LTC Outreach Program

1. LTC Outreach Program

2. Who We Are • TCE is a developmental service agency in Ottawa • Funded by the Ministry of Community and Social Services (MCSS) since 1979 • Originally served children with multiple disabilities and special communication needs i.e. deafness, aphasia and autism

3. What We Do • Support adults with developmental disabilities - 48 Day Supports - 77 Residential (includes group homes, apartments, townhouses with various levels of support) - 2 in Home share (individual living as part of a family) - 12-17 in LTC Outreach

4. By the Numbers • 55% of the individuals supported by TCE are over the age of 50 • Oldest person supported was 80 years old • Oldest person currently supported is 75 years old • Oldest person with Down Syndrome supported was 69 years old

5. History • TCE is one of 17 transfer payment agencies funded by MCSS to support individuals with developmental disabilities in Ottawa • In 2005, the Ontario government announced the closure of the 3 remaining provincial facilities for people with developmental disabilities, by March 2009.

6. Development Stage • TCE was requested to provide enhanced developmental service support to individuals moving from the provincial facility to Ottawa area LTC homes • The first individual moved into a LTC home in late 2005 • Over the next four years, 17 spaces were created in LTC (16 individuals from facility and one community)

7. Partnership • Majority clustered at 2 LTC homes • Primary partner is the original LTC home in Kanata • MCSS provided base funding which continues as an ongoing community resource for support in LTC • The partnership and program were developed and revised over time and continues to evolve.

8. MCSS & MOHLTC • Joint guidelines were developed by MOHLTC & MCSS to support the provincial facility project • Meetings and discussions were held with all parties including both Ministries to determine how to work together – highly motivated

9. Current Context • Referrals are received from different sources • developmental service agencies supporting individuals ready to transition to LTC • Families supporting family members applying to CCAC for LTC, already on the list or already in LTC and requiring enhanced support • Increasingly, enquiries and referrals come from a variety of sources i.e. acute care hospitals, CCAC, specialized services

10. Referral • All individuals must be on Developmental Services Ontario (DSO) registry in order to access our Outreach services • Must have applied and been approved by CCAC for referral to LTC • Application is reviewed and a determination made by TCE (in consultation with partners) whether ‘enhanced support’ is required

11. Support • Not all individuals with developmental disabilities require enhanced support to live successfully in a LTC home • Individuals with challenges due to communication, complicating conditions or behavior often require extra support • The type of intervention or resources required is unique to each person

12. What is Enhanced Support? • assistance with some activities of daily living • support for integration into community activities • case management and support for appointments • training or mentoring for staff • private room rate coverage if needed • access to specialized resources i.e. multi-disciplinary clinical team

13. Statistics • Program is no longer just ’17 beds’ rather a flexible resource utilized in a variety of ways depending on need • Originally supported 17 individuals (16 facility and 1 community) in 6 locations • Since 2005, 9 individuals have passed away • Since 2005, closed 3 sites and opened 4 new • Support 13 individuals in 7 locations • Goal is fewer locations with small clusters

14. The Team • 3-4 LTC Outreach staff on team • The workload is divided and shifts depending on the needs of the individuals • Contact and visits occur daily • Support is provided in accordance with each person’s individual plan.

15. Challenges • Steep learning curve for both partners • Program developed and evolved over time • Government’s guidelines were released which helped clarify process after our program was well underway • The models of service, culture, language, procedures and staff roles and responsibilities were different.

16. Roles & Responsibilities • There was a significant initial investment of time spent to: • clarify roles & responsibilities • draft job descriptions • Talk with and coach staff about each other i.e. staffing structure, policies & procedures, different focus and priorities etc • Lack of clarity could lead to false assumptions and misunderstanding when in fact each were just doing their own jobs

17. The Plan • A written plan was developed to address: - how we would work together - how we would communicate formally and informally - how issues would be dealt with as they arose with the goal of resolution as quickly as possible • It was and is important to check in and ensure things stay on track

18. Ingredients for Success • Two willing partners were open to trying something new and developed a trusting relationship over time • Both understood the value of having a specialized resource • Ensured we had the right staff in the position(s) with the skill set and motivation to build collaborative partnerships • Committed to work together through challenges with the goal of maintaining the individual’s placement

19. Factors to Consider • As people passed away and the facilities closed, some of the physical beds/spaces were ‘lost’ as other individuals moved into their vacant beds through the CCAC referral process • Admissions, transfers and referrals occur and resources are stretched and not used as effectively as possible

20. Future •  Growing need for LTC placements for people with developmental disabilities as ‘baby boomers’ age and people with disabilities live longer • Feedback from service providers and families indicate a comfort level in referring their loved one to CCAC & LTC if there is an option for placement which provides an ongoing linnk to developmental services

21. Working Together • Enhanced support provides a level of comfort to the LTC home in accepting an admission which may have caused hesitation in the past. • Developing sustainable and affordable models which utilize resources from both systems is the most realistic vision for the future • Innovative partnerships which combine resources from both sectors will lead to the best quality of life for seniors with often complex needs

22. Specialized Unit • By providing appropriate options for individuals transitioning to LTC, new placements and resources for young people will be freed up in developmental services. • Our joint goal with our LTC partner is a proposal for a designation under the MOHLTC legislation for an 8 bed ‘Specialized Unit’ • If approved by the LHIN, up to 8 beds at this Kanata LTC home would be protected

23. Designation • Resources, training, specialized skills and partnerships would not be diluted or lost. • Essentially, there would be a list maintained by CCAC, meeting a specific criterion for individuals with developmental disabilities requiring enhanced support • When a vacancy occurred in one of the 8 beds, it would be filled from the designated list.

24. What You Can Do • Do not work in isolation. Come together with other like-minded organizations whether developmental service, health care providers, CCAC, LHIN, hospital, etc • Identify the common issues and needs • Find a ‘friendly’ neighbor. A LTC home or agency you’ve had casual contact with and set up a time to meet

25. Find Common Ground • Share your story • Share others experiences across the province re cross-sector partnerships • Look for common ground, areas where you could share resources, (training, lunch and learn, planning meetings, etc) • Educate each other about your ‘worlds’ • Try a pilot project

26. Network • Approach your local planning table with a proposal to ‘pool’ or re-direct some resources and try a small LTC pilot project with a willing partner • Look for networking opportunities in the MOHLTC world or vice versa • Don’t give up!