Manitoulin Sudbury Best Start CAR CIL Final Report

Transcription

Manitoulin-Sudbury District
Greater Sudbury
Best Start Networks
Community Integration Leaders Project
Final Report
ACKNOWLEDGEMENT
The Ministries of Children and Youth Services (MCYS) and the Education (EDU) supported
Community Action Research Projects that were designed to help realize the government’s vision
and direction for early years programs and services as outlined in the Ontario Early Years Policy
Framework (OEYPF)
OEYPF describes the “vision and priority areas for action for the early years sector that ensures
Ontario’s children and families are well supported by a system of responsive, high-quality,
accessible, and increasingly integrated early years programs and services that contribute to
healthy child development today and a stronger future tomorrow”. 1
With the resources provided by this project the Best Start Networks in Greater Sudbury and
Sudbury Manitoulin District contracted with the Social Planning Council of Sudbury to
conduct the necessary research and implement the community research activities that would
enhance our knowledge and our skills in considering and testing innovative approaches in order
to improve access to information and services in northern and remote communities.
This opportunity has allowed us to gather extensive information on the history of the
development of our networks, the levels of integration we are experiencing, the impact of that
integration on families and service providers, the use of internet technology by families
throughout our district as well as to explore opportunities for increasing our capacity to share
knowledge with and serve families through innovative technologies.
The report on those activities follows. Product 5 (which is presented first) is the final report of
the innovation activities that were at the heart of this project. Data gleaned in the very
informative products 1 to 4 as well as the extensive review of the Sudbury North project is
incorporated into the lessons learned and the recommendations in product 5.
Products 1 to 4 and the Chapleau project review are complete and informative documents in
themselves and will play a key role in the ongoing development of integrated service delivery in
the Greater Sudbury/ Manitoulin Sudbury District.
The Social Planning Council of Sudbury was pleased to be engaged in this enriching project and
looks forward to the continued progress of the Networks throughout our communities.
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Ministry of Children and Youth Services Ministry of Education Community Action Research Project – Call for
Proposals
Greater Sudbury and Manitoulin-Sudbury
Community Action Research – Community Integration Leaders
Product 5: Innovative Ways to Improve Access to Services
This report was compiled and completed by
members of The Social Planning Council of Sudbury:
Janet Gasparini
Tammy Turchan
Annette Reszczynski
Harvey Briggs
And Consultants:
Susan Snelling
Peter Clutterbuck
Thanks to all the Best Start Network members and
service providers that participated in the community
consultations, surveys, and interviews.
Special thanks to the families that filed out the
parent surveys.
Table of Contents
INTRODUCTION ............................................................................................................................................. 1
PROJECT OVERVIEW...................................................................................................................................... 1
THE INFORMATION TECHNOLOGY “IT” COMPONENT .................................................................................. 2
Overview of the “IT” Component ............................................................................................................. 2
Website Findings ....................................................................................................................................... 2
Parent Survey Findings.............................................................................................................................. 5
Greater Sudbury and Manitoulin-Sudbury Combined .......................................................................... 6
Manitoulin-Sudbury Results................................................................................................................ 10
Greater Sudbury Results ..................................................................................................................... 11
Exploring New Options ........................................................................................................................... 13
THE “CHAPLEAU” CO-LOCATION MODEL COMPONENT ............................................................................. 18
Overview of the “Chapleau” Co-Location Model.................................................................................... 18
5 Key Elements of an Integrated Child and Family Services Model .................................................... 20
Consultation in the Manitoulin-Sudbury Districts .................................................................................. 24
Manitoulin Roundtable ....................................................................................................................... 24
LaCloche Roundtable .......................................................................................................................... 26
Sudbury East Roundtable .................................................................................................................... 29
ACCESS TO INFORMATION AND SERVICES FOR FAMILIES IN NORTHERN, RURAL AND REMOTE
COMMUNITIES: LESSONS LEARNED ............................................................................................................ 31
Use of Innovative Technologies .............................................................................................................. 31
Integrated Service Delivery Models ........................................................................................................ 33
Key Recommendations to Improving Access .......................................................................................... 35
INTRODUCTION
The Ministries of Children and Youth Services (MCYS) and Education (EDU) supported Community Action
Research – Community Integration Leaders Projects (CARCIL) that were designed to help realize the
government’s vision and direction for early years programs and services as outlined in the Ontario Early
Years Policy Framework.
CARCIL project funding was provided by MCYS to promote and support ongoing efforts towards the
creation of an integrated system of child and youth services for the two Best Start Networks in the
Manitoulin-Sudbury Districts and the City of Greater Sudbury.
The project reviewed the historical strategies, processes, decisions and conversations held in
communities that have made successful advances towards integration in order to understand how they
have progressed to their current state; and documented the on-going work of these communities as
they continue to progress toward integration under the CARCIL project.
The project supported the Networks’ consideration and testing of innovative approaches to improving
access to information and services in northern and remote communities. It allowed us to examine social
media and other virtual options on the established web sites used by both Networks. Additionally, the
co-location Sudbury North model of integrated service delivery was reviewed and tested throughout the
Manitoulin-Sudbury Districts.
The impact of integration on key outcomes for children and families was collected and analyzed. Finally,
all of the data was reviewed to determine how we can provide better access to information and services
for families in northern, rural and remote communities.
PROJECT OVERVIEW
The historical review of the work to date for both Best Start Networks in the Manitoulin-Sudbury
Districts and the City of Greater Sudbury can be found in the Community Action Research – Community
Integration Leaders Product 1-3: Moving to Integration reports (Appendix 1) for each of these areas.
The findings from this extensive review for both Networks is included in the discussion on providing
better access to information and services.
The impacts of integration on key outcomes for children and families were investigated through the data
collection that was designed and executed for this project. The details of those findings are attached in
the Community Action Research – Community Integration Leaders Product 4: Impact of Integration on
Key Child and Family Outcomes reports (Appendix 2) and have also contributed to the overall discussion
on access and services.
The primary focus of this report will be on the innovation pieces of this project. The Greater Sudbury
and Manitoulin-Sudbury Best Start Networks created an advisory committee that included the Chairs
and administrative leads of the Networks to guide and direct the consultant in the development of this
phase of the project. A work plan was created and activities commenced. The two strategies followed
separate courses of investigation. The two innovative pieces were referred to as the Information
Technology or “IT” component and the co-location model or “Chapleau” component of the project.
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1. The “IT” Component included:
Considering innovative ways to improve access to information by using the existing websites for
each of the Hubs, exploring mechanisms for expanding social media communications with
families, testing website promotions based on information about website users and
investigating the challenges of those who do not currently use the sites.
1. The “Chapleau” component included:
Considering innovative ways to improve access to services in northern and remote communities
by examining the Innovation Funded Pilot site, Sudbury North, to further define an integrated
model of service. This included identifying challenges, documenting costs and logistics of
replicating this model, consulting with other remote communities to investigate other potential
service delivery models, building on existing models and considering the unique community
challenges and readiness.
THE INFORMATION TECHNOLOGY “IT” COMPONENT
Overview of the “IT” Component
It was necessary to examine our current use of social media and the available websites in order to
develop a baseline from which we could try new initiatives and measure their impact.
Studio 123 is a local social marketing firm that was engaged by the advisory group to work with us on
the IT component. They conducted an initial review of the internet reach and capacity of the websites
used both by the Manitoulin-Sudbury Best Start Network (MSBSN) as well as the Greater Sudbury Best
Start Network (GSBSN).
GSBSN had a robust website that was developed in the last round of CARCIL projects. It is supported by
a children’s services staff member who manages content and the city’s information technology
department that has provided technological support. It is important to note that these duties have been
added to the workload of these individuals and that dedicated staff is not assigned to this task.
MSBSN had a webpage in the midst of the Manitoulin-Sudbury District Services Board (MSDSB) website
dedicated to the Best Start Hubs. The page was found once a viewer had come to the homepage and
navigated through the site. This site also had no staff dedicated to its management as a portal of
information for parents.
Initial discussion amongst the advisory committee revealed that we did not have solid evidence in
relation to the use of technology by the families who were participating in activities in the Hubs or
receiving services via the specialized services. Data gathering was key to all of the projects’ products
and thus was organized in such a way as to design the tools so that all of the research components were
addressed while only going to the respondents once. In this way we developed a parent survey that
would address families’ access and use of technology and services as well as their experience of
integration.
Website Findings
Studio 123 provided analysis and recommendations for website improvement that could be
implemented immediately in order to increase traffic to the websites.
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At the GSBSN website from December 19, 2013 to January 19, 2014 analytics determined that there
were 3373 visitors, 2124 of whom were unique visitors. 63% of that traffic was comprised of new
visitors. Those who accessed the site during that period on average viewed 4.5 pages per visit and spent
an average of 3.5 minutes on the site. The data on language patterns showed that 94% of the users had
English settings, 4% of the users had French settings, eight users had Chinese settings, and three users
had German settings. The analytics pointed to three hotspots on the site: the calendar with over 1000
views, the page dedicated to hubs which received over 600 views, and the page dedicated to
professionals which received over 300 views. Nearly 40% of these visits were from mobile devices, 26%
on tablets and 14% on mobile phones. 57% of visitors found their way to the site through a Google
search (the most generally use search terms: best start hubs Sudbury or a variation of this, specific
daycares, special events for families, things to do for families in Sudbury) and 23% visited the website
directly (they knew the domain address).
The GSBSN webpage was robust and already had its own identity and was using social media such as
Facebook and Twitter. Studio 123 recommended that they make the Facebook link more visible on
every page, for example, displaying a "follow us on" with a visible Facebook icon at the top of the page.
The goal of this recommendation was to drive more traffic to the Facebook page. They also suggested
posting a picture with most articles lending them a higher degree of visual appeal and making the
content somewhat easier for visual learners to digest. They made suggestions about text style
formatting that were primarily aesthetic, for example the line spacing of the news articles that were
present on the site at the time of the evaluation was “too tight”; and using "call out style" formatting
blocks for important pieces of information to make them stand out from the rest of the article. These
changes, they felt, would make the content more attractive to read for users of the site. The
recommendations also highlighted that the best start registration navigation link led to a form that is
not present but instead labeled "coming soon." Their final general recommendation was to point out
that the website was missing a favicon and that the one that was present was the theme template
favicon i.e., a user “liking” with that favicon did not “like” the site but rather “liking” the web-page
template.
They noted some problems on the homepage with the navigation menus, primarily that there were too
many of them and that these made it onerous to navigate through the site. While there was an obvious
significance to the primary and secondary menus the vertical menus in the image slider were
superfluous and had the effect of being confusing for the user. They found that the user had to tilt their
head to read the buttons in the slider. They also recommended that a link be added to "view more"
below the event feed on the homepage. They indicated that the image carousel speech should be
slowed slightly. Those who require more time to read require slower image rotation intervals to
facilitate their reading. Finally they pointed out that there was no text on the homepage that explained
what SudburyBestStart.ca is all about. They suggested using the first paragraph from the "about" section
below the carousel and adding a "find out more" button that links to the about page for more
information.
The consultants suggested it would be useful for search results to show up in two columns: one for
events and one for articles. Instead of having to look through several results to find what they are
looking for, a user could more quickly analyze results if they were categorized as an event or as an
article.
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In order to make the community calendar more user-friendly and much easier to navigate Studio 123
suggested two changes. The recommendations pointed out that when a user is clicking on a specific
event it would be useful for them to be able to click on an icon to add the event directly to their
calendar. They also suggested with respect to events that it would be better if they were to open in a
new tab when clicked so that you don't have to scroll up and down to navigate between the event and
the rest of the site.
The creation of a drop-down menu of categories and age groups to replace the sidebar menu was
recommended here. Rather than the sidebar they suggested that it would be wise to display the most
recently added/updated topics or, if possible, the most popular topics link in the side menu. They
recommended this to address the issue of having to point the user to the sidebar with an arrow.
The final set of short-term recommendations concerned the mailing list. In their evaluation they
assessed that the process was quite long for the user to subscribe to a mailing list. Their suggestion was
to make that process more intuitive by presenting the process one step at a time making it less
intimidating than seeing the full list of options to fill out. The longer it takes a user to do something the
more likely they will leave before completion. By making each step appear individually the user fills in
one step and then the proceeding step fades in making the overall appearance less onerous to the user
than having all of the steps presented at once.
Drawing from the data that was available from the analytics, Studio 123 noted that nearly half of the
users were visiting the website using a mobile device. Even though the template that was in use at the
time displayed the navigation in a summarized menu format, the user experience was still seen as
unnatural and frustrating, e.g., the content was not readjusting/reorganizing to fit the screen size of the
user's device. This left users having to pinch and zoom to read content and to navigate through the
website if they were working on a mobile device. The recommendation was to address this so as to
meet the expectations of their increasingly mobile users.
It was clear that there was much that could be done to to create a website with improved “usability”
from parent user perspective. To that end a number of changes were made. A date range search was
added to the calendar making it possible for users to specify a timeframe and narrow their search
parameters. The Facebook link, which was difficult for users to locate, was made easier to find; as the
research below shows Facebook was indicated as the second-most used form of internet access by the
survey respondents (85.9%). The professionals section of the site is now harder to find (so parents don’t
go there by accident). This provides a more contextually appropriate experience for parent-users of the
site. Finally, usability was enhanced by improved topic search functionality.
Improvements were made for contributors in order to make it easier to post, with fewer errors. The
language model on the site was also improved so that the site now automatically changes event
information in both official languages. This allows the user to post an event in either French or English
and when posted it updates in both languages (i.e., someone posting an update to an event on the
French version of the calendar will find the software has simultaneously made changes to the event on
the English event calendar (or vice versa). The calendar has also been upgraded to remove events out of
a recurring range of events.
With improvements made to the site the CARCIL project supported the official launch of the Greater
Sudbury Best Start website. While the site had been functional for some time there had never been an
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official launch. The event was well covered by local media. New posters and postcards were printed in
order to continue promotion of the site. An online contest was used to drive traffic to the site. Facebook
provides the opportunity to “advertise” your page in a way that will generate a lot of traffic quickly in
order to build up your audience. The GSBSN site used the targeting option to have their ad viewed by
women between the ages of 17 to 55. The ad included a message to “like” the GSBSN Facebook page
and get entered into a draw for $150. The contest ran for a total of 13 days and cost a total of $400.
The results of the advertising were significant. The ad reached close to 10,000 people with the numbers
of “likes” on the site doubling. In fact contests with even relatively small prizes seemed to be a good
motivator to attract people online. A prize of $250.00 was offered for participation in the online survey
conducted by the CARCIL project and resulted in substantial participation.
Collectively these efforts resulted in an 18% increase in unique visitors, 15% increase in new visitors and
44% increase in Facebook average daily reach. They also led to a 108% increase (from Sept 2013) in
parent email subscribers and a 42% increase in Facebook “likes”.
The MSBSN’s webpage did not have analytics embedded and therefore it was not possible to determine
the traffic or use of the site. Studio 123 used the GSBSN website analytics to come up with a list of
recommendations to improve the user experience.
The consultants recommended to the MSBSN that they purchase a separate web domain address for
Best Start so that users can access the hubs directly. Given that domains cost roughly $10 per year the
investment seemed worthwhile given the potential value it could add to the site. As MSBSN did not use
Facebook or other social media venues Studio 123 recommended that they explore these options
through the course of the project.
The Manitoulin-Sudbury Best Start Network, following the recommendation of the consultant, created a
separate URL (msbeststart.ca) which goes directly to its own page. The IT staff at MSDSB are
investigating mechanisms to integrate analytic tools into website and are working to incorporate
Microsoft Office 365 tools into the website for shared calendars, newsfeed, community space, and other
tools. Lessons learned from the Greater Sudbury site are providing valuable information as this work
moves forward.
Parent Survey Findings
The results of the parent survey were extremely informative to the IT project. While there was
anecdotal evidence that families, including families living in low income, had access to the internet, staff
were concerned about moving towards the use of technology as a means of getting information to
families if that access was not equitable.
The survey provided very conclusive evidence that we could integrate more IT options as access was
extensive. As indicated the research tools for the project were designed in order to gather data on all of
the questions going to the source only once. The questions on the use of IT were asked as part of a
larger survey that included data on parent’s use of services and the impact of integration. The survey
was made available online and was posted on the Best Start Network’s websites. As well it was posted
on the Facebook pages of any of the Hubs who had one. Hard copies of the survey were made available
at all of the Hub locations for families who didn’t have access to the internet. They were collected at the
Hubs and delivered to the researcher. One hundred randomly selected families with children under 12
who were receiving social assistance in each of the areas (Manitoulin-Sudbury, Greater Sudbury) were
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mailed a hard copy of the survey and invited to fill it out and send it back in a self-addressed, stamped
envelope or to visit the website and fill it out online. The Healthy Babies Healthy Children home visitors
brought copies of the survey to their clients and encouraged them to participate online or on hard copy.
A researcher attended a Best Start promotional event held in a local shopping mall with an Ipad and the
capacity to engage parents in the survey who visited the booth. Additionally, all the agencies who
participate in the Best Start Networks were emailed a link to the survey as well as a printable version
and were asked to share with their clients. Participants were offered the chance to enter their phone
number into a random draw for a $250.00 cash prize for participating. This methodology proved very
successful in getting not only a robust response to the survey but a response that was representative of
the socio-economic demographics of the communities.
Three separate analyses of the surveys were carried out: a combined analysis, a Manitoulin-Sudbury
analysis, and a Greater Sudbury analysis.
Greater Sudbury and Manitoulin-Sudbury Combined
This analysis contains all of the respondents (n=474). Most of the survey respondents were female
(92%). The largest group of respondents (n=167, 50%) were in the 31-40 age range. 94.3% of the sample
were between the ages of 21-50.
Income
2011 NHS Income levels (for CGS
& MS combined)
$0-14,999
Respondent’s
Reported Income (%
of total sample)
10.4
$15,000-29,999
$30,000-44,999
10.4
10.4
$0-29,999 >>>>>> 22.3%
$45,000-59,999
9.7
$30,000-59,999>> 26.8%
$60,000-74,999
$75,000-90,000
10.1
10.1
$60,000-89,999 >> 26.2%
$90,000+
38.9
$90,000+ >>>>>>> 24.6%
The income distribution of the sample was measured via the respondent’s indicating their pre-tax family
income. Comparing the survey results to the 2011 National Housing Survey data (family income, pre-tax)
we find that our sample very closely matches Statistics Canada’s income breakdown. Where our sample
does differ is in the highest income category; however it is closely representative in all of the other
categories. The representation in the $0-29,999 category is particularly relevant given that it is often
difficult to engage individuals from the lowest income category in research and that we were interested
in knowing if this particular demographic had access to the internet.
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Almost everyone in the sample indicated that they had Internet access (96.9%) with 90.8% indicating
that they had access at home. Of the respondents who answered this question and the question about
income (n=278) only nine individuals indicated they had no internet access, and of those five were in the
lowest income category. Six out of the nine respondents who reported that they cannot afford internet
access also reported having no internet access.
Most of the respondents access the internet from home (90.8%), of those who did not report having
access at home and who answered the question about income (n=22) five were in the lowest income
category, and fourteen were in the $0-44,999 income range. Three persons in the $90,000+ range
reported not having internet access at home. When asked where they tend to access the Internet the
majority of the sample, 68%, indicated that they tended to access the Internet at home. 5% of
respondents indicated that they accessed the internet where it was available for free.
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The majority of respondents indicated that they access the Internet four plus times per day and if we
add up the total of the three "larger usage" categories (4+ times a week, 1 to 3 times per day, 4+ times
per day) we see a significant majority of our sample were relatively frequent users of the Internet
(90.5%).
Frequency Percent
Valid
Valid
Percent
Cumulative
Percent
less than once a
week
6
1.3
1.4
1.4
1-3 times week
20
4.2
4.6
6.0
4 + week
31
6.5
7.2
13.2
1-3 times/day
93
19.6
21.5
34.7
4+ times/day
267
56.3
61.8
96.5
15
3.2
3.5
100.0
432
42
474
91.1
8.9
100.0
100.0
N/A
Total
Missing 99
Total
When asked what their most common forms of Internet usage were our respondents indicated that
email (93.4%) and Facebook (85.6%) were by far the most common forms of Internet usage in which
they engaged. As table 3 shows both YouTube (41.3%) and Pinterest (31.6%) were also popular options.
Interesting that in neither District was Twitter a popular social network modality with survey
respondents.
Type of Usage
Email
Facebook
Twitter
Instagram
Youtube
Pintrest
% of Respondents
93.4%
85.6%
6.4%
10.6%
41.3%
31.6%
Survey respondents were frequent users of the Greater Sudbury Best Start site. 77% indicated some
level of usage of the site. As the chart below shows, 19% of respondents indicated they had never heard
of the site while 61% reported that they had visited a few times or regularly. 42% indicated that they
had signed up for email updates on the site. Usage of the Greater Sudbury Best Start Facebook page by
comparison was lower with only 21.6% of respondents indicating that they had used the Facebook page.
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Given respondents high level of usage of Facebook in general it would seem that more effort to engage
them through the Facebook page could be beneficial in attracting larger numbers of parents to the Best
Start site.
The number of respondents indicating that they had used the Manitoulin-Sudbury Best Start site (47%)
was nearly the same as the number who indicated they had never heard of it. (41%).
When comparing the usage of the Greater Sudbury and Manitoulin-Sudbury Best Start sites with general
usage of Internet sites about children and parenting the numbers are encouraging. 67.2% of the
respondents indicated that they seek information about children and parenting from other sites. While
that number is high it is 10% below the reported usage of the Greater Sudbury Best Start site.
Respondents also indicated that finding information about children and parenting on the Internet is not
something that they find difficult with 90.9% indicating that they had no difficulty in finding information.
Those with No Internet Access
Our final question about Internet access asked respondents with no Internet access to indicate why they
did not have access. Respondents who had indicated access would not have been directed to this
question. A total of 22 respondents indicated that they had no Internet access and the "can't afford" and
"no computer" options were the most common reason given. Four respondents who answered the
income question reported that they could not afford internet access. Of those 2 were in the lowest
income group, 1 in the $30,000-44,999 category, and 1 in the $90,000+ category. As stated above of
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the respondents who answered this question and the question about income (n=278) only nine
individuals indicated they had no internet access, and of those five were in the lowest income category.
Six out of the nine respondents who reported that they cannot afford internet access also reported
having no internet access. Income is statistically correlated with internet access (using Chi-square for
independence) in the full sample (which includes those who listed no postal code), but this is based on a
very small subset of the sample (n=9). In that very small subset lower income does tend to mean a
greater chance of not having internet access. However, the number of persons reporting no internet
access was very small and this suggests we should view this relationship with a great deal of caution.
Manitoulin-Sudbury Results
The following analysis includes only those respondents from the Manitoulin-Sudbury Districts (n=62)
who indicated a postal code on their survey. A total of 474 respondents answered the survey, and of
those 328 indicated their postal code, of which 62 were from the Manitoulin-Sudbury Districts. 88% of
the respondents from the Manitoulin-Sudbury sample were female. 84% of the respondents were in the
21-40 age group.
Income
$0-14,999
$15,000-29,999
$30,000-44,999
$45,000-59,999
$60,000-74,999
$75,000-90,000
$90,000+
Respondent’s
Reported Income (%
of total sample)
7.5
22.5
12.5
17.5
12.5
7.5
20
2011 NHS Income levels
(Manitoulin-Sudbury)
$0-29,999 >>>>>> 25%
$30,000-59,999>> 31%
$60,000-89,999 >> 26%
$90,000+ >>>>>>> 18%
The income breakdown of our sample once again closely corresponds with the NHS 2011 data for the
Manitoulin-Sudbury area. Our sample is slightly overrepresented in the lowest income category and
slightly overrepresented in the highest income category. Overall, however it is a representative sample.
Internet access in the Manitoulin-Sudbury sample was slightly lower than in the combined sample,
90.3% of the respondents in the Manitoulin-Sudbury sample reported having Internet access.
The majority of the respondents in the Manitoulin-Sudbury portion of the sample access the Internet
from home (90%).
Respondents indicated a relatively high frequency of Internet usage with the three top categories (4+
times per week, 1 to 3 times per day, 4+ times per day) capturing most (81%) of the respondents.
Not unlike the survey results overall in MSBSB email (93%) and Facebook (89.5%) are the most common
types of Internet usage. YouTube (40.4%) and Pintrest (40.4%) are also significant.
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Best Start Websites
The charts below show the within-area (i.e., Manitoulin users using the Manitoulin Best Start site) and
Cross-area usage (i.e., Manitoulin users accessing the Greater Sudbury Best Start site).
Cross-Area Usage (in %)
Within Area Usage (in %)
59
60
40
20
0
4
16
14
2
5
0
60
40
20
0
53
2
12
18
2
7
0
When asked if they signed up for email updates from the Best Start site only 1 respondent indicated
they had done so (48 answered no). This would have had to have been from the GSBSN site as the
MSBSN site does not have this option. Likewise, overall usage of the Best Start Facebook page, which
would have to be the GSBSN page as MSBSN does not have one, was similarly low, with only 9.1% of the
Manitoulin-Sudbury responders indicating they use it. Respondents do use other sites to access
information about children and parenting, 57.9% of the Manitoulin-Sudbury respondents indicated they
use other sites. The overwhelming majority of respondents indicated that they did not find it hard to
get information about children and parenting on the internet (94.3%). This data indicates that most
families in the Manitoulin-Sudbury area are not accessing information about children and parenting
from either of the Best Start Networks on a regular basis and thus provides an opportunity for the
MSBSN to improve its outreach with the use of these tools.
A small number of respondents (6) indicated that they had no internet access. When asked why the
most common answer was “no computer.” None of the respondents indicated that their reason for not
having internet usage was due to their inability to use the internet.
Greater Sudbury Results
The following analysis includes only those respondents from Greater Sudbury who indicated a postal
code on their survey (n=265). 93% of the City of Greater Sudbury respondents were female and 86% of
the respondents were between the ages of 21 and 40 years.
The sample was representative with respect to income with the exception of the highest income
category, $90,000 plus, where our sample was overrepresented.
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Income
Respondent’s
Reported Income (%
of total sample)
10.6
9.3
11
9.3
8.8
10.6
40.5
$0-14,999
$15,000-29,999
$30,000-44,999
$45,000-59,999
$60,000-74,999
$75,000-90,000
$90,000+
2011 NHS Income levels
(Greater Sudbury)
$0-29,999 >>>>>>21.8%
$30,000-59,999>> 25.9%
$60,000-89,999>> 26.2%
$90,000+ >>>>>> 26.1%
Almost all of the Greater Sudbury respondents (98.9%) reported that they had internet access. Lack of
internet access is related to lower income in Greater Sudbury. However, the small number of persons
reporting no internet access (see combined analysis above) is so low that one must view this
relationship with caution.
96% of the respondents indicated that they access the Internet at home and this was by far the most
commonly selected option.
Internet usage is comparatively more frequent in the Greater Sudbury sample, with 87% of respondents
indicating they use it 1 to 3 times per day or 4+ times per day.
Email (93.5%) and Facebook (88.5%) were by far the most frequently used form of Internet activity for
the Sudbury respondents. YouTube (40.8%) and Pinterest (28.5%) were also significant types of Internet
usage among the Sudbury respondents.
Best Start Sites
The charts below show the within-area (i.e., Greater Sudbury respondents using the GSBSN site) and
Cross-area usage (i.e., Greater Sudbury users accessing the MSBSN site).
Cross-Area Usage (in %)
Within Area Usage (in %)
37
40
30
20
10
0
11
19
4
28
27
0
0
30
20
10
0
13
16
19
19
8
0
12
Respondents within Greater Sudbury were much heavier users of the Best Start websites actually using
the Manitoulin-Sudbury site more frequently than residents from that area.
When asked if they signed up for email updates from the GSBSN site, 127 of the Greater Sudbury
respondents answered yes (50.4%). Usage of the GS Best Start Facebook page was reported by 29% of
the Greater Sudbury respondents. Respondents do use other sites to access information about children
and parenting, 69.9% of the Greater Sudbury respondents indicated they use other sites. The
overwhelming majority of respondents indicated that they did not find it hard to get information about
children and parenting on the internet (92.9%)
A small number of respondents (3) indicated that they did not have internet access. When asked why
the most common answer was “no computer” and “can’t afford it.” None of the respondents indicated
that their reason for not having internet usage was due to their inability to use the internet.
The survey results were revealing and encouraging to the advisory committee and they moved forward
with confidence in exploring more opportunities to reach families through the use of social marketing
knowing that the vast majority of families in both communities had access to the internet.
Exploring New Options
A Webinar was planned and hosted on February 26, 2014. The project engaged with Cambrian College
and used their e-dome facility which is designed to deliver webinars and host teleconferences
throughout northeastern Ontario. The consultants from Studio 123 continued to work with us on the
development of the content and the delivery of the webinar. Throughout the two Districts the Best
Start Hubs were engaged in the promotion of the webinar. Particularly throughout the ManitoulinSudbury District, hubs hosted movie nights in order to bring families together to view the webinar with
the hopes of stimulating conversation. It was anticipated that this might be a mechanism with which we
could “bring experts” into local communities where small populations often don’t warrant the cost of
bringing these resources in. People could register to participate in the webinar in their own homes as
well. Information about the webinar was sent out through the Hub networks and advertised on the Best
Start website and Facebook page. One of the Hubs in the city organized a bus for parents from their
Hub to travel to the e-dome to participate live in the webinar. Child care and snacks were provided.
The content of the webinar was delivered by three Triple P practitioners. Triple P, an evidence-based
family intervention strategy designed to assist parents to improve their parenting skills and build
positive relationships with their children, is a joint initiative delivered throughout Greater Sudbury and
Manitoulin-Sudbury Districts that is often cited as one of our most integrated programs.
We are very pleased with the content that the webinar provided. The panelists provided answers and
advice for parents. There was significant cooperation between the two networks. Development of the
webinar provided an opportunity for the networks to work together. For example the panel included
staff from agencies in both Districts. The YouTube videos developed include the same staff and so have
appeal to both networks.
It was our hope that this opportunity would engage families and make information available throughout
our vast District. Unfortunately we did not have the parental uptake that we expected. 35 people
participated. Some of the feedback indicates that the timing was not good (although there was no
13
consistency to what the ideal time would be). We may have had a better turn out with more time to
advertise. Those who did participate were very satisfied and interested in the content. Webinars
require a significant time commitment from parents to view and participate in. Having the information
available for viewing at a later time will prolong the value of this modem. Studio 123 worked with the
presenters and developed twelve video clips that concentrate on specific issues raised in the webinar.
They created a Best Start YouTube channel (https://www.youtube.com/user/sudburybeststart) and
clips created from the Webinar are available as Parenting Pointers. Links to the pointers have been
posted on the websites and the Facebook pages with a particular video highlighted. The plan will be to
change the topic regularly to attract parents to the whole series.
This report based on google analytics of the Greater Sudbury Best Start Website, Facebook page and
YouTube video channel reveals the impact in traffic and thus reach to parents in the short time frame of
January to April 25, 2014.
Pre-launch
Jan 23,
2014- Feb
12, 2014:
Unique Visitors
% New Visitors
Page Views
Facebook
average daily
reach
Facebook
average daily
engaged users
You tube views
by end of period
ContestPromotion
(March 10
to March
30)
2371
52%
12,268
2961
Post
contest
(March 31April 20)
2,064
46%
14,594
124
Post launch
Feb 13,
2014March 5,
2014
2436
54%
13,669
179
Parenting
Pointers
promotion
April 2125*
2081
47%
13,732
234
8343
14
17
55
24
119
(prior to
parenting
pointers)
Jan 23- Feb
12
Views- 70
Minutes
118
Feb 13- March 30
VIEWS 69
ESTIMATED MINUTES
WATCHED 112
SUBSCRIBERS 0
(post parenting pointers
with an ad)
March 31- April 24th
VIEWS 715
ESTIMATED MINUTES
WATCHED 980
SUBSCRIBERS 2
Promotional events, contests and the use of Facebook ads bring new viewers to the site. Care must be
taken to ensure that the content continues to draw people back. These statistics do not include
activities on the Facebook pages of the individual Hubs
Activities continued throughout this time with a focus on content development on the website and
Facebook pages. Currently Facebook is being used by some Hubs and by the City of Greater Sudbury
Best Start Network. The City has created a Facebook page which according to Facebook offers “unique
tools for connecting people to a topic they care about, like a business, brand, organization or celebrity.
Pages are managed by people who have personal Timelines. Pages are not separate Facebook accounts
14
and do not have separate login information from your Timeline. You can like a Page to see updates in
News Feed.”
The Donovan Best Start Hub is using an open group. According to Facebook help “Groups make it easy
to connect with specific sets of people, like family, teammates or coworkers. Groups are private spaces
where you can share updates, photos or documents and message other group members. You can also
select one of three privacy options for each group you create.” The Donovan page is an open group
meaning anyone can view all of the material available on the page. The Aboriginal Best Start Hub is used
a closed group. People wanting access to the information have to ask to join and the information is not
publicly viewable. There are over 100 members in the Aboriginal Best Start Hub.
A review of all three pages indicates they are being used in different ways. While the CGS Best Start
Page provides updates and links to events or information the Donovan and Aboriginal Best Start Pages
are being used by families who live in the neighbourhood and participate in the Hub. There are often
inquiries on the page about specific Hub activities. Parents are asking very specific questions and there
is an almost instant reply. The difference between the open and closed group is who has access to the
information.
This use of Facebook by these two Hubs is particularly interesting. These Hubs are located in one of the
most socio economically disadvantaged neighbourhoods in the city. While the review of the messages
posted has only been cursory it appears that this medium is providing access to information to parents
who may have transportation or other issues making participation more difficult. It serves as an instant
message board inviting parents to community meals, providing links to information and events and
responding to inquiries.
15
The use of this tool reveals that there are many options and possibilities available to get information to
parents. It also reveals that agencies have not necessarily been able to keep up with quickly evolving
technology. The GSBSN has no dedicated staffing for the best start website and so it raises issues with
respect to the necessary maintenance over the long term that is involved with any kind of website.
While all of the Best Start Network partners have contributed content to the site there are concerns
about maintaining that content and keeping it current. As this is a site designed to provide important
information to parents about both events and issues it is important that the content be monitored and
accurate. Many of the agencies involved with the BS site have policies limiting their use of social media
tools. For example some organizations block Facebook from their servers so that staff cannot access
Facebook accounts. Open groups like the Donovan Best Start site, while proving to be a great
communication tool with parents, could be exposing members in ways unintended.
Digital Guidelines have been developed by Studio 123 based on the work done to date on the CARCIL
project.
The guidelines highlight how social marketing is a valuable tool that will put us in contact with our target
audience much more effectively than traditional marketing. Social marketing is driven by peer
recommendations which carry far more weight with the average person than direct advertising and
allows for far more frequent updates and interaction with the target audience. Social media marketing is
inexpensive compared to traditional marketing and allows you to get to a larger and much more specific
16
audience than other advertising options. It also allows you to measure your success with readily
available tools (Google analytics). The ability to measure the reactions of your target audience to your
message and the ability to interact quickly and flexibly with your target audience allows you to keep
your message pertinent and informative.
The guidelines provide a how to on using key features of the social media mediums that the families in
the survey identified as being those that they use. They provide a "10 minute strategy" for consistent
use of social media tools that are not only helpful but show the relative ease of using social media
marketing tools.
The guidelines provide more specific direction for the use of Facebook that will help to provide
consistency and support to the use of this medium throughout the system. They also include directions
for using the YouTube channel that was created for the project and that will now be available to all of
the Best Start partners in both networks.
In general it is important to make sure communication with the audience is consistent. Messages should
be replied to in a timely fashion, images posted need to be well-suited to the content, content should be
relevant to the organization and the followers, a casual and friendly yet professional tone should guide
interactions, unused pages or groups should be deleted, internet slang should be avoided, and
consideration for the target audience and how posts might affect them should be paramount. Critical or
negative comments should only be deleted if they are in some way offensive. Even critical comments
can be a means for interaction with your followers.
Given that Facebook and YouTube were the most used medium by families in our network the
guidelines focus on assisting both Best Start Networks with enhancing their websites and Facebook
pages to increase their reach. The guidelines are available to Hubs, neighbourhood teams and all of the
Network partners in order to expand their reach with this technology. As noted a Best Start YouTube
Channel was created. The guidelines include instructions for posting more videos on this site and both
networks have access to this medium. Following the completion of the CARCIL project (April 30, 2014) it
is expected that these guidelines and tools will have a significant impact on the use of these mediums by
the Network members.
An important next step in the use of social media as it pertains to providing information to families will
include extensive review of the impact of the guidelines as well as staff training and resource allocation
for the effective use of these tools.
17
THE “CHAPLEAU” CO-LOCATION MODEL COMPONENT
Overview of the “Chapleau” Co-Location Model
Simultaneously to the investigation in regards to the use of technology the project was moving forward
with an examination of the co-location of the Sudbury North Site. The focus of this part of the project
was to determine whether and how co-location improves children’s services integration and advances
the development of an effective, efficient integrated child and family services model. The research
reviewed progress to date at the Innovation Pilot Project site in Chapleau and documented the benefits,
challenges, costs and logistics of the pilot project. It also involved a review of other best practices of
relevant integrated services models that could inform development in rural and remote areas.
The Chapleau experience with co-location and integrated service delivery to children, youth and families
and the study of other models were the basis for consultation with community practitioners in child and
family services in Sudbury East, Manitoulin, and LaCloche to explore the potential for improving more
coordinated or integrated service delivery to families with special needs children in those communities.
The focus of this section is to provide a summary of the review of the Chapleau Pilot Project. The full
report of the review of the Chapleau Pilot Project is attached (Community Action Research-Community
Integration Leaders - Review of the Chapleau Innovation Pilot and Report on Field Consultations on CoLocation and Integrated Children’s Services Models Appendix 3).
Chapleau is a rather isolated community located in the land mass designated as Sudbury North. It is
approximately 400 km northwest of the City of Greater Sudbury and 200 km west of Timmins.
Approximately 2,500 people reside within a 157 square kilometer area that includes the town of
Chapleau and five First Nation reserves. There are 300 children between the ages of 0 – 12 living in 630
families in the town of Chapleau.
In 2011, through the Innovation Fund, the children serving agencies in Chapleau engaged in a process to
examine their capacity to integrate services through co-locating in a common site. There was already a
long standing history of the children’s service agencies working together in Chapleau under the
leadership of the Chapleau Children’s Service Providers’ Network (CCSPN). The Innovation Fund Project
resulted in the co-location of five children serving agencies in one site with the support, including
financial support, of the District Services Administration Board (DSAB).
The figure below shows the CCSPN’s core membership. In the Centre are the co-located agencies:
Children’s Community Network (CCN), Children’s Treatment Centre (CTC), Child and Family Centre (CFC),
Infant and Child Development Services (ICDS) and Children’s Aid Society (CAS). The Centre is surrounded
by several more agencies, the Sudbury and District Health Unit (SDHU), Child Care Centres (CCC) Best
Start Hubs (BSH) and the DSAB, all of which have fairly regular working relationships with the Centre.
There are additional community agencies not necessarily regularly engaged with the Centre such as the
Family Health Team (FHT), the local schools, and the Aboriginal People’s Alliance for Northern Ontario
(APANO) but they are still connected through the CCSPN. The Anishinaabe Abinoojii Family Services is
also an important community resource for First Nation’s children. It is depicted in the outer ring of the
network, with a dashed line of separation to reflect some reported distance.
18
The process of co-location was aided by an independent facilitator who worked with the executive
leadership of the five partner agencies to first develop a shared vision and process for co-location. The
basis of trust already established from having worked together for more than a decade made this relocation relatively smooth (Clutterbuck, 2014). There were some reservations among front-line and
managerial staff about CAS joining the co-located group in terms of potential family and community
aversion to using the Centre if the CAS was located there – but this concern proved unfounded
(Clutterbuck, 2014).
In terms of cost the new co-located space costs approximately $14, 831 more per year but is also much
more suitable in terms of both private office and meeting space and program delivery (Clutterbuck,
2014). The Chapleau model also revealed the relationships and capacity developed by co-locating CCN,
CTC, CFC, ICDS and CAS in one site. There were opportunities for sharing staff (SPA – single point access
is a full time receptionist paid for by two different agencies who provides reception for all of the
services) and a significant improvement was seen in the agencies capacity to meet the service principles
as defined by MCYS.
Integrated services models have been studied for application to a wide variety of fields in the human
services for a number of years now. Recently, the Mowat Centre in conjunction with KPMG reported the
results of an international survey of integrated services initiatives, which included Manitoulin-Sudbury
District, and spoke to the “integration imperative” for dealing more holistically with the complex needs
of various client populations (KPMG International Cooperative, 2013).
19
As mentioned earlier a search was undertaken for best practice models that could inform the
development of integrated services for children with special needs. Three models: the Wraparound
Model, the Community Hub Model and the No Wrong Door Model, illustrate the most common best
practice features internationally and domestically. The main features of each are relatively consistent in
terms of the key practice principles employed and the preceding discussion suggests that a number of
key elements are important in the design of an integrated service system for children with special needs
and their families. Many of them are reflected in the Chapleau Pilot with the Chapleau Pilot
demonstrating a significantly integrated service model. The following chart identifies the key elements
with commentary related to the operation and experience of the Chapleau Child, Youth and Family
Services Centre (Clutterbuck, 2014).
5 Key Elements of an Integrated Child and Family Services Model
Key Elements
Chapleau Child, Youth, and Family Services Centre
1. Vision/Mission/Values - Most models
of both co-location and integrated
service practices call for a rigorous and
deliberate planning process at the
outset engaging personnel at all levels
of the partner agencies in framing a
common vision, clear purpose, and
focused mission based on shared values
for “collective impact”. Collective
impact refers to the commitment of
separate organizations to focus their
respective capacities and resources in a
complementary way to achieve shared
community outcomes, beyond just
individual organizational results.1
 In Chapleau some work was done on a shared
vision related to co-location but mostly at the
executive and managerial level. While there was
information sharing with front-line staff, most of
their input was at the end of the process with
respect to physical appointments and décor of the
new shared workplace. The supervisors/managers
did facilitate a process on fears and expectations
with the front-line staff, however, which reduced
some anxieties that existed.
2. Collaborative Agreement – The
detailed Protocol Agreement of the Our
Kids Network in Halton is a good
example of the translation of a shared
vision, mission and values into a clear
 Again, the partners in the Chapleau Pilot are
operating on longstanding organizational and
professional working relationships rather than a
formal signed agreement. The collaborative
community culture that has developed over the
years extends not only to the traditional Circle of
 The Chapleau Pilot also involved re-locating the
staff of four agencies that were already co-located
in an unsuitable work setting and adding only one
additional partner. There are longstanding working
relationships and histories of working together at
both the front-line and managerial levels that
mitigated to some degree the need for extensive
work on framing a common vision, mission and
practices both in terms of sharing a work setting
and in the service planning and coordination
practices employed.
20
operational agreement stating roles
and responsibilities of all signatories to
the collaboration. Notably, the Halton
CAS is a full and equal partner in this
collaborative agreement, and has
assumed particular trustee and
financial accountability for the
functioning of the OKN. As also stated
in the OKN Protocol Agreement, clear
and formal definition of the structure
and process for working together and
sharing resources is a safeguard against
“staff turnover”. The service
coordination process is institutionalized
into community practice rather than
dependent on working relationships
and informal practices.
Care partners but also to other external community
agencies within the larger Children’s Service
Providers’ Network. These same conditions may
not exist in other communities seeking to establish
a collaborative initiative for integrated services. As
well, even in an established collaborative
community culture, there may be advantage in
institutionalizing service practices in the event of
personnel changes. Formal agreements may also
help the community agencies and their authority
structures deal with barriers to fuller integrated
practice such as CAS’ relationship to the Circle of
Care agencies in Chapleau.
3. Co-location – A shared work setting for
child and family service agencies is not
necessary and not always possible for
coordination and integrated service
provision. Community hub models do
offer the advantage of establishing the
“one-stop service” and “single point of
access” concept in a visibly physical
way for families and can reinforce the
notion of “seamless services”. When
not co-located, however, children’s
services can employ the “No Wrong
Door” approach with shared
understanding and protocols for intake
and appropriate referrals through
multiple physical points of access. Also,
even if not co-located, partnering
agencies can create, use and promote a
shared web site (virtual or cyberspace
co-location), which the OKN in Halton
does very effectively.
 Co-location is a central feature of the partners in
the Child, Youth and Family Services Centre in
Chapleau. Physical co-location may even be more
beneficial in smaller rural communities with a more
limited overall practitioner workforce in terms of
promoting team collegiality.
 Co-location can also be highly valued by
community partners external to the joined physical
site. Notably, in Chapleau several additional
agencies would be prepared to join the Centre if
adequate space were available. As well, DSB
supplements the salary for the Centre’s reception
position to ensure family access during full
weekday business hours.
 The quality of the shared physical space is also
critical based on feedback from managerial and
front-line key informants in Chapleau. There is a
high sensitivity to the need for space that allows
family privacy in their service and treatment
programs. The Centre’s front-line staff reported
greater effectiveness and even productivity in their
work performance when working out of a modern
and accommodating facility.
21
4. Service Coordination
a) Common Intake & Referral: This is the
most frequent and easiest area of
collaboration for which partners usually
develop common protocols. The
question is whether there is one point
of referral for multi-need families (first
level of coordination) acceptable to all
partner agencies. While the idea of a
“single point of access” where common
intake and referral occurs can be
facilitated by the identification of a
physical “one stop” service centre,
multiple agencies can agree to apply a
common intake protocol for referral to
the appropriate coordinating agency
(i.e. No Wrong Door approach) for
families in need.
 Chapleau combines the “one stop shopping” model
with a No Wrong Door approach in that the Centre
is perceived as the place to go for families with
special needs children. The internal intake and
referral mechanisms are in place for families to be
directed to the appropriate agency or agencies for
service. Other agencies such as community
agencies such DSB, DHU, and CCCC also know to
refer families presenting certain issues to the
Centre for aid.
 The CAS remains the exception in the intake and
referral process in Chapleau, since child welfare
regulations require that referrals be made out of
the Sudbury CAS office.
b) Family-Centered Planning: The
Wraparound model emphasizes that
the family be intensively involved in the
development of an integrated service
plan and also that for multi-need
families, a multi-disciplinary team of
professionals join with family and
friends or natural helping networks to
address the family’s issues. This is a
much different approach than seeing
the family primarily as a client that
needs issues addressed and its
problems resolved. It requires a more
community development oriented form
of practice rather than clinical
casework.
 The service professionals in all of the Chapleau
Circle of Care agencies do show tremendous
respect for the families that they serve, including
recognizing that families themselves have skills and
capacities to bring to the issue that they encounter.
All reports indicate that families value the service
received out of the Centre and have good relations
with the practitioners.
c) Integrated Service Plan: The most
developed integrated models engage
the family and service practitioners in
development of one integrated service
plan with assignments of the plan’s
various parts to different parties for
 The planning process is more informal and less
integrated in Chapleau. There is some coordination
on what each agency can provide for multi-need
families but no single integrated service plan is
developed and tracked as a whole. Different
workers usually stay apprised of what others are
doing through informal communications and
 Still, families still seem to be more passive than
active in the development of their service plans.
They are not engaged in the service planning
process with other team or case conference
members and primarily work with Centre
practitioners on an individual basis.
22
implementation and then regular case
conferences to track progress on the
parts and the whole.
d) Information Sharing: Integrated service
plans cannot work without the ability of
workers to share information in their
work with multi-need families. All agree
that this requires parental consent and
usually common consent forms are
developed for this purpose and shared
computer file systems are set up.
meetings, occasional case conferences, and access
to the CIMS to which each, except CAS, file their
reports.
 In Chapleau, the Circle of Care agency practitioners
do secure parental consent in order to share
information on their work with families on the
CIMS. CAS, however, has its own data filing system
and does not post to nor have access to the CIMS
for families with which it is working. It can secure
parental consent to share its information with
other workers and other workers can do so
similarly to share information with the CAS worker.
The success of these arrangements, of course,
depends on high trust levels between families and
their front-line workers.
e) Assigned Service Coordinator: There
 In the Chapleau Centre, the CCN position of Rural
Services Coordinator (RSC) is designed to perform
should be a fixed point of responsibility
the service coordination function. Common
for ensuring the development and
practice, however, is for the worker with the
“case managing/coordinating” of the
heaviest service role with a family to serve as the
service plans for multi-need families. At
lead on their service delivery. This is an accepted
one time this was considered a function
practice in the field now, especially when families
best performed by someone without
can select their own case coordinator. It would be
strengthened, however, in Chapleau if there were
other service delivery responsibilities. It
one single integrated service plan created for
is more recognized now that other
multi-need families.
options for service coordination can
work. For example, the agency taking
the heaviest service responsibility for a
family may also assume the lead role on
service coordination with other
agencies. In the strongest Wraparound
models, the family selects its preferred
case coordinator from the service team
with which it is working (e.g. Halton
OKN).
f)
Access to Specialized Expertise – This is
a special challenge for rural
communities without immediate access
to resources available in larger urban
communities.
 The Child, Youth and Family Centre does
coordinate scheduled visits of expert clinicians and
resource people from Sudbury three to four times
a year.
23
5. Service Development and Systems
Planning – A lot of information is
generated in the service delivery
process, which is only enhanced by
effective collaboration among
providers. How this data in aggregate
form with proper confidentiality
protections is used for planning
purposes is an important question and
one that suggests the development of
mechanisms and structures for interagency collaboration at the systems
planning level as well.
 Although data available on the CIMS is not
aggregated in any systematic way for planning
purposes in Chapleau, the Chapleau Children’s
Services Providers’ Network is a regularly meeting
group that does take on initiatives arising from the
experience and expressed needs of the
participants, which extend beyond the co-located
partners at the Centre. A more systemic form of
planning could build on this important base
infrastructure, which would require clear
assignment of this responsibility to a preferably
independent non-direct service delivery party.
Consultation in the Manitoulin-Sudbury Districts
Following the thorough review of the Chapleau model a presentation was prepared for delivery to the
Local Service Providers Network’s (LSPN) in Manitoulin, LaCloche and Sudbury East. The purpose of the
presentation and ensuing community consultations was to review the co-location experience and other
potential models of integrated service delivery to children, youth and families in order to explore the
levels of integration in these communities and their potential for improving coordinated or integrated
service delivery to families with special needs children in those communities (Clutterbuck, 2014).
The Chairs of the LSPN in each District were contacted and a meeting time and place was organized.
Members of the LSPN were invited along with management leads from the participating agencies. A
research team from the SPCS attended in each community and provided an overview of the results of
the Chapleau review. Participants then discussed the model of service planning and delivery in their
own respective areas, the features of the Chapleau model that had merit for them and other
possibilities for improving more coordinated or integrated children’s services in their areas (Clutterbuck,
2014).
Manitoulin Roundtable
The service delivery model on Manitoulin Island is impacted by the large geographic area that is served
and the jurisdictional issues that exist in service delivery between seven First Nation’s communities
representing forty percent of the population and the off-reserve population, many of whom are not First
Nations and require services from main stream organizations. Manitoulin Island is the largest
freshwater island in the world with a mass of 3107 km². This area is home to seven First Nations, six
townships, one municipality, two towns, and one unorganized area. There is a total population of
13,048, of which 1880 are children between the ages of 0 and 12 years. The aboriginal population in this
area numbers 5295. A total of 3935 families live in this area.
Little Current, the community that serves as the entrance to the Island, is a service hub. Schools in the
area are well used for outreach. With such a large geography to cover service providers are challenged
to meet all of the needs. There was a desire and commitment to integrate services in an effective way
24
in order to better serve the whole population on Manitoulin Island. (Full details of the service planning
and delivery models as depicted by the maps can be found in Appendix 3)
Children’s Services in the Manitoulin Area Depicted by Local Community
As the figure below illustrates, for the most part both front line service providers and management staff
saw themselves at the very early stages along the continuum of integrated service delivery. They
indicated that the Vision/Mission/Values/Principles were implicit and unwritten and that the
collaborative agreements were mostly informal understandings. They felt that they were further along
the continuum in terms of “no wrong door” services with some co-location and good communication.
Service co-ordination and systems planning tended towards the fragmented and disconnected end of
the scale.
Portrayal of Manitoulin Positioning on the Key Elements of an Integrated Children’s Services Model
25
Nations and require services from mainstream organizations. There was a desire and commitment to
integrate services in an effective way in order to better serve the whole population on Manitoulin
Island.
Suggestions included:
1) Review the location of service delivery – perhaps a more central location would allow for better
service delivery for families and more effective use of resources. Mindemoya is more centrally
located on the Island.
2) More effective collaboration – perhaps a “shared space” available in different communities that
could be used by a variety of agencies. School space was cited as an example. Co-ordination of
services could be arranged so that families were coming to the school on a day when all services
would be available.
3) Common Intake/Referral System – perhaps the current system of intake by CCN could be
expanded to include both MYCS and other funded services when possible
4) Case Co-ordination – perhaps a common intake form that would gather all of the information on
what a family and/or child needs and then the responsibility for ensuring those needs are met
would be assigned to the agency most involved with the family. Timelines and reporting back
would become the responsibility of the case manager.
5) Use of technology – perhaps better use of the technology currently available (video
conferencing) as well exploration of other possibilities – i.e. Skype, Tele-health resources, other?
LaCloche Roundtable
LaCloche, the geographic area that includes the townships of Baldwin, Espanola, Nairn and Hyman, and
Sables-Spanish River, is more similar to Chapleau in that the area is more compact at 1142 km². It runs
along Highway 17 from the town of Massey at its western end to the town of Nairn Center on the
eastern end extending up Highway 6 to Espanola and on to Manitoulin Island. The total population of
LaCloche is 8946 persons, of whom 910 are children between the ages of 0 and 12 years. This area is
home to 2915 families.
The service delivery model in LaCloche is impacted by the proximity of people to the urban centre of
Espanola. More than half of the population lives there and those in the District have less than 40 km to
travel to get there. However for those without transportation this can still pose great difficulties for
receiving services. There are agencies co-existing within Espanola in space that is not meeting their
needs. There are others who are interested in co-locating if an appropriate space could be found.
26
Children’s Services in the LaCloche Area Depicted by Local Community
Given that LaCloche is a much smaller geographic area than Manitoulin Island or Sudbury East the
“map” produced had more in common with the Chapleau model.
Espanola is the hub of LaCloche and as such is the centre for most services including health, education,
economic and social services. Residents in the surrounding communities of Massey, Webbwood,
Baldwin Township, McKerrow, Narin Center, Sable Spanish River and Walford for the most part travel
into Espanola or to the City of Greater Sudbury given their relative proximity (60 kms) to those areas.
Participants did not discuss the continuum of integrated service delivery directly as presented. Based on
the discussion, however, it was evident that they operated from an unwritten common Vision/Mission
/Values/Principles grounded in what they described as “rural culture”.
There were many collaborative agreements but primarily these were informal understandings. Based on
the work of the CCN case managers they operated from a “no wrong door” approach. Some services are
co-located with opportunity to increase the participants in a co-located site.
Service co-ordination, again based on the work of individuals, was described closer to seamless. It was
not necessarily based, however, in connected systems planning. The following figure suggests where
LaCloche is positioned on the key elements of an integrated model.
27
Portrayal of LaCloche positioning on the Key Elements of an Integrated Children’s Services Model
Espanola. More than half of the population lives there and those in the District have less than 40 km to
1)
Based on the experience of co-location in Chapleau the LaCloche area could benefit from a
larger, more adequate and suitable space for providing children’s services. This would allow
for a review of services based on the lessons learned in Chapleau and the development of a
more formal system of integration.
2)
Consider a “common space” within such a facility that could be used by those
agencies/individuals that travel into LaCloche to provide services.
3)
Common Intake/Referral System – Case Co-ordination – examine the current system of
intake by CCN and determine if a common intake/referral system would solidify the wellfunctioning current system that would be expanded to include other than MYCS funded
services – i.e. Health Unit services.
4)
Use of technology – perhaps better use of the technology currently available (video
conferencing) as well exploration of other possibilities – i.e. skype, telehealth resources,
other?
28
Sudbury East Roundtable
Sudbury East is the largest geographic area other than Sudbury North that was consulted on service
delivery in the Manitoulin Sudbury District. At 3225 km² it forms an irregular crescent around the City of
Greater Sudbury and includes diverse and distinct communities. Killarney on the far west corner of the
District is a relatively isolated community with a small population (505 people 2011 Census). The
communities of Markstay-Warren, Hagar, St. Charles, Noelville, Monetville, French River and Alban run
from Highway 17 in the north east around to Highway 400 in the south west along the connecting
Highways 535 and 64. The area has a total population of 6526 persons of which 690 are children
between the ages of 0 and 12. 2155 families reside in Sudbury East. There is a relatively high
proportion of first language French speakers in Sudbury East (40.4% as compared to 25% for the whole
Sudbury Manitoulin/ Greater Sudbury catchment area) with most French language speakers outside of
the community of Killarney.
The service delivery model in Sudbury East is impacted by the large geographic area that is served, its
proximity to Greater Sudbury and the expanded capacity of the service provider network that engages
cross sectoral partners from health, education and the municipalities. The Sudbury East planning model
in some ways has advanced the integrated service delivery model far beyond the capacity of children’s
service providers to incorporate a network of agencies and individuals with some capacity to deal more
holistically with families. Children serving agencies for the most part provide services from a home base
in Greater Sudbury but at the same time have designed a model that allows them to tap into the rural
culture that has become more apparent in the District.
Children’s Services in the Sudbury East Area Depicted by Local Community
Members of the Sudbury East Service Providers Network (SESPN) indicated there were very high levels
of cooperation and informal networking amongst themselves in terms of directing clients towards each
other if those services were going to help meet the client’s needs. They indicated however that there
was no shared case management and that the decision makers resided in Greater Sudbury.
29
While staff in this area have training in Triple P they indicated that there were barriers to delivering the
service and had not had much success in attracting parents to the service. Families are reluctant to
travel to other communities for services and want things available in their own community.
When presented with the integrated service model, the figure below indicates that Sudbury East
roundtable participants had a shared vision/mission but for the most part they operated on the less
integrated end of the scale.
Portrayal of Sudbury East Positioning on the Key Elements of an Integrated Children’s Services Model
cross-sectoral partners from health, education and the municipalities. The Sudbury East planning model
culture that has become more apparent in the District.
The SESPN did not so much offer suggestions for more or different ways of furthering integration in their
area but rather provide some lessons learned that might be incorporated in other areas.
1) Engaging cross disciplinary partners who are available in the area creates the conditions for a
more holistic approach to meeting family’s needs. Staff in the agencies serving families know
who to call to get needs met when they can’t do so themselves.
2) The use of available shared space in rural communities is very valuable to the delivery of
services to families.
3) Collaboration with school boards needs to become more formalized with consistent policies in
all boards for the delivery of early learning, child care and children’s services. Schools are
30
natural hubs and are present throughout rural Districts and need to be utilized as community
centres.
4) The rural culture of the Districts (smaller numbers of people, shared knowledge of available
services, “knowing each other”) often makes collaboration and coordination easier in rural
areas. When agencies employ individuals who live in the area that capacity is enhanced.
Services providers coming from larger, more urban areas do well to tap into that culture.
5) Integrated service delivery in rural areas has to respond to the unique features of the areas. The
MSDSB has been innovative and supportive of efforts by children serving agencies as well as
other service providers in ensuring families (and other individuals) are having their needs met.
As DSSAB's are unique to the north the capacity of these bodies could be reviewed to encourage
participation in the delivery mechanisms of an integrated service.
ACCESS TO INFORMATION AND SERVICES FOR FAMILIES IN NORTHERN,
RURAL AND REMOTE COMMUNITIES: LESSONS LEARNED
The community action research project provided a wealth of information in regards to the delivery of
information and services to families throughout our district. The City of Greater Sudbury itself covers a
land mass that measures 100 km from the most south westerly point to the most north easterly point.
In some pockets of this urban area rural and remote communities exist. The Districts of ManitoulinSudbury covers vast territories with significant differences in population, culture, and capacity. While
service providers are challenged to meet the needs of all of the families who reside here, significant
progress has been made. It is important to note that in the far north of Ontario, along the James Bay
Coast and throughout Northwestern Ontario, communities identified as rural and remote would differ
significantly than those referred to in this report.
Use of Innovative Technologies
All of the partners involved with the CARCIL project were pleasantly surprised to determine the extent
of the availability of and access to the internet throughout the district. There had never been a
comprehensive review of internet usage and our survey was extremely informative. We were
particularly pleased that the demographics of the respondents so closely resembled the demographics
of the communities. The response rate was sufficient to move forward confidently with the use of IT for
increasing access to information and services for all families.
The use of innovative technologies including social media has developed in the children’s sector without
any strategic planning. There has been little to no professional development and there are no
consistent policies in regards to the use of many of these mediums. Websites are developed and may
or may not have technical support in their maintenance depending upon the size of an organization and
its own internal capacity for managing IT. Some agencies have policies that actually block the use of
tools such as Facebook and Twitter. Where these tools have been used by service providers there is no
consistency in the way they are used. It appears to depend upon the skill set, risk aversion and time
allocation of the agency involved.
31
The Guidelines provided by Studio 123 (Appendix 4) in this project will provide a basis for moving
forward with the use of these medium. Standardized templates could be developed for all of the Hubs
with a discussion and decision as to the most effective tools to use. Facebook pages and/or Facebook
groups provide varying opportunities and one might be more advantageous than the other especially at
the Hub level.
Professional development should be explored through workshops or webinars to ensure that staff have
the appropriate tools and time must be allocated for staff to engage in this way. Consistency in posting
and responding is identified as important in ensuring that families can get their needs met.
The Greater Sudbury Best Start Website is extensive and inclusive. The changes made to the site on the
advice of the consultants have made it more accessible and user friendly. The calendar feature is the
most used tool on the site and provides an important venue for providing information to parents. Again
staff training and time allocation are key to ensuring that the data is updated and comprehensive to
engage users and keep them coming back. In this way the site can continue to be used to get important
messaging out to parents. The Manitoulin-Sudbury Best Start network’s web presence is relatively
limited and the IT staff at the MSDSB should use the knowledge gained in this project to increase their
online capacity.
The development and presentation of a webinar was a key feature of the CARCIL project. It was
anticipated that the use of webinar in a large geographic area would provide a mechanism to bring
expertise to parents and service providers throughout the district. In an attempt to provide both face to
face and online support many Hubs organized “movie nights” providing child care and food. Our
experience with this medium was less than satisfactory. It was difficult to engage parents for the length
of time a webinar takes. It was also difficult to find a time that suited parents for the “live” event.
However the creation of short vignettes from the webinar content that remain accessible to parents on
YouTube will ensure that this material is not lost. (As would be the case if the presentation had been a
one-time guest speaker appearance). Given the short time frame of this project we are not able to
monitor the long term impact of having the videos available however we will continue to highlight a link
to the information and monitor its uptake over the next several months. As we develop expertise in
using YouTube videos we will be able to continue to use this medium for the delivery of information to
parents via the website and Facebook pages developed.
The Greater Sudbury Best Website developed in the last round of CARCIL funding has an “ask us” feature
that encourages parents to send questions via email. The questions are routed to the most appropriate
responder in the children service sector, for instance, SDHU, Best Start Hub, Childcare etc. The number
of requests coming though this feature has remained relatively low and stable at one per week and has
not been impacted by the increased traffic to the site created via the CARCIL initiatives.
Use of technology was cited in the community consultations held in regards to the Chapleau co-location
project.
In Chapleau teleconferencing capacity had been installed but was not yet being used. There was no
consistency to the capacity for the use of technology in the rest of the Manitoulin Sudbury District. In
the review of the Sudbury North Project the consultants reviews several more sophisticated
technologies (rather the use of social media tools) that are available and or being used for service
delivery in other areas. He references a “tiered support model” being used in Australia, a client needs
32
identification tool being used by legal clinics in the US and Tele-health tools being used widely in the
delivery of health care services. Other than CIMS (Client Information Management System) that is used
by agencies delivering specialized services we found no evidence of the use of these sophisticated
technology tools. The information provided in the review of Sudbury North provides a solid basis from
which to explore the use of emerging technologies in the delivery of services to children and families in
rural and remote areas. Use of these tools will require investments in staff training and technological
equipment. It would be important to examine the use of technologies by the health care and education
system to determine if there are resources that could be shared.
Integrated Service Delivery Models
The Best Start Networks in Greater Sudbury and the Manitoulin-Sudbury Districts are engaged with and
committed to the ministry’s vision for the early year’s sector that challenges them to provide an
integrated service delivery model to children, youth and their families.
The examination of the work to date in both networks, the review of the impact of integration on
outcomes, the extensive review of the Sudbury North project in Chapleau and the detailed discussions
with the local service provider’s networks in the rural communities of Manitoulin Island, LaCloche and
Sudbury East reveals valuable information to guide next steps.
Rural communities are highly impacted by their geography, diversity, culture, and capacity. There is a
distinct sense of rural culture that came through in all of the discussions. Individuals who work in the
sector, if they are from the community, often have a familiarity with services and opportunities available
in their community. There is a flexibility present and a sense that in order to get things accomplished
one must bring all of the available resources together. People know one another and so an informal
network of collaboration and coordination often develops. In a more inclusive form – as was the case in
Sudbury East – it involves all of the potential partners available to meet a family’s needs.
From our review it is evident that co-location and integration are both beneficial to service delivery and
can provide greater access and outreach to remote and rural populations. Both have the potential to
provide the structure that allows a single point of entry for clients. Co-location is not a necessary
condition for integration, nor is it a sufficient condition for integration. Co-location can be successful (as
in the case of Chapleau) when the geography covered by the service providers is limited and can be
managed from a transportation perspective. The service provider network in LaCloche could seriously
consider a more formalized arrangement of co-location. In large geographical areas such as Manitoulin
and Sudbury East a single facility could prove challenging to the delivery of services. Integration
however can provide services in areas where population levels are too low to allow for the type of
service provider models we see in more populated areas. Providers reported that through an integrated
model there is an increase in the level of access to both services and information.
An integrated service model requires planning, coordination, buy-in from the partners, and a
community vision to be successful. Planning needs to occur at the local level, in the case of the MSDSB
this would be at the level of the local service provider networks. Local solutions require local knowledge.
While the rural culture as described contributes to this planning a difficulty that emerged in all of the
areas was the capacity of management to engage at the local level. Integrated services require the
support of management to move forward. Decision makers must be involved in the process in order to
support and manage the decisions made. There is a fine balance to be found between this support and
the freedom and flexibility that exists in the rural areas that is proving successful at meeting family’s
33
needs. Front line staff play a crucial role in the community development aspect of the planning. Their
input on who else can be brought into the network, who else might have resources is vital to the
outcomes. Likewise the input of families should play a considerable role in the planning process.
Service providers at the community level are best positioned to engage with families and ensure that
their voices are part of the planning process. There was not a lot of evidence of this involvement
through the data collection process and interestingly families in the MSDSB area actually perceived
services to be more integrated than the service providers thought they would. Work needs to be done
to formalize the engagement of families in the planning.
Integration and/or co-location can provide for cost-sharing initiatives that allow for greater levels of
service to clients. Shared staff in the Chapleau pilot is a good example. Creating a full time job with the
combined resources from agencies that may only require part time services will contribute to
recruitment and retention of qualified staff. Use of shared space contributes significantly to access to
information and services. Schools are natural Hubs in rural areas as they are the “one stop” used by
almost all families. The relationship between school boards and the Best Start Network and Hubs is
essential in the development of an integrated system. There were many excellent examples throughout
the district where schools were being well used by service providers. Hubs have become key
contributors to early year’s development. The use of schools needs to be consistent among all boards
with direction from the ministry in this regard. In the current system there are different rules,
opportunities and costs depending upon the Board and the local principal. Increased and improved use
of schools could be expanded upon as a next step in the development of integration services.
Integration and/or co-location can make it easier for families to receive help from multiple agencies if
needed. It might allow for extended or full time operating hours in small communities. An interesting
observation of the co-location facility in Chapleau, which could be evident in other shared space
arrangements, was the reported decreased stigma associated with the use of some agencies when that
agency was located in the midst of other programs or agencies.
The barriers to integration clearly differ across rural settings. In rural settings where population centers
are in relative close proximity (Chapleau, LaCloche) the issues are different from those where small
population centers are spread out over a larger area (Sudbury East, Manitoulin). Geography plays a large
role in service provision both in terms of the distances that need to be overcome and in providing
services to small populations, typically too small for a full set of local services, spread over a large area.
It became apparent throughout the process of gathering data for this project that “integration” can be
viewed very differently depending upon your role in service delivery. Universal programs such as Hubs,
Daycare, education and programs and events may not be as complex from an integration perspective as
are specialized services. Universal programs generally require registration once and cooperative and
collaborative relationships seem to be built with relative ease. Specialized services require a more
detailed intake process. They may require a referral and families may find themselves on a wait list.
The services are generally very specific in nature (i.e. speech and language therapy, occupational
therapy, special needs resourcing etc.) and most often require very specific skill sets. The operation and
delivery of these services are dependent upon the agency and mandates may differ. Agencies must be
concerned with the management of their case loads. While progress in the integration of all service
delivery is apparent from the data gathered there is a distinction from the service providers’ perspective
in regards to integration. The reality is that a continuum is ever present in the delivery of service.
34
Movement on the continuum between universal service providers and specialized service providers
needs to be happening both internally in their own fields as well as between both ends of the spectrum.
Universal
Programs
Specialized
Levels of integration
Services
In Chapleau a common intake form is used and case management is carried out by the agency that has
the most involvement with the families. In the conversations in the other communities a common
intake form was suggested by all as a valuable next step in integration. Case management in some areas
resembles the Chapleau model and in other areas is not yet developed. Formal structures for case
management are seen as another key tool.
Clear direction from the ministries involved would lead to the engagement of all of the providers as long
as that engagement came with the appropriate resources to support the work of integration. Partners
are more than willing to work together and have made significant progress in that direction.
Working at the appropriate level of integration from co-operation to full integration with a shared vision
and mission improves access to information and services delivery in rural and remote communities.
Key Recommendations to Improving Access
The research undertaken and results produced in this CARCIL project are valuable both as a mechanism
for advancing the understanding of integration from a rural and remote perspective and as individual
pieces of research that will contribute significantly to the ongoing development of integration in Greater
Sudbury and the Manitoulin-Sudbury Districts. The stand-alone pieces such as the report on the
Sudbury North “Chapleau” project, the review of community based planning models, the extensive
knowledge gained on the outcomes for children or the Guidelines to using social media all provide very
comprehensive information that will direct the next steps of integration in the Networks.
Use of Innovative Technology
1. The Best Start Networks should create strategic plans around the use of social media including
websites, Facebook, YouTube and other media that emphasize consistency, staff training, and
allocation of staff resources including the sharing of resources when possible.
2. Policies should be developed and shared that ensure social media can be used with ease and
effectiveness.
3. The Guidelines provided through this project should be used as the basis for the development of
the social media presence of the Networks to ensure that the tools are being used in an
effective manner.
35
4. Continual monitoring of sites, feedback, new opportunities and feedback should direct the
growth in the use of these tools.
5. The use of more sophisticated technology for servicing families in rural and remote areas such
as teleconferencing, the “tiered support model”, client management tools and the opportunities
provided through Tele-health services should be examined and supported with appropriate
resources if they are found to be successful in service delivery.
Use of Integrated Service Delivery Models
6. Understand integration as a continuum and clarify the desired levels of integration at both a
local and district wide level as well as in terms of universal and specialized services. For example
integration in the case management of a child and family with multiple special needs is
approached differently than in the delivery of a universal parenting program. Care must always
be taken to ensure that the right level of integration is exercised to obtain optimal results.
7. Adopt common intake mechanisms and structured case management processes throughout the
children services sector.
8. Use the key elements of an Integrated Children’s Service Model developed in the report as the
guidelines to further integration in rural and remote areas. Ensure that rural culture, differences
in geography, local knowledge, First Nation jurisdictional realities, and the provision of French
language services are used to customize efforts to move forward with integration. Provide
mechanisms for families to be incorporated in the planning process and continue to respect the
valuable role that front-line workers play. Take advantage of opportunities such as shared space
or staffing to enhance capacity in communities with smaller populations.
9. Understand that rural culture provides for and necessitates integrated service delivery. This
includes informal collaboration and a holistic approach to service provision. At the same time
rural and remote service providers require consistent managerial support at both the local and
district levels.
10. Expand the use of community schools as hubs. Consider shared space options in schools as a
focal point for parents and as a cost saving measure.
11. Ministry direction needs to be clear and supportive and must come from an inter-ministerial
perspective so that mandates are not conflicting. Integrated service delivery must be supported
with financial resources so that agencies can participate and efforts can move forward through
ongoing, dedicated support.
36
Greater Sudbury
Best Start Networks
Appendix 1
Product 1- 3: Moving to Integration
Manitoulin-Sudbury District Best Start Network
Susan J. Snelling, PhD
Social Research Consulting Inc
With assistance from
Lynne O’Farrell
Tammy Turchan
From the Social Planning Council
Thanks to all the Best Start Network members and service providers that participated in the community
Special thanks to the families that filed out the parent surveys.
Table of Contents
EXECUTIVE SUMMARY……………………………………………………………………………………………………………………………….1
PURPOSE ....................................................................................................................................................... 5
INFORMATION SOURCES ............................................................................................................................... 5
KEY RESEARCH QUESTIONS ........................................................................................................................... 6
1. Historical review of steps to advance toward service integration ......................................................... 6
2. Defining an integrated system of child and family services ................................................................... 6
3. Building an integrated services system ................................................................................................. 6
RESULTS......................................................................................................................................................... 7
Steps toward Integration............................................................................................................................... 7
Integration of Universal or Specialized Services? ................................................................................ 10
Integration from the Perspective of Families ...................................................................................... 11
Comparisons to Other Systems ........................................................................................................... 12
Enablers of Integration ................................................................................................................................ 13
Key Enablers ............................................................................................................................................ 13
Shared Planning and Vision ..................................................................................................................... 13
Local Service Provider Networks ............................................................................................................. 14
Collaboration out of Necessity ................................................................................................................ 15
Barriers to Integration ................................................................................................................................. 15
Geography ............................................................................................................................................... 15
Lack of Shared Planning........................................................................................................................... 16
Gaps at the Network Table ...................................................................................................................... 16
Challenges Associated with Triple P ........................................................................................................ 18
Differing Mandates.................................................................................................................................. 18
Lack of Resources to Support the Work of Integration ........................................................................... 19
Burden of Reporting ................................................................................................................................ 19
Ways to Reduce Barriers ............................................................................................................................. 20
Ministry Leadership ................................................................................................................................. 20
Share Successes....................................................................................................................................... 20
Components of a System for Integrated Child and Family Services ............................................................ 21
Access Strategies ......................................................................................................................................... 21
One Point of Entry ............................................................................................................................... 21
Central Registration ............................................................................................................................. 21
Transportation..................................................................................................................................... 21
Hubs and Experience with Co-Location ................................................................................................... 22
Cultural and Linguistic Diversity .............................................................................................................. 22
Technology .............................................................................................................................................. 22
Building an Integrated Services System: Difficult Discussion Topics............................................................ 23
Building Relationships with First Nations ................................................................................................ 23
Network Functions: Focus on Planning ................................................................................................... 24
Network Structures: Representation and Engagement ........................................................................... 24
CONCLUSIONS ............................................................................................................................................. 25
Appendix A: List of Manitoulin- Sudbury Districts Best Start Network Interviewees................................... 26
Appendix B: Interview Questions ................................................................................................................ 27
Appendix C: Online Survey Questions ......................................................................................................... 29
EXECUTIVE SUMMARY
PURPOSE
The purpose of this component of the Community Integration Leaders project was to 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.
Data gathering was accomplished through four methods: Focus group discussion with ManitoulinSudbury Districts Best Start Network; Key informant interviews; Online survey of stakeholders;
Document review. In addition to these information sources specific to this project, results from a parent
survey conducted for another aspect of this study are also reported where relevant.
KEY RESEARCH QUESTIONS
1. Historical review of steps to advance toward service integration
1. How does the community define integration? What stage along the integration continuum is
the community currently located? [Note: This process will also gather data on the
interconnections among children and youth services, and the results of these inquiries will be
analyzed in terms of social networks currently operating within the Network].
2. What ‘things’ are perceived to be important to move toward integration (e.g. community
champion, community vision, municipal buy-in, accountability framework, etc.)? How did the
community achieve these?
3. What is the single most important thing the community did to make significant progress
toward integration?
4. 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
1. Describe your community’s vision for integrated child and family services, including but not
limited to:
a. What strategies will be used to make it easy for families to access, or enter into, the
integrated system of services?
b. What is the role of physical hubs (co-located or geographically clustered services) in the
integrated system model?
c. How will families be seamlessly connected to different services within the integrated
system?
1
d. How will the integrated system respect and support the diverse cultural and linguistic
needs of families?
e. What are the technology requirements of the integrated system of services?
3. Building an integrated services system
1. Provide details about the three to five most difficult discussion topics for your community
planning network. For each, please describe:
a. The context through which the conversation was initiated;
b. Why the topic is perceived as being a difficult discussion (e.g. conflict between sectors or
key stakeholders, disagreement within the network about how to proceed, topic required
more discussion than anticipated, etc.);
c. The strategies used by the network to resolve the discussion; and
d. The outcome(s) of the discussion.
RESULTS
Steps toward Integration
Informants were asked to consider the Ministry definitions of the four Levels of Integration (MCYS,
Defining Integration, 2011): Awareness; Coordination; Collaboration; Integration.
Online survey respondents were most likely to say that the system was between ‘coordination’ and
‘collaboration’, with about 40% of respondents choosing this option. Another 45% felt that the system
was below this most frequent rating. Similar to the findings of the online survey, most interviewees
described a system between the coordination and collaboration stage, with some situations in which
awareness would be the best description.
Integration from the Perspective of Families
Online survey respondents were asked to represent the perspectives of families about levels of
integration. The greatest number of respondents, almost half, chose ‘coordination’, with other responses
spread across the options. Overall, responses on perspectives of families tended to be slightly lower on
the scale than the responses reflecting the agencies’ perspectives. None thought that families would
perceive a fully integrated system.
In addition to the online survey of providers, parents who use services throughout the Manitoulin and
Sudbury Districts were asked to rate the level of integration they experienced. The majority of parents
reported higher levels than providers did or that providers thought would be the experiences of parents:
almost half said the service was at collaboration, and another 25% reported integration, the highest level.
Key informants were asked how they think families experience the system level of integration. Most
respondents felt that families might experience somewhat less progress toward integration than agencies
do.
2
Enablers of Integration
Key Enablers
Online survey respondents were asked to indicate the most important enabler of progress toward
integration. The top responses, in order, were:



A planning process/accountability framework that supports partners in moving toward
integration;
Support and buy-in from partner agencies/organizations;
A community vision that is inclusive of integration.
Some similar enablers were identified by interviewees, with some different areas of emphasis:



Shared Planning and Vision;
Local Service Provider Networks;
Collaboration out of Necessity.
Barriers to Integration
Interviewees were asked to identify challenges or barriers to moving toward 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
Ways to Reduce Barriers
As interviewees identified barriers, they also described the strategies they had tried to reduce those
barriers, or what they thought might reduce the barriers they were experiencing.


Ministry Leadership
Share Successes
Components of a System for Integrated Child and Family Services
As part of this CARCILs project, a separate investigation of models of integration has been undertaken.
The full details of this exploration will not be presented here. Rather, components of an integrated
system that emerged from interviews will be described as related to questions on access, physical hubs,
cultural and linguistic diversity, and technology.
3
Access Strategies



single point of entry for families
shared registration
challenges associated with transportation
Hubs and Experience with Co-Location
Best Start hubs have been, and will continue to be, key to the vision of integrated services. Although
these sites have been very helpful at improving access and integration, there is also a sense that
outreach beyond these sites will also be necessary.
Cultural and Linguistic Diversity
The Manitoulin-Sudbury Best Start Network interviewees described an approach that combines
awareness and cultural safety training for staff, hiring to represent the community when possible,
welcoming spaces, representation of diverse cultural and linguistic groups on the Network, outreach
to those agencies that are not yet engaged, and a true spirit of partnership and willingness to learn.
There was also a note that a priority must be to serve families with the highest needs, along with the
importance of serving families with diverse cultural or linguistic needs.
Technology
Interviewees and online survey respondents felt that there had been many advances with respect to uses
of technology. Although it was acknowledged that not every family can be reached through technology,
many can, and the increasing access to smart phones and high-speed internet mean that these are viable
modalities for many families. Interviewees noted that there will always be a need for diverse approaches,
including new technologies and person-to-person interaction.
Building an Integrated Services System: Difficult Discussion Topics
Difficult discussion topics identified by interviewees included:
1. Building relationships with First Nations
2. Network Functions: Focus on Planning
3. Network Structures: Representation and Engagement
CONCLUSIONS
This project benefited from the participation of Manitoulin-Sudbury Districts Best Start Network members
and other community agencies to reflect the current state of progress toward integration, the challenges
that have been encountered, and the potential next steps. Progress is being made toward collaboration
and integration through the efforts and dedication of members, and the enthusiasm and potential for
further progress provides a solid foundation for these communities.
4
Manitoulin-Sudbury Districts Best Start Network
Community Integration Leaders Report
PURPOSE
The purpose of this component of the Community Integration Leaders project was to:


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.
INFORMATION SOURCES
Data gathering was accomplished through four methods:




Focus group discussion with Manitoulin-Sudbury Districts Best Start Network, January
2014
Key informant interviews with 18 Manitoulin Sudbury Districts Best Start Network
members across key locations, roles, and organizations (January-February 2014)
Online survey of stakeholders (February 21-March 10 2014). The survey was completed
by 51 respondents from the Manitoulin-Sudbury Districts Sudbury system, of which 24
provided complete information.
Document review of key products, strategic documents, or other sources of information
about the history and directions of the Best Start Network or network member
organizations.
In addition to these information sources specific to this project, results from a parent survey conducted
for another aspect of this study are also reported where relevant, to reflect the experiences of families
with the children and youth services system.
The research was undertaken jointly for the Manitoulin-Sudbury Districts and the City of Greater Sudbury.
Many key informants are connected with both systems and were able to speak about each Best Start
Network, or about the system across the two network areas. Readers of both reports will notice some
overlap in content, which reflects the fact that 13 out of 18 key informants spoke about both systems.
5
toward integration?
limited to:
system?
needs of families?
6
RESULTS
HISTORICAL REVIEW OF STEPS TO ADVANCE TOWARD SERVICE INTEGRATION: HOW DOES THE COMMUNITY
DEFINE INTEGRATION? AT WHAT STAGE ALONG THE INTEGRATION CONTINUUM IS THE COMMUNITY
CURRENTLY LOCATED?
Defining Integration, 2011):

Awareness
o Organizations in the community are aware of others’ programs and services but they
organize their activities based solely on their own mandate and planning processes.
o There is the potential for service gaps and/or duplication of services across organizations.

Coordination
o Organizations in the community modify their own service planning to avoid duplication or
to improve links among organizations, using their knowledge of other services or
programs.
o They maintain a master list of local agencies and refer families to other agencies as
necessary.
Collaboration
o Some, or all, organizations in the community jointly plan programs and services and
modify their own services as a result of mutual consultations and advice.
Integration
o Organizations in the community operate as a single system, under a single governance
and resource umbrella and/or memorandum of understanding that commits all partners
to clear processes for decision-making and resource allocation.
o Common values and philosophies, and common program policies and practices.
o Children and families experience seamless, timely and effective supports which are
monitored and improved through shared outcomes and continuous quality improvement.
o Some programs may have been consolidated or re-engineered.


Online survey respondents were most likely to say that the system was between ‘coordination’ and
‘collaboration’, with about 40% of respondents choosing this option (see Table 1).
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Table 1: Where along the continuum would you say the Manitoulin-Sudbury Districts system is at right
now? (n=24)
Response
Chart
Percentage
Count
1 Awareness
12.5%
3
1.5
12.5%
3
2 Coordination
20.8%
5
2.5
41.7%
10
3 Collaboration
8.3%
2
3.5
0.0%
0
4 Integration
4.2%
1
Total Responses
24
Another 45% felt that the system was below this most frequent rating. Thus, although there is no clear
consensus, it is probably fair to conclude that, in the view of survey respondents, the system is below full
collaboration.
Similar to the findings of the online survey, most interviewees described a system between the
coordination and collaboration stage, with some situations in which awareness would be the best
description. No one described a fully integrated system, other than the specific instance of Triple P.
“I feel like we vary between awareness and collaboration. I don’t feel we’ve reached
integration, and some of that is just due to project work, so we might be collaborating with
other agencies on projects, and then once those projects are finished there’s less collaboration.
I think the work that we’re doing through the Triple P initiative brings us closer to integration,
but that’s just one program.”
The specific experience of integration in Chapleau was mentioned, given the fairly recent move to
co-location of several services.
“You know, one example might be the integration work that happened up in Chapleau, several
agencies co-locating, I would say that’s closer to the integration, and while there’s still behind
the scenes stuff that has to evolve, at least from the client’s perspective the physical location
encompasses all of those agencies, and I think as they evolve what happens behind the doors,
the client won’t even really see that anymore.”
There are two levels at which progress toward integration could be happening: the local level and the
District level. It appears that collaboration is happening in local communities in some instances, but
collaboration across the entire District area is considered to be less advanced. For some respondents,
collaboration or integration across the Districts is unlikely and may not be a valuable goal, given the vast
differences between communities and the distances between them. Although the Manitoulin-Sudbury
8
Best Start Network, which operates at the District level, was the focal point for this investigation of levels
of integration, interviewees who work in local areas of the Districts were also likely to talk about levels of
integration at the local level and to speak about the local service provider networks that operate in each
area. Interviewees whose connection is largely to the Best Start Network and to the Districts as a whole,
rather than to the local services, were less likely to refer to the local service providers network, but still
noted differences between each community.
“I think we’re back at awareness and coordination, in terms of the network. Within the
communities itself, I think there’s a little bit more coordination at some of the local tables, and
that’s really what we’re looking at, is what’s happening on the ground at the actual community
level.”
“If you’re actually looking at the DSSAB area, from Chapleau to Manitoulin, we’re not even
close to even coordinating anything. I don’t know if we’ll ever get to, between the four areas,
to integration. It’ll be tough, just because of the geographical area.”
“It’s harder to bring all of the appropriate partners because the region is just not set up as
easily defined, and some of the partners, in terms of identifying who the partners are, took a
little bit longer, because of the challenges and understanding, not everyone at the network
serves each of the parts of the DSSAB. …It’s easier to become siloed, because it’s clear there’s
Manitoulin, there’s Lacloche, there’s Sudbury East, and there’s Chapleau, and although they
share some of the same needs, they don’t share all of the same needs.”
The majority of respondents found it difficult to assess the levels of integration for the Districts because
of the variability by region. Further discussions related to integration would benefit from clarity around
the focus of integration efforts: the local level or the District level. Certainly, there is a relationship
between local and District levels, but progress toward integration at the local level will not necessarily
further integration between local areas or at the District level. It may be useful to reflect on the Sudbury
example of neighbourhood teams and the parallels to local service provider networks. Although there
are some meaningful differences, including the fact that local networks in some cases preceded the Best
Start Network, the neighbourhood teams and the local networks have in common that they are tied to a
relatively small geography and may involve partners that are not participants at the Best Start Network.
The specific meaning of integration, or the important features of integration, came into play as
interviewees answered. Many interviewees commented that it depends on the scope of services that are
considered as part of the system. People obviously answer given the scope of services they are most
familiar with, and so the responses vary because respondents’ frames of reference vary.
“Collaboration, integration, I guess from my perspective it depends on what scope of services
you’re looking at. So if you were talking about it sort of from education and childcare and hubs,
that’s one thing, and if you’re looking at it broader to the whole of children’s services, it would
be something else.”
Triple P was sometimes cited as an example of work that is integrated, or is approaching integration.
There are leaders from more than one agency at each seminar and group, and the planning and decisionmaking is done jointly. There is not, and cannot be, single ownership of Triple P because it is a
9
community-based model that transcends any single agency. However, Triple P has encountered some
challenges in the District areas (described elsewhere), so even this experience of integration is not
without limitations in the Districts.
Integration of Universal or Specialized Services?
Some interviewees articulated a distinction in what they would see as the types of child and family
services that would benefit from progress toward integration. Some felt that it was most important for
specialized services to be working in an integrated way for the benefit of families. They were less
concerned about integration across universal services. It may be that integration of universal services,
such as hubs, appears less important in the Districts because it is less likely that a family will access more
than one hub, given the distances between them. This is different from the situation in urban centres in
which families may access different hubs and it is important to have similarities across hubs. That is not to
say that there is no benefit to having a consistent system of hubs, but any differences between hubs may
be less obvious and less consequential in areas where families typically only interact with one hub.
Some interviewees expressed the opposite view: the possibility that the Best Start Network may be most
likely to have success in collaborations and integration across universal services. Some suggested that
specialized services should not necessarily be integrated, in the sense that the service delivery might
become blended across agencies. They still see the need for each area of expertise to maintain the
separateness of what they offer, so that families receive service from those most qualified to deliver it.
Some recalled earlier Ministry definitions of ‘fusion’, in which separations between services are
eliminated, and there is a sense that this would not be a reasonable outcome to pursue.
“I guess in my mind, I wasn’t really thinking of the hub being part of the whole streamline of
services. It’s different because parents go at their leisure. To me, the integration needs to
occur within the agencies where parents need the service.”
“We’ve got some … direct service providers providing a universal service, so their ability to
collaborate a little bit more, and do some planning together, is very different than specialized
services that only come in when there’s a need. …We provide two very distinct types of
services to the families in need, so to pull it together and jointly plan programs and services, as
you see under collaboration, and modify the type of service we provide, we can’t. …You’re not
going to see, for example, changes necessarily to the way that children’s mental health
services, or preschool speech and language services, or healthy babies services, are actually
run, through the Best Start initiative.”
It appears that a significant part of what has been achieved is that some outward-facing aspects of the
system appear integrated. From the perspective of many interviewees, the fact that parents and families
who would not know who delivers what services is important evidence of a system that is collaborative or
integrated.
“We’ve had a [project] committee, and there were some members from various sectors sitting
on it, and we had some projects which were very collaborative and integrated, and came up
with a product where I would say the customer wouldn’t really know who developed it.”
10
“We have different departments, and you know, different ministries, different funding, but yet
clients don’t have any clue about all that. ….I definitely think that’s what is important, because
if you’re a client, you want something seamless, and something that’s hassle free. So I think if
we do that well in the system in general, then clients will think it’s positive.”
integration. The greatest number of respondents, almost half, chose ‘coordination’, with other responses
spread across the options. Overall, responses on perspectives of families tended to be slightly lower on
the scale than the responses reflecting the agencies’ perspectives. None thought that families would
perceive a fully integrated system (see Table 2).
In additional to the online survey of providers, parents who use services throughout the Manitoulin and
Sudbury Districts were asked to rate the level of integration they experienced. The majority of parents
reported higher levels than providers did or that providers thought would be the experiences of parents:
almost half said the service was at collaboration, and another 25% reported integration, the highest level.
Table 2: Thinking about the system of child and youth services from the perspective of the families you
serve, where along the continuum would they say the system in Manitoulin-Sudbury Districts is at right
now? (n=22)
Response
Chart
Percentage
Count
1 Awareness
13.6%
3
1.5
4.5%
1
2 Coordination
45.5%
10
2.5
22.7%
5
3 Collaboration
9.1%
2
3.5
4.5%
1
4 Integration
0.0%
0
Total Responses
22
Key informants were asked how they think families experience the system level of integration. Most
do. It seems that although there are some good examples of collaboration, for families looking to access
services across the spectrum, providers feel that there are still aspects of the system that could be
confusing for families, especially those needing to access multiple services or who are new to the system.
11
“I would suspect that they get confused. We’re probably clearer in our own minds of where
we’re at than they perceive us to be.”
“I believe that families who are currently involved with services, or choose to be informed
persons about services in our community, would select collaboration, but at the same time, in
my experience, it leads me to think that many families would have an awareness of the
existence of services in the community, but maybe don’t choose to know more about them
because they either don’t have a need, or they don’t really care about it.”
“The people in the [school-based] program made it feel very seamless for families. …These
families who come to the school typically would not have some identified needs, they might
just come to spend the morning with their children, engage with other families. From a more
specialized perspective, I’m not sure those families might consider it seamless, because I think
they’re still doing a lot of knocking. You know, not sure where to go.”
Several respondents also mentioned that they had less certainty about the experiences of families, and
were lacking this kind of information.
“I still don’t think we’ve landed on a really good tool that gives us the feedback we’re looking
for, … so I honestly don’t know what a family [would say].”
Comparisons to Other Systems
In asking interviewees to think about integration of “the system”, they sometimes drew comparisons
across systems, especially for interviewees who are involved in both the Greater Sudbury and ManitoulinSudbury Districts systems. Revealingly, there is no consensus on which system is further along toward
integration, which suggests that the markers of integration are being defined differently by different
respondents. For some, because the Greater Sudbury system involves a larger number of players, the
system is by definition less integrated. Additionally, at least for Best Start Hubs, there is a level playing
field of funding in Manitoulin-Sudbury which paves the way for easier collaboration than is the case in the
City of Greater Sudbury. For others, the Greater Sudbury system is more advanced because the planning
and system changes that have been accomplished are more far-reaching. Thus, what is considered to be
important in defining integration varies, and so then do the judgements of which system is further along
toward integration. It is also worth noting that shared geography is considered by some respondents to
be an enabler of integration, at least at the community level (e.g., Lacloche, Chapleau) whereas for
others, the sheer size of the geography across the districts is a challenge.
“In my mind I think of them almost in the opposite ways. In the city we’ve done a good job at
the kind of management, leadership level, and now we’re just moving into the neighbourhood
level, whereas in the Sudbury-Manitoulin District they’ve already done a good job at the
neighbourhood level, and we translate that into creating the leadership level that supports
that.”
“I would say we’re moving along on the collaboration piece as well. We may not be as far
ahead as Sudbury is, and I think a key factor might have been the geography in the DSSAB,
that’s been a bit of a challenge for agencies to try and do that collaboration.”
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“It is much easier to make things happen in the district than it is in the city, so although the city
feels a lot more collaborative, we… take a long time to make things happen. In the district, they
tend to talk a little bit, but move things along fairly quickly because there are less people
involved.”
WHAT ‘THINGS’ ARE PERCEIVED TO BE IMPORTANT TO MOVE TOWARD INTEGRATION (E.G. COMMUNITY
CHAMPION, COMMUNITY VISION , MUNICIPAL BUY -IN, ACCOUNTABILITY FRAMEWORK, ETC.)? HOW DID THE
COMMUNITY ACHIEVE THESE? WHAT IS THE SINGLE MOST IMPORTANT THING THE COMMUNITY DID TO MAKE
SIGNIFICANT PROGRESS TOWARD INTEGRATION?
Key Enablers
integration, as shown in Table 3 below. The top responses, in order, were: A planning
process/accountability framework that supports partners in moving toward integration; Support and buyin from partner agencies/organizations; A community vision that is inclusive of integration.
Table 3: In your opinion, what has been the most significant factor in moving towards integration in
Manitoulin-Sudbury Districts?
Response
Chart
Percentage
Count
Strong community champion or champions for the
integration of services/supports.
9.5%
2
23.8%
5
Support and buy-in from the municipality(ies) for the
4.8%
1
Support and buy-in from partner
agencies/organizations.
28.6%
6
A planning process/accountability framework that
supports partners in moving toward integration.
33.3%
7
Total Responses
21
Shared Planning and Vision
Several aspects of a shared planning process that should be pursued more completely were mentioned by
key informants, including a shared vision, a results-based accountability framework, and terms of
reference that would outline vision, mission and mandates.
13
“A terms of reference is a good idea, because I think that we all need to be moving toward the
same goal, and have …a vision, a mission, a mandate. Even though the mandates may be
different within different ministries, I think people underneath the same roof need to
understand each other’s mandates, because without understanding each other’s mandates,
then how could you work together?”
“We’re planning more, … and I thought ‘this is exciting now, this is why we came to those
tables, is to do that planning, looking forward’, and that’s exciting, things like that where we’re
not just running around in circles. I think we’re getting there, it’s slowly getting there.”
“I think these are steps toward an overall vision that we can all share, and obviously there’s
going to be differences for different communities, but an overall vision is necessary to guide
planning.”
Integration is a key area of focus for the Manitoulin-Sudbury Best Start Network. The Network Terms of
Reference outlines the following scope:
Best Start will create a comprehensive integrated system of services that supports and engages
families with children including children with special needs. The scope of the initiative is
intended to be as broad as possible, covering the spectrum of health, education, social
supports and children’s services respectful of the Ministry’s School’s First policy. Essential
elements in the integration of services for the Districts of Manitoulin and Sudbury include
building equity of access to a service system that responds to the uniqueness and geographic
realities of its various communities; and a community based and driven service system that
builds on its capacity, is flexible, economically sustainable, community responsive, effective and
accountable.
Additional work to define a shared vision and revise other aspects of the terms of reference were
identified as positive next steps in progress toward integration.
Local Service Provider Networks
As noted in the earlier discussion of levels of integration, the interviewees identified development at a
local level as being important. The Local Service Provider Networks were seen by some as important
enablers of integration. Some felt that the tables, although important, were not living up to their
potential since the focus continues to be on information sharing rather than shared planning.
“Each community is going to feel a little bit different, and I find that by the nature of their
geography, you really get a sense of that more so from the DSSAB than you would with the
hubs in the Sudbury area. So in Chapleau it’s working in one way, and in Sudbury East it’s
working in another way, and on Manitoulin it’s in this way, and Lacloche, right. So I think that
their champions there are the local service providers. They go out and they connect.”
“I was impressed with the local service providers network, watching what’s going on now with
the DSSAB at the level of bringing in First Nations, and the integration piece there. They’ve got
some cooperation and some cohesiveness, and they’ve got some relationship going on that’s
just great, just to sit back and watch grow. The DSSAB is one of those sort of situations where
14
there’s not that many organizations, as a primary organization, they are the same people and
they work hard together to make things work.”
“I’m a real advocate for our local children’s service provider network. I feel that that was the
beginning stage of partners coming together, finding out what each other offers. I think that’s
hugely important that we know what each other offers in the community. We often have
common clientele and it makes the most sense when we can share our resources and
information, and often staff, for different things.”
Collaboration out of Necessity
To some extent, partners in the Districts feel that they have no choice but to collaborate because
their communities are so small. There is no way to avoid other agencies within small communities,
or, thinking across the Districts as a whole, because their agencies are thin on the ground, they
partner because the work could not get done across their areas if they did not.
“You don’t have a choice to collaborate in the district, so it changes everything. And there’s
not enough funding. Some of these places can’t survive on their own little amounts, so they
have to partner.”
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 ?
Geography
The large geography of the Manitoulin and Sudbury Districts, coupled with the small population numbers,
create a practical and resource challenge for services in the District. Often, funding is such that there is
one worker, perhaps working less than full-time hours, covering an immense geography. Providers are
dedicated to delivering service where it is needed, but given the pressures of geography and limited
resources, integration may take a back seat. Transportation is also a challenge for the Districts, such that
services provided in one location may not be accessible to all families because the families have no way of
getting there.
“I guess the standard one that you’ll probably hear from everybody in the district is the
geography. Even as far as our planning, when we’re sitting at the Best Start network we’re
planning for a very large district that some of us have maybe never even been in the
communities that we’re planning for, that’s difficult, and that’s where we realize that we need
the support of the local tables. It’s helpful at the Best Start level that we have hub leads from
each of those four communities attending fairly regularly, so that gives the table a true picture
of what’s going on in the communities.”
“I don’t think it would ever work to completely integrate them [the four communities in the
Districts], especially in terms of planning, because the needs are different. We could almost
have areas within those areas, they vary so much. So if this network was ever to integrate too
deeply, then I would fear the outcomes as far as what’s being lost at the local level. Because
15
even breaking our area into four distinct geographies is questionable, when you start to look at
the little differences even within those.”
Lack of Shared Planning
Although some shared planning is happening, and has been seen to be positive for the network, there are
also barriers to planning well together. This may be due to lack of time, not the right people at the table,
or lack of sustained emphasis on planning. There has been a move to more emphasis on planning
recently, but the planning framework and expectations of network members are not yet clearly
established. There is a recognition that such an undertaking will require more time, either at meetings, or
by some individuals to take on pieces of work outside of meetings.
“But we don’t plan, we’re not, and I think the main reason that we’re not planning is it’s a table
made up of frontline workers. So we’re sharing information, each of the agencies is very
different, the staff have very different levels of autonomy. So as we were moving toward
turning these tables into planning tables, I had really hoped that we would somehow be able to
involve managers from the organizations as well, even if it was once a year.”
“I think if we were to establish a solid work plan that came out of a planning day. We’ve had a
couple of opportunities for planning, but then we never refer back to the plan, and that
happens in agencies all the time, you do strategic planning, and then you never really look at it
again. I know within our agency, this last round of strategic planning that we did, we have the
plan on our desk, it’s a one pager for each of the programs, whenever we’re making a decision
we try to determine where it fits in that plan, it doesn’t mean it wouldn’t happen, but we’re
consciously thinking about what we committed to do over the next three years. I think that if
we were thinking in that way at the network level, we might feel more productive.”
“A lack of a planning process. If we could sit down and plan for the year, so that we know
what’s coming up, and we can identify what month, because we’re only meeting monthly, so if
a month goes by, or two months, and then it extends into three months, we’ve got a very large
part of the year that’s already passed, and we haven’t done anything. So I think that we should
do some planning at the beginning of the year, set aside the time. If you need to have extra
meetings in between, then that’s what we need to do if we really want to see this move
forward.”
It is widely acknowledged that not all agencies involved with children and families are participants at
the Best Start Network table, probably for a variety of reasons. Although the consistent participants
have made progress toward integration, the gaps in coverage mean that there are aspects of
integration that are not possible without broader representation. Another aspect of membership at
the Network table is that the person who sits at the network is not always someone in a decisionmaking capacity for their agency, and that also has implications for progress toward integration. It is
particularly challenging to have decision-maker representation at the District table, because very
few agencies have executive directors or managers in the Districts. Some do make an effort to
16
attend the District meetings but there are additional challenges that are not experienced for
Networks in urban areas where the leads are all situated there.
Having the right agencies, and the decision-making members of those agencies, represented at the
planning tables is critical to being able to move toward integration:
“We have the intent of having the right agencies at the Best Start Network. Now, whether
there’s a body there or not, for example, the school boards are not all represented, but what
we can get is as good as we can get.… I think that a lot of those agencies that are at the table
are not integrated agencies either, so for them to try to buy-in to an integrated model, you may
see some reluctance there, because they themselves are not integrated per se.”
“I think we’re limited in our ability to move forward because we have many service providers in
our community that still don’t see the need to participate with each other, whether it’s a
formalized partnership or just being aware of what the services are out there, and I think that
definitely is a gap in our community, because it overall affects what we offer to clientele.”
“One of the really important elements of building integrated models is that relationship
building is key, and you can’t just take it for granted, and you can’t hope it stays the same, you
have to actually plan for people changing, and who gets introduced to who, and how do you
rebuild those relationships, and I think it’s something that happens kind of organically, but we
have to start paying much more attention to it, because you’re going to want to maintain that
relationship, so who is the person that you’re going to have to get to know, and how do you
build that. I think it’s an important piece.”
In particular, it was noted that First Nations are not well represented at the table, although for full
integration of services, it would be important to have mechanisms for consultation and relationship
building with First Nations. Some steps have been taken in this direction, but it was acknowledged that
the relationships require ongoing investment. The development of an aboriginal advisory committee,
with representation from each of the four areas, to provide insight and to partner as appropriate, is
thought to be a positive initiative that is currently underway.
It was also noted that First Nations have done a lot of work to establish their own services and
approaches to providing their own programs, so the goal may not be integration of all services.
Appropriate partnerships and sustained relationships, on the other hand, are clearly beneficial for
everyone.
“I think it’s important to remember that the end goal is not complete integration of every single
thing, it’s a continuum, and I think it’s being as far along the continuum that it makes sense to
be. I think one of the things this table did that was a huge step was to take those planning
dollars and say to the aboriginal community here, you spend this money, I thought that was a
very big step that the table took, and they’re starting to lay the groundwork for what needs to
happen.”
17
“We’ve received some more funding to work more with First Nations. Those relationships have
been slow moving, but again, there’s a lot of will to move forward. We trip over our feet a little
bit too, but that’s all part of the process.”
Challenges Associated with Triple P
Although Triple P is an integrated approach that interviewees recognized as valuable, Triple P has been
more difficult to get off the ground in some District areas than has been the case in Sudbury. Part of the
reason it has been more challenging is that parents are less likely to attend events because there is
stigma in small communities associated with seeking help.
“The reason for that, which I’m told by our frontline staff who actually live and work in those
communities, is that stigma of ‘everyone knows each other’. …We’re really going to be working
towards eliminating that stigma, and normalizing parenting, that it’s okay for you to come to
these things, and to get support, but I think that’s why it hasn’t been so successful in the
outlying communities.”
Differing Mandates
A significant barrier to progress toward integration is differing mandates. With the number of agencies
around the table, and the number of funders and accountability structures, there are some very real
barriers to setting mandates aside and doing what serves the community vision. As interviewees
described, at the end of the day, they are accountable for their meeting their mandates, not for being
part of an integrated system. They were quick to say that this is not cut and dried; there are ways to work
around mandates and to approach funders with a different idea, but they have frequently encountered
contradictory lines of accountability that could not be ignored. It was also noted that, until partners
become completely comfortable with integration as a goal, that they can sometimes retreat back to
individual mandates and accountabilities to move away from the extensive changes integration would
involve.
In further exploration of the issues associated with mandates, other related issues, such as fear and
uncertainty, emerged. Much of this discussion was in the context of wanting to move to the best possible
system, and recognizing that integration is a valued goal, but also acknowledging that there are many
uncertainties about what the future holds and whether the way forward is clear. With those uncertainties
comes fear. As noted by several interviewees, these responses are normal and to be expected – and the
remedy is open communication and shared decision-making around the way forward and the implications
of possible changes. A related aspect of agency mandates is the need to be cognizant of union
requirements and collective agreements, which also create limitations on what roles and responsibilities
can be shared, changed, or re-engineered.
“I think that people can actually feel threatened by the word integration, especially with all this
talk over the last couple years now about integrating children and family services, …I think
people can feel threatened, because if you think this is all moving towards everything under
one agency or something, that’s going to make agencies feel a little bit threatened, about their
space, about their jobs, about what they do.”
18
“The union can definitely be an issue, because we have had to work with our union, and have
had to ensure that jobs weren’t taken away, and when you’re integrating, you’re obviously
reassigning duties, you’re creating new positions, new job descriptions, so it might change
some jobs.”
Lack of Resources to Support the Work of Integration
Interviewees reported that they lack resources to contribute to the work of integration, in terms of
infrastructure support, time to spend on initiatives, and funding to support shared initiatives and the
process of building together. Interviewees were aware of the full-time coordinator position in Sudbury
that enables that Network to progress more quickly with integration initiatives, and it appears that such
an option is not feasible with the funding the District Best Start Network has.
“Even with our Chapleau project, we had some consultant support, helping us, organize our
meetings, keeping us moving, and when the project ends, that ends. So unless you were
successful in the course of the project, in cultivating champions and local leaders to carry it… I
would have to say after it ended with Chapleau, we really hadn’t got back on to it in the same
degree. The managers are still meeting. The staff are now moving to having regular meetings,
but I think we’ve got more work to do, and it’s harder to do as an add-on.”
“If we really, truly wanted to move on some of the initiatives that the table has talked about,
then we would have somebody working on this stuff full-time. We would, but we just can’t
afford it.”
“I sit at a thousand tables, and I can tell you that the ones where the work moves forward are
the ones where it’s somebody’s job to make the work move forward, because people come
with the best of intentions and they want good things to happen, but when we all go back to
our desks and start to do our day jobs, … we just think that stuff will happen, and my
experience has certainly been that it doesn’t.”
An aspect related to lack of resources is workload, including travel across the District areas that can be a
barrier to doing the work involved with integration. There is a certain level of frustration about the slow
progress toward working in an integrated way, because there are so many other competing priorities.
“Looking at when we did this activity [research on integration], what was it, two years ago, I’m
pretty sure we’re at about the same place we were two years ago. Even though we’re talking
more about it, and we’re moving towards it, we’ve had a lot of tasks that have come up in the
past two years, like that template that we worked forever on, and we’re always the seat of our
pants … working on those deadlines and these templates, that we don’t have goals for this
network set up yet. So there’s so much more work to do with this network before we get
there, because I think two years ago we were about the same place.”
Burden of Reporting
An aspect related to resources and competing priorities is the reporting required by funders. There was a
sense that it was becoming increasingly difficult to find the time to do the work of integration, which,
among other things, requires time to meet, build relationships, and plan.
19
“I think another thing that we would hope the ministry would aspire to is some sort of common
reporting. Our workers are tasked with so much administration that we don’t get to do the
frontline work that we’d love to do, because of the excessive reporting. So if at some point,
way down the road, there could be a vision of some sort of common reporting system between
integrated agencies, that would be good.”
Ministry Leadership
Lack of Ministry direction was identified as a barrier to integration, but interviewees also identified
specific ways in which Ministries could play a role in furthering progress. One strategy was simply to
provide incentives for movement toward integration. Ensuring that integration conversations continue to
happen at all levels of the system, including Ministry-led tables, was another strategy. There was
recognition that although the Ministry could move integration along by mandating it, that would not be
the best way to proceed, given that so much of integration relies on buy-in and implementation of a
consensus vision. This kind of shared movement is not easily achieved, and although Ministry leverage
and leadership would be helpful, community partners also need to identify the value in integration for
themselves in order to ensure their true and sustainable participation. Clearly, Ministry leadership and
direction is valued and needed, not to the exclusion of community-directed leadership, but as a support
and adjunct, to break down some intransigent barriers.
“I think it would be great, in a perfect world, is that immediately a clear communication from
the ministry, and their expectations, and their collection of statistics, would be really important,
and that they’re consistent for the long term, they have the long term plan. They’re not just
going to drop things in the community and say do something, and then a year later they change
it. …. And I think too, when we’re looking at the ministry expectations, they should include a
flexibility for each community as well, and each agency, to build on people’s strengths.”
Share Successes
To address the barriers of incomplete participation in the Best Start Network, it was suggested that the
value of the successes of the collaborations should be shared and promoted. The move toward resultsbased accountability, in which community-level goals are shared and progress toward them is reported
on, were part of the thinking about how to promote the good work being done as an integrated system.
“I think that we have to get better at talking about the outcomes and why things are better.
…So I think it’s a combination of that, of continuing to build the relationships and flaunting our
successes and saying look, this really works.”
20
WHAT STRATEGIES WILL BE USED TO MAKE IT EASY FOR FAMILIES TO ACCESS, OR ENTER INTO, THE
INTEGRATED SYSTEM OF SERVICES ? HOW WILL FAMILIES BE SEAMLESSLY CONNECTED TO DIFFERENT SERVICES
WITHIN THE INTEGRATED SYSTEM?
Access Strategies
One Point of Entry
There is a sense that having a single point of entry for families would be helpful in many cases. It
was also noted, however, that a single point of entry does not necessarily mean that all services are
located under one physical roof. There is greater comfort with the idea that there would be multiple
ways to enter the system, and that wherever a family may enter, that will be the door to other
services. There is less reliance on the idea of one physical location, although that option may make
sense in some settings where travel distance is less of a challenge.
“I think it’s easiest connecting families to different services seamlessly within the system when
we have one entry point. It causes a lot less confusion for them, and then when the community
partners are aware of the system existing, and the referral processes that are involved, that
again comes back to being aware of what each other does, and whose role is responsible, so I
think initially it’s that gatekeeper for services and then they can redirect within the system
where they need to be sent to.”
Central Registration
The experience with a shared registration for Triple P has been positive. Interviewees and survey
respondents highlighted the value in continuing to work toward centralized registrations and information
sharing, so that as families enter the system, they are not having to repeat their stories. From the family
perspective, once they enter the system and tell their story once, there should be no need to start over
with someone else.
Transportation
Many informants described the challenges associated with transportation to programs. These challenges
are not easily overcome, especially in rural areas. However, placement of programs in schools, which are
located in communities, and local program development, such as is being developed with neighbourhood
teams, are strategies to mitigate the transportation challenges.
“It’s difficult for families to access programming sometimes. It doesn’t matter how integrated
your program is if you’re at home and you can’t get to it.”
21
WHAT IS THE ROLE OF PHYSICAL HUBS (CO-LOCATED OR GEOGRAPHICALLY CLUSTERED SERVICES) IN THE INTEGRATED
SYSTEM MODEL?
Best Start hubs have been, and will continue to be, key to the vision of integrated services. These are
locations in which core services are available, and in which families can be connected to specialized
services as needed. The trust that is established with users of the hub creates an opportunity to
offer other connections. There was also a sense that too much focus on a ‘one-stop, one-site’
approach may not be without limitations. Although these sites have been very helpful at improving
access and integration, there is also a sense that outreach beyond these sites will also be necessary.
“In terms of integration, people forget that there’s physical integration and then there’s
systemic integration, and obviously the geography we cover, it’s 45,000 square kilometres.
You’re not going to put up one super-building in the centre of 45,000 square kilometres and
have everybody come, it’s just not realistic.”
HOW WILL THE INTEGRATED SYSTEM RESPECT AND SUPPORT THE DIVERSE CULTURAL AND LINGUISTIC NEEDS OF
FAMILIES ?
The Manitoulin-Sudbury Best Start Network interviewees described an approach that combines
awareness and cultural safety training for staff, hiring to represent the community when possible,
welcoming spaces, representation of diverse cultural and linguistic groups on the Network, outreach
to those agencies that are not yet engaged, and a true spirit of partnership and willingness to learn.
There was also a note that a priority must be to serve families with the highest needs, along with the
importance of serving families with diverse cultural or linguistic needs.
Technology
WHAT ARE THE TECHNOLOGY REQUIREMENTS OF THE INTEGRATED SYSTEM OF SERVICES ?
of technology. The Best Start website, for one, is a use of Internet to make information easily available to
families. Other potential and growing uses of technology include social media, and making internet
access and computers available at hub sites. Although it was acknowledged that not every family can be
reached through technology, many can, and the increasing access to smart phones and high-speed
internet mean that these are viable modalities for many families. Interviewees noted that there will
always be a need for diverse approaches, including new technologies and person-to-person interaction.
“If we were to have a website, or use Facebook, or some sort of electronic method for people
to one-stop shop.”
“We wouldn’t want to miss the most vulnerable of our families that don’t have access to a
phone or technology at all. So yes, it does play a role, but it’s not the end all role.”
“I like seeing that we’re moving towards some of the videos for helping families who are maybe
a bit more isolated, and watching parenting videos from home, I like that concept. Possibly the
22
technology to be used for record keeping, so like in Sudbury with the CIMS card, if we had
something similar that would save time, and they just swipe, and then you’ve got their
information, and you’ve got more time to be spending with families rather than tracking stats.”
“I know they’re trying with CIMS to have a one record system. I know Children’s Aid, Children’s
Mental Health is using it, and central access is using it, hubs are using it to a certain degree, but
because of privacy issues, we’re sort of on a separate continuum, so that if I have a child in a
hub, and I want to make a referral, they should be able to access that information, it should be
there, people shouldn’t have to tell their story five million times. I think having an automated
system would certainly help, it’s one of the things, there’s a lot of things, but I think that would
be one of the things.”
PROVIDE DETAILS ABOUT THE THREE TO FIVE MOST DIFFICULT DISCUSSION TOPICS FOR YOUR COMMUNITY PLANNING
NETWORK . FOR EACH, PLEASE DESCRIBE:




THE CONTEXT THROUGH WHICH THE CONVERSATION WAS INITIATED;
WHY THE TOPIC IS PERCEIVED AS BEING A DIFFICULT DISCUSSION (E.G. CONFLICT BETWEEN SECTORS OR KEY
STAKEHOLDERS , DISAGREEMENT WITHIN THE NETWORK ABOUT HOW TO PROCEED , TOPIC REQUIRED MORE
DISCUSSION THAN ANTICIPATED, ETC.);
THE STRATEGIES USED BY THE NETWORK TO RESOLVE THE DISCUSSION; AND
THE OUTCOME(S) OF THE DISCUSSION.
1. Building relationships with First Nations
2. Network Functions: Focus on Planning
3. Network Structures: Representation and Engagement
Building Relationships with First Nations
The Manitoulin-Sudbury Best Start Network covers Districts in which there are several First Nations as
well as many First Nations families living off reserve. There have been ongoing partnerships between
First Nations and non-native agencies, many of these with the local providers rather than with the
Network per se. The Network has also made attempts to connect with First Nations and agency
representatives, and there has been recent participation at the Network table from Kenjgewin Teg
Educational Institute (KTEI). Interviewees continue to feel that there is more to do in building
relationships with First Nations, and also struggle with the best and most meaningful ways to do this. For
completeness, there would need to be relationships with all area First Nations or their representatives,
which in itself amounts to several new relationships to cultivate. There is no single First Nations
organization that represents First Nations across the Districts, and so the complexity of the task is part of
the challenge. It would certainly be possible to start with those relationships that have already begun,
but it was noted that there continue to be gaps in representation at the table.
23
There were also questions about the Best Start’s responsibility for on-reserve work: are Best Start
Network tables expected to have First Nations representatives, or this simply an option to consider?
There are aboriginal planning funds that have come to the Network, but it is not clear what expectation
there is for those funds. In the current round, those designated funds were given to KTEI to direct that
planning, which most interviewees felt was appropriate, but questions remain about the purpose of those
funds and what will be expected in future years.
It was noted that it should not be assumed that First Nations will wish to have their own on-reserve child
and family services integrated with off-reserve services. Thus, any discussions of integration, as the
Network has been having, are influenced by potential limitations as to the reach of integration initiatives.
Ultimately, area First Nations will determine when and how they will interact with the Best Start Network,
but the Network must also continue to partner as appropriate and build relationships with First Nations.
Network Functions: Focus on Planning
There was a general sense that the planning and implementation of Network activities has been slow and
often interrupted by other tasks and reporting that are required for the Network. It was also noted that
in order to successfully attract and retain people to the Best Start Network, members will have to feel
that their time is well spent when they do attend meetings. The need for travel also adds to the
responsibilities and time required for the Best Start Network members.
Many interviewees spoke of the need to plan more completely and effectively, and from that, have
an implementation approach that gives a sense of what will be discussed and accomplished at
monthly meetings. The lack of a dedicated staff person with responsibility primarily for Best Start
Network functions was seen as a barrier to a more developed planning process. Although many see
the need for more planning and implementation, there was also a sense that the way to accomplish
this is not clear, given that competing priorities limit the time that can be dedicated to Best Start.
This is in contrast to Sudbury, where there is a Best Start coordinator who takes responsibility for
some Network tasks including integration work.
There was a suggestion that EDI scores could be better used in the Districts to advance thinking about
priorities and understand trends and changes. There is a sense that these data have been used to better
effect in Sudbury, but that the same could be done in the District. However, it was also noted that the
small sample sizes for EDI data in some District communities would pose a challenge that is not present in
Sudbury.
Interviewees were hopeful about several initiatives underway including Results-Based Accountability, and
work toward a stronger vision for the Network. Greater predictability of funding for the Network, that is
anticipated to come with the transition to the Ministry of Education, is also seen as an enabling step.
Network Structures: Representation and Engagement
Another aspect of the Network that was felt to require attention is the membership. There is a core
group of attendees who attend frequently, and then others who attend sporadically, or who send
rotating members to the meetings, and still other potential partners who are not at the table. This
24
variability in membership is an impediment to building the relationships that will be key to further
progress toward integration.
Along with the questions of which agencies participate at the table, and how to secure consistent
attendance, there is the question of whether the member is in a decision-making capacity at their agency.
It is recognized that agencies are thin on the ground and that it is helpful to a certain extent to have
representation from any level of the organization, but the work of integration requires decisions on the
part of the participating agencies to deliver service in a new way, to partner in new ways, and these are
commitments that can only be made by decision-makers in their organizations.
It should also be noted that if the Network does become a consistent grouping of decision-makers, the
obligations on those members to communicate effectively to frontline staff increase, since there will not
be representation at the table from frontline. The online survey, which had responses from both
management and frontline staff, did receive input from staff that they may feel there is gap in
information flowing to them. This point is critical to the work of integration, given that integration
happens at the both the administrative levels and at the ground level when staff are interacting with
families and sharing information about what is available to them.
“Communication between service providers, communication within agencies. I think that one
of the gaps that we’ve experienced over the last few years is that the representatives sitting at
a Best Start table, for example, are typically EDs, program directors, managers, that type of
thing, so ensuring that the information that’s shared at those meetings flows down to the
frontline workers within the agencies has been a challenge over the years, with probably just
about every agency, at different times, and then that communication back up the chain as
well.”
CONCLUSIONS
This project benefited from the participation of Manitoulin-Sudbury Districts Best Start Network members
and other community agencies to reflect the current state of progress toward integration, the challenges
that have been encountered, and the potential next steps. Progress is being made toward collaboration
and integration through the efforts and dedication of members, and the enthusiasm and potential for
further progress provides a solid foundation for these communities.
25
Appendix A: List of Manitoulin- Sudbury Districts Best Start Network Interviewees
NAME
Ginger Forget
ORGANIZATION
Chapleau Child Care Centre
Sherry Fournier
Jane Bauer
Suzanne Malette
Child & Community Resources
Children’s Community Network
Conseil scolaire catholique du Nouvel
Ontario
Conseil scolaire publique du Grand
Nord de l’Ontario
Infant Development (Specialized
Services)
Manitoulin Family Resources
Sylvie Langlois
Pierrette VincentSchroeder
Lori Clark
Ray Hannah
Donna Moroso
Lina Davidson
Susan Nicholson
Stephanie Brazeau
Dan Boivin
Karen Renout
Janet Gasparini
Sue Caverson
Kathy Longarini
Sharon Spier
Manitoulin-Sudbury District Services
Board
Manitoulin-Sudbury District Services
Board
Ministry of Education
Our Children, Our Future
Preschool Speech and Language &
Infant Hearing
Social Planning Council of Sudbury
Sudbury & District Health Unit
The Rainbow District School Board
ROLE
Executive Director, LSPN Chair (Sudbury
North)
Executive Director
Executive Director, BSN Co-Chair
Directrice de la petite enfance
Agente de développement Communautaire
Supervisor
Program Director, Children's Programs,
LSPN Chair (Manitoulin)
Children’s Program Supervisor, BSN CoChair
Director of Integrated Social Services
Child Care Advisor
Executive Director
Manager of Program Services
Manager / Coordinator, North Bay
Regional Health Centre
Executive Director
Manager, HBHC
Community Outreach Coordinator
Superintendent
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Appendix B: Interview Questions
Interview Questions -- Best Start Key Informants
Thank you for participating in this interview for the Community Integration Leaders project. Your
responses are voluntary and you can stop your participation at any time. I would like to voice
record this interview, with your permission. I may use quotations from the interviews in the
report, and I would identify you as one of the key informants for this project. Is that acceptable
to you?
1. Where do you work and what is your role vis-à-vis Best Start and child and family
services?
2. How long have you been involved with Best Start? With your agency?
3. Integration from the Ministry’s perspective has four levels along a continuum (MCYS, Defining
Integration, 2011): (refer to diagram)
a. When you think about the system from the perspective of your agency or role, where
would you say the system is at right now? Why?
b. When you think about the system from the perspective of the families you serve,
where would they say the system is at right now? Why?
4. Since the inception of the Best Start Network, what has been most important in moving along the
continuum towards integration? Why? What other factors have contributed?
5. What do you consider to be the main barriers or challenges that have limited or slowed-down
progress toward integrated services?
6. What would help to eliminate or reduce these barriers or challenges?
7. What do you think will be the next important steps toward integration of services?
8. What would make it easier for families to enter the system?
9. What would make it easier to connect families to different services seamlessly within the system?
10. What would support cultural and linguistic diversity?
11. What should be the role of physical hubs (co-located or geographically clustered services) in the
12. How could technology support integration?
13. What have been some of the most difficult discussion topics for your community planning
network? For each, please describe:
b. Why the topic is perceived as being a difficult discussion
27
14. To your knowledge, in what ways has children’s healthy development been impacted by service
integration? Our framework for defining “children’s healthy development” is the EDI domains. So,
“healthy child development” means children’s physical health and well-being, their social skills and
emotional maturity, their ability to communicate their needs, understand others and their interest
in literacy and numeracy.
This might include:
a. The impact on program planning and service delivery (e.g. school readiness, family support,
nutrition, recreational programs/services)
b. Strategies to support initiatives, programs, or professional development (e.g. Triple P,
Emergent Literacy)
15. From your experience, in what ways has service integration impacted the early identification of
children with special needs?
This might include:
a. The impact on planning (e.g. screening plans, transition to school plans)
b. The community's capacity to deliver screening
c. Wait-list and service delivery impacts
d. Any other impacts not mentioned
16. From your perspective, in what ways has the service system responded or made system changes
in relation to identified needs?
This might include:
a. Client or community needs (e.g. accessibility, targeted services)
b. Service delivery (e.g. inclusive, supportive or seamless)
c. Staff (e.g. professional development or training)
d. Network (e.g. communication or planning)
17. To what extent do you feel it would be valuable for there to be greater integration between
Greater Sudbury and Manitoulin-Sudbury districts?
18. What would be your advice to someone from another community that wanted to move toward a
more integrated system of child and family services?
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Appendix C: Online Survey Questions
We are seeking the input of Best Start Network member agencies through this online survey. The survey
can be completed by anyone who works in child and youth services in any capacity. We expect the survey
may take you up to 15 minutes, or up to 30 minutes if you answer for both City of Greater Sudbury and
Manitoulin-Sudbury Districts. You can save the survey and return to it later, if you save the link the survey
provides when you press "save and continue later". The survey will be open until Friday March 7.
Background: Community Action Research - Community Integration Leaders (CAR-CILs) project funding has
been provided by the Ministry of Child and Youth Services to promote and support ongoing efforts
towards the creation of an integrated system of child and youth services in the Manitoulin-Sudbury and
City of Greater Sudbury Best Start Networks.
Purpose: This component of the Community Integration Leaders project is to document ways
that communities have made successful advances toward integration, and document the on-going work
of these communities as they continue to progress toward integration.
YOUR ROLE
Your organization name:
Would you describe your role as:
Front line staff
Management
Administrative staff
Other, please specify... ______________________
Do you have knowledge of child and youth services in: (Check all that apply: If you check both, you will do a
separate survey for each region)
Greater Sudbury
Manitoulin-Sudbury Districts
[Questions for Greater Sudbury have been removed from this list of survey questions.]
The following questions ask you to think about the system of child and youth services in the ManitoulinSudbury Districts and the Manitoulin-Sudbury Best Start Network.
29
Awareness
Coordination
Collaboration
Integration
1
2
3
4
Organizations in
the community are
aware of others’
programs and
services but they
organize their
activities based
solely on their own
mandate and
planning processes.
There is the
potential for
service gaps and/or
duplication of
services across
organizations.
Organizations in the
community modify
their own service
planning to avoid
duplication or to
improve links among
organizations, using
their knowledge of
other services or
programs. They
maintain a master
list of local agencies
and refer families to
other agencies as
necessary.
Some, or all,
organizations in the
community jointly
plan programs and
services and modify
their own services as
a result of mutual
consultations and
advice.
Organizations in the community
operate as a single system, under
a single governance and resource
umbrella and/or memorandum of
understanding that commits all
partners to clear processes for
decision-making and resource
allocation. There are common
values and philosophies, and
common program policies and
practices. Children and families
experience seamless, timely and
effective supports which are
monitored and improved through
shared outcomes and continuous
quality improvement. Some
programs may have been
consolidated or re-engineered.
1
1.5
2
2.5
3
3.5
4
Please add any comment to explain your choice along the continuum:
30
Thinking about the system of child and youth services from the perspective of the families you serve, where
along the continuum would they say the system in Manitoulin-Sudbury Districts is at right now? Please drag
the button below to indicate your answer.
1
1.5
2
2.5
3
3.5
4
How important has each of the following factors been in moving along the continuum towards integration
of services in Manitoulin-Sudbury Districts? If a factor is not present at all, check Not Applicable.
Not very
important
Somewhat
important
Very
important
Don't
know
Not
Applicable
Strong community champion or
champions for the integration of
services/supports.
A community vision that is inclusive of
integration.
Support and buy-in from the
municipality(ies) for the integration of
services/supports.
A planning process/accountability
framework that supports partners in
moving toward integration.
In your opinion, what has been the most significant factor in moving towards integration in ManitoulinSudbury Districts? (Choose only one).
31
Strong community champion or champions for the integration of services/supports.
Support and buy-in from the municipality(ies) for the integration of services/supports.
Support and buy-in from partner agencies/organizations.
A planning process/accountability framework that supports partners in moving toward integration.
Please provide any comments about factors that have influenced progress toward integration in
Thinking about the early identification of children with special needs, how much has improved service
integration in Manitoulin-Sudbury Districts affected the system's ability to offer:
Not at
All
Slightly Somewhat Very
much
Don't
Know
a full range of information and resources
developmental assessments
18 month well baby screenings
physical assessments (i.e. dental, vision,
hearing)
speech and language services for children up
to age six
support for parents of children with special
needs
outreach services to remove barriers to access
Please make any comments about ways that early identification of children with special needs has been
affected by service integration in Manitoulin-Sudbury Districts.
Thinking about healthy child development, how much has improved service integration in ManitoulinSudbury Districts affected the system's ability to:
32
“Healthy child development” can include children’s physical health and well-being, their social skills and
emotional maturity, their ability to communicate their needs and understand others, and their interest in
literacy and numeracy.
Not at All Slightly Somewhat Very much Don't Know
plan programs and services
deliver services
offer accessible services
Please make any comments about the ways that healthy child development has been affected by improved
service integration in Manitoulin-Sudbury Districts.
Thinking about the system being responsive to changing needs, how much has improved service integration
in Manitoulin-Sudbury Districts affected the system's ability to:
Not at
All
much
Don't
Know
address family/children's needs as identified by
neighbourhood/community
provide accessible services as needed
provide inclusive services
provide seamless services
provide supportive services
provide professional development and training
engage in effective communication and knowledge
transfer
engage in cross-sectoral planning
Please make any comments about the ways that the system's responsiveness to changing needs has been
affected by improved service integration in Manitoulin-Sudbury Districts.
How have wait times at your agency been affected by improved service integration in Manitoulin-Sudbury
Districts? If your agency does not have wait times for service, check Not Applicable.
33
Increased
greatly
Increased
slightly
Not
changed
Decreased
slightly
Decreased
greatly
Don't
know
Not
applicable
Wait
times
have:
Please make any comments about ways that wait times have been impacted by service integration in
Barriers and Enablers of Integration
What do you consider to be the main barriers or challenges that have limited
or slowed-down progress toward integrated services in Manitoulin-Sudbury
Districts?
What would help to eliminate or reduce these barriers or challenges?
What do you think will be the next important steps toward integration of
services in Manitoulin-Sudbury Districts ?
Seamless, Welcoming Services
What would make it easier for families to enter the system in ManitoulinSudbury Districts?
What would make it easier to connect families to different services seamlessly
within the system in Manitoulin-Sudbury Districts?
What would support cultural and linguistic diversity in the system in
Manitoulin-Sudbury Districts?
How could technology support integration in Manitoulin-Sudbury Districts?
34
Using the continuum in the table below, please rate the level of integration demonstrated in your
organization’s relationship with the other sectors/organizations making up the in Manitoulin-Sudbury
Districts Best Start Network.
1:
Awareness
2:
Coordination
3:
Collaboration
4:
Integration
Don't
know
Not
applicable:
We don't
have a
relationship
with this
sector
Best Start Hubs
English Public (RDSB)
French Public (CSGNO)
English Catholic
(SCDSB)
French Catholic
(CSCNO)
Child Care Sector
Children’s Health Care
(may include: Sudbury
& District Health Unit;
Health Sciences North
– Family and Child
Programs; First
Nation Health
Services)
Children’s
Development Services
(may include: NEMHC;
Children’s Community
Network; Child &
Family Centre;
Sudbury Development
Services; CGS
Children’s Services)
Children’s Protection
Services (may include:
Children’s Aid
35
Services; Kina
Gbezhgomi; Haven
House; Genevra
House;)
Children’s Recreation
Services
Children’s Special
Needs Services (may
include: CCN; CCR;
Children’s Treatment
Centre; CGS Children’s
Developmental
services; Special
Needs Resource
Program; Speech and
Language)
Early Years Services
(may include: Better
Beginnings Better
Futures; Our Children
Our Future; OEYC)
Prenatal Services (may
include: HBHC;
Breastfeeding Clinics;
Centre de Sante
Communautaire;
Aboriginal Prenatal
Nutrition; CCN (Special
Needs Resource
Program)
Parenting Related
Triple P)
Family Resource
Manitoulin Family
Resources; CAP-C)
36
High levels of integration may not be necessary for the system to be effectively delivering services to
children/families. With this in mind, please rate how well your agency's current level of integration with
each sector in Manitoulin-Sudbury Districts is meeting system needs.
The system needs
are met by the
current level of
integration. No
change is needed.
The system needs
could be better met
through improved
integration. Change
would be valuable.
Not applicable:
We don't have a
relationship with
this sector
Best Start Hubs
English Catholic (SCDSB)
French Catholic (CSCNO)
Child Care Sector
Children’s Health Care (may include:
Sudbury & District Health Unit;
Health Sciences North – Family and
Child Programs; First Nation Health
Services)
Children’s Development Services
(may include: NEMHC; Children’s
Community Network; Child & Family
Centre; Sudbury Development
Services; CGS Children’s Services)
Children’s Protection Services (may
include: Children’s Aid Services; Kina
Gbezhgomi; Haven House; Genevra
House;)
Children’s Recreation Services
Children’s Special Needs Services
(may include: CCN; CCR; Children’s
Treatment Centre; CGS Children’s
Developmental services; Special
Needs Resource Program; Speech
and Language)
Early Years Services (may include:
Better Beginnings Better Futures; Our
37
Children Our Future; OEYC)
Prenatal Services (may include:
HBHC; Breastfeeding Clinics; Centre
de Sante Communautaire; Aboriginal
Prenatal Nutrition; CCN (Special
Needs Resource Program)
Parenting Related Services (may
include: Triple P)
Family Resource Services (may
include: Manitoulin Family
Resources; CAP-C)
1
April 2014
38
Greater Sudbury Best Start Network
0
Susan J. Snelling, PhD
Social Research Consulting Inc
With assistance from
Lynne O’Farrell
Tammy Turchan
From the Social Planning Council
Thanks to all the Best Start Network members and service providers that participated in the community
Special thanks to the families that filed out the parent surveys.
Table of Contents
EXECUTIVE SUMMARY……………………………………………………………………………………………………………………………….1
PURPOSE ....................................................................................................................................................... 6
INFORMATION SOURCES ............................................................................................................................... 6
KEY RESEARCH QUESTIONS ........................................................................................................................... 7
1. Historical review of steps to advance toward service integration ......................................................... 7
2. Defining an integrated system of child and family services ................................................................... 7
3. Building an integrated services system ................................................................................................. 7
RESULTS......................................................................................................................................................... 8
Steps toward Integration............................................................................................................................... 8
Integration from the Perspective of Families ...................................................................................... 12
Enablers of Integration ................................................................................................................................ 14
Key Enablers ............................................................................................................................................ 14
Shared Vision, Leadership, and Resources .............................................................................................. 15
Trust ........................................................................................................................................................ 15
Champions............................................................................................................................................... 15
Representation and Membership at the Network Table ......................................................................... 16
Embracing Change................................................................................................................................... 16
Direction from Ministry ........................................................................................................................... 17
Barriers to Integration ................................................................................................................................. 17
Lack of Ministry Direction........................................................................................................................ 17
Differing Mandates.................................................................................................................................. 18
Gaps at the Network Table ...................................................................................................................... 19
Resources to Support the Work of Integration ....................................................................................... 20
Complexity............................................................................................................................................... 21
Varying Relationships with Schools and School Boards ........................................................................... 21
Ways to Reduce Barriers ............................................................................................................................. 21
Ministry Leadership ................................................................................................................................. 21
Stretch Mandates .................................................................................................................................... 22
Share Successes....................................................................................................................................... 23
Start Small, Build, and Sustain ................................................................................................................. 23
Continue Dialogue with Schools and Schools Boards .............................................................................. 23
Progress Toward an Integrated System of Child and Family Services ......................................................... 24
Components of a System for Integrated Child and Family Services ........................................................ 27
Access Strategies ..................................................................................................................................... 27
Central Registration ............................................................................................................................. 27
Transportation..................................................................................................................................... 27
Neighbourhood Teams ........................................................................................................................ 27
Hubs and Experience with Co-Location ................................................................................................... 28
Cultural and Linguistic Diversity .............................................................................................................. 28
Technology .............................................................................................................................................. 29
Building an Integrated Services System: Difficult Discussion Topics............................................................ 29
Ways to Serve Marginalized Families ...................................................................................................... 30
Funding.................................................................................................................................................... 31
Hub Locations .......................................................................................................................................... 32
CONCLUSIONS ............................................................................................................................................. 32
Appendix A: List of Greater Sudbury Best Start Network Interviewees ....................................................... 33
Appendix B: Interview Questions ................................................................................................................ 34
Appendix C: Online Survey Questions ......................................................................................................... 36
EXECUTIVE SUMMARY
PURPOSE
The purpose of this component of the Community Integration Leaders project was to 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.
Data gathering was accomplished through four methods: Focus group discussion with hub leads and
others; Key informant interviews; Online survey of stakeholders; Document review. In addition to these
information sources specific to this project, results from a parent survey conducted for another aspect of
this study are also reported where relevant.
a. How does the community define integration? What stage along the integration continuum is
b. What ‘things’ are perceived to be important to move toward integration (e.g. community
c. What is the single most important thing the community did to make significant progress
toward integration?
d. What are the barriers that have limited or slowed-down progress toward integrated services?
limited to:
system?
needs of families?
1
i. The context through which the conversation was initiated;
ii. Why the topic is perceived as being a difficult discussion (e.g. conflict between sectors
or key stakeholders, disagreement within the network about how to proceed, topic
required more discussion than anticipated, etc.);
iii. The strategies used by the network to resolve the discussion; and
iv. The outcome(s) of the discussion.
RESULTS
Defining Integration, 2011): Awareness; Coordination; Collaboration; Integration.
Online survey respondents were most likely to say that the system was at ‘collaboration’, with about onethird of respondents choosing this option. Most interviewees described a system between the
coordination and collaboration stage, with some situations in which awareness is a better description.
Interviewees also commented that there had been progress in this regard over the last few years since
previous studies had been conducted.
Along with Triple P, other examples of collaboration and integration were cited: The Chelmsford
project, which was a new approach to planning and delivering programs based on neighbourhood
needs and assets, and then the current ‘neighbourhood teams’ approach that builds from the
experience in Chelmsford.
integration. As with the perspectives of the agencies themselves, the greatest number of respondents
chose ‘collaboration’, although responses were spread across the options and tended to be slightly lower
on the scale than the responses reflecting the agencies’ perspectives.
In addition to the online survey of providers, parents who use services throughout the City of Greater
Sudbury were asked to rate the level of integration they experienced. The majority of parents reported
higher levels than providers did: approximately one third reported experiencing coordination, another
third experienced collaboration and collaboration, and another 15% report integration, the highest level.
Interviewees were also asked how they think families experience the system level of integration. Most
do.
2
Key Enablers
integration. The top responses, in order, were:



A planning process/accountability framework that supports partners in moving toward
integration;
Support and buy-in from partner agencies/organizations;
Interviewees echoed these enablers and also mentioned other enablers.






Shared Vision, Leadership, and Resources
Trust
Champions
Representation and Membership at the Network Table
Embracing Change
Direction from Ministry
Interviewees were asked to identify challenges or barriers to moving toward integration.






Lack of Ministry Direction
Differing Mandates
Resources to Support the Work of Integration
Complexity
Varying Relationships with Schools and School Boards





Ministry Leadership
Stretch Mandates
Share Successes
Start Small, Build, and Sustain
Continue Dialogue with Schools and Schools Boards
3
Progress Toward an Integrated System of Child and Family Services
As part of moving toward integrated child and family services, in 2011 the Great Sudbury Best Start
Network changed its name to the ‘Best Start Integration and Planning Network’ whose mission is to
promote healthy childhood development by supporting families and children through a responsive, flexible,
comprehensive and seamless system – an integrated system of services for children and families.
Access Strategies



Transportation
Neighbourhood Teams
Best Start hubs have been, and will continue to be, key to the vision of integrated services. Although
these sites have been very helpful at improving access and integration, there is also a sense that
outreach beyond these sites will be necessary.
Considerable work has already been done to be welcoming to all families in Greater Sudbury. Specifically
with respect to cultural and linguistic diversity, the Family and Community Engagement Strategy (FACES)
framework is in use in hubs and daycares to provide resources and supports for creating more inclusive
environments.
Technology
of technology. Although it was acknowledged that not every family can be reached through technology,
many can, and the increasing access to smart phones and high-speed internet mean that these are viable
modalities for many families. Interviewees noted that there will always be a need for diverse approaches,
including new technologies and person-to-person interaction.
1. Ways to serve marginalized families
2. Funding
3. Hub locations
4
For all of these issues, participants spoke of a climate of trust and transparency, in which, although
everyone may not agree, everyone has a right to speak and be heard. Not all of these issues have been
‘resolved’, but all of them have been aired to a certain extent and there is commitment to further
dialogue.
CONCLUSIONS
This project benefited from the participation of The Greater Sudbury Integration and Planning Best Start
Network members and other community agencies to reflect the current state of progress toward
integration, the challenges that have been encountered, and the potential next steps. Progress is being
made toward integration through the efforts and dedication of members, and the history of working
together and innovating provides a solid foundation for these communities.
5
Greater Sudbury Best Start Network Community
Integration Leaders Report
PURPOSE
The purpose of this component of the Community Integration Leaders project was to:


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.
INFORMATION SOURCES
Data gathering was accomplished through four methods:




Focus group discussion with hub leads and others, January 2014
Key informant interviews with 16 Best Start Network members across key locations,
roles, and organizations (January-February 2014)
Online survey of stakeholders (February 21-March 10 2014). The survey was completed
by 65 respondents from the Greater Sudbury system, of which 40 provided complete
information.
Document review of key products, strategic documents, or other sources of information
about the history and directions of the Best Start Network or network member
organizations.
In addition to these information sources specific to this project, results from a parent survey conducted
for another aspect of this study are also reported where relevant, to reflect the experiences of families
with the children and youth services system.
The research was undertaken jointly for the Manitoulin-Sudbury Districts and the City of Greater Sudbury.
Many key informants are connected with both systems and were able to speak about each Best Start
Network, or about the system across the two network areas. Readers of both reports will notice some
overlap in content, which reflects the fact that 13 out of 16 key informants spoke about both systems.
6
toward integration?
limited to:
system?
needs of families?
7
RESULTS
HISTORICAL REVIEW OF STEPS TO ADVANCE TOWARD SERVICE INTEGRATION: HOW DOES THE COMMUNITY
DEFINE INTEGRATION? AT WHAT STAGE ALONG THE INTEGRATION CONTINUUM IS THE COMMUNITY
CURRENTLY LOCATED?
Defining Integration, 2011):




Awareness
o Organizations in the community are aware of others’ programs and services but they
organize their activities based solely on their own mandate and planning processes.
o There is the potential for service gaps and/or duplication of services across organizations.
Coordination
o Organizations in the community modify their own service planning to avoid duplication or
to improve links among organizations, using their knowledge of other services or
programs.
o They maintain a master list of local agencies and refer families to other agencies as
necessary.
Collaboration
o Some, or all, organizations in the community jointly plan programs and services and
modify their own services as a result of mutual consultations and advice.
Integration
o Organizations in the community operate as a single system, under a single governance
and resource umbrella and/or memorandum of understanding that commits all partners
to clear processes for decision-making and resource allocation.
o Common values and philosophies, and common program policies and practices.
o Children and families experience seamless, timely and effective supports which are
monitored and improved through shared outcomes and continuous quality improvement.
o Some programs may have been consolidated or re-engineered.
Online survey respondents were most likely to say that the system was at ‘collaboration’, with about onethird of respondents choosing this option (see Table 1).
8
Table 1: Where along the continuum would you say the Greater Sudbury system is at right now? (n=40)
Response
Chart
Percentage
Count
1 Awareness
2.5%
1
1.5
5.0%
2
2 Coordination
17.5%
7
2.5
17.5%
7
3 Collaboration
35.0%
14
3.5
20.0%
8
4 Integration
2.5%
1
Total Responses
40
The majority of other responses were spread between coordination and the rating just below integration.
Thus, although there is no clear consensus, it is probably fair to conclude that, in the view of survey
respondents, the system is at the level of collaboration or close to that, without achieving full integration.
Most interviewees described a system between the coordination and collaboration stage, with some
situations in which awareness is a better description. No one described a fully integrated system,
although there are examples of integrated approaches, such as with Triple P. Interviewees also
commented that there had been progress in this regard over the last few years since previous studies had
been conducted.
Along with the Ministry definitions of the levels of integration that were provided for respondents to
consider, there were also important aspects of integration that emerged from the interviews. People
described a system that is efficient and seamless, and also one in which the uniqueness of each aspect of
the system is preserved. Integration, for these participants, is not a ‘cookie-cutter’ or ‘one-size-fits-all’
concept. The sense is that integration involves barrier-free access for families, and empowers families to
receive services they want and need, in a way that makes sense for them and is possible within the
existing resource limitations.
“The concept of ‘every door is the right door’ is something I think we should all be aspiring to,
and that’s really a seamless integrated system…. It doesn’t mean everyone does everything: ‘no
wrong door’ means you’re on the same road together, and you have the same basic values …in
how you approach things, in how you approach your work, and no agency can be the one
answer to everything either.”
“I still really like the uniqueness of every agency and how everybody contributes a little
something.”
The specific meaning of integration, or the important features of integration, came into play as
interviewees answered. For many, agencies modifying their own services (part of the definition of
9
collaboration) is in evidence, and therefore they consider the system to be primarily at that level.
However, many interviewees went on to say that it depends on the scope of services that are considered
as part of the system. People obviously answer given the scope of services they are most familiar with,
and so the responses vary because respondents’ frames of reference vary. There is a reflection that
greater integration has happened in settings in which the mechanisms, resources and processes have
been in place to support integration.
“I also think that in the children’s sector, the early years sector, we’re more integrated than
working with the other sectors, for example mental health.”
“Collaboration, integration, I guess from my perspective it depends on what scope of services
you’re looking at. So if you were talking about it sort of from education and childcare and hubs,
that’s one thing, and if you’re looking at it broader to the whole of children’s services, it would
be something else.”
Triple P was often cited as an example of work that is integrated, or is approaching integration. There are
leaders from more than one agency at each seminar and group, and the planning and decision-making is
done jointly. There is not, and cannot be, single ownership of Triple P because it is a community-based
model that transcends any single agency.
“Triple P is actually a very good example, because that’s also incorporated into the larger
mental health system, not only the children, but the adults, you know, that whole system, and
so we’ve come together as a system and it really, that one model is truly an integrated model.”
Along with Triple P, other examples of collaboration and integration were cited: The Chelmsford
project, which was a new approach to planning and delivering programs based on neighbourhood
needs and assets, and then the current ‘neighbourhood teams’ approach that builds from the
experience in Chelmsford. Partners for Children and Youth, a community-wide table for high-level
discussions and solutions related to children and youth, was also cited as having potential to support
greater integration, albeit being in its early stages.
“Our past CARCIL project out in Chelmsford was a really good small version of a pilot project of
what it could look like when partners really collaborate together, and you know, they’ve
identified assets within the community, and what are some gaps that can be filled, and people
understanding each other’s roles better, and how they can assist each other in meeting the
needs of families, and where their strengths and assets are, and I think with the commitment of
agencies to really look at this whole neighbourhood approach, which really does force us to
move along that continuum to force us to work in all levels, awareness, coordination,
collaboration, and ultimately integration.”
In some cases, participants looked at the Ministry definition of integration and commented that we will
never fully reach that because it requires common governance, and that seems unlikely. However, one
respondent commented that it is not outside the realm of possibility:
10
“People make comments about ‘we’re never going to really be integrated, and our governance
is not going to be shared, and we’re not going to be putting money in together’: well in fact,
London has done some of that, and I think Hamilton as well.”
It seems that the prospect of shared governance seems remote, although there are examples, in Triple P
and examples from other places, in which such a move toward integration has happened.
The Ministry definition of integration, although familiar to interviewees, does not address all of the
questions or possibilities related to an integrated system. There are many questions that remain about
full integration, particularly as concerns the Ministry definition and intention with respect to integration.
“I don’t think it’s necessarily that governance means that you’re giving up your budgets and
your dollars and your staffing for this. I think governance can mean many things, and I think in
our community we need to figure out what does that mean, and what does integration truly
mean for us, and what does the ministry really, truly mean by integration, and are we all
aligned in our vision of integration.”
There is a sense that a shared vision and shared purpose are the most critical components of an
integrated system: other aspects of the system may vary from the definition while still exemplifying
integration, or at least seamlessness.
“I sometimes wonder if we spent too much time trying to define service integration, and we
haven’t really talked a lot about the purpose of service integration, and I wondered if we
shouldn’t have done that a little bit more so that people understand that it’s about, improving
outcomes, and improving family experiences, and finding system efficiencies.”
One step forward may be to continue the work to clarify and come to consensus on the purpose of a
more integrated system. Even in very recent BSIPN restructuring, there was needed discussion related to
the vision and goals of the network, and what those imply for membership and participation at the
meetings.
It appears that a significant part of what has been achieved is that some outward-facing aspects of the
system appear integrated. From the perspective of many interviewees, the fact that parents and families
who would not know who delivers what services is important evidence of a system that is collaborative or
integrated.
“I would say collaboration for sure, because we’re definitely jointly planning, we’re modifying
our services, … all of the hubs who are run by different agencies, we’re doing actual
programming together, so no one knows, well, this is [agency X] and [agency Y]: This is just a
hub.”
As noted previously, a common example of integration included Triple P:
“We’re integrated in the way of Triple-P, for example, and we all have the same single system
of governance and policy, we’re under the same umbrella, we’re not this agency in that, we’re
just Triple-P.”
11
However, the meaningful achievements in terms of presenting an integrated face to the community do
not necessarily mean that there is integration at the interagency level. There is evidence reflective of
collaboration, in that there is considerable joint planning at the Network level, although it appears that a
lot of planning also still happens at each agency. To be fully integrated by the Ministry definition would
mean acting as a single system, with integrated systems of governance and common policies, and the
system is not integrated at that level.
“I know this [Ministry] definition is really talking about governance and things like that, but to
me, integration is when people are just showing up and everybody is adding whatever they can
contribute and we just make it happen, and I think … although that’s the goal, people still come
and represent their piece of the world, and respond in terms of flexibility based on those
pieces. So I think we’re expanding that understanding, but it’s still pretty new.”
integration. As with the perspectives of the agencies themselves, the greatest number of respondents
chose ‘collaboration’, although responses were spread across the options and tended to be slightly lower
on the scale than the responses reflecting the agencies’ perspectives (see Table 2).
Table 2: Thinking about the system of child and youth services from the perspective of the families you
serve, where along the continuum would they say the system in the City of Greater Sudbury is at right now?
Response
Chart
Percentage
Count
1 Awareness
7.7%
3
1.5
10.3%
4
2 Coordination
20.5%
8
2.5
15.4%
6
3 Collaboration
28.2%
11
3.5
15.4%
6
4 Integration
2.6%
1
Total Responses
39
In additional to the online survey of providers, parents who use services throughout the City of Greater
Sudbury were asked to rate the level of integration they experienced. The majority of parents reported
higher levels than providers did: approximately one third reported experiencing coordination, another
third experienced collaboration and collaboration, and another 15% report integration, the highest level.
However, the responses were distributed across the response categories, and it should be noted that 17%
of parents reported that the system was working at the level of awareness. There are many different
12
influences on the experiences of families, such as the type and number of services they are accessing, and
that may explain the diversity of experiences reported by parents.
Interviewees were also asked how they think families experience the system level of integration. Most
do – although recall that agencies tended to consider that the best examples of collaboration are in the
outward-facing collaborative efforts experienced by families. It seems that although there are some good
examples of collaborative or integrated services, for families looking to access services across the
spectrum, there are still aspects of the system that are not integrated. It may also be the case that
although there are meaningful activities at the management level to collaborate and integrate, these
activities do not always translate to frontline staff who are providing direct service. For families whose
primary interaction with the system is with front line service providers, collaborations at the planning and
administrative level may not have an immediate impact.
“I would suspect that they get confused. We’re probably clearer in our own minds of where
we’re at than they perceive us to be.”
“I think families probably see us more at coordination, or you know, a bit of a combination
between coordination and collaboration, and I say that because I think that when families are
interacting with the frontline staff in particular, that there isn’t always that good knowledge of
the collaboration that exists.”
Several respondents also mentioned that they had less certainty about the experiences of families, and
were lacking this kind of information.
“I still don’t think we’ve landed on a really good tool that gives us the feedback we’re looking
for, … so I honestly don’t know what a family [would say].”
In asking interviewees to think about integration of the system, they sometimes drew comparisons across
systems, especially for interviewees who are involved in both the Greater Sudbury and ManitoulinSudbury Districts systems. Revealingly, there is no consensus on which system is further along toward
integration, which suggests that the markers of integration are being defined differently by different
respondents. For some, because the Greater Sudbury system involves a larger number of players, the
system is by definition less integrated. For others, the Greater Sudbury system is more advanced
because the planning and system changes that have been accomplished are more far-reaching. Thus,
what is considered to be important in defining integration varies, and so then do the judgements of which
system is further along toward integration. It is also worth noting that shared geography is considered by
some respondents to be an enabler of integration, at least at the community level (e.g., Lacloche,
Chapleau) whereas for others, the sheer size of the geography across the districts is a challenge.
“In my mind I think of them almost in the opposite ways. In the city we’ve done a good job at
the kind of management, leadership level, and now we’re just moving into the neighbourhood
level, whereas in the Sudbury-Manitoulin District they’ve already done a good job at the
neighbourhood level, and we translate that into creating the leadership level that supports
that.”
13
WHAT ‘THINGS’ ARE PERCEIVED TO BE IMPORTANT TO MOVE TOWARD INTEGRATION (E.G. COMMUNITY
CHAMPION, COMMUNITY VISION , MUNICIPAL BUY -IN, ACCOUNTABILITY FRAMEWORK, ETC.)? HOW DID THE
COMMUNITY ACHIEVE THESE? WHAT IS THE SINGLE MOST IMPORTANT THING THE COMMUNITY DID TO MAKE
SIGNIFICANT PROGRESS TOWARD INTEGRATION?
Key Enablers
integration, as shown in Table 3 below. The top responses, in order, were: A planning
process/accountability framework that supports partners in moving toward integration; Support and buyin from partner agencies/organizations; A community vision that is inclusive of integration.
Table 3: In your opinion, what has been the most significant factor in moving towards integration in the City
of Greater Sudbury?
Response
Chart
Percentage
Count
Strong community champion or champions for the integration
of services/supports.
5.6%
2
22.2%
8
Support and buy-in from the municipality(ies) for the
11.1%
4
27.8%
10
A planning process/accountability framework that supports
partners in moving toward integration.
30.6%
11
Having staff who are dedicated specifically to the work of Best
Start.
2.8%
1
Total Responses
36
A comment provided in the survey speaks to the importance of the planning process:
The strategic plan developed by the BSN has given focus and direction to the movement
forward of the system. While the leads at the integration table were engaged in the process up
14
to now the strategic plan has moved things to the next level where front line staff are taking
more ownership.
Shared Vision, Leadership, and Resources
According to interviewees, a key enabler of progress toward integration is a shared and clear vision that is
kept in the forefront of planning and discussion. A deep commitment to fulfilling the vision, and a
dedication to meeting the needs of families, is a related aspect of this enabler. The commitment is
facilitated by strong and dedicated leadership at top levels of organizations, including a willingness to
commit resources to supporting the work of integration. The support from the City to second a leader for
a period of time to move aspects of Best Start quickly, and then to fund a permanent position with
responsibility for Best Start, are tangible examples of this kind of resource support. Although opinions
differed about the single most important thing that contributed to progress toward integration, the
elements described above are fairly consistently described as critical to the process. Although a planning
process was not explicitly identified by respondents as the most important enabler, as it was in the online
survey, fulfilling the vision was seen by interviewees as requiring shared planning and implementation.
The current vision guiding action is that "Every child in the City of Greater Sudbury has the Best Start in
Life". This healthy child development is to be accomplished by "supporting families and children through a
responsive, flexible, comprehensive and seamless system-- an integrated system of services for children
and their families".
Trust
Such a shared vision does not happen without communication and relationship building. The partners
have connected and met regularly, and have built trust over time, trust that now enables a more
integrated approach to child and family service planning and delivery.
‘“Knowing each other, and whom they service, and what the needs of the population that they
service is, where’s the overlap, where are the gaps, and being able to have sort of frank
discussions on how to fill those gaps, those items have been helpful, sort of a trust situation,
that if you do change, that it’s not just one program that changes, that there’s movement
elsewhere to wrap around the supports and services that are in place, …there’s support in
terms of the change that you’re moving forward collectively.”
Champions
Although champions were not at the top of the list of the most important enabler in the online survey,
champions have been important, according to interviewees. The champions are not seen as single
individuals acting on their own in support of the system. Rather, what is being described is more in terms
of leadership of the system, and a grouping of leaders with mutual respect and strong relationships, and
sometimes a willingness to put the needs of the system before the needs of their agencies.
“There have been some strong folks out there who have really pushed us along that system,
and I don’t know if we could have achieved that much if we didn’t have those champions. I
think it’s their relationship with one another, knowing that some of them have been around for
a long while, and they have fostered strong relationships with the other child and family service
15
agencies, and I think that there is mutual respect among those higher level executive directors
in terms of the work that they do together, and an understanding or appreciation for the work
of their agencies, and I think it really heavily boils down to relationships, and ultimately, no
matter what their own mandate or own work, they have the same goal of wanting to make
sure that families get the necessary help and services that they need.”
“We do have some examples of champions or leaders that have said this is not about me
getting more money, it might even be about me letting some stuff go, and we have some good
examples of that, but I don’t think that it’s all of us.”
Representation and Membership at the Network Table
Having the right agencies, and the decision-making members of those agencies, represented at the
planning tables is also critical to being able to move toward integration:
“We want to make decisions, but at the same time we don’t always have the right people to
make the decisions, and that’s why communication is key, … we have people representing
agencies, and they’re not, perhaps, the decision makers, and so when it’s time to really make a
strong commitment, we can’t always move forward, and so that link to the decision making
authority, and the communication piece, is critical.”
It has been important to continuously act in ways that break down silos that are naturally present when
bringing together multiple agencies. As one example of a way that silos have been broken down, one
interviewee describes a recent change to the subcommittee structure at the BSIPN:
“The former sub-committees were really sector based, and so we gave parts of our strategic
plan to those sub-committees, and those sub-committees from one specific sector led the
project. They wanted partners from outside of their sector, but it was really led by one sector.
What we’ve done when we’ve restructured, is we’ve set them up so that they’re not sectorspecific. So they’re much more ‘how can we all collaborate on this one goal’, so they’re goal
specific, according to our strategic plan, and there is not really one sector that’s leading it, it’s
this group that’s multi-sector. “
Another enabler of progress in the Greater Sudbury system is that there has been a high degree of
consistency in the players. Overall, participants mentioned the importance of the continuity the
consistent presence of partners can bring. Along with that consistency has come trust, which is only built
over time and with intention.
“It’s an evolution to get to that readiness to say ‘we’re going to do this as a community’, and
build trust that you’re not going to get lost in it, or your sector’s not going to get lost in it.”
Embracing Change
One of the outcomes of trust is a system that can support and embrace change when it is needed. The
Greater Sudbury system has been willing and able to take risks and look at system improvements because
the level of trust is such that participants feel they are contributing to something larger than themselves
and do not immediately look to protecting their own positions. This kind of change also requires a
commitment of significant time to meet and communicate.
16
“That’s a sign that we’re moving along the spectrum of integration, because we are having that
self-reflection, and we are changing, and we’re in a constant mode of change, and I think when
you think of transformation, that’s what happens, is you’re in a mode of constant change.”
“They say that we’re sort of way ahead in terms of community planning than many other
communities, but there’s pretty consistent check-ins. I think that’s why we’ve evolved and
changed so much over the years…. It’s been a responsive evolution. I don’t think it’s been
because we don’t know what we’re doing, I think it’s been responsive to, as the needs change,
demographics, as we get more data, as each of our agencies evolves to doing different things
or setting different standards of quality or different standards of excellence, or trying to meet
the needs of our constituent families.”
Direction from Ministry
Another important enabler of progress toward integration is clarity and direction from funding
Ministries.
“We know things are moving under the Ministry of Education, so you have more agencies’
mandates that are under one ministry, and I think that it becomes incumbent upon them to
have to meet the ministry needs, it’ll be an ongoing challenge to have all the rest of us joining
this movement of integration, those of us that are not mandated by the same ministry, but, I
think that having ministry expectations does help get things done.”
“I think having the expectation from the ministry, having that framework, even though it’s very
broad, it’s still something to live within or aim for, or push against, so that brings about
collaboration.”
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 ?
Lack of Ministry Direction
Although Ministry direction was considered by some to be a potential enabler, many also mentioned that
lack of clarity from Ministries has been a barrier to progress toward integration. Most interviewees see
two sides to this issue: The community has not been hampered by restrictive direction, but there is a
sense that further direction may be coming, and people do not want to move too far in one direction only
to find out that another direction is preferred by the Ministry. There has been feedback from the
Ministry that a community-directed approach is desired, and this is generally welcome, but this is
considered along with the fact of limitations that exist because of Ministry funding streams, limitations
and policies. Interviewees also spoke of the length of time it has taken for the Ministry to provide clarity
on some issues that have been brought to their attention.
“I’ve been at meetings with the ministry where they’ve said the system, the community just
needs to be more innovative. I don’t think there’s a more innovative community than our
17
community, and if we can’t do something, it’s because MCYS has stopped us and said no, that’s
not something you can do.”
“I think because Education is so big, and its communication is really difficult, that the vision is
definitely not on the ground completely in education, it’s hit and miss, so a lot of time is spent
from community partners educating Education, and Education is leading the initiative! So it’s
not gloom and doom, but it’s something that would have to be paid attention to in terms of a
potential barrier to integration.”
Differing Mandates
A significant barrier to progress toward integration is differing mandates. With the number of agencies
around the table, and the number of funders and accountability structures, there are some very real
barriers to setting mandates aside and doing what serves the community vision. As interviewees
described, at the end of the day, they are accountable for their meeting their mandates, not for being
part of an integrated system. They were quick to say that this is not cut and dried; there are ways to work
around mandates and to approach funders with a different idea, but they have frequently encountered
contradictory lines of accountability that could not be ignored. It was also noted that, until partners
become completely comfortable with integration as a goal, that they can sometimes retreat back to
individual mandates and accountabilities to move away from the extensive changes integration would
involve.
“It’s very limited, and I think overall, it’s a huge administration piece, at a much upper level,
and I really believe that in order to assist some of that, we have to kind of neutralize some of
the funding mandates, and become more about the community at large, and in some ways
we’re working on that right now with this neighbourhood team planning, but I still see the
barriers.”
““I also think it’s hard to think outside the box, of whatever your box happens to be. I
sometimes think there’s desire, but not always time and resources to execute. ….We’re just
having enough trouble keeping up with what we’re doing. We’ve at times been able to open it
up, but it’s not, I don’t think particularly well thought out or consistent, and yeah, and right
now it’s just done based on goodwill and not because it’s required, you know, it’s not built in as
part of our jobs.”
“Sometimes there’s not structural support there, and other times it might be that we’re
bounded by our legal obligations to the program that we serve. So I have certain deliverables to
my program, I can’t service seven year olds because I’m not funded to service seven year olds,
so I mean, as much as I might think that might be a good thing, I just can’t do that, so you
know, integration can only go so far.”
In further exploration of the issues associated with mandates, other related issues, such as fear and
uncertainty emerged. Much of this discussion was in the context of wanting to move to the best possible
system, and recognizing that integration is a valued goal, but also acknowledging that there are many
uncertainties about what the future holds and whether the way forward is clear. With those uncertainties
comes fear. It was also noted that part of what makes people and agencies hold on to the current
18
situation is that they are proud of what they are doing and do not want to compromise that. It is valuable
to have pride and to be aware of the good work that is being done, and contemplating large scale change
may raise the possibility that some good things may change. As noted by several interviewees, these
responses are normal and to be expected – and the remedy is open communication and shared decisionmaking around the way forward and the implications of possible changes. A related aspect of agency
mandates is the need to be cognizant of union requirements and collective agreements, which also create
limitations on what roles and responsibilities can be shared, changed, or re-engineered.
“Another part I think too is it’s scary to really change a whole way of practice, not so much that
people are owners, but they’re afraid that by doing so you’re going to be missing something
and creating a larger problem, because even though the past practice may not be perfect, you
know what parts are working and what parts aren’t.”
“I think one of the biggest challenges is ownership, and…that’s what makes us passionate about
our work. So we own it because we love it, and we think it’s great, but that also prevents us
from being willing to think about the possibilities of really truly integrating that service with
another agency or another sector.… I think as we trust each other more, and continually talk
about ‘we’re all here for better services for families, to help children to have quality programs’,
those kind of things make us think we have the same outcome in mind.”
“Whenever you’re trying to move a system, people need to be open and vulnerable and willing
to step outside of their current silo, and I think there’s a lot of progress there. I think there’s
plenty of willingness on the frontline and mid-management level, but some work still has to
occur at the administrator level to clear some of those barriers out of the way so people can
get the job done.”
It is widely acknowledged that not all agencies involved with children and families are participants at
the Best Start Network table, probably for a variety of reasons. Although the consistent participants
have made progress toward integration, the gaps in coverage mean that there are aspects of
integration that are not possible without broader representation. Another aspect of membership at
the Network table is that the person who sits at the network is not always someone in a decisionmaking capacity for their agency, and that also has implications for progress toward integration.
“Those partners that are not completely engaged, … internally I’m sure they have their own
barriers…. I’m not trying to be critical of them…. But I think in terms of us as a community
moving towards integration, there are players that don’t show up, and that makes it much
more difficult….You can’t force those big players to come, for sure, although I would’ve thought
that the ministry would have had more leverage. Maybe now that we’re going to the Ministry
of Education we’ll have even less leverage, because they will remain funded by MCYS, so we
may have less leverage with them, but I think that’s been a barrier to really thinking about an
integrated system.”
“I think clarity around who needs to be at the table is essential for advancing it, ... the people
who are responsible for advancing change in their organization in the system must be the
19
people at the network, and then the operational group, there’s lots of work, and they can meet
on other things, but I think it confuses things, and makes some of the discussion feel more
challenging, because they’re being approached from two very different angles.”
In particular, it was noted that First Nations are not well represented at the table, although for full
integration of services, it would be important to have mechanisms for consultation and relationship
building with First Nations. Some steps have been taken in this direction, but it was acknowledged that
the relationships require ongoing investment.
“We have an aboriginal hub lead, … and they have a committee. ….But it’s been interesting to
me since the FACES funding is gone and that committee has quit meeting, again, the hub leads
tend to be the actual physical hub leads, and Shkagamik-Kwe is not there, and Friendship
Centre is not there, so we’ve not been able to maintain those ties beyond that project.”
It has also been important to communicate within and across levels of the partner agencies. There have
been instances in which frontline staff were not informed of developments at the Best Start Network
table because the message had not been transferred by their executive directors. This was noted in
online survey responses (in which responses from frontline staff were available) as well as in interviews.
“We had done a very good job in Sudbury at the leadership level having, you know,
conversations, and where we weren’t doing a good job was in connecting with the frontline
services, and we would say things, you know, at the leadership level, and if you went to a
frontline they would say ‘what are they talking about, I don’t even know about that’. …I think
that they did a very good job in Sudbury kind of reshaping that focus so that the hub leads now
meet on a regular basis and they’re far more integrated.”
Resources to Support the Work of Integration
The existing investment on the part of the City to staff a coordinator position for Best Start has been a
significant contribution to the current progress toward integration. That said, interviewees reported that
they lack other resources to contribute to the work of integration, both in terms of time to spend on
initiatives, as well as funding to support shared initiatives and the process of building together. Some
spoke of previous contribution by the Ministry to Early Years Coordinator positions, that were considered
to be a boon to the progress of Early Years.
It was also noted that the on-the-ground work of integration, as exemplified in neighbourhood teams, is a
community development role, and staff who take on these roles do not have training in community
development. Hub staff often come to this work with early childhood education backgrounds, but that
does not necessarily prepare them to build consensus among neighbourhood partners, such as police,
school principals, and others. There is no question about their dedication to the neighbourhood teams,
but to truly support their work, a commitment to training and professional development would be
needed.
“I wish the Ministry of Ed would do what they did with the Early Years coordinators, which is
invest for a one or two year period of time, and really assign people with that task only, to
mobilize and build up the neighbourhood teams, and because I do think there’s a lot of value in
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that, and if the government’s not going to do it, then maybe that’s something that we need to
look at as a system.”
Complexity
As interviewees considered the barriers they had experienced, they reflected on the complexity of their
situation and of the integration task. The ‘system’ for children and youth is multi-faceted, multi-partner
and involves multiple orientations to service delivery. Interviewees identified the critical nature of a
shared vision to try to overcome the size and complexity of the task.
“From my perspective it would be the complexity of the work involved. You know, because our
numerous partners, our numerous agencies, with different mandates, and different funders,
and perhaps even different individual visions, and that’s why it’s so important to have that
shared purpose or that shared vision, and I also think it’s the number of people that’s involved,
in that sometimes we have systems within systems that add that layer of complexity.”
“Another limitation, or just something that slows us down a little bit, is really just the sheer size
of the system here in the City of Greater Sudbury. ….The whole child and youth sector is
massive in our community, and pulling people and agencies together, some of whom have
really strong mandates for child development, and others who have it as part of a much
broader mandate.”
Varying Relationships with Schools and School Boards
Although hubs and childcare have been well incorporated into schools, these co-locations are not without
challenges. In some cases, these are strong and supportive mutual partnerships. In other cases, hubs and
childcares are considered to be tenants in school space and are subject to changes in school preferences
without much consultation. Some school boards charge rent for hub space on a cost-recovery basis,
although this is not a consistent practice since some hubs do not pay rent in schools. It was also noted
that space is at a premium in many schools and it is challenging to find space to allow or expand services.
“Something as bizarre as we’re all under Ministry of Education, but [hubs] have to pay a school
board to rent the space at the school, so I get money from the ministry, I cut a check, and hand
it back to the school board, who sends it to the Ministry who funds us….”
Ministry Leadership
Lack of Ministry direction was identified as a barrier to integration, but interviewees also identified
specific ways in which Ministries could play a role in furthering progress. One strategy was simply to
provide incentives for movement toward integration. Ensuring that integration conversations continue to
happen at all levels of the system, including Ministry-led tables, was another strategy. There was
recognition that although the Ministry could move integration along by mandating it, that would not be
21
the best way to proceed, given that so much of integration relies on buy-in and implementation of a
consensus vision. This kind of shared movement is not easily achieved, and although Ministry leverage
and leadership would be helpful, community partners also need to identify the value in integration for
themselves in order to ensure their true and sustainable participation. Clearly, Ministry leadership and
direction is valued and needed, not to the exclusion of community-directed leadership, but as a support
and adjunct, to break down some intransigent barriers.
“[The Ministry enforcing it] doesn’t do much for getting a spirit of cooperation going, and will it
be structured such that it’s best for the system versus what’s better for the bottom line, the
dollars, making the decisions based on what’s better for the clients, as opposed to just because
of dollars and cents?”
“I’m not sure that we’re going to move much further down that spectrum of integration until
some of that has been cleared up, and I think it’s because there’s a lot of anxiety with our
service providers, that whole shift, and so they’re waiting. They’re used to working with MCYS,
and all of a sudden they’ll be working with the Ministry of Education, we now have an Ontario
Policy Framework on the Early Years, but it’s really led by the Ministry of Education, so you
know, what does that mean to me as an agency. So I think we’re going to see people a little bit
kind of maybe slow down, not stop, but maybe slow down a little bit and wait.”
“I think we need clear expectations from the ministry. I think the agencies involved in the
network need to identify clearly what integration means for us. I think we need to be very open
and honest about what those barriers are, and what would be the strategies to help overcome
them. I think also, I think as we continue and foster the development of neighbourhood teams,
that will also work towards integration.”
“If I read this definition of integration, so operating under a single system, under a single
governance and resource umbrella, and a memorandum of understanding commits all
partners, well, when we’re operating under different ministries, with different mandates,
different funding formulas, I think that this creates a disjointed system….All of those things I
think just need to be clarified, and I do think that that direction probably best comes from a
ministry level. If they expect community agencies to integrate on the ground without those
kinds of supports, I don’t really believe that will happen. I think it’s asking too much.”
Stretch Mandates
The varying mandates of the agencies involved were noted as a significant barrier. Most interviewees
referred to this issue in one way or another. It appears that participants in the system are willing to work
together for the benefit of families, but that they come up against their accountability to their funders.
One obvious example is with respect to age limits for services. Many programs have specific age ranges
for eligibility, and although they may see the need for serving other age groups, and there may be a gap
in the system with respect to that age group, they are not able to encompass a broader age range
because of their mandates and funding parameters. Most interviewees acknowledge that they work in an
imperfect system where the desired flexibility is not always there, and they simply want to work together
22
with as much flexibility as is possible – and to push the boundaries of what is considered ‘possible’ in
order to serve children and families.
“It’s not that we would want anybody to come to the table where it doesn’t make sense, but it
means in my mind, can you bend in such a way that maybe this is not traditionally what we do,
but it’s not so far outside of our mandate.”
Share Successes
To address the barriers of incomplete participation in the Best Start Network, it was suggested that the
value of a successes of the collaborations should be shared and promoted. The moves toward ‘collective
impact’ and results-based accountability, in which community goals are shared and progress toward them
is reported on, were part of the thinking about how to promote the good work being done as an
integrated system.
“I think that we have to get better at talking about the outcomes and why things are better.
…So I think it’s a combination of that, of continuing to build the relationships and flaunting our
successes and saying look, this really works.”
Start Small, Build, and Sustain
With respect to the resource limitations and complexity barriers, several interviewees talked about
starting small. Having said that, many also raised the importance of sustainability, so that projects do not
run for a time and then fade away after their supports are no longer in place. The concept of a backbone
organization (related to ‘collective impact’ strategies identified earlier) was also mentioned as a possible
approach to supporting movement toward integration.
“Perhaps it’s starting with smaller projects. Like the City has done, for example, the
neighbourhood teams, and the FACES project, and some of the work between the health unit
and hub staff for children with speech delays, like, language issues. I think those projects are
showing that it’s doable, but it’s on a larger scale that it seems to be difficult.”
“If you’re going to go to integration there needs to be someone moving and motivating the
system. So there’s got to be a backbone agency, or a lead agency. … Big isn’t always better. If
you can build a backbone agency, everybody keeps their identity but you have a backbone
agency that provides the consistency to the system, as opposed to a corporate structure.”
Continue Dialogue with Schools and Schools Boards
Best Start partners are in support of colocation of services in schools, given the value for families of
having that central location. The shift to Ministry of Education for some programs formerly under MCYS
is seen as a potentially valuable change to support further integration. However, as noted, relationships
with schools vary, particularly with respect to costs. There is a sense that hubs are considered ‘tenants’ in
schools, rather than partners. Hubs would welcome a partnership with schools and school boards on a
more even footing that acknowledges that everyone has a role in supporting children and families. These
challenges are being overcome and it is felt that further positive changes may emerge with the transition
to Ministry of Education.
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“I think it was a fabulous idea to move those daycares and hubs into schools. I think whoever
thought of that was brilliant, brilliant, because the nucleus is really the school, it’s not us, it’s
the school. The whole shift to the Ministry of Education makes a lot of sense to me. I’d move
everything into the schools, realizing of course space is an issue.”
Progress Toward an Integrated System of Child and Family Services
The preceding discussion of integration enablers, barriers and strategies is part of an ongoing dialogue
about what integration means for the City of Greater Sudbury. As part of moving toward integrated child
and family services, in 2011 the Network changed its name to the Best Start Integration and Planning
Network whose mission is to promote healthy childhood development by supporting families and children
through a responsive, flexible, comprehensive and seamless system – an integrated system of services for
children and families.1
The re-structuring that has taken place over the last several years has resulted in the follow Best Start
Network configuration2:
1. Best Start Executive Committee (Partners for Children & Youth & Mayor’s Roundtable on
Children/Youth);
2. The Best Start Integration & Planning Network – This committee meets on a monthly basis to
plan, develop and implement strategic direction. The BSIPN is linked to the Research Team (all its
components) as well as to the Expert Committees;
3. Research Team – inclusive of the following:






Hub Governance
CGS Child Care
Hub Managers
Triple P
Aboriginal Advisory Committee
Regional French Language Network
4. Expert Committees – the following four committees meet to develop and implement workplans
and provide reports/update to BSIPN at each meeting:




1
2
Early ID & Intervention
Access and Information Management
Family & Community Engagement
EL Skill Development & Quality Programming
Best Start Integration and Planning Network Strategic Plan 2012-2015
SBS Sudbury Best Start Proposed Structure
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Just as the Network itself has experimented with different committees and structures, the way in which
the Network evaluates its movement towards integration has changed over the years. Since 2010, the
Data Analyst Coordinators role has evolved and changed, initially in the transition from the ICYS database
to CIMS and now through the competencies they have gained as a result of being trained in Results-based
Accountability (RBA). In Greater Sudbury, the DAC works with Network members to identify, capture and
report on agreed-upon population-level data, performance measures, accomplishment and ‘stories’
behind the data. The 2011-2012 fiscal year saw the CGS Best Start Network apply a results-based
accountability framework to its Integration and Planning Network (BSIPN) planning priorities.
Targeted and desirable results that were identified by the membership included:





Children Ready For School;
Children Achieving Their Full Potential;
Inclusive and Supportive Community;
To Promote and Strengthen Partnerships; and
Stable Families
It is the intention of the Network to take each of the aforementioned ‘desired results’ and to focus on3:



Understanding the causes and factors influencing the indicators;
Understanding the partners needed to achieve the desired results; and finally,
Understanding the strategies or actions that potentially could address the causes and
improve the results.
In addition to a mission and vision statement, the 2012-2015 strategic planning document sets out values
and guiding principles. In determining the appropriateness of Network activities, considerations will
include: fairness/equity; inclusiveness; diversity; professionalism; innovation; integrity; collaboration; and
openness. The following guiding principles have also been identified as critical to uphold4:






3
4
The Network is committed to the creation of an integrated system of services for children 0
– 12 years;
Child & Family Centres will be located in schools so that families will become comfortable
and part of their community;
Planning will be based on the needs and priorities of families in our community, and on
evidence including best practices, data, and evaluation;
The Network is committed to being responsive to community and parental input;
Network planning will be guided by government direction;
Transparent, deliberate and open communication within the network and with the public
will be upheld;
25



The Network is committed to a ‘no wrong door’ policy – i.e. that planning a system of
services and access for families to the ‘system of services’ through any one agency or
program;
The Network will make recommendations and provide advice to community partners and
governing bodies, including supporting the implementation of recommendations made;
and,
The Network will monitor its work through ongoing evaluation.
Since 2012, the Network has moved forward on five priority areas as reflective of the five Community
Results previously mentioned:
Priority 1: Engage all Families (Related Desired Result = Inclusive & Supportive Services)

Implement and utilize a common ‘system registration’

Develop & Implement a Community Engagement Strategy
Priority 2: Facilitated family access to information, basic needs, parent education, supports & services
(Related Desired Result = Stable Families)

Build, coordinate, and implement neighbourhood teams

Develop & maintain an integrated website for families and professionals

Support & enhance the Triple P Initiative and Mental Health programming
Priority 3: Promote and Strengthen Partnerships (Related Desired Result = Inclusive & Supportive Services

Plan and participate in two partner-strengthening opportunities per year (recognition,
celebrations, activities, or training)

Participate in the Results-based Accountability Planning which defines and documents our shared
vision and collaborative work

Mechanism (processes & protocols) for reciprocal resource sharing. Formalize partnerships with
MOU/agreements and structures
Priority 4: Provide co-ordinated children’s programs & services that address emerging issues of that family,
neighbourhood or community (Related Desired Results = Children who are ready for School AND Reaching
their Full Potential)

Develop and implement community-wide early screening

Supported transition to Early Learning-Kindergarten

Support Integrated Speech & Language Experience Initiative & Emergency Literacy Initiatives
Priority 5: Sustain and enhance the quality of service delivery and staffing across Early Learning (Related
Desired Results = Children who are ready for School AND Reaching their Full Potential)

Develop and Implement a Community-wide Professional Development Strategy
26

Support the development and implementation of a RECE (Registered Early Childhood Educator)
Recruitment & Retention Strategy

Increase professional across RECE
WHAT STRATEGIES WILL BE USED TO MAKE IT EASY FOR FAMILIES TO ACCESS, OR ENTER INTO, THE
INTEGRATED SYSTEM OF SERVICES ? HOW WILL FAMILIES BE SEAMLESSLY CONNECTED TO DIFFERENT SERVICES
WITHIN THE INTEGRATED SYSTEM?
Access Strategies
The experience with a shared registration for Triple P has been positive. Interviewees and survey
respondents highlighted the value in continuing to work toward centralized registrations and information
sharing, so that as families enter the system, they are not having to repeat their stories. From the family
perspective, once they enter the system and tell their story once, there should be no need to start over
with someone else.
Transportation
Many informants described the challenges associated with transportation to programs. These challenges
are not easily overcome, especially in rural areas. However, placement of programs in schools, which are
located in communities, and local program development, such as is being developed with neighbourhood
teams, are strategies to mitigate the transportation challenges.
“It’s difficult for families to access programming sometimes. It doesn’t matter how integrated
your program is if you’re at home and you can’t get to it.”
Neighbourhood Teams
The experience with a neighbourhood team in Chelmsford has led to expansion of this concept, such that
neighbourhood teams are now being developed is several other areas. The teams are significant to
integration because they lead to greater responsiveness to the local circumstances that determine child
and family well-being.
“I think, for the Sudbury area, of course, the neighbourhood teams is a big deal, and that’s
where it seems to be working, and I think that’ll be the next big development.”
“We’ve created teams, based around the hub system, in a number of neighbourhoods, and
now we’re starting to, with those teams, look very closely at that very neighbourhood-level
27
data,…and so you start to take care of some of those things for families that get in the way of
being able to focus on early childhood development, not having enough food to eat, or enough
to pay the rent, but to really get to know that at our neighbourhood level, and then be able to
think about what are the resources you bring …and then to start measuring the outcomes
based on that.”
“Because of those neighbourhood teams, I think we’re going to start thinking we can’t do this
from one place, one agency, one leader. I think we’re going to start really being more
responsive. The neighbourhood teams will give us the information that we need to be more
responsive, but I think we’re going to start doing things differently, and that’s going to bring us
to a much more integrated place.”
WHAT IS THE ROLE OF PHYSICAL HUBS (CO-LOCATED OR GEOGRAPHICALLY CLUSTERED SERVICES) IN THE INTEGRATED
SYSTEM MODEL?
Best Start hubs have been, and will continue to be, key to the vision of integrated services. These are
locations in which core services are available, and in which families can be connected to specialized
services as needed. The trust that is established with users of the hub creates an opportunity to
offer other connections.
There was also a sense that too much focus on a ‘one-stop, one-site’ approach may not be without
limitations. Although these sites have been very helpful at improving access and integration, there is also
a sense that outreach beyond these sites will be necessary.
“We’re thinking that the way that we have it set up right now at one site isn’t the answer, the
be-all, that we should go into other schools, other agencies, other venues, and do our work,
rather than paying $10,000 to be at one site.”
HOW WILL THE INTEGRATED SYSTEM RESPECT AND SUPPORT THE DIVERSE CULTURAL AND LINGUISTIC NEEDS OF
FAMILIES ?
Considerable work has already been done to be welcoming to all families in Greater Sudbury. Specifically
with respect to cultural and linguistic diversity, a framework is in use to further work in this regard. This
framework, developed as part of the Family and Community Engagement Strategy (FACES) project, was
funded by the Trillium Foundation and The Learning Partnership and was used as an adjunct to the
already established relationships at the Best Start Network to explore the reality for marginalized families
and their use of the Best Start Hubs. As a result of the project, the Framework was developed that
provides resources and supports for creating more inclusive environments. The FACES Framework is
currently being used in Hubs and Daycares. Additional training and implementation will be the next steps
toward full implementation of the FACES framework.
28
It was also noted that Aboriginal families have benefited from culturally appropriate services and that
relationships with Aboriginal communities, service providers, and families are important for the rest of
the system to welcome and pursue.
French language services, although available in many areas and services, are another area in which
constant attention is required, to ensure that services continue to be available in French. Supports for
children and families who want to learn French, or English-speaking children in French-speaking settings,
are needed and will be available particularly through the French-language school boards.
Technology
WHAT ARE THE TECHNOLOGY REQUIREMENTS OF THE INTEGRATED SYSTEM OF SERVICES?
of technology. The Best Start website, for one, is a use of Internet to make information easily available to
families. The centralized childcare registry in the City of Greater Sudbury is another similar resource.
Other potential and growing uses of technology include social media, and making internet access and
computers available at hub sites. Although it was acknowledged that not every family can be reached
through technology, many can, and the increasing access to smart phones and high-speed internet mean
that these are viable modalities for many families. Interviewees noted that there will always be a need
for diverse approaches, including new technologies and person-to-person interaction.
PROVIDE DETAILS ABOUT THE THREE TO FIVE MOST DIFFICULT DISCUSSION TOPICS FOR YOUR COMMUNITY PLANNING
NETWORK . FOR EACH, PLEASE DESCRIBE:




THE CONTEXT THROUGH WHICH THE CONVERSATION WAS INITIATED;
WHY THE TOPIC IS PERCEIVED AS BEING A DIFFICULT DISCUSSION (E.G. CONFLICT BETWEEN SECTORS OR KEY
STAKEHOLDERS , DISAGREEMENT WITHIN THE NETWORK ABOUT HOW TO PROCEED, TOPIC REQUIRED MORE
DISCUSSION THAN ANTICIPATED, ETC.);
THE STRATEGIES USED BY THE NETWORK TO RESOLVE THE DISCUSSION; AND
THE OUTCOME(S) OF THE DISCUSSION.
1. Ways to serve marginalized families
2. Funding
3. Hub locations
For all of these issues, participants spoke of a climate of trust and transparency, in which, although
everyone may not agree, everyone has a right to speak and be heard. Not all of these issues have been
‘resolved’, but all of them have been aired to a certain extent and there is commitment to further
dialogue.
29
“We certainly had lots of things to talk about that are not necessarily easy, but…, I think we’ve
been transparent and open and willing to struggle with stuff and willing to make changes, and
so I think that that’s what’s helped.”
It should be noted that such openness does not come easily or without effort, and the work is not done
without continuous attention.
“I remember one of the participants on the Best Start network in Sudbury saying, you know,
unless you were considered a mover or shaker, your opinion did not count, that there were
certain people that were highly influential and other people were afraid to say anything if they
disagreed with them. So I think there’s lots of work that we could do on networks to build trust
and leadership in everybody.”
“We’ve always had a chair that will ensure that people have had their opportunity to say what
they want. …We do something with an idea that comes from Hamilton, and they call them ‘safe
harbour’ conversations. Basically what they do is say ‘okay, we’re putting this on the agenda
because this has come up several times here or there, on the side, after the meetings,
whatever, so we’re going to put it on the agenda’, and then they talk to the people that are
crucial for that conversation, and we’ve really started to do that.”
Ways to Serve Marginalized Families
Part of the complexity of the system is the recognition that agencies differ in terms of their focus,
whether it is for marginalized or low income populations, or with a universal orientation. Agencies with
these areas of focus work well together in Sudbury, but the question of who the priority client groups
should be is an important one, often defined by agency mandates . Interviewees commented that there
is potential for barriers to arise in this regard, because universal programs do not necessarily meet the
particular needs of marginalized populations, and programs targeted to the needs of specific populations
can be scrutinized for not serving a broader audience. A blend is important, and has been achieved to
varying degrees, but there is a need to continue to monitor the balance of services so that all families
receive what they need in ways that area accessible and acceptable to them.
‘Difficult’ discussions have arisen with respect to marginalized populations, perhaps because these are
issues about which people feel passionately, and one in which mandates may explicitly conflict. The
importance of “a voice for the poor” at network discussions in one way of describing what the need is,
and it is felt that that voice should not be the responsibility of a small handful of agencies.
Part of the challenge is not just related to agency mandates, but also to social circumstances in which
there is stigma in associating with programs that serve or focus on marginalized populations, or social
pressures that create divisions among clients. The communities are not at a point where everyone
welcomes everyone else at a hub or other service, no matter how welcoming the staff may be. It has
been observed that marginalized families may be easily dissuaded from accessing service if they feel
judged by other participants, and this is an aspect of service integration that is not completely within the
control of agencies. Efforts are made to maintain a welcoming environment that is open to everyone, but
this is an ongoing challenge to integration for all agencies, given that integration is not only about visions
30
and governance, but also about the ability to successfully provide service for all community members.
The following quotations speak to different aspects of this ‘difficult discussion’.
“So that stigma, where do we become that community at large, and how do we work
cohesively together. …There were situations where we know for a fact, we put a hub in a
particular spot, and we were excited because there was social housing happening, in a great arc
around this school, so initially, we had all these parents coming to that hub, and it was great, …
and then what was happening was they were feeling ostracized. They weren’t being treated
equal, they weren’t comfortable, and they just stopped going.”
“That the discussion around our marginalized families attending hubs, I think that was probably
the trickiest one that came up, because you couldn’t say to the hubs that they’re not going
because they’re not feeling comfortable, because that’s a real touchy issue, because it seems
like you’re telling them they’re not doing their job well. … All parents, all families need
parenting strategies, and they all need supports, and they all should be allowed, and then we
don’t have the dollars within the system, but these families shouldn’t have to suffer for that,
right? So if we had more hubs available in more areas, we could have more designated hubs to
be for marginalized families, but we don’t have the dollars within the system to open the hubs
everywhere they need to be opened.”
“They were very sensitive to criticisms that the hubs were just serving middle class moms on
mat leave, and that our families that were more marginalized didn’t feel comfortable going
there, their ways of being weren’t reflected in the way these centres were designed, or the
people that attended them, there was a period of real sensitivity. …What we’re finding is that
the hubs are almost trying to find their way out of that difficulty by doing new and different
things in some of the housing project communities.”
“We know that at some hubs, we need to see more, we would like to see more of our at-risk
population. It’s universal, but we have to ask ourselves those hard questions as to why aren’t
we seeing some of the populations we want to see, and are we set up in the best location, are
we offering programming that’s of interest to people.”
Funding
With a move to greater integration comes a highlighting of inequalities or inequities in the system.
Not all agencies providing hub or hub-like services receive the same funding to do so, and as these
agencies come together and aim for similar levels of service, the differences in funding come out. It
appears that because the system operates as separately governed agencies with separate funding,
there may be little the Network can do to address those issues directly. The Network is not in a
position to equalize budgets between different agencies, and as a result these differences continue
to persist. The resolution, if there is one, may need to come from outside the Network. There is also
a sense that money and funding issues are not easily talked about.
31
“Funding. We tip-toe around that a lot. There’s a lot of things we can’t do because we don’t
have the funding to do it, and we know that, other agencies might have funding, may not, I’m
not sure, but just no one talks money.”
Money, money, money. Funding, equity, those are very difficult, touchy situations, and even
just this exercise [hub review] that we’ve just gone through, you can see people getting their
backs up, and afraid of losing, really, and so, at one of the meetings we said listen, let’s not
make this about closing down programs, let’s not go there now, because if we start doing that
people will start not attending, not participating. …But money’s a touchy issue. [And are the
answers to that, if there are any answers, are they at that Network table?] Probably not. No,
it’s probably bigger than us.”
Hub Locations
As referred to in the previous quotation, a recent hub review process has been undertaken by the
network, with participation from all involved partners. As part of the review, there will need to be
decisions made about possible shifts in the locations of hubs – decisions that will be made with the best
interests of families and communities at heart. However, these decisions also carry with them a feeling of
potential loss, as is the case with any change process. Schools, school boards, hubs and other agencies all
have a vested interested in hub locations, and given the scarcity of funding to support hubs, it is
anticipated that the choices may be difficult. It has also been acknowledged as part of these discussions
that the physical location of a hub should not be the only important determinant of where and how the
work of a hub can happen – the need to move beyond “bricks and mortar” conversations is part of the
way to be creative in responding to this challenge.
“Another one that I think continues to be difficult is any time we do a review of the system, so
how many hubs do we have, and where are they located, it tends to be tricky. Just recently
they did a review like that and they talked about well, in this school it’s costing us this much
money for cost recovery to be in this school, and in that school it’s free space, and so those are
difficult conversations to have, because you have those school board reps there, and you have
these people who are doing the work of hubs there.”
CONCLUSIONS
This project benefited from the participation of The Greater Sudbury Integration and Planning Best Start
Network members and other community agencies to reflect the current state of progress toward
integration, the challenges that have been encountered, and the potential next steps. Progress is being
made toward integration through the efforts and dedication of members, and the history of working
together and innovating provides a solid foundation for these communities.
32
Appendix A: List of Greater Sudbury Best Start Network Interviewees
NAME
Sherry Fournier
Jane Bauer
Joanne Tramontini
Laura Whalen
Suzanne Malette
Janet Gasparini
Megan Dumais
ORGANIZATION
Child & Community Resources
City of Greater Sudbury
Conseil scolaire catholique du Nouvel
Ontario
Conseil scolaire publique du Grand
Nord de l’Ontario
Infant Development (Specialized
Services)
Ministry of Education
Preschool Speech and Language &
Infant Hearing
Sudbury & District Health Unit
Kathy Longarini
Sharon Spier
Sylvie Langlois
Pierrette VincentSchroeder
Lina Davidson
Dan Boivin
Stephanie Brazeau
Susan Nicholson
Karen Renout
ROLE
Executive Director
Executive Director, BSN Co-Chair
Manager
Best Start Coordinator
Directrice de la petite enfance
Agente de développement
Communautaire
Supervisor
Child Care Advisor
Executive Director
Manager / Coordinator, North Bay
Regional Health Centre
Executive Director
Manager, Health Promotion and BSN CoChair
Community Outreach Coordinator
Superintendent
33
Appendix B: Interview Questions
Interview Questions -- Best Start Key Informants
Thank you for participating in this interview for the Community Integration Leaders project. Your
responses are voluntary and you can stop your participation at any time. I would like to voice
record this interview, with your permission. I may use quotations from the interviews in the
report, and I would identify you as one of the key informants for this project. Is that acceptable
to you?
1. Where do you work and what is your role vis-à-vis Best Start and child and family
services?
2. How long have you been involved with Best Start? With your agency?
3. Integration from the Ministry’s perspective has four levels along a continuum (MCYS, Defining
Integration, 2011): (refer to diagram)
a. When you think about the system from the perspective of your agency or role, where
would you say the system is at right now? Why?
b. When you think about the system from the perspective of the families you serve,
where would they say the system is at right now? Why?
4. Since the inception of the Best Start Network, what has been most important in moving along the
continuum towards integration? Why? What other factors have contributed?
5. What do you consider to be the main barriers or challenges that have limited or slowed-down
progress toward integrated services?
6. What would help to eliminate or reduce these barriers or challenges?
7. What do you think will be the next important steps toward integration of services?
8. What would make it easier for families to enter the system?
9. What would make it easier to connect families to different services seamlessly within the system?
10. What would support cultural and linguistic diversity?
11. What should be the role of physical hubs (co-located or geographically clustered services) in the
12. How could technology support integration?
13. What have been some of the most difficult discussion topics for your community planning
network? For each, please describe:
b. Why the topic is perceived as being a difficult discussion
34
14. To your knowledge, in what ways has children’s healthy development been impacted by service
integration? Our framework for defining “children’s healthy development” is the EDI domains. So,
“healthy child development” means children’s physical health and well-being, their social skills and
emotional maturity, their ability to communicate their needs, understand others and their interest
in literacy and numeracy.
This might include:
a. The impact on program planning and service delivery (e.g. school readiness, family support,
nutrition, recreational programs/services)
b. Strategies to support initiatives, programs, or professional development (e.g. Triple P,
Emergent Literacy)
15. From your experience, in what ways has service integration impacted the early identification of
children with special needs?
This might include:
a. The impact on planning (e.g. screening plans, transition to school plans)
b. The community's capacity to deliver screening
c. Wait-list and service delivery impacts
d. Any other impacts not mentioned
16. From your perspective, in what ways has the service system responded or made system changes
in relation to identified needs?
This might include:
a. Client or community needs (e.g. accessibility, targeted services)
b. Service delivery (e.g. inclusive, supportive or seamless)
c. Staff (e.g. professional development or training)
d. Network (e.g. communication or planning)
17. The last documentation of Greater Sudbury integration as part of a Community Integration
Leaders grant was the Chelmsford Project in 2011. Are there important initiatives that have
happened since 2011 I should pay particular attention to?
18. To what extent do you feel it would be valuable for there to be greater integration between
Greater Sudbury and Manitoulin-Sudbury districts?
19. What would be your advice to someone from another community that wanted to move toward a
more integrated system of child and family services?
35
Appendix C: Online Survey Questions
We are seeking the input of Best Start Network member agencies through this online survey. The survey
can be completed by anyone who works in child and youth services in any capacity. We expect the survey
may take you up to 15 minutes, or up to 30 minutes if you answer for both City of Greater Sudbury and
Manitoulin-Sudbury Districts. You can save the survey and return to it later, if you save the link the survey
provides when you press "save and continue later". The survey will be open until Friday March 7.
Background: Community Action Research - Community Integration Leaders (CAR-CILs) project funding has
been provided by the Ministry of Child and Youth Services to promote and support ongoing efforts
towards the creation of an integrated system of child and youth services in the Manitoulin-Sudbury and
City of Greater Sudbury Best Start Networks.
Purpose: This component of the Community Integration Leaders project is to document ways
that communities have made successful advances toward integration, and document the on-going work
of these communities as they continue to progress toward integration.
YOUR ROLE
Your organization name:
Would you describe your role as:
Front line staff
Management
Administrative staff
Other, please specify... ______________________
Do you have knowledge of child and youth services in: (Check all that apply: If you check both, you will do a
separate survey for each region)
Greater Sudbury
[Questions for Greater Sudbury have been removed from this list of survey questions.]
Greater Sudbury
The following questions ask you to think about the system of child and youth services in the City of
Greater Sudbury and the Greater Sudbury Best Start Network.
Awareness
Coordination
Collaboration
Integration
36
1
2
3
4
Organizations in
the community are
aware of others’
programs and
services but they
organize their
activities based
solely on their own
mandate and
planning processes.
There is the
potential for
service gaps and/or
duplication of
services across
organizations.
community modify
their own service
planning to avoid
duplication or to
improve links among
their knowledge of
other services or
programs. They
maintain a master
other agencies as
necessary.
Some, or all,
community jointly
plan programs and
services and modify
a result of mutual
consultations and
advice.
1
1.5
2
2.5
3
3.5
4
Thinking about the system of child and youth services from the perspective of the families you serve, where
along the continuum would they say the system in the City of Greater Sudbury is at right now? Please drag
the button below to indicate your answer.
1
37
1.5
2
2.5
3
3.5
4
How important has each of the following factors been in moving along the continuum towards integration
of services in the City of Greater Sudbury? If a factor is not present at all, check Not Applicable.
Not very
important
Somewhat
important
Very
important
Don't
know
Not
Applicable
Strong community champion or
champions for the integration of
services/supports.
A community vision that is inclusive of
integration.
Support and buy-in from the
municipality for the integration of
services/supports.
A planning process/accountability
framework that supports partners in
moving toward integration.
Having staff who are dedicated
specifically to the work of Best Start.
In your opinion, what has been the most significant factor in moving towards integration in the City of
Greater Sudbury? (Choose only one).
Strong community champion or champions for the integration of services/supports.
Support and buy-in from the municipality(ies) for the integration of services/supports.
38
A planning process/accountability framework that supports partners in moving toward integration.
Having staff who are dedicated specifically to the work of Best Start.
Please provide any comments about factors that have influenced progress toward integration in the City of
Greater Sudbury.
Thinking about the early identification of children with special needs, how much has improved service
integration in the City of Greater Sudbury affected the system's ability to offer:
Not at
All
much
Don't
Know
a full range of information and resources
developmental assessments
18 month well baby screenings
physical assessments (i.e. dental, vision,
hearing)
speech and language services for children up
to age six
support for parents of children with special
needs
outreach services to remove barriers to access
Please make any comments about ways that early identification of children with special needs has been
affected by service integration in the City of Greater Sudbury.
Thinking about healthy child development, how much has improved service integration in the City of
Greater Sudbury affected the system's ability to:
“Healthy child development” can include children’s physical health and well-being, their social skills and
emotional maturity, their ability to communicate their needs and understand others, and their interest in
literacy and numeracy.
Not at All Slightly Somewhat Very much Don't Know
deliver services
39
Please make any comments about the ways that healthy child development has been affected by improved
service integration in the City of Greater Sudbury.
Thinking about the system being responsive to changing needs, how much has improved service integration
in the City of Greater Sudbury affected the system's ability to:
Not at
All
much
Don't
Know
address family/children's needs as identified by
neighbourhood/community
provide accessible services as needed
provide inclusive services
provide seamless services
provide supportive services
provide professional development and training
engage in effective communication and knowledge
transfer
engage in cross-sectoral planning
Please make any comments about the ways that the system's responsiveness to changing needs has been
affected by improved service integration in the City of Greater Sudbury.
How have wait times at your agency been affected by improved service integration in the City of Greater
Sudbury? If your agency does not have wait times for service, check Not Applicable.
Increased
greatly
Increased
slightly
Not
changed
Decreased
slightly
Decreased
greatly
Don't
know
Not
applicable
Wait
times
have:
Please make any comments about ways that wait times have been impacted by service integration in the
City of Greater Sudbury.
40
Barriers and Enablers of Integration
What do you consider to be the main barriers or challenges that have limited or
slowed-down progress toward integrated services in the City of Greater
Sudbury?
What would help to eliminate or reduce these barriers or challenges?
What do you think will be the next important steps toward integration of
services in the City of Greater Sudbury?
Seamless, Welcoming Services
What would make it easier for families to enter the system in the City of
Greater Sudbury?
What would make it easier to connect families to different services seamlessly
within the system in the City of Greater Sudbury?
What would support cultural and linguistic diversity in the system in the City of
Greater Sudbury?
How could technology support integration in the City of Greater Sudbury?
Awareness
Coordination
Collaboration
Integration
1
2
3
4
Organizations in
the community are
aware of others’
programs and
services but they
organize their
activities based
solely on their own
mandate and
planning processes.
There is the
potential for
service gaps and/or
duplication of
services across
community modify
their own service
planning to avoid
duplication or to
improve links among
their knowledge of
other services or
programs. They
maintain a master
other agencies as
Some, or all,
community jointly
plan programs and
services and modify
a result of mutual
consultations and
advice.
41
organizations.
necessary.
Using the continuum in the table above, please rate the level of integration demonstrated in your
organization’s relationship with the other sectors/organizations making up the City of Greater Sudbury
Best Start Network.
1:
Awareness
2:
Coordination
3:
Collaboration
4:
Integration
Don't
know
Not
applicable:
We don't
have a
relationship
with this
sector
Best Start Hubs
English Catholic
(SCDSB)
French Catholic
(CSCNO)
Child Care Sector
Children’s Health Care
(may include: Sudbury
& District Health Unit;
Health Sciences North
– Family and Child
Programs; Centre de
Sante
Communautaire; First
Nation Health
Services)
Children’s
Development Services
(may include: NEMHC;
Children’s Community
Network; Child &
Family Centre;
42
Sudbury Development
Services; CGS
Children’s Services)
Children’s Protection
Children’s Aid
Services; Kina
Gbezhgomi; Genevra
House; Haven House)
Children’s Recreation
Services
Children’s Special
Needs Services (may
include: CCN; CCR;
Children’s Treatment
Centre; CGS Children’s
Developmental
services; Special
Needs Resource
Program; Speech and
Language)
Early Years Services
(may include: Better
Beginnings Better
Futures; Our Children
Our Future; OEYC)
Prenatal Services (may
include: HBHC;
Breastfeeding Clinics;
Centre de Sante
Communautaire;
Aboriginal Prenatal
Nutrition
(N’Swakamok); CCN
(Special Needs
Resource Program)
Parenting Related
Triple P)
43
Family Resource
CAP-C; Manitoulin
Family Resources)
High levels of integration may not be necessary for the system to be effectively delivering services to
children/families. With this in mind, please rate how well your agency's current level of integration with
each sector in the City of Greater Sudbury is meeting system needs.
The system needs
are met by the
current level of
integration. No
change is needed.
The system needs
could be better met
through improved
integration. Change
would be valuable.
Not applicable:
We don't have a
relationship with
this sector.
Best Start Hubs
English Catholic (SCDSB)
French Catholic (CSCNO)
Child Care Sector
Children’s Health Care (may include:
Sudbury & District Health Unit;
Health Sciences North – Family and
Child Programs; Centre de Sante
Communautaire; First Nation Health
Services)
Children’s Development Services
(may include: NEMHC; Children’s
Community Network; Child & Family
Centre; Sudbury Development
Services; CGS Children’s Services)
Children’s Protection Services (may
include: Children’s Aid Services; Kina
Gbezhgomi; Genevra House; Haven
House)
Children’s Recreation Services
Children’s Special Needs Services
(may include: CCN; CCR; Children’s
Treatment Centre; CGS Children’s
44
Developmental services; Special
Needs Resource Program; Speech
and Language)
Early Years Services (may include:
Better Beginnings Better Futures; Our
Children Our Future; OEYC)
Prenatal Services (may include:
HBHC; Breastfeeding Clinics; Centre
de Sante Communautaire; Aboriginal
Prenatal Nutrition (N’Swakamok);
CCN (Special Needs Resource
Program)
Parenting Related Services (may
include: Triple P)
Family Resource Services (may
include: CAP-C; Manitoulin Family
Resources)
5
April 2014
45
Cross Network Connections
Table of Contents
Manitoulin-Sudbury District and Great Sudbury Best Start Networks: Cross-Network Connections ............ 1
Benefits to Families ................................................................................................................................... 1
Reasons to Consider More Collaboration/Integration Between Networks ............................................... 1
Efficiency for participants at both networks......................................................................................... 1
Shared planning .................................................................................................................................... 1
Reasons to Prefer Defined Boundaries Between Networks ...................................................................... 2
Efficiency for participants at one network............................................................................................ 2
Focused planning .................................................................................................................................. 2
Funding ................................................................................................................................................. 2
Potential Points of Connection .................................................................................................................. 2
Other Strategies to Consider ..................................................................................................................... 3
Questions and Issues for Further Consideration ....................................................................................... 3
Existing Examples ...................................................................................................................................... 4
Manitoulin-Sudbury District and Greater Sudbury Best Start Networks: CrossNetwork Connections
The CARCILs project was a joint initiative of the Greater Sudbury Best Start Network (known as the Best
Start Integration and Planning Network) and the Manitoulin-Sudbury District Best Start Network. As
part of the CARCILs research, interviewees were asked to reflect on the potential for greater connection
between the networks. This brief report outlines the findings of that investigation.
The two networks already are connected in several ways: there are several agencies that participate in
both networks; in some cases the same people from those agencies sit on both networks; some children
and families use services provided in both geographic areas or move back and forth between areas; and
there has been information sharing between networks on common issues. In addition to these points of
connection, joint meetings of the networks have happened starting in 2013, and some joint
subcommittees, such as the Triple-P subcommittee, are already in place.
Benefits to Families
Interviewees remarked that the question of whether and how to collaborate or integrate should come
back to benefits for families. Would families be better served by information sharing and meaningful
cooperation across networks? Most felt that there would be advantages to pursuing this approach, and
the steps that have been taken to have occasional joint meetings are in keeping with this perspective.
Would families be better served by a combined network? Most interviewees were not persuaded of the
overall benefit of one integrated network. Interviewees from organizations that serve families across
the network areas tended to see that their services are already reasonably well integrated with other
similar agencies. However, there were certainly reflections that there are gaps in the accessibility of
services across the system and that families could benefit from more collaborative efforts to address
those gaps.
Reasons to Consider More Collaboration/Integration Between Networks
Efficiency for participants at both networks
Many network participants who sit on both networks are in strong support of more collaboration
between the networks. From an efficiency perspective for organizations that participate in both
networks and serve populations in both areas, greater connections have benefits. There is currently
some duplication across networks: Some information from the Ministry or other sources is shared at
both tables, participants may have to present the same updates twice, the same topics of discussion
may arise, and so on. It was also noted that, given the ongoing challenge of engaging agencies who are
not now participating in Best Start networks, there might be more participation if there were fewer
tables.
Shared planning
Many interviewees saw benefit shared planning and efficiency across networks, in that planning tasks
might only need to be completed once.
1
Reasons to Prefer Defined Boundaries Between Networks
Efficiency for participants at one network
For organizations that serve populations in only one of the network areas, the benefits to greater
connection are not as pronounced. In fact, such connection could mean a lack of efficiency for them.
For example, joint meetings would involve some discussions that have no direct relevance to their
programs. That is not to say that there would not be interest in hearing about initiatives or issues in
other areas, but the implications for their services would be minimal.
Focused planning
One of the challenges articulated for each of the networks was the breadth of the planning and
integration tasks that face the Best Start networks. By broadening the table and the geographic area,
the breadth of the planning task would only increase, potentially increasing the sense that planning
tasks are slow-moving and difficult to accomplish in a timely manner. Maintaining the separate planning
functions allows some degree of focus for the networks and preserves a sense that the networks are
able to respond to local issues and needs.
Funding
Interviewees also spoke of the funding implications of integration across networks –there has been a
sense that if the planning funding were pooled, the issues of the smaller population in the district areas
would be lost in the shadow of the Greater Sudbury issues. For both networks, there is a feeling that
their resources are already stretched – the prospect of stretching further to reach a larger audience
provokes some concern. Of course, there are resources within both networks, so any pooling would not
necessarily mean a thinning of resources, but there is no eagerness to create additional resource
challenges unless there is overall clear benefit to families.
Potential Points of Connection
Interviewees had many points of agreement on where they saw potential for greater collaboration
across networks.
•
•
•
•
•
Shared training and professional development
Shared material on websites, knowing that families may draw from both; perhaps a shared
website
Subcommittees on areas of mutual interest, as has been done with the Triple-P subcommittee
Quarterly joint meetings were supported, primarily for building familiarity across networks,
working together and discussing issues that do cross networks, and shared learning. Quarterly
joint meetings are also considered to be a small acknowledgement of the ‘meeting burden’
borne by people who attend both networks, since for that month they have only one meeting
instead of two.
Maintaining the separate networks still allows local planning to occur, which most interviewees
also felt was important.
2
•
Collaboration and steps toward integration were supported when the purpose and benefit of
such movement is clear, not for ‘theoretical’ reasons that move toward inter-network
integration without considering what may be lost.
Other Strategies to Consider
•
•
•
Making a conscious effort at each network to ask whether the issue at hand crosses over to the
other network, and discussing the issue together when practical.
When the circumstance makes sense, working together: to address gaps and snags, to build
knowledge about other services, to collaborate on projects. In other words, some shared
planning and implementation could be beneficial.
Monitoring successes and learning opportunities, and building in opportunities to learn from the
other network about their experiences. For example, strategies used by Local Service Provider
Networks in Manitoulin-Sudbury District have been informative to the development of
neighbourhood teams in Greater Sudbury, since the focus of both is local services.
Questions and Issues for Further Consideration
Interviewees had questions about the potential for greater collaboration, and raised issues for
consideration. Many of the same issues that arise about integration within networks (as articulated in
the CARCILs report for each network) also arise when considering integration across networks:
•
•
•
•
•
•
•
•
•
Do the networks share a similar vision – or could they find a similar vision?
What would be the value of shared planning for families?
What supports would be available for working toward collaboration or integration across the
networks? As has been the case within networks, work toward integration does not happen
without dedicated effort and supports.
The areas are similar in some respects and different in others –how can collaborations work
together on issues of similarity and allow for separate development on issues of difference (such
as rural service delivery or needs of larger municipalities versus smaller ones)?
How can the network members build trust across a larger and diverse area?
Would the system become too complex to be manageable?
What could be lost?
Where would meetings be held?
Who would need to be at the table?
It is noteworthy that the current Best Start Network structures and boundaries, although reasonable
and aligned with other structures such as municipal governments and District Services Boards, are also a
function of history. Best Start Networks have been set up with one in each of Greater Sudbury and
Manitoulin-Sudbury Districts, although many organizations (e.g., child protection, public health, school
boards, children’s mental health, specialized services, etc.) have mandates to serve both areas. If the
premise had started with networks set up along the lines of one of these organizations, the structure
would look different. The current structure may or may not be the best one, but it is a function of how
the groups originated rather than a very conscious decision on how best to work together.
3
Existing Examples
People and agencies already work together across the districts in many ways, some related to Best Start
and others outside of that structure. Thus, there are personal connections already in place that would
help any moves toward further collaboration. Interviewees noted that communication and relationships
are key to establishing this potential for successful collaboration.
Triple P is the most obvious example of a shared project that is jointly administered. Overall, this was
felt to be a strong example of the potential for sharing, but it was also noted that with one
representative from district area on the subcommittee, the issues associated with distance, rurality or
other district issues can get lost at the end of a meeting agenda, or can be overshadowed. Although
efforts have been made to address these challenges, this example also points to the complexity
associated with working across a large and diverse area.
The experience with Partners for Children and Youth, which covers the District areas as well as Greater
Sudbury, is that the engagement of Greater Sudbury-based participants has been easier than
engagement of participants from the District areas. Distance to travel for meetings, and the prevalence
of Sudbury-based organizations at the table create an imbalance that has not entirely been overcome in
the early development of this group. With an intent to involve partners from a wide range of sectors,
the number of potential participants across the districts is extensive. The success of this group at
working across the districts may be instructive for Best Start networks.
Finally, it was noted that the experience of working together on the CARCILs project funding proposal (of
which this report is a part), is another example of successful shared initiatives that may serve as a basis
for future collaborations.
4
Greater Sudbury
Best Start Networks
Appendix 2
Product 4: Impact of Integration on Key Child and Family Outcomes
This report was compiled and written by
Tammy Turchan
Data Analysis Coordinator
The Social Planning Council of Sudbury
Thanks to all the Best Start network
members and service providers that
responded to surveys and interviews,
and to the agencies that provided data.
Special thanks to the families that filed
out the parent surveys.
Table of Contents
INTRODUCTION ............................................................................................................................................. 1
EXECUTIVE SUMMARY................................................................................................................................... 1
METHODOLOGY ............................................................................................................................................ 3
DATA SOURCES ............................................................................................................................................. 4
PARENT PROFILE ........................................................................................................................................... 8
EARLY IDENTIFICATION OF CHILDREN WITH SPECIAL NEEDS ....................................................................... 9
Service Delivery Outcomes ....................................................................................................................... 9
Child and Family Outcomes .................................................................................................................... 10
HEALTHY CHILD DEVELOPMENT ................................................................................................................. 12
Service Delivery Outcomes ..................................................................................................................... 12
SERVICE WAIT TIMES .................................................................................................................................. 18
SYSTEM’S ABILITY TO RESPOND TO CHANGING NEEDS.............................................................................. 20
PARENT SATISFACTION WITH CHILD AND FAMILY SERVICES IN THE COMMUNITY ................................... 21
Parent’s Experience of Integration ......................................................................................................... 22
CONCLUSION............................................................................................................................................... 23
APPENDIX I: CAR CIL Parent Survey ............................................................................................................ 24
APPENDIX II: Kindergarten Parent Survey .................................................................................................. 27
INTRODUCTION
This report identifies the outcomes that have been impacted by system integration in the ManitoulinSudbury Districts. The research question specifically asked about the child and family outcomes in relation
to the early identification of children with special needs, healthy child development, service wait times,
they system ability to respond to identified needs and parent satisfaction. The goal of integration is a
‘seamless system’ that is easy for families to navigate and access through improved planning and delivery
of child and family services. Therefore the impacts of integration included ‘service delivery’ and ‘child and
family’ outcomes.
EXECUTIVE SUMMARY
Early Identification of Children with Special Needs
The early identification of children with special needs has increased significantly through improved service
integration. Positively impacting: speech and language services, development assessments, access to and
sharing of information and resources, as well as the supports provided to parents of children with special
needs. The Manitoulin-Sudbury Districts are challenged by large geographical boundaries and the results
of the evaluation show that the DSSAB BSN continues to contest with removing such barriers to access
and improving outreach services.
Service providers and practitioners are sharing information and tools at the Network table and as result
have an increased capacity to assist families in terms of the quality and expediency of services as well as
supporting children through the transition and entry into the school system. As service capacity continues
to increase so does the number of children being served and system administrators expressed the benefits
of maintaining flexible funding guidelines which allow them to allocate funding to appropriate resources
and identified needs. Overall, improved service integration has had positive impacts on children and their
families, with children being identified earlier and families being better served.
Healthy Child Development
Improvements in service integration have increased the ability of the system to plan and deliver programs
and services which has had positive impacts on healthy child development. Specifically, the school
readiness of children, improved parenting skills of parents and overall service accessibly.
Best Start Hub usage has doubled since 2009. The highest attended programs were play-based though
library and language-based programs were also well attended. The most common reason parents
reported for not accessing services was that the service was not available near to where they live.
The number of children attending licensed child care in the Manitoulin-Sudbury Districts has also
increased, at least for children beyond infancy years where childcare spaces are more readily available.
Transportation continues to be a challenge for the Districts due to the large and dispersed nature of the
area and will require flexible solutions. Additional challenges exist around serving First Nation children,
rooted in funding complexities among the various levels of government serving First Nation communities.
The Early Development Instrument trends reveal a number of areas where early learning and child care
programs have helped prepare children for entry into school such as literacy, cognitive development,
communication, and social competence, all areas where children in the Manitoulin-Sudbury Districts
1
scored above or equal to the provincial average. However, in the areas of physical health and well-being,
and emotional maturity, children are scoring well below the provincial average which is likely linked to
larger underlining social issues.
Service Wait Times
Wait times for most services within the Network do not present a barrier to access and the majority of
service providers reported that wait times have not been impacted by system integration. The services
that do have wait times are predominantly specialized services, which have been experiencing a rise in
service demand primarily boosted by an increase in the numbers of children with special needs being
identified early. The reoccurring theme rooted in the challenges of servicing a rural geography was
highlighted by services providers as having an impact on the length of wait times for specific services.
Service providers are aware of these challenges and take advantage of the Network’s integration to best
support families through other services while they wait for a particular service or program to become
available.
System’s Ability to Respond to Changing Needs
There is bright side to the nature of the vast Northern geography of the Manitoulin-Sudbury Districts,
namely its rural culture. The culture has a strong sense of social support which extends to the children
and families working with BSN service providers. Flexibility and creativity are also adaptive characteristics
that have become an important part of the service providers’ ability to respond to the ever changing needs
of children and their families in this very challenging geography. Bolstered by improved system
integration, the Networks’ ability to provide inclusive, supportive, accessible services and the seamless
delivery of services continues to be strong. Service providers are sharing knowledge and information and
are developing collaborative cross-sectoral committees aided by flexible funding guidelines which allow
them to increase their overall planning capacity and address multi-dimensional issues.
Parent Satisfaction with Programs and Services
Parent satisfaction with programs and services is very high. The majority of parents surveyed reported
being satisfied or very satisfied with the support services, programs, workshops, referrals and information
they receive. They are comfortable discussing their family’s needs with service providers and find the staff
to be helpful and knowledgeable. Although parents are less satisfied with wait times for services and
access to services. Overall most parents report a positive experience with the ‘seamless’ delivery of
services. Nearly half found the system to be at collaborative level of integration and another quarter said
they have experienced an integrated system.
2
METHODOLOGY
The methodology used to address the research question included: data analysis from various sources
including the Early Development Instrument (EDI), the Kindergarten Parent Survey (KPS); a review of data
from various agencies serving children and families through central access and referrals, parent support,
early learning and child care services; survey and interview with key service providers to identify the
impacts of integration on planning and service delivery; and surveying parents regarding their experience
and satisfaction with the programs and services.
The following indicators were used to measure the outcomes.



The impacts of service integration on the system’s ability to offer:
o A full range of information and resources
o Developmental assessments
o 18 month old well-baby screenings
o Physical assessments (i.e. dental, vision, hearing)
o Speech and language services for children up to age six
o Support for parents of children with special needs
o Outreach services to remove barriers to access
The number of referrals received by the central access agency
The number of children using specialized services as reported by parents






The impacts of service integration on the system’s ability to:
o Plan programs and services
o Deliver services
o Offer accessible services
Children’s school readiness as measured through EDI
Children’s participation in pre-school programs
Children’s participation in licensed child care
Parent’s participation in family and/or parenting support programs
Parent’s perception of program impacts for child and parent in relation to:
o Children’s school readiness
o Support for children
o Support for families
o More knowledgeable about child development
o Improved parenting skills
Service Wait Times



The impacts of service integration on agency wait times
The number of children waiting for service as reported by parents
Parent satisfaction with wait time
3
System Response to Identified Needs

The impacts of service integration on the system’s ability to respond to identified needs including:
o Addressing family/children’s needs as identified by neighbourhood or community
o Providing accessible services as needed
o Providing inclusive services
o Providing supportive services
o Providing seamless services
o Providing opportunities for professional development and training
o Engaging in effective communication and knowledge transfer
o Engaging in cross-sectoral planning
Parent Satisfaction



Parent satisfaction with services in relation to:
o Activities for children
o Support services for children
o Support services for parents
o Programs and/or workshops for parents
o Information available to parents
o Referrals and connections to other services/agencies
o Access to services/programs
o Registration process to services/programs
o Wait time for services/programs
Parent satisfaction with service delivery in relation to:
o Staff assistance
o Staff knowledge about community services
o Practicality of information
o Comfortable communication of needs
Parent’s experience of integration along the continuum
DATA SOURCES
Community Agencies
The agencies that are represented in the data review include: Children’s Community Network (CCN),
Districts Services Board: Children’s Services, Best Start Hubs, Our Children Our Future (OCOF).
Early Development Instrument (EDI)
The EDI is a questionnaire that measures young children’s readiness to learn at school. School readiness
refers to children’s ability to benefit from the educational activities at school and to be able to meet these
demands. The EDI provides data that assesses school readiness across five developmental domains –
physical health and well-being; social competence; emotional maturity; language and cognitive
development; and communication skills and general knowledge.
Senior Kindergarten students are classified into four readiness categories based on the results of the EDI:
“vulnerable”, “at risk”, “ready”, and “very ready”. The degree of school readiness predicts how well
4
children will do at school. Of particular interest are children who are vulnerable as these children are less
ready to learn and less likely to succeed at school.
% of students at or above
provinical standard
EQAO worked with the EDI researchers from the Offord Centre at McMaster University to explore the
relationship between EDI results and the EQAO results in Grade 3 reading and mathematics.
Relationship Between EDI (2005-2008) and Achievement in
Grade 3 Reading (2008-2011): Ontario
100
80
60
40
20
0
36
47
61
74
42
51
62
78
73
68
63
34
At Risk
63
49
47
Ready
77
46
30
Physcial Health and Emotional Maturity Social Competence
Well-being
Vulnerable
82
30
Language and
Cognitive
Development
Communication and
General Knowledge
Very Ready
% of students at or above
provincial standard
The EQAO reading results for Grade 3 students show that students who were “ready” or “very ready” in
kindergarten were far more likely to meet or exceed the provincial standard in reading than those who
were “vulnerable” or “at risk”. It should also be noted that a substantial amount – about one-third to
one-half – of those who were identified as “vulnerable” or “at risk” in kindergarten did achieve the
provincial standard in Grade 3 reading. Similar trends were observed in Grade 3 mathematics results.
Grade 3 Mathematics (2008-2011): Ontario
100
80
60
40
20
0
71
41
55
84
51
61
73
82
73
44
87
78
At Risk
39
Ready
73
60
58
Well-being
Vulnerable
90
Language and
Cognitive
Development
44
85
57
Communication and
General Knowledge
Very Ready
EDI data is available at the Districts or community level and allows for comparisons across communities
and across time, by specific developmental domains.
In Manitoulin-Sudbury, 232 senior kindergarten children were evaluated by their teachers in February
2012. This includes four school boards – English and French, Public and Catholic schools.
Unfortunately EQAO data is not publically available for the majority of schools in the Manitoulin-Sudbury
Districts due to the small number of children. Thus, the trends in children’s literacy and mathematics
5
cannot be compared over time. However, based on the provincial relationships, similar conclusions can
be drawn that children vulnerable in senior kindergarten are far less likely to be at or above the provincial
standards of Grade 3 reading, writing or mathematics.
The Kindergarten Parent Survey (KPS)
The KPS is a survey that was developed by the Offord Centre for Child Studies – who also developed the
Early Development Instrument. The KPS provides information on family characteristics and experiences
of children prior to entering kindergarten.
In Manitoulin-Sudbury, 117 parents responded to this survey. These were the parents (or guardian) of
the 232 senior kindergarten children in Manitoulin-Sudbury who were involved with the EDI, including
children with identified Special Needs. That represents an overall response rate of 50%.
A 50% response rate for a voluntary survey is high and suggests that the responses are a good
representation of the population of parents in Manitoulin-Sudbury. To further verify and demonstrate
this representation, the KPS demographic information was compared to Statistics Canada data.
As the chart below indicates, parents with higher levels of education (university bachelor degree or higher)
were more likely than parents with lower levels of education (those with or without a high school diploma)
to fill out the KPS survey. This means that those with higher education are over-represented and those
with less education are under-represented in the KPS results. However the majority of respondents held
a college or trade diploma and were representative of the population.
% of respondents
Parent's Highest Level of Education
60
40
20
0
49 45
8
18
25
15
High School
Incomplete
High School
KPS
n=113
16
12
7
College-Trade Undergraduate
Diploma
Degree
4
Graduate
Degree
NHS (25-64 yrs)
In terms of family structure, two –parent families were more likely to complete the KPS than lone-parent
families or families that share custody. This means lone parent families are under-represented in the KPS
results. The category “other” included children living with grandparents or temporary care, which the
Census did not have a similar category for comparison.
Family Structure
82
100
50
12
69
31
5
0
One Parent / Shared Custody
n=114
Two Parent
KPS
Other
Census
6
% of respondents
In terms of household income, families earning more than $100,000 a year were over-represented and
families earning less than $50,000 year were under-represented in the KPS results. Those with middle
earnings, of $50,000 to $100,000, were representative of the population.
Household Income Pre-tax
60
43
33
40
36
30
33
18
20
0
<$50,000
$50,000-100,000
n=89
KPS
>$100,000
NHS
The results of the KPS is a good source of data about the experiences of parents and children in our
community. However, based on the under-representation of lone-parent families and of families with
lower education and incomes, the data should be interpreted with this in mind. For example, barriers to
services based on cost may be under-represented because families with low incomes are underrepresented.
CAR-CIL Parent Survey
A parent survey was designed to capture parent’s program usage, experience of integration and
satisfaction with child and family services. Of particular interest is parents’ satisfaction with service
delivery, administrative processes, and for those that use multiple services, their “seamless service”
experience.
The survey was distributed through multiple partners and means to capture as wide a scope as possible.
The partners included Best Start hubs, child care centers, Healthy Babies Healthy Children, Children’s
Community Network, Children’s Aid Society and Ontario Works. The means included an online and paper
survey, as well as surveying parents in the Shopping Mall during a Best Start hub promotion.
A total of 62 parents completed the survey. Based on an economic comparison between the surveyed
families and the National Household Survey, these families are representative of the family with children
population in Manitoulin-Sudbury.
% of respondents
Household Income: Parent Survey vs Manitoulin-Sudbury
40
30
20
10
0
n=40
30
25
$0 - $29,999
30
31
20
$30,000 - $59,999
26
$60,000 - $89,999
20
18
$90,000 +
Household Income, Pre Tax
Parents
NHS
7
The CAR-CIL Network Survey / Interview
Through an online-survey and in-person interviews, Network members (20 respondents) were asked to
what degree the following outcomes have been impacted by service integration in our community:




Early identification of children with special needs
Healthy child development
Service wait times
Ability of the service system to respond to changing needs
In order to understand the degree of impact, members could rate the impact as “not at all”, “slightly”,
“somewhat” or “very much”. To gain a better understanding of the context of the impacts, members
were also encouraged to comment in the survey and during the interviews.
PARENT PROFILE
This is a brief profile of the parents that are represented in the survey results. As indicated above, the
majority live in two-parent household and have a college or trade diploma. Lone-parent and lower
educated families are under-represented, while those with higher levels of education are overrepresented. In terms of household income, middle-income families were representative of the
population, while lower income families were slightly under-represented and higher income families
were over-represented.
Parents are accessing child and family support programs and indicated that these programs are
beneficial to themselves and their children. The most common reasons they were did not access
services is because it is not available in their area, it occurs an inconvenient times and they were not
aware or did not have information about the service.
In terms of licensed child care, the most important consideration for parent is the quality of care and
reputation of the center. Accessibility, that is the cost, location and hours of operation, was also very
important. In terms of barriers, the most frequent barrier to accessing child care cited by parents was
the cost. Other barriers were that times did not fit in with their work schedule, that it is difficult to find
care when a child is ill, and it can be difficult to get a child care space.
8
EARLY IDENTIFICATION OF CHILDREN WITH SPECIAL NEEDS
Improved service integration in the BSIPN has positively impacted the early identification of children with
special needs. There is more awareness and capacity to screen and identify needs across the system. And
in many cases, there is an increase in the number of children being referred or receiving services. This in
itself, presents the challenge of meeting the increasing demand.
Service Delivery Outcomes
Network members were asked about the impact on the range of resources and services available for
children with special needs including developmental assessments, physical assessments, screening
capacity, speech and language services, and parent support of children with special needs.
Based on the survey results of 20 respondents, the areas that have been most affected (somewhat to very
much) are speech and language services (82%), information and resources (76%), support for parents with
special needs children (75%), and developmental assessments (60%). Approximately half of the
respondents indicated that the 18 month screening and physical assessments had been somewhat
impacted by integration, and equal half indicated the impact was slight or not at all.
Early ID of Children with Special Needs: Service Delivery
Outcomes
70
63
57
60
40
50
44
38
43
36
33
44
36
31
25
30
19
20
10
50
47
50
13
6
19
14
13
7
7
0
0
0
0
7
0
0
Info &
Resources
Develop.
Assess.
Not at All
18 Month
Screen.
Slightly
Physical
Assess.
Speech &
Parent
Outreach
Language Support - SN Services
Somewhat
Very much
Members were also asked about the impact on outreach services to remove barriers to access. Over half
(57%) indicated that the impact on outreach services was slight or not at all. Providing outreach services
is likely challenged by the large geography and dispersed population in the Manitoulin-Sudbury Districts.
As one respondent stated:
For the agencies that do collaborate together we have a great working relationship and have
assisted families with referrals and supports. Our local service provider's network is in the planning
stages of hosting an early years screening day in the community. There are still families out there
that are harder to reach with transportation and little access to technology being a big issue.
Another respondent re-iterated the challenge of servicing the more rural areas:
It would be beneficial to do screening in the rural areas for preschoolers going to school. No
screening has been done but it has been in the urban areas.
9
Manitoulin-Sudbury has a significant aboriginal population (25%1), and one respondent spoke to the need
for culturally sensitive support:
In the Manitoulin Districts especially with First Nation children there is still a lack of early
identification and early year’s mental health. There is nothing culturally based or delivered from
a cultural model that would connect First Nation families to the process of early identification.
Child and Family Outcomes
Children are identified earlier and families are better served because integration has improved the
Networks ability to share information, plan service delivery as well as build the system’s capacity to
identify issues and refer families to the appropriate service.
Having special service providers around the Network table, sharing their information and tools, help
inform universal service providers with new developments, what to look out for, and how to use common
tools to identify an issue, such as a delay. For agencies that are often the first provider to come into
contact with the child and family, such as hubs and child care – this increases their capacity: practitioners
are better versed in screening, where to refer families and who to connect them to depending on the
need. This also means that a larger ‘net’ is being cast and more children are being identified earlier and
get the assessments earlier.
One respondent summarized the impacts succinctly:
I believe that there is now easier, clearer access to services when you have an identifiable
organization that is the one stop shopping place. It makes it easier for parents to know where to
go. It then results in earlier identification. It has allowed us access to broader selection of resources
and support, and it really enhances our team planning and overall achievement of goals that we’re
working towards.
The trajectory of this early identification is more support when the child enters the school system. The
Network has worked with transition to school plans, including brochures to assist families, as well as plans
for the school so they can be prepared to support that child.
While early identification and earlier referrals are a positive development, providers expressed concerns
about the capacity of their programs to meet the increasing demand. However, the system administrators
expressed that they were better able to meet the needs in their communities because of more flexible
funding guidelines.
This has allowed them to allocate the funding toward an identified need – in this case, special needs
resourcing, and increase support for families:
We were able to talk about increasing special needs resourcing because the need was out there
and there just wasn’t enough, of one body, 1.34 bodies I think we had, to service the Districts, and
now we’ve got 2.34 bodies, you know, we were able to add one more full-time person, the need’s
out there, and we talked about it, it was identified, and it was resolved.
1
Statistics Canada, 2011.
10
The number of referrals that the Children’s Community Network2 (CCN) processes each year for children
in Manitoulin-Sudbury Districts remains pretty consistent at approximately 850 children per year, with an
average of 130 children between the ages of 0-6. The number received through the Greater Sudbury and
Manitoulin-Sudbury DSSAB partner agencies (Education, Specialized Services, Health, and Early Learning
Sectors) has grown over the last 3 years, from 431 in 2010-11 to 459 in 2011-12 to 476 in 2012-13. This
may be in part due to the concerted efforts of the Network to plan toward the early identification of
children with special needs.
The KPS asked parents if in the years before their child started kindergarten, if their child received help
from specialized services. The specialized services used most often by children were speech and language
(21) and hearing (6) services. Services involving dental (5), physical (5), learning (3), developmental (3),
special nutrition (1), and behavioural (2) support were used comparably. Mental health (0), blind/low
vision (1), and English as a Second Language (0) services were used very little.
This data indicates that far more children are using specialized services (47) than are waiting for them
(13), which suggests that specialized services is meeting about 75% of the need in these communities.
This coincides with the response from parents, where a quarter of them (25%) indicated they were less
than satisfied with the wait time for services.
Overall, improved service integration has had positive impacts on children and their families, with children
being identified earlier and families being better served. Integration has improved information sharing
and planning while flexible funding guidelines have enabled administrators to allocate funding to
appropriate resources and identified needs.
Servicing a large rural geography and developing culture appropriate service delivery continues to be a
challenge, but the flexible funding has enabled the Network to increase special needs resourcing as well
as develop an Aboriginal Advisory Committee to assist with these challenges.
2
Data obtained through CCN Annual Reports 2010-2013
11
HEALTHY CHILD DEVELOPMENT
Integration has had many positive impacts from the system’s ability to plan and deliver services to
improved school readiness for children and improved parenting skills for parents. Of the 5 EDI domains,
2 are better than average, 1 is average, and 2 are worse than average. The areas that children are doing
well are in the areas of language and cognitive development, communication and social competence.
However, the prevalence of vulnerability (low on 1) has steadily increased since EDI was introduced in
2005.
In general, there has been an increase the utilization of children and parents attending programs, and
parents report that they and their child has benefited from the services they have received.
Network members were asked if improved service integration had affected the system’s ability to support
healthy child development. Based on the survey results of 18 respondents, the majority indicated that
improved service integration has had moderate to high impacts. Three quarters (73%) indicated that the
system’s ability to plan and deliver programs and services to support children has been positively
impacted.
In the words of one respondent:
When we work together it allows for identification of common needs and gaps, it allows us to work
cooperatively with each other to plan and deliver services, we’re able to share resources and
information, we’re able to partner for special events and activities that we usually have common
clientele that we’re trying to reach, it establishes a better awareness of programs and services
that are available in our community. So I think it definitely has a very positive impact.
Healthy Child Development: Service Delivery Outcomes
80
67
56
60
40
56
28
28
28
17
20
0
0
6
11
6
0
Not at All
deliver services
Slightly
Somewhat
Very much
In terms of the system’s ability to offer accessible services, 62% said integration had improved the
accessibility of services.
I believe that there is now easier, clearer access to services when you have an identifiable
organization that is the one stop shopping place. It makes it easier for parents to know where to
go. It then results in earlier identification. It has allowed us access to broader selection of resources
and support, and it really enhances our team planning and overall achievement of goals that we’re
working towards
12
However, a lack of transportation can be a real challenge to offering accessible services, and may require
service delivery accommodations, such as bringing the service to the client. In the words of one
respondent, “transportation is always a factor.”
Another respondent described that providers are flexible and responsive in their effort to support and
accommodate families:
Agencies are still looking at ways to access those families that are harder to reach. We have had
some success in providing some temporary transportation for a family to a Day Care…(and) having
more workers meet families in their home communities.
With a Districts that has a significant aboriginal population (25%), supporting children in First Nation
communities was emphasized. First Nation communities have different funders (federal vs. provincial)
and different agencies (on-reserve and off-reserve) providing services and sometimes these services are
not coordinated or accessible enough to meet the needs of the children.
Despite having services from MCYS child and youth workers, First Nation communities need more
comprehensive clinical services such as clinicians to assist Child and Youth Workers in the schools
to work with children. Also there needs to be more coordinated and comprehensive mental health
services to work with families at home. Now that there is child and youth workers added in the
schools for First Nations it has been a positive impact, but simply there is a need for more workers
and comprehensive services.
Children school readiness has improved and is better than average in 2 of 5 domains, and 1 is on par with
the provincial average. There has been a steady increase in the number of children and parents attending
programs and accessing services. The vast majority of parents indicate the services they used have been
a support to themselves and/or their child, have improved their child’s school readiness as well as their
own parenting skills and their knowledge of child development.
Early Development Instrument (EDI) Trends
Based on the results of 3 EDI cycles, the prevalence of children’s vulnerability (Low 1) has worsened as
well as their vulnerability in Physical Health & Well-Being. Vulnerability in Emotional Maturity has
remained the same for this cycle but are all worse than the provincial average.
The depth of vulnerability (Low 2) has also remained the same but is better than the provincial average.
Social Competence, Language & Cognitive Development and Communication & General Knowledge have
all improved since 2008 and are better than the provincial average.
EDI
2005
2008
2011
Ontario Higher Than Average
% Low:1 Domain or More
29
32
34
28
2 of 5 Domains
% Low: 2 Domains or More
10
11
10
13
% Low: Physical Health & Well-Being
10
14
20
13
% Low: Social Competence
6
6
9
9
% Low: Emotional Maturity
14
15
15
10
% Low: Language & Cognitive Dev.
8
6
4
10
% Low: Comm. & Gen. Knowledge
9
9
6
12
Green = Better than Provincial Average Red = Higher than Provincial Average Black = Same as Provincial Average
13
Domains that deal with literacy, cognitive development and communication have improved and are
significantly better than average. This is an area that programs – such as Best Start hubs and child care –
have the greatest impacts – and based on the EDI – they are succeeding in helping children prepare for
school.
The domains such as Physical Health and Well-Being and Emotional Maturity often reflect areas that are
difficult for programming to address. Issues around physical independence (i.e. going to the washroom
by themselves, sucking their thumbs), physical readiness (i.e. being properly dressed, arriving late or
hungry), hyperactivity and inattention are areas that are often beyond the scope of hub or child care
programming, and denote more complex issues within the family.
Children and Family Participation in Programs
Best Start Hubs
Best Start hubs are located or provide outreach services in Chapleau, Manitoulin Island, the Lacloche area
(Espanola, Massey, Webwood) as well as Sudbury East (Noelville, Markstay, Warren and St.Charles).
The number of children and parents accessing Best Start hubs has increased over the years, and in fact
has doubled since 2009. The hubs are serving more people, who are also making more visits.
Number of Children and Adults Served
800
644 652
529
600
400
409 393
307 331
388
443
Number of Child and Adult Visits
8000
6000
514
4000
200
6285
4386
3144
5158
4358
4180
3732
3113
3075
4744
2000
0
0
2008
2009
2010
Children
2011
Adults
2012
2008
2009
Children
2010
2011
2012
Adults
In fact, the most frequently used program were the play-based programs for children3. About 30% of
children attended a play-based program, such as a Best Start Hub at least once a week or more and many
attended at least once a month or once in the year before starting Kindergarten (17% each).
Children’s literacy is important to parents and many used library, literacy or language-based programs.
Almost 20% of children visited a library at least once a week or once a month and 40% go at least once a
year. Literacy programs were used by 13% of children at least once week, while another 10% attend at
least once a month, and almost 2 in 10 (17%) attended at least once a year. In terms of language-based
programs, such as Wordplay Jeux de mot, 5% of children attended at least once a week or more, 6%
attended once a month or more, and 12% had attended at least once in the 12 months prior to starting
kindergarten.
3
KPS Survey
14
Arts-based and culture or ethnic-based programs were the least attended, with 15% or less of children
attended at least once a week.
Preschool Program Attendance
100
80
60
% of children
attended
40
20
0
Once/Week
Once/Month
Once/Year
Play-Based Programs (i.e. Hubs)
Literacy Programs
Music/Arts/Dance
Library
Book Store
Cultural
Not at All
Children's Language Based Programs
n=113
The most frequent reasons that parents who did not access services for their child gave were that the
program or service that they needed or wanted for their child was not available near where they live
(17%); that it occurred at an inconvenient time (16%), that they didn’t know the program or service was
available or that they didn’t have information about the services (14% each). Cost was also a barrier for
8% of respondents.
Another major support to families and contributor to healthy child development is child care. The number
of children accessing licensed child care in Manitoulin-Sudbury has increased.
Average Enrollment: Licensed Child Care
600
400
342
364
368
385
421
2009
2010
2011
2012
2013
200
0
Based on the Kindergarten Parent Survey, the majority of children between 0-18 months are cared for by
their parents (64%) or an unlicensed care giver (26%). Only 10% of parents indicated that their child was
in a licensed care. This likely reflects the large proportion of parents using parental leave (81%) as well as
the small number of child care spaces available for infants. The majority of parent’s length of parental
leave was at least 6 months to a year (69%) while another 30% had over year.
The proportion of children in licensed, unlicensed and parent-only care equalized once parental leave
expires and child care spaces become more accessible for children beyond infancy.
15
% of respondents
Type of Child Care
100
64
50
36
35
26
10
29
0
0 to 18 months
1.5 yrs to 4 yrs
Age of Child
Parent Only
n=110
Licensed*
*Licensed
centre or home
Unlicensed
The amount of children in unlicensed care remains consistent for all ages, likely due to the expense of
child care or the lack of licensed child care in the more rural areas. The most frequent barrier to childcare
indicated by parents was the cost (39%) followed by conflicting with work schedules and the challenge of
finding care during a child’s unplanned illnesses or family emergencies (23% each). 12% of parents
reported difficulty in obtaining a child care space, while a small proportion indicated they didn’t have
enough information (4%) or special needs servicing (3%).
Barriers to Childcare
No SN services
No Info
No Space
Doesn't Fit Schedule
Unplanned illness/emergency
Too Expensive
3
4
12
23
23
39
0
5
10
15
20
25
30
35
40
45
% of respondents
n=117
Parents were also asked to rate the importance of different factors when choosing child care. By far the
most important factor in choosing child care was the quality of care and reputation of the center, which
93% of respondents rated at “very important”. This is significant because families in the ManitoulinSudbury Districts do not always have licensed child care centers in the more rural areas, and may have to
rely upon informal child care in people’s homes.
% of respondents
100
Importance in Choosing Child Care
80
60
40
20
0
Not Important
n=99
Reputation / Quality
Somewhat Important
Location
Hours
Cost
Very Important
Professional ECEs
16
Accessibility was an important factor to the majority of parent – the cost, location, and hours of operation
were considered “very important” to about three-quarters of respondents. The professional
qualifications of the staff (Registered Early Childhood Educators) was also important, but to a lesser
degree than the other factors.
In terms of support services for families4, the majority of parents access child and family support services
(64%). Almost half used prenatal services; and a third accessed parenting programs or workshops. Almost
a quarter accessed speech and language services. The more targeted the service, the less likely parents
were to use or need it, as is the case with special nutrition services (19%), information/referrals (15%),
mental health (12%) and special needs services (3%).
% of respondents
Supportive Services Usage: Manitoulin-Sudbury
64
70
60
50
40
30
20
10
0
44
31
22
19
15
12
3
Our Children Our Future (OCOF) is an agency that not only provides universal Best Start services but also
provides targeted programs to support families. OCOF offers a number of programs for families that are
port of the Community Action Program for Children and the Canada Prenatal Nutrition Program, such as
Collective Kitchen, Creating Healthy Babies, Steps and Sages and Parent Discussion Groups.
The number of children or adults being served through OCOF has remained consistent or risen slightly
compared to 2011, and they are visiting their programs more.
Adult and Child Visits: OCOF
Adults and Children Served: OCOF
600
500
400
300
200
100
0
435
460 494
481
2011
2012
Adults
4
Children
526
426
2013
6000
5000
4000
3000
2000
1000
0
5105
3678
3644
2490
2011
2012
Adults
5069
3164
2013
Children
CAR CIL Parent Survey
17
Importantly the services in Manitoulin-Sudbury are helping parents and children5. Almost 90% of parents
‘agreed’ or ‘strongly agreed’ that the services they have accessed have been a support to their family
and/or their child. Approximately 80% said that services have improved their child’s readiness for school
and that the parents know more about healthy child development. And just over 60% said that their
parenting skills have improved because of the services they’ve used.
Child and Family Outcomes: Manitoulin-Sudbury
% of respondents
60
54
52
51
50
40
30
20
40 42
37
36
37
31
25
24
16
5
10
18
13
0
12
0 0
7
0 0
0 0
0
0
More Knowledgeable Services Support My Service Support My
re: Child
Family
Child
Development
Strongly Agree
Agree
Neither Agree, Nor Disagree
Improved School
Readiness
Disagree
Improved Parenting
Skills
Strongly Disagree
SERVICE WAIT TIMES
Overall, service wait times have not been impacted by integration. The specialized service sector appears
to meeting about 75% of the need and wait lists are a concern for service providers and system
administrators. Early identification is often cited as the means to getting children the services they need
as soon as possible. It is good that more agencies are doing screening and are better able to identify
concerns but it also raises concerns about longer wait lists. However, the Manitoulin-Sudbury Districts
has been able to use some of their funding to increase their special needs resourcing in order to better
provide these services.
Network members were asked to what degree, if any, integration has made to the wait times in their
agency. The majority of respondents indicated it wasn’t applicable to their service (7) or that they didn’t
know (4). Of the 8 respondents that had services with wait times, half indicated that wait times for their
services had increased (2 greatly, 2 slightly) and half indicated ‘no change at all’.
Even agencies without wait times indicated how Network partners have responded in their communities
to help support children and families through early identification and community programming.
There is not a wait time at my agency however accessing other services through my agency do
have wait times. Letting others know about these wait times has encouraged the importance of
early referrals. It has also brought on talk regarding other things families can do in the community
while waiting for services.
5
18
Another respondent repeated the recurring theme of the challenge children and families living in rural
areas have in accessing services - sometimes due to lack of transportation or due to fewer opportunities.
There are services that can be accessed but what remains to be an issue at times are the long
waitlist for families. Or a service that comes from an urban area to a rural area can only provide a
certain amount of hours in this area when the waitlists indicate that services is needed.
Overall, families are satisfied with the wait times for services. As previously discussed6, far more children
are using specialized services (47) than are waiting for them (13). As the chart below illustrates, the
proportion of children waiting for the most commonly used service (speech and language) also had the
lowest number of children waiting for these services. A good indication that children with the most
common need are being served in a timely manner.
Special Services
1
0
0
1
1
0
1
2
1
3
1
1
33
0
5
2
5
1
6
2
ESL Services
Blind/Low Vision
Mental Health
Behavioural
Developmental
Special Nutrition
Learning Support
Occupational/Physical therapy
Dental (beyond regular)
Hearing
Speech/Language
0
21
50
100
# on Wait List
# Children
150
200
Based on this data, 1 in 4 children (25%) needing special services in on a wait list. Corroborating this
information is the fact that 25% of parents indicated they were less than satisfied with wait times, with
13% indicating ‘somewhat’ and 13% indicating ‘dissatisfied’.
Community providers try to provide other programs and supports for families and children while they
wait for another service.
6
KPS
19
SYSTEM’S ABILITY TO RESPOND TO CHANGING NEEDS
The Manitoulin-Sudbury Districts have flexible and ingenuous ways of responding to identified needs in
their communities. Whether it be funding, service provision, or assisting families with transportation,
they step up and do what is necessary to help their families.
Network members were asked if improved service integration in Manitoulin-Sudbury affected the
system’s ability to respond to identified needs in their communities. Based on the survey results of 17
respondents, the majority indicated that integration has had moderate impacts on their ability to respond
to changing needs.
Most respondents (82%) indicated that the system’s ability to address the needs of families and children
as identified by their community had moderate impacts. Service delivery has improved, with the majority
of respondents indicating that integration has improved the system’s ability to provide inclusive,
supportive, accessible and seamless services (73%, 82%, 63%, and 56% respectively).
In terms of the system’s ability to support the Network’s ability to engage in effective communication and
knowledge transfer, the majority indicated moderate to high impacts (71%). It was emphasized that
providers are sharing and using information to plan around the gaps and needs that arise.
Service Provider's Network have discussed gaps in service and looked at recent documents which
outline the social, speech, health, etc. of children in communities and discussed ways to try to
address some of these needs. There has been a big improvement in sharing of information,
professional development opportunities and events occurring in the community.
In terms of cross-sectoral planning, the majority indicated moderate to high impacts (64%). This has been
facilitated by more flexible funding guidelines that have allowed them to increase their collaboration and
planning capacity through the development of committees – the Professional Development Committee,
the Supervisor’s Network, and the Aboriginal Advisory Committee.
About half of the respondents said integration also affected their ability to provide professional
development and training.
Respond to Changing Needs: Service Delivery Outcomes
90
80
70
60
50
40
30
20
10
0
82
63
69
60
53
50
38
18
0
31
27
13
0
Neigh. /
Community
0
0
13
0
Accessible
Serv.
Inclusive
Serv.
Not at All
36
29
19
6
Seamless
Serv.
Slightly
50
4141
13
0
Supportive
Serv.
Somewhat
6
18
12
PD &
Training
14
0
0
Comm. &
Know.
Transf.
Planning
Very much
20
As mentioned, the Manitoulin-Sudbury Districts have a large geography with small ‘urban’ centers and
dispersed rural populations. While this presents many challenges for families and providers in terms of
transportation and service accessibility, it also has a strong culture of social support – that is, “looking out
for each other”.
In these communities, providers are flexible and ingenuous in the ways they support families. There are
less professionals and services than in larger urban centers so they feel they have to step in and help. This
means there is less “silos” or protectionism and providers don’t see “my families” and “your families” but
“our families”. They respond to the needs presented – regardless of their specialization, and will go
beyond their specific mandates to assist families.
I think that’s when the community has to draw together and find those missing pieces, do what
they can with what they’ve got. I know that we’re working right now with the French River area,
and they’re in the process of building a splash pad, and they’ve asked for our assistance to work
with that, and that’s not usually our mandate, but we’ll see what we can do to support that piece.
PARENT SATISFACTION WITH CHILD AND FAMILY SERVICES IN THE
COMMUNITY
Parent’s satisfaction with services and programs for children and families is very high in ManitoulinSudbury. Over 80% of respondents indicated they were ‘satisfied’ or ‘very satisfied’ with the activities
for children (90%), the support services for both children and parents (82% and 84%), the programs and
workshops they’ve used (83%), and the referrals and information that they’ve received (85% and 82%).
The areas they reported somewhat less satisfaction was in the administrative areas of wait times (75%)
and access to services (74%).
Parent Satisfaction with Services and Programs for Children
and Families: Manitoulin-Sudbury
% of respondents
60
50
40
30
20
10
0
Very Satisfied
Satisfied
Somewhat Satisfied
Dissatisfied
Very Dissatisfied
Parents also were asked about their experiences with staff and service delivery. The vast majority
reported that they ‘agree’ or ‘strongly agree’ that the staff is helpful (94%), knowledgeable about other
21
services in the community (87%), that they provide them with information they can use (90%), and that
they feel comfortable to talk to staff about their families or child’s needs (86%).
% of respondents
Service Delivery Outcomes: Manitoulin-Sudbury
80
60
58
53
41
47
40
41 45
32
40
20
5
12
2
0
10
0
0
3
9
0
2
0
0
Helpful Staff
Strongly Agree
Staff Know about Other
Services
Agree
Comfortable Discussing My
Needs
Disagree
Useful Information
Strongly Disagree
Parent’s Experience of Integration
An important outcome for both the Network and for parents and families, is the experience of a ‘seamless
system’. Parents that used multiple services were asked to rate their experience along the integration
continuum. The document “Defining Integration: A Best Start Working Paper” defines what parents
should expect to experience at each stage of the continuum. These definitions were summarized in the
parent survey.
Of the 36 parents that responded to this question, a quarter of them experienced an integrated system.
This meant that 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.
Almost half experienced a collaborative system. This meant that the programs and services they used are
well organized and seem to work well together; and sometimes they are even available in the same place.
19% felt it was coordinated; that 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.
Only 8% felt that the agencies were only aware of each other. This meant that they go to different service
providers for different things and although staff might tell them about other services, they have to figure
it out for themselves.
% of respondents
Parent's Experience of Integration: Man-Sud
60
47
40
20
25
19
8
0
Awareness
Coordination
Collaboration
Integration
Integration Continuum
22
Considering the majority of parents use universal programs and services, such as hubs and child care which
are situated in the schools their child will attend or an older child may already attend, the experience of
integration may be higher for these families than for those that use specialized services. It would be of
value to survey the families of specialized service providers to gain insight on their experience of a
seamless system.
CONCLUSION
Integration has improved the Manitoulin-Sudbury Districts ability to support children and families through
sharing and using information to plan for the needs identified in their communities. The flexibility of
funding guidelines has enabled them to increase their capacity to plan and deliver services, namely special
needs resourcing, which was an identified need. There is a general increase in the participation in playbased and parent support programs.
There is a strong rural culture that puts families first and mandates second, so that providers do what they
can to help assist families – whether that be providing them with transportation to supporting initiatives
outside their own mandate to purchasing the services they need out of their own funds.
This results in families feeling very satisfied with the services they receive and the providers who deliver
them. Families feel that they and their child have benefited from the programs and services through
improved parenting skills, knowledge about child’s development, and school readiness. This is supported
by EDI results that indicated the children in Manitoulin-Sudbury Districts are excelling in language,
cognitive development and communication. The children are socially competent but are struggling in
areas of emotional maturity and physical health and well-being.
23
APPENDIX I: CAR CIL Parent Survey
The purpose of this survey is to evaluate your experience with the Best Start system of children and
family resources within the Greater Sudbury and Manitoulin-Sudbury area. What you tell us will help
inform us about families’ awareness, access, experiences, and satisfaction with programs and services
that are designed to support you, your child and your family.
This survey will only take a couple minutes to complete and your answers will remain anonymous. Your
participation is voluntary so if there are questions you prefer not to answer or if you decide to stop the
survey – for any reason – that’s fine. We are very grateful to you – and to other families – for taking the
time to answer some questions.
Programs and Services
1. Have you and/or your children used any of the following programs or services? (check all that apply)
a. Prenatal programs
b. Child care services
c. Early Learning programs
d. Nutrition or Breakfast programs
e. Parenting programs
f. Child and Family support programs (Best Start hubs, OCOF)
g. Information and referral services
h. Services for children with special needs
i. Speech and language services
j. Children’s mental health services
k. Children’s culture and ethnic-based programs
l. Children’s recreation services (Public pools, skating, YMCA)
m. A public library
2. Overall, how satisfied are you with the programs and services that you’ve used ? Very Aatisfied;2 =
Satisfied; 3=Somewhat Satisfied; 4=Dissatisfied; 5 = Very Dissatisfied; Don’t Know; Not applicable;
No answer
a. Activities for children
b. Support services for children
c. Support services for parents
d. Programs and/or workshops for parents
e. Information available to parents
f. Referrals and connections to other services/agencies
g. Access to services/programs
h. Registration process to services/programs
i. Wait time for services/programs
3. Were you unable to attend programs or use services for any of the following reasons? Check all that
apply
Cost was too much
Services were not available in my language
No services where I live
Didn’t know services were available
24
Times did not work for me
Didn’t have information about services
No way to get there (no car, no buses, cost)
Not applicable
Waiting list too long
Not Eligible
Other (please tell us) _____________________
______________________________________________________________________________
4. Based on your overall experience with the programs and services you’ve used, please give your
opinion about each of the following statements. Strongly agree; Agree; Neither Agree, Nor disagree;
Disagree; Strongly disagree; Don’t Know; Not applicable; No answer
a. Staff are as helpful as my family needs them to be
b. Staff have information about outside services
c. I feel comfortable discussing my family’s needs with staff
d. The programs and services are a support to my family
e. My child receives the support he/she needs
f. My child is more school-ready because of the programs or services
g. I know more about my child development because of these programs or services
h. The information I have received is useful
i. The things I have learned from these programs or services are useful
j. My parenting abilities have improved because of the programs or services
5. If you have used multiple programs and/or services, please choose the description that best
describes your experience: (Choose one of the following answers)
a. I go to different service providers for different things and although staff might tell me about
other services I have to figure it out for myself.
b. When I go to service providers they often tell me about other programs and even help me
connect with them but I have to make my own appointments, register and often have to
wait for services.
c. Programs and services are well organized and seem to work well together; sometimes they
are even available in the same place.
d. I don’t notice the difference between service providers. I get all the help I need arranging
things and many supports are available at the same place.
Demographics
6.
What is your gender?
a. Female
b. Male
c. Other
7. What is your age category?
a. Under 20
b. 21 – 30
c. 31 – 40
d. 41 - 50
e. 51 +
25
8. Please indicate your child/children’s age categories (check all that apply)
a. 0 – 3 yrs old
b. 4 – 6 years old
c. 7 – 9 years old
d. 10 – 12 years old
e. 13 years and over
9. How much does your family earn before taxes are deducted?
a. Under $14,999
b. $15,000 - $29,999
c. $30,000 - $44,999
d. $45,000 - $59,999
e. $60,000 - $74,999
f. $75,000 - $89,999
g. $90,000 or over
10. What is your postal code? __________________
Thank you for taking the time to fill out this survey.
26
APPENDIX II: Kindergarten Parent Survey
27
28
29
30
31
32
33
34
35
City of Greater Sudbury
Product 4: Impact of Integration on Key Child and Family Outcomes
This report was compiled and written by
Tammy Turchan
Data Analysis Coordinator
The Social Planning Council of Sudbury
Thanks to all the Best Start network
members and service providers that
responded to surveys and interviews,
and to the agencies that provided data.
Special thanks to the families that filed
out the parent surveys.
Table of Contents
INTRODUCTION ............................................................................................................................................. 1
EXECUTIVE SUMMARY .................................................................................................................................. 1
METHODOLOGY ............................................................................................................................................ 2
DATA SOURCES ............................................................................................................................................. 4
PARENT PROFILE ........................................................................................................................................... 8
EARLY IDENTIFICATION OF CHILDREN WITH SPECIAL NEEDS ....................................................................... 9
Service Delivery Outcomes ....................................................................................................................... 9
HEALTHY CHILD DEVELOPMENT ................................................................................................................. 12
SERVICE WAIT TIMES .................................................................................................................................. 23
SYSTEM’S ABILITY TO RESPOND TO CHANGING NEEDS.............................................................................. 25
PARENT SATISFACTION WITH CHILD AND FAMILY SERVICES IN THE COMMUNITY ................................... 27
Services and Service Delivery .................................................................................................................. 27
Parent’s Experience of a Seamless System ............................................................................................. 28
CONCLUSION............................................................................................................................................... 29
APPENDIX I: CAR CIL Parent Survey ............................................................................................................ 30
APPENDIX II: Kindergarten Parent Survey .................................................................................................. 33
INTRODUCTION
This report identifies the outcomes that have been impacted by system integration in the City of Greater
Sudbury. The research question specifically asked about the child and family outcomes in relation to the
early identification of children with special needs, healthy child development, service wait times, the
system ability to respond to identified needs and parent satisfaction. The goal of integration is a ‘seamless
system’ that is easy for families to navigate and access through improved planning and delivery of child
and family services. Therefore the impacts of integration included ‘service delivery’ and ‘child and family’
outcomes.
EXECUTIVE SUMMARY
Integration has improved information sharing and awareness amongst providers of the needs in the
community and the services available to support families. There has been increased planning toward
early identification which has resulted in increased capacity to offer screening, identify needs, provide
information and referrals. This is a positive development for children and families, and has resulted in an
increase in the number of children being referred and/or receiving services. This in itself presents the
challenge of meeting the increasing demand. Service providers are challenged to provide the support –
both specialized and universal – by limited funds and resources. This can result in long wait times.
The improvements in planning and delivering services amongst Greater Sudbury organizations is a direct
result of improved service integration. Common branding, database systems, registration processes,
language, practices and delivery models are the hallmarks of collaborative approach to service delivery,
and there are many examples of this in the Greater Sudbury network. The biggest challenge that arises
is over-capacity and limited resources, which impacts the accessibility of services.
Children’s school readiness has improved or remained stable, with 2 of 5 EDI domains being better than
average and 1 is on par with the provincial average. There has been steady improvements in Grade 3
writing, reading and mathematics. Overall, there has been a steady increase in the number of children
and parents attending programs and accessing services. The vast majority of parents indicate the services
they use have been a support to themselves and/or their child, have improved their child’s school
readiness as well as their own parenting skills and their knowledge of child development. However,
barriers exist for some families, including the cost and availability of licensed child care, inconvenient
program hours, and not enough awareness or information about programs and services.
Service Wait Times
Overall wait times have not been impacted by integration. It appears specialized service sector is meeting
90% of the demand and 15% of parents are dissatisfied with the wait time. Services that support the most
common specialized needs, such as speech and language, have the lowest number of children on wait lists
while children with less common needs appear to wait longer. Wait times need to be researched and
monitored in order to better access the impact of integration on this indicator and to better understand
parent concerns.
1
Ability of the Service System to Respond to Changing Needs
Integration has improved the Networks ability to provide inclusive, supportive, and accessible services.
The trust that has been developed amongst Greater Sudbury partners enables them to have open
discussions about issues and needs in the community. They often jointly plan and organize programs and
services, and will collaborate with other agencies to deliver their services to facilitate better access for
families. Increasing access can result in programs operating beyond their capacity and at the limits of
their resources, an issue that was reiterated by survey and interview respondents.
Parent Satisfaction with Programs and Services
Parent satisfaction with services and service delivery is very high. Highest satisfaction was found in the
activities and support services for children, followed by the information and support services for parents
as well as the connections or referrals to other agencies. Somewhat less satisfaction was found in wait
times for services. Parents’ service experience of an integrated system fell in the mid-range, between
coordination and collaboration.
METHODOLOGY
The methodology used to address the research question included: data analysis from various sources,
including Education and Quality Accountability Office (EQAO), the Early Development Instrument (EDI),
the Kindergarten Parent Survey (KPS); a review of data from various agencies serving children and families
through central access and referrals, early identification and special needs support, preschool speech and
language services, mental health services, parent support, early learning and child care services; survey
and interview with key service providers to identify the impacts of integration on planning and service
delivery; and surveying parents regarding their experience and satisfaction with the programs and
services.
The following indicators were used to measure the outcomes.



The impacts of service integration on the system’s ability to offer:
o A full range of information and resources
o Developmental assessments
o 18 month old well-baby screenings
o Physical assessments (i.e. dental, vision, hearing)
o Speech and language services for children up to age six
o Support for parents of children with special needs
o Outreach services to remove barriers to access
The number of referrals received by the central access agency, preschool speech and language,
infant and child development and special needs resourcing.
The number of children using specialized services as reported by parents

The impacts of service integration on the system’s ability to:
o Plan programs and services
2






o Deliver services
o Offer accessible services
Children’s school readiness as measured through EDI
Children’s school success as measured through EQAO
Children’s participation in pre-school programs
Children’s participation in licensed child care
Participation in family and/or parenting support programs
Parent’s perception of program impacts for child and parent in relation to:
o Children’s school readiness
o Support for children
o Support for families
o More knowledgeable about child development
o Improved parenting skills
Service Wait Times



The impacts of service integration on agency wait times
The number of children waiting for service as reported by parents
Parent satisfaction with wait time
System Response to Identified Needs

The impacts of service integration on the system’s ability to respond to identified needs including:
o Addressing family/children’s needs as identified by neighbourhood or community
o Providing accessible services as needed
o Providing inclusive services
o Providing supportive services
o Providing seamless services
o Providing opportunities for professional development and training
o Engaging in effective communication and knowledge transfer
o Engaging in cross-sectoral planning
Parent Satisfaction


Parent satisfaction with services in relation to:
o Activities for children
o Support services for children
o Support services for parents
o Programs and/or workshops for parents
o Information available to parents
o Referrals and connections to other services/agencies
o Access to services/programs
o Registration process to services/programs
o Wait time for services/programs
Parent satisfaction with service delivery in relation to:
o Staff assistance
3
o Staff knowledge about community services
o Practicality of information
o Comfortable communication of needs

Parent’s experience of integration along the continuum
DATA SOURCES
Community Agencies
The agencies that are represented in the data review include: Children’s Community Network (CCN), Child
and Community Resources (CCR), Wordplay Jeux des Mots, Triple P Positive Parenting Program, Greater
Sudbury Children’s Services, Best Start Hubs (CIMS database), Our Children Our Future (OCOF), YMCA.
Early Development Instrument (EDI)
The EDI is a questionnaire that measures young children’s readiness to learn at school. School readiness
refers to children’s ability to benefit from the educational activities at school and to be able to meet these
demands. The EDI provides data that assesses school readiness across five developmental domains –
physical health and well-being; social competence; emotional maturity; language and cognitive
development; and communication skills and general knowledge.
Senior Kindergarten students are classified into four readiness categories based on the results of the EDI:
“vulnerable”, “at risk”, “ready”, and “very ready”. The degree of school readiness predicts how well
children will do at school. Of particular interest are children who are vulnerable as these children are less
ready to learn and less likely to succeed at school.
EDI data is available at the City or neighbourhood level and allows for comparisons across neighbourhoods
and across time, by specific developmental domains.
In Greater Sudbury, 1624 senior kindergarten children were evaluated by their teachers in February 2012.
This includes four school boards – English and French, Public and Catholic schools.
Education Quality and Accountability Office (EQAO)
EQAO is designed to measure student achievement of Ontario Curriculum learning expectations in regards
to reading, writing and mathematics. These assessments are completed for all students in Grade 3 and
Grade 6. The Ontario Secondary School Literacy Test (OSSLT) is a literacy assessment completed in Grade
9.
EQAO worked with the EDI researchers from the Offord Centre at McMaster University to explore the
relationship between EDI results and the EQAO results in Grade 3 reading and mathematics.
4
% of students at or above provinical standard
Grade 3 Reading (2008-2011): Ontario
90
74
80
70
40
51
47
50
36
63
49
47
42
77
68
63
62
61
60
82
78
73
34
46
30
30
30
20
10
0
Well-being
Vulnerable
At Risk
Ready
Language and
Cognitive
Development
Communication and
General Knowledge
Very Ready
The EQAO reading results for Grade 3 students show that students who were “ready” or “very ready” in
kindergarten were far more likely to meet or exceed the provincial standard in reading than those who
were “vulnerable” or “at risk”. It should also be noted that a substantial amount – about one-third to
one-half – of those who were identified as “vulnerable” or “at risk” in kindergarten did achieve the
provincial standard in Grade 3 reading.
% of students at or above provincial standard
Similar trends were observed in Grade 3 mathematics results.
Grade 3 Mathematics (2008-2011): Ontario
100
90
80
70
60
50
40
30
20
10
0
84
73
71
55
41
44
At Risk
39
Ready
73
60
58
Well-being
Vulnerable
85
78
73
61
51
90
87
82
Language and
Cognitive
Development
57
44
Communication and
General Knowledge
Very Ready
5
The Kindergarten Parent Survey (KPS)
The KPS is a survey that was developed by the Offord Centre for Child Studies – who also developed the
Early Development Instrument. The KPS provides information on family characteristics and experiences
of children prior to entering kindergarten.
In Greater Sudbury, 995 parents responded to this survey. These were the parents (or guardian) of the
1624 senior kindergarten children in Greater Sudbury who were involved with the EDI, including children
with identified Special Needs. That represents an overall response rate of 61%.
A 61% response rate for a voluntary survey is very high and suggests that the responses are a good
representation of the population of parents in Greater Sudbury. To further verify and demonstrate this
representation, the KPS demographic information was compared to Statistics Canada data.
As the chart below indicates, parents with higher levels of education (university bachelor degree or higher)
were more likely than parents with lower levels of education (those with or without a high school diploma)
to fill out the KPS survey. This means that those with higher education are over-represented and those
with less education are under-represented in the KPS results. However the majority of respondents held
a college or trade diploma and were representative of the population.
% of respondents
Parent's Highest Level of Education
60
40
20
0
48 45
4
High School
Incomplete
25
13
12
High School
KPS
19 12
16
College-Trade Undergraduate
Diploma
Degree
7
Graduate
Degree
NHS (25-64 yrs)
In terms of family structure, two –parent families were more likely to complete the KPS than lone-parent
families or families that share custody. This means lone parent families are under-represented in the KPS
results.
% of respondents
Family Structure
80
100
50
16
71
29
4
0
One Parent / Shared
Custody
Two Parent
KPS
Missing
Census
In terms of household income, families earning more than $100,000 a year were over-represented and
families earning less than $50,000 year were under-represented in the KPS results. Those with middle
earnings, of $50,000 to $100,000, were representative of the population.
6
% of respondents
Household Income Pre-tax
60
40
20
39
38
43
35
26
19
0
<$50,000
$50,000-100,000
KPS
>$100,000
NHS
The results of the KPS is a good source of data about the experiences of parents and children in our
community. However, based on the under-representation of lone-parent families and of families with
lower education and incomes, the data should be interpreted with this in mind. For example, barriers to
services based on cost may be under-represented because families with low incomes are underrepresented.
CAR-CIL Parent Survey
A parent survey was designed to capture parent’s program usage, experience of integration and
satisfaction with child and family services. Of particular interest is parent’s satisfaction with service
delivery, administrative processes, and for those that use multiple services, their “seamless service”
experience.
The survey was distributed through multiple partners and means to capture as wide a scope as possible.
The partners included Best Start hubs, child care centers, Healthy Babies Healthy Children, Children’s
Community Network, Children’s Aid Society and Ontario Works. The means included an online and paper
survey, as well as surveying parents in the Shopping Mall during a Best Start hub promotion.
A total of 266 parents from Greater Sudbury filled out the survey. Based on an economic comparison
between the surveyed families and the National Household Survey, most of these families are
representative of the family with children population in Greater Sudbury – with the exception of an overrepresentation of higher income families.
% of respondnets
Household Income: Parent Survey vs CGS
60
41
40
20
22
20
26
19
20
26
26
0
n=227
$0 - $29,999
$30,000 - $59,999
Parents
$60,000 - $89,999
$90,000 +
NHS
7
The CAR-CIL Network Survey / Interview
Through an online-survey and in-person interviews, Network members were asked to what degree the
following outcomes have been impacted by service integration in our community:




Early identification of children with special needs
Healthy child development
Service wait times
Ability of the service system to respond to changing needs
In order to understand the degree of impact, members could rate the impact as “not at all”, “slightly”,
“somewhat” or “very much”. To gain a better understanding of the context of the impacts, members
were also encouraged to comment in the survey and during the interviews.
PARENT PROFILE
This is a brief profile of the parents that are represented in the survey results. As indicated above, the
majority live in two-parent household and have a college or trade diploma. Lone-parent and lower
educated families are under-represented, while those with higher levels of education are overrepresented. In terms of household income, middle-income families were representative of the
population, while lower income families were slightly under-represented and higher income families were
over-represented.
Parents are accessing child and family support programs and indicated that these programs are beneficial
to themselves and their children. The most common reasons they were did not access services is because
it is not available in their area, it occurs an inconvenient times and they were not aware or did not have
information about the service. Some specialized programs require a physician’s referral and 6% of parents
do not have a family doctor.
In terms of licensed child care, the most important consideration for parent is the quality of care and
reputation of the center. Accessibility, that is the cost, location and hours of operation, was also very
important. Cost was cited as the biggest barrier in accessing licensed child care, followed by the difficulty
in obtaining a space, limits around unplanned illnesses or emergencies, and concerns about the quality of
care.
8
EARLY IDENTIFICATION OF CHILDREN WITH SPECIAL NEEDS
Improved service integration in the BSIPN has positively impacted the early identification of children with
special needs. There is more awareness and capacity to screen and identify needs across the system. And
in many cases, there is an increase in the number of children being referred or receiving services. This in
itself, presents the challenge of meeting the increasing demand.
Network members were asked about the impact on the range of resources and services available for
children with special needs including developmental assessments, physical assessments, screening
capacity, speech and language services, and parent support of children with special needs.
Based on the survey results, all of the resources and services available have been moderately (‘somewhat’)
to significantly (‘very much’) impacted by service integration. Over 80 percent of respondents indicated
impacts in the system’s ability to offer developmental assessments (100%), speech and language services
(87%), a full range of information and resources (93%), 18 month well baby screenings (91%) physical
assessments (85%) and support for parents of special needs children (80%).
Early ID of Children with Special Needs: Service Delivery
Outcomes
70
58
60
59
57
50
43
43
35
40
37
32
27
30
20
10
60
58
38
29
20
15
13
Physical
Assess.
Speech &
Language
9
6
27
33
0
0
Info &
Resources
Develop.
Assess.
18 Month
Screen.
Slightly
Somewhat
Parent
Support - SN
Outreach
Services
Very much
Members were also asked about the impact service integration has had on outreach services to remove
barriers to access. This appears to be the most challenging service to affect with one-third of respondents
indicating a slight impact.
The success is described by one respondent, as well as the challenges the children’s sector experiences
with supporting children with special needs:
The 18 month well baby visit information session to physicians and the best start network and
staff has been beneficial in promoting the importance of early identification. The work produced
by the school transition committee has been instrumental in assisting children and families with
special needs successfully transition into the school systems. Barriers still remain to certain
essential services within the community (i.e. children on the spectrum have an extremely long wait
9
for assessment then interventions, making the children's sector, responsible to support these
families until they are finally able to access the service mandated to support them).
The issue that is raised is that while improving early screening and identifying children with special needs
is improving, it also presents the challenge of meeting that need by the service providers mandated to
provide it as well as other service providers who try to support those families in the in-term.
The other success interviewees expressed was the transition to school planning that has occurred
between school boards and service providers. However, challenges around privacy and sharing
information can prevent the school from having full access to the child’s information.
Based on the data collected from specialized service providers, the number of children being screened,
referred for and/or receiving specialized services has increased slightly over the last few years.
The number of referrals that the Children’s Community Network1 (CCN) processes each year remains
pretty consistent at approximately 1800 children per year. The number received through the Greater
Sudbury and Manitoulin-Sudbury DSSAB partner agencies (Education, Specialized Services, Health, and
Early Learning Sectors) has grown over the last 3 years, from 431 in 2010-11 to 459 in 2011-12 to 476 in
2012-13. This may be in part due to the concerted efforts of the Network to plan toward the early
identification of children with special needs.
Child and Community Resources2 (CCR) provides screening support to child care centers. In a 12 month
period between January to December 2010, 75 unique children were screened. The agency went through
a period of changing their service delivery model in the year of 2011, and the next available 12 month
period of screening was from July 2012 to June 2013 and in that time, 120 unique children were screened.
Due to service delivery model changes and an expanded capacity in 2013 when an additional consultant
was hired, it is unclear if the increased screening capacity is a related to service integration or the agencies
overall changes.
Preschool Speech and Language3 has seen a slight increase in the number of children referred to their
service, from 475 in 2008-09 to 530 in 2012-13. The Infant and Child Development program referrals
remain pretty consistent, with 138 referrals in 2009-10 and 135 referrals in 2012-134.
The KPS asked parents if in the years before their child started kindergarten, if their child received help
from specialized services. The specialized services used most often by children were speech and language
(203) and hearing (86) services. Services involving dental (49), physical (39), learning (38), special nutrition
(34), developmental (32), and behavioural (25) support were used comparably. Mental health (11),
blind/low vision (6), and English as a Second Language (6) services were used less.
This data indicates that far more children are receiving special services (529) than are waiting for them
(50), which suggests specialized services is meeting about 90% of the need in Greater Sudbury.
1
Data obtained through CCN Annual Reports 2010-2013
Data provided by CCR research team.
3
Data provided by Wordplay/Jeux des Mots.
4
Data provided by Infant and Child Development Program.
2
10
Some children may not be on a wait list or receiving the services they need because they do not have a
family doctor. 6% of parents reported that their child did not have a family doctor which prevents families
from being able to access the services they need if a physician’s referral is required.
Many parents and children enter the children’s service system through Best Start hubs and child care.
And staff make many referrals to other services in the community (hubs made 900 referrals in 2013).
However, most of these referrals are to universal programs such as parenting services, pre-school
programs, child care services, recreation services, library services, or other hub services. Based on an
analysis of CCN’s referrals, very few referrals are attributed to the early learning sector (hubs and
daycares).
However, interviewees expressed increased awareness and capacity within hubs and daycares to identify
needs as well as having the conversation with parents that their child may benefit from an assessment
and support.
I think that the knowledge level of the staff working in the hubs, some work that has happened on
having difficult conversations with parents, where you might have just looked the other way, in
past.
From what I see in working with our special needs provider, I find that people are better, I find the
daycare staff better able to identify when there is a need, and to get the assessments in earlier.
The conundrum expressed by interviewees is that while increasing early identification and referrals to
services is good, it also presents the challenge of meeting that increased demand. The increase in demand
without an increase in funding means that families and children wait longer and longer for those services.
Additionally, other service providers are taxed with trying to support those families while they wait for
services, and sometimes even use their own financial resources to purchase the services the family needs.
Sometimes we’ve had to purchase some services that really are the mandate of community
agencies, but we can’t wait, you know, so if we can leverage funds we can sometimes get services.
So that part hasn’t been coordinated, but again, I feel that’s because of waitlists, financial strains
on organizations that currently exist without a mandate to go broader, or you know, it’s seen more
as a waitlist problem.
In summary, the themes that arose through the survey and interviews is that integration has improved
information sharing and awareness amongst providers of the needs in the community and the services
available to support families. There has been increased planning toward early identification which has
resulted in increased capacity to offer screening, identify needs, provide information and referrals. This
is a positive development for children and families, the earlier the identification, the sooner the child can
begin assessments and interventions.
However, the other theme that arose, is that service providers are challenged to provide the support –
whether targeted or universal – by limited funds and resources. This can result in long wait times for the
children needing these services.
11
HEALTHY CHILD DEVELOPMENT
The system’s ability to support healthy child development through planning and delivering programs and
services has improved with integration.
Overall, EDI vulnerability is improving or stable. Of the 5 domains, 2 are better than average, 1 is average,
and 2 are worse than average. The areas that children are doing well are in the areas of language and
cognitive development, communication and social competence which is reflected in the EQAO
improvements found in Grade 3 writing, reading and mathematics.
In general, there has been an increase the utilization of children and parents attending programs, and
parents report that they and their child has benefited from the services they have received.
Network members were asked if improved service integration had affected the system’s ability to plan
and deliver services to support healthy child development. Twenty-nine people responded to this
question. Over 85% of respondents indicated moderate to significant impacts in the system’s ability to
support healthy child development.
Over 40% indicated that the ability to plan and deliver programs and services has been significantly
impacted by service integration, while another 40% indicated moderate impacts. In terms of being able
to offer accessible services - about one-third (31%) indicated significant impacts, while over half (55%)
indicated moderate impacts. Only 10 to 14 percent indicated that the impact of service integration had
been slight.
Healthy Child Development: Service Delivery Outcomes
60
41
55
48
43
43
31
40
20
14
10
14
0
Slightly
deliver services
Somewhat
Very much
The themes that arose through interviews was how a more integrated system supported strategic
planning and implementing initiatives, so that families experienced a more cohesive service and common
language – regardless of what agency delivered the program, for instance, Best Start hubs or Triple P, the
Positive Parenting Program. Families who visit a Best Start hub encounter common registration process,
activities, referrals services, and parenting support (Triple P) regardless of the agency delivering hub
services. The same can be said about Triple P which also has a common registration process, language
and practices and is delivered by multiple organizations.
Another common theme was the strategic use of data for planning services and programs, notably the
EDI results. As one respondents put it:
12
Since the recent EDI scores have come out, is that I like the direction that we’re focusing on, in
areas where communities might be struggling, it is the hub’s responsibility to really work hard on
those specific areas. So focusing in on a few things to make that difference instead of trying to be
great at everything.
While over 85% of survey respondents indicated moderate to significant improvements in accessibility
due to improved integration, the issue of funding, limited resources and over-capacity arose as the biggest
barriers for accessibility – for universal services, targeted services and specialized services alike.
One respondent described it from the Best Start hub perspective:
As with all services, limited funds to Best Start Hubs limit the amount of hours of program planning,
therefore is not accessible to all families. As well, many of the hubs are overcapacity at times, and
families not able to access.
And another respondent from the specialized service mirrored this perspective:
Never enough funding to support children with special needs into child care centers, i.e. funding
for support staff is lacking in a significant manner.
result of improved service integration. Common branding, database systems, registration processes,
and there are many examples of this in the Greater Sudbury network. The biggest challenge that arises is
over-capacity and limited resources, which impacts the accessibility of services – in other words, the
Greater Sudbury network is almost a victim of its own success.
Children’s school readiness has improved or remained stable, with 2 of 5 EDI domains being better than
average and 1 is on par with the provincial average. There has been steady improvements in Grade 3
writing, reading and mathematics. Overall, there has been a steady increase in the number of children
and parents attending programs and accessing services. The vast majority of parents indicate the services
they use have been a support to themselves and/or their child, have improved their child’s school
readiness as well as their own parenting skills and their knowledge of child development.
Early Development Instrument (EDI) Trends
Based on the results of 3 EDI cycles, the prevalence of children’s vulnerability (Low 1) has improved as
well as their vulnerability in Language and Cognitive Development, and Communication and General
Knowledge, which are all better than the provincial average.
The depth of vulnerability (Low 2) has remained the same as well their Social Competence, both of which
are on par with the provincial average. While Emotional Maturity vulnerability has also remained the
same, it is higher than the provincial average.
Children’s Physical Health and Well-Being has improved since 2008, however it is still an increase from
2005 – which continues to represent an upward trend – and it is still higher than the provincial average.
13
EDI
2005
2008
2011
Ontario Higher Than Average
2 of 5 Domains
% Low:1 Domain or More
29
29
27
28
% Low: 2 Domains or More
14
15
14
14
% Low: Physical Health & Well-Being
13
16
14
13
% Low: Social Competence
9
9
9
9
% Low: Emotional Maturity
14
14
14
10
% Low: Language & Cognitive Dev.
9
6
6
10
% Low: Comm. & Gen. Knowledge
11
11
10
12
Green = Better than Provincial Average Red = Higher than Provincial Average Black = Same as Provincial Average
Domains that deal with literacy, cognitive development and communication have improved and are better
than average. This is an area that programs – such as Best Start hubs and child care – have the greatest
impacts, and based on the EDI, are succeeding in helping children prepare for school.
The domains such as Physical Health and Well-Being and Emotional Maturity often reflect areas that are
difficult for programming to address. Issues around physical independence (i.e. going to the washroom
by themselves, sucking their thumbs), physical readiness (i.e. being properly dressed, arriving late or
hungry) hyperactivity and inattention are areas that are often beyond the scope of hub or child care
programming, and denote more complex issues within the family.
Children’s School Success: Meeting Provincial Standards
Percent at Provincial Standard
The Education Quality and Accountability Office5 (EQAO) indicates that the children’s capacity to meet or
exceed the Grade 3 provincial standard in writing, reading and mathematics has improved in Greater
Sudbury – with the greatest improvements found in their literacy skills. Between 2008 and 2013, the
percent of students achieving the provincial standard in writing, reading and math increased by 9%, 8%,
and 3%, respectively.
CGS Grade 3 EQAO 2008-2013
80
75
70
76
73
68
67
65
65
60
59
66
67
65
55
50
2008-09
2010-11
Writing
Reading
2012-13
Math
Similar literacy trends are found in both the writing and reading skills of Greater Sudbury children in Grade
6. Between 2008 and 2013, the percent of students achieving the provincial standard in writing and
reading increased by 8% and 6%, respectively. However, the same cannot be said about their skills in
5
EQAO data compiled from 4 school boards: CSCNO, CSPGNO, RDSB, SCDSB
14
mathematics, with only 62% of Grade 6 students in 2012-13 meeting or exceeding the standard compared
to 68% in 2008-09 school year, a decrease of 6%.
Percent At Provincial Standard
CGS Grade 6 EQAO 2008-2013
80
73
75
64
68
65
77
72
69
70
79
75
62
60
55
50
2008-09
2010-11
Writing
2012-13
Reading
Math
Child and Family Participation in Pre-School Programs and Services
City of Greater Sudbury has 10 English hubs, 4 French hubs, and 1 Aboriginal hub that are operated by
Child and Community Resources (7), Centre Pivot du Triangle Magique (2), Jubilee Heritage Family
Resources (2), Better Beginnings Better Futures (2) and Our Children Our Future (2).
Previous to 2011, agencies had separate database programs which resulted in some families being
counted more than once, if they attended more than one agency’s hub. Integrating a single database
program amongst the different agencies, Client and Information Management (CIMS), has improved the
system’s ability to accurately capture the usage.
Over 3,200 unique children were served at a hub in 2013, which represents 40% of Greater Sudbury’s child
population aged 0-4.
Number of Unique Children and Adults: 2008 to 2013
5000
3000
2000
3938
3642
4000
2723
2330
3503
3264
2968
2795
3099
3347
2691
2596
1000
0
2008
2009
2010
Number of Children
2011
2012
2013
Number of Adults
15
These children made over 35,000 visits in 2013, which is an increase from previous years (other than
2012). This indicates that children and families are utilizing the hubs more and more.
Number of Visits Children and Adults: 2008 to 2013
40000
30000
26866
27819
20075
20807
2010
2011
21766
19076
20000
10000
35120
36134
16605
13854
25748
24716
2012
2013
0
2008
2009
Number of Adults
Number of Children
Children’s physical activity is an important contributor to their physical health and well-being, as well as
building resilience. Based on the data provided by the YMCA, child and pre-school memberships have
increased since 2010, with more than 200 children and preschoolers accessing their programs.
YMCA Memberships: Child and Pre-school
1000
556
500
656
448
504
687
530
0
2010
2011
Child
2012
Pre-school
In terms of preschool program attendance, the KPS asks parents how often their child attended or visited
various programs in the 12 months before they started Kindergarten.
Over 20% of children attended a play-based program, such as a Best Start Hub at least once a week or
more. Some (15%) attended once or month or more, and over 20% attended at least once in the year
before starting Kindergarten.
Supporting children’s literacy is important to parents. Over 20% of children visited a library and/or
bookstore at least once a month or more. With some (15%) visiting the library more frequently (at least
once a week) and almost half of all children had visited a library (43%) or bookstore (47%) in the 12 months
prior to starting kindergarten. Many children attended a literacy program – with 22% attending at least
once a week or once a month, and another 26% went at least once a year (26%).
While not used as frequently, children are also using language and art-based programs. In terms of
language-based programs, such as Wordplay Jeux de mot 23% had attended at least once in the 12 months
16
prior to starting kindergarten. In terms of culture or ethnic-based programs, 14% had attended at least
once in the last year before starting kindergarten.
90
Preschool Program Attendance
80
70
60
% of children 50
attended 40
30
20
10
0
Once/Week
Once/Month
Once/Year
Play-Based Programs (i.e. Hubs)
Literacy Programs
Music/Arts/Dance
Library
Book Store
Cultural
Not at All
Children's Language Based Programs
Parents were asked if they were unable to use services for their child in the year prior to starting
kindergarten, and the most frequent reasons that parents who did not access services for their child gave
were that the program occurred at an inconvenient time (19%), that they didn’t know the program or
service was available (18%) or that they didn’t have information about the services (18%).
Parents also have difficulty accessing services, for various reasons. 12% said the services were too
expensive – whether that be child care or arts/sports programs. 9% said the wait list was too long – and
they were unable to get the services their child needs in the 12 months prior to starting school. 7%
indicated that the service they needed or wanted for their child was not available near where they live;
and 4% indicated they didn’t have the transportation to access the service.
Children’s Participation in Licensed Child Care
Another major support to families and contributor to healthy child development is child care. The number
of children accessing licensed child care in Greater Sudbury has increased.
The capacity of the licensed child care system has continued to grow, with 22% of children in 2008, and
25% of children in 2010, having access to a licensed child care space. In 2012, 27% of children aged 0-12
had access to a licensed child care space. This capacity is significantly higher than other municipalities
that have an average capacity of 17%6.
Since 2010, the capacity of Greater Sudbury’s licensed child care system has grown by almost 500 spaces.
As the chart illustrates, there are approximately 1,000 unused licensed spaces. However these unused
6
OMBI 2009 and 2012 Performance Benchmarking Report
17
spaces often reflect school-age spaces, and do not reflect the location, age-group or language capacity.
The KPS reports that one quarter (25%) of parents indicated that a barrier they experienced when looking
for child care arrangements were that “no spaces” were available. This likely reflects the difficulty parents
may find in obtaining a space in their desired location, language, or for their younger children, especially
babies.
Licenced Child Care Utilization
6000
5666
5293
5186
4563
4437
4143
4000
2000
0
2010
2011
# of llicensed spaces
2012
# of children served in a typical month
Based on the Kindergarten Parent Survey, the majority of children (75%) between 0-18 months are cared
for by their parents. 25% of parents indicated their infants were in child care – with only 8% indicating
that care was licensed. This likely reflects the large proportion of parents using parental leave (81%) as
well as the small number of licensed child care spaces available for infants. The majority of parent’s length
of parental leave was under 6 months to a year (72%) while another 28% had over year.
This changes significantly as parental leave expires and children grow older with 60% of children aged 1.5
to 4 years old in childcare, of which 38% was licensed.
% of respondents
Type of Child Care
80
60
40
20
0
75
40
8
38
22
17
0 to 18 months
1.5 yrs to 4 yrs
Age of Child
Parent Only
Licensed*
Unlicensed
*Licensed
centre or home
The amount of children in unlicensed care remains pretty consistent for all ages, likely due to the expense
of child care. The most frequent barrier to childcare indicated by parents was the cost (40%). The
difficulty in obtaining a child care space (25%), finding care during unplanned illnesses or family
emergencies (23%), conflicting schedules and concerns about the quality of care (21% each) were also
noted by parents. A small proportion indicated they didn’t have the transportation (6%), the information
(5%) or the special needs servicing (2%) they required.
18
Barriers to Childcare
No SN services
2
No Info
5
Transportation
6
Quality Concerns
21
Doesn't Fit Schedule
21
Unplanned illness/emergency
23
No Space
25
Too Expensive
40
0
5
10
15
20
25
30
35
40
45
% of respondents
n=995
Parents were asked to rate the importance of various factors when choosing childcare. By far the most
important factor considered is the reputation of the Centre and the quality of care (93%). The
qualifications of the staff, cost, hours of service and location were of near equal importance (69% to 74%).
100
Important Factors in Choosing Childcare
90
% of respondents
80
70
60
50
40
30
20
10
0
Not Important
Reputation / Quality
Somewhat Important
Location
Hours
Cost
Very Important
Professional ECEs
Family Support Programs and Services
In terms of support services for families7, the majority of parents indicating they or their child has used
child and family support services (77%). More than 40% of parents used prenatal services and 25%
accessed parenting supports. Speech and language services were the most frequently used specialized
service (25%). The more targeted the service, the less likely parents were to use or need it.
7
19
% of respondents
Supportive Service Usage: CGS
90
80
70
60
50
40
30
20
10
0
77
42
25
25
15
15
7
4
Our Children Our Future (OCOF) is an agency that not only provides universal Best Start services but also
provides targeted programs to support families. OCOF offers a number of programs for families that are
port of the Community Action Program for Children and the Canada Prenatal Nutrition Program, such as
Collective Kitchen, Creating Healthy Babies, Steps and Sages and Parent Discussion Groups.
Approximately 5000 visits are made by adults each year to these support programs, and over 5500
children visit OCOF every year.
OCOF Visits: Adult and Children
6792
8000
6000
4908
5522
5263
5167
5841
4000
2000
0
2011
2012
Adults
2013
Children
Best Start hubs are one of the places that provide parents with supports and workshops. Parent discussion
workshops used to be led by a community expert or practitioner. Based on parent feedback, these
discussions became more informal and facilitated by hub staff. Due to the MCYS definition of a ‘workshop’
as formal, structured, educational and skill-building group programs, parent discussion in many hubs no
longer fell under this category. Parent discussions are often weekly programs at the hubs and were the
most common ‘workshop’ provided in the past. Restructuring these workshops into programs may
account for the decrease in workshop numbers.
20
Number of Adults in Workshops: 2008 to 2013
1337
1500
1000
1275
1250
943
647
500
511
0
2008
2009
2010
2011
2012
2013
Number of Adults in Workshops
Healthy Babies Healthy Children8 is a home visiting program for pregnant women and parents of children
under 6 years of age. This program is led by the Sudbury & District Health Unit and it provides parents
with advice and support about pregnancy and parenting and links families with other support services in
the community.
The number of unique families that have been served remained relatively consistent from 2008 until 2012
– at almost 300 families a year. The organization indicated that in 2013 the thresh-hold for risk level was
lowered. This means that families were identified as being ‘with risk’ at a lower threshold and were visited
to determine if the HBHC program was needed. Not all of those families would have been followed long
term but they received a visit and were assessed for their risk level. This impacted the number of unique
families served and the number of family visits in 2013.
HBHC: NUMBER OF UNIQUE
FAMILIES SERVED
500
409
400
300
261
269
296
288
HBHC: NUMBER OF FAMILY
VISITS
3000
294
3538
4000
2674
2515
2008
2009
3064
2894
2725
2010
2011
2012
2000
200
1000
100
0
0
2008
2009
2010
2011
2012
2013
2013
Triple P is an evidence-based Positive Parenting Program that was introduced in Greater Sudbury in 2010.
The City of Greater Sudbury provides three levels of Triple P service: seminars (Level 2), individual sessions
(Level 3) and group (Level 4) through thirty-four community partners, including Best Start Hubs, school
boards, daycares, health services, and family resource centers.
Since its inception, over 320 practitioners have been trained at various levels, the Triple P website received
over 900 requests for Triple P service or information. In 2012, over 550 parents had accessed the program.
8
Data provided by Healthy Babies Healthy Children.
21
The Children’s Community Network is the central access point for Greater Sudbury and ManitoulinSudbury families in need of specialized services. It has also assumed the role of central access to Triple P
programs beyond Level 2. The number of referrals has grown every year, from 80 in 2010, 158 in 2011,
and 208 in 2012.
Triple P is an excellent example of the integrated approach that has been supported by the Best Start
Network in Greater Sudbury. The investment in financial and human resources, a common data base, a
model of parenting support that uses a common language and common practices, and is collectively
delivered to families through common community locations displays many of the hallmarks of an
integrated model of service integration.
Program and Service Outcomes for Families
Importantly, the services in Greater Sudbury are helping parents and children9. Over 85% of parents
‘agreed’ or ‘strongly agreed’ that the services they have accessed have been a support to their family
(93%) and/or their child (86%). Almost 80% said that they know more about healthy child development.
And 75% said that services improved their child’s school readiness and their parenting skills.
Child and Family Outcomes: CGS
% of respondents
60
50
40
30
20
49
39 39
47
44
43
39
37 38
32
17
7
3 2
10
0 0
20
18
11
5
1 1
3 2
2
0
More Knowledgeable Services Support My
re: Child Development
Family
Strongly Agree
9
Agree
Service Support My
Child
Improved School
Readiness
Disagree
Improved Parenting
Skills
Strongly Disagree
22
SERVICE WAIT TIMES
Overall, service wait times have not been impacted by integration. The specialized service sector appears
to meeting about 90% of the need, with far more children receiving services than are waiting for them.
However, when asked, one-third of parents said they were less than satisfied with the wait time for
services.
Community providers, like Hubs, try to provide other programs for families and children while they wait
for another service – but these programs do not offer the service required by families.
Network members were asked how the wait times at their agency had been affected by improved service
integration. 11 agencies that have wait lists responded to the survey. From the agencies perspective, the
majority of respondents (7) indicated that service integration had not changed the wait times in their
agency at all. One respondent indicated that the wait time had increased slightly, while 3 respondents
indicated a decrease – 2 slightly and 1 greatly.
Early years services are often a stop-gap measure while children wait for the appropriate service.
As one respondent stated:
Our service's wait times has not been affected by improved service integration. As many services
continue to have waiting periods, we continue to have to hold onto families and children until they
are able to access the appropriate service. Although all families are encouraged to attend hubs,
these do not offer the individualized/ specialized service interventions required by families of
children with special needs.
Overall, most families are satisfied with wait times. As previously mentioned, far more children are
receiving special services (529) than are waiting for them (50), which suggests specialized services is
meeting about 90% of the need in Greater Sudbury. Corroborating this information is the fact that 85%
said they were ‘very satisfied’ (29%), ‘satisfied’ (36%) or ‘somewhat satisfied’ (20%). 15% of parents
indicated they were ‘dissatisfied’ (9%) or ‘very dissatisfied’ (6%) with wait times.
As the chart below illustrates, the proportion of children waiting for the most commonly used services
(speech, hearing and dental) also had the lowest number of children waiting for these services. A good
indication that children with these more common needs are being served in a timely manner.
However, compared to the number of children receiving support, 20 – 30 percent were waiting for
physical therapy, mental health and learning support services. And some services – while serving a small
number of children – had proportionately higher wait lists, such as ELS and Blind/Low vision services.
23
Special Services
3
ESL Services
6
3
6
3
Blind/Low Vision
Mental Health
11
4
Behavioural
25
3
Developmental
32
3
Special Nutrition
34
8
Learning Support
12
Occupational/Physical therapy
38
39
3
Dental (beyond regular)
49
4
Hearing
86
4
Speech/Language
0
203
50
100
# on Wait List
# Children
150
200
The City of Greater Sudbury maintains a Child Care Registry database. This database has some limitations,
in that parents often register before they require the space (i.e. pregnant mothers) and the children
placed in care may not reflect the same children that requested care in that year. However, based on this
data, the number of fulfilled requests has grown over the years, with 57% of requests fulfilled in 2010 to
61% in 2011 and 70% in 2012.
This coincides with data from the KPS which reports that one quarter (25%) of parents in 2012 indicated
that a barrier they experienced when looking for child care arrangements were that “no spaces” were
available. This likely reflects the difficulty parents may find in obtaining a space in their desired location,
language, or for their younger children, especially babies.
In terms of subsidized child care, the City of Greater Sudbury Children’s Services reports that there is no
waitlist for child care subsidy.
24
SYSTEM’S ABILITY TO RESPOND TO CHANGING NEEDS
The majority of Network members indicated moderate to significant impacts on the system’s ability to
respond to changing needs.
Network members were asked how service integration had affected the system’s ability to respond to
changing needs at the neighbourhood level, the service delivery level as well as the system’s capacity for
professional development, communication and planning.
The strongest impacts of integration (80% or more indicated ‘somewhat’ to ‘very much’ of an impact)
were found in systems ability to provide inclusive (93%), accessible (86%), and supportive (83%) services.
89% indicated that the system’s ability to address family and children’s needs as identified by
neighbourhood had improved – with mention to the development of neighbourhood teams and the use
of neighbourhood level data.
Based on reports at the BSPIN table there appears to be a focus on being responsive at both the
planning table and at the hub level - i.e. changing programming to respond to EDI data.
In terms of improving the system’s capacity through professional development and training, 80%
indicated a positive impact. The development of the Best Start website for families and professionals has
increased awareness amongst providers of the professional development and training opportunities.
Response to Changing Needs: Service Delivery Outcomes
60
57
54
53
52
50
43
42 42
36
40
37
34
30
28
30
20
11
15
14
41
38
37
31
33
29
20
17
7
10
0
Neigh. /
Community
Accessible
Serv.
Inclusive
Serv.
Slightly
Seamless
Serv.
Supportive
Serv.
Somewhat
PD &
Training
Comm. &
Know. Transf.
Planning
Very much
The areas that saw considerable impact, but to a lesser degree, was the system’s ability to engage in
communication and knowledge transfer, and cross-sectoral planning (72% and 71% indicating moderate
to high impacts). The system’s ability to provide seamless services appears to be the most challenging,
with 42% indicating integration had only slightly improved seamless services.
25
Interviewees often cited the Networks ability to discuss issues as they arise and then plan to resolve them.
They are able to draw upon each other’s expertise, from specialized service delivery to serving
marginalized families, to learn from one another and strategize together to find solutions.
For example:
I think that the network provides that venue or that platform or springboard when people know
something’s coming up in the community, whether it be a new funding opportunity, whether it be
families that are saying they can’t access summer camps, or summer programs, it comes to the
network and we work it out. So I think that’s more responsive than ever. Same thing with training:
why are we all training differently or in silos. Same with the recruitment piece. There’s been some
really good conversations, how can we support each other, and if you have an HR specialist and I
have an HR specialist, and I have an HR specialist, why can’t we just gather our thoughts together
and have one HR strategy.
Whether it is around programming, training, recruitment or working together to address an issue brought
to their attention by a partnering agency, they are able to talk about it and tackle it.
When there are key issues within the community around things that pop up that there seems to
be commonality, and I’ll use this example, … they struck a task group from the subcommittee to
work with, you know, the aggressive four year old issues, you know, school boards are bringing
forward issues with having these little four year old kids being very aggressive, so the specialized
needs partners all got together to work … on it now, how do we address this issue within our
community, and work together to really help, solve this, and help kids be better prepared when
they get into school, and what are the behavior needs, or the services and programs needed, in
order to help reduce, the aggression that exists. So I would say that definitely that that committee
has been instrumental in working together to try to make sure that they’re dealing with the issues
that are coming up within the community, and trying to work together to provide the necessary
services.
A challenge that was reiterated by interviewees was that in many cases the system was responding to the
needs, but that it drew upon limited resources. Limited resources and succeeding beyond capacity was
cited by a number of interviewees.
I think that the better that we’re getting at it, … that we’re reaching more people, and the
consequence of that is that we don’t have the resources that we need to, the better that we do
the more challenging it is because we have [the same?] resources. So we’ve been doing more work
in the last year or so, and creating momentum, and now we’re beyond capacity, we can’t handle
any more.
The trust that has been developed amongst Greater Sudbury partners enables them to have open
discussions about issues and needs in the community. They often jointly plan and organize programs and
services, and will collaborate with other agencies to deliver their services to facilitate better access for
families. Increasing access can result in programs operating beyond their capacity and at the limits of
their resources, an issue that was reiterated by survey and interview respondents.
26
PARENT SATISFACTION WITH CHILD AND FAMILY SERVICES IN THE
COMMUNITY
Parents are extremely satisfied with services and service delivery in Greater Sudbury. They feel that
programs and services are well organized and that service providers help them get the services they need.
Services and Service Delivery
Parent’s satisfaction with services and programs for children and families is very high in Greater Sudbury.
Over 80% of respondents indicated they were ‘satisfied’ or ‘very satisfied’ with the activities (87%) and
the support services for children (83%). Three-quarters indicated satisfaction with the information (75%)
and supports for parents (77%) as well as the referrals and connections to other agencies (73%) and their
access to services (74%). The area they reported somewhat less satisfaction was in the area of waiting for
services (66%).
% of respondents
Parent Satisfaction with Services and Programs for Children and
Families: CGS
50
45
40
35
30
25
20
15
10
5
0
Very Satisfied
Satisfied
Somewhat Satisfied
Dissatisfied
Very Dissatisfied
Parents also were asked about their experiences with staff and service delivery. The vast majority
reported that they ‘agree’ or ‘strongly agree’ that the staff is helpful (97%), knowledgeable about other
services in the community (93%), that they provide them with information they can use (90%), and that
they feel comfortable to talk to staff about their families or child’s needs (91%).
27
Parent's Experience of Service Delivery: CGS
60
55
47 46
% of respondents
50
50
46 45
42
40
40
30
20
10
2
1
0
7
7
6
1
1
0
2
0
0
0
Helpful Staff
Strongly Agree
Staff Know about Other
Services
Agree
Comfortable Discussing My
Needs
Disagree
Useful Information
Strongly Disagree
Parent’s Experience of a Seamless System
An important outcome for both the Network and for parents and families, is the experience of a ‘seamless
system’. Parents that used multiple services were asked to rate their experience along the integration
continuum. The document “Defining Integration: A Best Start Working Paper” defines what parents should
expect to experience at each stage of the continuum. These definitions were summarized in the parent
survey.
The majority of parents (68%) indicated that their experience of using multiple services fell between
coordination and collaboration.
Parent's Experience of Integration: CGS
36
% of respondents
40
32
30
20
17
15
10
0
n=158
Awareness
Coordination
Collaboration
Integration
Integration Continuum
Of the 158 parents that responded to this question, 15% of them experienced an integrated system. This
meant that 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.
36% experienced a collaborative system. This meant that the programs and services they used are well
organized and seem to work well together; and sometimes they are even available in the same place.
28
32% felt it was coordinated. This meant that when they go to service providers they often tell parents
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.
17% felt that the agencies were only aware of each other. This meant that they go to different service
providers for different things and although staff might tell them about other services, they have to figure
it out for themselves.
Considering the majority of parents use universal programs and services, such as hubs and child care which
are situated in the schools their child will attend or an older child may already attend, the experience of
integration may be higher for these families than for those that use specialized services. It would be of
value to survey the families of specialized service providers to gain insight on their experience of a
seamless system.
CONCLUSION
result of improved service integration. Improved service integration in the BSIPN has positively impacted
the early identification of children with special needs. There is more awareness and capacity to screen
and identify needs across the system. Common branding, database systems, registration processes,
and there are many examples of this in the Greater Sudbury network.
Overall, there has been a steady increase in the number of children and parents attending programs, being
referred and accessing services. The specialized service sector is meeting most of the needs of children
and families and children’s school readiness has improved or remained stable. Improved literacy,
cognitive development and communication in the early years has led to steady improvements in Grade 3
writing, reading and mathematics.
The vast majority of parents are satisfied with the services they have used, the staff that deliver them
and the benefits that they and their child have experienced. The services have been a support to
themselves and/or their child, have improved their child’s school readiness as well as their own parenting
skills and their knowledge of child development.
The Greater Sudbury network is a victim of their own success and faces the challenge of programs and
services experiencing over-capacity and limited resources, which impacts the accessibility of services
and creates longer wait times for children.
29
APPENDIX I: CAR CIL Parent Survey
The purpose of this survey is to evaluate your experience with the Best Start system of children and
family resources within the Greater Sudbury and Manitoulin-Sudbury area. What you tell us will help
inform us about families’ awareness, access, experiences, and satisfaction with programs and services
that are designed to support you, your child and your family.
This survey will only take a couple minutes to complete and your answers will remain anonymous. Your
participation is voluntary so if there are questions you prefer not to answer or if you decide to stop the
survey – for any reason – that’s fine. We are very grateful to you – and to other families – for taking the
time to answer some questions.
Programs and Services
1. Have you and/or your children used any of the following programs or services? (check all that apply)
a. Prenatal programs
b. Child care services
c. Early Learning programs
d. Nutrition or Breakfast programs
e. Parenting programs
f. Child and Family support programs (Best Start hubs, OCOF)
g. Information and referral services
h. Services for children with special needs
i. Speech and language services
j. Children’s mental health services
k. Children’s culture and ethnic-based programs
l. Children’s recreation services (Public pools, skating, YMCA)
m. A public library
2. Overall, how satisfied are you with the programs and services that you’ve used ? Very Aatisfied;2 =
Satisfied; 3=Somewhat Satisfied; 4=Dissatisfied; 5 = Very Dissatisfied; Don’t Know; Not applicable;
No answer
a. Activities for children
b. Support services for children
c. Support services for parents
d. Programs and/or workshops for parents
e. Information available to parents
f. Referrals and connections to other services/agencies
g. Access to services/programs
h. Registration process to services/programs
i. Wait time for services/programs
3. Were you unable to attend programs or use services for any of the following reasons? Check all that
apply
Cost was too much
Services were not available in my language
30
No services where I live
Didn’t know services were available
Times did not work for me
Didn’t have information about services
No way to get there (no car, no buses, cost)
Not applicable
Waiting list too long
Not Eligible
Other (please tell us) _____________________
______________________________________________________________________________
4. Based on your overall experience with the programs and services you’ve used, please give your
opinion about each of the following statements. Strongly agree; Agree; Neither Agree, Nor disagree;
Disagree; Strongly disagree; Don’t Know; Not applicable; No answer
a. Staff are as helpful as my family needs them to be
b. Staff have information about outside services
c. I feel comfortable discussing my family’s needs with staff
d. The programs and services are a support to my family
e. My child receives the support he/she needs
f. My child is more school-ready because of the programs or services
g. I know more about my child development because of these programs or services
h. The information I have received is useful
i. The things I have learned from these programs or services are useful
j. My parenting abilities have improved because of the programs or services
5. If you have used multiple programs and/or services, please choose the description that best
describes your experience: (Choose one of the following answers)
a. I go to different service providers for different things and although staff might tell me about
other services I have to figure it out for myself.
b. When I go to service providers they often tell me about other programs and even help me
connect with them but I have to make my own appointments, register and often have to
wait for services.
c. Programs and services are well organized and seem to work well together; sometimes they
are even available in the same place.
d. I don’t notice the difference between service providers. I get all the help I need arranging
things and many supports are available at the same place.
Demographics
6.
What is your gender?
a. Female
b. Male
c. Other
7. What is your age category?
a. Under 20
b. 21 – 30
c. 31 – 40
31
d. 41 - 50
e. 51 +
8. Please indicate your child/children’s age categories (check all that apply)
a. 0 – 3 yrs old
b. 4 – 6 years old
c. 7 – 9 years old
d. 10 – 12 years old
e. 13 years and over
9. How much does your family earn before taxes are deducted?
a. Under $14,999
b. $15,000 - $29,999
c. $30,000 - $44,999
d. $45,000 - $59,999
e. $60,000 - $74,999
f. $75,000 - $89,999
g. $90,000 or over
10. What is your postal code? __________________
Thank you for taking the time to fill out this survey.
32
APPENDIX II: Kindergarten Parent Survey
33
34
35
36
37
38
39
40
Greater Sudbury
Best Start Networks
Appendix 3
Review of the Chapleau Innovation Pilot and Report on Field
Consultations on
Co-Location and Integrated Children’s Services Models.
Submitted by
Prepared by
Peter Clutterbuck
PC Human Resources
and
Janet Gasparini
April 23, 2014
Table of Contents
1. INTRODUCTION …………………………………………………………………………………………………………
2. RESEARCH METHODS ………………………………………………………………………………………………..
3. STRUCTURE OF THIS REPORT …………………………………………………………………………………….
1
2
1.0 RESEARCH FINDINGS ………………………………………………………………………………………………………..
1.1 The Children’s Service Universe in Chapleau ………………………………………………………....
1.2 Co-location Process ………………………………………………………………………………………………..
1.3 Co-location Costs ……………………………………………………………………………………………………
1.4 Benefits of Co-location …………………………………………………………………………………………..
1.5 Challenges of Co-location ………………………………………………………………………………………
2.0 SERVICE COORDINATION THROUGH THE CO-LOCATED CENTRE ………………………………………
3.0 ANALYSIS OF FINDINGS ……………………………………………………………………………………………………
3.1 Co-location Models and Success Factors ……………………………………………………………….
3.2 Service Integration Continuum ……………………………………………………………………………..
3.3 Integrated Service Delivery …………………………………………………………………………………..
4.0 BEST PRACTICE MODELS ………………………………………………………………………………………………..
4.1 Wraparound Model ………………………………………………………………………………………………
4.2 Community Hub Model ………………………………………………………………………………………..
4.3 No Wrong Door Model …………………………………………………………………………………………
4.4 Use of Technology ………………………………………………………………………………………………..
5.0 KEY ELEMENTS OF AN INTEGRATED CHILDREN’S SERVICES MODEL …………………………….….
3
3
6
7
8
10
12
13
13
16
17
20
20
22
24
25
27
2
PART A: REVIEW OF THE CHAPLEAU INNOVATION PILOT ............................................... 3
PART B: FIELD CONSULTATIONS IN THE MANITOULIN-SUDBURY DISTRICT …………….… 32
(a) MANITOULIN ………………………………………………………………………………………………………….... 32
(b) LACLOCHE ……………………………………………………………………………………………………………….. 37
(c) SUDBURY EAST ………………………………………………………………………………………………………… 41
CONCLUDING COMMENTS …………………………………………………………………………………………………… 47
BIBLIOGRAPHY …………………………………………………………………………………………………………………….. 50
Review of the Chapleau Innovation Pilot and Report on Field
Consultations on
Co-Location and Integrated Children’s Services Models
1. INTRODUCTION
The Chapleau co-location and integrated children’s services pilot site is one of a five part study of the
Innovation Project for the Greater Sudbury Best Start Network Community Integration Leaders (Sudbury
Manitoulin DSB and City of Greater Sudbury) and the Ministry of Children’s and Youth Services (MCYS).
Greater Sudbury CIL contracted with the Social Planning Council of Sudbury (SPCS) to undertake a review
of the development and implementation of the co-location of five children services agencies into one
physical site as a Child, Youth and Family Services Centre (the Centre) in Chapleau. The focus of the study
was to determine whether and how co-location improves children’s services integration and advances the
development of an effective, efficient integrated child and family services model for potential application
in other rural communities in Sudbury-Manitoulin. The research was to review progress to date at the
Innovation Pilot site in Chapleau and document the benefits, challenges, costs and logistics. It also
involved a limited search for best practices of relevant integrated services models that could inform
development in Sudbury North. The Chapleau experience with co-location and integrated service delivery
to children, youth and families and study of other models were the basis for consultation with community
practitioners in child and family services in Sudbury East, Manitoulin, and LaCloche to explore the
potential for improving more coordinated or integrated service delivery to families with special needs
children in those communities.
With the Best Start Network CIL’s approval, SPCS contracted with Peter Clutterbuck, PC Human
Resources, to conduct the basic research for the Chapleau Innovation Project, while the Executive
Director of SPCS took the research results into the field for consultations with the three other
communities in Greater Sudbury-Manitoulin. Peter Clutterbuck has done extensive work on social
inclusion and integrated planning for social and economic development in multiple communities in
Northern Ontario (North Bay, Sudbury, Timmins-Cochrane, Sault Ste. Marie, and the District of Parry
Sound) primarily through the SPCS and the Social Planning Network of Ontario.
1
2. RESEARCH METHODS
Information for the Chapleau Innovation Pilot review was collected in the following ways:
 Review of background documentation related to the review and the Chapleau pilot (e.g.
Innovation Project proposal and reports; Northern Framework for Ministry Funded Children and
Youth Services).
 A limited internet search for relevant best practice models on co-location and integrated service
models.
 Development of an interview protocol covering the areas of study.
 Completion of telephone interviews in late December through January 21 with senior
management of all the partner agencies in the co-located site (6) and of several major children’s
services partners not co-located in Chapleau (2) as well as two telephone interviews with the
immediate supervisors/managers of several Chapleau Centre workers (post-site visit in early
February).
 Site visit to Chapleau on January 27-29 to interview the front-line workers co-located in the
Chapleau Centre (6) plus staff in partner agencies not co-located (3).
 Presentation of preliminary findings to the Chapleau Children’s Service Providers Network (Jan.
29) for clarification of feedback and discussion on the benefits and challenges of the co-location
and of the Centre’s integrated services practices.
 Review by telephone with the Manitoulin-Sudbury CAS Financial Manager of the accounting of
costs associated with the co-location and the projected annual operational costs of the colocation site for comparison with costs of the previous sites of co-located agencies.
 Organization, facilitation and recording of roundtable discussions of the Chapleau Pilot findings
and integrated children’s services model with the Children’s Services Providers Networks in
Manitoulin and LaCloche (March 25) and Sudbury East (April 7).
3. STRUCTURE OF THIS REPORT
This report is organized into two major parts in addition to this introductory section. Part A reports on the
findings of the review of the co-located Child, Youth and Family Service Centre in Chapleau and an
analysis of its approach to providing integrated services to children with special needs with a view to
identifying the main components of an effective integrated children’s services model.
Part B summarizes the children’s service scene in Manitoulin, LaCloche and Sudbury East and reports on
the deliberations of the relevance and potential of the learning from the Chapleau pilot to these areas in
relation to both co-location and a more integrated children’s services model.
2
PART A
REVIEW OF THE CHAPLEAU INNOVATION PILOT
1.
RESEARCH FINDINGS
1.1
The Children’s Service Universe in Chapleau
Figure 1, reviewed and confirmed with the Chapleau Children’s Service Providers’ Network on January 29,
graphically portrays an overview of the children’s services scene in Chapleau.
Figure 1
Chapleau Children’s Service Providers Network
FHT
Schools
DSB
CCC
st
1
Nations
st
1
Nations
DHU
BSH
CCN
S
B
CTC
ICDS
CFC
CAS
H
T
Co-located in The Child, Youth
& Family Services Centre
APANO
Abinoojii Family
Services
At the centre of the graphic is the Child, Youth and Family Services Centre (the Centre) made up of the
following five co-located agencies:
3





Children’s Community Network (CCN), the central access point for children’s services funded
by the MCYS.
Child and Family Centre (CFC), providing children’s mental health services.
Children’s Treatment Centre (CTC), operating out of Sudbury Health Sciences (Regional
Hospital).
Infant and Child Development Program/Services (ICDS), also operating out of Sudbury Health
Sciences.
Children’s Aid Society (CAS), a branch office of the Children’s Aid Society of the Districts of
Sudbury and Manitoulin.
Notably, CCN, CFC, CTC, and ICDS were already sharing office space prior to the current co-located site,
but were residing in an unsatisfactory and unsuitable building (e.g. lack of family privacy for
appointments) not centrally located in the Town of Chapleau. These four agencies were operating
collaboratively together prior to the co-location; they were and are now commonly referred to as the
“Circle of Care”. They took occupancy of the modern, more spacious and newly renovated location for
the Chapleau Child, Youth and Family Services Centre in the spring of 2013. The Child Protection Worker
for CAS, previously located in separate office space from the other four agencies, joined the Centre in
September 2013.
There is a longstanding tradition of communication among children’s services in Chapleau through
Chapleau Children’s Service Providers’ Network (CCSPN) formed 18 years ago. Figure 1 shows the
CCSPN’s core membership including the co-located agencies in the Centre and the following several
agencies with fairly regular working relationships (making and receiving family referrals) with the Centre:
 Manitoulin-Sudbury District Social Services Administration Board (DSB)
 Sudbury and District Health Unit (SDHU)
 Chapleau Child Care Centre/Garde d’enfants/Best Start Hub (CCCC-BSH)
There are additional community agencies not necessarily regularly engaged with the Centre such as the
Family Health Team (FHT), the local schools, and the Aboriginal People’s Alliance for Northern Ontario
(APANO) but they are still connected through the CCSPN. The Anishinaabe Abinoojii Family Services is
also an important community resource for First Nations’ children as depicted in Figure 1. It is depicted in
the outer ring of the network, with a dashed line of separation to reflect some reported distance from the
larger universe of children’s service providers, including the Centre. Senior management of the Centre
agencies plan more outreach and engagement with Abinoojii this year in order to make stronger
connection and improve working relationships.
Figure 2 illustrates the staffing at the Centre, showing some shared arrangements among the Circle of
Care agency partners.
4
Figure 2
Chapleau Child, Youth and Family Services Centre Staffing
•
CFC
Child & Youth
Care Clinician
(1 FT)
•
•
Special Needs
Resource
Worker
(Shared PT)
ICDS
•
CCN
Rural Services
Coordinator (.8 FTE)
Medical Secretary/
Team Assistant (1FT)
(.5 CTC/.5 DSB $$)
•
CAS
Child Protection
Worker (1 FT)
CTC
Intervention
Workers (2 PT)
The Children’s Community Network employs one staff person 25 hours/week, a Rural Services
Coordinator reporting to a CCN Manager in Sudbury.
Children’s Treatment Centre employs two part-time Intervention Workers and also pays 50% of the salary
of the Medical Secretary/Team Assistant, which serves as a reception function for all agencies at the
Centre. Since CTC makes this contribution to the reception function, it does not pay any of the rental
costs for the Centre. The Medical Secretary/Team Assistant position was previously half-time but the DSB
provided the additional salary required to bring this to a full-time position so that the Centre’s doors are
open during regular business hours Monday to Friday.
The Child and Family Centre (children’s mental health services) employs one full-time Child & Youth Care
Clinician but also shares a part-time Special Needs Resource Worker with ICDS. CFC covers 12 hours per
week of this position and ICDS covers 8 hours per week.
The CAS combined two former half-time positions prior to the co-location into one full-time Child Care
Protection Worker at the Centre.
Notably, all staff report to Sudbury-based program managers/supervisors for their respective agencies
rather than to an on-site Centre manager.
5
1.2
Co-location Process
The co-location process in Chapleau was initiated in 2011 and guided by a project steering committee of
the executive level leadership in the partner agencies, all headquartered in Sudbury with front-line staff
stationed in Chapleau. Early on in the process, there was consideration of additional partners in the colocation (DSB, SDHU and CCC) but particular circumstances in each case resulted in the five current
partners only. An additional constraint to a larger set of co-located partners was the limited availability of
suitable real estate in the small Town of Chapleau.
An independent facilitator worked with the executive leadership of the five partner agencies to frame a
shared vision and a process for the co-location initiative. Executive leadership made seven visits to
Chapleau and information sessions were held with the front-line staff. When funding for the
independent facilitator ended, the executive project committee met less frequently and the responsibility
for implementation was delegated to the supervisory/managerial level of the agencies.
All executive and supervisory staff interviewed for this study agreed that their ability to collaborate
effectively and successfully on this initiative was enabled by more than a decade of working together in
Greater Sudbury. The strong and longstanding organizational and professional working relationships, plus
experience of four of the partners already sharing a location in Chapleau had established a basis of trust
upon which to undertake relatively easily the re-location to the new Centre.
There was limited front-line staff input into the overall co-location process except for the physical
appointments and décor of the new facility. This was not a serious concern, since all front-line staff were
highly motivated and excited about moving to better working space and conditions. Both managerial and
front-line staff did have some reservations about CAS joining the co-located group in the new Centre in
terms of anticipating family and community aversion to use of the Centre in which the mandated child
welfare authority was located. All key informants agreed, however, that this concern proved unfounded.
As the co-location planning moved to implementation, some tensions were evident among front-line staff
around issues not directly related to co-location. The Sudbury-based supervisors/managers facilitated a
process with staff on defining the expectations and demands of working together in the new co-located
site and the introduction of a new partner. This plus the intervention of executive leadership helped to
resolve these issues early. The supervisors/managers set up a regularly scheduled monthly tele-call with
front-line staff, and also ensured that all of the Centre’s front-line staff made a commitment to meet biweekly for information sharing and issue resolution over and above their work together with family
clients.
6
1.3
Co-location Costs
An overview of the costs of the co-location to the participating agencies follows:1
Physical Site Costs
Leasehold improvements (base contract)
Extra Renovations
Furniture and fixtures
Moving expenses & materials
Video-conferencing camera (new)
Safety and Security
Exterior & interior signage
Miscellaneous
HST (net after rebate)
TOTAL
$80,000
9,277
5,255
4,027
3,911
1,902
1,458
3,128
1,995
_______
$110,953
Notably, there were no penalty charges for early termination of leases, since all agency partners were on
a monthly lease arrangement with their previous landlords and four of the agencies were already
occupying the same space.
Sources of funding to cover the physical costs of the co-location:
MCYS
Sale of workstations (CFC, CCN, HSN)
Total revenue for physical co-location
Deficit
Deficit coverage:
CAS (50%)
CCN (25%)
CFC (25%)
Total
$90,000
10,000
_______
$100,000
10,953
$5,477
2,738
2,738
_______
$10,953
The partner agencies incurred additional costs related to furniture for their offices and other equipment
and appointments to the Centre (e.g. microwave and coffeemaker for the kitchen) for which detail was
not collected for this report.
1
Thanks to Allan Lamothe, Financial Manager with Sudbury-Manitoulin CAS, for provision of this information and
clarification on details by telephone interview.
7
In addition to costs related to the physical preparation and move into the new Centre, the cost of work
with the independent facilitator was $20,000. Also, based on estimates provided by key informants, a
minimum of 85 hours of executive leadership time among the five partner agencies was committed to the
co-location process.
Key informants also provided estimates of the travel and accommodation charges for on-site meetings in
Chapleau that total just under $10,000 for the two years of planning and implementation. Time and
travel costs of Sudbury-based supervisors/managers are not included in these figures, since this work was
incorporated within their regular supervisory work in relation to the Chapleau site.
An estimate of the operating costs of the new co-located site compared to the previous unsatisfactory
site occupied by the four Circle of Care agencies indicates that it will be higher on an annual basis but for
much more suitable space in terms of both private office, meeting and program delivery space.
Estimate 2014
Lease
Janitorial
Utilities
Internet communications
Plowing (per occurrence)
Telephone (one line)
Security
TOTALS
Est. 2014
$/year
49,187
8,990
5,000
2,712
1,000
670
461
__________________
$68,020
Pre-co-location
Annual
32,205
8,880
(in rent)
5,424
(no figures)
5,800
880
$53,189
The estimated annual operating property cost for the new co-located Centre in 2014 is $68,020
compared to a combined annual operating property cost for the previous Circle of Care site plus CAS’s
previous location of $53,189. Notably, CAS’ previous annual operating space costs ($27,964) were a little
higher than the combined Circle of Care agencies property costs ($25,225).
At the outset, CAS is committed to covering 50% of the lease costs for the new location ($24,593),
although this is up for renegotiation at a future date. The remaining 50% will be equally shared by CCN
and CFC. CTC, however, as in the previous location will continue to cover 50% of the salary/benefits for
the Medical Secretary/Team Assistant for the Centre ($23,660) in lieu of rent. This position serves as
reception and general office support to all the agencies in the Centre.
1.4
Benefits of Co-location
Key informants at the front-line, executive and supervisory levels of the partner agencies and also among
other managers and workers in other agencies serving children and families in Chapleau were very
8
consistent on the reported benefits of the new co-located site for families, front-line workers and their
respective organizations.
For Families
 The availability of services for special needs children and families under one roof (i.e. a “onestop” Centre) makes it easier for families to receive help from multiple agencies if needed,
although the four Circle of Care agencies were also previously co-located.
 The new Centre is central and easily accessible to families compared to the much less
satisfactory previous location of the Circle of Care agencies.
 The Centre offers welcoming, pleasant, comfortable premises for service delivery and has the
kind of space that allows privacy for counseling and treatment programs.
 The extension of the reception desk to a full-time position allows the Centre’s doors to be open
to families for regular weekday business hours (previously with only a half-time reception desk,
the office hours alternated between two and three days per week).
 The stigma historically associated with the child protection mandate of the CAS is mitigated by
inclusion in the overall “one-stop” Centre, and families are showing no reluctance or hesitancy
to come to the Centre.
For Staff
 There is a much improved space and working environment for staff with a unanimously higher
reported level of job satisfaction.
 The proximity of a co-located site increases the level of communication among staff vis-à-vis
shared client families and it is easier to arrange case conferences. Although four of the agencies
were previously co-located, staff indicated that the new site was more suitable to
communication and meetings with each other and also was enhanced further by more ready
access to the CAS Child Protection Worker, who had not been in the previous site.
 The Circle of Care and CAS staff reported a better understanding and appreciation of each
other’s expertise and agency services and a stronger sense of collegiality compared to joining
the new Centre.
 Staff felt much safer in the Centre’s new location, especially when needing to see client families
for evening appointments.
 Independently completing a short survey comparing the pre- and post-colocation periods, frontline staff indicated that their ability to enact most principles of coordinated and integrated
service delivery as defined by the MCYS Northern Framework was better in the new co-located
site as shown in Table 1 following.
9
Table 1
Staff Assessment of Their Service Delivery
Service Principles
(Northern Framework, 2005)
Post-co-location compared to Pre-colocation
No. staff respondents = 9
Not as
Well
Child, Youth, Family-Centred
Individualized (NR = 1)
Culturally Competent
Least Intrusive
Community-based
Flexibility
Effectiveness
Shared Responsibility
Co-ordination, Collaboration
Same







Better









Notably, the survey results in Table 1 show that staff felt that they could honour most service delivery
principles at least as well and most often better in the new co-located site. In discussion of these survey
results at the CCSPN meeting on January 29, staff explained that they felt that they managed to maintain
a consistently high standard of “individualization” in working with their families both before and after the
new co-location. In terms of “cultural competence”, they also indicated a continuing concern about
overcoming the current distance from Abinoojii Family Services and developing a stronger working
relationship with it as they work out of the new co-located Centre.
For Agencies
 The co-location process re-affirmed the shared values and principles among the partner
agencies.
 The co-location with the addition of CAS has set the stage for greater service integration among
the partners in the future.
 The co-location provides an opportunity for the direct reports of the front-line staff in Chapleau
to coordinate better their supervisory responsibilities (e.g. assuming shared responsibility for
managing the monthly tele-calls with Chapleau staff).
 It is easier to manage Chapleau front-line staff when there is a collegial team environment and
staff are happier with their physical working conditions.
1.5
Challenges of Co-location
Key informants identified the following challenges in the Chapleau Pilot that could inform co-location
initiatives in other communities:
 The public communications around the Child, Youth and Family Services Centre takes time and
careful thought to work through. Each agency still has its own promotional material, although
there is a pamphlet that identifies each agency and the services it offers through the common
10
Centre. There remains a sense that the logo for each agency should continue to appear on
materials and a common Centre web site is still in development. So, the partner agencies are
showing some caution about completely submerging their individual identities and public
profiles into the Centre.
 Some among the partner agencies in the Centre feel that professionals in other outside service
agencies should become more familiar with the Centre’s range of services without worrying
about making family referrals to specific agencies, since the Centre’s intake and referral process
manages that. This speaks to the need for a more targeted form of outreach and
communication to the service and professional sectors, which has been initiated.
 There is recognition among managers and staff at the Centre and among child and family
service providers outside the Centre that the co-location could include more agencies and
enhance service coordination even more fully (e.g. inclusion of DSB, CCC, BSN). The timing was
not right for some groups with respect to their current space arrangements (e.g. DSB had just
moved into a new facility) and also lack of suitable, large enough buildings in Chapleau were
major constraints to a greater set of co-located partners.
 Planning and managing a co-location process in Chapleau at the executive leadership and
supervisory level out of Sudbury were difficult. Northern communities are used to the distance
factor in most aspects of daily work and life in general. With no general Centre manager on site
in Chapleau for the Circle of Care agencies and with a new partner in CAS, a great deal of
coordination of time and travel had to be managed out of Sudbury. All key informants indicated
that the co-location process benefited greatly from the strong existing working relationships
among the agency partners at the senior management, supervisory and front-line levels.
 All key informants agree that there was concern that the “stigma” associated with CAS clients
might affect community acceptance and use of the new Centre. This proved not to be the case
and is attributed to the strong working relationships and mutual support among front-line staff
and their support for the CAS worker, although some managerial interventions were required to
deal with a degree of interpersonal tension that surfaced involving previous CAS staff.
 Front-line staff did indicate some anxiety about Information “oversharing” that could occur in a
co-located site where workers from different agencies work so closely together. This was linked
to the reticence that some clients in a very small town have about workers who are often
friends and neighbours discussing all aspects of their lives with other workers who are also
friends and neighbours. As well as appropriate staff discretion and discipline, this suggests the
need for clear protocols in working relationships and information sharing conveyed directly to
families as they begin service or treatment.
11
2. SERVICE COORDINATION THROUGH THE CO-LOCATED CENTRE
Figure 3 illustrates the service path of a family accessing the Child, Youth and Family Services Centre in
Chapleau. The same process applied in the previous site for the Centre with the exception that CAS is now
part of the on-site service mix, although not part of the Circle of Care.
1) A family requiring service is referred by other agencies/professionals or calls/drops into the
Centre. This is how the Centre serves as a “single point of access” for families and children with
special needs in Chapleau.
2) The Medical Secretary at the Centre’s reception desk takes calls and basic contact information on
the family and refers the family to the CCN Rural Services Coordinator who applies a common
intake protocol for all the Circle of Care agencies at the Centre.
3) Based on the intake protocol and identification of the family’s need, the Rural Services
Coordinator makes a referral as appropriate to one or more of the agency workers that make up
the Circle of Care (CFC, ICDS, CTC) within the Centre.
4) The RSC may also make a referral as appropriate to an outside agency such as DSB (housing or
income assistance) or DHU (e.g. parent education or prenatal training).
5) Although CAS is located in the Centre and the CCN RSC may also refer to CAS if she thinks there is
a child protection issue, direct referrals or queries for child welfare services are routed first to the
CAS office in Sudbury for referral back to the Chapleau CAS Child Protection Worker, rather than
to the CCN RSC.
6) When a family has multiple needs, all involved agency workers at the Centre will case conference
to coordinate their services, including CAS if there is a child protection issue. In multi-need family
situations the RSC is supposed to serve as case manager and track that all service plans are being
implemented. The workers themselves, however, decide who will assume the case coordination
function and usually the worker with the heaviest involvement in the family’s service plan will
assume the lead worker and coordination role. An overall integrated Service Plan is not regularly
prepared, filed and tracked through the case conferencing process, although case conferences
are conducted as the lead worker for a multi-need family deems necessary.
7) All Circle of Care agencies file their client information, service plans and client progress with the
Central Information Management System (CIMS), which is available to all the workers. Parental
consent is necessary for this action.
8) Operating under a more stringent CAS mandate and regulations, the Child Protection Worker
does not file her client information on the CIMS nor has access to the CIMS. The CAS worker and
other agency workers use careful discretion in sharing information about CAS family clients.
9) The Medical Secretary/Team Assistant coordinates with the Centre workers their requirements
for more specialized expertise to prepare a regular schedule (three-four times per year) for
clinical visits from the Sudbury offices of the partner agencies.
12
Figure 3
Service path at Chapleau Child, Youth and Family Services Centre
DSB
Phone or
Referral
Refer to intake
Centre Reception
Family
DHU
Other
CCN RSC
Sudbury-Manitoulin CAS
CIMS
Case Conferencing
Chapleau CAS Worker
M
U
L
T
I
N
E
E
D
F
A
M
I
L
I
E
S
CFC
CTC
ICDS
3 ANALYSIS OF FINDINGS
3.1 Co-Location Models and Success Factors
Four basic types of co-location models have been identified by extensive case study research done by the
Department of Communities of the State of Queensland Government in Australia. These are:
 Amalgamation Model – Partner agencies merge into one legal organization and establish a
management board usually representative of all previously independent agencies.
 Cooperative Model – Formal collective of independent agencies assuming shared
responsibility for the site.
 Co-Governance Model – Sub-committee with representation from all partners manages the
site under organizational auspices of one partner.
 Lead Agency Management -- Large organization manages the centre and holds the lease for
the building in which all the agencies are co-located, supported by the management
committees of the smaller organizations which sub-lease the building from the large agency.
13
(Lennie, updated 2010)
The Chapleau pilot seems to be a combination of the Co-Governance and the Lead Agency models, since
CAS holds the lease to the premises and other partners share in operational costs in a variety of ways (e.g.
in lieu of rent CTC pays for half the salary of the full-time Centre receptionist).
There is no formal protocol agreement among the partner agencies for the Chapleau site. It is informally
“co-governed” by the Sudbury-based supervisors/managers of the front-line staff in Chapleau. The most
formal and regular oversight mechanism is the monthly tele-conference call of Sudbury-based
managers/supervisors with the front-line staff of the Centre supplemented with occasional supervisory
visits to Chapleau. This informal type of governance from a distance is enabled by the strong and
established professional and organizational working relationships among the partner agencies. It is
further facilitated by the existing working relationships among front-line staff, with the CAS worker being
the only additional staff member at the Centre not being co-located with the other agency workers in the
previous Centre site.
The Centre has just acquired video-conferencing equipment (not yet used at time of consultant site visit),
which will allow Skype sessions with the Sudbury supervisors/managers in the future.
The Queensland study by Lennie also offers some key decision factors for the co-location of multiple
partners. Table 2 offers an assessment of the Chapleau pilot co-location against these decision factors
using a five-point scale.
Table 2
Assessment of Chapleau Pilot on Co-Location Decision Factors
Decision Factors
a)
b)
c)
d)
e)
f)
g)
Complementarity & synergies among parties
Similar client base & demographics
Not competitive with each other
Share service philosophy, vision and goals
Community service & client-focused service delivery model
Self-evaluation ability & willingness to share information
Have a community development focus
Chapleau Pilot
Assessment







a) Complementarity and synergies – This is evident from a history of working together professionally
and organizationally. Concerns about addition of CAS to the mix proved unfounded and all frontline Centre workers report high satisfaction with working relationships.
b) Similar client base – It is clearly evident that the agencies share a client base made up of families
with children and youth with special needs. The CAS mandate extends a bit further into dealing
with broader family issues requiring attention to child protection.
c) Competitive issue – When the Northern Framework was introduced in 2005, there was some
retrenchment among the children’s service providers especially as CCN was formed and funding
reallocation put pressure on the agency partners. The partner agencies recognize, however, that
14
they need to work together to fulfill their individual mandates, especially in remote, rural
communities where lower service demand does not merit full-time staff and therefore requires
combining their resources to share staff, which also creates more full-time jobs and which also
helps to attract qualified staff to this remote rural community for work.
d) Shared philosophy, vision, goals – Prior to the new co-location work was done by the executive
level leadership to frame a shared vision and goals for the move into the new Centre. This could
have been enhanced, however, with a deeper involvement and direct participation of front-line
staff in the vision-framing exercise.
e) Community and client-focused delivery model – Co-location has improved community
accessibility to coordinated children’s services and each agency emphasizes individualized
assessment and service planning for families on their caseloads.
f) Self-evaluation ability & info sharing – there is evidence that front-line staff are open and willing
to share information and use CIMS, except that there are constraints on the ability of CAS to
share information and CAS is not a completely integrated part of the Circle of Care.
g) Community development focus – There is not so much evidence of a community development
dimension to the Centre’s approach to community service delivery. It is very much focused on
service delivery to its family client base, although it provides clinical services flexibly in terms of
delivery in homes, schools and childcare settings. The Centre is an integral part of the larger
Chapleau Children’s Service Providers Network, which has explicitly defined its mission in terms of
community development and which does undertake outreach and service development
initiatives.
Table 3 assesses the Chapleau pilot in terms of success factors as derived by the Queensland study of
multi-tenant co-locations sites.
Table 3
Assessment of Chapleau Pilot on C-o-Location Success Factors
Success Factors
a)
a)
b)
c)
d)
e)
f)
a)
b)
Senior management leadership commitment/involvement
Good relationships among parties involved
Energy, flexibility & ability to embrace the new
Transparent info sharing & clear communication
Developing a shared vision
Use of “fair” decision-making processes
Providing resources & training supports
Chapleau Pilot
Assessment







Senior management – Executive management leaders from the partner agencies drove the
process from the outset as a project committee and then turned it over to the agencies’
supervisors/managers for implementation.
Good relationships – There are longstanding professional working relationships among the
Sudbury-based executive leadership and managers/supervisors and with most of the front-line
staff which, except for CAS, were already in one location, although an unsuitable facility. All
15
c)
d)
e)
f)
g)
front-line staff reported that CAS’ inclusion in the co-location improved their working
relationship with CAS.
Energy/flexibility/ability for the “new” – Note that this was not a “new” arrangement for four of
the agency staff, which may not be the case in other co-location opportunities. The addition of
CAS was the only new element and all partners show openness and flexibility in that respect.
Transparent information sharing – Front-line staff were not really kept in the loop on the
development of the co-location in Chapleau, which could have presented a problem if: (a) they
did not already have strong working relationships with each other (b) they were not all unhappy
with their existing space and were excited about moving into better working facilities.
Developing shared vision – Executive leadership in Chapleau put time into this with an
independent facilitator. Front-line staff were not involved in this, although they did work
through a process with their supervisors/managers to define mutual expectations for working in
the new co-located site.
Use of “fair” decision-making – Again the issue is whether a stronger level of participation of
front-line staff in the whole co-location process would be advisable and probably necessary
under different circumstances (e.g. lack of well-established working relationships with each
other)
Resources – One clear advantage in Chapleau was that there were no lease termination costs to
the four original agency partners since they were already in one building, which would have to
be factored in under conditions where agencies were in separate spaces. Otherwise the
resources required for the co-location were provided primarily by Ministry funding but also by
contributions from the agency partners, including flexible arrangements on covering the
ongoing annual operational costs of the Centre. Notably, CAS currently covers 50% of the
annual lease costs, which will be open for reconsideration in the future.
3.2 Service Integration Continuum
The literature establishes a fairly consistent construct for the continuum from functioning independently
and autonomously as an independent organization through different stages of work with other
organizations (cooperation/coordination/collaboration) in common purpose towards full integration. A
combination of the constructs framed by Cairns et al. (2003) and Fine (2005) is used in Table 4 to suggest
where the Chapleau Pilot stands on this continuum in terms of features enabled primarily by the location
of the five partner agencies in one physical site.
16
Table 4
Chapleau Pilot on the Autonomous to Integration Continuum
Autonomy
Agencies acting
completely
independently.
Cooperation
Coordination
Independent
agencies share
information &
undertake joint
activities.
Agency partners
agree to align
activities to
minimize
duplication under
some form of
protocol &
management
structure
Collaboration
Agencies are
separate but
pool resources
for common
goals, share
responsibility
under some form
of governance
and plan.
Integration
Agencies
dissolve
boundaries &
merge some or
all activities,
processes &/or
assets into a
single
org’n/system.
Chapleau Pilot
•
•
Consensual
case
conferences
Scheduling of
external clinical
team visits to
Chapleau
•
•
•
Co-located
Shared costs
Some shared
staff
Except for CAS:
• Use of CIMS
• Common
reception &
intake
functions
Source: Presented in Lennie, 2010 as adapted from Cairns, Harris & Hutchinson, 2003 and Fine,
2005
The Chapleau Pilot exhibits features that place it on the “coordination-collaboration” stage of the
continuum with possibly the Central Information Management System and common reception and intake
functions being examples of integration, although CIMS is not currently used by CAS and the reception or
referral process for CAS clients still goes through the Sudbury CAS office. Cairns et al. do identify shared
co-location models with “joint management structures” as evidence of collaboration. The Chapleau Pilot
displays those features, although the joint management structure is directed out of Sudbury by the
supervisors/managers of the five agencies’ front-line staff in a less than formal way. Designating a single
manager for the site either in Chapleau or in Sudbury would be evidence of moving towards integration
on the continuum. Only one of the key informants interviewed for this review, however, foresaw an onsite centre manager as happening or necessary in the future.
3.3
Integrated Service Delivery
Especially among the senior management of the five agency partners, co-location is considered as a first
step towards more integrated service delivery. Front-line staff perceive it primarily as a move to a better
and more functional work setting and the welcome addition of the CAS worker into a close working
17
relationship. Beyond the features of physical co-location that promote more coordinated and integrated
services for families, however, there are operational features of the Chapleau Centre that require study.
Figure 2 portrays and explains the service path for family clients in the Chapleau Centre, especially for
serving multi-need families. Although there are some constraints imposed on the CAS worker’s full
participation, the Chapleau Centre’s staff function as a team in serving multi-need families.
Table 5 is a chart on integrated services from the literature scan done for the Chapleau Pilot in 2012 and
based on a classification system developed by the Department of Disability in Australia. The yellow
highlighted cells indicate where the Chapleau Centre Pilot would seem to fall for each component of
team work across disciplinary fields.
Fully integrated services demand that community practitioners work in a “trans-disciplinary” way as
indicated in the far right hand column, i.e. team members understand each other’s service model and
approach fairly well and recognize that the best outcomes result from integrated, cross-disciplinary work
in which each discipline’s contributions are equally valued. As well, families with their lived experience
and personal knowledge of their situations are integrated into the team as full members.
In Chapleau the service workers engage the family around their individual treatment plans rather than as
part of the service team. Inclusion of multi-need families as part of a planning and service contracting
team would be an enhancement leading toward a more integrated services approach.
In a moderately integrated services approach, staff teams work in an “inter-disciplinary” way, sharing
their respective areas of expertise and combining them into a common service plan for which each
discipline assumes responsibility for its part. Families may be involved directly to a degree as well in the
“interdisciplinary team” model.
Overall, operationally the Chapleau Centre strongly reflects movement beyond “multi-disciplinary” team
work into “inter-disciplinary” teamwork. Staff team functioning (“organic complexity”) is based on
professional relationships more than structured operational procedures (“institutional complexity”).
There are, however, several key system features that guide inter-agency teamwork – shared intake and
referral, coordination of service delivery for multi-need families, and file sharing with family consent
through CIMS. The Chapleau Centre falls short of complete interdisciplinary teamwork, however, in three
respects:
1) Lack of active family participation in service planning with the whole team as opposed to
working with individual service workers on their respective areas of service responsibility.
2) Individual service plans are created and implemented by each worker for a multi-need family
based on consultation and case conferencing with colleagues but a single integrated service
plan is not generated out of this process and tracked.
3) Limitations and constraints on the full participation of the CAS Child Protection Worker with the
front-line Circle of Care practitioners.
18
Table 5
Chapleau Centre by Collaborative Team Models
Component
Philosophy of
Team Interaction
Multi-disciplinary
Team members recognize the
importance of contributions
from several disciplines.
Inter-disciplinary
Team members are willing
and able to share
responsibility for services
among disciplines.
Family Role
Generally, families meet
with team members
separately by discipline,
The family may or may not be
considered a team member.
Lines of communication
are typically informal,
Members may not think of
themselves as part of a team.
Families may work with the
whole team or team
representatives.
Staff
Development
Staff development generally is
independent and within
individual disciplines.
Staff development is
frequently shared and
held across disciplines.
Assessment
Process
Team members conduct
separate assessments by
disciplines.
Team members conduct
assessments by discipline
and share results.
Service Plan
Development
Team members develop
separate plans for
intervention within their own
disciplines.
Team members implement
their plan separately by
discipline.
Goals are developed by
discipline and shared with
the rest of the team to form
a single service plan.
Team members implement
parts of the plan for which
their disciplines are
responsible.
Lines of
Communication
Service Plan
Implementation
The team meets regularly for
case conferences,
consultations, etc.
Trans-disciplinary
Team members commit to
teach, learn, and work across
disciplinary boundaries to
plan and provide integrated
services.
Families are always members
of the team and determine
their own team roles.
The team meets regularly to
share information and to
teach and learn across
disciplines (for consultations,
team building, etc.).
Staff development across
disciplines is critical to
team development and role
transition.
The team participates in an
arena assessment, observing
and recording across
disciplines.
Staff and family develop plan
together based on family
concerns, priorities, and
resources.
Team members share
responsibility and are
accountable for how the plan
is implemented.
Source: Adapted from Chapleau Pilot Integrated Services Literature Scan, 2012 (from Australian Dept. of
Disability, 2004)
19
4 BEST PRACTICE MODELS
Integrated services models have been studied for application to a wide variety of fields in the human
services for a number of years now. Recently, the Mowat Centre in conjunction with KPMG reported the
results of an international survey of integrated services initiatives, which included Manitoulin-Sudbury
District, and spoke to the “integration imperative” for dealing more holistically with the complex needs of
various client populations (KPMG International Cooperative, 2013). The Chapleau Innovations Pilot
conducted its own scan of the integrated services literature for key elements and success factors as
indicated in Tables 4 and 5 of this report and also applied to the situations in the three consulted
communities in Part B (Chapleau Innovation Project, 2012).
For this report a search was undertaken for best practice models that could inform the development of
integrated services for children with special needs among the research cited in the Bibiography section at
the end of this report. The following three models illustrate the most common best practice features
internationally and domestically. Although presented separately, the main features of each are relatively
consistent in terms of the key practice principles employed.
4.1
Wraparound Model
The Alberta Department of Education is developing and implementing the “wraparound’ collaborative
services model on a province-wide level to provide seamless services to vulnerable school-age children. It
is a school-based approach that engages specialized support services as well as families themselves in the
service planning and implementation process.
Figure 4
Alberta’s “Wraparound” Model
20
The Alberta model is based on a review of the research literature that identifies ten key principles of
effective collaborative servicer delivery:










Collaborative -- Team members work cooperatively and share responsibility for developing,
implementing, monitoring and evaluating a single wraparound plan. The plan reflects a blending
of team members’ perspectives, mandates and resources. The plan guides and coordinates each
team member’s work toward meeting the team’s goals.
Community‐based -- The wraparound team implements service and support strategies that take
place in the most inclusive, most responsive, most accessible and least restrictive settings
possible, and that safely promote child and family integration into home and community life.
Culturally responsive -- The wraparound process demonstrates respect for and builds on the
value, beliefs, cultures, and identity of the child/youth and family, and their community.
Family engagement characterized by voice and choice -- Family and child/youth perspectives are
intentionally elicited and prioritized during all phases of the wraparound process. Planning is
grounded in family members’ perspectives, and the team strives to provide options and choices
such that the plan reflects family values and preferences.
Individualized -- To achieve the goals laid out in the wraparound plan, the team develops and
implements a customized set of strategies, supports and services.
Natural Supports -- The team actively seeks out and encourages the full participation of team
members drawn from family members’ networks of interpersonal and community relationships.
The wraparound plan reflects activities and interventions that draw on sources of natural
support.
Outcome based -- The team ties the goals and strategies of the wraparound plan to observable
or measurable indicators of success, monitors progress in terms of these indicators, and revises
the plan accordingly.
Strengths based -- The wraparound process and the wraparound plan identify, build on, and
enhance the capabilities, knowledge, skills and assets of the child and family, their community
and other team members.
Team driven -- The wraparound team consists of individuals agreed upon by the family and
committed to the family through informal, formal, and community support and service
relationships.
Unconditional commitment -- A wraparound team does not give up on, blame or reject children,
youth and their families. When faced with challenges or setbacks, the team continues working
toward meeting the needs of the youth and family and toward achieving the goals in the
wraparound plan until the team reaches agreement that a formal wraparound process is no
longer necessary.
(Alberta Education et al., 2010, p. 2)
21
4.2
Community Hub Model
The literature on the co-located community hub model across diverse sectors points towards a number of
principles and methods that guide the development of hubs. These include:
• Community hubs depend on strong partnerships and collaboration.
• Community hubs are usually hosted by a lead organization among a set of partners -- an
established agency that serves as trustee (financial responsibility), administrator (oversight of
shared support staff and office services to multiple agencies), and property manager for the hub
facility.
• Community hubs bring together agencies in a way that improves access to information among
clients but also among workers from different agencies.
• Community hubs promote a "seamless continuum of services" in that they de-emphasize the
specific service provider and take advantage of the partnership commitment and the physical
proximity of other providers in the same location to emphasize finding the appropriate
response to the individual/family need.
• Community hubs are locally based and, thus, can be shaped according to community needs and
assets.
 Community hubs have a flexible, community development orientation and thus are adaptable
to the changing environment.
• Community hubs optimize the creative use of physical space in both formal program delivery
and informal community use ways.
(Clutterbuck and Lord, August, 2010).
While the benefits of a hub model will depend on the structure, practices, and aims of the hub in
question, some of the general benefits of a hub model include:
• Single point of access to a range of services
• Clients are more aware of the kinds and range of services available
• Better coordination of service delivery as hubs allow for more interaction between
organizations and sectors, more collaboration and referral systems based on both
organizational and practitioner relationships.
• Possibility for capacity building of services involved, with exchanges of knowledge and practices
among the service workers that occurs in shared space.
• Better access to space for meetings, events, community organizing, etc.
 Cost-efficiencies resulting from co-locating multiple providers in one physical space and
providing a central administrative function (e.g. shared maintenance and office services).
(Clemo & Smith, 2007; Bertram, Pascal, Bokhari, Gasper, & Holtermann, 2002)
22
Applying the community hub model to immigrant settlement support services, since April 2006, five lead
organizations in the Regional Municipality of York — COSTI Immigrant Services, Catholic Community
Services of York Region (CCSYR), Centre for Information & Community Services (CICS), Job Skills and York
Region Neighbourhood Services (YNS) -- have been developing and implementing an integrated service
delivery model out of co-located community hub sites. Since opening the first Welcome Centre in 2006,
four additional community hub centres have been launched across the Region, all operating on the same
principles of integrated services and coordination. The five lead agencies are responsible for providing the
core immigrant services at the Welcome Centres including: settlement and integration services; language
training; accreditation and qualifications assistance, and employment supports. The lead organizations,
together with other participating community agencies, determine the mix of additional services and
programs (such as legal services, mental health services, culturally-appropriate family counseling, etc.)
within the Centre. The community hub is designed as “a coordinated, one-stop concept [to] provide all
services to assist immigrants under one-roof . . . in a welcoming, culturally-sensitive way.”2
The key operating principles of the Welcome Centre community hub model in York Region are:
• Single Point of Access – No individual agency logos are displayed at the Welcome Centres, which
are promoted as multi-service centres for immigrants and their families without profiling the
specific service agencies involved in providing client service. The intention is to promote the
Centre as a resource for newcomers and not for any specific agency services, even though the
front-line staff who engage clients work for their own agencies. The creation of the hub at the
organizational level of the partner agencies also sets up the conditions for front-line workers to
work collaboratively, since their physical proximity allows them to share information and easily
consult with each other informally or in scheduled meetings.
• Co-Governance -- There is a lead governance committee made up of the Manager of the
Welcome Centre and executive directors of the five organizational partners. A chair is appointed
by the governance committee. There are several other subcommittees such as finance,
information technology. The collaboration is not incorporated and does not have a board.
Under a detailed Memorandum of Understanding, the five agency collaborative assigns
responsibility for physical site and operational management responsibility to one lead agency
for each of the five Welcome Centres in the Region.
• Centre Policies – The mission statement and Centre policies were framed with input from
program managers and front-line staff of all partners.
• Matrix Management – All agencies hire the manager and administration staff for each Welcome
Centre. The managers and administration staff of each Centre are accountable to the lead
agency; front-line staff remain accountable to their “home” agencies but are supervised by a
Centre Manager on operational matters related to the Centre. Each Welcome Centre Manager
gives input to agency performance reviews of the front-line staff.
• Seamless Service Delivery – There is a single intake and referral process for immigrant families
at each Welcome Centre. Staff teams are formed for multi-need families and agency staff share
case management responsibilities.
2
http://www.welcomecentre.ca/york/about/background.html
23
•
System Planning -- Data are collected on referral and service paths and used for planning by
partner agencies. The community provides input into governance and planning through
consultations with the community and client feedback mechanisms. A community liaison staff
person outreaches to the community for the explicit purpose of identifying community needs.
4.3
No Wrong Door Model
The community hub model can be adapted to situations in which the main offices of partner agencies are
not co-located in one physical site. A collaborative can set up a shared organizational capacity to
implement the “No Wrong Door” approach, which provides access to families through several locations,
all of which ensure smooth entry onto a service path that is highly individualized to family needs. The key
remains a shared vision and commitment among agency partners to work together, usually formalized in
a clear working agreement.
The Halton Our Kids Network (OKN) is a good practice example of that approach. The Halton OKN was
based on the Healthy Babies, Healthy Children Guidelines in the 1990s for children 0-6 years old and was
expanded to focus on children with complex needs up to 18 years old in 2004. Eight agencies formally
contracted with each other to coordinate services for this child and family population – The Regional
Municipality of Halton, Halton Children’s Aid Society, the Halton District School Board, the Halton Catholic
District School Board, Halton Regional Police Services, Erinoak Kids Centre for Treatment and
Development, the Halton Multicultural Council and Reach Out Centre for Kids (ROCK, child and family
mental health services). Through the agreement the partnership sets up OKN with a paid director and
neighbourhood staff stationed at local school sites. CAS is an equal partner with the others and is serving
as the Secretariat for the OKN (receives and accounts for funding). An additional 30 local and regional
service agencies associated with the OKN are identified as community participants, although not part of
the formal agreement.
The key elements of the OKN model are:
• Formal Agreement – The eight partner agencies have signed onto a detailed Protocol
Agreement specifying their shared commitments and responsibilities for providing “seamless
service” experience to families, including the joint hiring and oversight of the OKN staff. The
Agreement “provides a structure for the Protocol partners to work together and share
information and resources, regardless of staff turnover.”3
• Hub Entry Points – Three school-based hubs with paid “Neighbourhood Coordinators” serve as
single points of entry for children, youth and families.
• Service Coordination – Common intake is done at the hub sites but also by all the partner
agencies (No Wrong Door) and referrals are forwarded to ROCK, which assumes responsibility
for service coordination for multi-need families. Support teams or circles are arranged made up
of the family, other informal or natural supports, and the appropriate service professionals.
Together the team plans and implements a single integrated service plan that is tracked by a
designated Service Coordinator.
3
http://www.ourkidsnetwork.ca/Public/Home.aspx
24
•
•
•
Family-driven – Families are always engaged in service planning, make decisions, and can select
a preferred Service Coordinator from among engaged agencies to manage their integrated plan.
Guidelines & Training – Protocol agencies have developed together and adopted explicit service
coordination guidelines and conduct joint staff training under the direction of an OKN Service
Coordination Steering and Training Committee.
OKN Web Site – A user friendly web site identifies all partners, provides parent information,
guiding videos, and a data portal for practitioners for statistics and maps to the neighbourhood
level on the demographics of children, youth and families in Halton Region. A researcher with
ROCK does track identified needs from the client caseload for service development and planning
purposes.
4.4
Use of Technology
Notably, video-conferencing equipment has been purchased and installed in the Chapleau Child, Youth
and Family services centre, although at the time of the consultant’s site visit it had not yet been set up
and used. Clearly, this will be beneficial to the Centre staff and their supervisors who can convert their
monthly tele-conference calls into videoconference meetings. This raises the question, however, of other
potential uses in the Centre’s direct service delivery. For example, could scheduled visits of specialized
expertise from Sudbury for work with front-line staff and their client families be reduced through the use
of the video-conferencing? Are there other uses of advancing technology that may also be deployed in
rural, remote service areas such as Chapleau to enhance or even substitute for current service practices
that involve costly time and travel when delivered directly by a worker in-home or other distant
community settings? Do the Internet and web-based videos and other tools offer equally effective and
more efficient services to families in their own homes?
A recent study on integrated service in Ontario done for the Mowat Centre points to a greater use of
web-based and communications technology. The Mowat study refers to the “tiered support model”
employed in the Australian state of Victoria as an example of how to better manage client needs ranging
from moderate to complex.
Figure 5
Victoria’s Tiered Support Model
25
Source: KPMG International Cooperative, 2013, p. 24
As Figure 5 illustrates, most clients are referred to on-line resources for information (i.e. “self-support”).
Clients with “moderate needs” are guided by a caseworker to access services that they require. Clients
with complex needs receive intensive “managed support” involving wraparound support as described
previously.
Technology is also used in other service fields to sort clients by intensity of need and manage caseload
demand. For example, more community legal clinic service models in the United States are using
telecommunications and web-based models to help low income people with legal rights issues to get the
information they need before engaging legal staff for direct advocacy. In addition, videoconferencing
with working and pro bono lawyers working out of larger urban centres is used by low income clients in
smaller rural and remote communities, sometimes out of local community legal clinic and sometimes out
of other community-based organizations such as public libraries (McHenry, 2013; Pine Tree Legal
Assistance, 2013).
Increasingly, of course, tele-health services frequently with a video-component are being used for
consultation with medical specialists by local doctors or directly with clients in rural and remote
communities (Alberta Health Services, 2013; KPMG International Cooperative, 2013). One early study on
the viability of tele-health services to rural and remote communities investigated community readiness.
Jennett et al. identify readiness factors for using tele-health technology among patients, practitioners,
organizations and the general public. Patient sense of isolation and health practitioner dissatisfaction
with ability to deliver service were identified as “core readiness” factors as were organizations’
recognition of unaddressed needs. Information and understanding of what tele-health service is and how
it works leads to patient “engagement” and growing curiosity and peer influence and cooperation
facilitates practitioner engagement. “Structural readiness” involves serious planning, training and
investment (Jennett et al., 2003, p. 262).
Are these approaches applicable to or even appropriate for integrated children’s services delivery in rural
areas? Certainly, caution would be needed in self-support models that referred families to on-line
resources for information or guidance on dealing with their children’s needs. In recent years, there has
been some research and study on the use of videoconferencing in the services to children and youth with
special needs with some hopeful results. Duncan et al. cite 19 studies using “telepsychological
treatment” through videoconferencing, many in rural communities, but only three involve services to
children or youth (2014, p. 117). These preliminary findings show potential promise, however. The
authors indicate the importance of sound telecommunications infrastructure and the clear designation of
a “remote site coordinator’ for videoconferencing treatment and consultation services. Duncan et al.
explain that role as follows:
The coordinator serves as the bridge between the telepsychologist and the
client/family at the remote site. The coordinator assists by promoting the
telepsychological service, scheduling the consult, compiling the intake packets,
26
socializing the client/family to videoconferencing, utilizing the technology, assisting
during the consultation, and helping the client/family follow-up on
recommendations. (2014, p. 120)
There are also ethical considerations to consider in service delivery through the use of technology that
varies from face to face interaction (Duncan et al., 2014).
Other researchers are exploring the use of technology and videoconferencing in particular in children’s
services with pilot studies also showing promise including evidence of high levels of family client
satisfaction (Comer et al., 2014; Jones et al., 2014).
The use of videoconferencing for on-site consults with the family and their worker or workers at a
community service centre such as in Chapleau seems very feasible with the possibility of extension in the
future to front-line staff holding sessions from the Chapleau Centre with families in their homes in
remote communities. This development, of course, would depend on a family’s access to the required
computer hardware (videocam) and software in the home or some secure and private community setting.
5
KEY ELEMENTS OF AN INTEGRATED CHILDREN’S SERVICES MODEL
The preceding discussion suggests that a number of key elements are important in the design of an
integrated service system for children with special needs and their families. Many of them are reflected
in the Chapleau Pilot, some could be strengthened and, it is important to note that there are some
particular circumstances in the Chapleau Pilot that may not necessarily apply to other northern rural
communities. The following identifies the key elements with commentary related to the operation and
experience of the Chapleau Child, Youth and Family Services Centre.
Table 6
Key Elements of Integrated Child and Family Services
Key Elements of
Integrated Child and Family Services
 Vision/Mission/Values – Most models of
both co-location and integrated service
practices call for a rigorous and deliberate
planning process at the outset engaging
personnel at all levels of the partner
agencies in framing a common vision, clear
purpose, and focused mission based on
shared values for “collective impact”.
Collective impact refers to the
commitment of separate organizations to
focus their respective capacities and
Chapleau Child, Youth, and Family Services Centre
 In Chapleau some work was done on a
shared vision related to co-location but
mostly at the executive and managerial
level. While there was information sharing
with front-line staff, most of their input
was at the end of the process with respect
to physical appointments and décor of the
new shared workplace. The
supervisors/managers did facilitate a
process on fears and expectations with the
front-line staff, however, which reduced
some anxieties that existed.
27
resources in a complementary way to
achieve shared community outcomes,
beyond just individual organizational
results (Duncan, 2013).
 The Chapleau Pilot also involved relocating the staff of four agencies that
were already co-located in an unsuitable
work setting and adding only one
additional partner. There are longstanding
working relationships and histories of
working together at both the front-line
and managerial levels that mitigated to
some degree the need for extensive work
on framing a common vision, mission and
practices both in terms of sharing a work
setting and in the service planning and
coordination practices employed.
 Collaborative Agreement – The detailed
Protocol Agreement of the Our Kids
Network in Halton is a good example of
the translation of a shared vision, mission
and values into a clear operational
agreement stating roles and
responsibilities of all signatories to the
collaboration. Notably, the Halton CAS is a
full and equal partner in this collaborative
agreement, and has assumed particular
trustee and financial accountability for the
functioning of the OKN. As also stated in
the OKN Protocol Agreement, clear and
formal definition of the structure and
process for working together and sharing
resources is a safeguard against “staff
turnover”. The service coordination
process is institutionalized into community
practice rather than dependent on
working relationships and informal
practices.
 Again, the partners in the Chapleau Pilot
are operating on longstanding
organizational and professional working
relationships rather than a formal signed
agreement. The collaborative community
culture that has developed over the years
extends not only to the traditional Circle of
Care partners but also to other external
community agencies within the larger
Children’s Service Providers’ Network.
These same conditions may not exist in
other communities seeking to establish a
collaborative initiative for integrated
services. As well, even in an established
collaborative community culture, there
may be advantage in institutionalizing
service practices in the event of personnel
changes. Formal agreements may also
help the community agencies and their
authority structures deal with barriers to
fuller integrated practice such as CAS’
relationship to the Circle of Care agencies
in Chapleau.
 Co-location – A shared work setting for
child and family service agencies is not
necessary and not always possible for
coordination and integrated service
provision. Community hub models do
 Co-location is a central feature of the
partners in the Child, Youth and Family
Services Centre in Chapleau. Physical colocation may even be more beneficial in
smaller rural communities with a more
limited overall practitioner workforce in
28
offer the advantage of establishing the
“one-stop service” and “single point of
access” concept in a visibly physical way
for families and can reinforce the notion of
“seamless services”. When not co-located,
however, children’s services can employ
the “No Wrong Door” approach with
shared understanding and protocols for
intake and appropriate referrals through
multiple physical points of access. Also,
even if not co-located, partnering agencies
can create, use and promote a shared web
site (virtual or cyberspace co-location),
which the OKN in Halton does very
effectively.
terms of promoting team collegiality.
 Co-location can also be highly valued by
community partners external to the joined
physical site. Notably, in Chapleau several
additional agencies would be prepared to
join the Centre if adequate space were
available. As well, DSB supplements the
salary for the Centre’s reception position
to ensure family access during full
weekday business hours.
 The quality of the shared physical space is
also critical based on feedback from
managerial and front-line key informants
in Chapleau. There is a high sensitivity to
the need for space that allows family
privacy in their service and treatment
programs. The Centre’s front-line staff
reported greater effectiveness and even
productivity in their work performance
when working out of a modern and
accommodating facility.
 Service Coordination -a) Common Intake & Referral – This is the
most frequent and easiest area of
collaboration for which partners usually
develop common protocols. The question
is whether there is one point of referral for
multi-need families (first level of
coordination) acceptable to all partner
agencies. While the idea of a “single point
of access” where common intake and
referral occurs can be facilitated by the
identification of a physical “one stop”
service centre, multiple agencies can agree
to apply a common intake protocol for
referral to the appropriate coordinating
agency (i.e. No Wrong Door approach) for
families in need.
 Chapleau combines the “one stop
shopping” model with a No Wrong Door
approach in that the Centre is perceived as
the place to go for families with special
needs children. The internal intake and
referral mechanisms are in place for
families to be directed to the appropriate
agency or agencies for service. Other
agencies such as community agencies such
DSB, DHU, and CCCC also know to refer
families presenting certain issues to the
Centre for aid.
b) Family-centred planning – The
 The service professionals in all of the
Chapleau Circle of Care agencies do show
 The CAS remains the exception in the
intake and referral process in Chapleau,
since child welfare regulations require that
referrals be made out of the Sudbury CAS
office.
29
Wraparound model emphasizes that the
family be intensively involved in the
development of an integrated service plan
and also that for multi-need families, a
multi-disciplinary team of professionals
join with family and friends or natural
helping networks to address the family’s
issues. This is a much different approach
than seeing the family primarily as a client
that needs issues addressed and its
problems resolved. It requires a more
community development oriented form of
practice rather than clinical casework.
tremendous respect for the families that
they serve, including recognizing that
families themselves have skills and
capacities to bring to the issues that they
encounter. All reports indicate that
families value the service received out of
the Centre and have good relations with
the practitioners.
 Still, families seem to be more passive
than active in the development of their
service plans. They are not engaged in the
service planning process with other team
or case conference members and primarily
work with Centre practitioners on an
individual basis.
c) Integrated service plan -- The most
developed integrated models engage the
family and service practitioners in creating
one integrated service plan with
assignments of the plan’s various parts to
different parties for implementation and
then regular case conferences to track
progress on the parts and the whole.
 The planning process is more informal and
less integrated in Chapleau. There is some
coordination on what each agency can
provide for multi-need families but no
single integrated service plan is developed
and tracked as a whole. Different workers
usually stay apprised of what others are
doing through informal communications
and meetings, occasional case
conferences, and access to the CIMS to
which each, except CAS, file their reports.
d) Information sharing – Integrated service
plans cannot work without the ability of
workers to share information in their work
with multi-need families. All agree that
this requires parental consent and usually
common consent forms are developed for
this purpose and shared computer file
systems are set up.
 In Chapleau, the Circle of Care agency
practitioners do secure parental consent in
order to share information on their work
with families on the CIMS. CAS, however,
has its own data filing system and does not
post to nor have access to the CIMS for
families with which it is working. It can
secure parental consent to share its
information with other workers and other
workers can do so similarly to share
information with the CAS worker. The
success of these arrangements, of course,
depends on high trust levels between
families and their front-line workers.
e) Assigned Service Coordinator – There
should be a fixed point of responsibility for
ensuring the development and “case
 In the Chapleau Centre, the CCN position
of Rural Services Coordinator (RSC) is
designed to perform the service
30
managing/coordinating” of the service
plans for multi-need families. At one time
this was considered a function best
performed by someone without other
service delivery responsibilities. It is more
recognized now that other options for
service coordination can work. For
example, the agency taking the heaviest
service responsibility for a family may also
assume the lead role on service
coordination with other agencies. In the
strongest Wraparound models, the family
selects its preferred case coordinator from
the service team with which it is working
(e.g. Halton OKN).
f)
Access to specialized expertise – This is a
special challenge for rural communities
without immediate access to resources
available in larger urban communities.
Specialized staff based at larger
institutional settings in urban areas can be
available for consultation via telephone or
electronic communications such as
videoconferencing or Skype technology.
On-site field visits as required can also be
used, although more expensive.
 Service Development and Systems
Planning – A lot of information is
generated in the service delivery process,
which is only enhanced by effective
collaboration among providers. How this
data in aggregate form with proper
confidentiality protections is used for
planning purposes is an important
question and one that suggests the
development of mechanisms and
structures for inter-agency collaboration at
the systems planning level as well.
coordination function. Common practice,
however, is for the worker with the
heaviest service role with a family to serve
as the lead on their service delivery. This is
an accepted practice in the field now,
especially when families can select their
own case coordinator. It would be
strengthened, however, in Chapleau if
there were one single integrated service
plan created for multi-need families.
 The Child, Youth and Family Centre does
coordinate scheduled visits of expert
clinicians and resource people from
Sudbury three to four times a year.
 Although data available on the CIMS is not
aggregated in any systematic way for
planning purposes in Chapleau, the
Chapleau Children’s Services Providers’
Network is a regularly meeting group that
does take on initiatives arising from the
experience and expressed needs of the
participants, which extend beyond the colocated partners at the Centre. A more
systemic form of planning could build on
this important base infrastructure, which
would require clear assignment of this
responsibility to a preferably independent
non-direct service delivery party.
31
PART B
FIELD CONSULTATIONS IN THE MANITOULIN-SUDBURY DISTRICT
Following the thorough review of the Chapleau model a presentation was prepared for delivery to the
Local Service Providers Network’s (LSPN) in Manitoulin, LaCloche and Sudbury East. The purpose of the
presentation and ensuing community consultation was to review the co-location experience and other
potential models of integrated service delivery to children, youth and families in order to explore the
potential for improving more coordinated or integrated service delivery to families with special needs
children in those communities.
The Chairs of the LSPN in each district were contacted and a meeting time and place was organized.
Members of the LSPN were invited along with management leads from the participating agencies. A
research team from the SPCS attended in each community and provided an overview of the results of the
Chapleau review. Participants then discussed the model of service planning and delivery in their own
respective areas, the features of the Chapleau model that had merit for them and other possibilities for
improving more coordinated or integrated children’s services in their areas.
(a)
Manitoulin Roundtable
Manitoulin Island is one of four areas that make up the Manitoulin Sudbury District. It is the largest
freshwater island in the world with a mass of 3,107 square kilometres. This area is home to seven First
Nations, six townships, one municipality, two towns, and one unorganized area. There is a total
population of 13,048, of which 1,880 are children between the ages of 0 and 12 years. The aboriginal
population in this area numbers 5,295. A total of 3,935 families live in this area.
On March 25 members of the Manitoulin LSPN met in Little Current on Manitoulin Island. Attendees
included staff and management from Children’s Community Network, Rainbow District School Board,
Sudbury and District Health Unit, Manitoulin Sudbury DSB, Manitoulin Family Resources, Child and Family
Centre, M’Chigeeng Daycare and Gore Bay Child Care Centre.
Following the presentation of the Chapleau results, the group participated in a mapping exercise that
located the service delivery model for the island. As described Manitoulin Island is a large geographic
area with several urban centers and many kilometers between locations.
32
Map 1
Children’s Services in the Manitoulin Area Depicted by Local Community
The “map” was depicted using a power point presentation to represent what the participants had
indicated. Little Current is clearly the Hub of children’s services on Manitoulin Island. CCN, CFC PSL
(WordPlay- Jeux de Mots) are all located in one building on Water Street. Very nearby are the offices of
CTC, ICDS and the DSB. Child welfare services throughout the Manitoulin/Sudbury District and eventually
in the City of Greater Sudbury as well are in the process of being divested to First Nation’s Communities
and their own child welfare agencies. On Manitoulin, Kina Gbezhgomi Child and Family Services (KGCFS),
an agency incorporated in 1991 that provides Child and Family Services to all seven First Nations on
Manitoulin Island, will be responsible for these services. Child welfare services for non-native families will
continue to be provided by the Children’s Aid Society of the Districts of Sudbury and Manitoulin. Currently
the CAS has an office in Little Current. However, when the transition is complete, these services will be
delivered from Greater Sudbury.
There are schools located in the four urban centres on the Island. All of the schools are operated by the
Rainbow District School Board. All but the Assiginack Public School in Manitowaning have day care
centers located in the schools. The daycares in Central Manitoulin PS in Mindemoya as well as Little
Current PS are operated by Manitoulin Family Resources (MFR). The daycare in Charles C. McLean PS in
33
Gore Bay has service provided by Gore Bay Child Care Centre. Home-based daycares in several locations
on the Island are supervised by MFR. Four of the seven First Nations on Manitoulin Island operate their
own elementary schools and Wikwemikong operates a high school as well. These schools are federally
funded but the Ontario Ministry of Education provides funding for daycares in schools.
Manitoulin Family Resources is a multi service agency that operates throughout the Island as well as in
LaCloche. It provides services to women, children and families that include resources, advocacy, support
and education through programs in the areas of children’s services, violence against women prevention,
and emergency food assistance. Along with the daycare provided as described, MFR operates a Best Start
Hub at Little Current PS with satellite programs in Mindemoya, Manitowaning, Tehkummah and Gore Bay.
The Executive Director of MFR is the Chair of MLSPN.
The Sudbury & District Health Unit has offices in Mindemoya and offers services throughout the Island.
Healthy Babies Healthy Children (HBHC) is the primary parent support program offered by SDHU and
provides prenatal, postnatal and early childhood support in-home from a Public Health Nurse
(PHN) and a Family Home Visitor for those who qualify following the application of the HBHC screen.
Every new mother is offered a phone call within 48 hours of discharge from hospital by a PHN to offer
information, support and counselling. The SDHU only provides HBHC off-Reserve as each First Nation has
its own HBHC Program. The SDHU also offers local telephone support for information and support
around pregnancy, and parenting. Breastfeeding counselling is available over the phone or by
appointment in the Mindemoya District Office (in addition to in-home with HBHC Program)
The Family Health Teams and Midwives were identified as partners with whom agencies could be working
more collaboratively in the delivery of services.
The seven First Nations Communities on Manitoulin Island manage children’s services in their own
communities, which include education, childcare, health care, recreation activities and most recently
child welfare services. There are some services offered jointly between First Nations communities (i.e.
Mnaamodzawin Health Services, Noojmowin Teg Health Centre), some that are specific to each
community and some services that are provided by non-First Nations’ agencies such as Infant and Child
Development and the relationship between MFR and Noojmowin Teg. At a conference held in March
2013 (Building Bridges Gathering) an attempt was made to identify services and agencies and to provide
an opportunity for network building. The report of this conference identifies the need for more in-depth
mapping of services as the discussions revealed that there are several structural barriers to service
delivery such as lack of public transportation, funding and bureaucratic limitations. The report went on to
recommend that In order to develop and support relationships among agencies and First Nations, three
key items could be addressed: getting an overall ‘picture’ of what programs and services are available,
building on existing networks, and connecting with the Best Start Network.
At the consultation on March 25 representatives from the M’Chigeeng First Nations Childcare Center and
participants from non-native service organizations expressed interest in better connections and more
collaboration as a focus of integrated planning. The Ministry of Education is responsible for childcare
34
services offered in First Nations’ schools (which are funded federally). Recently they have invested
resources in capacity building amongst the childcare providers.
Participants in the dialogue indicated that the co-located services in Little Current were not as integrated
as the model in Chapleau. CFC is the lease holder for the shared space. CCN provides intake and referral
services as they do in Chapleau and provides communication and information services as necessary. This
includes referral to MCYS funded services as well as to other partners including the SDHU and MFR as
necessary. The close proximity of agencies in Little Current allows for informal collaboration. There is no
shared staff amongst any of the agencies. For the most part families from throughout Manitoulin Island
travel to Little Current for services however there are instances when workers travel out to other parts of
the Island to see clients.
MFR works in close collaboration with the Rainbow District School Board. Managing the childcare sites in
two of their schools and operating the Best Start Hub in Little Current. Little Current Public School is a
designated priority school and as such has additional resources to support children and families. MFR
works closely with the school in the delivery of ancillary services through this opportunity.
When asked to view their planning and service delivery model through the lens of the integration scale
participants identified examples of coordination, collaboration and integration as shown in Table 7.
Table 7
Manitoulin Roundtable: Area Examples in Relation to the Integration Continuum
Autonomy
Cooperation
Coordination
Agencies acting
completely
independently.
Independent
agencies share
information &
undertake joint
activities.
Agency partners agree
to align activities to
minimize duplication
under some form of
protocol &
management structure
Collaboration
Integration
Agencies are separate
but pool resources
for common goals,
share responsibility
under some form of
governance and plan.
Agencies dissolve
boundaries &
merge some or all
activities,
processes &/or
assets into a single
org’n/system.
Manitoulin
Referrals between
agencies
•
•
•
SDHU partners
with agencies to
deliver programs
Hubs in schools
sharing space with
childcare and
education
Hub outreach
•
•
Event based
activities
Case
management for
complex cases
•
•
•
Use of CIMS
(but not by all)
Triple P
Hubs and
childcare in
some locations
operated by
the same
agency
As Figure 6 illustrates, for the most part both front line service providers and management staff saw themselves at the very early stages along the
continuum of integrated service delivery. They indicated that the Vision/Mission/Values/Principles were implicit and unwritten and that the
collaborative agreements were mostly informal understandings. They felt that they were further along the continuum in terms of “no wrong
door” services with some co-location and good communication. Service co-ordination and systems planning tended towards the fragmented and
disconnected end of the scale.
35
Figure 6
Manitoulin Roundtable: Portrayal of Manitoulin Positioning on the Key Elements of an Integrated Children’s
Services Model Based on Consultation Discussion
Nations and require services from main stream organizations. There was a desire and commitment to
integrate services in an effective way in order to better serve the whole population on Manitoulin Island.
1) Review the location of service delivery – perhaps a more central location would allow for better
service delivery for families and more effective use of resources. Mindemoya is more centrally
located on the Island.
2) More effective collaboration – perhaps a “shared space” available in different communities that
could be used by a variety of agencies. School space was cited as an example. Co-ordination of
services could be arranged so that families were coming to the school on a day when all services
would be available.
3) Common Intake/Referral System – perhaps the current system of intake by CCN could be
expanded to include both MYCS and other funded services when possible
4) Case Co-ordination – perhaps a common intake form that would gather all of the information on
what a family and/or child needs and then the responsibility for ensuring those needs are met
would be assigned to the agency most involved with the family. Timelines and reporting back
would become the responsibility of the case manager.
5) Use of technology – perhaps better use of the technology currently available (video conferencing)
as well exploration of other possibilities – i.e. skype, telehealth resources, other?
36
(b)
LaCloche Roundtable
LaCloche is the geographic area that includes the townships of Baldwin, Espanola, Nairn and Hyman, and
Sables-Spanish River. The area is more compact at 1142 square kilometres. It runs along Highway 17
from the town of Massey at its western end to the town of Nairn Center on the eastern end extending up
Highway 6 to Espanola and on to Manitoulin Island. The total population of LaCloche is 8,946 persons, of
whom 910 are children between the ages of 0 and 12 years. This area is home to 2,915 families.
The round table discussion on March 25 in LaCloche included members of the LaCloche Service Providers
Network and was attended by a mix of front line and supervisory staff from CCN, SDHU, MFR, Rainbow
District School Board (RDSB), Manitoulin Sudbury District School Board (MSDSB), ICDS, CFC and Our
Children Our Future (OCOF).
After the presentation of the Chapleau model, the group engaged in a mapping exercise of the current
model of service delivery in LaCloche. Given that LaCloche is a much smaller geographic area than
Manitoulin Island or Sudbury East the “map” produced had more in common with the Chapleau model.
Espanola is the hub of LaCloche and as such is the centre for most services including health, education,
economic and social services. Residents in the surrounding communities of Massey, Webbwood, Baldwin
Township, McKerrow, Narin Center, Sable Spanish River and Walford for the most part travel into
Espanola or to the City of Greater Sudbury given their relative proximity (60 kms) to those areas.
Map 2
Children’s Services in the LaCloche Area Depicted by Local Community
37
Most of the children service delivery organizations have a presence in Espanola. Several agencies are colocated in one facility. Not unlike the Chapleau experience the current facility is inadequate to meet the
needs of the agencies and moving to a larger location is being considered. Better quality and larger space
would provide the opportunity for more agencies to co-locate as well as the opportunity for a more
structured model of co-location.
The “map” in LaCloche depicts the much smaller geography that is serviced via agencies and programs
that are centred in Espanola. CCN, CFC, ICDS and Preschool Speech and Language (WordPlay- Jeux de
Mots) are all located in what is described as inadequate space on Grey Street. Health Sciences North,
which manages CTC as well as ICDS, is the leaseholder on the property. The administrative offices for the
Manitoulin Sudbury District Services Board are located in Espanola. They provide administrative support
to all of their offices throughout the District from this location as well as direct client service for Ontario
Works, childcare, employment supports and housing. Specialized staff from CFC and CTC travel from
Greater Sudbury to the offices in Espanola and see families both in home and at the office. The CAS has
no permanent office in Espanola and provides service to families out of Greater Sudbury.
The SDHU has an office in Espanola and provides all of the services of the Health Unit including Healthy
Babies Healthy Children, breast feeding support, prenatal classes and Triple P training. It works in
partnership with the Family Health team, the Manitoulin Midwives and Our Children Our Future (OCOF)
when possible.
There are six schools located in LaCloche operated by three different Boards of Education including the
Rainbow District School Board, Huron Superior Catholic District School board and Conseil scolaire
publique du Grand Nord de l'Ontario (CSPGNO). RDSB and CSPGNO are actively involved in the Best Start
Network.
All but Webbwood Public School have day care centers located within the schools. The daycares are
operated by three different licensed providers including One Tot Stop, All Stars Childcare and OCOF. All
are supported by the DSB through childcare subsidies and early learning resources.
Manitoulin Family Resources is a multi service agency that operates throughout the Island as well as in
LaCloche. It provides services to women, children and families that include resources, advocacy, support
and education through programs in the areas of children’s services, prevention of violence against
women, and emergency food assistance. In Espanola MFR manages several licensed home day cares and
provides its VAW services by appointment, meeting women in safe spaces in the community.
There is a Family Health Team and Midwives operating in LaCloche who were identified as partners with
which agencies work when opportunities arise.
Our Children Our Future (OCOF) is primarily a federally funded agency providing the Community Action
Program of Canada (CAPC) on behalf of the Public Health Agency of Canada. OCOF has built a significant
number of partnerships with community agencies and funders to enhance its capacity to offer services to
children and families. In partnership with the DSB, OCOF operates Best Start Hubs in LaCloche and
Sudbury East. In LaCloche it has partnered with all three school boards operating in this area and
38
operates a Hub in Sacred Heart School with administrative space provided at A.B. Ellis School. OCOF
provides outreach services to all of the schools in the district using shared space provided by the school
and offering school readiness, play groups, collective kitchens/food security programs and parent
support. OCOF has staff trained in Triple P and participate in the delivery of Triple P parenting. OCOF
management staff participate in the Manitoulin Sudbury Best Start Network
Viewing their planning and service delivery model through the lens of the integration scale, participants in
the LaCloche roundtable discussion identified examples of coordination, collaboration and integration as
shown in Table 8.
There was a robust discussion about the capacity of the case managers from CCN. Participants indicated
that because the staff was from the area there were strong bonds and extensive capacity to “get things
done”. The participants spoke of the longstanding, rural culture that exists in smaller communities and
how it contributes to integrated service delivery.
Table 8
LaCloche Roundtable: Area Examples in Relation to the Integration Continuum
Autonomy
Agencies acting
completely
independently.
Cooperation
Coordination
Independent
agencies share
information &
undertake joint
activities.
Agency partners
agree to align
activities to
minimize
duplication under
some form of
protocol &
management
structure
Collaboration
Integration
Agencies are
separate but
pool resources
for common
goals, share
responsibility
under some form
of governance
and plan.
Agencies
dissolve
boundaries &
merge some or
all activities,
processes &/or
assets into a
single
org’n/system.
LaCloche
Service planning
across agencies
•
•
•
SDHU partners
with agencies
to deliver
programs
Hubs in schools
sharing space
with childcare
and education
Hub outreach
by OCOF to
schools in the
district
•
Service
coordination
by CCN case
managers –
they know
the services
very well and
advocate on
behalf of
clients to get
what they
need
•
•
Use of CIMS
(but not by
all)
Triple P
39
Participants did not discuss the continuum of integrated service delivery directly as presented. Based on
the discussion, however, it was evident that they operated from an unwritten common Vision/Mission
/Values/Principles grounded in what they described as “rural culture”. There were many collaborative
agreements but primarily these were informal understandings. Based on the work of the CCN case
managers they operated from a “no wrong door” approach. Some services are co-located with
opportunity to increase the participants in a co-located site. Service co-ordination, again based on the
work of individuals, was described closer to seamless. It was not necessarily based, however, in
connected systems planning. Figure 2 suggests where LaCloche is positioned on the key elements of an
integrated model.
Figure 7
LaCloche Roundtable: Portrayal of LaCloche positioning on the Key Elements of an Integrated Children’s
Services Model based on Consultation Discussion
Espanola. More than half of the population lives there and those in the district have less than 40 km to
1)
Based on the experience of co-location in Chapleau the LaCloche area could benefit from a
larger, more adequate and suitable space for providing children’s services. This would allow
for a review of services based on the lessons learned in Chapleau and the development of a
more formal system of integration.
2)
Consider a “common space” within such a facility that could be used by those
agencies/individuals that travel into LaCloche to provide services.
40
3)
Common Intake/Referral System – Case Co-ordination – examine the current system of intake
by CCN and determine if a common intake/referral system would solidify the well-functioning
current system that would be expanded to include other than MYCS funded services – i.e.
Health Unit services.
4)
Use of technology – perhaps better use of the technology currently available (video
conferencing) as well exploration of other possibilities – i.e. skype, telehealth resources,
other?
(c)
Sudbury East Roundtable
Sudbury East is the largest geographic area (other than Sudbury North where Chapleau is located) that
was consulted on service delivery in the Manitoulin Sudbury District. At 3225 square kilometres, it forms
an irregular crescent around the City of Greater Sudbury and includes diverse and distinct communities.
Killarney on the far west corner of the district is a relatively isolated community with a small population
(505 people in the 2011 Census). The communities of Markstay-Warren, Hagar, St. Charles, Noelville,
Monetville, French River and Alban run from Highway 17 in the northeast around to Highway 400 in the
southwest along the connecting Highways 535 and 64. The area has a total population of 6526 persons
of which 690 are children between the ages of 0 and 12. 2155 families reside in Sudbury East. There is a
relatively high proportion of first language French speakers in Sudbury East (40.4% as compared to 25%
for the whole Sudbury Manitoulin/ Greater Sudbury catchment area) with most French language speakers
residing outside of the community of Killarney.
The round table discussion in Sudbury East included members of the Sudbury East Service Providers
Network and revealed a very different makeup from the LSPN’s in the other areas. In Sudbury East the
network has extended itself to include several service providers who deliver services to families and
individuals that extend beyond those services delivered to children. While most of the children’s serving
agencies are represented on the SESPN there are other key players. The consultation was attended by a
mix of front line and supervisory staff from CCN, SDHU, MSDSB, ICDS (who also represented CTC), CFC
and OCOF. Also joining were individuals from the Sudbury East Community Health Centre, Alpha en
partagé, and two municipal politicians including the Mayor of St. Charles. Not present at the consultation
but participating in the SESPN were the Sudbury East Seniors Support, Employment Options, Mental
Health and Addictions services, VICARS, and the local Libraries. Of note there is no school board presence
on the LSPN at this time.
The presentation on the Chapleau model was completed and the group was engaged in a mapping
exercise of the current model of service delivery Sudbury East. Once again the “map” produced a
distinctive model of service delivery. All of the children serving agencies that are funded by MCYS or the
Ministry of Health service this area from the City of Greater Sudbury through service providers who travel
to and from the area on a regular basis.
41
The community of St. Charles provides a focus for coordinated service delivery through the Fabien
Gauthier Centre. The upper level of École St-Charles Borromée has been converted to use for service
providing agencies and thus provides a shared space facility. Some of the SESPN members have offices in
this centre including OCOF and Alpha en partagé. Other agencies from Sudbury and Manitoulin Sudbury
use the space to see clients. Other residents of the centre include Contact North, and the library.
Map 3
Children’s Services in the Sudbury East Area Depicted by Local Community
The “map” in Sudbury East depicts the vast geography that is serviced by many of the same agencies
working in other areas of the Manitoulin Sudbury District. The picture is unique and quite different. As
indicated all of the specialized services in this area are delivered from the home base in Greater Sudbury.
CCN provides service co-ordination as they do throughout the area and all of the agencies provide their
services through the same, regularly scheduled employee except for CAS who assigns cases to staff as
they are encountered. The CCN coordinator provides communication and coordination for cases that
require multiple services. Referrals come from schools, paediatricians, Health Sciences North and often
are as a result of parents’ own inquiries. Case management is facilitated by the agency that has the most
direct contact with the family. For those agencies who participate in the usage of CIMS, data is available
for case coordination.
The facility in St. Charles co-locates a number of services and provides space for others that provide
services to families and individuals beyond but including families with children. Alpha en partagé is an
agency providing literacy training and education upgrades with funding from the Ministry of Training
Colleges and Universities. When funding was decreased in 2011, the MSDSB invested $35,000 in the
42
agency to continue to fund the position of Community Liaison Officer to ensure that the clients serviced
by the DSB were able to receive the support they required to upgrade their skills in order to find
employment. This position continues to be funded to this day. The liaison worker provides essential
supports to residents of the area. This includes families with children who need access to specialized
service. The SESPN provides the capacity for collaboration and coordination around family’s needs. The
CCN case manager for this area participates at the planning meetings and like other members of the
SESPN responds to requests from network members in a timely way through their connections. Other
key players in terms of children’s needs at the SESPN include the Sudbury East Community Health Centre,
the DSB’s integrated services case manager and staff from OCOF.
The Sudbury East Community Health Centre is a bilingual community health centre funded by the LHIN.
Community health centres have a mandate for both the delivery of clinical services (i.e. doctors, nurse
practitioners, dieticians, social workers and registered nurses) and community capacity building with a
focus on health promotion and prevention. The Community Development worker participates on the
SESPN and makes herself available to support families and children as opportunities arise. Most of her
programming involves seniors as there has been difficulty in recruiting volunteers for children’s services.
Support, however, is available when projects are initiated. The Community Health Clinic has a site in St.
Charles, Noelville and Warren.
The DSB has a mandate to deliver social assistance, employment supports, housing and children’s services
throughout the Manitoulin Sudbury District. They have adopted an integrated service model that
provides for case management for any of those services that a client may require. The DSB office is based
in Warren with staff travelling to satellite offices in Noelville which they share with College Boréal (a
French language community college based in Greater Sudbury). Staff will travel throughout the district to
meet with clients – sometimes in their homes or convenient locations. The DSB provides a number of
vans that are used throughout the district in order to support families and individuals accessing services.
Partners at the SESPN utilize this service when possible. The DSB participates on the SESPN and again
benefits from the connections at the planning table in being able to connect the clients to the resources
they require.
Our Children Our Future provides Best Start Hub services throughout the Sudbury East area. The main
Hub is in Noelville in St. Antoine School. They offer play groups and a monthly Family Fun Night. They
partner with the school to deliver a French school readiness program. They travel to schools in Alban,
Monetville and Markstay to provide outreach services. They have a permanent space in the Fabien Centre
in St. Charles that is used for outreach services and is shared with agencies requiring space – i.e.
Wordplay. They participate with other agencies in the delivery of Triple P and are involved with food
security initiatives such as emergency food hampers and collective kitchens. They partner with local
organizations when possible to make things happen such as the current efforts to create a splash pad in
French River. They too are key players in the SESPN.
The SDHU has an office in St. Charles. The two staff who work there deliver the generalized health
promotion/prevention services of the Health Unit. Healthy Babies Healthy Children, breast feeding
43
support, prenatal classes and Triple P are all offered to families in Sudbury East from the offices in
Greater Sudbury. SDHU staff from St. Charles participate on the SESPN.
There are eight schools located in Sudbury East including seven elementary schools and a high school. All
four school boards, French and English Catholic and Public operate schools in this area. None of the
school boards are represented on the SESPN. There are varying degrees of cooperation and collaboration
amongst service providers and individual schools. Partnering relationships tend to be built on personal
relationships as opposed to a more formal system of collaborating.
There are licenced childcare centres in Markstay Public School and École Camille Perron. As well there is
before and after school care provided at St. Thomas School in Warren. The YMCA provides services in
Markstay and Le Carrefour in the other two. West Nipissing Childcare provides support to licenced home
based daycares but spaces are difficult to find. Many families that work in Greater Sudbury bring their
children into childcare facilities located there. If they are eligible for a subsidy the DSB will pay it to the
Sudbury based daycare.
Viewing their planning and service delivery model through the lens of the integration scale participants
identified examples of coordination, collaboration and integration as shown in Table 9.
Table 9
Sudbury East Roundtable: Area Examples in Relation to the Integration Continuum
Autonomy
Agencies acting
completely
independently.
Cooperation
Coordination
Independent
agencies share
information &
undertake joint
activities.
Agency partners
agree to align
activities to
minimize
duplication under
some form of
protocol &
management
structure
Collaboration
Integration
Agencies are
separate but
pool resources
for common
goals, share
responsibility
under some form
of governance
and plan.
Agencies
dissolve
boundaries &
merge some or
all activities,
processes &/or
assets into a
single
org’n/system.
Sudbury East
LSPN work on
general projects,
events, share
agency updates
Refer clients to
each other
•
•
•
SDHU partners
with agencies
and school
boards to
deliver
programs
Hubs in schools
sharing space
with childcare
and education
Hub outreach
•
Use of CIMS
(but not by
all)
44
Members of the SESPN indicated there were very high levels of cooperation and informal networking
amongst themselves in terms of directing clients towards each other if those services were going to help
meet the client’s needs. They indicated however that there was no shared case management and that
the decision makers resided in Greater Sudbury.
While staff in this area have training in Triple P they indicated that there were barriers to delivering the
service and had not had much success in attracting parents to the service. Families are reluctant to travel
to other communities for services and want things available in their own community.
When presented with the integrated service model, Figure 8 indicates that Sudbury East roundtable
participants had a shared vision/mission but for the most part they operated on the less integrated end of
the scale.
Figure 8
Sudbury East Roundtable: Portrayal of Sudbury East Positioning on the Key Elements of an Integrated
Children’s Services Model based on Consultation Discussion
cross-sectoral partners from health, education and the municipalities. The Sudbury East planning model
culture that has become more apparent in the district.
45
The SESPN did not so much offer suggestions for more or different ways of furthering integration in their
area but rather provide some lessons learned that might be incorporated in other areas.
1) Engaging cross disciplinary partners who are available in the area creates the conditions for a
more holistic approach to meeting family’s needs. Staff in the agencies serving families know
who to call to get needs met when they can’t do so themselves.
2) The use of available shared space in rural communities is very valuable to the delivery of services
to families.
3) Collaboration with school boards needs to become more formalized with consistent policies in all
boards for the delivery of early learning, child care and children’s services. Schools are natural
hubs and are present throughout rural districts and need to be utilized as community centres.
4) The rural culture of the districts (smaller numbers of people, shared knowledge of available
services, “knowing each other”) often makes collaboration and coordination easier in rural areas.
When agencies employ individuals who live in the area that capacity is enhanced. Services
providers coming from larger, more urban areas do well to tap into that culture.
5) Integrated service delivery in rural areas has to respond to the unique features of the areas. The
MSDSB has been innovative and supportive of efforts by children serving agencies as well as
other service providers in ensuring families (and other individuals) are having their needs met. As
DSSAB's are unique to the north the capacity of these bodies could be reviewed to encourage
participation in the delivery mechanisms of an integrated service.
46
CONCLUDING COMMENTS
It is important to keep in mind that strong levels of integration must not be used as the sole criteria upon
which to judge effectiveness or efficiency of a group of service providers. Integration is best understood
as a continuum vs. a scale offsetting the mistaken notion that strong integration is always best. In this
section, the unique culture of rural communities is exposed to demonstrate the natural aptitude that
exists there for service integration, challenges and areas to build on. As shown, informal networking
among service providers is often strong in rural communities. Instead of eliminating the need for formal
collaborative agreements, clearly stated vision/mission/values or systems planning – all of which are key
elements of integration – the culture can be leveraged in their favour to help accelerate the provision of
services in a more seamless, efficient and community responsive way. In looking at Figures 1 – 4 – where
the 5 key elements of integration are examined within each community – Chapleau stands out as being
the farthest along in terms of service integration, followed by Sudbury East, LaCloche and Manitoulin
Island.
Rural Context Conducive to Integration and Cross Sectoral Networking
The Chapleau Innovation project shows strong integration in the areas of Co-location and Service Coordination, less so in Vision/Mission/Values/Principles and Collaborative Agreement and the least in
Systems Planning. In Chapleau, 4 of the 5 co-located organizations were co-located before in another
location for some time and were already operating collaboratively. The evidence suggests that integrated
services tend to happen more naturally in rural communities where due to geographic proximity and rural
culture people know each other and tend to know what resources are available in the community. This is
clearly an advantage and lends itself to the practice of reaching beyond partners who share the same
funder and/or mandate to those on the outside who nevertheless have common goals and objectives.
This rural aptitude bodes well for the Chapleau Innovation project whose next steps include
strengthening relationships with those not yet engaged like the schools and First Nation service providers.
Similar to Chapleau, the LaCloche model - where 4 children’s service providers are co-located - was noted
as informally connecting with multiple partners as the need/opportunity arises including the Family
Health Team and Midwives. In Sudbury East, the same practice of working cross sectorally can be seen.
The Sudbury East Service Providers Network (SESPN) has extended itself to include those beyond whose
services are delivered to children - like the Sudbury East Seniors Support, Employment Options, Mental
Health & Addictions services and the local libraries.
On Manitoulin Island 3 children’s service organizations are co-located in Little Current and are very close
to the offices of 3 other organizations, 2 of which are children’s services.
While the close proximity of those at the co-located location and the other agencies allows for a
significant amount of informal collaboration - integration within the actual co-located location itself is
low. So, though rural, the service delivery model on Manitoulin Island is impacted significantly by the
large geographic area being served and jurisdictional issues that exist between First Nation communities
and the off-reserve population. In other words, while small rural contexts tends to be conducive to
47
integration and cross sectoral networking particularly on an informal level – it is not a guarantee as all
rural areas are unique and bring with them have their own challenges which shall be discussed.
Rural Context System Integration Maximizes Service Capacity & Recruitment/Retention Potential
Co-location, a key element of system integration helps make it possible to maximize staff resources and
recruitment and retention potential – particularly in rural communities. For example, in Chapleau a
previous part-time position was made into a full-time one by combing funding from 2 organizations
making it possible to extend the Centre’s hours from part –time to regular business hours. Combining
part time positions into full time ones also increases the likelihood of recruiting and retaining qualified
staff where typically it is difficult to attract and retain qualified people. The cost sharing that co-location
can stimulate is also a real advantage in small rural communities where resources are limited and service
is impeded.
Another example of rural context system integration maximizing service capacity is in LaCloche where Our
Children Our Future (OCOF) – members of the Manitoulin Best Start Network and the LaCloche Service
Providers Network - partner with all 3 school boards in the area to provide outreach services to all of the
schools using space (including administrative) provided by the schools to offer school readiness and food
security programs.
There are many areas where cost sharing and enhanced service provision due to service integration is
possible but are not as of yet realized. In Sudbury East for example, the connection between the 4
school boards (8 schools) in the area and the Sudbury East Service Planning Network has as of yet not
been formally established despite the fact that several provide space to child care operators. Staff
functions (i.e. common intake and referral, and shared supervision) shared technology including video
conferencing and office and program space are all examples of cost sharing opportunities – many of
which hold promise but have yet to be explored.
Necessity of Strong Supervisory Function
A rural context and the benefits that go with it also carry certain potential challenges as well. For
example, given staff live and work in the same small community – they are more likely to be privy to each
other’s private affairs which also may impact negatively on the work environment. Mechanisms like
regularly scheduled meetings between supervisors and front-line staff - that allow for prompt
intervention are essential supports In Chapleau regular meetings of this nature as well as regular
opportunities for front –line staff to meet to deal with issues above and beyond their clients helped to
ensure a smooth transition to the new site and beyond. This is particularly important since rural service
environments tend to function more on an informal basis and supervisors and managers tend to be
located off-site requiring long distance travel which is time consuming and costly. Sharing supervisors
between organizations could be a solution to this as could enhanced access to videoconferencing for the
same purpose.
48
Importance of Front - Line Staff
Front-line staff play a significant role in the success of integrated services. Often in small rural settings,
front-line staff take on responsibilities they would not normally take on in larger organizations. This
capacity and experience coupled with their knowledge of the needs of their clients’ gives front - line staff
valuable insight into client, organization and system needs. So once again, organizations in small rural
communities have an edge in terms of system integration. Front-line staff are often hired from the local
community (Sudbury East and LaCloche are good examples of this) bringing with them knowledge of the
local community which is naturally extended to the organization. As such input from front-line staff
needs to be formalized in so far making regular opportunities for them to participate in planning and
recognizing them as having an integral role in the integration process.
Community Development & Family Centered Planning
Similar to formalized input from front-line staff - family centered planning is part and parcel of the
community development model. A central tenant of community development is that community
members or in this case service users have skills and capacities they can bring to the issues they
encounter. In fact, the notion that the role of the professional is to solve the issue for the family is seen
as counterproductive - at best. The community development model does not set up client and
professional on opposite sides of the health continuum but brings them together around the issue
making the process of resolving that issue part of developing the communities overall capacity.
Chapleau, Sudbury East, LaCloche and Manitoulin Island all indicate families are not involved in the actual
planning of services even though in Chapleau staff show tremendous respect for the families that they
serve, including recognizing that families have skills and capacities to bring to the issue that they
encounter and in Sudbury East, staff recognize the value of engaging cross discipline partners for a more
holistic approach to meeting family’s needs. Families clearly occupy the receiving side of the clinical
relationship in all existing models. For small rural service providers , family centered planning can seem
onerous – however like input from front -line staff, input and participation from family can be integrated
into planning in fairly straight forward ways using a vast array of community development tools. Finally,
the community development model would also help service providers to be more culturally responsive to
First Nation families and improve upon their ability to deliver services and build partnerships.
Appropriate Space and “Close-location”
Co-location is recognized as a key element in service integration. What must not be underestimated
however is the quality and overall suitability of the space. In small rural communities space that is big
enough to accommodate all of the partners appropriately as well as attend to the privacy needs of
families is not always available. Sometimes, “close-location” vs co-location will need to suffice and with
careful planning many of the same benefits can be realized.
49
BIBLIOGRAPHY
Alberta Education, Edmonton Public Schools, Community-University Partnership for the Study of Children,
Youth, and Families and Learning Solutions (November 2010). Wrapping Supports and Services around
Alberta’s Students: Research Summary. Edmonton: Alberta Provincial Wraparound Research Project.
http://www.cup.ualberta.ca/wp-content/uploads/2011/07/Wraparound-Research-Summary-2010.pdf
Alberta Health Services (May 20, 2013). Stollery expands use of videoconferencing technology.
Edmonton, Alberta, Media release.
Bertram, T., Pascal, C., Bokhari, S., Gasper, M., & Holtermann, S. (2002). Early excellence
centre pilot programme second evaluation report 2000-2001. Norwich: Queen’s Printer.
www.surestart.gov.uk/surestartservices/settings/earlyexcellence
British Columbia (2008). Making it Work! A Framework for Action. Children and Youth with Special Needs.
Victoria, B.C.: Ministry of Health Services, Ministry of Education and Ministry of Children and Family
Development. http://www.mcf.gov.bc.ca/spec_needs/pdf/CYSN_FrameWorkForAction_Combo_LR.pdf
Cairns, B., Harris, M. and Hutchison, R. (2003). Key Findings on Voluntary Sector Mergers. Centre for
Voluntary Action Research: UK.
http://www.abs.aston.ac.uk/newweb/research/CVAR/forms/MergerKeyFindings.pdf
Chapleau Innovation Fund Project (December 18, 2012). Integrated services literature scan. Unpublished
paper, Sudbury, Ontario.
Clemo, J., & Smith, P. (2007). Building a community hub [PowerPoint presentation]. www.chap-ohio.net
Clutterbuck, P and Lord, K. (August 2010). Towards an Integrated Immigrant Services Delivery System in
Durham Region. Research and Considerations for Moving Forward. V.2, Ajax, Ontario: Community
Development Council Durham.
http://www.cdcd.org/cms_lib/Towards%20an%20Integrated%20Immigrant%20Service%20Delivery%20Sy
stem%20-%20CDCD%20Aug%202010.pdf
Dept of Disability, Housing and Community Services. (February 2004) Best Practice Service Delivery
Models: Therapy Australian Capital Territory (ACT), Directions Paper, Australia.
Comer, J.S., Furr, J.M., Cooper-Vince, C.E., Kerns, C.E., Chan, P.T., Edson, A.L., Khanna, M., Franklin, M.E.,
Garcia, A.M., and Freeman, J.B. (2014). Internet-Delivered, Family-Based Treatment for Early-Onset OCD:
A Preliminary Case Series. Journal of Clinical Child and Adolescent Psychology, 43(1), pp. 74-87.
Duncan, A.B., Velasquez, S.E., and Nelson, E.L. (2014). Using Videoconferencing to Provide Psychological
Services to Rural Children and Adolescents: A Review and Case Example. Journal of Clinical Child and
Adolescent Psychology, 43(1), pp. 115-127.
Duncan, H. D. (March 2013). Collective Impact and Place-Based Strategies through the Lens of ABCD.
Presentation to the United Way of Bartholomew County. Chicago, Ill.: Asset based Community
50
Development Institute.
http://www.uwbarthco.org/sites/uwbarthco.oneeach.org/files/Collective%20Impact%20%20ABCD.pdf
Fine, M., Pancharatnam, K. & Thomson, C. (2005).Coordinated and Integrated Human Service Delivery
Models. SPRC Report 1/05. Sydney: Social Policy Research Centre, The University of New South Wales.
http://www.sprc.unsw.edu.au/reports/SPRCReport1_05.pdf
Gold, J. with Hjartarson, J. (2012). Integrating Human Services in an Age of Fiscal Restraint. A Shifting
Gears Report. Toronto. The Mowat Centre, University of Toronto and KPMG International.
https://www.kpmg.com/Ca/en/IssuesAndInsights/ArticlesPublications/Documents/Shifting-GearsReport.pdf
Jennett, P., Jackson, A., Healy, T., Ho, K., Kazanjian, A., Woollard, R., Haydt, S., and Bates, J. (2003). A study
of a rural community’s readiness for telehealth. Journal of Telemedicine and Telecare, Vol. 9, pp. 259-263.
Johnson, S. (November 8, 2011). Impact of Social Science on Policy: Sure Start Case Study. Research
Report. Economic and Social Research Council, University of Hull Business School.
http://www.esrc.ac.uk/_images/sure_start_final_report_tcm8-20116.pdf
Jones, D.J., Forehand, R., Cuellar, J., Parent, J., Honeycutt, A., Khavjou, O., Gonzalez, M., Anton, M., and
Newey, G.A. (2014). Technology-Enhanced Program for Child Disruptive Behaviour Disorders:
Development and Pilot Randomized Control Trial. Journal of Clinical Child and Adolescent Psychology,
43(1), pp. 88-101.
KPMG International Cooperative (2013). The Integration Imperative: reshaping the delivery of human and
social services. Report produced for The Mowat Centre, School of Public Policy and Governance,
University of Toronto.
http://www.kpmg.com/global/en/issuesandinsights/articlespublications/pages/integrationimperative.aspx
Lennie, J. (February 2010). Learnings, case studies and guidelines for establishing shared and collaborative
service delivery in the non-government sector. Evaluation of the Multi-Tenant Service Centre (MTSC)
Pilots Project. (updated from August 2008). Brisbane, Australia: Department of Communities,
Queensland Government.
https://www.communities.qld.gov.au/resources/communityservices/community/publications/finalreport-multi-tenant-service-centre-evaluation-dr-june-lennie.pdf
McHenry, K. M. (March 2013). US Legal Aid: State Planning and Reconfiguration. Powerpoint presentation
on US Clinic Reform and Montana Legal Services Association. Toronto: Legal Aid Ontario.
McCain, M. and McCain, W. (March 2010). Building the Future in Atlantic Canada. Integrating Early
Childhood and Family Services.
http://www.mwmccain.ca/media/uploads/pdfs/BuildingTheFutureAtlanticCanada.pdf
51
Ministry of Children and Youth Services (April 2005). Northern Framework for Ministry-Funded Children
and Youth Services. Operational Guide.
http://www.childrenscentre.ca/Resources/Articles/MCYS%20Northern%20Framework.pdf
Nova Scotia Health Research Foundation (January 2012). Collaborative Service Delivery. Jurisdictional
Review. Halifax, N.S. http://www.pmcs.ca/nova-scotia-health-research-foundation-collaborative-healthresearch-models
Ontario Hospital Association (undated). Local health Hubs for Rural and Northern Communities. An
Integrated Service Delivery Model Whose Time has Come. Paper produced by Small, Rural and Northern
Hospitals Advisory Group, Toronto, Ontario.
https://www.oha.com/KnowledgeCentre/Library/Documents/Local%20Health%20Hubs%20for%20Rural%
20and%20Northern%20Communities.pdf
Pine Tree Legal Assistance (January 2013). Report to the Maine Civil Legal Services Fund Commission. Pp.
93-101 http://www.mbf.org/sites/default/files/MCLSFC/MCLSFCRpt-JudiciaryComm.pdf
http://www.ptla.org/about-us
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Greater Sudbury
Best Start Networks
Appendix 4
sudburybeststart.ca | DIGITAL GUIDELINES
SUDBURY
MANITOULIN
BEST START HUBS
Digital Guidelines
1
TABLE OF CONTENTS
Social vs. Traditional................................................................................................................................................ 3
Why Social?................................................................................................................................................................ 4
The Benefits of Being Social.................................................................................................................................. 5
Measuring Social Success...................................................................................................................................... 6
Time-Saving Tools.................................................................................................................................................... 7
10-Minute Strategy.................................................................................................................................................. 8
The Best Platforms For You.................................................................................................................................... 9
Using Facebook...................................................................................................................................................... 10
Using YouTube........................................................................................................................................................ 11
Using Twitter........................................................................................................................................................... 12
Consistent Communication................................................................................................................................ 13
Posting Protocol..................................................................................................................................................... 14
One Last Thing........................................................................................................................................................ 15
2
Social vs.
Traditional
Traditional marketing (print advertising, billboards, TV, radio, etc) has a linear, A to B,
one-way communication process. Social Marketing is a multi-stream communication process
that allows you to send a message out to your audience, allow them to share it with others,
receive a message back and interact with them in real-time. It is the best way to communicate
with current and prospective clients in absence of face to face interaction.
TRADITIONAL MARKETING
YOU
SOCIAL MARKETING
CLIENT
3
Why
social?
78%
of consumers trust peer recommendations.
(Which can be done more easily via social media.)
Only 14% of consumers trust traditional advertisements.
60
million
mORE THAN
50%
status updates happen on Facebook daily.
Imagine how fast that positive referral could spread between friends.
of the world’s population is under 30 years old.
They are parents, or potential parents that use social media.
Facebook tops Google for
YouTube is the world’s 2nd
social media is a very
weekly traffic in the U.S.
largest search engine.
inexpensive way to ACCESS
information.
*
In terms of accessibility, social media is at the forefront. For those living under the
poverty line, the last thing they will let go is their smartphone.
*
Statistics from socialnomics.net
4
The benefits of
BEING sociaL
• IT IS AN Inexpensive way to generate exposure for your busineSS
• IT IS Effective in increasing your web traffiC/subscribers
• It will expand your reach
• It will improve your SEARCH ENGINE OPTIMIZATION ranking. SEARCH ENGINES SUCH AS GOOGLE AND YAHOO RANK YOU HIGHER WHEN THERE ARE SOCIAL MEDIA POSTS LINKING TO YOUR WEBSITE. THE HIGHER YOUR RANK, THE MORE QUICKLY YOU CAN BE FOUND.
• It will help drive traffic to the hubs
• It will reduce your overall marketing costs
EXPOSURE FOR YOU
INTERACTION WITH YOUR CLIENTS
STAYING TOP-OF-MIND WITH PARENTS
Successful marketing is engaging your audience and
having them interact. Your goal is to align yourself
with the conversation.
5
IMPORTANT QUESTIONS ABOUT SOCIAL MEDIA
MEASURING
SOCIAL SUCCESS
• Metric tools: Google Analytics can measure how many hits your website is getting in reaction to social media postings. It can also define where your clicks are coming from geographically, how often users return to your page and how they found it.
• Measuring consumers’ reactions online: If your audience is participating in the conversation on social media, you are on the right track, and your strategy is effective.
• Bottom-line: If more consumers are coming into the Best Start Hubs, accessing your services, visiting your website and engaging online in response to your social marketing efforts, then you’re succeeding.
6
TIME-SAVING
TOOLS
• HootSuite is the most effective tool for spreading your message across Twitter and Facebook. You can load many different accounts on both platforms and send a tweet or change your status on all accounts, or specific ones, all in one application. You can also preset a date and time for your posts so that you can better plan and manage your tweets and posts. This feature also allows you to better manage your time for those employees taking on social media above and beyond their other duties.
• K lout is an online service that helps you measure your success on social media. It tracks in real-
time the effectiveness of individual posts and your overall social presence. This allows you to gage what type of content your audience is most interested in.
7
10-MINUTE
STRATEGY
1
Write two new status updates/posts, tweets and network updates.
2
Reply to comments posted by members concerning your previous status
updates/posts.
3
Scan your Facebook/Twitter/LinkedIn news feed and make one comment per day on
relevant status updates.
4
Share significant events with parents on a weekly basis. You can also share partner
agencies’ events if they are relevant to your audience.
5
Reply to pending inbox and direct messages within 24 hours when possible.
8
THE BEST
PLATFORMS
FOR YOU
Through our discussions, we’ve determined that Facebook is the most effective tool to reach
parents. We’ve also developed video content for YouTube which can drive the content for your
Facebook posts.
Facebook has over 500 million active users so you’re sure to find your audience. Using the Facebook “Like”
button can improve your Search Engine Optimization value as well. In addition, it’s no secret that women
aged 55 and over are the fastest growing demographic on Facebook. This paired with peer recommendations will create great referrals between grandparents and young parents.
YouTube is the second most used search engine on the internet, trumped only by Google. It has the largest library of videos on the internet. We’ve determined that short videos are a great way to engage parents and they also make for great shareable content. Video posts often get more attention than a simple textual post because it stands out visually and is generally more entertaining. You can also deliver more information in a short amount of time using video.
Twitter is also an important part of your social formula. The growing popularity of Twitter in our region makes it an excellent compliment to your other social efforts. Although not as relevant as Facebook
for your organization, one Best Start account can be used to share partner information and engage with
agency professionals. On Twitter, you are limited to tweets using 140 characters or less , which means you must be as concise with your message as possible. Using hashtags, such as #sudbury, makes your tweets searchable by anyone on Twitter, which allows you to target certain topics, locations, and terms.
9
GUIDELINES TO EFFECTIVELY MANAGE SOCIAL MEDIA ACCOUNTS
Using
Facebook
• Make your posts as concise as possible. The more quickly you can get your message across, the more people it will reach. It has been proven that shorter posts get read more than longer ones.
• Use relevant images in your posts as much as possible. The presence of an image is simply more visually appealing than a block of text and will stand out in the News Feed.
• Reply to comments within 24 hours on weekdays and within 72 hours over the weekend. This shows the importance you place on engaging with your audience and will promote others to join in the conversation.
• Maintain posting consistency. By posting in a certain timeframe day after day, your audience will come to expect your posts and will return more often.
• Be sure to share information from other agencies that is relevant to your followers. One caution for this is limiting the amount of posts you share to a few per week. As a general rule, shared content should account for no more than 20% of original Best Start posts.
• Facebook ads can be used to promote larger events. Using this tool allows you to target a
specific demographic including age, interests, geographic location, and more. These ads are very inexpensive and are often more effective than traditional advertising methods.
• Do not create personal pages or group pages for hubs. Always create a public page using facebook.com/pages/create - we recommend choosing an “Organization” page and then selecting “Community Organization” from the dropdown menu.
General Facebook page information
When creating a new Facebook page
Customizing your page: Watch Video
Controlling posts on your page: Watch Video
Improvements to page insights: Watch Video
To maintain consistency when naming
individual hub pages, use the following
format: Best Start Hub - Location Name.
For example, Best Start Hub - Donovan
10
USING
YOUTUBE
• The main purpose of your YouTube account will be to feed the social networks where you have the largest presence with engaging videos. It’s important to monitor the account to reply to any comments or questions regarding any videos you have online.
• Create playlists to organize videos. For example, the live event from February 26th, 2014 has a
playlist dedicated to video coverage of the event. Your Parenting Pointers series is also
organized in one playlist. Subsequent videos should be organized in this manner.
• When creating video content, use the same formula while editing. For example, each video should start with the Greater Sudbury and Manitoulin Best Start Hubs logos, and end on a slide containing the website link.
• Tags can be used to categorize videos and make them more accessible in searches by YouTube users. Although most of the views will come through shares on Facebook, tagging the videos appropriately can result in residual views from a broader audience.
11
Using
TWITTER
• Try to be as clear and brief as possible due to the limitation of characters on Twitter.
Tweets can’t surpass 140 characters. It is not advised to post tweets in parts (part 1, part 2, etc).
• Twitter is a great platform to interact and engage with other industry professionals. Retweet relevant information from partner agencies so they know you are on their radar.
• Use hashtags to categorize your tweets. A hashtag creates a searchable term. To create a hashtag, simply use the pound sign directly next to your word, with no spaces - For
example: #BestStartQA
• Use bit.ly to condense long web addresses to lower the amount of characters used in your
tweet. To access this free service, type in bit.ly in your web browser’s address bar, then paste in
the address you want to condense and link to. The service creates a shortened link to the address you want your audience to visit. bit.ly can also be used for posting links to Facebook.
• Use the @ symbol to direct your tweet to a certain account. This is a great way to start
a conversation. For example: “Hi @username, we will be open until 5pm tomorrow.”
12
CONSISTENT
COMMUNICATION
• Delete unused pages and groups—they confuse and misguide the user. It also makes the brand seem less current.
• Reply to messages within 24 hours on weekdays and within 72 hours on weekends. This is just good practice across all social platforms.
• Do not delete or avoid critical comments unless they are offensive.
• Offensive posts should be deleted as soon as possible.
• When posting images, make creative choices that fit well with the Best Start Hubs brand.
• Post content that relates to quality of life and family benefits (educational resources, recreation, events, workshops etc.)
• Always use a casual, friendly, yet professional tone when posting and interacting with
your audience.
• Avoid the use of internet slang such as lol, nm, :), ;), etc.
• Always consider your target audience and how they’ll react to your posts.
13
POSTING
PROTOCOL
Here is an example of how to distribute the
Parenting Pointers videos throughout your
networks.
From the Best Start YouTube account, start
by copying the web address of one of the
videos and pasting it in a post.
WEBSITE
DSSAB
Sudbury
Best Start
Shorten your post as
much as possible. Use
bit.ly to shorten the web
address to conserve
characters. Use relevant
hashtags in your posts.
Example text:
Write a short post to accompany the video and to
describe it in a clear and concise way.
Example text:
Highlight the videos in
a prominent area on the
website to maximize
visibility.
Replace welcome video
with Parenting Pointers
clips periodically.
Another great
segment from our
resourceful video series.
#parentingpointers
#beststart
Still wondering the difference between quiet time and
timeout? Trish breaks it down for us.
*Parenting Pointers clips should be posted once every two weeks.
14
ONE LAST
THING
Social media is an interactive way to express the style, tone and personality of your organization.
Don’t be afraid to bend the rules a little and see how it works. By monitoring the reaction to your
posts, you’ll get a better grasp of what your audience is receptive to.
Once you get to know the type of content your audience reacts to, run with it!
15
16

Manitoulin Sudbury Best Start CAR CIL Final Report

Transcription

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