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Friday, October 21, 2005

The role individualizing funding and independent planning support will play in BC’s system transformation initiative. Friday, October 21, 2005. Vision.

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Friday, October 21, 2005

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  1. The role individualizing funding and independent planning support will play in BC’s system transformation initiative. Friday, October 21, 2005

  2. Vision Children and adults with developmental disabilities, supported by family members and friends, will have the opportunities and supports needed to pursue their goals and participate as full and valued citizens in their communities.

  3. CLBC’s Mandate • All services for adults with developmental disabilities. • Independent planning support, family support and residential services for children and youth with developmental disabilities aged 6 - 18. • Independent planning support by request for families with children with developmental disabilities under age 6.

  4. The new service delivery model reflects a new way CLBC staff will relate to and support people with developmental disabilities and families. • CLBC will work to improve community confidence and be less bureaucratic for people supported and staff working for it.

  5. Guiding Principles • Safety, security and well-being of individuals and families is paramount. • Community is the vehicle for change. • Individuals and families are the decision-makers. • All relationships are founded in mutual respect and trust.

  6. Guiding Principles • Sustainable supports are developed by introducing flexibility, increasing choice and stimulating innovation and creativity. • The focus will be on planning support to prevent crises. • Seamless, straightforward access to flexible and responsive supports. • Standards of financial performance are consistent with government’s financial security and reporting requirements.

  7. CLC Service Delivery Model Individuals, families and communities Facilitators Quality Service Analysts Community Councils Community Planning & Development Managers [14] Quality Service Managers [9] ProvincialAssessmentCentre VPCommunity Planning and Development Director Communications VPQuality Services DirectorStrategic Planning DirectorHR / Org.Development Director Policy VP Corporate Services Chief Info. Officer CEO Advocate for Service Quality Advisory Committee to the BOARD CLBC Board of Directors MINISTER

  8. The Process of System Change Devolution Transformation A multi year process July 1, 2005

  9. Clear Work Roles and Responsibilities Historic Staff Roles Facilitators • Individual and family support • Individual and family support • Administration • Eligibility • Funding Allocations • Managing contractual relationships Quality Service Analysts • Administration • Eligibility • Funding Allocations • Managing contractual relationships

  10. Facilitators will provide information, advice and practical assistance to eligible individuals and families, independent from service providers and funding decisions, to assist them in developing and implementing personal support plans. Independent Planning Support

  11. Facilitator Individuals and families will decide when to access a Facilitator whose roles can include: • Initial contact for individuals and families requesting support and service. • Providing information and referrals. • Helping develop and implement support plans, including accessing generic services.

  12. Facilitator • Promoting activities which utilize community capacity and encourage interest in creating innovative approaches to service. • Assisting in crisis situations. • Helping people access or coordinate supports with MCFD and other children and family supports outside of CLBC.

  13. Facilitator • Providing support with transitions for children, youth, individuals and families. • Assisting with changes in existing supports. • Helping link people without family and friends to a personal support network. • Liaising with Quality Service Analysts as needed [e.g. ensuring changes in a support plan or safeguard concerns are addressed as required].

  14. Facilitators must be adept at working in two very different paradigms.

  15. Systems Community

  16. Quality Service Analyst Deals with the allocation and administration of funded supports and their accountabilities. • Determines eligibility. • Assesses and approves IF / service requests based on a personal support plan. • Ensures safeguards are outlined in personal support plans, in place and working. • Purchases and monitors service deliverables and outcomes in contracts.

  17. Quality Service Analyst • Identifies trends and gaps in service and provides input to CLBC’s service and strategic planning process. • Works with providers to enhance capacity and flexibility based on community feedback. • Helps transform current service delivery approaches by encouraging innovation. • Works with other Analysts [and Facilitators] to contract for emergency / crisis response.

  18. What Change will Mean for Individuals and Families • Individuals and families will decide what’s best for them. • Greater range of choices and more flexibility, including using IF to pay for needed supports and services. • More opportunity for community inclusion.

  19. What Change will Mean for Individuals and Families • Policies and rules that are clear and public. • Greater community input into how supports are provided. • Change only when a better, person centred alternative is available or requested.

  20. Benefits to Communities • Community input in planning and evaluating service delivery. • Services that are more accountable to individuals and communities. • Encouragement and support for local creativity and innovation. • Greater integration of individuals into community.

  21. Funding Priorities • Health, safety and well-being of individual. • Diminished capacity of parent/caregiver. • Safety of parent/caregiver. • Helping individuals to stay in their community / home. • Transitioning individuals. • Investment in prevention.

  22. Some Current Initiatives • Development site • Innovations framework • Agency project • From Good to Great – Phase 2 • Strategic Plan • IF and Direct Payments • Flexible Individual and Family Support Policy • Community Councils

  23. For More Information http://www.communitylivingbc.ca/

  24. The Planning Function – Key issues to consider in designing any new system • Payment • Governance • Ensuring an adequate infrastructure exists in the community • Training, monitoring, and certification

  25. There are, however, problems with both of these models.

  26. A Supply Side Model Operating funds for the Agency could come via an annual contract with the funding body Not for Profitcommunity organizations hire and supervise a group of planners It is arguable that since a governance board of consumers/advocates can oversee the work of planners, issues about planning quality and access can be addressed, but personal choice and control are minimal. There are also concerns about the efficient use of scarce fiscal resources.

  27. A Demand Side Model Payment to planners could be authorized via the individual’s plan that has been approved and funded Planners operate privately in the marketand are hired directly by the individual consumer Arguably, this approach is more efficient and maximizes personal choice but experience inside and outside of the disability field suggests that the free market creates risks for planning quality and personal autonomy

  28. A Mixed Model ADVANTAGES OF A MIXED MODEL • Training and regulatory oversight • Function less likely to become bureaucratic • Personal choice maximized while flexibility, creativity & responsiveness are safeguarded • Community development needs can be effectively addressed • Overall consumer direction retained Core funded/consumer controlled community agency mandated to: • Maintain an information database • Link consumers to peer supports • Provide core planning staff able to respond to initial consumer needs • Maintain a list of approved “fee for service” planners with whom peoplecan contract • Train, monitor and support community planners

  29. Mixed Model in Practice Contracted community planner workswith person and network NETWORK Independent, “fee for service” community planners Purchased services and employed supports What happens when the person needs help? Core Funded, Consumer Driven Agency • The • Individual • Paying • Employing • Choosing • Contracting • Database • Core staff • Links to peer supports • Training capacity • Maintain list of approved planners • Train, monitor and support community planners PLAN

  30. The 3 Models Compared No infrastructure - Brokers are 100% funded Infrastructure is 100% funded Small % of funding used for infrastructure Non-profit agencies Fee for service communityplanners Mixed model - core services & fee for service planners Choice and control are significantlylimited Concerns about access, planning quality & personal autonomy Autonomy & planning quality are safeguarded; resources used efficiently;infrastructure exists

  31. The Status of Independent Planning Support ADOPTION-IN-PRACTICE ADOPTION-IN-THEORY We are reaching the point of initial acceptance Societal Institutionalization Conceptualization Widespread Implementation Initial Acceptance Source: Robert J. Flynn & Kathleen R. Nitsch (Editors), Normalization, Social Integration and Community Services, Baltimore: University Park Press, 1980. Resource (Re) Allocation Legislative Legitimation

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