Understanding the fabric of our community / comprendre le tissu de notre communauté Manitoulin-Sudbury District Greater Sudbury Best Start Network’s Community Integration Leaders Project Project Update – March 28, 2014

Understanding the fabric of our community / comprendre le tissu de notre communauté Products 1,2 & 3 Purpose Document the historical strategies, processes, decisions and conversations of communities who have made successful advances toward integration to understand how they have progressed to their current state; and Document the on-going work of these communities as they continue to progress toward integration under the Community Integration Leader project.

Understanding the fabric of our community / comprendre le tissu de notre communauté Key Research Questions 1. Historical review of steps to advance toward service integration How does the community define integration? What stage along the integration continuum is the community currently located? What is the single most important thing the community did to make significant progress toward integration? What are the barriers that have limited or slowed-down progress toward integrated services? How can the ministry help to eliminate or reduce these barriers? 2. Defining an integrated system of child and family services Describe your community’s vision for integrated child and family services 3. Building an integrated services system Provide details about the three to five most difficult discussion topics for your community planning network.

Understanding the fabric of our community / comprendre le tissu de notre communauté Greater Sudbury

Understanding the fabric of our community / comprendre le tissu de notre communauté Where along the continuum would you say the Greater Sudbury system is at right now?

Understanding the fabric of our community / comprendre le tissu de notre communauté Thinking about the system of child and youth services from the perspective of families, where along the continuum would they say the system in Greater Sudbury is at right now?

Understanding the fabric of our community / comprendre le tissu de notre communauté P ARENTS E XPERIENCE OF I NTEGRATION : CGS %LevelDescription 17Awareness They go to different service providers for different things and although staff might tell them about other services, they to figure it out for themselves. 32Coordination Service providers often tell them about other programs and even help them connect with these services but parents have to make their own appointments, register and often have to wait for services. 36Collaboration This meant the programs and services they used are well organized and seem to work well together. Sometimes they are even available in the same place. 15Integration They don’t notice the difference between service providers and they get all the help they need arranging things and many supports are available at the same place.

Understanding the fabric of our community / comprendre le tissu de notre communauté Enablers of Integration

Understanding the fabric of our community / comprendre le tissu de notre communauté In your opinion, what has been the most significant factor in moving towards integration in Greater Sudbury?

Understanding the fabric of our community / comprendre le tissu de notre communauté Enablers Shared Vision, Leadership, and Resources Trust Champions Representation and Membership at the Network Table Embracing Change Direction from Ministry

Understanding the fabric of our community / comprendre le tissu de notre communauté Barriers to Integration Lack of Ministry Direction Differing Mandates Gaps at the Network Table Resources to Support the Work of Integration Complexity Varying Relationships with Schools and School Boards

Understanding the fabric of our community / comprendre le tissu de notre communauté Ways to Reduce Barriers Ministry Leadership Stretch Mandates Share Successes Start Small, Build, and Sustain Continue Dialogue with Schools and Schools Boards

Understanding the fabric of our community / comprendre le tissu de notre communauté Components of a System for Integrated Child and Family Services Strategies – Central Registration – Transportation Neighbourhood Teams Hubs and Experience with Co-Location Cultural and Linguistic Diversity Technology

Understanding the fabric of our community / comprendre le tissu de notre communauté Building an Integrated Services System: Difficult Discussion Topics Ways to Serve Marginalized Families Funding Hub Locations

Understanding the fabric of our community / comprendre le tissu de notre communauté Manitoulin-Sudbury Districts

Understanding the fabric of our community / comprendre le tissu de notre communauté Where along the continuum would you say the Manitoulin- Sudbury Districts system is at right now?

Understanding the fabric of our community / comprendre le tissu de notre communauté Thinking about the system of child and youth services from the perspective of families, where along the continuum would they say the system in Manitoulin-Sudbury Districts is at right now?

Understanding the fabric of our community / comprendre le tissu de notre communauté P ARENTS E XPERIENCE OF I NTEGRATION : M AN -S UD %LevelDescription 8Awareness They go to different service providers for different things and although staff might tell them about other services, they to figure it out for themselves. 19Coordination Service providers often tell them about other programs and even help them connect with these services but parents have to make their own appointments, register and often have to wait for services. 47Collaboration This meant the programs and services they used are well organized and seem to work well together. Sometimes they are even available in the same place. 25Integration They don’t notice the difference between service providers and they get all the help they need arranging things and many supports are available at the same place.

Understanding the fabric of our community / comprendre le tissu de notre communauté Enablers of Integration

Understanding the fabric of our community / comprendre le tissu de notre communauté In your opinion, what has been the most significant factor in moving towards integration in Manitoulin-Sudbury Districts?

Understanding the fabric of our community / comprendre le tissu de notre communauté Enablers of Integration Shared Planning and Vision Local Service Provider Networks Collaboration out of Necessity

Understanding the fabric of our community / comprendre le tissu de notre communauté Barriers to Integration Geography Lack of Shared Planning Gaps at the Network Table Challenges Associated with Triple P Differing Mandates Lack of Resources to Support the Work of Integration Burden of Reporting

Understanding the fabric of our community / comprendre le tissu de notre communauté Ways to Reduce Barriers Ministry Leadership Share Successes

Understanding the fabric of our community / comprendre le tissu de notre communauté Components of a System for Integrated Child and Family Services Strategies – One Point of Entry – Central Registration – Transportation Hubs and Experience with Co-Location Cultural and Linguistic Diversity Technology

Understanding the fabric of our community / comprendre le tissu de notre communauté Building an Integrated Services System: Difficult Discussion Topics Building Relationships with First Nations Network Functions: Focus on Planning Network Structures: Representation and Engagement

Understanding the fabric of our community / comprendre le tissu de notre communauté Product 4 - Purpose Impact of integration on key child & family outcomes How have the following outcomes been impacted by service integration in our community? Early identification of children with special needs Healthy child development Service wait times Ability of the services system to respond to changing needs Parent satisfaction with child & family services

Understanding the fabric of our community / comprendre le tissu de notre communauté G REATER S UDBURY

Understanding the fabric of our community / comprendre le tissu de notre communauté The data represents response rates from three surveys. “Don’t know” and “Not applicable” responses were removed from the the analysis. Not every respondent answered every question – thus the number of total responses can vary. 1.The Network Survey (32 respondents) 2.The CAR-CIL Parent Survey (246 respondents) 3.The Kindergarten Parent Survey (995 respondents) S URVEY R ESPONSE

Understanding the fabric of our community / comprendre le tissu de notre communauté Over 80% of respondents indicated that all resources & services have been moderately to significantly impacted. Developmental assessments (100%) A full range of information and resources (93%) 18 month screening (91%) Speech and language services (87%) Physical assessments (85%) Support for parents with special needs children (80%) The most challenging service to affect is outreach services. Outreach services (67%) E ARLY I DENTIFICATION

Understanding the fabric of our community / comprendre le tissu de notre communauté Over 85% of respondents indicated moderate to significant impacts: Plan programs and services (89%) Deliver services (86%) Offer accessible services (86%) Child and Family Outcomes Overall, EDI vulnerability is improving or stable. 2 of 5 EDI domains are more vulnerable than average (PHWB, EM) 2 of 5 are better than average and 1 is average (LGCD, CMGK, SC) EQAO Gr 3 writing, reading and math have improved since 2008 Increase in the number of child/parents attending programs since 2010 Parents said services support their family (93%) and/or their child (86%) Parents said they are more knowledgeable about child development (78%) Parents said services improved child’s school readiness (75%) and their parenting skills (75%) H EALTHY C HILD D EVELOPMENT

Understanding the fabric of our community / comprendre le tissu de notre communauté Of the 11 agencies that reported wait times, the majority (7) indicated no change at all, 3 decreased, and 1 increased. Community providers, like Hubs, try to provide other programs for families and children while they wait for another service – but these services do not offer the service required by families. Far more children are receiving special services (529) than are waiting for them (50) – which means specialized services is meeting about 90% of the need. (KPS) However, when asked, one-third of parents said they were less than satisfied with the wait time for services. S ERVICE W AIT T IMES

Understanding the fabric of our community / comprendre le tissu de notre communauté The majority of Network members indicated moderate to significant impacts on the system’s ability to respond to changing needs. Addressing child/family needs identified at the community level (89%) Being able to provide inclusive (93%), supportive (83%), accessible (86%) and seamless (58%) services Being able to engage in effective communication & knowledge- transfer (72%) and cross-sectoral planning (71%) Professional development and training (80%) S YSTEM R ESPONSIVENESS

Understanding the fabric of our community / comprendre le tissu de notre communauté Parent satisfaction with services and service delivery is high. Highest satisfaction was found in the activities (87%) and support services for children (83%) 75% were satisfied with the information and support services for parents 75% were satisfied with referrals or connections to other agencies and their access to services Over 90% of parents indicated that staff: Was helpful Knowledgeable about other community services Provide them with useful information Easy to talk to about their families and/or child’s needs Somewhat less satisfaction was in the area of waiting for services (66%) P ARENT S ATISFACTION

Understanding the fabric of our community / comprendre le tissu de notre communauté Whether for universal programs or specialized services –agency respondents indicated a lack of funding for programming hours and staff support was a challenge to meet the needs of children and families. The most common barriers experienced by parents and families is that the service occurs at inconvenient times, that they didn’t know about the service or have enough information about it, it’s too expensive, (particularly child care and children’s recreational programs), and the wait list is too long. C HALLENGES

Understanding the fabric of our community / comprendre le tissu de notre communauté M ANITOULIN -S UDBURY D ISTRICTS

Understanding the fabric of our community / comprendre le tissu de notre communauté The data represents response rates from three surveys. “Don’t know” and “Not applicable” responses were removed from the the analysis. Not every respondent answered every question – thus the total number of responses can vary. 1.The Network Survey (20 respondents) 2.The CAR-CIL Parent Survey (59 respondents) 3.The Kindergarten Parent Survey (117 respondents) S URVEY R ESPONSE

Understanding the fabric of our community / comprendre le tissu de notre communauté Moderate to significant impacts in the system’s ability to offer: Speech and language services (82%) A full range of information and resources (76%) Support for parents with special needs children (75%) Developmental assessments (60%) Slight to moderate impacts in the system’s ability to offer: 18 month screening (100%) Physical assessments (86%) Outreach services (86%) E ARLY I DENTIFICATION

Understanding the fabric of our community / comprendre le tissu de notre communauté Moderate to significant impacts in the systems ability to: Plan programs and services (73%) Deliver services (73%) Offer accessible services (62%) Child and Family Outcomes 2 of 5 EDI domains are more vulnerable than average (PHWB, EM) 2 of 5 are better than average and 1 is average (LGCD, CMGK, SC) Steady increase in the number of child/parents attending programs 90% of parents said services support their family and/or their child 80% of parents said services improved child’s school readiness and that parents are more knowledgeable about child development Over 60% said services have improved their parenting skills H EALTHY C HILD D EVELOPMENT

Understanding the fabric of our community / comprendre le tissu de notre communauté Of the 8 agencies with wait times who responded, half said their wait times had increased – for some slightly for others greatly and half said their wait times had not changed at all Community providers try to provide other programs for families and children while they wait for another service. Far more children are using special services (47) than are waiting for them (13) – which means specialized services is meeting about 75% of the need. (KPS) A quarter of parents said they were less than satisfied with the wait time for services. S ERVICE W AIT T IMES

Understanding the fabric of our community / comprendre le tissu de notre communauté The majority of Network members indicated moderate to significant impacts on the system’s ability to respond to changing needs. Addressing child/family needs identified at the community level (82%) Being able to provide supportive (82%), inclusive (73%), accessible (63%) and seamless services (56%) Being able to engage in effective communication & knowledge- transfer (71%) and cross-sectoral planning (64%) Professional development and training (53%) S YSTEM R ESPONSIVENESS

Understanding the fabric of our community / comprendre le tissu de notre communauté Parent satisfaction with services and service delivery is very high. Over 80% indicated satisfaction with: Activities, programs and support services for children Workshops, information and support services for parents Referrals and connections to other agencies Over 80% of parents indicated that staff: Was helpful Knowledgeable about other community services Provide them with useful information Easy to talk to about their families and/or child’s needs Somewhat less satisfaction was in the administrative areas of: Wait times and access to services (75%) P ARENT S ATISFACTION

Understanding the fabric of our community / comprendre le tissu de notre communauté Access and Outreach are challenged by transportation issues. Families getting to the service and providers getting to families is challenged by the large rural geography. First Nation communities lack comprehensive clinical services and screening. There is a need for a cultural model that would connect those families to the process of early identification. The most common barriers experienced by parents and families is that the service is not available in their area, occurs at inconvenient times, that they didn’t know about the service or have enough information about it, and the cost of the service (particularly child care and children’s recreational programs). C HALLENGES

Understanding the fabric of our community / comprendre le tissu de notre communauté considering and testing innovative approaches to improve access to information and services in northern and remote communities examining the use of social media and other virtual options on the established web sites used by both communities reviewing the co-location Sudbury North project as a model of integrated service delivery. Report 5 – Project Specific Questions

Understanding the fabric of our community / comprendre le tissu de notre communauté Survey data in regards to use of IT 474 respondents – excellent! Income distribution of responders very closely matched income distribution of communities 96.9% of respondents had access – 90.8% of those at home Use of IT

Understanding the fabric of our community / comprendre le tissu de notre communauté , Facebook, YouTube – are most popular Twitter is only being used by small numbers – accessed by 77% or respondents – 42% using updates – 21% on Facebook Manitoulin site – 47% 67% finding parenting info in other places Use of IT

Understanding the fabric of our community / comprendre le tissu de notre communauté Work to date: Building on the Greater Sudbury Best Start Website Improved “usability” from parent user perspective: Added date range search to calendar Made facebook link easier to find Made professionals section harder to find (so parents don’t go there by accident) Improved topic search functionality Improved usability for contributors to make it easier to post, with less errors Site now automatically changes French event when English event changes (or vs/versa) Calendar is being upgraded to remove events out of a recurring range of events. Improved content from parent user perspective: Content is being developed around parent experience on the site and at Hubs “New to Best Start? Here's what you need to know” – Hubs- “things to know before you go” Video content. Use of IT

Understanding the fabric of our community / comprendre le tissu de notre communauté Supported the launch of CGS Best Start Network Great media coverage CBC CoverageCBC Coverage Printed new/more posters and postcards to continue promotion of the site Launched a contest to get more people to sign on (contest status had reached 1185 people on Facebook by March 6) Resulting in 18% increase in unique visitors, 15% increase in new visitors and 44% increase in facebook average daily reach 108% increase (from Sept 2013) in parent subscribers and 42% increase in Facebook “likes” Use of IT

Understanding the fabric of our community / comprendre le tissu de notre communauté Developing a more independent website in Sudbury Manitoulin msbeststart.ca now goes directly to its own page working with IT staff at MSDSB to investigate mechanisms for integrate analytic tools into website incorporate Microsoft Office 365 tools into the website for shared calendars, newsfeed, community space etc. Use of IT

Understanding the fabric of our community / comprendre le tissu de notre communauté Hosted a live ‘webinar’ Ask the Expert – All about Parenting Using the content to develop 12 YouTube videos that will be uploaded to websites/facebook pages We will be able to monitor the uptake of the videos Receiving Social Media Guidelines from our consultant Content will be used to review use of social media at the Hub level Consistency to Facebook pages, use of s, use of Youtube, Investigating the use of blogs and chat rooms What is our capacity to use these tools in the field? Use of IT

Understanding the fabric of our community / comprendre le tissu de notre communauté 2011 – envisaged as first stage in more integrated service model for Chapleau Four agencies already co-located in unsuitable facility – CAS, DSB and SDHU also considered joining new Centre – only CAS joined in the end Pilot Project Committee of Sudbury-based Executive Directors constructed to oversee co-location development – 3-4 on-site visits Developed a shared vision working with independent facilitator Search for suitable location and site Several meetings with front-line staff Program managers/supervisors took lead late in process to oversee the move Managers worked with staff on expectations in new location and with CAS joining Bi-weekly joint staff meetings and monthly tele-call meetings with Sudbury managers initiated to monitor progress with co-location Co-location

Understanding the fabric of our community / comprendre le tissu de notre communauté CFC CTC CCN ICDS CAS DSB DHUCCC BSH Schools 1 st Nations FHT Chapleau Children’s Service Providers Network Co-located SPA Int/Ref/Coord

Understanding the fabric of our community / comprendre le tissu de notre communauté Benefits of co-location – Families One stop” centre for families to get help with their children Central, easily accessible Less stigma for CAS families Greater sense of continuity and coordination in services received from multiple agencies Agencies/staff Proximity to each other increases level of communication vis-à-vis shared caseload families - easier to arrange case conferences More informed of each other’s agencies services and expertise Stronger sense of collegiality among staff, especially with respect to addition of CAS worker Set stage for greater service integration in future Co-location

Understanding the fabric of our community / comprendre le tissu de notre communauté Staff Assessment on Service Delivery Service Principles (Northern Framework, 2005) Post-Co-location compared to Pre-Co-location Not as WellSameBetter Child, Youth & Family Centered   Individualized  Culturally Competent   Least Intrusive   Community-based  Flexibility   Effectiveness  Shared Responsibility  Co-ordination, Collaboration 

Understanding the fabric of our community / comprendre le tissu de notre communauté Taking the Chapleau model out into the field Manitoulin and Lacloche Sudbury East April 7 Co-location

Understanding the fabric of our community / comprendre le tissu de notre communauté CCN CFC PSL CTC ICD S DSB MFR FHT Childcar e SDHU M’Chigeen g Childcare

Understanding the fabric of our community / comprendre le tissu de notre communauté Co-location Analysis is not complete ‘perhaps a more central location would provide better access – is Little Current best? – what about Mindemoya? Could we find shared space in other communities that multiple agencies could work from How to deal with transportation

Understanding the fabric of our community / comprendre le tissu de notre communauté Co-location Common intake & referral system Case co-ordination – someone being assigned Can we use technology better to do this Skyping, teleconferencing, telemedicine capacities

Understanding the fabric of our community / comprendre le tissu de notre communauté Question for today: “How can we provide better access to information and services for families in northern, rural and remote communities?” Greater Sudbury/Manitoulin-Sudbury CARCIL