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The Shared Assessment Process

This guide outlines steps to assess OCAN Lead presence, contact, and transfer in mental health services, facilitating efficient client reassessment.

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The Shared Assessment Process

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  1. The Shared Assessment Process When a New Client Enters Your HSP and When an Existing Client is Ready for Reassessment Process Start Determine if an OCAN Lead exists 1 Does an OCAN Lead Exists? Yes Contact the OCAN Lead(s) to identify yourself No You are the OCAN Lead 2 3 3a Determine whether to keep/transfer the OCAN Lead 4 Reassessment Are you the OCAN Lead? End Follow Discharge Rules 5 9 End Contribute to the OCAN Lead Gather OCAN information from ALL contributors Complete OCAN If ready for Discharge No Yes 6 8 7 Time (t) <= 30 days to complete OCAN Tips and Notes The following slides provide the process steps and general tips and notes for each step. The GTA LHIN Case Study specific tips and notes can be found in the Case Study section of this toolkit.

  2. Determine if an OCAN Lead Exists When a New Client Enters Your HSP and When an Existing Client is Ready for Reassessment Process Start Determine if an OCAN Lead exists 1 Does an OCAN Lead Exists? 2 Process Steps Notes/Tips • Determine if an OCAN Lead exists • The first step is to determine if an OCAN Lead exists. • GTA5: • Ask the Consumer if other service providers are involved, and/or • Check the IAR • Proceed to Step 2 • 2. Does an OCAN Lead Exist? • If you are aware that an OCAN Lead already exists, • Proceed to Step 3. • If you are not aware that an OCAN Lead exists, Proceed to Step 3a. Can more than one OCAN Lead exist?: At this stage of implementation, there may be one or more OCAN Leads because the process for sharing is new • An OCAN Lead may not exist because: • Consumer is new to the community mental health system • Consumer has never had an OCAN done before • OR • Consumer chose not to share their OCAN so you are not aware that an OCAN Lead exists • OR • A Consumer has been discharged from the Mental Health system (with a (Prior to) Discharge OCAN) for over 3 months.¹ Reasons why an OCAN Lead may not exist1:

  3. Contacting the OCAN Lead and Contributors When a New Client Enters Your HSP and When an Existing Client is Ready for Reassessment Process Does an OCAN Lead Exists? Contact the OCAN Lead(s)/Contributors to identify yourself You are the OCAN Lead Yes No 2 3a 3 Process Steps Notes/Tips 3. Contact the OCAN Lead(s) /Contributors to identify yourself If in Step 2 you determined that an OCAN Lead exists and it is you, then you need to contact the contributing providers and/or other OCAN Leads. If you determined that an OCAN Lead exists and it is not you, then you need to contact the OCAN Lead to identify yourself as a contributing provider. Proceed to Step 4 3a. You are the OCAN Lead If in Step 2, you determined that an OCAN Lead does not exist or you are not aware that one exists, then you are automatically the OCAN Lead and responsible for completing the OCAN. Proceed to Step 8 • Scenarios for when an OCAN Lead exists: • The following are three possible scenarios for Step 3, • if an OCAN Lead exists: • You are the OCAN Lead and there are other Leads* • You are the OCAN Lead and there are Contributors • You are a Contributor (if you are not the OCAN Lead, • then you are considered a Contributor). • *If you are handling multiple Leads: • When youare the OCAN Lead and begin a reassessment with a • Consumer, you may come across a service provider from • another Functional Centre also acting as OCAN Lead. • In this situation, you will contact the other OCAN Lead and • proceed to step 4 to determine which provider to propose • as the single OCAN lead.

  4. Transferring the OCAN Lead When a New Client Enters Your HSP and When an Existing Client is Ready for Reassessment Process Determine whether to keep/transfer the OCAN Lead 4 Are you the OCAN Lead? 5 Process Steps Notes/Tips • 4. Determine whether to keep/transfer the OCAN • Lead • OCAN Lead and Contributors have a conversation and • determine who will be the OCAN Lead – to keep the • current, or to transfer to another. • GTA5: • All Contributing providers and OCAN Lead use the • following criteria: • Service provider completing the Full OCAN • Non-appointment based services can only be the OCAN Lead where individuals are not receiving other services • Service providers choosing to be responsible for assessing on the broadest range of needs • Proceed to Step 5 • It’s all about the conversation! Between the Service • Providers involved and between the Consumer and • Service Providers • The first choice for the OCAN Lead should be the • Functional Centre completing the fullest data set. If there • is more than one Service Provider completing the fullest • data set, then secondary criteria need to be considered. • These decisions are flexible and will be made at the local • level. • Reasons why the OCAN Lead role would change?² • Consumer leaving service • There is more than one OCAN Lead • The current OCAN Lead does not meet the criteria • Service providers and Consumers determine a more suitable Lead • 5. Are you the OCAN Lead? • Once the OCAN Lead has been determined, • if you are the OCAN Lead, proceed to Step 7OR • If you are a Contributor to the OCAN Lead, proceed to Step 6

  5. Gather OCAN Information When a New Client Enters Your HSP and When an Existing Client is Ready for Reassessment Process Are you the OCAN Lead? 5 End Contribute to the OCAN Lead Gather OCAN information from ALL contributors Complete OCAN No Yes 6 7 8 Time (t) <= 30 days to complete OCAN Process Steps Notes/Tips 6. Contribute OCAN information to the OCAN Lead3 The contributing providers provide the Mental Health Functional Centre Use information and relevant collateral information to the OCAN Lead. Specific timelines to meet the “30 day OCAN completion window” should be established at the local level.3(See GTA5 Timeline) END • The OCAN Lead will gather and review information that is • provided by the contributing provider. If information from • the contributing provider cannot be gathered, the OCAN • Lead will complete and submit the OCAN without it. • Managing Challenges • HSPs will be responsible for their own policies and • guidelines related to an agreement/conflict resolution • mechanism for shared assessment. • Network/Partnerships/Providers will support local • practices for the development of an agreement/conflict • resolution mechanism. • Network/Partnerships/Provider can also refer to chapter • 1.5 (dispute resolution) of the MOHLTC operating manual • for Mental Health Services and Addiction Treatment • Services (2003). This manual can be found on the • following link: http://www.health.gov.on.ca/english/providers/pub/mental/operations/operations.pdf • GTA5: • Attempt to resolve at the worker level. • In the event of a discrepancy, the Lead is responsible for the information. E.g. If there is a variation in the need rating, the Lead’s determination appears in the OCAN with the discrepancy documented in comments • Follow agency policy/processes around escalation if required 7. Gather OCAN Information from ALL Contributors3 Collect all Mental Health Functional Centre Use information from all identified Contributing Functional Centres plus relevant collateral information Specific timelines to meet the “30 day OCAN completion window” should be established at the local level.3 (See GTA5 Timeline) Proceed to Step 8 GTA5 Timeline • The Lead has one week to contact all contributing • providers. The Lead must specify the dates by which • he or she would like to receive their input before the • assessment closes. • The contributor must provide all of their input within • 5 days of the end of the assessment completion period, • as specified by the OCAN Lead

  6. Completing the OCAN and Discharge When a New Client Enters Your HSP and When an Existing Client is Ready for Reassessment Process End Follow Discharge Business Rules Reassessment 9 Complete OCAN If ready for Discharge 8 Process Steps Notes/Tips 8. Complete OCAN4 The OCAN Lead is responsible for completing the OCAN according the OCAN business rules. If it is time for Reassessment, proceed to Step 4 If the Consumer is ready to be discharged from all Functional Centres, then proceed to Step 9. 9. Follow Discharge business rules5 Once a Consumer is ready to be discharged from all Functional Centres, a (Prior to) Discharge OCAN is to be completed by the OCAN Lead. To-date, you have learned Discharge rules based on being discharged from a single HSP. These discharge rules, will now expand to being discharged from the Participating Functional Centres in Shared Assessment. Mental Health System. Privacy and Security Notes • Contributing Provider responsibilities: • Manage Consent as per your privacy policies • Report Privacy & security incidents and complaints to your Privacy Officer • Refer Consumer to OCAN Lead in response to request for access to assessment • Refer Consumer to OCAN Lead in response to request for correction to assessments • OCAN Lead responsibilities: • Manage consent as per your privacy policy • Report Privacy & security incidents and complaints to your Privacy Officer • Provide Consumers with access to assessments upon request as per your privacy policy • Respond to requests for corrections to assessments • Responsible for custody and control of the information in the OCCAN

  7. Business Rules for Shared Assessment When a New Client Enters Your HSP and When an Existing Client is Ready for Reassessment The Shared Assessment model follows the regular OCAN business rules that have been provided to you. The following are rules that pertain to specific steps in the business process and are noted by a footnote. A rule number with a “(SA)” indicates that a modification to the rule has been made for shared assessment. Discharge (DX) Rules: DX-BR-1 (SA)¹, 5 A consumer can only be discharged from an HSP once the consumer has exited all services recorded in the Mental Health Functional Centre Use section of OCAN. A (Prior to) Discharge assessment is conducted by the OCAN Lead when the consumer is discharged from all functional centres. DX-BR-3 (SA), DX-BR-4 (SA)¹, 5 If an OCAN consumer is discharged from the mental health system and re-enters the system within three months of discharge, the consumer is reassessed based on the first reassessment cycle. If an OCAN consumer is discharged from the mental health system and re-enters the mental health system after three months of discharge, the consumer completes an Initial OCAN. Initial OCAN (IA) Rules: IA-BR-1¹ An Initial OCAN is conducted only for the consumer who is new to the community mental health system or is re-entering the system more than three months after the consumer's last (Prior to) Discharge OCAN. OCAN Lead Rules: OL-BR-1 (SA)² If a consumer is involved with more than one provider, only the OCAN Lead should complete the Core OCAN. Other contributing providers can provide input to the OCAN Lead to facilitate completion of the OCAN. OL-BR-1.1 (SA)² If a consumer is involved with more than one provider, only the OCAN Lead should complete the Core+Self OCAN. Other contributing providers can provide input to the OCAN Lead to facilitate completion of the OCAN. OL-BR-1.2 (SA)² If a consumer is involved with more than one provider, only the OCAN Lead should complete the Full OCAN. Other contributing providers can provide input to the OCAN Lead to facilitate completion of the OCAN. OL-BR-6² How to determine the OCAN Lead when there are more than one functional centres involved:• Scenario 1: If functional centre A completes the Core OCAN and functional centre B completes the Core + Self OCAN, then functional centre B is the OCAN Lead• Scenario 2: If functional centre A completes a Core OCAN and functional centre B completes a Full OCAN, then functional centre B is the OCAN Lead OL-BR-6.1² How to determine the OCAN Lead when there are more than one functional centres involved:• Scenario 1: If functional centre A completes the Core OCAN and functional centre B completes the Core + Self OCAN, then functional centre B is the OCAN Lead• Scenario 2: If functional centre A completes a Core OCAN and functional centre B completes a Full OCAN, then functional centre B is the OCAN Lead

  8. Business Rules for Shared Assessment When a New Client Enters Your HSP and When an Existing Client is Ready for Reassessment The Shared Assessment model follows the regular OCAN business rules that have been provided to you. The following are rules that pertain to specific steps in the business process and are noted by a footnote. A rule number followed by a “(SA)” means the rule has been modified for Shared Assessment. OCAN Lead (OL) Rules cont’d. OL-BR-6.2² How to determine the OCAN Lead when there are more than one functional centres involved:• Scenario 1: If functional centre A completes the Core OCAN and functional centre B completes the Core + Self OCAN, then functional centre B is the OCAN LeadScenario 2: If functional centre A completes a Core OCAN and functional centre B completes a Full OCAN, then functional centre B is the OCAN Lead OL-BR- 44 If a consumer is receiving services from more than one functional centre, only the OCAN Lead should complete the OCAN. Other contributing providers can provide input to the OCAN Lead to facilitate completion of the OCAN. OL-BR-54 If a consumer is receiving services from more than one functional centre, only the OCAN Lead should complete the OCAN. Other contributing providers can provide input to the OCAN Lead to facilitate completion of the OCAN. OCAN Submission Rules: SUB-BR-14 An OCAN canonly be submitted to the central repository when the "OCAN completed by OCAN Lead" field is checked "Yes". OCAN Uploading Rules: UP-BR-14 Once an OCAN is completed and the 30 day assessment timeframe has passed, no changes can be made until the time of the next reassessment. Note: If a significant change occurs, then a Significant Change reassessment is completed. UP-BR-24 OCAN updates should be tracked locally (i.e., through progress notes) and incorporated during the next assessment.

  9. Business Rules for Shared Assessment When a New Client Enters Your HSP and When an Existing Client is Ready for Reassessment The SharedAssessment model follows the regular OCAN business rules that have been provided to you. The following are rules that pertain to specific steps in the business process and are noted by a footnote. A rule number followed by a “(SA)” means the rule has been modified for Shared Assessment. OCAN Transfer (OT) Rules: OT-BR-5 (SA)² If a consumer exits the OCAN Lead functional centre at the time of reassessment but is still involved with other functional centres, the OCAN Lead functional centre is responsible to submit the last completed reassessment before transferring the OCAN Lead responsibility.The functional centre that is most involved with the consumer and completes the fullest data set (i.e., Full OCAN) is responsible to complete the next assessment/reassessment. Mental Health Functional Centre Use Section Rules: MHFCU-BR-2 (SA)3 All functional centres that the consumer is involved with must be captured in the Mental Health Functional Centre Use section. All functional centres outside the Mental Health System that the consumer is involved with must be captured in the Other Agency section. Exit Rules: EXIT-BR-23, 4, 5 If a consumer receives services from two functional centres and exits service from the contributing provider, the contributing provider must provide the “Exit Disposition” information to the OCAN Lead to be incorporated into the Mental Health Functional Centre Use section.

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