Review of Transitional Support Services at Bellwoods: Community Connect Program

Transcription

1 Review f Transitinal Supprt Services at Bellwds: Cmmunity Cnnect Prgram Presented by: Lri Hllway, CEO Cpyright 2017 Bellwds Centres fr Cmmunity Living Inc. All rights reserved

2 4 Bellwds Experience Backgrund, size and resurce, accmplishments, qualificatins, etc. 3

3 Backgrund Infrmatin Established 60 years ag, Bellwds Centres fr Cmmunity Living Inc. is a charitable, nt-fr-prfit rganizatin prviding cmmunity based, client direct supprt services, independent living educatin prgrams, and accessible, affrdable husing fr persn with physical supprt needs living in the Trnt area, t enable them t live independently. Fcuses n meeting cmmunity needs thrugh partnership develpment t supprt health and husing system pririties Cmmitted t enabling adults and senirs with physical supprt needs t live as independently as pssible and t direct their wn services Prvide individualized services and prgrams in variety f living envirnments in Trnt area 3

4 Our Services Our services include a cmprehensive and integrated cntinuum f supprts which include prvisin f persnal supprt services, supprtive husing ptins and availability f MILE services PSW services include: assistance with persnal grming and hygiene, rising and retiring, psitining and transferring, dressing and undressing, eating, bwel and bladder, and light meal preparatin Mbile Independent Living Educatin (MILE) Services is a cmmunity based educatin prgram fr clients 16 years f age and lder with a permanent physical disability - MILE prgram fcuses n hme and cmmunity skills develpment t maximize safety and independent living in the cmmunity thrugh prvisin f educatin and supprt fr identified, time limited bjectives - MILE team assists clients t achieve ptimal safety and independence in their hme thrugh skill develpment and cmmunity linkage - MILE staffing mdel includes: Prgram Facilitatrs (Occupatinal Therapists, Registered Nurse, and an Independent Living Educatr) 4

5 Bellwds Services and Prgrams Summary Overview Supprtive Husing/ Cmmunity Cnnect Husing Hubs 24/7 PSW services available n site Permanent husing at Shaw (10), Dundas (31), and Mimic (13) Cmmunity Cnnect (CC) at Shaw (21) ffers up t 6 mnth transitinal supprts fr ALC patients 24/7 access t PSW services Husing partnerships with St. Clare s Multi-faith and Mahgany Management Sudbury (9) and Deauville (10), New in 2019 Madisn (10), New in 2020 Birchmunt (25) including 3 bariatric units Attendant Outreach MILE Prgram PSW services ffered within client hme, place f wrk r schl Available frm 6 a.m. midnight daily Services are available n a pre-scheduled visitatin basis Fcus n ptimizing safety and independence in the hme thrugh assessment, skills training, cmmunity linkages and case management Staffed by Independent Living Educatrs and Prgram Facilitatrs 5

6 Cmmunity Cnnect ALC Transitinal Prgram Cmmunity Cnnect (CC) prgram began after extensive cmmunity cnsultatin with acute care hspitals, rehabilitatin and lng term care hmes (LTCH) Supprts a Hmes First apprach and structures the needs f each individual Grwn t 21 fully furnished and rent geared t incme units with Bellwds supprtive husing site at 300 Shaw Street Functins as a intermediary prgram t supprt the transitin back in the cmmunity Past 5 years, 140 clients have received services in the CC prgram 6

7 CC Prgram Benefits Partnership t supprt transitin Include: finding care, prfessinal services, utpatient supprts with discharge facilities, and ther cmmunity supprt service Cmprehensive intake assessment prcess Tgether with applicant, their family, referral surce, cmmunity supprt netwrk, and CCAC Supprts an integrated systems apprach T enable ALC ppulatin t transitin back t cmmunity Enhanced prgram supprts Include: independence living educatin and husing access supprt delivered by MILE team Access t Bellwds transitin supprts Supprt services prvided by certified PSW in a supprtive husing envirnment with access t service 24/7 7

8 Cmmunity Cnnect Prgram length Current duratin is up t 6 mnth with discharge date adjustment by exceptin nly 1. Assistance with finding a discharge destinatin 2. Supprts transitin t identified destinatin 3. Identificatin/ prcurement f required equipment and cmmunity supprt services 4. Linkage and referrals with lcal service prviders 5. Prgram ffers transitin supprt after discharge as needed n shrt term basis 8

9 ALC/Cmmunity Cnnect # s Year # f ALC days reduced , , , , ,772 Ttal 26,397 Year # f Transitined ALC Clients Ttal 140 9

10 Csts Avidance 26,397 ALC days X $1000 a day (Acute Care) $26,397,000 ver the last 5 years Prgram csts ver last 5 $5M 10

11 Tp 5 Features 1. Cllabrative apprach t prblem slving fcused n achieving a successful discharge t the cmmunity 2. Planning and service prvisin that is client and family centred and tailred t anticipated discharge destinatin 3. A transparent apprach t cmmunicatin and service expectatins that includes all stakehlders e.g. referral team, client, family and ther invlved prviders 4. Husing first apprach 5. Inclusive with the gal f realistically balancing needs f client and health care system with cnsideratin f available cmmunity resurces 11

12 Outcmes Build client cnfidence t return t independent living in the cmmunity Build cnfidence f caregiver t reengage in caregiver rle, test if lve ne culd manage in with supprt Prvide simulated envirnment that can mimics real wrld pst discharge in the safety f 24/7 envirnment Creates flw in the system, can address high care needs, which gives almst everyne a change t see if cmmunity independence is an ptin Therapeutic and nn-therapeutic supprts included alng with system navigatin, husing security = ne stp shpping 12

13 Hw t Scale What wuld Bellwds need t d mre t achieve the gals f Patients First (everyne wh can reasnably be cared fr in the cmmunity will be) and the 2017 ALC strategy (reduce ALC vlume)? Expand cncept mdel t include mbile supprtive husing Additinal resurces fr mental health and addictins, alchl dependence prgrams Mre Rent supplements Mre availability f supprtive husing, case management Mre husing alternatives, Grants fr accessibility mdificatins 13

14 Questins?