1. TVCC Interim School Therapy Services
Contracted OT, PT and SLP Services
Current manager of TVCC’s OT, PT and SLPs who work in the schools
Project Manager for new Interim school therapy services
Thanks for the opportunity to share what I have learned and our plans to date
Looking for feedback from school leadership
Training tool under development for teaching staff and service provider staff that will be available before the March break
Referral forms will be on TVCC website as well.

2. Community Connector Visit to TVCC
Regional rehabilitation centre serving children and youth with physical disabilities, developmental disabilities and/or communication needs, primarily in Southwestern Ontario
Services provided to more than 8,000 children and youth every year
StacyAccredited via CARF
June 2, 2015

3. Community Connector Visit to TVCC
TVCC Vision
Our Clients at Their Best
Stacy
June 2, 2015

4. Community Connector Visit to TVCC
TVCC Mission
We provide rehabilitation services which support participation in all areas of life for children, youth and young adults:
focusing on the strengths of individuals and their families at home, school, workplace, and community
pursuing research, education and advocacy
participating in a local and regional system of services
StacyChange indent
June 2, 2015

5. First Step in Special Needs Strategy for Integrated Rehabilitation
Ontario Children’s Treatment Centres to manage contracts for contracted OT, PT and SLP at publicly funded schools
LHIN/CCAC care coordinators no longer involved
Short term plan for approximately 1 year
Provincial advisory committee is reviewing proposals to come to common solutions
Long term plan may not look like proposals
Goal: minimize change because the long term plan is not yet determined
Do important changes that will make a difference: reduce clinician travel, increase clinical time

6. Staying the Same after transition
LHIN involvement with:
all services in private schools
nursing at school and home
therapy (OT, PT and SLP) at home
Important to note

7. Process to Request School Therapy until Transition
School team refers to the LHIN (CCAC)
LHIN Care Coordinator determines eligibility
SW LHIN has a contracts with St. Elizabeth, VON, Paramed, Closing the Gap and TVCC to provide services in London, Middlesex, Oxford/Norfolk and Elgin
Review
TVCC is one of the service provider agencies for LM and O
Families that had an existing relationship with TVCC could request TVCC to continue to follow
KEEP USING THIS PROCESS UNTIL APRIL 1 OR TOLD OTHERWISE

8. Changing after Transition in Publicly Funded Schools
School team will make referrals directly to TVCC
TVCC will determine eligibility
TVCC will determine which service provider agency
Majority of schools in London, Middlesex, Oxford, Elgin, Huron, Perth, Grey and Bruce – the area of the SW LHIN
TVCC remain a SP in London; Middlesex and Oxford

9. How the service is staying the same
Amount of money allocated for therapy sessions
Service provider agencies
Eligibility for service
Waitlist
School board SLP
Other TVCC services
This is not the SNS proposals you may have heard of
For every 6 children receiving therapy there are 4 waiting in Southwestern Ontario
For service provider agencies – they have the choice to continue their LHIN contract for school services with TVCC or not

10. LHIN Priority for Therapy System as of Jan 2017
Level 1: immediate service Level 2: waitlisted – released by referral date Level 3: waitlisted Waitlisted as of Jan 2018: 13% of PT, over 40% of SLP, over 55% of OT
Historically not shared with schools and families - ? Results in inappropriate expectations?

11. SLP Immediate Service New onset or worsening swallowing difficulties
ACS system needed for basic needs
ADD: post surgical
Service as deemed necessary by clinician and approved by CC

12. SLP Waitlisted
Level 2: Severe articulation, fluency, voice/resonance, severe emotional impact
Level 3: Moderate articulation, fluency, voice/resonance, moderate emotional impact
Max 3 blocks of treatment for level 2 = 30 visits
Max 2 blocks of treatment for Level 3 = 20 visits
Clinician will choose how to use allotted visits using best practices, family and school input.

13. OT Immediate Service Urgent swallowing
Unable to access bathroom or classroom
Skin integrity
Toileting, lifting equipment
Safety risk due to change in physical status

14. OT Waitlisted
Level 2: school mobility, seating/positioning, teach school re: feeding, transfers, updated equipment, sensory concerns limit safety/attendance. ADD FM written communication equipment need
Level 3: DD, severe FM, sensory limits participation
Max 8 visits
? Add FM difficulties requiring equipment to Level 2

15. PT Immediate Service Acute chest
Safety risk to ambulation/physical mgt
Acute pain
Post op ADD BOTOX
Skin integrity
Safety risk due to sudden change in physical status

16. PT Waitlisted
Level 2: chronic chest, accessibility, revisions to orthotics, mobility equipment, (botox), equipment, teaching staff transfers
Level 3: mobility/co-ord with moderate impact
Max 8 visits

17. Transition to School
School can refer to ISTS if school OT, PT or SLP assist needed for transition planning (discuss with preschool therapist)
Preschool and School therapist will work out roles
Accommodates for lack of Care Coordinator

18. Referral Process – New
School: TVCC referral form, OT/PT/SLP referral forms
Parent: Client Background Information form
Parent: Consent and Authorization to Share
School makes referral
Changing because the LHIN care coordinator no longer involved
Need the information to decide on the urgency of the child’s need
school recommending the referral and outlining reason for therapy (estimated needs if a preschooler) and strategies and equipment already available and tried, reports, school contacts
**Parent responsible to ensure that the school receives their 2 parts. The school will forward the complete package to TVCC.
Schools will have all the forms and they also will be posted on our website.
If eligible – may not get immediate service. Children with less urgent needs are waitlisted.

19. Details Specific to SLP Services
Couple differences because school boards also have SLP

20. Referral Process JK SLP
Preschool SLP refers to TVCC and school board simultaneously for JK students
Preschool SLP completes the paperwork with the parent
Referral to TVCC rather than LHIN is only difference

21. Board SLP and Contracted SLP Roles
Board SLP follows children with primarily language difficulties and mild articulation
Contracted SLP for children with moderate to severe articulation difficulties. Limited number of visits. (Change: group sessions will be allowed).
No change to division of work– see: 2011 CCAC SHSS Program Criteria and Severity Level Definitions for SLP
If needs moderate to severe speech/articulation/pronounciation of words then TVCC Interim School Therapy SLP addresses this need.
TVCC Interim School Therapy SLP includes direct session to develop skills; the consultation is mainly with the parent for required followup at home.

22. Overall Impact for Children and Families Currently Receiving School Therapy
Same service provider
Similar models of service delivery
LHIN Care Coordinator no longer involved
Reports look different
Slide refers to expected impacts with the changes
Contracted service providers may opt out of contract
Typewritten reports that summarize progress on goals will no longer use the LHIN format
Care coordinator no longer calling re: school services.