DS017 - Wed 26 Feb 2014 / Mer 26 fév 2014

SELECT COMMITTEE ON
DEVELOPMENTAL SERVICES

COMITÉ SPÉCIAL SUR LES
SERVICES AUX PERSONNES AYANT UNE DÉFICIENCE INTELLECTUELLE

Wednesday 26 February 2014 Mercredi 26 février 2014

DEVELOPMENTAL SERVICES STRATEGY

DSO PROVINCIAL NETWORK

The committee met at 1622 in committee room 1.

DEVELOPMENTAL SERVICES STRATEGY

DSO PROVINCIAL NETWORK

The Chair (Mrs. Laura Albanese): Good afternoon, everyone. We are in session. We have the provincial DSO network that is going to present to us, so I would ask you to come forward and to please take your seat. I want to remind members that this will be a presentation of up to 10 minutes. Then we will have 30 minutes for questions, divided equally by the three parties, so that’s 10 minutes each. You may begin any time. Please start with your name and with your title for the purposes of our Hansard. Thank you and welcome to our committee.

Ms. Lea Pollard: Thank you very kindly. My name is Lea Pollard and I’m the chair of the DSO Provincial Network. I’m also the executive director of Contact Hamilton and we administer the DSO for the Hamilton-Niagara region. I’m joined today by some of my DSO colleagues who are sitting behind me.

I want to begin our presentation today by thanking you for the opportunity to come and speak before you, and also to thank you for the important work on behalf of Ontarians with developmental disabilities and their families, and your goal of improving their experiences and their outcomes with the adult developmental services sector. As a DSO network, we wish to be supportive and helpful to you in this process.

I would like to acknowledge that we did develop a written submission that I believe you folks have, which is fantastic. I won’t go into the recommendations or the system challenges, as they are contained in the report, although I’d be very happy to answer any questions you may have around that.

In the slide deck that I have distributed, the systems issues are again captured on slides 15 and 17, and the DSO network’s recommendations to help make some adjustments to our system are found on slides 19 through 21.

What I would like to do today, given the time that we have, is really to focus on the DSOs and what they do and their history. Starting on slide 4, I would like to speak a little bit about our DSO network and to just share that our network is a relatively new network. It was established in 2012. DSO organizations were implemented in 2011. Our network is made up of nine organizational members, which include all nine DSOs from across the province.

Our primary objectives as a network are to identify and respond to relevant issues that impact DSO organizations, and also to support and promote provincial consistency, while at the same time needing to be mindful and respectful of local and regional uniqueness, and trying to balance the need to be responsive to our local and regional communities and to be provincially consistent in key areas.

Our goal is to develop a strategic work plan to guide our work activities over the next few years and then to develop that in response to emerging needs and trends.

For me to be able to speak about DSOs and what it is that we do and what we’re responsible for, it’s important for me to spend a minute or two talking about our roots. The roots of DSO organizations stem from the developmental services transformation that began in the adult developmental services sector in the mid-2000s. In large part, it was the ministry’s response to concerns that they were hearing from families, from individuals and from service providers and their associations regarding the system and how it needed to improve. Areas that they addressed included access, service quality and transparency. The need for choice about the services that folks wanted to receive and how they wanted those services delivered were key areas of feedback.

In 2008, the ministry introduced new legislation to help guide a transformed system of adult developmental services for folks who were searching for services from our ministry, and that new legislation, in short form, is referred to as SIPDDA, the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act. Embedded in that act are key system elements of a transformed system. What’s important to recognize and remember is that these key system elements have to be thought of as interdependent, as connected to one another; that these elements don’t stand alone; and that for us to really achieve a fully transformed adult developmental services sector, all of the elements need to be implemented. They need to be mature, and we need to work together with all of the elements in an integrated way to really achieve the full benefits of them.

Slide 6 speaks to the key elements that are found within the legislation, and you will notice that one of the key elements in the legislation is the creation of application entities now known as Developmental Services Ontario organizations. While we have many responsibilities, at its core, the responsibility for DSO organizations is the fair and equitable and provincially consistent application process.

Other key elements of the system, when it’s fully transformed, include: one provincial definition for eligibility—and we have that; that has been fully implemented—and the creation of a minimum set of quality service standards for service organizations as well as for the DSOs, and that has been implemented. We see in the legislation a confirmed list of services and supports that will be funded through the ministry.

Direct funding is introduced as a new component in the legislation that will enable folks to directly control how they would like their supports delivered when that option becomes available to them. We see direct funding partially implemented with the Passport Program, but we understand that that component will be enhanced over the years.

An element of transformation that has not yet been implemented—and, quite frankly, there are a lot of questions around what it is and when it’s going to happen and what its role is—is called funding entities. So we really don’t have a whole lot of context about that piece, but that is an element of transformation that has yet to be implemented.

I would like to draw your attention to slide number 7, which tries to bring together some of the complexity facing DSO organizations in terms of the different contexts in which DSO organizations operate. DSOs provide direct service to folks in the form of confirming eligibility, helping folks apply for adult developmental services and supports, and helping people link with the services they require. So there is a direct connection to individuals.

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But DSOs also have functions as it relates to helping the system. When we speak about the system, what’s important to understand is that DSOs operate within three types of contexts:

The first is a provincial context. There are functions that we have that are embedded right in the legislation. Our policy directives tell us, “You must do this, and you must do it this way,” for example, the application process or the eligibility confirmation process. The goal there is no matter where you live in the province, your experience with those key processes should be similar and consistent.

But DSO organizations are also responsible for specific regions within the province, and those regions differ between them. We are also responsible within our region for unique local communities. So balancing the need of ensuring that we consider the needs of local communities, that we consider the unique needs of our regions, with making sure we understand where we must be provincially consistent and how we can be flexible to respond to local unique needs is certainly a task for DSOs to manage.

Slide 8 is a list of the mandates that DSO organizations operate within. That was part of the submission and so I’m sure that you’ve read that, and if you have any questions, I’d be very happy to answer them as much as I can.

With respect to slide 9, this is a visual representation, at a very high level, of some of the key processes DSO organizations engage in. What I want to draw to your attention here is that access to services is not a one-time event. It is in fact engaged in as many times as it’s required or needed by families. So when an individual’s needs change, that may trigger a time to call the DSO and update information about the person’s needs, and then that would trigger us updating our service recommendations and actions on behalf of a family. Sometimes a person’s situation changes and that also requires updating of their information.

What’s important to note here as well is that once a person is registered with the DSO and their needs change and they have new requests for information or for services, they re-engage with the DSO at the point of updating their information. They don’t have to redo the entire eligibility process.

On slide 12, I wanted to highlight on behalf of our network the key successes of DSO organizations. Each individual DSO organization can certainly point to very concrete successes and achievements in their regions. What we’ve done here is highlight at the highest level, at a provincial level, some key successes.

Really, for the first time in the province of Ontario we now have one visible, fair and equitable access process to the adult developmental services sector. We have nine single points of entry across the province. We have consistent eligibility criteria that used to replace individual eligibility criteria across the province. Our assessor staff have to meet not only some minimum standards for eligibility to be an assessor, but also must be certified and recertified on a regular basis. Of course, DSO organizations must maintain and adhere to quality assurance measures. I’ll note that last fiscal year our DSO organizations underwent a compliance review and we were all successful in our compliance review.

An area of success that really, today, is actually a significant area of challenge, but it poses the opportunity to be a great area of success, is with the provincial database. We are experiencing a lot of difficulty with that because it’s not fully operational yet, but it poses the greatest opportunity for us because we can have one database where every individual’s needs are identified, where we can understand who is needing what service, what level of support they require in order to be well supported and have their needs met, and where the greatest needs in our community are. It will support not only understanding at an individual level what the needs are, but will also support really good, accurate, solid planning at the local level, at the regional level and also at the provincial level, and it will be an unduplicated count. We don’t have that yet, and that has been one of the biggest criticisms for DSOs. However, it poses the greatest opportunity for us.

DSOs have experienced challenges over the past two years and a bit, since we have been in operation. One of our key challenges has been that some key policies or procedures that relate to some of our key functions have not yet been given to us—so some key procedures around service vacancy matching or helping people access services across multiple regions at the same time: Those are directives we don’t yet have. So what ends up happening is that DSO organizations, in order to be responsive to folks at the time that their needs are presented, are having to manage that on a one-off basis, if you will, where we try to work with one another to develop some interim processes. That can’t always be accommodated because of the time pressures sometimes associated with individual needs, and that results in us not being as consistent provincially in some key areas as we should be.

A key challenge for us—and I’ve already mentioned it—is the fact that our provincial database is not yet fully operational. It’s not very user-friendly, and when it came to us on our opening day, it did not come with orientation and training at that time. We’ve had to work with our province closely in helping to develop the database and use it to the best of our ability.

The database also, at this point in time, does not support all of the key business requirements or business functions of DSOs, which means that many DSOs have to use secondary or supplementary databases in order to capture business processes or capture key data, in order to be able to provide our communities with some level of information. DSOs have experienced higher-than-anticipated volumes than when we were planning for DSOs, before we became operational.

DSO agencies have had to deal with their fair share of criticisms. What I will tell you is that we understand that a lot of that has to do with changed management, introducing changes and experiences people have had. We look at opportunities like today and other opportunities within each of our communities to provide education around who we are and what it is that we do.

What concerns us as a network is that for some families, this is impacting their desire to be connected with the system to apply for services. Some families are feeling apprehensive, anxious or distrustful of the access process or the service system in general. I know that none of us wants that. We all want to be able to move forward and work in a supportive way with our families and individuals.

In terms of key challenges, I’ll end with how our experience has been that the changed management, the need for information and context and education around developmental services transformation, around the introduction of DSOs, has not been at its best. We are looking to our ministry to provide leadership and guidance there to support us, as this is a very significant piece in the development of our sector. Again, the DSOs are one of several elements of a transformed system.

The Chair (Mrs. Laura Albanese): I’m going to stop you there. We had talked about a 10-minute presentation; we’re now at 17, I think, although we haven’t addressed the rest of the presentation. I don’t know what the committee members want to do. I am just mindful of the fact that we’ll have a vote later on. Unless you want her to continue, we could just move on to the questions. We have this with ourselves and we can read it.

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Ms. Lea Pollard: I am finished the presentation.

The Chair (Mrs. Laura Albanese): Oh, okay. Good.

Ms. Lea Pollard: So I was going to conclude on that and thank you again for your interest.

The Chair (Mrs. Laura Albanese): Thank you for being here and for giving us this overview and your point of view, which was needed by the committee. Ms. Jones, you may begin.

Ms. Sylvia Jones: Thank you, Ms. Pollard, for appearing. As the Chair alluded, we’re glad that you have appeared because, as you can imagine, the DSO and the process of the DSO has come up a lot in our presentations.

I’m wondering if you know, as the network, what the annual budget is of the combined nine DSOs in Ontario.

Ms. Lea Pollard: I don’t today, but that is certainly information that I can bring forward.

Ms. Sylvia Jones: Thank you. You made reference to when the provincial database will be fully operational. Have you any indication or can you share with the committee when you anticipate that would be? Because that follows up on—many of the questions that we end up asking research and other ministries are, “Where are the numbers?”

Ms. Lea Pollard: Thank you for that question. We don’t have control over the development of the provincial database. We certainly, as a network, have been advocating routinely and passionately with the ministry to resolve the issues with the database and to ask as well for time frames around when that will be accomplished. We realize that part of the dissatisfaction with our service provider partners, in large part, is that we can’t give them the fulsome information that they need to be able to do the kind of service planning that, as communities and regions in the province, we need to do.

I can tell you that we continuously advocate; I know that other provincial bodies have been advocating to the ministry. But I don’t have a time frame for you. I wish I did.

Ms. Sylvia Jones: Yes, I wish you did too. You made reference to one of the reasons that the database is important, which is the assurance that we won’t have shopping, for lack of a better word, for services, depending on which part of the province you’re in. Quite frankly, I haven’t heard that. We have nine DSOs. I don’t hear, anecdotally, a lot of families saying, “I’m going to apply in this DSO and this DSO and see which one gives me better services.” They’re just too far from their home communities. Do you have examples of that happening?

Ms. Lea Pollard: I apologize if I gave that impression. I think what I was trying to say was that there certainly are families who are prepared to look across regions for services. Some families feel the desperation of their situations. Others may have family members who live in different regions, and so having their family member supported outside of the region they currently live in would be okay, because they would be living closer to another family member. We certainly have situations where families wish to explore services from different regions. They would apply through the DSO in their home community, and the DSO then would share information with the other regions.

Ms. Sylvia Jones: Okay, thank you. I’ll let my colleague go.

Mrs. Christine Elliott: I’d also like to thank you, Ms. Pollard, for appearing before the committee today. I just have a few questions. One is, we’ve heard from some of the families who have come to see us that they feel, in situations where the DSOs are also service providers, that if they’re looking for more individualized programming and planning, they don’t necessarily get offered that and they are really steered more in the direction of the services that are provided directly by the DSO. Are you aware of that as an issue? Has that been voiced to you?

Ms. Lea Pollard: That has not been voiced to me. My DSO in the Hamilton-Niagara region is not a provider of other adult developmental services, so we don’t have that.

What I would recommend in situations like that is that the family connect with the DSO—the feedback process or the complaints mechanism—to identify their concern. Because if that’s the case, then that needs to be addressed by the DSO.

Mrs. Christine Elliott: I think part of the problem is the families feel that they don’t really have any alternative and they don’t have an option to request anything else. They feel that you either accept what’s offered, or nothing, and they’re desperate and they’ll take anything. I think that is something that we need to examine, I guess, in the course of this committee and the recommendations that we’re going to make. I recognize that yours is not directly impacted, but it is something that we have heard about from families.

The other question I wanted to ask you is about the value of upfront planning with families. That was something that certainly those of us who were involved in the 2008 hearings for Bill 77—as it then was—the importance of planning early on with the families to understand what their wishes were for their child, and to the extent that the young person was able to voice their own wishes, that they have the opportunity to do that.

Do you feel that with the way DSOs are presently set up, that there is that truly independent planning and facilitation that is available to families?

Ms. Lea Pollard: Independent planning or person-directed planning is one element of a transformed system, so it’s embedded in the legislation in SIPDDA, and that occurs outside of the DSO process.

So the DSO process, without minimizing it, is really about application to ministry-funded services. It’s about advising people of other service opportunities available in their local community that are funded from other sources, for example, and also advising families of the option of person-directed planning.

I know that person-directed planning is now starting to become implemented within our sector, so that’s relatively new. I know that there is a formation of a network that families can go to to access person-directed planning.

I think there’s also the notion or the element of transitional-aged youth planning on behalf of young people who are 14 and over, in anticipation of them leaving the children’s services system, and trying to engage families at that point in time to think about planning for adulthood.

Mrs. Christine Elliott: Do you think it would be helpful to allow the DSOs, or someone else, to facilitate the planning before the formal assessment is done in order to really understand what the issues are for that young person and what their supports truly should be before you then let them know what’s available in the community, so that you can truly individualize the plan for them?

Ms. Lea Pollard: I think that’s wonderful. Certainly that would be the intent as well of the transitional-aged youth planning protocol that’s being implemented across the province, to get families and individuals to think about planning that’s broader than services, to have really meaningful connections in the community. To do that work first is very helpful so that you know what it is that you want to ask for in terms of services and supports.

Mrs. Christine Elliott: We also know that—I’m sure you’re aware—there have been many criticisms levelled at DSOs, but bottom line, it seems to me that you’re doing the best you can with the resources you have, but the reality is, you have long wait-lists because there aren’t the funds available to be able to serve all the people who have those needs.

I see in your slide deck that the demand far exceeded the supply, and that was a surprise to some extent, but I’m wondering, if there are all these children in the pipeline who were already receiving SSAH, why it was such a surprise that they would have continued to need Passport funding when they reached the age of 18.

Ms. Lea Pollard: The decision to discontinue Special Services at Home at age 18 was a ministry decision. That was not a decision made by the DSO obviously, and I believe that occurred in 2012.

The piece in there about demand exceeding supply is in relation to the service sector. So the needs folks have far outweigh the services that are available in order to address those needs. The volumes at the DSO are higher than what we had anticipated when we were developing our expressions of interest to become the DSO for each of our regions.

I know that DSOs are doing the best they can to ensure that people receive a timely access process—when they call us, that their application appointment occurs as quickly as possible. But you’re correct, some DSOs have fairly lengthy waiting lists, and that is a relative term.

I think the other thing I would say there is that—I lost my train of thought actually. I’m sorry about that. If I remember it, I’ll finish my thought—sorry.

Mrs. Christine Elliott: Okay. I have another question.

Ms. Lea Pollard: Okay.

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The Chair (Mrs. Laura Albanese): Last one.

Mrs. Christine Elliott: All right.

What do you think would be the most significant recommendation that this committee could make with respect to the operation of the DSO?

Ms. Lea Pollard: I think the most significant recommendation would be twofold, and that is that the DSO organizations are provided with the tools that they need to be able to fully realize their mandate and their function, the most important being the resolution of the provincial database issue. That is integral to the work that we do. It should incorporate all of our business processes and it should be user-friendly. If we could achieve efficiencies there, we would be able to respond more quickly as well.

Mrs. Christine Elliott: Thank you very much.

Ms. Lea Pollard: You’re very welcome.

The Chair (Mrs. Laura Albanese): Ms. DiNovo.

Ms. Cheri DiNovo: Thank you, Ms. Pollard, for coming before us. Have you had a chance to read some of the testimony that we’ve heard from parents, especially as it relates to the DSO?

Ms. Lea Pollard: Yes.

Ms. Cheri DiNovo: Just to follow up on my colleague’s point: I don’t think we heard anything nice. What we heard was a lot of frustration from parents. A phrase sticks in my head: “less system, more service.” Parents and families and recipients felt that you’re kind of the middleman. All you did was assess endlessly, and then, at the end of the assessment, if there was some service, that would be great, but there was just another long waiting list at the end of the assessment. I understand you’re not in charge of providing those services. We heard that. I guess my first question to you is: What would you say to those parents?

Ms. Lea Pollard: That’s a very good question and a question that requires a lot of thought. As a parent myself, I appreciate that question, and I think I can speak on behalf of our network members, that we appreciate the experience our families have. It is a real frustration that services are not plentiful enough to be able to meet people’s needs in a timely way.

I would remind us that the introduction of Developmental Services Ontario organizations are one of several elements of transformation, that the system isn’t yet at full maturity, and so the expectations we have today need to be managed a wee bit. While it’s difficult for families to understand, and I appreciate it, because as family members, we are concerned about our son, our daughter, our sister, our brother, today, and ideally people’s needs should be met today, but our system hasn’t matured yet to that, and so it will take some time.

I know that DSO organizations are doing their very best to advocate with our ministry about moving forward transformation and communicating that, because I think a significant piece is that transformation is occurring, but it’s not occurring within a context. People don’t understand that there’s more to come according to our legislation, that the system should be changing, that the system should be more responsive once transformation is completed. That’s not really well understood or appreciated, because the change management of that hasn’t really occurred. So we really need to go back and provide that context, provide that reassurance, at the same time.

Ms. Cheri DiNovo: Thank you. The other question I had was: What parents seem to desperately want is what has been called a system navigator so that when a child—first of all, there’s a whole issue, of course, just getting an assessment when children are young, but suffice to say that when the assessment is made when the child is very young, someone can set up a plan and work with that family, not just till they’re 18 or after they’re 18 but for their lives. I heard you say something to my colleague about the difference there, so I’m wondering: Can the DSOs be system navigators in that sense? Can they morph into that?

Ms. Lea Pollard: I think that there are opportunities, and again, why I would really go back to, “What is the most important recommendation?”: It is to really give the DSO the tools it needs to be able to fulfill its mandate and to give us the clarity to be able to do some of the work that needs to be done.

We hear, too, the importance of system navigation. Folks need to be supported as they make transitions. Folks need to know where it is they’re going. That’s very critical, and I think the DSOs have a role to play in that. I would be interested to work with our other partners around who is best and how we best support families.

One of our recommendations speaks to the need to bring together various ministries and various sectors to look at ways that we can, in an integrated way, best support people, because people are people regardless of the abilities or disabilities they have. Folks should be able to take part in what our communities have to offer. Having a developmental disability should not disqualify you from receiving the same services and supports other family members and folks receive, but we need to do that in an integrated way. We need to understand what other sectors need to know and how we can support that. What role can the DSO play in that? What role can service providers play in that?

Miss Monique Taylor: Thank you, Lea, for being here with us today. I have some questions designed around the application process that families go through. We heard several times that they’re intrusive, that they’re demeaning—these are words that I heard—they’re unnecessary.

I’m seeing here that part of your mandate is that every five years that application process has to be completed. Is it the full extent of the application that has to be completed every five years?

Ms. Lea Pollard: We don’t know the answer to that, and we would certainly advocate that it wouldn’t be the whole kit and caboodle again, so we’re looking for some direction around that.

Miss Monique Taylor: Yes, because that was a serious problem that I heard over and over again.

The qualification of the assessors—what exact qualifications do they have?

Ms. Lea Pollard: The qualifications of the assessor include having a minimum of at least five years’ experience working in developmental services; having a post-secondary degree or diploma in a related field, ideally, developmental services; and having experience and knowledge. There’s a policy directive specific to the assessor qualification, so you can get the detail right from the DSO policy directives.

In addition to that—that’s just to get through the door and to be hired—assessors also have to undergo fairly significant training to be certified to administer the application package that we have today, and then they have to be recertified every 18 months thereafter.

Miss Monique Taylor: Do you believe that the process of the application works as you’ve seen so far? I mean, when we hear of a 30-year-old man who is sitting with his mother and his mother is being asked if that man can take care of his bathroom abilities—do you know what I mean? That’s the intrusive part. Do you think those questions are absolutely necessary, especially done every five years?

Ms. Lea Pollard: The application process is a standardized process and assessors are trained in how to ask questions and must ask the questions a certain way and must ask all of the questions. That’s part and parcel of the application process, and assessors really don’t have a whole lot of flexibility around that.

We also hear from family members that the application process was actually helpful to them because it permitted them time to think through some of the areas that were talked about. But different people have different expectations.

One of the things assessors do during the application process is give families a link to a confidential survey where families can provide detailed feedback about the application process itself and the tool. So we really encourage families to give us feedback around that, and not to us, but directly to the ministry.

Miss Monique Taylor: Thank you. Nine DSOs are set out across the province; they’re the first point of contact. What happens if I’m 200 miles away from a DSO? How does that work in rural Ontario? Do you know?

Ms. Lea Pollard: I don’t know the answer to that specifically. However, I would presume that the DSO would have processes in place, whether they travel to folks on a routine basis or not. But that would be a really good question. I can bring some information back to you around that if you are interested in that.

Miss Monique Taylor: Thank you.

Chair, to research, could we find an answer to—which question was I asking? You want to talk about brain breaks.

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The Chair (Mrs. Laura Albanese): The application, maybe?

Miss Monique Taylor: The application process.

Ms. Lea Pollard: Or the feedback?

Miss Monique Taylor: Yes, the feedback, thank you, and comments for the application process. If we can get information on that, maybe a breakdown of what it looks like, maybe some of the feedback answers to it. Would we be allowed to access those?

The Chair (Mrs. Laura Albanese): From the ministry. Okay. Thank you.

Miss Monique Taylor: Thanks, Lea.

The Chair (Mrs. Laura Albanese): We’ll now move to the government side. MPP Hunter?

Ms. Mitzie Hunter: I will start, and Ms. Wong has questions, as well as Mr. Balkissoon. If I can say that what I heard in Thunder Bay when the DSO presented to us on that final day was that they had satellite offices as well to deal with the geography, but geography was a challenge. He did say that to us.

Thank you, Ms. Pollard. It was really comprehensive. I feel that you’re speaking to us at a very unique point in the work that we’ve been tasked to do, which is to look at the developmental services supports that are provided to adults with developmental disabilities and dual diagnosis across the province, and how we integrate cross-ministry support across a lifetime.

I think that the vision that you have to look at an integrated way of support for people is very consistent with the mandate of this committee. We are at the mid-point, and the next stage, once the draft report is tabled, is to move into report-writing for recommendations. So I think that you’re here at a pretty good point in the work that we’ve been tasked with.

I wondered what you have seen, with your years of experience in the field, in terms of what has changed, but more specifically, what you hope to see in terms of once this work is complete. How will it improve supports to people with developmental disabilities? Because that’s what we’re ultimately trying to do.

Ms. Lea Pollard: Thank you for that question. I’m going to start quite broadly with my answer to that because I really feel—and I’m speaking personally now—that what we need to do is to embrace folks who have developmental disabilities as citizens first, and that we need a real, integrated approach to supporting folks. We need to understand what folks need and we need to be able to provide the supports that they need in a way that is meaningful to them.

I would hate to see the creation of a parallel sector for folks with developmental disabilities. People are people, and they are citizens of this province, and if I happen to have a developmental disability and I have health needs, I should be able to get my health needs managed and supported through the health sector, through the education sector, through housing etc. The notion of coming together across ministries to work together, not just in a partnership way, not just in a collaborative way, but in a really integrated way—what can the developmental services sector give you by way of information, knowledge exchange and support to be able to support our citizens with developmental disabilities? What are the specific supports that really can only be provided by the developmental services sector? And we should then be freed up to be able to provide those services and supports in a way that is timely and in a way that is individualized to that person.

My sense is that the only way to achieve that is by coming together in an integrated way. I think that our ministry has the opportunity to not only set the vision and to set the policy, but to bring our ministries together and to lead that, and to be the champion for that. And DSOs, service providers, families and other sectors at the decision-making level can come together to facilitate and implement that.

Ms. Mitzie Hunter: Thank you.

The Chair (Mrs. Laura Albanese): Ms. Wong.

Ms. Soo Wong: Thank you very much for your presentation. I just want to get clarification. The current legislation covering DSO—does it prohibit the whole network from collaborating and communicating with sectors like health right now?

Ms. Lea Pollard: It certainly does not prohibit us from doing that at all. I think that at the individual DSO level, each of us is invested in each of our communities and working with other systems and sectors. Unfortunately—or fortunately, without passing judgment—we’re so early on in our implementation as well. A lot of our focus has been on implementing our service, doing that the best that we can with the resources that we have available to us. We’ve been focused largely on that.

We have to prioritize issues as they come before us, and I think that we do that. We have struggled, as a network, to be able to come together on a consistent basis to work through provincial consistency issues. That has really been a function of workload and managing all of that, but the desire to do that is there.

Ms. Soo Wong: I’m particularly interested: Has your network invited the LHINs—because the local health integrated networks also have an association similar to your network. Has there been any crossover conversation? Because we consistently heard across the province that there needs to be some kind of collaboration, because your constituents, the clients, need not only the DSO support, but they definitely need a lot of health care support.

Ms. Lea Pollard: Absolutely.

Ms. Soo Wong: So at your provincial level at the network, have you reached out to go over and have some conversation with the LHINs on how to best service your clients and the families?

Ms. Lea Pollard: The short answer is no, we have not done that. Part of the work that we need to do as a network is that development of that strategic plan: What are our priorities? Who are the core groups of folks we need to be meeting with and working with closely?

Ms. Soo Wong: The other thing I consistently heard—my colleague Ms. DiNovo asked this question earlier. We consistently heard across Ontario that families and clients are very, very hurt that the staff from DSO have been disrespectful, have been intimidating and, most importantly, have not heard. What service or support does the DSO network have, in terms of customer service? Because we consistently heard families and individuals saying the DSO has been intimidating, has been bullying. I asked the question at Thunder Bay to your colleague at DSO up there, and I did not get an adequate answer.

I want to know: Does your network address the issue of customer service? Because no government-funded agencies should be intimidating their clients. I need to know, from your network: Do you talk about customer service? Do you talk about making sure their concerns are being heard and that the families have been dealt with, not being disrespectful? Because this is not acceptable behaviour, what I’m hearing across Ontario. Does your network talk about these kind of concerns?

Ms. Lea Pollard: Thank you for that question. It disturbs me to hear that that has been the experience of families, and that concerns me. That should not be the experience of families. Every DSO has a complaints process and has a feedback mechanism, and we rely on hearing that feedback so that we can address that directly with the DSO that is involved. That’s important.

As a network, we have not yet come together in a very focused way around the notion of customer service. That is one of many areas that our DSO network needs to examine. But I would certainly encourage families to go to their local DSO and find out what that complaints process is—that should be made available—as well as the feedback process, so that their concerns can be noted and then supported, because that should not be the experience of people when they come to us for help.

The Chair (Mrs. Laura Albanese): Mr. Balkissoon.

Mr. Bas Balkissoon: Thank you very much. I just want to understand your recommendation where it says, “MCSS to resolve all outstanding issues with the provincial database.” Can you elaborate on what the issues are, what you need this database for and what is in the data itself?

Ms. Lea Pollard: Yes. The database contains the application package, so the information that people provide to us during the application process is contained in there. The database should also be able to support some of our key functions. So, for example, when there is a service vacancy available, that database should be able to help us, in a very timely way, identify who is waiting for a service like that and what their priority is, to help us with the matching and linking process. That’s an example.

We need a database that we can generate reports from. Right now, we can’t generate our own customized reports. The ministry has been able to provide us with some reports, but they’re more generic in nature. We need the capacity to be able to run reports to say with confidence, “These are the number of folks who are waiting. This is kind of what their profile is. This is what they’re waiting for.”

Those are examples. Our database is also not at this point in time very user-friendly.

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Mr. Bas Balkissoon: Okay. Just to clarify: Is the data stored centrally?

Ms. Lea Pollard: Yes. We have one provincial database, and the data is stored in there, and each DSO has access to its data.

Mr. Bas Balkissoon: So you’re basically saying the program itself doesn’t have the features you’re looking for.

Ms. Lea Pollard: It needs to be further developed, yes. That’s right.

Mr. Bas Balkissoon: How long ago did you receive access to this program?

Ms. Lea Pollard: We received the database when we opened our doors on July 1, 2011.

Mr. Bas Balkissoon: And how long ago have you complained that these are the issues, that you need additional functionality in the program?

Ms. Lea Pollard: We have been quite open about our need to have that database meet our needs since the beginning.

Mr. Bas Balkissoon: So it’s over two years.

Ms. Lea Pollard: Yes.

Mr. Bas Balkissoon: Do you know how much collaboration and consultation the ministry did with the user groups before they got somebody to write this program?

Ms. Lea Pollard: I believe the program is what’s called an out-of-the-box program, so it was already developed. Now it needs to be customized to the work that we do, so that’s part of the challenge.

Mr. Bas Balkissoon: Is it a program we bought from another province, or just bought off the shelf from a supplier?

Ms. Lea Pollard: Do you know what? I don’t have all of the detail around that, and I know that the ministry would be the one that would be able to give you a really good, appropriate answer around that. I’m sorry; I don’t have the detail.

Mr. Bas Balkissoon: Thank you. Now I understand your problems.

The Chair (Mrs. Laura Albanese): Thank you. The time that we had allocated to each party has expired, but I don’t know if there are any other questions that the members want to ask. Yes, Ms. Jones?

Ms. Sylvia Jones: Not so much for our presenter, thank you, but we have heard reference to—I keep calling it Bill 77, because when I was in committee it was Bill 77, so whatever its formal name is now—that there were sections of that legislation that have not received royal assent. I think we’ve asked, but if we haven’t, can we get those specific sections that have not yet received royal assent from 2008?

The Chair (Mrs. Laura Albanese): Royal assent. Okay. Therefore, I can release our presenter. Thank you very much for appearing before the committee.

Ms. Lea Pollard: Thank you. It’s been a pleasure.

The Chair (Mrs. Laura Albanese): It’s been very helpful to have you here, and we thank you all for the work you do every day. We know it’s very important, especially for people and families with disabilities.

Ms. Lea Pollard: Thank you very kindly.

The Chair (Mrs. Laura Albanese): Thank you.

Ms. Mitzie Hunter: Excuse me, I—

The Chair (Mrs. Laura Albanese): I’d like to know at this point if there are any further directions for the researcher—

Ms. Mitzie Hunter: I do, yes.

The Chair (Mrs. Laura Albanese): —and that’s what Ms. Hunter is about to ask. Please.

Ms. Mitzie Hunter: Thank you, Madam Chair. I thought you were going to move on to another area.

I really like Ms. Jones’ question about what pieces of the legislation are still outstanding. I would also like to understand any known costs associated with its further implementation, if that was known.

The Chair (Mrs. Laura Albanese): Any further questions?

Ms. Erica Simmons: Costs?

The Chair (Mrs. Laura Albanese): Costs.

Ms. Erica Simmons: Costs associated with further—

Ms. Mitzie Hunter: Attached to the—yes.

The Chair (Mrs. Laura Albanese): With further implementation.

And then I would like to know—are we done with directions to the researcher? Never, eh?

Ms. Wong.

Ms. Soo Wong: Madam Chair, on our table this afternoon, there were a bunch of reports from the ministries, different ministries’ responses. I think they were addressed to the researcher. I have some questions from these reports. I wanted some clarification. Is it a good time to ask them now, or do we wait until—

The Chair (Mrs. Laura Albanese): Sure, depending on the time.

Ms. Soo Wong: I just have two quick questions. Tab number 25 deals specifically, I believe, with my question dealing with the Healthy Homes Renovation Tax Credit. This is the first time—I don’t know if maybe other members of the committee know about this program. At the bottom of page 2 of this memo, it talks about the Home and Vehicle Modifications Program. I don’t know—I’ve never heard of—

The Chair (Mrs. Laura Albanese): Sorry; did you just say tab 25?

Ms. Soo Wong: Tab 25 is a response from the Ministry of Finance to my question on the Healthy Homes Renovation Tax Credit. This is the first time that I’ve ever heard of this Home and Vehicle Modifications Program. But the interesting piece is, if it has been around—I don’t know how many years—remember, there were witnesses saying that we should expand our healthy homes tax credit from seniors to those who are developmentally or physically disabled, so they can get access to it, and yet the Ministry of Finance indicated this particular program. So, my question here, Madam Chair, is: How much information is out there to promote this program to the public? What is being done? Because if this program has been around for many years—my colleagues Mr. Balkissoon and Ms. Jones say it has been here for many years—how come a witness, and I believe it was in London, expressed concern that we are focusing only on seniors and not support? If it’s around for many years, where is the responsibility of this ministry to let it be known to DSO or elsewhere who the clients are who need these kinds of programs? Obviously, constituents didn’t know about the program and are asking for the government to fund and support them. That’s what I want to ask.

The Chair (Mrs. Laura Albanese): Mr. Balkissoon.

Mr. Bas Balkissoon: Madam Chair, the vehicle modification program is the program that you can modify your vehicle if you can’t use your feet or your hand or whatever. They create other things. The home part of it is the ramps that you need for your home and other stuff.

I think what the deputants were asking us for is the new credit, which is the $1,500 tax refund if you want to change a door handle or a bathtub or whatever. That is what they didn’t have access to, and they wanted to get that program extended to give them access to those additional funds.

The vehicle fund has always been available, as I know, as part of ODSP and all the other things.

Ms. Soo Wong: It may not be, because my question here is: Are the constituents who are currently in ODSP aware of these programs? Are there similarly differences between the Healthy Homes Renovation Tax Credit versus the Home and Vehicle Modifications Program?

Mr. Bas Balkissoon: There’s a huge difference.

Ms. Soo Wong: I don’t know the differences. But it would be good to know.

The other piece here is, I wonder: Are the clients currently at the DSO aware of these programs? Because they shouldn’t be coming to the committee if they knew about the program, and making that recommendation to the committee.

The Chair (Mrs. Laura Albanese): So, just to summarize: You would like the ministry to tell us how—

Ms. Soo Wong: The differences between the Healthy Homes Renovation Tax Credit—

The Chair (Mrs. Laura Albanese): The difference between the two programs—

Ms. Soo Wong: Yes.

The Chair (Mrs. Laura Albanese): —and then how they are promoting these programs—

Ms. Soo Wong: To the DSOs.

Mr. Bas Balkissoon: But I think we should clarify, Madam Chair. The folks who are coming here—the disabled person was a child or a family member. That person doesn’t have access to the Healthy Homes Renovation Tax Credit. It’s the homeowner who does. So, if I’m a disabled person and I’m a tenant, I don’t have access. I think that’s what they were complaining about.

Ms. Sylvia Jones: Or if you’re a mom or a dad looking after an individual—

Mr. Bas Balkissoon: Yes, you don’t have access. That’s the problem. The Healthy Homes Renovation Tax Credit was a one-time deal for a specific time frame, and I believe the program has closed. Somebody mentioned to us, when we were in London—

The Chair (Mrs. Laura Albanese): I don’t think it’s closed.

Interjections.

Mr. Bas Balkissoon: Okay. When we were in London, I remember clearly the person saying, “I don’t have access to this program because I’m not a homeowner; I’m a tenant. And the government should look at changing that to allow me to have access to it because I’m disabled.”

The Chair (Mrs. Laura Albanese): It says here that the home renovation tax credit is only available to people who owe Ontario personal income tax, so that may be one issue.

Mr. Bas Balkissoon: I think the other issue would be they don’t own their home.

The Chair (Mrs. Laura Albanese): People who qualify but have lower incomes would not claim this tax credit because it would not provide them with any tax savings. I guess not everybody qualifies, and that may be the issue. In any case, if we could ask for some clarity of the different programs.

Yes, Ms. Wong?

1720

Mr. Bas Balkissoon: I had one other request. I don’t know how to deal with this—

The Chair (Mrs. Laura Albanese): Okay, so I’ll go to Ms. Wong and then Mr. Balkissoon.

Mr. Bas Balkissoon: I don’t know how we’re going to deal with this, but I think we need to have a complete presentation on this database so we understand it. To me, the key functionality of DSOs is to have a working database that is networkable, that can tell them when things are available and provide service at a faster rate. It seems as though it’s not there. Why was the program developed before consulting the users, and who did the ministry consult to build this thing? Or did they buy it off the shelf?

The Chair (Mrs. Laura Albanese): Should we ask for that?

Ms. Sylvia Jones: Yes.

The Chair (Mrs. Laura Albanese): A presentation on the database?

Ms. Sylvia Jones: Why can’t we just get the details? I mean, bless them, but I don’t want to spend a lot more time having the ministry come and do ministry speak, so let them give us the material on where the program came from and, quite frankly, why they don’t have a database that the DSO can work with.

Mr. Bas Balkissoon: And why the program came after the legislation rather than before.

The Chair (Mrs. Laura Albanese): Okay. We’ll request that information.

Ms. Sylvia Jones: But I don’t want another presentation from the ministry.

Miss Monique Taylor: How are they maintained? Who’s watching over those data banks?

The Chair (Mrs. Laura Albanese): Can we have a list of questions that the members could put together? Maybe everyone has their own list of questions that we want to send to the ministry.

Mr. Bas Balkissoon: I’m more concerned that if I put a question now and they give me an answer, I’ll have another question, whereas if they’re here—this could be very, very technical, but very, very important, because the DSOs will never be successful unless you have a proper, working resource tool in your program.

Ms. Sylvia Jones: You’re really good at burning time, Bas.

Mr. Bas Balkissoon: Well, you’ll never fix the problem if their basic tool to connect a client to a service is not there.

The Chair (Mrs. Laura Albanese): I’d like to hear Ms. DiNovo’s opinion.

Ms. Cheri DiNovo: Can I just make a suggestion? I think we’ve heard the question; we would like a response from the ministry to her concerns. End of story. Let’s give them a page or two. We’ve already got this much paper. I think a page or two in response to her concerns would be appropriate.

Ms. Erica Simmons: Key challenges or responses?

Ms. Cheri DiNovo: Key challenges. She focused on the database; let’s have them focus on the database and give us a response.

The Chair (Mrs. Laura Albanese): I don’t hear consensus for another presentation.

Ms. Wong and Ms. Taylor.

Ms. Erica Simmons: Can I just clarify? Just the database or key challenges, especially the database?

Ms. Cheri DiNovo: I think we’re centring in on the database. I think I agree that if they don’t have a database that works, what are they doing?

Miss Monique Taylor: Right. She also stated that she didn’t know what the financial—

Ms. Erica Simmons: The total budget of all the DSOs?

Miss Monique Taylor: No, there was something else that was supposed to be part of the package—the mandate that they didn’t receive.

Ms. Cheri DiNovo: Actually, that was a question that you had, Monique: What is the cost of administering DSOs, period? What is the cost?

The Chair (Mrs. Laura Albanese): Yes, the initial question.

Miss Monique Taylor: One of their things under the legislation—

Ms. Mitzie Hunter: Some $27 million.

Miss Monique Taylor: —for the direct funding is the creation of funding entities that will eventually have a role with respect to funding. They have no idea what the funding entities are, or what that means. They’ve been trying to find out and they still don’t know what it means, but it’s supposed to be part of the broad picture.

The Chair (Mrs. Laura Albanese): So this one has not been implemented and they don’t know much about it. It’s not the application entities; it’s the funding entities. Is that correct?

Okay. So, I had Ms. Wong still in queue.

Ms. Soo Wong: Madam Chair, tab number 23 was, again, put on the table for us to review, from the Ministry of Education. I believe it’s also to my question about the membership of SEAC on page 5 of the report.

So I was correct: Parents are not excluded from becoming a member of SEAC. That’s what it says right there. I think maybe we should put that somewhere in the report process, because there’s a perception out there that parents with children in the system cannot be members of SEAC, and it’s clearly written here. It says SEAC membership—

The Chair (Mrs. Laura Albanese): Yes, but it also says “however.”

Ms. Soo Wong: Yes, but at the bottom here, it says, “I would encourage anyone considering becoming a member of SEAC to contact the local school board directly for more information.” So parents are not exclusively—am I reading correctly?

Ms. Erica Simmons: We said that in the report. They’re not excluded—

Interjections.

Ms. Erica Simmons: A parent can sit on the SEAC, but they must do it as a member—

Ms. Soo Wong: —of the association.

Miss Monique Taylor: So they’re not there as a parent. They’re there as—

Interjections.

The Chair (Mrs. Laura Albanese): A parent would need to be a member of a local provincial association and would need to be nominated by that local association for representation.

Ms. Soo Wong: I think this is something that we need to put in our hat when we think about the final report. That’s what I was trying to say when I read that.

The Chair (Mrs. Laura Albanese): Maybe we want to change that regulation.

Any other hands up? Okay, Miss Taylor, Ms. Hunter and Ms. Jones.

Miss Monique Taylor: When we’re also talking about the database, I want to know who does their IT of the database. So when they’re having problems and issues with the database, and they need to move it forward, who are they speaking to and who is supposed to be doing that?

The Chair (Mrs. Laura Albanese): Okay. Ms. Hunter.

Ms. Mitzie Hunter: One of the things—I didn’t ask the question of Lea, but it really struck me that the cross-ministry integration is not happening. I didn’t hear them being aware of how to support the system and I am concerned about that. It just feels like it’s not happening, and I’m not sure if this group is the right group to answer that question, but there seems to be an expectation on the part of families and individuals that they can go to this DSO and—

The Chair (Mrs. Laura Albanese): Find answers.

Ms. Mitzie Hunter: Right, and receive a certain service delivery. But the coordinating body for the act is not integrated into cross-ministries. It just seemed as if they were a world unto themselves.

Miss Monique Taylor: I didn’t hear her response when you asked if she speaks with the LHINs.

Ms. Mitzie Hunter: No, she does not.

Interjections.

Ms. Soo Wong: Exactly. That’s why I asked that question, because I just got the feeling, unless they’ve been directed by the legislation, they’re not going to go reaching out. There was no intent, even though their clients do need their health care support badly—I mean, I didn’t even bother going to deal with the CCAC, dealing with the long-term-care piece, but I got it very clear, they were working in isolation, in silos, and they were not even planning to talk to the Ministry of Education. Their clients are obviously over 21, but they’re still working with those who are currently 17 to 21 so they can better transition to the real world.

The Ministry of Training, Colleges and Universities—they seem to be working in silos, in isolation. That’s why I think part of the problem is that they just—I mean, they used the line that they have to “implement the mandate,” blah, blah, blah, but I don’t see them reaching out to go over to support their client and their needs in terms of employment, in terms of training, colleges and universities, and particularly the health piece. I was struck—even though they’re a newly created organization, a provincial organization, they seem to work in silos. That’s what I’m sensing in that piece.

Interjection.

The Chair (Mrs. Laura Albanese): Sorry, I have to go one at a time for Hansard. Otherwise, they’re having difficulty. Thank you, Ms. Wong. Next, Ms. Elliott, did you have a comment? Otherwise, I’ll go to Ms. Jones, who was waiting from before.

Ms. Sylvia Jones: A separate topic: Did I hear $27 million is the annual operating budget for all nine DSOs?

The Chair (Mrs. Laura Albanese): I’m sorry, $27 million, or is it $7 million? Ms. Hunter?

Ms. Mitzie Hunter: It’s $27 million.

The Chair (Mrs. Laura Albanese): It’s $27 million.

Ms. Sylvia Jones: Okay. The database that doesn’t work and—we’ll get that into the recommendations.

The Chair (Mrs. Laura Albanese): Ms. Elliott, did you have a comment?

Mrs. Christine Elliott: Sure. Just to respond to Ms. Wong, I agree with you that there should be much more integration, but I think we shouldn’t necessarily be surprised that they haven’t contacted the LHINs because they’re responsible to Comsoc, and it’s a different ministry. So I think they really don’t have a mandate to do that. I think the mandate needs to come from above and probably not even through Comsoc. I think that’s something that we need to wrestle with as we make our recommendations about the appropriate vehicle to bring all of these groups together from the various ministries, to look at this holistically. I think that’ll probably be one of the biggest things that we’ll have to deal with when we start our deliberations.

The Chair (Mrs. Laura Albanese): So, before we get called upstairs, I wanted to also ask the committee: What should we do next week? I understand that we had another organization that Mrs. Elliott had requested we speak to, but so far we have not been able to get in contact with them. If we do get in contact with them, we can certainly ask them to come and present. If we do not, should I call a meeting for next week? Do we want to start report writing?

Ms. Sylvia Jones: Yes.

The Chair (Mrs. Laura Albanese): Open or closed session?

Interjection.

The Chair (Mrs. Laura Albanese): Closed.

Ms. Sylvia Jones: That’s standard.

The Chair (Mrs. Laura Albanese): Yes, that’s usually standard.

Ms. Sylvia Jones: Yes. I think that while there are sections that we still want to learn more about, there are certainly some parts of the interim report that we can start pulling out and making suggestions on. That would make, I know, the researcher’s job easier, if they could start that sooner rather than later.

The Chair (Mrs. Laura Albanese): Okay. So then we’re all in agreement?

The Clerk of the Committee (Mr. Trevor Day): I was just going to say, if we can get the presenter, it will be open session to start with, with the presentation. If not, it’ll be a closed-session meeting for report writing and discussion.

The Chair (Mrs. Laura Albanese): Okay. Thank you. We are adjourned.

The committee adjourned at 1731.

CONTENTS

Wednesday 26 February 2014

Developmental services strategy DS-561

DSO Provincial Network DS-561

Ms. Lea Pollard

SELECT COMMITTEE ON DEVELOPMENTAL SERVICES

Chair / Présidente

Mrs. Laura Albanese (York South–Weston / York-Sud–Weston L)

Vice-Chair / Vice-Présidente

Mrs. Christine Elliott (Whitby–Oshawa PC)

Mrs. Laura Albanese (York South–Weston / York-Sud–Weston L)

Mr. Bas Balkissoon (Scarborough–Rouge River L)

Ms. Cheri DiNovo (Parkdale–High Park ND)

Mrs. Christine Elliott (Whitby–Oshawa PC)

Ms. Mitzie Hunter (Scarborough–Guildwood L)

Mr. Rod Jackson (Barrie PC)

Ms. Sylvia Jones (Dufferin–Caledon PC)

Miss Monique Taylor (Hamilton Mountain ND)

Ms. Soo Wong (Scarborough–Agincourt L)

Substitutions / Membres remplaçants

Mr. Jack MacLaren (Carleton–Mississippi Mills PC)

Clerk / Greffier

Mr. Trevor Day

Staff / Personnel

Ms. Erica Simmons, research officer,
Research Services

Ms. Heather Webb, research officer,
Research Services