Chairman and Members of the Health and Social Services Committee

Transcription

1 THE REGIONAL MUNICIPALITY OF HALTON Report To: From: Chairman and Members of the Health and Social Services Committee Bonnie Ewart, Commissioner of Social Services Date: January 4, 1995 Re: The Social Services Department - Issues for 1995 Report No.: SS RECOMMENDATION REPORT Purpose THAT Report SS re The Social Services Department - Issues for 1995 be received for information. The purpose of this Report is to inform on social services generally, Halton s Social Services Department, and some of the major issues that will come forth to Committee and Council through Background Social services in Ontario are delivered through a complicated network involving all levels of government, the non-profit sector, the private sector, voluntary organizations, and volunteers. The major funding sources are through the federal and provincial levels of government. The federal government funds the provinces through the Canada Assistance Plan (CAP) and the Established Program Financing (EPF). One of the central issues with the current Federal Social Security Review (Report SS-02-95) is the potential decrease of federal funding to the provinces. This could have a major impact on municipalities should the provinces pass these decreases on. The lead ministry in the Ontario government to fund social services is the Ministry of Community and Social Services. More recently, with Long Term Care Reform, all services related to seniors have been transferred to the Ministry of Health. In Ontario there are 839 municipal corporations. Through the last couple of decades, for the purposes of social services delivery, these municipal jurisdictions have been consolidated into 68 social service administrations. The social services administrations are at the regional, county, separated cities, and district welfare board level. This has considerably streamlined the municipal sector for the purposes of social services delivery. Most of these social service administrations are members of the Ontario Municipal Social Services Association (OMSSA) which provides networking and training opportunities. The term Municipalities is a generic term used to denote these 68 social services administrations.

2 2 Municipalities are mandated through provincial legislation to deliver the General Welfare Assistance program and homes for the aged (recently renamed long term care facilities ). All other programs delivered by municipalities are discretionary, however once a municipality delivers these other discretionary programs, they are operated under provincial legislation and have various cost sharing implications. Most of the municipalities offer a full range of social services to their community primarily because these programs provide services to persons in financial need who would otherwise not be served by other organizations in the community. The Halton Social Services Department The overall budget for Halton Social Services is 80% subsidized by the province, however there are varying cost-sharing formulas relating to each of the program areas. The department is functionally organized into five divisions as follows: Income Maintenance Children s Services Community Services Allendale Administrative Services The Income Maintenance Division operates the General Welfare Assistance Program (GWA). The GWA Act mandates municipalities to operate a financial assistance program for residents who are individuals or heads of families in financial need because of unemployment or under-employment, ill health, age or lack of a family provider. Persons who are sole support parents or medically disabled are referred on to the provincial Family Benefits Program (FBA) which is administered by the province with an office in Burlington which covers all of Halton. These two pieces of legislation, (GWA and FBA) are being merged into one Act. The debate for well over ten years is with one piece of legislation, there should be one administration and one delivery agent. While there are a few joint delivery systems piloted across the province, the role of municipalities for the future remains an open debate. Supporting the General Welfare Assistance Program are two programs which provide items of special need not contained within basic GWA allowances (food, clothing, shelter). Special need items such as prescription drugs, prosthesis, dental work, etc. are administered by municipalities under the Special Assistance and Supplementary Aid Programs. A function which supports the delivery of GWA is an Eligibility Review Unit, which contains staff who are dedicated to performing file audits and investigating situations of questionable eligibility. Halton also purchases services from community agencies. We have four contracts with counselling agencies to provide individual and family counselling, eight contracts with organizations providing housing for persons who are in need of shelter (such as women s emergency shelter, addiction treatment services, supervised living for persons with emotional and/or psychiatric problems) and homemakers and nurses services that are outside of the Homecare program eligibility. A major thrust in the Income Maintenance Division is to provide employment services to persons who are unemployed and on social assistance. Halton Region has been the broker for the Jobs Ontario Training Program for the past two years and is involved in developing the Job Link strategy which is discussed under the issues section.

3 3 The Children s Services Division provides subsidy to working parents for child care in centres or private homes. We own and operate three of our own child care centres, two in Oakville (Margaret Drive and Sedgewick) and one in Georgetown (Maple Avenue). In addition, we purchase child care spaces from child care centres and child care agencies in the community and serve approximately 1,500 children at any one time. The Children s Services staff also work with the community to provide leadership and training to all providers of child care services to assist in improving the quality of child care throughout Halton. In addition, should an agency, an individual or a company wish to get into the business of providing child care services, staff assist them to develop their own programs. All child care agencies are licensed and monitored by the province and operated under the provincial Day Nurseries Act. The Community Services Division operates Pegasus, the special transit service for disabled persons, which is cost-shared with the Ministry of Transportation (50%). It also administers the social service grants to community agencies. These are based on annual applications to provide operating and capital funds to community agencies who are unable to receive funds elsewhere. The application process is coordinated with the four United Ways serving Halton. It is the Community Services Division that also provides research and planning for the department and works with the community at large to facilitate community development and planning. Allendale is Halton s home for the aged, which is now called a long term care facility. It replaces the former Halton Centennial Manner, and is located in Milton at Highway 25 and Child s Drive. Allendale is a 200 bed, modern, state of the art facility for persons who require institutional care. Alongside of Allendale we are continuing to operate 100 beds in Martin House, which is next door and part of the former buildings of Halton Centennial Manor. This is a temporary plan and is discussed below in the issues section. In addition to the normal requirements of daily living, Allendale provides its residents with social and recreational activities, as well as amenities such as chapel services, hair dressing, and a pub/bistro. Allendale also operates community outreach programs, which include three respite beds, a seniors day centre (Milton Place) and ongoing information to the community about services for seniors. As well, Allendale runs two supportive housing projects in Burlington, one at Bonnie Place and one at Wellington Terrace. The Administrative Services Division is the locust of responsibility for administrative, financial, and automated systems for the department. It also is responsible for general reception and intake services on behalf of the department. The Regional Administration Building provides the base of activity for the Social Services Department, however, in addition to the three child care centres and Allendale there are also sub offices in each of the municipalities which allow local interviewing for the Income Maintenance Program. These offices are co-located with either Halton s Health Department local offices or the federal Unemployment Insurance offices. Major Program Issues for 1995: 1. Employment Strategy for Persons on Social Assistance Halton Region has operated an employment program, as a complement to the General Welfare Assistance program, for over 13 years. Traditionally, when the economy was good and jobs not scarce, the program focused primarily on hard to serve clients with significant barriers to employment. Upon referral from a social assistance caseworker, the employment counsellor would complete a full assessment and assist the client in mapping out and working through a plan towards

4 4 employment. Among other things, this might include resolving personal issues, retraining or upgrading, resume preparation and job search. Two years ago, in response to rising unemployment levels, the province introduced Jobs Ontario Training, a program designed to stimulate jobs in the private sector and assist the long term unemployed back into employment through training credits to qualifying employers. The Region (Business Development and Social Services departments) was awarded the brokerage in Halton and rather than hire new employees to staff the three year project, staff elected to move existing employment staff temporarily into Jobs Ontario. More than 1,300 clients have been placed in over 500 companies to date. After three extensions the program is now being phased down to end March 31, Staff will be reassigned to the Job Link Strategy, which is a coordination of existing services for social assistance recipients through the development of local resource centres spearheaded by the province. Currently most municipalities in Ontario are going through consultative processes to assist them in designing the most appropriate model for Job Link in their communities. Because of our long standing role in employment programs for social assistance recipients, it is anticipated that the Region will play a major role. All stakeholders (consumers, business, labour, educators, federal, provincial and municipal funders, community agencies and planning groups) are involved. It is expected that a community proposal for Halton will be submitted to the province in January. 2. Restructuring the Social Assistance Systems in Halton Ontario is one of the few remaining provinces that still operates two parallel social assistance systems: General Welfare Assistance (short term) and Family Benefits Allowance (long term/disability). Despite numerous studies and proposals to amalgamate or replace the two systems this has yet to happen, with the exception of a few pilot operations that have never been confirmed. Over the past year staff in Income Maintenance have worked with staff at the Ministry of Community and Social Services in the local Family Benefits office to restructure the way that we do business. Initially this has resulted in Halton staff completing one application for sole support parents for eligibility for both programs. Staff believe that there are many more practices that can be amalgamated to both improve client service and eliminate duplication and system inefficiencies. As a result we will be aggressively pursuing additional initiatives that will achieve these objectives with the province. 3. General Welfare Assistance Over the past year General Welfare Assistance cases have declined by 10%. This has meant that caseloads have been reduced from 172 cases per worker to 140 cases per worker. An optimum caseload size is around 115 cases per worker. This allows staff to support and monitor clients more closely. Although abuse of the social assistance system always receives significant attention, the merits of the program for persons in need are significant. The implementation of Job Link will be a positive initiative that will allow caseworkers and employment counsellors to empower clients to reduce or eliminate their reliance on the system. With caseloads and workloads high, efforts have primarily focused on assisting those coming onto the system. With these pressures easing and a number of new eligibility controls in place, staff will be able to shift the focus for social assistance recipients to exit strategies. In 1995 staff will be reporting on the results of enhanced eligibility review initiatives implemented in 1994 and reviewing staffing resources required to deliver the program in the future. 4. Customer Service Evaluations

5 5 In 1993, staff in the Income Maintenance Division started a Work Smart process to allow us to improve our business practices and better achieve our responsibility to provide an excellent service balanced with system accountability within a healthy working environment. This exercise has resulted in many changes and adjustments in the way that we deliver our programs. Additionally, we implemented a process to obtain client feedback on our services and staff. In 1995 staff will be reporting the results of two client surveys and two client focus groups to Council. We will also be developing a strategy to obtain ongoing consumer input into our services. 5. Automation While considered a support, automation is a major initiative that will continue to be expanded on through 1995 and beyond. The department basically has two automated systems - the CIMS system, which is a province-wide cheque production system for the GWA program; and the CSIS system, which is an information system to manage the Children s Services programs. In addition, Allendale has a trust accounting system to manage residents funds, as well as some smaller operating systems for food services and maintenance. A major new technology is being tested by the province called caseworker technology. This likely will come to Halton the latter part of 1995 or early 1996, which will ultimately result in the concept of lap top computers for all the caseworkers in the General Welfare Assistance program. Currently the program is very manually and paper driven and the intent is to have instant input when taking applications and documenting changing circumstances through the client interviews. This system is expected to link, on a province-wide basis, the General Welfare Assistance program with the provincial Family Benefits Program, the federal Unemployment Program and the other pension/social security programs such as Workers Compensation and Old Age Security. This is a major undertaking and will further the streamlining of all social security programs for the future. There will be a cost-sharing expectation on behalf of the municipalities, but details of this initiative are not specific enough at this stage to know the implications for Halton. Within the automation agenda we have proceeded with direct bank deposit for general welfare assistance cheques and are moving to the same concept for tendered vendor services such as optical services. Automation advances will be reported to Council in an ongoing way. 6. Long Term Care Reform/Allendale As of July 1, 1993, the province implemented Long Term Care Reform with the introduction of Bill 101. This Bill collapsed homes for the aged and nursing homes into long term care facilities and gave the responsibility to the Ministry of Health. It introduced a new funding formula for all long term care facilities and it introduced a program manual of standards that must be met by long term care facilities. The new bill also transferred the responsibility for new admissions to Placement Coordination Services. The Regional Corporation no longer controls admissions. The major impact of long term care reform to the Social Services Department is in the funding of Allendale. There is a new funding formula and resulting red circling which could have significant cost implications. The new funding formula is based on the new levels of care classification system. Once a year the province comes to the facility and classifies all residents by reviewing the files. Under the new formula, Allendale s approved per diem for 1993 was $ This was determined with October 1992 data. In 1993, as an interim measure, the Province honoured Allendale s 1992 per diem of $ This became known as the red circled per diem. In 1994, Allendale was again reviewed and the case mix index was reduced with the result that the approved per diem was reduced to $ The red circling at the 1992 level remained.

6 6 The impact of the introduction of the funding formula in mid 1993 was particularly significant for Allendale. The new 200 Bed facility on the Milton site had just been completed; it was built with a philosophy of creating a home-like atmosphere, and providing residents with privacy and convenience. The result is a beautiful building with semi-private washrooms, 80% single rooms, eight small dining rooms and 160,000 square feet to keep clean and functioning. The residents are thrilled with their living area. The feel of an institution has disappeared. Meals are pleasurable, and food consumption has increased. All of this was accomplished in partnership with the Ministry of Community and Social Services, with the expectation that the funds to deliver the service and run the building would continue to be approved by the Ministry. The fact that there is increased square footage and additional amenities in the new building, and that the residents are frailer, makes the operation more staff intensive and, therefore, more expensive than what the Province is now willing to support. Throughout 1994, the Province threatened to take away the red circling dollars; after each threat, they extended the time frame by several months. They are now saying that they will give 60 days notice of any change in funding. The impact of losing the red circled dollars is a shortfall of $1.7 million; the Region would either have to pick this amount up, or service would have to be cut back severely. Allendale implemented significant cost saving measures in 1993 and 1994 with further cuts planned for However, parallel with the cuts in staff, there have been significant increases in expenditures. The Ontario Nursing Association (ONA) union received an interest arbitration settlement which gave them parity with the hospitals. ONA pay equity has just been settled with increased wages to the nurses. The costs of benefits for all staff have increased. Long service employees entitlement to increased vacation results in increased back-filling costs. These are a few of the larger increases. Cutting cost means cutting staff. This is difficult beyond a certain point as there is no accepted definition of adequate level of care. There are guidelines in the new standards for some areas of staffing, but not all. These guidelines, plus the design of the new building, prevent the lowering of staffing levels beyond a certain point. The residents, the families, the staff, and the community have certain expectations, built up over the years, of the Corporation in its delivery of service. Allendale has an excellent reputation for caring for the elderly. To reduce the level of service significantly will be difficult, if not impossible. 7. Martin House Martin House is the remains of the former Halton Centennial Manor which was a 370 bed facility built in the 1960 s. The redevelopment plan was to build 200 beds in Milton (Allendale) and then to move 80 to 100 beds in each of Burlington and Oakville over the next seven to ten years. The plan for Burlington has been on hold for the last three years, in that the Province is not responding to the request for capital to build in Burlington. The philosophy of the Province is to develop community services, not to enhance institutional service. It is well recognized, however, that the number of institutional beds per population across the various municipalities varies widely across the Province and Halton, in particular, has the lowest ratio of beds. The major issue for Halton as a community is to increase its supply. The redevelopment plan was intended to upgrade the existing beds managed by the Region. With the development of the two new facilities in the south on hold, continuing to operate 100 beds in Martin House was seen to be an interim solution in order to prevent a significant loss of beds to the community.

7 7 Martin House is an old facility and it will need major capital investment if it is to continue to function much longer as a long term care facility. The 100 residents are housed on the second and third floors. Milton Community and Information Services rents half of the ground floor and the old laundry. There are several community agencies which are interested in renting space in Martin House with the expectation of subsidized rent. In 1995, decisions must be made about the future of Martin House. 8. Redevelopment of Allendale Grounds The redevelopment of Halton s 20 acres at Highway 25 and Child s Drive in Milton began over a decade ago with the planned construction of Allendale in the southwest corner. The Council approved vision for the site is a range of health and social services which includes a continuum of care concept for seniors. Compatible services for the site were various forms of senior and family housing, a seniors recreation centre, a child care centre rental space for community agencies serving seniors and the general population, the reconstruction of the existing residence for young offenders and a police services building. There are various options available for siting these facilities, with the recognition that the northwest corner of the property is the most valuable tract of land. The development of the property is progressing in stages. In addition to Allendale, the property contains two existing buildings from the previous Halton Centennial Manor. Martin House is located to the east of Allendale and is addressed above. The former Pettit House, which is located near the centre of the property, has been renovated and leased to the Town of Milton for a seniors recreation centre. Plans are now under way to reconstruct the existing residence for young offenders (Cassata), as well as a Police Services building in the north central parcel. This will leave two major parcels of land for future decision making - being the northwest corner and a strip along the eastern boundary. 9. Child Care Services A number of reviews and restructuring are occurring within the child care system in Halton, which affects both our delivery of services, as well as the community at large. Halton s child care staff have played a major leadership role in the community to develop and improve the child care system throughout Halton. The child care system encompasses both formal and informal services. The formal system represents roughly 15% of child care arrangements and service is provided in centres or private homes that are licensed and operated under the Day Nurseries Act. The informal system serves the majority of the population who choose to make personal arrangements with friends and families for their child care needs. As mentioned in the introduction, Halton operates its own centres and private home child care agency, as well as purchases spaces from the formal sector. Both the federal government and the province have spoken for several years about a reformed child care system. While there is not a decision to proceed in an overall reform of the system, there are many initiatives that Halton is involved in to improve upon the existing system. We have and will continue to be involved in the development of child care centres within the public school system. We are also facilitating the development of flexible child care programs with education and recreation partners. We are participating in a restructuring of a system that supports child care for children with special needs. Currently we employ resource teachers who work with these children in child care centres. An issue has recently surfaced within the home child care system through a publicized court challenge which has called into question whether the providers of private home child care are employees of the agency that recruits them. This affects Halton, as we are our own agency and licence individual homes for private home child care. As well, there are four other agencies offering

8 8 private home child care services in Halton. We are taking the lead to facilitate a restructuring of the home child care system to address this issue. We are also reviewing our Sedgewick Crescent regional child care centre to determine whether it would be better located as a program in a Burlington school site. This will be the subject of a Council Report through If the program is relocated, the building and property that it is currently housed in is a Regional asset for future decision making. Periodic Council Reports inform on the status of child care services by municipality - number of children served, waiting lists, vacancy rates in the system and planned expansions in the community. 10. Pegasus Pegasus is the region-wide transit system for elderly and disabled persons. The service connects the four municipalities, in that it provides ridership across municipalities in Halton. It has been operating for seven years and through last year s budget deliberations staff were directed by Council to review the service. There are 300 registrants for the service, however in reviewing the usage there are roughly 25 passengers who consume the majority of the service and the purpose for which they are using the service relates to personal health care. Under long term care reform, transportation for community health care purposes is a responsibility of the provincial program. Staff have been negotiating with community transportation systems (e.g. the volunteer Red Cross Services) to see who can accommodate these riders. The issue remains as to whether Pegasus as a Regional special transit system should continue to be operated by the Region and, if so, what level of service it should provide to the community. A Report outlining the final results of the review of the service will be brought forward to Council during the first quarter of Social Service Grants Each year community agencies apply to Halton Region for funding some of their operational and capital expenses through a regional social service grant. The application process is coordinated with the four United Ways of Halton and Regional allocations are recommended at a Health and Social Services Committee meeting. Traditionally, 40 to 45 agencies reapply each year with some new requests added to the list. The grants have some history as many were allocated to agencies by the area municipalities and when the Region formed, the responsibility was transferred to the Regional Social Services Department. Most of the agencies are funded by the province, the United Ways and community fundraising activities. The Regional grant is intended to provide extra funding for necessary services that are not funded through these other sources. The Regional funding is voluntary and not cost-shared with the province. The applications will be summarized in a Council Report that outlines issues and options to aid Council decision making. The agencies have an appeal route at Committee, as well, Committee has the option to invite any agency to present their case in person should elaboration be needed. The process has been streamlined considerably over previous years. It has been somewhat controversial in recent years in that questions are being raised in Council as to the ongoing funding of these grants. All grants over the last couple of years have been held to no increase. Staff are committed to reviewing the grants to better rationalize what we are funding and why, with the potential of revamping the program to tie it into the Human Services Plan and healthy community concept. This task is not easy, as each of the agencies individually are able to present a very worthwhile case. It is only with the setting of priorities that we can then make decisions to fund certain services over other services and we have not, as a community, been able to determine these priorities as yet. The grants allocations will come to Committee in February/March.

9 9 12. Human Services Plan Policy B1c of the Regional Plan, which was approved by Regional Council on March 30, 1994 (Schedule :A: to By-law 49-94) states that, It is the policy of the Region to (B1c1) prepare and update every five years, in collaboration and partnership with the School Boards and other human services planning organizations, a Human Services Plan that will include: (B1c1[a] an assessment of the current state of health and social well-being in Halton, based on information from the State of the Environment Report.... The Social Services Department, in conjunction with the Halton Collaborative Planning Group (which includes the Health and Social Services Departments and the Halton District Health Council, Halton Social Planning Council and the Children s Council of Halton) and the Region s Health and Planning and Development Departments are in the process of designing a collaborative process to develop both the Human Services Plan and the State of the Environment Report. A Report highlighting this process will come to Committee in January or February of Strategic Plans Halton Region has been involved with other community planners to develop community strategic plans for a number of target populations in the community, such as seniors, persons with physical disabilities, children, and youth. Most of these plans have been funded by grants from the province and have been spearheaded through a partnership including the District Health Council, Halton Region Social Services and Halton s Health Department. These plans will periodically come before Committee and Council to update on the implementation of activities that have been committed to by the various stakeholders in the community. In particular, the plan for persons with physical disabilities will be the subject of a Committee meeting in January. 14. Advisory Committees The Social Services Department supports and staffs a few community advisory committees which assist us to understand our community. Reports from these committees will come to Council periodically to inform on various activities that they are involved in and work plans that they are undertaking over the next few years. There is Regional Council representation on most of the committees and the ones associated with the Social Services Department are: The Elderly Services Advisory Committee (ESAC) The Transit for the Disabled Advisory Committee (TDAC) The Children s Council and its related Child Care Committee - this is an independent non-profit corporation 15. Corporate and Departmental Service Access Committee Halton Region is involved in a partnership with several other major community agencies, including the Police and the School Boards which address multicultural/antiracist organizational change. The intent is for each organization to learn from each other with support from the province to identify training needs within their own organizations to better serve the growing diversity within our communities. Halton has a corporate-wide committee that supports this initiative with many departmental-specific activities taking place within various staff groups who are being trained and sensitized to the particular service needs of persons from various ethnocultural groups. CONCLUSION

10 10 There are many challenges facing the Social Services Department as most of the program areas which are very closely linked to provincial and federal policy and decision making are under review, both for financial reasons as well as to address jurisdictional issues. Halton is seen as having a progressive Social Services Department and a good quality service for Halton residents. Should funding sources become problematic and decisions are made to reduce programs or service levels, Halton residents would likely not get the services that are contained within this department from other agencies in the community. The philosophy of the department is to provide essential services that are not offered elsewhere in the community, as well as to facilitate the community to develop a full spectrum of community funded services. Halton staff are very connected to the forums in the community dealing with planning and service issues and are seen

11 11 to have a high stake in insuring that residents of Halton receive the necessary range of support services in a way that promotes well being, independent functioning, and healthy communities. Respectfully submitted, Bonnie Ewart, Commissioner Social Services Department BE:ah Approved by John S. Burke, Chief Administrative Officer Staff Number SS [THE SOCIAL SERVICES DEPARTMENT - ISSUES FOR 1995]