Toronto Developmental Services Sector - VISION AND ALIGNMENT PROJECT

VISION AND ALIGNMENT PROJECT - Toronto Developmental Services Sector

A Request for Stakeholder Input

The Vision and Alignment Project is an MCSS Fiscal Innovation Fund project intended to build consensus regarding a shared vision for the Toronto developmental services collaborative model and ensure that parts of the model are aligned with that vision. The project is being carried out with the extensive involvement of stakeholders in the developmental services (DS) system including funders, service providers, families and self-advocates. This discussion paper has been prepared to inform you about the project and solicit your input to the emerging vision and potential strategic directions for the Toronto DS sector.

The Process to Date

A Steering Committee was drawn from the Toronto Developmental Services Forum to lead the project and recruit a consultant to serve as a project facilitator. Work got formally underway in December 2005.
The consultant conducted a situation analysis through a review of documented information and interviews with a cross-section of individuals drawn from provider agencies, families and the Ministry of Community and Social Services (MCSS).
An intensive full-day stakeholder planning and consultation session was held in Toronto on February 8, 2006 and attended by over 40 stakeholders. Participants reviewed the information from the situation analysis, engaged in various planning and visioning exercises and identified some possible future directions for the sector.

What Happens Next?

The next step of the consultation process begins with this discussion paper, which reflects the thinking of the participants in the planning process so far. This is "work in progress" that will evolve as we hear more from our various stakeholders. Please read it carefully and consider the questions posed.

Groups and individuals may complete the attached response form and fax or mail their comments directly to the project facilitator. Focus questions have been provided to guide discussion and feedback. Focus group sessions with families, self-advocates, MCSS staff and agencies from related sectors will take place in early March.

Please complete this questionnaire by Friday March 17, 2006.

A final project report with recommendations will be completed in late March.

Issued February 28, 2006.

THE ENVIRONMENTAL CONTEXT

The following "SWOT" analysis (strengths, weaknesses, opportunities and threats) for the Toronto DS sector was assembled from the situation analysis and expanded based on the deliberations at the February planning session:

Strengths:	Philosophy of acceptance and inclusion Large number of agencies and service providers History of collaboration among agencies Family and client involvement Dedication, commitment and responsiveness of agencies Creativity in solving problems and meeting needs "Pockets of excellence" within the system Increasing community awareness Positive relations with MCSS
Weaknesses:	Outcome measurement and evaluation Slow and cumbersome decision making A complex and sometimes intimidating system Coordination and communication within the system Some territorialism and lack of trust among agencies Overall resource levels Reliance on government for funding Gaps in services, especially at client transition points Equity of access to services Awareness/knowledge of how the system works Collaboration with and between other sectors Recruitment and retention of quality staff Need for greater family/individual choice Lack of quantitative data on needs and supports Agencies not accredited
Opportunities:	The transformation process Streamlining the existing model Placements out of facilities Increasing community capacity Increased collaboration among stakeholders Integration with regular systems/generic community resources Capturing best practices in the sector Some new resources coming to the sector Increased consumer and family involvement Better cooperation and coordination between Ministries Use of technology Expanded services Family/agency collaboration Partnerships with the private sector New funding sources Specialized networks
Threats:	Aging clients and caregivers Increasing medical needs of clients Labour pressures and human resource issues Crisis orientation of the system Entrenched ideology Increased numbers of families/individuals in crisis Mergers leading to lack of choice Insulation of the sector Rigidity in funding streams Declining infrastructure and overall system erosion Becoming overwhelmed by demand Divisiveness among agencies The overall state of the health system Lack of professional development, training and succession planning
Any strategic initiatives undertaken in the Toronto DS sector should build on strengths, rectify weaknesses, capitalize on opportunities and address threats.

Focus Question:

Should any other strengths, weaknesses, opportunities or threats be considered?

Strengths:
Weaknesses:
Opportunities:
Threats:

A VISION FOR THE TORONTO DS MODEL

A vision statement describes the "preferred future state" of an organization and its stakeholders. Participants at the February 8th planning session engaged in a number of exercises to identify elements of a shared vision for the Toronto DS collaborative model. The emerging vision has five components:

Quality and Accountability - Continuous quality improvement through a commitment to best practices, formalized standards and measurable outcomes.
Community Integration - Individuals living successfully with full inclusion in their own communities drawing on specialized as well as generic services and resources.
System Effectiveness - A coordinated system that is simple, seamless and provides the right service in the right place at the right time.
Empowerment and Individual Choice - Empowered individuals who are aware of their role in the community, know their citizenship responsibility and are able to choose from a full range of service options.
Resources - Efficient use of resources embedded in the DS sector the same way they are in education and health.

Focus Question:

Have any components of the vision been overlooked?

Feel free to comment or suggest revisions to the vision components.

Based on the above, the following vision statement for the Toronto DS collaborative model is proposed:

A system of exemplary services for the lifelong support of individuals with developmental disabilities that is integrated, coordinated, accessible and accountable.

Feel free to comment or suggest revisions to the vision statement.

EMERGING DIRECTIONS

A number of broad strategic directions that could be undertaken by agencies in the Toronto DS sector have emerged from the process so far:

1.0 Measurement and Evaluation

1.1  Gather quantitative data on needs, resources, service gaps and duplications.
1.2  Establish system-wide accountability indicators.
1.3  Develop common assessment and measurement tools.
1.4  Promote and support agency accreditation.

2.0 Integration and System Coordination

2.1  Develop an integrated sector data base and registry.
2.2  Foster linkages within and between sectors such as education, health and
       long-term care.
2.3  Link with Local Health Integration Networks and Family Health Teams.
2.4  Partner with generic community services.
2.5  Develop common practices and protocols to deal with difficult situations.
2.6  Explore further streamlining of the Toronto DS collaborative model.

3.0 Human Resource Development

3.1  Ensure fair staff compensation benchmarked with other sectors.
3.2  Establish coordinated staff development and training.
3.3  Develop incentives and awards for staff.
3.4  Ensure adequate succession planning within agencies.

4.0 Community Profile

4.1  Increase public awareness at all levels.
4.2  Increase family and client education re: sector services and processes.
4.3  Increase opportunities for family and client involvement.
4.4  Increase investment in community development and public engagement.

5.0 Financial Resources

5.1  Advocate for ongoing annualized funding to address waiting lists.
5.2  Advocate for individualized funding.
5.3  Explore private sector partnering.
5.4  Enhance existing partnerships to maximize resources.
5.5  Utilize technology to lever resources and improve resource utilization.

Focus Questions:

Are there any suggested revisions to these draft goals?

Measurement and Evaluation:
Integration and System Coordination:
Human Resource Development:
Community Profile:
Financial Resources:
Have any important goals been missed?

Adopting a Business Model

A breakout group at the planning session suggested that a business model could be adopted as a foundation for the achievement of the vision. In this context the sector would be viewed as the "company", individual agencies would be "departments" and the government would be the "resource base". Characteristics of the model presented at the session were as follows:

Individuals, not agencies would be funded.
Programs would be "allowed to fail", and resources reallocated.
A separate entity (department) would be responsible for individual advocacy and picking up any consumers who fall through the "open" model.
A business model for accreditation (such as ISO 9000) would be used.
Industry associations could lobby government.
The business model would not necessarily mean "for profit".

Focus Questions:

Feel free to make comments about the business model approach.

Would it work?

How could it be adapted to the Toronto DS sector?

Moving Forward

Once the focus group sessions have been completed and all stakeholder feedback has been received, the consultant will finalize the vision and directions and prepare draft recommendations and an implementation plan. These will be reviewed with the Steering Committee and a final project report will be submitted in late March.

Please offer any other comments or suggestions about the Vision and Alignment Project.

Individual/Group completing form: (Optional)

Your input is greatly appreciated.