1. Complex Case Resolution Process Children’s Case Resolution

2. Complex Case Resolution Process Need in the community: o The complex case resolution process came into existence when the provincial government realized that the only way a family with a child with very complex needs could get all of his/her needs met was to have them placed in care To address this, MCYS developed the Complex Case Resolution Process, which takes the following form: o Regional, e.g., Leeds and Grenville, Complex Case Resolution Committee’s (currently composed of MCYS supervisors, Executive Directors from Community Living, North Grenville, BDACI, DSLG, CMHLG, FCSLLG, and an invite to CCAC) o Other community stakeholders involved in case resolution are the school boards and health sectors such as CCAC, LHINs, etc. o Current chair is Allan Hogan, Executive Director, FCSLLG

3. Process All funding requests submitted to the regional committee Committee meets a minimum of once a year and when an application has been submitted Final approval for funding rests with the Ministry Once approved, each case are reviewed at a minimum of once a year, and more frequently as needed Funding is provided on a fiscal, year to year basis

4. In the past 2 years 8 Complex Special Needs cases applications were reviewed o 2 were approved for funding o The costs range between $65,000 and $186,000 o Both cases were funded to receive residential services

5. Criteria for applications: With the understanding that the child/youth’s needs span multiple sectors and care providers, clearly documented evidence is required to show that significant work and collaboration has already been undertaken to try to meet their needs Meeting the child/youth’s needs clearly go beyond the scope and resources of the referring agen(cies). There is increased likelihood of the child/youth coming into care if further intervention is not provided Family must be engaged in and aware of the application process

6. Where are children/youth placed: With adequate supports, a number of children/youth who are funded through the Complex Case Resolution process are able to continue to live with their families Some youth, who need a residential placement, unfortunately are placed outside of Leeds and Grenville Why is this? Children’s treatment beds were available to Leeds and Grenville- 1970’s—1990, e.g. Sunnyside Children’s Centre in located in Kingston In the early to mid 1990’s—children’s residential services dismantled into local/regional services- LLG/ Hastings/ Frontenac/etc Treatment beds were available through Sampson House (Child and Youth Wellness Centre), but closed around 2001 due to changes in funding models and a desire by MCYS to look at a different residential treatment format Goal for the future: to look at developing residential placements within Leeds and Grenville that can meet the youth’s needs with community supports

7. What are the Issues that Result in Someone’s Story Being Told to the CCSN Case Resolution Committee?

8. Children with severe disabilities such as Autism who have one or more additional issues o Severe behaviour problems o Communication difficulties o Seizure disorders o Medical conditions such as diabetes Children with severe intellectual disabilities, physical disabilities and medical issues which result in them being considered medically fragile Children with mental health Issues, including addictions, and intellectual disabilities who fall “between the cracks” Children with any combination of the above who o live in poverty which reduces their parents’ ability to cope o don’t sleep well which reduces their parents’ ability to cope o face challenges in the education system

9. Case Study Children’s Case Resolution

10. The situation Received a call from a parent who was requesting assistance for his son Son was currently hospitalized at CHE0- to be discharged March 15

11. Diagnosis and Behaviour Child (currently 13 yrs) diagnosed at 2 yrs. 7 mo. ASD with global developmental delays Hospitalized for serious development issues, also demonstrating violent behavior. Discharge information from CHEO indicated an additional Dx Anxiety Disorder NOS School attendance at risk; police involvement

12. Interventions from multiple sectors and care providers CLNG immediate response: case management, behavior supports (DSLG), respite (talked with BDACI), MCSS contacted to negotiate immediate increase to ACSD referral to Children’s Case Resolution two well credentialed workers who were scheduled in home daily with behavioural backup ASD respite committee approved contingency funds (2,500.00) Several SORs reported, staff were becoming increasingly concerned about safety, school board decided to send child to school in Smiths Falls.

13. Interventions from multiple sectors and care providers Summer camp experience did not have the structure the child needed, placed in a more secure setting Psychologist recommended in house treatment for 6 – 9 months Worked with school board for an alternative school placement which later broke down. Child charged by police Medical issues addressed – gastro, dental and medication change Dietary changes needed

14. The Request MCYS requires additional funding to stabilize child Family is asking for change, would like child to return home, requesting MCYS provide funding Current behavioral profile includes extreme aggression (biting, poking others with sharp objects, incontinence, fecal smearing, destruction of property)