosis; Development of clinical behavioural treatment plans; Behavioural intervention plans approved by a registered psychologist, psychological associate or other clinicians with experience in behaviour intervention; Psychological, psychiatric, and/or behavioural interventions; Crisis stabilization; Speech therapy; Language and communication skills training, behavioural assessment and intervention; and Assessment of needs in adaptive functioning. Staff are required to have a regulated health professional designation.

DS Professional and Specialized Services Scenarios Scenario 18 Amanda has just turned 18 years of age. She had a lot of difficulty in school but she never did receive a formal assessment. Her parents would like her to attend a day program at an agency. Amanda would require an assessment by a psychologist to confirm her eligibility for services and supports from the DS sector agencies as per the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities (SIPDD) Act .

Scenario 19 Carrie has been living in a group home in the community. Her behaviours have escalated to a point that staff are unable to keep other individuals safe from her. She throws chairs, clothes, and other items. She has been banging her head against the wall. The staff had her evaluated for physical illnesses by her family physician and he could not find a medical reason for her change in behaviour. Carrie has been referred to the professional support services for a psychiatric evaluation and behaviour management services.

The behavioural support team has been looking over the documentation to determine antecedents to the incidents that have taken place. They have worked with residential staff to establish behavioural protocols and they come back twice a week to monitor the situation. They will adjust the behaviour protocols as needed. They also spent time doing staff training regarding the protocols and the diagnosis that was established following the psychiatric assessment.

Scenario 20 Alex is unable to communicate his needs to the staff because he is non verbal. Following a speech assessment, the communicative disorders assistant and the speech pathologist have been working with staff to develop alternate methods of communication. They have developed a picture book. They are working on teaching signs to Alex and the staff. Since Alex has been able to make his needs known through the use of the picture book, his behavioural episodes have decreased dramatically.

DS Employment Supports (8871) CPS – DSB – Employment Supports (Transition) 8871 (SIPDD Act) DS Employment Supports 8871 (SIPDD Act)

DS Employment Supports (8871) Services and supports include: Vocational alternative supports preparing for or supporting individuals in a non-competitive employment setting for remuneration typically less than minimum wage Transitioning individuals to competitive employment Job development, training, and coaching Intervention with employers to maintain employment for the individual

DS Employment Supports Scenarios Scenario 21 Jeremy was excited to have a job in the community. In order to find the most suitable job placement, Jeremy first had an interview with the employment services worker, Julie. She assisted him to complete the employment questionnaires. Since he had never been in the workforce she enrolled him in the pre employment training program.

Once he completed the pre-employment training, Julie had connected him with a job in the community, working in a grocery store. Julie did a number of shifts with him so that he could learn the expectations of the job. Gradually as he became more comfortable she decreased her support until Jeremy was able to do the job on his own. He does not receive minimum wage because he does not produce to the same level as other employees, but he hopes that this will change in the future. Julie only stops by occasionally to talk to Jeremy and the employer to ensure that the placement does not break down.

DS Coordination Processes (XXXX) Specialized Community Supports-Adult-Assessment & Counselling 8857 (SIPDD Act) Access Mechanism – Developmental Services 8864 (MCSS Act) Passport - Designated Agency/Local Access Mechanism 8883 (MCSS Act) DS Coordination Processes XXXX (MCSS Act)

DS Coordination Processes (XXXX) This detail code will only be used on an interim basis. Services related to the application processes but not delivered by the application entities and may include: Prioritization and allocation of funding; Administration of direct funding budgets; Service coordination and information provision to individuals relating to services available in the geographical area

DS Application Entity (8882) DS Application Entity 8882 (SIPDD Act) Application Entity 8882 (SIPDD Act)

DS Application Entity (8882) Services provided include: Receiving inquiries/requests for individuals who wish to receive DS services Provision of information on services and supports provided by service agencies in the geographical area Confirming and reviewing eligibility Administering the Application Package to assess the applicant’s support needs Providing Individual Service and Supports Plans Matching eligible applicants with services and supports Provision of direct funding (pending proclamation of relevant sections of the legislation)

DS Application Entity Scenarios Scenario 22 Cheryl has never received any supports or services from the DS sector. She has contacted the DSO to obtain information regarding services and to confirm her eligibility. The DSO asks her to bring in all pertinent medical and psychological assessments. The DSO will have Cheryl complete an in depth application package (ADSS and SIS) to determine her support needs after eligibility is confirmed. Cheryl will then have an Individual Services and Supports Plan done to determine what she would like to do. The DSO will refer the person to available services that best meet their needs.

DS Direct Funding Budgets (XXXX) 8883 Passport – Designated Agency/ Local Access Mechanism 8875 Special Needs – Phase II – Adults with a Developmental Disability (Adult SSAH only) DS Direct Funding Budgets (XXXX)

DS Direct Funding Budgets This detail code will be used on an interim basis where services are purchased directly by an individual or primary caregiver through individualized funding administered by a transfer payment agency. This code will primarily be used by Passport – Designated agencies who will now also be administering the funds that were previously funded through Adult SSAH programs.

DS Community Networks of Specialized Care (8887) Specialized Resources - Community Networks of Specialized Care 8887 (SIPDD Act) SCS – Adult-Video Conferencing 8863 (SIPDD Act) DS Community Networks of Specialized Care (CNSC) 8887 (SIPDD Act)

DS Community Networks of Specialized Care (8887) Services and supports provided include: Coordinating and enhancing the specialized service system and building capacity of the DS, health care, academic community, and related service sectors including: Health Care Capacity Building French Language Service Resources Research by post-secondary educational institutions related to dual diagnosis and challenging behaviour Videoconference support to telemedicine, distance education and service system planning Education and training

DS Community Networks of Specialized Care Scenario 23 Lauren has a diagnosis of Joubert Syndrome. Lauren lives in a remote community in Northern Ontario. There is not a lot of access to specialists and the family would like to be able to help other professionals in the community understand the management and treatment of her condition. The network of specialized care was able to teleconference with specialists from Sick Children’s Hospital. The team from Sick Children's hospital was able to provide support to the local family physician and Lauren’s family.

There was a French interpreter present during the teleconference since Lauren’s family is Francophone. The family was also able to connect with resources from the Joubert Syndrome Foundation and Related Cerebellar Disorders. Scenario 24 A number of agencies want more information regarding dual diagnosis. The Community Network of Specialized Care has developed a number of teaching sessions related to this topic and they have made these sessions available throughout Ontario by videoconferencing. Agencies provide the space to staff who want further training via videoconferencing. This assists agencies to offer training without the added costs of travel and hotel accommodations.

Broader Public Sector – Other Developmental Services (8876) Broader Public Sector – Other Developmental Services 8876 (MCSS Act) Broader Public Sector – Other Developmental Services 8876 (MCSS Act)

Broader Public Sector – Other Developmental Services (8876) This detail code is used to reflect pay equity adjustment costs using the proxy method of comparison for staff positions that MCSS no longer funds or contracts for, with the agency. The Ministry will work with agencies to address reallocation of any approved funds for purposes other than that identified for 8876. Ministry staff will be addressing any remaining funds in this detail code in the future.

DS Service Data Standards Service data definitions have been standardized across detail codes and program areas. As a result, there are a few common data elements that answer simple questions across the DS detail codes: How many people were served? How much service was offered? Some of the data elements are only meaningful in some services. For example Resident Days data element is not relevant to community participation services and therefore not available for reporting in that service. Section 4 of the DS Chapter shows data elements by detail code. Data standards include some optional data elements. For DS, the data element Volunteer Hours of Service is optional. If agencies collect this data, they can use this optional element to tell the story about their services to the ministry. Section 6 of the DS Chapter defines all data elements.

Service Data Definition Components 78

Data Elements by Detail Code

Key Metrics

Individuals Served Unique/unduplicated number of individuals by the language in which they receive services An individual is counted only once per year for each detail code where they received service The number of individuals served are year to date (cumulative) For DS Application Entity includes all individuals that have started the eligibility confirmation process For DS Community Participation Supports includes the number of students between 14 and 21 who have been linked with a mentor

Individuals Served by Service/ Support Type Unique individuals are reported in the following support type subcategories: Intensive Case Management (Dual Diagnosis) Psychological Assessments Behavioural Supports Speech Therapy – English Speech Therapy – French The number of individuals served are year to date (cumulative)

Individuals Served by Level of Support Unique/unduplicated number of individuals served by the amount of in-person support they receive from paid staff during the reporting period The amount of support excludes: Emergencies or non typical amounts of support Time spent on activities on behalf of the individual, where the individual or substitute decision maker is not present An individual can only be reported in each subcategory once per reporting period

Individual Served by Level Of Support cont’d Unique individuals are reported in the following subcategories: Daily Support 0 – 8 hours per day Daily Support 8 – 24 hours per day At least once a week At least once a month Less than once a month The number of individuals served are based on a snapshot (point of time)

Individuals Served by Level of Support Scenario John receives 2 hours of support 2 days per week in April and May, and 0 days in June, and 0 in the entire 2nd quarter. --- When reporting for the 1st quarter John will be included under “At least once per week” and for the 2nd quarter John is not included as an “Individual Supported”. Lisa receives 2 hours of support 5 days per week in April and May, and 9 hours of support 5 days per week in June and the entire 2nd quarter. In both quarter 1 and 2 report Lisa as an Individual Supported under “Daily Support 8-24 hours per day.

Support Days The number of calendar – days when services and supports are provided in-person by paid staff to the individual being served or to the substitute decision maker. A support day must be documented and may be provided by one or more paid staff but is counted once from the recipient’s perspective A support day does not include activities with landlord, medical professionals, etc. on behalf of individuals where the individual or substitute decision maker is not present Support days are year to date (cumulative)

Respite Hours Report the number of respite hours provided One weekend is counted as 48 hours If one staff person is providing respite for one hour to two individuals, two hours are reported in respite hours Respite hours do not include travel, documentation, and other activities that are performed on behalf of individuals when the individual is not present Respite hours are year to date (cumulative)

Resident Days The number of calendar days an individual is receiving services The day of entry is counted but not the day of exit unless the individual only stays one day and then one day is counted Short absences of less than 4 days in length do not need to be tracked separately and are included in the resident day count Resident days are year to date (cumulative)

Resident days are reported in the following subcategories: Permanent Resident – number of days a permanent resident is occupying the residential space, if the individual is visiting another location and staff will accompany the individual to provide support report the days Respite – number of days an individual receiving respite services is occupying the residential space eg. while a permanent resident is away on a temporary absence, another individual stays in the residential setting Days on Hold – number of days the residential space is on hold for an individual. This includes when a resident is away for more than 4 days, or the days between a new resident being identified and the day they move into the residence.

Beds The total number of residential spaces per service provider The spaces include all beds in the count: MCSS funded and non-MCSS funded beds The number of residential spaces is a snapshot (point in time)

Bed Days Available The cumulative number of days a residential space is available and staffed during the reporting period The total spaces available each day of the month are added together whether occupied or not Spaces or beds which cannot be staffed or are closed for renovations are not available for service and are not included

The following diagram shows the relationship between key residential data that will be used to calculate occupancy & cost per unit metrics in DS residential programs: Section 6 of the DS Chapter shows the summary of data elements & metrics. Residential Data Elements Diagram (1) Resident Days Days that an individual occupies a bed (3) Bed Days Available = + (2) Vacancy Days Days that a bed is available but not being used or held (5) # of Beds X 365 days/yr = + (4) Days that a Bed is Closed e.g. renovations 92

Volunteer Hours of Service This data element is optional The number of hours spent by volunteers providing services without paid compensation during the reporting year who are scheduled to support front line staff Volunteer hours do not include family, friends or board members The hours are year to date (cumulative)

Training Hours Number of training hours received by health practitioners or specialists Hours are reported for each of the recipient’s perspective from the start time of the session to the end time eg. 10 recipients attended a 2 hour session would be reported as 20 hours Training hours exclude travel time, documentation, preparation, and other activities performed outside of the training session Training hours are reported on a year to date (cumulative) basis in the following subcategories: English – training hours of English training sessions/ workshops/conferences French – training hours of French training sessions / workshops/conferences

Training Recipients Number of individuals that received training - (all individuals participating in training should be counted rather than an unduplicated count) Training recipients are reported on a year to date (cumulative) basis in the following subcategories: English – individual who attended English training sessions/workshops/conferences French – individual who attended French training sessions/workshops/conferences

Practitioners Number of health care practitioners, including specialists and general practitioners, who agree to provide health care to individuals with a developmental disability Each health care practitioner who agrees to provide health care will be counted once in the fiscal year Practitioners are reported on a year to date (cumulative) basis in the following subcategories: English – practitioners provide services in English French – practitioners provide services in French

Research Projects Number of research projects that were commissioned by the Community Networks of Specialized Care during the reporting year Multi-year projects are included in the annual counts for each of the years until they are completed The number of research targets are reported as a snapshot

Videoconferencing Hours The number of hours for which videoconferencing equipment was used for training, planning, capacity building and administrative purposes Videoconferencing hours are reported in the following subcategories: Planning and training Delivery of Client Service – hours of videoconference sessions that included the individual for purposes of service delivery Videoconferencing hours are reported as year to date (cumulative)

Assessments Number of applicants is reported by the status of their standardized needs Applicants are reported in one of the following subcategories according to their status at the end of the reporting period: Application withdrawn Assessment in Progress – applicants in the process of completing the application package Assessment Complete – English – eligible applicants who completed the application package in English Assessment Complete – French – eligible applicants who completed the application package in French

Eligibility Confirmations Unique/unduplicated applicants that are going through eligibility confirmation process during the reporting period Applicants are reported in one of the following subcategories: Waiting for Eligibility Confirmations ( in progress) Confirmed Eligible Deemed Ineligible The number of applicants are reported as a snapshot (point in time)

Psychological Assessments Number of psychological assessments completed during the reporting period The completed assessments are reported in one of thefollowing subcategories: Assessments to Assist in Determining Eligibility – number of ministry Assessment Reviews to Determine Eligibility Other Assessments The number of assessments are year to date (cumulative)

Passport Recipients Unique/unduplicated number of individuals receiving Passport funding The number will be reported in the following subcategories: Direct funding only – number of individuals who receive only direct funding for services and supports TP Funding Only – number of individuals who only receive services and supports from a service agency Combination of TP and Direct Funding – number of individuals who receive services and supports from a service agency as well as direct funding for services and supports The number of recipients are year to date (cumulative)

Passport Mentoring Participants Unique/unduplicated individuals participating in Passport mentoring during the reporting period The number will be reported in the following subcategories: Mentors – number of mentors Mentees – number of students Unmet requests for Mentors – number of students that are waiting for a mentor The number of participants is year to date (cumulative)

Person-Directed Planning Unique/unduplicted individuals for whom person-directed planning is taking place during the reporting period The number is year to date (cumulative)

From/To Tool

Ministry of Community Ministère des Services sociaux et and Social Services communautaires 2012/13 Transfer Payment Budget Package Modifying the Generic Budget file to Incorporate Data Standards Financial Planning and Business Management Branch

2012-13 Budget Package– New Tabs Two new tabs added: Service Data YTD Actual & Analysis

2011-12 vs 2012-13 Modified Generic Budget Package Following slides reflect screen shots

2011-12 Budget Package Service Data Summary – (Submission&Contract tab) These sections removed from SubCon tab and now reflect in new tab i.e. Service Data tab

2012-13 Generic Modified Budget Package Service Data Summary – (Service Data tab) Once the detail codes are entered in the Staffing Worksheet(s) their associated data elements are automatically populated. If a data element appears provide data, unless otherwise stated. Both recorded together

Custom Menu: Change Form Type

2011-12 Budget Package Year to Date - Service Data Schedule (YTD-Trimestriel Tab) These sections removed from YTD tab and now reflect in new tab i.e. YTD Actual & Analysis tab

2012-13Generic ModifiedBudget Package Year to Date - Service Data Schedule (YTD Actual & Analysis Tab) Highlighted column identifies that Significant Variance Report is Required Entry of the cumulative YTD Actual(s) and YE estimate(s) are to be entered here.

Next Steps Videoconference session December 15 December 16 December 19 Francophone December 20 Presentation and speaker’s notes will be available on www.oasisonline.ca Budget Package Release Jan/Feb Frequently Asked Question Bulletins available at www.oasisonline.ca March 13 , 2012 Forum

Post Training Support The OBRC Committee members will act as a resource to agencies The Ministry has identified a lead in each Regional Office Questions regarding interpretation of the transfer payment reporting standards should be referred to your Program Supervisor or the Regional Ministry lead

Regional Champions Central East Region Margaret Patrowiczmargaret@newleaf.ca Central West Region Kathy Wassinkkwassink@christian-horizons.org Eastern Region ZullChagganzchaggan@kerrysplace.ca Hamilton/Niagara Region April Papineauapapineau@clhaldimand.com Toronto Region Flavian Pinto fpinto@cltoronto.ca North East Region Karen Carmichael kcarmichael@communitylivingnorthbay.org Northern Region Rhonda Stone rhonda_stone@cla-algoma.org South East Region Darlene Ryan darlene.ryan@clpe.on.ca South West Region Linda Karnaslkarnas@clc-k.ca Supporting Executive Directors: North East Region Ann Kenney akenney@clsm.on.ca South West Region Lu-Ann Cowell lcowell@clc-k.ca John Bedelljbedell@wdds.ca

MCSS Information Strategy & the TP Reporting Standards Project: Context and Background
December 2011Policy Research and Analysis Branch, MCSS

Background Previous Data Issues Not meaningful Incomparable Inaccurate Ad-hoc collection Unreliable measures/indicators In early 2007, PRAB led a series of regional and corporate consultations that centered on the Ministry’s information capacity and needs. The following data issues identified solutions considered in the Information Strategy: Solutions Streamline reporting to definable, feasible data Define data standards Implement data quality rules Collect important data in regular reporting tools Define metrics that can be reliably measured using data standards On July 18, 2007, Ministry Management Committee (MMC) which includes the Deputy Minister approved the Information Strategy.

Current State Analysis Currently, our ability to reliably use data is restricted for a number of reasons. Data Not Accessible Absence of Data Standards Authoritative sources unknown Data is not comparable Information is not easily located or shared Data is not meaningful Data collectedcannot be reliably used for decisions Lack of stakeholder buy-in for accurate, quality reporting Patchwork of policies and strategies Lack of clear policy objectives and direction Disconnectedtools Fear of and constraints (e.g FIPPA) on information sharing Lack of Policy Direction on IT Drivers Unclear Information Management (IM) Roles and Responsibilities Lack of Collaborative Approaches to IM

Collect & Store Disseminate Collaborate Mobilize Define MCSS Information Strategy The TP Reporting Standards consist of 2 of the projects below: Financial Inputs Standards, and Detail Codes & Service Data Standards projects VISION – Inform Decisions With Modern Analytic And Collaborative Tools Using Sound Information GOALS Ensure all available information is accessible to those who need it. Develop analytic tools to facilitate informed decision making. Promote a culture of openness and sharing across organizational boundaries. Streamline and standardize data to improve its quality, relevance and accuracy. Information collected once and used often. PROJECTS Modified Excel Package Automated TP Budget Package Survey Tools (DARTS) Client Level Information System Online Resource Centre (Intranet) InfoNotes Records and Document Management System External Source Database InfoKNOW (Collaboration Site) Human Services Ministries Information Network Financial Inputs Standards Detail Codes and Service Data Standards Program Outputs & Outcomes Client Level Information Standards Geographic Information System (GIS) Enterprise Project Management Analytic Tools Research and Evaluation Agenda 120

About TP Reporting Standards Transfer Payment (TP) Reporting Standards provide a set of standardized data elements and definitions for Transfer Payment Agency (TPA) budget and actual reporting to the ministry. The standards consist of: Detail Codes; Service Data; and Financial Inputs (including staffing data). Using the standards, the ministry can answer basic questions about services, such as: What services are delivered by a program? How are the services delivered? What is the service system capacity within a region? How much services are provided? How many individuals are seeking services? What is the unit cost of a service? 121

Benefits TP Reporting Standards are central to the ministry’s ability to: Comply with the Transfer Payment Accountability Directive; Respond to Provincial Auditor concerns and questions about value for money; Reliably measures comprehensive costs, financial pressures, and service capacity; Reduce administrative burden on agencies aligning with the Open for Business objectives; Provide meaningful measurement of services; and Enable reliable measurement of service demand, capacity and efficiency. 122

Development Overview The development of the TP Reporting Standards consisted of an extensive 4-year process outlined below: Inputs Processes Outputs Ministry stakeholders: Over 30 Corporate policy and operational experts Over 75 Regional experts Operational & Policy networks Ministry resources: Current data Logic model measures Business practices and policies Legislation External resources Industry standards Over 200 service provider representatives Environmental scans Systematic reviews using criteria & checklists (see appendices) Iterative development in working groups Structured surveys (In total 389 survey responses) Information days Agency pilot testing Agency focus groups French & English sessions Policy and Operations ADM approval of TP Reporting Standards Streamlined, adaptable data set Consistent definitions Data quality rules Comprehensive manuals Comparable metrics Stakeholder buy-in Methodology for future enhancements Improved business practices/rules

Changing Detail Codes in Future The following events can trigger the ministry’s need to either add or delete detail codes or modify existing definitions: Program Additions/Changes Policy Changes Legislative Changes New Reporting Requirements Funding Changes and Announcements

Appendices

Detail Code Evaluation Checklist The following checklist was used to evaluate existing and proposed detail codes during the development of the TP Reporting Standards. It will be used to develop and evaluate detail codes in future years. 126

Service Data Standards Evaluation Checklist The following checklist was used to evaluate existing and proposed service data elements during the development of the TP Reporting Standards. It will be used to develop and evaluate data elements in future years. 127

Transfer Payment Reporting Standards