NETWORK E-BULLETIN - NOVEMBER 2008 EDITION

Network Budget Update & Go-Forward Plans

Working Together For Kids & Teens with Disabilities … Children’s Treatment Network is a new service delivery model for kids with multiple disabilities in Simcoe and York. It links over 40 healthcare, education, recreation, social and community services organizations so they can take a team approach to each child’s care. For the first time, parents have one point of contact for a single plan of care for kids from birth to age 19. The Network coordinates services needed and monitors each child’s progress through all the phases of their development. The Network is also expanding services that are critically needed in the community to bring more services closer to home and help reduce waitlists. Parents and professionals can contact the Network by calling 1-866-377-0286 or online at www.ctn-simcoeyork.ca.

NEWS AT A GLANCE:

• Message from new Network CEO Louise Paul - Update on Network Operating Budget and Go-Forward Plans
• ‘Frontline Focus’ News Bulletin for Professionals Launches in November
• Some Network Milestones
  

Message from new Network CEO Louise Paul

First of all, I’d just like to say how excited I am to be working with all of you. It’s an honour to be on the front line with a community of parents and professionals who are dedicated to finding new ways to build on our strengths so we can better serve kids with disabilities. Even though the Network is still in the early stages of implementation, it’s clear that the passion and commitment to enhancing service and bringing the ‘single plan of care’ vision to life is already making a difference to kids and families.

Building on a legacy of accomplishment
Over the last three years, Network partners have made incredible progress in building the new Network system and expanding services available in the community. During this first phase of development, the efforts of Network partners from 4 school boards, 7 hospitals and over 34 rehabilitation and community service organizations have resulted in hiring additional professionals, expanding services, reducing travel and wait times and bringing more services closer to home. And many families no longer have to travel long distances for some specialty services that are now available on our doorstep.

Network partners also developed the new ‘single plan of care’ tools and processes - including a shared electronic record - that allow professionals from multiple organizations to work together and take a team approach to each child’s care.

Although there is much more to be done to fully operationalize the Network, the progress made so far has had a significant impact on kids and families and provides us with a solid foundation for moving forward.

Network operating budget and go-forward plans
The past three years have been focused on fast tracking development of the Network system, including expanding services and developing the single plan of care approach. However, there have been recent developments that will affect the next phase of the Network’s evolution.

In our current funding year (April 2008 - March 2009) the Network did not receive the financial resources needed to continue accelerating the Network’s development. Network partners worked diligently together to address the 08/09 situation with minimal impact to families. However, we have had to slow some service expansion and professional recruitment plans.

Given the current economic situation, there will continue to be significant pressure in 2009/10 on all government services including healthcare, education and children’s services. Network partners are in the process of determining how to minimize the impact of budget constraint on Network services as much as possible. In other words, we are focused on reducing overhead and exploring creative ways to use existing resources more effectively. Reducing access to services would be a last resort after all other options have been explored. Of course, we will continue to monitor the situation and keep you advised of any possible changes to service levels.

Despite economic and financial challenges, Network partners will continue to drive coordinated, integrated care into the community. Examples of some of the progress that’s been made so far are highlighted in ‘Some Network Milestones’ at the end of this eBulletin.

Transitioning more children to single plan of care a key priority
In the spring, hundreds of front line professionals, partner organization leadership teams and parents and families of kids with special needs participated in meetings focused on ‘Charting the Network’s Future’. These meetings were held to identify key areas of focus and priority for the next phase of the Network’s development. The overwhelming response from all groups was to stay the course toward realizing the Network’s vision and ramp up engagement of all Network partner organizations to fully operationalize the single plan of care approach for more children.

Working with partners to consolidate and align existing planning processes with single plan of care
Partners in every sector of children’s services have told us that this next stage in the Network’s development requires that we work closely together to align each organization’s processes and existing best practices with the single plan of care tools and approach. We also need to ensure that families do not have to participate in repetitive case conferences or tell their story numerous times. We’ll be meeting one-on-one with all partner organizations to consolidate and integrate critical planning processes like access and intake, waitlist management, documentation, clinical pathways and reporting so that we can remove barriers to transitioning more children into single plan of care.

Who should receive a single plan of care?
It is not necessary or appropriate for every child with special needs to transition to a single plan of care. Many children with a range of disabilities are very well supported through the comprehensive programs and services currently provided by Network partners.

There are approximately 4,800 children and youth with multiple disabilities and complex conditions who would benefit from the intensive service coordination and integrated team support provided by a single plan of care to participate fully in daily living, school and play. These children and families include:

• Children with a combination of physical, developmental, communication or mental health needs who may already be receiving services from a number of Network partners and require service coordination and/or specialized rehab treatment
• Children with complex and/or long-term medical conditions who require long term therapeutic support, specialized equipment or travel to treatment centres outside the community
• Families at risk of crisis or breakdown who require more comprehensive service coordination and support to effectively implement a single plan of care involving multiple service providers
  

To date, over 200 children have begun to transition to the single plan of care process. These are children participating in a special research study conducted by McMaster University. The study will help evaluate which families and children most benefit from intensive integrated care and measure effectiveness of the new system.

Prioritizing the next wave of children to begin the transition to single plan of care
In order to ensure an effective transition for each child and not overload the system, Network partners will begin to gradually transition waves or groups of children and families. We’ll be meeting with Network partners to develop specific targets and timelines around numbers of children to begin the transition throughout 2009 and 2010.

Network partners have developed an assessment tool and process that will be used to prioritize kids and families based on the child’s urgency of need and available service capacity. The next group of kids to be assessed and prioritized are 700 children who have been receiving Network funded services, which include a range of occupational and physiotherapy, augmentative communication, feeding and swallowing and spasticity management services. A shared electronic record has already been opened for most of these children.

The assessment and prioritization process includes conversations with each family and input from the professionals working with the child to determine urgency of need. Upon parental consent, a shared electronic record will be established for each child, if one does not yet exist. Then the team currently serving the child will begin to coordinate care plans and services aligned with the single plan of care approach. This approach involves developing an integrated care plan for each child that is aligned with the family’s strengths, needs and visions, as well as coordinating services and monitoring each child’s progress through all the phases of their development.

I’m looking forward to working closely with all the Network’s partners as we continue to operationalize the system and bring single plans of care to more children in the community who need them.

‘Frontline Focus’ News Bulletin for Professionals Launches in November
In response to numerous requests from across the Network, the first issue of a monthly bulletin designed specially for frontline professionals will be delivered to your desktop at the end of November.

‘Frontline Focus’ is a direct line to all the Network ‘news you can use’. It provides Network professionals with headline news on the latest operational and clinical developments - including updates on policies and procedures, new services information, Local Team news and events, training and professional development opportunities and electronic record quick tips. With the click of a mouse you’ll be able to get more details or access the latest forms and procedure guidelines from SharePoint, the Network’s online information repository.

We encourage everyone working with a Network partner organization to use Frontline Focus as a key source of operational information. The first issue will be emailed to all professionals who are registered SharePoint or Electronic Record Users. If you are not yet a registered user, please email silvie.thickett@ctn-simcoeyork.ca and ask to be added to the Frontline Focus email list.

Some Network Milestones
Travel and wait times have been reduced by bringing 5 specialty services to the community. In addition, professional development workshops and special training sessions held by Network partners are helping to broaden knowledge and expand the capability of service providers and families to screen, assess and provide treatment for more children:

Augmentative Communication

• 2 service teams have reduced wait times from 4 years to approximately 9 months. Over 150 kids no longer have to travel long distances for this service
• Over 240 occupational therapists and speech-language pathologists attended training sessions focused on how to conduct collaborative team assessments, set goals and identify strategies and tools for pre-school and school aged children
• Almost 400 teachers, education assistants and parents took part in special educational workshops to increase their ability to use a range of communication strategies and tools that support kids in their daily communication at home and at school
• 15 mentors have been trained and dispersed throughout pre-school programs and school boards to provide additional expert support to frontline staff
  

Spasticity Management

• Establishment of clinics has shortened wait times for Botox® assessment/injection. Kids with cerebral palsy and neurological challenges can now receive bacclofen pump services close to home
• A special Botox® learning session was conducted for over 40 therapists on clinical treatment and assessment of candidates so therapists can help more children access this service. A seminar for over 30 therapists on current trends in paediatric orthotic devices raised knowledge levels about spasticity management tools
  

Paediatric Diagnostic Assessment

• Expansion of services has reduced wait times from 1 year to 4 months with community paediatricians and teams of speech-language therapists helping to speed diagnosis for preschool kids with autism
• With the hire of our two developmental paediatricians (Drs. Nicky Jones-Stokreef and Anita Jethwa), expanded services for school aged children and kids who have complex presentations of autism and other developmental disorders have provided more kids with comprehensive assessments that enable the family and school to better identify the medical interventions and behavioural programming supports that are required
  

Feeding and Swallowing

• Services for school aged children have been expanded. Videofluoroscopic swallowing studies are now conducted in 3 local hospitals. Wait times have been dramatically reduced to about 1 month
• 20 professional development workshops were held for 300 rehab professionals, dieticians, nurses and early interventionists to expand knowledge about current trends in managing a range of issues including behavioural feeding approaches and strategies to address complex feeding and swallowing challenges
  

Seating and Mobility

• Across the Network, approximately 7 additional therapists are now able to authorize the prescription of wheelchairs and other mobility devices
• A Seating Mentorship role has been developed to support front line clinicians in the assessment of more seating needs
• Approximately 60 physiotherapists and occupational therapists have attended educational sessions on mat assessments, prescription requirements, and home renovations
  

To learn more about Children’s Treatment Network visit www.ctn-simcoeyork.ca.