Waterloo Children & Youth Services Planning ... - Social Services

Waterloo Children & Youth Services
Planning Council
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FINAL REPORT: Integrated Access to Services Project
A project developed by a sub-committee of the
Waterloo Region Children and Youth Services Planning Council (CYSPC)

June 2012
Acknowledgements
Waterloo Region Parents
To all of the parents in Waterloo Region who took the time to attend the parent forum and
answer the survey, many thanks. Your willingness to share your experience and make
suggestions for future consideration has been invaluable!
Sue Simpson
Director, Waterloo Region Family Network
Thanks for your valuable assistance with the parent forums and with the distribution of the
parent surveys. Your support for this project had a significant impact on its successful
completion.
Access to Services Working Group
Denise Watson, KidsAbility
Sue Simpson, Waterloo Region Family Network
Randy Penney, Kathy Payette, Lutherwood
Thanks for your guidance on the design of the project, the interpretation of the results and the
careful thought you put in to the final recommendations.
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Executive Summary
The focus of the Integrated Access to Services Project was to explore the feasibility of
developing a “single point screening” service (telephone line) in Waterloo Region for Ministry of
Children and Youth Services funded organizations that would serve as the information and
screening gateway for parents seeking services for vulnerable children. Through face to face
meetings and electronic surveys, participants were asked; a) to describe their experience
accessing and/or supporting parents to accesses services for vulnerable children and; b) for
feedback on the idea for a single phone screening line.
Feedback from parent participants resulted in a number of themes that suggest that parents in
Waterloo Region spend a great deal of time searching for the right service at the right time for
their vulnerable child(ren). In many cases, parents shared challenges such as calling over 9
services, filling out numerous forms and sifting through inaccurate and conflicting information
before services were found. A review of the current system of access resulted in a finding that
there are over 35 separate access points (points on intake) in Ministry of Children and Youth
Service funded organizations in Waterloo Region. According to many parents, they generally
felt that service providers listened to their needs and understood their situations. Often their
experience while in a service was described as very positive.
Information collected from service providers was limited to face to face feedback as the
response to the electronic survey was poor. Service providers spoke regularly about their
efforts to provide up to date and accurate “information services” to parents, and demonstrated
a strong commitment to ensuring they had capacity to stay informed about service options for
parents. Service providers describe similar internal practices to keep up to date on available
services by informal means, via a professional network that is focused on keeping each other
knowledgeable on available services. Some suggested that up to 35% of their time is spent
providing information to families. Service providers’ description of this function of their role
suggests that there is a great deal of duplication in the system across the region. It is argued,
that this is due, in part, to fact that over 35 organizations are providing similar information
services to families. Very few services are marketed directly to the public by service providers.
The strengths and challenges of the experiences of many individuals who participated in this
review led to a number of important recommendations presented in this report by the Access
to Services Steering Committee. Specifically the Committee agrees that the recommendations
are feasible and would serve to significantly improve the system of accessing services for
vulnerable children in Waterloo Region.
Strategic Recommendations
1. Develop an efficient system of access to services that supports parents to find the “right”
service at the “right’ time for vulnerable children in Waterloo Region”.
2. Create a single/coordinated “screening” phone line for families of vulnerable children
and youth in Waterloo Region.
3. Ensure the model is reviewed and coordinated within the broader context of child and
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youth system planning.
Operational Recommendations
4. Ensure a direct and coordinated connection between 211 and the single/coordinated
“screening” phone line.
5. Undertake and maintain a direct marketing campaign to families, primary health care
providers, educators and others on the single/coordinated screening system for
vulnerable children in Waterloo Region.
6. Establish and maintain high priority responsibility for accurate and up-to-date
information on all aspects of available services for vulnerable children.
7. Ensure a direct and ongoing connection to the Waterloo Region education system with
formalized systems and protocols for ease of access to services for vulnerable children in
Waterloo Region.
8. Build in continuous quality-improvement standards and expectations with regular parent
and youth feedback.
9. Develop integrated intake forms and an associated process for ease of sharing
information among service providers.
10. Ensure systems and processes for accessing services are designed for all families in
Waterloo Region with special attention to cross cultural, resource and readiness issues.
11. Build in capacity for transition planning and system navigation support for families of
vulnerable children with high needs.
12. Consider recommendations for operations reviewed in this report (e.g. live voice, flexible
hours, capacity for crisis intervention etc.)
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Table of Contents
1. Description……………………………………………………………………………………………..….Pg. 6
2. Management of the Project…………………………………………………………………..…..Pg. 6
3. Project Design………………………………………………………………………………………..…..Pg. 7
4. Limitations……………………………………………………………………………………………..…..Pg. 8
5. Outcomes…………………………………………………………………………………………………..Pg. 8
5.1 Market Pull vs. Market Push……………………………………………………….…..….Pg. 8
5.2 Valliant Efforts to Serve the Public ………………………………………………..…..Pg. 9
5.3 Knowledge Accuracy……………………………………………………………………….....Pg. 11
5.4 Points of Contact…………………………………………………………………………..…….Pg. 11
5.5 Importance of the School System…………………………………………………..……Pg. 13
5.6 Quality Feedback…………………………………………………………………………………Pg. 13
5.7 Paperwork……………………………………………………………………………………........Pg. 14
5.8 Resources and Capacity of both Parents and the System……………….......Pg. 14
5.9 Transition Planning………………………………………………………………………........Pg. 15
5.10 Coordination is “Synergy” …………………………………………………………….…….Pg. 15
5.11 Participant Recommendations…………………………………………………………….Pg. 16
6. Discussion and Recommendations………………………………………………………………Pg. 16
6.1 Reduce the Points of Contact………………………………………………………………Pg. 16
6.2 Single Coordinated System of Information and Access………………………..Pg. 17
6.3 Coordinated within the Broader Context of Child and Youth Services….Pg. 18
6.4 Coordinate with 211…………………………………………………………………………….Pg. 18
6.5 Market the Service to the Public………………………………………………………....Pg. 19
6.6 Ensure Accurate and Up To Date Information………………………………………Pg. 20
6.7 Direct Connection to Schools (Teachers)……………………………………………..Pg. 20
6.8 Monitor Quality……………………………………………………………………………………Pg. 21
6.9 Limit Paperwork and Share Documentation…………………………………………Pg. 21
6.10 Engagement Strategies for All Families…………………………………………………Pg. 22
6.11 Work Together as a “System“ for kids with High Needs………………………..Pg. 22
6.12 Further Recommendations for Operations ………………………………………….Pg. 22
7. Summary………………………………………………………………………………………………........Pg. 23
8. Appendix ……………………………………………………………………………………………………..Pg. 25
9. References……………………………………………………………………………………………………Pg. 36
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1. DESCRIPTION
A project developed by a sub-committee of the Waterloo Region Children and Youth
Services Planning Council (CYSPC) to complete a review of the process and experience of
accessing services for vulnerable children and youth in Waterloo Region. The Council is
made up of over 30 major service providers funded by the Ministry of Children and Youth
Services. The Councils mission is to…
“…plan for, promote and continually improve a local system of
services and supports for vulnerable children, youth and their
families”
The overall objective of the project was to gather feedback on what is working for families
and service providers in the area of access to services and seek out further feasible means
to enhance the current strengths and build a system that is welcoming, easy to
navigate, well-coordinated and efficient. Specifically the committee was interested in
exploring the feasibility of developing a “single point screening” service (telephone line)
that would serve as the information and screening gateway for parents seeking services
for vulnerable children.
2. Management of the Project
The project was managed by a two tiered committee consisting of the Integrated Access
to Services Steering Committee and a smaller committee called the Integrated Access to
Services Working Group.
The Steering Committee
The steering committee is made up of several members of the Council and several
additional members recruited for this work. The Steering committee oversaw the project
and made decisions on the final results and recommendations to go to the Council.
The “Steering Committee” Membership
Lesley Barraball, kidsLINK - lbarraball@kidslinkcares.com
Barb Cardow, Region of Waterloo - bcardow@regionofwaterloo.ca
Kevin Clouthier, kidsLINK - kclouthier@kidslinkcares.com
Maria Deboer, Extend a Family - mdeboer@eafwr.on.ca
Debbie Engel, kidsLINK - dengel@kidslinkcares.com
Pamela Martindale-Niven, MCYS – pamela.martindale@ontario.ca
Jayne Matzeg, KidsAbility - jmatzeg@KidsAbility.ca
Kathy Payette, Lutherwood – kpayette@lutherwood.ca CHAIR
Andrea Reist, Region of Waterloo - areist@regionofwaterloo.ca
Esther Rhee, Autism services Waterloo Region – erhee@aswr.ca
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Sue Simpson, WR Family Network - suesimpson@waterlooregionfamilynetwork.com
Karen Spencer, Family and Children’s Services - karen.spencer@facswaterloo.org
Laura Thies, Developmental Services Resource Centre - l.thies@dscwr.com
Denise Watson, KidsAbility - dwatson@kidsability.ca
The “Working Group” Membership
The “working group” consisted of Denise Watson, chair, (KidsAbility), Sue Simpson,
(Waterloo Region Family Network), Randy Penney, (Lutherwood) and Laurie Robinson,
(Consultant). Later in the project Kathy Payette, (Lutherwood) replaced Randy Penney on
the working group.
The Working Group met several times during the project to discuss and provide feedback
on the design of the project, the choice of informants/participants, the data collection
methods and the development of questions for the participants.
Following the data collection phase the working group was expanded to include Andrea
Riest, (Region of Waterloo), Esther Rhee, (Autism Services Waterloo Region) and Neil
Butler (Developmental Services Resource Centre). The expanded working group met to
discuss outcomes and develop initial recommendations to bring back to the Steering
Committee.
3. PROJECT DESIGN
This project was designed to gather information from participants about their experience
accessing services and/or supporting a family’s efforts to access services for vulnerable
children in Waterloo Region. The information was collected by in person interviews and
focus groups with parents (Appendix 1- Parent Forum Poster), direct service providers
(Appendix 2 – email invitation) and senior leadership for existing single points of access
including Front Door, Developmental Services Resource Centre (DSRC), and Child Care
Special Needs Access Point (SNAP) (Appendix 3 – email invitation). The Consultant also
collected in person feedback from three community planning groups, including the
Waterloo Catholic District School Board, Special Education Advisory Committee (SEAC),
the Student Support Leadership Initiative (SSLI), and the Transitions Network Committee.
Efforts were made to meet with the Waterloo Region Board of Education, Special
Education Advisory Committee (SEAC) however this could not be arranged. Never the
less, many Waterloo Board SEAC members were aware of the review and had contributed
to the information gathering in other forums.
Electronic surveys were developed and distributed to 35 senior leaders from a variety of
MCYS funded services that have their own “intake process” or access to service process
(Appendix 4 – survey for service providers).
An electronic survey was also developed and distributed to parents as an alternative to
attending the “in person” Parent Forum (Appendix 5 – survey for parents).
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Each of the above informants was asked a series of identical or similar questions that
were developed initially in consultation with the Integrated Access Working Group. As
new information came up during the inquiry, questions were revised or added to the in
person interviews to ensure all issues were explored.
All of the information collected was then formulated into themes to form the basis of the
report, including recommendations for future direction.
4. Limitations
Despite the wealth of information gathered from the surveys there are two issues that
should be considered when interpreting the results.
First, the service provider survey had a fair response rate (n=11, 35 were sent) however,
several respondents skipped questions they felt were not applicable. As a result, it was
nearly impossible to gather any reliable aggregate results for most of the questions on the
survey. Consequently, service provider feedback summarized in this report comes
primarily from approximately 14 hours of face to face interviews and focus groups with a
variety of providers including committee members, intake staff, and senior administration
from single points of access.
Second, a question on the parent survey appeared to produce contradictory results that
are likely caused by a lack of clarity in the questions. These questions were related to
numbers of contacts made before finding a service. Never the less, the survey results
discussed in this document were reported as they occurred, particularly when they were
supported by information gathered in face to face meetings.
5. Outcomes - Themes:
5.1 Market Pull vs. Market Push
“[I spent] hours and hours on the phone calling one organization
after another trying to figure out where my son qualifies for
services and what services are available at large.” Parent
A consistent theme found amongst parents appeared to be one of always “pulling” for
services and rarely experiencing a market “push”. In both the parent forums and in
surveys, parents reported having to dig for information about services spending a great
deal of time making phone calls and talking to friends or other parents. One parent
reported “I spent about 60 hours on the telephone, trying to find the appropriate service
for my child. This was just about 14 years ago, but, it was extremely stressful”.
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Survey results indicate that that the majority of parents finally found or accessed a service
for their child by hearing about the service from another service provider (figure 1). The
second most common way to hear about a service was from a friend. No parent who
filled out the survey (n=48) reported hearing about the service from advertisement, radio,
or television or from a brochure. The same story was heard in the parent forums.
Figure 1
Although many service providers produced pamphlets and made efforts to communicate
to the public about their services, few if any “market” their services directly to the public
in any formal manner. The single points of access agree that they do little advertising
directly to the public beyond pamphlets, newsletters and websites. All appeared to agree
that a great deal of their effort in this regard went in to keeping other service providers up
to date on their own services and vice versa. One senior administrator from a service
organization commented that funders typically would not approve a budget line for
marketing. Not when those dollars could be devoted to services.
One single point of access administrator commented that advertising to the public would
overload the service system. With long waits already, there was no need to advertise.
5.2 Valiant Efforts to Serve the Public
In the focus group with intake workers and interviews with senior administers of the three
single points of access, it was very clear that all felt a strong commitment to providing
information to parents on the range of service options in Waterloo Region. Many spoke of
the significant effort and resources that are devoted to keeping up to date on what is
available for families. In general, intake staff agreed that this role was a “huge
responsibility” one suggested that it was their “ethical” responsibility.
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All intake workers keep lists of contact information and eligibility criteria on others services
at hand for this work, use a variety of sources to supplement the lists (existing directories
of which there are many) and many produce their own lists. Keeping this information up
to date was also a self-ascribed responsibility albeit a very difficult task.
There was a sense amongst service providers that the task of keeping up to date on the
service system was a “constant battle”. In a system that is constantly changing some even
commented that they could not keep their own service descriptions (e.g. websites) up to
date. One service provider suggested that despite our best efforts “even service providers
don’t know what each other does”.
One intake staff person suggested that approximately 30-35% of the calls she receives
typically do not turn into clients of her own service. In these instances the worker
described that she devoted a great deal of time and attention to listening to parents,
screening for appropriateness for their own service and then making suggestions to
parents for what service might better suit their needs. All of the intake workers who
attended the focus group (n=15) agreed their roles were similar.
When asked about the importance of their “clinical” knowledge base, in order to do this
work, intake workers tended to agree that they relied heavily on their training and
expertise in child and youth development and clinical interviewing skills to understand
what families were experiencing. There was some discussion of whether families got tired
of telling their story “over and over” or whether, on occasion, telling the story was part of
the therapeutic process. In terms of parents experience of the knowledge of the persons
they spoke to while accessing a service only approximately 8% reported that persons were
not knowledgeable (Figure 2). In contrast to the questions about the knowledge of the
system or services (reviewed later), parents were generally very pleased with the level of
knowledge of intake staff and of their understanding and empathy.
Figure 2
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5.3 Knowledge Accuracy
Despite the positive response by parents on the knowledge and understanding the
persons they spoke to during their efforts to access services, and the consistent message
from service providers about the importance of maintaining and providing accurate
information to families about the existing service system, parents repeatedly described
that they were not always given accurate information. According to one parent
“sometimes you end up educating the person on the phone”. One participant stated that
accessing information about services was “very difficult, everyone had bits and pieces of
information without much contact information or current information”.
Parents report information is often inaccurate and different depending upon who you talk
to. Several parents suggested that they often started their search with their family
doctors or paediatricians. On this topic, one parent commented “I have come to expect
that they [doctors] know very little”
Parents had numerous suggestions for “coordinating” information and filling in the
knowledge gaps or inaccuracies in the system. Many suggested their best source for
information was from another parent who had experience in the system.
5.4 Points of Contact – Perseverance and Desperation for the Well Resourced
When asked about how many contacts it took for parents to find the right service the
answers varied, but what came across loud and clear was the determination and
perseverance that parents had to find what their child needed. One parent stated, “they
are the loves of my life, I would do anything for them”. This parent videotaped her
children and sent it to the service before she could convince them her child qualified for a
program. Over 30% of parents who filled out the survey (n=48) reported making over 9
contacts before finding a service. (Figure 3)
Figure 3
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In another survey question about how many services parents explored before finding the
right service, approximately 40% reported to contact with 1 to 3 services before finding
the right one (figure 4). Approximately 20% of parents report not having found the right
service yet.
Figure 4
In parent forums and surveys some parents described their experience finding a service
and then having to deal with their child “aging out” or finishing a “block” of treatment.
One parent reported that she’d heard other parents talk about being so desperate for
service that they accepted a service that was not “perfect” but enough to keep them
connected to a support system. Many parents reported using insurance dollars, or their
own financial resources to purchase services during periods when they were exploring
other options. Many parents expressed concern for those families unable to do the same
for lack of financial and other resources.
In both parent forums during discussions of the experience of accessing a service parents
expressed concern for other parents who might not have the resources needed to endure
the long and complicated process for finding the right service in Waterloo Region. One
parent whose first language was not English described his experience as difficult and
expressed concerns for others whose language barriers and hesitation to ask questions
would most likely prevent them from successfully navigating the access journey. This
parent started his search by asking his landlord about the services in the region. He later
described that it was an administrative support person at his child’s school that told him
about self-referring to KidsAbility despite having visited a local hospital a year earlier. He
stated that the time lost by not receiving accurate information in the first place was a
grave concern.
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5.5 Importance of the School System
Many parents and service providers expressed their belief that the school system plays a
significant role in the process for accessing services for vulnerable children. Some
referred to teachers at “key players” however, many shared concerns that “teachers
don’t often don’t know what’s out there” for kids. Because educators see kids “every
day” service providers expressed an opinion that the school system has a responsibility to
work collaboratively with service providers to coordinate the system responses. A few
parents shared concerns about a lack of follow through by an education system that
appears ill-equipped and under resourced to respond flexibly to the needs of vulnerable
children.
In service provider interviews there were similar concerns raised that perhaps the
education system might not place as much importance on their role to provide
information to families as some believed they should. Despite this concern, however,
many also appeared to be empathetic towards a system that was struggling with
competing demands.
5.6 Quality Feedback
While exploring the strengths and challenges of the experience of accessing services in
Waterloo Region, both parents and service providers were asked about ideas and efforts
to improve the quality of the services. In the survey, parents were asked if they were
advised of a complaint process during their search for services. Results show that nearly
80% of parents were not notified of a complaint process (figure 5). During discussions
about this in parent forums several commented that even if they had been told about a
process, they likely would not have spoken up. One said “why bother”, another said she
was “not comfortable” and another stated there would be a “fear of retribution”.
Figure 5
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In discussions and in survey results with service providers regarding a complaint process,
there were mixed responses about having a complaint process in place and the ways in
which parents are advised of the process. Many expressed concern that they may not pay
enough attention to gathering parent’s views on their process for accessing service and
that this would be an area for improvement.
Both parents and service providers talked about ideas and efforts to improve the quality
of experience for parents attempting to access a service in Waterloo Region. One parent
commented that his business background helped him to see that “services are not set up
for quality initiatives” and wondered why service providers didn’t “use the data, it is
there”
One parent who described complaining to a service was buoyed by a response from the
provider that she would be going to “mommy heaven” for her courage. Many parents
commented that the Access to Services Project itself was long overdue. Many expressed
their gratitude to being asked about their experience, and most felt there was
tremendous opportunity for improvement.
5.7 Paperwork
The topic of paperwork or the filling in of forms came up over and over in both parent
forums and in discussions with service providers. Parents consistently expressed their
frustration with filling out forms that were “tedious” and repetitive. I addition, many
parents expressed concern that their files were not read by service providers and that
assessment reports went unopened. In some cases, parents felt their children’s ability to
adapt to new situations and achieve success was jeopardized by service providers not
paying attention to documentation that clearly outlined recommendations. As one
parent stated “I’m tired of filling in forms that nobody reads”.
5.8 Resources and Capacity of both Parents and the System
Many of the participants in the project, both parents and service providers described
considerable concern about the lack of resources and capacity of both the system and the
parents of vulnerable children. Cross cultural issues, stigma, parent readiness, wait lists, a
lack of access to a diagnosis, financial and emotional stress were examples of issues faced
by parents and service providers alike.
Cross cultural and language issues were commented on by both parents and service
providers who agree that the associated issues complicated an already complex system
and made the experience for parents far more difficult. Despite a variety of efforts made
by service providers to meet the needs of our multicultural community there is a sense
that we have not made much progress.
Some expressed worry that for those parents who might not be ready to recognize the
urgency or severity of their child’s needs, that the current system may not be built for
engaging them in a way that can address their needs early enough.
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Parents regularly agreed that their capacity to navigate the system is dependent upon
their intellectual, emotional, financial and physical capacity to keep going. One
commented that it was easy to understand how some “totally burnt out parents” give up
parental rights so that they can get help for their family. Some described leaving their
jobs or reducing their work hours to part time to make room for their devotion to
accessing, securing and keeping services for their children.
5.9 Transition Planning
During discussions with service providers and parents the theme of the importance of
planning for transitions came up during a few key discussions. This appeared to be
especially true for children with the most complex and high needs. In these situations, as
one parent put it, the issues don’t “magically disappear”. At every transition, (e.g. into
the school system, from one class room to another, from one service to another, from
youth services to adult services) parents find themselves starting over with the process of
accessing the right service or telling their story again to the “next teacher” or service
provider. Some referred to this as system that thinks in “silos” including those across
government Ministry’s for those parents who access both MoHLTC and MCYS services.
Service providers describe complexities in their efforts to support families during
transitions. Plans made too early may need changing due to changes in the service
system. Some families may not be “ready” to commit to a plan that may seem too far
down the line to think about.
5.10 Coordination is “Synergy”
Early in the process of talking with parents and service providers about the possibility of a
“single phone line” or a “single point” of access for services for vulnerable children,
several participants expressed concern that a “single point access is not doable”. A few
suggested that the service system in Waterloo Region was too big to consider one entry
point. One parent commented that “bigger is not better”. On the other hand, early in the
process of data collection both service providers and parents began responding to this
question by immediately introducing the notion that increased “coordination” was “long
overdue”.
Service providers with experience in single points of access spoke about the “synergy”
they had experienced by working with others to streamline access points and work
together to support families. A senior administrator at one single point of access stated
that coming together to coordinate services meant the “whole horizon opened up for
families”. It led to the “reinvention of ourselves” and the supports they designed for
families during the process of accessing services and reduced wait lists by avoiding the
duplication of families on more than one waitlist for service. Similarly the “synergy”
experienced at another existing single point led to creative collaborations between
service providers that worked to individualize services for families and saw ways to be
more flexible in their admission criteria.
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As a result, we introduced the notion of “coordinated access” into the dialogue at parent
forums and in face to face meetings with service providers.
Parent’s responses to the survey question, “during your search, would a service help
phone attended by an experienced professional have been helpful in connecting you to all
available resources in the Region of Waterloo What do you think of this idea as a future
resource” where overwhelmingly positive. “Love that idea”, “yes, yes, yes”! There were
also several important recommendations for ensuring the highest quality of such a
service.
5.11 Participant Recommendations (in brief)
Live voice is important – live resources with capacity for consultation.
Parents support each other – access to a parent with experience in the system
would be helpful.
Shared governance – that the service not be “owned” or run by one organization,
but set up as a partnership.
Capacity for crisis intervention and immediate support would be helpful.
Get youth input into the design of the system. Find out what youth would want.
Service resource continuity….call parent’s back, check up on them.
Ensure that the service is welcoming, kind, empathic. Someone with the time to
give parents what they need, to listen.
Ensure there is a coordinated electronic information system (especially basic client
information, name, address, Physician, School, contact people, etc.).
6. DISCUSSION & RECOMMENDATIONS
Strategic Recommendations
6.1 Efficient System of Access
Over 30% of parents who filled out the survey (n=48) reported making over 9 contacts
before finding a service and expressed concern about the inefficiency of the system.
Clearly parents are spending a great deal of time calling service after service to collect and
decipher information about the types of services available for their children and the
eligibility requirements. Given that the current system in Waterloo Region has over 35
separate access points for MCYS funded services this finding is not unexpected (Appendix
6 – Current System of Access to MCYS Services).
Many parents expressed concern for families who might not have the capacity to do the
work required to find services in Waterloo Region. They were especially vocal about their
concern for families with cross cultural issues. It is not difficult to imagine that for
someone with English as a second language that calling over nine services for information
would be overwhelming. Therefore the committee recommends that Waterloo Region
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service providers should work together to reduce the points of contact necessary for
parents to find a service for their child.
Recommendation #1
Develop an efficient system of access to services that supports parents to find the
“right” service at the “right’ time for vulnerable children in Waterloo Region”.
6.2 Single Coordinated System of Information and Access
A single/coordinated system of accessing services is recommended as a necessary
alternative to the current system that appears to be made up of a vast variety of
uncoordinated and inconsistent information sources. In addition to the 35 separate
access points for MCYS funded organizations that serve vulnerable children, many more
are offered in our community funded by other Ministries or funding sources, too many to
name.
Despite positive feedback from parents about the clinical knowledge of intake staff, and
the best intentions of intake staff to provide accurate and up to date information to
families seeking services, parents consistently complained that information was
inaccurate and uncoordinated. In addition, it appears that parents’ reliance on family
doctors and pediatricians for information was often met with disappointment. Although
speaking with medical professionals directly about this issue was beyond the scope of this
project, it is not inconceivable to surmise that medical professionals in this community
find it very difficult to keep up to date on what services are available for their patients. It
is likely that the same uncoordinated and inconsistent information would be found by
doctors who seek to out information for their patients as are found by parents.
If it is conceivable that intake workers spend an average of ¼ of their time providing
information about services to the public (a more conservative estimate than suggested in
the theme section of this report), it could be argued that this effort could easily (albeit
crudely) be quantified. With over 35 separate points of intake in MCYS funded
organizations if each had only 1 staff person devoted to this role there would be the
potential for 8.75 full time equivalent intake staff performing this information service. At
an average salary with benefits of 70K each, this converts to over 600K in annual salaries
devoted to providing information to potential clients.
In an effort to calculate a more accurate estimate of costs associated with providing
information to families about services, a brief survey was conducted with intake staff.
With the approval of their administration, intake staff were asked to submit statistics on 4
areas including, the total number of calls to intake over a one year period; estimated time
per call; total number of registered clients; and, the intake worker’s salary range. All 15
participants of the intake worker forum were asked to participate in the survey, we
received 7 responses.
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Seven organizations in Waterloo Region received over 17 hundred calls for information in
a one year period. The time per call was estimated to range between 5 to 30 minutes
(average 20 minutes was used). The average salary was $42.00 per hour (with 20%
benefits added in). If this data was averaged and applied to all 35 separate access points,
it would appear that approximately 250 K per year is going in to the staffing costs for
providing information services in Waterloo Region. However, in this approach there is no
way to account for the time that is devoted to ensuring information is up to date,
(researching other services, documenting changes) nor is there a way to quantify other
associated activities, such as completing written documentation, making referrals, etc.
In summary, despite the lack of accurate means of quantifying the collective costs to the
community for providing information in the current manner, one might conclude that the
final costs are somewhere between 300 and 600 thousand dollars a year and that a good
deal of this is “re-work” being done on the part of intake staff. One might wonder how
much of these resources might be redirected to service should the system be
coordinated Although there may be a variety of options for improving coordination and
accuracy of information for families accessing services in for vulnerable children in a more
efficient manner, the committee recommends that a single coordinated screening phone
line would serve to streamline the system and serve both parents and professionals alike.
Recommendation #2
Create a single/coordinated “screening” phone line for families of vulnerable children
and youth in Waterloo Region.
6.3 Coordinated within the Broader Context of Child and Youth Services
It is believed that any system that attempts to streamline and coordinate access to
services for vulnerable children must be coordinated within the broader context of
services for “all children”. As a result, should this project move forward, planning should
address the various touch points that exist in the larger service system including those
cross Ministries e.g. CCAC’s or other related activities e.g. Children’s Planning Table
(Region of Waterloo), Autism Services Waterloo. The model developed by Waterloo
Region for the Ministry of Children and Youth funded services would benefit from paying
close attention to the opportunities for collaboration and even formal partnerships with
the broader system. Therefore the committee recommends;
Recommendation #3
Ensure the model is reviewed and coordinated within the broader context of child and
youth system planning.
Operational Recommendations
6.4 Coordinate with 211
211 is a three-digit phone number, 2-1-1, and website www.211ontario.ca that provides
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information on community, social, health and government services in Ontario. The
service, funded by the United Way and the Ontario Government is designed to help
Ontario residents “find support to be resilient and resourceful, no matter what life
situation is challenging them”. 211 is an information phone line and website that is
available 24 hours a day, every day of the year. The service is available in over 150
languages, the website is bilingual, and can help families find services in both French and
English. Calls to 211 are free of charge, anonymous and confidential.
211 is in some cases a good starting point for families looking for services for children. It
is staffed by operators that are trained to respond to inquiries about a full range of
services from recreation programs to specialized support and whose expertise is in
guiding the caller in searching the existing data base to find the right service.
In discussing the service with senior administration at 211, based in the Niagara Region, it
was clarified that 211 is not meant to provide in-depth information about services, nor
are the staff who answer the phones qualified to assess the caller’s needs. They are
simply there to give information about existing services and the contact information
associated with the service. As a result, it is recommended that should the Council decide
to pursue a coordinated single point screening line that the system is coordinated with
211 to ensure that parents of vulnerable children are referred directly from 211 to the
system for accessing services for vulnerable children.
Recommendation # 4
Ensure a direct and coordinated connection between 211 and the single/coordinated
“screening” phone line.
6.5 Market the Service to the Public
It appears service providers who maintain their own access (“intake”) systems have been
working under a great deal of constraint with limited resources that is complicated and
perpetuated by the silos created by an uncoordinated system for accessing services. As a
result, service providers have been forced to do a tremendous amount of the same work
keeping up to date on each other’s services. No “one” service has a mandate to
coordinate information and communicate this to the public, yet every service we spoke to
felt an individual responsibility to keep up to date on service availability and provide this
information for potential clients who call them. As a result, there appears to be a lot of
waste of resources to maintain a system that is focused almost exclusively on educating
within the system with few mechanisms for taking information about the “system” to the
public.
Recommendation # 5
Undertake and maintain a direct marketing campaign to families, primary health care
providers, educators and others on the single/coordinated screening system for
vulnerable children in Waterloo Region.
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6.6 Ensure Accurate and Up To Date Information
According to the data collected for this project it was not uncommon for parents to start
their search for services with a friend or another service provider, but they also sought
information from their family doctors, and/or their child’s teacher. In a document
published by the Provincial Centre for Excellence for Children’s Mental Health at CHEO
entitled, Access & Wait times in Child and Youth Mental Health: A Background Paper
(2010), it is reported that many young Canadians turn to their family doctors and then to
their schools for information on mental health. The report also noted that a considerable
amount of evidence suggests that many children and youth go to hospital emergency
departments as the chosen access point for mental health services (Davison et. al., 2010).
Although the report is focused on mental health, it is argued that its findings serve to
further inform this project on access to services for all “vulnerable” children across
sectors.
In relation to the above, during this review it became apparent that despite the efforts of
service providers (intake staff) to maintain accurate information, it was common for
parents to report that they often got inaccurate and out of date information about
services. The same feedback was given for family doctors and schools. However, intake
worker’s reported to be spending a great deal of effort (and resources) on attempting to
keep up to date on available community services and eligibility criteria. But they also
described the difficulties associated with this task. In addition, intake workers discussed
concerns that the considerable number of existing published parent/service resource
guides were not being used or insufficient for parent’s use. As a result, it could be argued
that a there is a tremendous amount of rework being done by service providers to stay up
to date and current but that few of them have a “formal” well-resourced system for doing
so.
Recommendation # 6
Establish and maintain high priority responsibility for accurate and up-to-date
information on all aspects of available services for vulnerable children.
6.7 Direct Connection to Schools (Teachers)
As noted, on several occasions parents voiced frustration over the lack of information
they got from their child’s school about seeking help for a variety of issues for their
vulnerable child. At the same time, however, some did express their understanding and
concern that the school system, especially teachers, were not equipped to provide what
was needed. Despite this understanding, both parents and educators agreed that there is
an important role for schools in supporting families to access services. In many instances,
teachers are in a position where their observations of children can lead to early
intervention and even prevention of issues escalating. It is not difficult to imagine that as
a parent, one would expect that if a teacher had a concern about one’s child that they
would also offer some guidance as to where to go for help. However, it could be argued
that it would be unreasonable for anyone to expect that School Boards, Principals or
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Teachers could develop a system and maintain the vast amount of information there
exists about the current number of options for services for vulnerable children. Rather, it
is argued that a single/coordinated access point for vulnerable children would serve as a
tremendous resource for educators who could easily be oriented to this streamlined
system through standardized and formalized protocols. As a result, the committee
recommends that any coordinated access point should include a strong and ongoing
relationship with the education system.
Recommendation #7
Ensure a direct and ongoing connection to the Waterloo Region education system with
formalized systems and protocols for ease of access to services for vulnerable children in
Waterloo Region.
6.8 Monitor Quality
Because this review attempted to gather information about the “experience” of both
parents and service providers, the inquiry included a question for parents about the
existence and use of any complaint mechanism offered to them from service providers
about their efforts to access services. Similarly, service providers were asked if they had a
complaint mechanism in place for clients, and if clients were routinely advised of the
mechanism. Results of this line of questioning appeared to produce significant
discrepancies between service provider’s information and parents’ experience, however,
as noted; many parents did not feel in a position to complain. However, many of the
parents who participated in this review expressed their gratitude for being asked to
contribute to the knowledge gathering effort in this project, and used the opportunity to
express their belief that should Waterloo Region decide to implement a coordinated
system of access to services, that quality measures should be embedded into the
procedures, and that both parents and youth be invited to give regular feedback. In
particular, it was noted that the voice of youth was missing from this inquiry and that
both parents and youth should be represented on any organizing committee struck to
plan for and implement these recommendations. As a result of this theme, the
committee is recommending that any coordinated model of accessing service should have
standardized quality improvement efforts built in.
Recommendation #8
Build in continuous quality-improvement standards and expectations with regular
parent and youth feedback.
6.9 Limit Paperwork and Share Documentation
Filling out paperwork and applications for service is a common activity for families
applying for any service. However, for those families of vulnerable children whose search
often brought them to several access points, filling out paperwork was experienced as
tedious and repetitive. For this reason, parents consistently asked for planning to include
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giving serious consideration to limiting the need to repetitious information collection and
documentation. Many suggested that a coordinated access system must include some
form of electronic sharing of information, most especially basic information that is
sometimes referred to as “tombstone” information. When privacy issues were discussed
in parent forums there appeared to be a consensus that privacy issues were a parent’s
“last concern”. It was more important to them to be efficient and get access to answers
in a timely fashion. As a result, the committee is recommending that this important issue
be a high priority for consideration should a single coordinated access system be
developed.
Recommendation #9
Develop integrated intake forms and an associated process for ease of sharing
information among service providers.
6.10 Engagement Strategies for All Families
This recommendation is related to the strongly held position that a coordinated system
for accessing services for vulnerable children must be designed to meet the various needs
of our community. Cross cultural issues (religion, language, cultural practices, etc.),
readiness (acceptance, motivation, cognitive understanding, capacity etc.) and resource
issues (limited financial resources, job demands, transportation etc.) were all mentioned
at one time or another during the review. The complexities of the current system with
over 35 point of entry were viewed as a significant barrier to service for families with any
of the issues listed.
Recommendation #10
Ensure systems and processes for accessing services are designed for all families in
Waterloo Region with special attention to cross cultural, resource and readiness issues.
6.11 Work Together as a “System“ for kids with High Needs
As was discussed earlier, for those children with the highest and most complex needs
parents were consistently frustrated with a system that appeared to have few options for
supporting transitions from one service to another without “starting over” with the
application and assessment phase. In fact, this issue was highlighted by service providers
as a significant challenge for them as well. Although many service providers play a
leadership role in supporting client transition by reaching out to service partners and
holding “joint service planning meetings”, the processes are different for each service and
many are not known to the community of services. This issue is especially critical for
parents whose children’s needs accelerate quickly and are in urgent need of additional or
different services. As a result, the committee recommends that a single coordinated
access system should include a standardized system for supporting transitions.
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Recommendation #11
Build in capacity for transition planning and system navigation support for families of
vulnerable children with high needs.
6.12 Further Recommendations for Operations
During the review many of the participants suggested ideas for operating a single
coordinated access system that the committee felt deserved consideration. As a result,
the following recommendation was included;
Recommendation #12
Consider recommendations for operations reviewed in this report (e.g. live voice,
flexible hours, capacity for crisis intervention etc.)
7. Summary
This project has served to facilitate an important opportunity for parents and service
providers to share their experience, both accessing and providing access to services for
vulnerable children and youth in Waterloo Region. In doing so, participants in focus
groups found others with like experiences and many were inspired by each other to share
ideas for making further improvements to the system. The strengths and challenges of
the experiences of many individuals has overall, led to a number of important
recommendations, some of which are already being tested in other communities in
Ontario in coordinated access points such as Growing Great Kids (Wellington County) and
the Children’s Treatment Network (Simcoe York). It is for these reasons that the Access
to Services Steering Committee has taken the position that the recommendations are in
fact, feasible options for improving the system here in Waterloo Region. Collaboration,
innovation, and family-centred care are thought to be key principles to guide efforts to
improve access to services (Davison et. al., 2010) and many would say that Waterloo
Region has a strong history and commitment to all three.
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8. Appendices
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Appendix 1
January 16, 2011
7:00 p.m. to 9:00 p.m.
KidsAbility
50 Hallmark Drive
Waterloo, ON, N2K 3P5
OR
January 19, 2011
12:30 to 2:30 p.m.
KidsAbility
50 Hallmark Drive
Waterloo, ON, N2K 3P5
The Integrated Access to Services Committee
(A sub-committee of the Waterloo Region Children & Youth Services Planning Council)
Laurie Robinson, Consultant, Robinson Consulting, laurie_robinson@rogers.com Tel:
519.635.6719 or Sue Simpson, Director of Programs and Operations, Waterloo Region Family Network
suesimpson@waterlooregionfamilynetwork.com Tel: 519.804.1786 ext. 100
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Appendix 2
Email to Service Providers for Intake Workers Focus Group
I have been contracted by the Waterloo Region Children and Youth Services Planning Council
(CYSPC) to complete a review of the process and experience of accessing services for vulnerable
children and youth in Waterloo Region. The Council is made up of over 30 major service
providers funded by the Ministry of Children and Youth Services. The Council’s mission is to…
“…plan for, promote and continually improve a local system of
services and supports for vulnerable children, youth and their
families.”
The project is called the Integrated Access to Services Project. The design of the project is to
gather feedback on what is working for families and service providers seeking, and connecting
to services. The main objective of the project is to look for practical ways to enhance current
strengths, and continue building a system that is welcoming, easy to navigate, well
coordinated and efficient! The information will be gathered through a combination of parent
surveys, focus groups and face-to-face interviews guided by a list of questions.
The Council is very committed to gathering the views of service providers. As a result, we are
hosting a focus group for Intake staff with experience working with families who are seeking
access services. The focus group will be held on January 13, 2012 at 1770 Kings St. E. in the
kidsLINK Early Intervention Services Office, Training Room.
With the permission of the participants, the meeting will be audio taped and used to ensure the
accuracy of information. Of course, no names or other personal identifiers will be used in the
reporting, and all taped recordings will be destroyed after their use. The final summarized
information gathered during the project will be written in a report, with recommendations that
will be submitted and reviewed by the Integrated Access to Services Advisory Committee and a
final report forwarded to the Council. All those who participate in the project will be provided
full access to the final report. The final report is due back to the committee by March 1, 2012.
The participating of intake staff at your organization is considered key to the Council’s ability to
represent their views and ideas for enhancing the system for accessing services for vulnerable
children and youth in Waterloo Region. If your staff are able to participate in the review,
please send me their contact information I will forward the details (copied to you) in the
coming weeks. If you wish to discuss the project with me directly, please call me at
519.635.6719, or email me at laurie_robinson@rogers.com
Sincerely,
Laurie Robinson
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Appendix 3
Email to senior service people who administrate single points of access.
Dear ____________
As you know, I have been contracted by the Waterloo Region Children and Youth Services
Planning Council (CYSPC) to complete a review of the process and experience of accessing
services for vulnerable children and youth in Waterloo Region. The Council is made up of over
30 major service providers funded by the Ministry of Children and Youth Services. The Council’s
mission is to…
“…plan for, promote and continually improve a local system of
services and supports for vulnerable children, youth and their
families.”
The project is called the Integrated Access to Services Project. The design of the project is to
gather feedback on what is working for families and service providers seeking, and connecting
to services. The main objective of the project is to look for practical ways to enhance current
strengths, and continue building a system that is welcoming, easy to navigate, well
coordinated and efficient! The information will be gathered through a combination of parent
surveys, focus groups and face-to-face interviews guided by a list of questions.
The Council is very committed to gathering the views of service providers. As a result, I am
requesting to meet with you personally to gather input from you (or your designate) about your
experience and knowledge as leaders involved in the administration of a “single point of
access” such as Front Door. My plan is to meet personally with the senior people involved in
three single points of access in Waterloo Region, including those associated with Special Needs
Resourcing (SNAP) and the Developmental Services Resource Centre (DSRC).
With your permission, the meeting will be audio taped and used to ensure the accuracy of
information. Of course, no names or other personal identifiers will be used in the reporting,
and all taped recordings will be destroyed after their use. The final summarized information
gathered during the project will be written in a report, with recommendations that will be
submitted and reviewed by the Integrated Access to Services Advisory Committee and a final
report forwarded to the Council. All those who participate in the project will be provided full
access to the final report. The final report is due back to the committee by March 1, 2012.
As leaders in the provision of single points of access your wisdom and experience is considered
key to the Council’s ability to understand and represent your views for enhancing the system
for accessing services for vulnerable children and youth in Waterloo Region. Please let me
know if you are able to book an appointment time with me for any time between January 3 and
February 1, 2012, and I will coordinate a time that suits all of us. I expect the meeting may take
up to 1 ½ hours. If you wish to include another Manager from your organization in the meeting,
or designate this to a senior manager in charge, please forward their contact information and I
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will communicate directly with them. If you wish to discuss the project with me directly, please
call me at 519.635.6719, or email me at laurie_robinson@rogers.com
Thank you, in advance, for your participation in this very important project.
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Appendix 4
Invitations to 4 community planning groups, including both Special Education Advisory
Committees (Catholic and Public School Boards), Student Support Leadership Initiative,
Transitions Network Committee in person
To: “Committee”
Good Afternoon,
I have been contracted by the Waterloo Region Children and Youth Services Planning Council
(CYSPC) to complete a review of the process and experience of accessing services for vulnerable
children and youth in Waterloo Region. The Council is made up of over 30 major service
providers funded by the Ministry of Children and Youth Services. The Council’s mission is to…
“…plan for, promote and continually improve a local system of
services and supports for vulnerable children, youth and their
families.”
The project is called the Integrated Access to Services Project. The design of the project is to
gather feedback on what is working for families and service providers seeking, and connecting
to services. The main objective of the project is to look for practical ways to enhance current
strengths, and continue building a system that is welcoming, easy to navigate, well
coordinated and efficient! The information will be gathered through a combination of parent
surveys, focus groups and face-to-face interviews guided by a list of questions.
The Council is very committed to gathering a broad selection of views including those of
educators and other related stakeholders dedicated to serving children, youth and
families. Your group was suggested as one to seek to meet with. As a result, I am asking to
attend one of your upcoming meetings to tell you more about the project and hear your
answers to our questions. I will need approximately 30 to 45 minutes on your agenda.
The session will be audio taped, with your permission, and used by me to ensure I get accurate
information. Of course, no names or other personal identifiers will be used in the reporting,
and all taped recordings will be destroyed after their use. The final summarized information
gathered during the project will be written in a report, with recommendations that will be
submitted and reviewed by the Integrated Access to Services Advisory Committee and a final
report forwarded to the Council. All those who participate in the project will be provided full
access to the final report. The final report is due back to the committee by March 1, 2012.
Thank you for considering my request. Your participation in this review is considered key to the
Council’s ability to represent your views and ideas for enhancing the system for accessing
services for vulnerable children and youth in Waterloo Region. Please email me directly at
laurie_robinson@rogers.com, or call me at 519.635.6719, to discuss a date. Should you have
any further questions related to the project, feel free to send them along.
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Appendix 4
Survey email
Dear Service Provider
This survey has been developed as part of a study supported by the Waterloo Region
Children and Youth Services Planning Council (CYSPC) to complete a review of the
process and experience of accessing services for vulnerable children and youth in
Waterloo Region. The Council is made up of over 30 major service providers
funded by the Ministry of Children and Youth Services. The Council’s mission is to…
“…plan for, promote and continually improve a local system of services and supports
for vulnerable children, youth and their families.”
The study is called the Integrated Access to Services Project. The design of the study
is to gather feedback on what is working for families and service providers seeking,
and connecting to services. The main objective of the project is to look for practical
ways to enhance current strengths, and continue building a system for
finding/accessing services that is welcoming, easy to navigate, well coordinated
and efficient!
The Council is very committed to gathering your views and wishes to thank you in
advance for completing the survey. The final summarized information gathered
during the project will be written in a report, with recommendations that will be
submitted and reviewed by the Integrated Access to Services Advisory Committee
and a final report forwarded to the Council. All those who participate in the project
will be provided full access to the final report. The final report is due back to the
committee by March 1, 2012.
Insert in the survey doc….
Survey Introduction: This survey is designed to gather information from service
providers who have experience providing support to families in Waterloo Region
who are in the process of accessing services for their children. By “access” we
mean, how do you support families to find the “right” service for their child
Professionals in the field often call this the “intake” service or the “referral process”.
By “service” we mean those services that might best be described as “social
services” (e.g. mental health services, services for help with a child and or youth
with a developmental disability, a physical disability, a problem with the law,
problems learning or school related problems etc.).
If you provide an “intake” or “referral” service we are very interested in your
experience! Please take the time to complete the survey.
Again, we wish to thank you in advance for taking the time to describe your experience
for us. Should you have any questions about the survey please contact Laurie
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Robinson by email at laurie_robinson@rogers.com, or by phone at 519 635-6719.
Questions:
1. Describe briefly your intake process List 4-5 major activities
Description box
2. How do your clients find out about your services Advertisement, word of mouth, etc.
Description box
3. What mode of communication or information sharing works best for clients who are
attempting to access your service (telephone, in person, email, web information etc.)
Description box
4. Do you have a client complaint process If Yes, how do you inform clients of this
process
Description box
5. Do you keep records of complaints If yes, are you willing to share this information at a
later time
Description box
6. When talking with families about access to services, do you get a sense of how many
points of contact they have had before they find the “right” service
Description box
7. How many calls do you receive from families attempting to access a service
Per month
Per year
8. Do you keep statistics on the number of calls you receive each month/year that DO NOT
turn out to be registered clients
If Yes, are you willing to share this statistics at a later time
Description box
9. In general, what do clients expect from your service
Description box
10. What role, responsibility and knowledge do you think an Intake staff person must have
when providing services to families
Description box
11. In general, what would you like to improve about your system for supporting families to
access services
Description box
12. In general, what works well about your system for supporting families to access
services
Description box
13. What would be an ideal system for families to access services for vulnerable children in
Waterloo Region
Description box
14. Would a single help (phone line) staffed by an experienced professional be helpful for
families attempting to access services What do you think about this idea for the
future
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Description box
15. If you would like to provide follow up information regarding this survey, please email
laurie_robinson@rogers.com.
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Appendix 5
Survey email…
Dear Parent
This survey has been developed as part of a study supported by the Waterloo Region
Children and Youth Services Planning Council (CYSPC) to complete a review of the
process and experience of accessing services for vulnerable children and youth in
Waterloo Region.
The Council’s mission is to…
“…plan for, promote and continually improve a local system of services and supports
for vulnerable children, youth and their families.”
The study is called the Integrated Access to Services Project. It is designed to gather
feedback on what is working for families seeking, and connecting to services. The
main objective of the project is to look for ways to build a system that is welcoming,
easy to navigate, well coordinated and efficient!
The Council is very committed to gathering your views and wishes to thank you in
advance for completing the survey. The final summarized information gathered
during the project will be written in a final report forwarded to the Council. The
final report will be made available thought
Follow the link to complete the survey.
If you know of any other parent with experience accessing services please forward this
email and suggest they fill out the survey. Every experience is a valuable
experience!
Many Thanks!
Insert in the survey doc….
Survey Introduction: This survey is designed to gather information from parents who
have experience accessing services for their children in Waterloo Region. By
“access” we mean, what was your experience of finding the right service for your
child Professionals in the field often call this the “intake” service. By “service” we
mean those services that might best be described as “social services” (e.g. mental
health services, services for help with a child and or youth with a developmental
disability, a physical disability, a problem with the law, problems learning or school
related problems etc.).
If you have had experience accessing service for more than one child, you may wish to
choose only one to describe. If you prefer to comment on more than one
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experience you may elect to submit more than one survey.
Again, we wish to thank you in advance for taking the time to describe your experience
for us. Should you have any questions about the survey please contact Laurie
Robinson by email at laurie_robinson@rogers.com, or by phone at 519 635-6719.
Questions:
1. Is your child male or female
Pick list 0k
2. Age of your child at the time you began the process of finding/accessing a service
Pick list ok
3. Describe briefly the process you went through to find services for your child
Description box ok
Describe how easy or difficult it was to find information about the service
Description box ok
4. How many contacts (phone calls, visits etc.) did you have to make until you found the
right service
Pick list ok
5. How did you hear about the service you finally found/accessed
Pick list ok
6. Overall, how knowledgeable was the person(s) you spoke to while you were
finding/accessing a service
Pick list ok
7. While going through the process of finding/accessing a service, were you notified of a
complaint process
Pick list
If yes, did you have a complaint Did you report it
Description box ok
8. Approximately how many services or service organizations did you have contact with
before you found the “right” service
Pick list ok
9. Approximately how long did it take you to find the “right” service
Pick list …add “I am still waiting” and “I have never received the right service”
10. Were you placed on a wait list for service If yes, how long did you wait
Pick list
11. At any time were you on more than one wait list for service If yes, how many
Pick list
12. Describe briefly what could have been done to improve your experience
finding/accessing a service
Description box
13. Describe what really worked for you Do you have an example of an intake service that
was exceptional
Description box
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14. What would be an ideal system for accessing services for children and families
Description box
15. Would a single help (phone line) staffed by an experienced professional have been
helpful to you during your search What do you think about this idea for the future
Description box
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References
Access & Wait Times in Child and Youth Mental Health: A Background Paper (2010)
The Canadian Association of Paediatric Health Centres
The National Infant, Child, and Youth Mental Health Consortium Advisory
The Provincial Centre of Excellence for Child and Youth Mental Health at CHEO
Contact Information for the author of this Report
Laurie A. Robinson, MSW
Robinson Consulting
519.635.6719
Waterloo, Ontario, Canada
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