Services delivered: Access intake service planning

Component: Young Parent Services

Legislation: Child, Youth and Family Services Act, 2017

Service description

Coordinated Access and Intake services are intended to provide timely, effective intervention to children and youth under the age of 18 with multiple and/or complex special needs.

People served

Children and youth under 18 years of age with multiple and/or complex special needs who need timely, effective intervention.

Program/service features

Coordinated access

Coordinated access is a collaborative, community-based approach to streamline access to mental health services and other types of supports. It helps children, youth and families access appropriate services and supports quickly and easily.

The intent of coordinated access is to minimize service gaps and duplication between service providers and sectors by establishing clear linkages among service providers, and between service providers and partners from the broader sector. In some service areas an access mechanism or service provider may have the responsibility for managing the coordinated access process. The coordinated access process supports system-level planning and integrated case management. It is likely to involve parties and professionals such as district school boards, local schools, Home and Community Care Support Services (formerly called LHINs), family health teams, psychiatrists, children’s aid societies, special needs Coordinating Agencies, Service Planning Coordinators, and others.

Through the coordinated access process service providers assess the needs of the child/youth and identify services to meet their needs (e.g., through access to mental health services or through collaboration with or redirection to other sectors that better match their needs). Developing and facilitating coordination among community agencies and partners is crucial.

Intake, eligibility and consent

The intake process often represents the first point of contact for the child, youth or family into the service system and involves the collection of basic information about the child or youth requiring service. Screening, as part of intake, involves confirming eligibility based on age (under 18 years of age). During the intake process, the client’s presenting needs and the availability of services are also considered. As part of the intake process, the client’s level of need and urgency is assessed in order to determine the appropriate service required, establish priority for service(s) based on risk, and identify the need for crisis services, where necessary. Preliminary service options are communicated to the child or youth and family at intake.

The process also includes obtaining any necessary consents regarding treatment, assessments and information sharing from the child, youth, or substitute decision- maker. Consent to treatment may also need to occur throughout the treatment process.

Identifying strengths, needs and risks

Service providers and staff must comply with applicable legislation including: the Health Care Consent Act, 1996 (HCCA); Substitute Decisions Act, 1992; and the Personal Health Information Protection Act, 2004 (PHIPA) – consult e-laws (www.e-laws.gov.on.ca) for further information.

Service providers are responsible for identifying the strengths, needs and risks of children and youth. The initial identification of strengths needs, and risks may occur simultaneously at intake to inform identification of initial service needs (e.g., brief services). This process involves using interviews, observations, and results of standardized, evidence-informed tools to identify the strengths, needs and risks of children, youth, and families. This information is then used to determine service and treatment needs, further inform triage and prioritization of children and youth for service when the level of risk is high, inform the development of a service plan, identify areas of strength to build upon and establish a baseline for outcome monitoring and measurement. Where the needs of the child or youth require longer- term interventions, a more thorough process to identify strengths, needs and risks will be undertaken to inform service planning, and this will occur throughout treatment to reassess changing service needs.

The results are discussed with the child or youth and their family to establish a clear understanding, engage, and elicit their views and reach agreement about service recommendations. Under some circumstances, a specialized consultation or assessment, which is designed to provide advice in the assessment, diagnosis, prognosis and/or treatment of a child or youth, may be needed to fully identify strengths, needs and risks.

Child, youth and family engagement

Child, youth, and family engagement is the process of partnering with children, youth and their families in the development and implementation of their service plans. It is an integral part of the family-centered approach to service delivery. Through engagement with children, youth and families, all service providers will become more accountable to the population that they serve. Service providers will be able to communicate the needs of children, youth, and families.

Child, youth and family engagement recognizes that children, youth and families bring a unique and critical perspective to their treatment, from identifying their own needs, to understanding what strategies might be most successful to achieve their goals and monitoring whether services are having the intended impact or outcome.

The term "engagement" implies an active partnership between children, youth and families, and service providers. This requires that professionals listen to children, youth, and families, engage them in two-way communication, and involve them in decision-making in a meaningful and purposeful way.

Specific service provided

Processes to support service delivery

Key processes contribute to the client experience and support the delivery of services to children, youth, and their families throughout their involvement with the CYMH service sector.

These processes support a coordinated, collaborative, and integrated approach to the delivery of community-based services for children, youth with multiple and/or complex special needs and their families. The processes emphasize a child- youth- and family-centered approach to service delivery that engages children, youth and families at every turn, from the moment the need for a service is identified, through the delivery of that service, and transition out of that service, to the point at which feedback is provided on how well the service has met their needs.

Key processes to support the provision of services and supports include:

  • coordinated access
  • intake, eligibility, and consent
  • identifying strengths, needs and risks
  • child, youth, and family engagement
  • service planning and review
  • case management and service coordination
  • monitoring and evaluating client response to service transition planning and preparation

Program goals

Services are delivered based on the principles of child-, youth- and family-centered service; seamless service delivery and information sharing; and meeting diverse needs through inclusive, accessible, and culturally safe practices.

Child/youth and family-centered service

  • Services are delivered in a way that is family-centered and ensures the family, children and youth are actively engaged and their input is incorporated throughout service delivery
  • Family-centered service recognizes that each child, youth, and family is unique; that the family is the constant in the child/youth’s life; and that the family has expertise in their child/youth’s abilities and needs
  • Through family-centered service, service providers work with the family, and the child/youth as appropriate, to make informed decisions about the services and supports the child/youth and family receive. The strengths and needs of all family members are considered

Seamless service and information sharing

  • The intent of coordinated access is to minimize service gaps and duplication between service providers and sectors by establishing clear linkages among service providers, and between service providers and partners from the broader sector
  • As a result of coordinated access, families will experience seamless service and information sharing. With consent, information about a family’s needs will be shared between providers. Families should not feel like they are repeating intake and assessment information or repeating their stories unnecessarily; however, families should be encouraged to share information with providers and can share their stories with new providers if they wish

Meeting diverse needs

  • Coordinated Access and Intake services will be inclusive, accessible, and culturally safe for all families and children/youth. Services will be respectful of the values and meet the diverse needs of children, youth, and their families
  • Service providers will be aware of distinct approaches required to address the needs of First Nations, Metis, Inuit and urban Indigenous children and youth. This includes providing culturally safe services and linkages and referrals to Indigenous service providers and other community resources as required

Ministry expectations

Services are child and family-centered and support the diverse needs of families in a way that is culturally safe, promotes equity, anti-racism, and anti-oppression.

The following are minimum expectations for these processes 
Coordinated access

  • Clear pathway protocols are in place to coordinate access and services for children, youth, and families between and across service providers and community partners from related sectors (including but not limited to primary care and education)
  • Service providers use information collected through collaboration with community partners to inform the approach to access and to service. The collection of information is supported by information-sharing protocols, subject to applicable legislation, regulation, and policy directives, including privacy and consent requirements
  • The impact of partnerships and collaborations with regard to child, youth and family access to appropriate services is regularly reviewed and assessed by the Coordinating Agency through their planning work

Intake, eligibility and consent:

  • a clear intake process is developed that supports establishing eligibility for services
  • the process for intake screening and delivering services to clients is documented and the written process is available to families, children, and youth when they make contact
  • the client’s needs and urgency of treatment/intervention is assessed using evidence- informed tools
  • preliminary service options are communicated to the child or youth and family at intake
  • where appropriate, the child or youth and family are referred to other services
  • a client record is created to capture information and support service planning, service delivery and ongoing case management
  • children and youth are prioritized for service based on need and urgency, and immediate crisis support and response is provided to those at risk or in crisis (e.g., impulsive self- harming behaviour), or efforts are made to help them access to immediate services
  • to the extent possible, service planning, coordination, treatment and/or communication will occur with all involved providers, including those from other sectors. This may involve information sharing with appropriate providers, subject to applicable legislation, regulation, and policy directives, and subject to privacy and consent requirements
  • when there is a waitlist for service, clients will be informed at intake and at regular intervals about their status on the waitlist
  • clients and families will be provided with information, supports and resources to help them while waiting, such as contact names and phone numbers, crisis contacts, referral to other services, and community services and supports they can access

Identifying strengths, needs and risks

  • a strength needs and risk assessment process is in place and adapted according to the intervention and treatment needs of the child or youth or family
  • the strengths, needs and risk assessment identifies and evaluates the strengths, needs and resources of the child or youth and family that are relevant to the intervention and treatment process
  • the strengths, needs, and risk assessment will consider the child or youth within their family, community, cultural, socio-economic, and religious contexts
  • the strengths, needs and risk assessment will include information already gathered from the child or youth, parent/caregiver, or other practitioners subject to applicable legislation, regulation, and policy directives including privacy and consent requirements, so they do not have to unnecessarily repeat themselves

Child/youth and family engagement

  • youth and families are provided with orientation on youth and family engagement policies and practices and how they can take part in engagement activities
  • children, youth, and their families are engaged in the development and implementation of individual treatment or service plans and participate in processes to identify the impact of service
  • participatory methods are used to evaluate the outcomes of services to the greatest extent possible
  • children, youth, and their families provide input into planning, evaluation, and delivery of services
  • children, youth, and their families are given the opportunity to provide feedback on their overarching experience with the service

Availability of service

Intake processes to access services are available in every service area.

Reporting requirements

The following service data will be reported on at an Interim and Final period. Please refer to your final agreement for report back due dates and targets.

Service data nameDefinition
# of children/youth: Access intake service planning: 11-14yrs: Former CYMHNumber of children and youth who are deemed eligible and have consented to service and who are between the ages of 11 and 14 (inclusive) at the date of intake or at the start of the fiscal year if service carries over.
# of children/youth: Access intake service planning: 0-5yrs: Former CYMHNumber of children and youth who are deemed eligible and have consented to service and who are between the ages of 0 and 5 (inclusive) at the date of intake or at the start of the fiscal year if service carries over.
# of children/youth: Access intake service planning: 15-17yrs: Former CYMHOf the total number of unique clients, the number of children and youth who are deemed eligible and have consented to service and who are between the ages of 15 and 17 (inclusive) at the date of intake or at the start of the fiscal year if service carries over.
# of children/youth: Access intake service planning: 6-10yrs: Former CYMHNumber of children and youth who are deemed eligible and have consented to service and who are between the ages of 6 and 10 (inclusive) at the date of intake or at the start of the fiscal year if service carries over.
# of children/youth by gender identity: X: Access intake service planning: Former CYMHOf the total number of unique clients, the number of children/youth eligible for mental health having a third gender identity (i.e., Trans/Transgender, Non-Binary, Two-Spirited, or Binary as well as anyone who chooses not to display their gender identity). Gender identity: Each person’s internal and individual experience of gender. It is their sense of being a woman, a man, both, neither, or anywhere along the gender spectrum. A person’s gender identity may be the same or as different from their assigned sex at birth. Gender identity has nothing to do with a person’s sexual orientation. 
Children/youth would be counted only once in this data element.
# of children/youth by gender identity: Female: Access intake service planning: Former CYMHOf the total number of unique clients, the number of children/youth eligible for mental health services having identified their gender identity as female. Gender identity: Each person’s internal and individual experience of gender. It is their sense of being a woman, a man, both, neither, or anywhere along the gender spectrum. A person’s gender identity may be the same or as different from their assigned sex at birth. 
Gender identity has nothing to do with a person’s sexual orientation. Children/youth would be counted only once in this data element.
# of children/youth by gender identity: Male Access intake service planning: Former CYMHOf the total number of unique clients, the number of children/youth eligible for mental health services having identified their gender identity as male. Gender Identity: Each person’s internal and individual experience of gender. It is their sense of being a woman, a man, both, neither, or anywhere along the gender spectrum. A person’s gender identity may be the same or as different from their assigned sex at birth. 
Gender identity has nothing to do with a person’s sexual orientation. Children/youth would be counted only once in this data element.
# of children/youth eligible for Service access intake service planning: Former CYMHThe total number of unique children/youth who were eligible and consented to receive CYMH services from the service provider or its partners/sub-contractors, and for whom a record has been created, within one fiscal year. A child/youth cannot be counted more than once in a fiscal year in this data element. A child/youth is to be reported once in the initial quarter in which he/she was first deemed eligible and consent was provided to receive CYMH supports and services. If active service occurs across more than one fiscal year, the child/youth is to be counted once in each fiscal year. For example, a child/youth started receiving service on March 15 and ended this instance of service on July 15. On July 15, the individual is placed on a waitlist to receive another service and starts a second service on September 12 which ends on January 20. This individual would be counted as a unique client once in the fourth quarter of the first fiscal year and once again in the first quarter of the second fiscal year.
# of hours of direct services: Access intake service planning: Former CYMHNumber of hours of direct service. The total number of hours of "Direct" service provided by staff to individuals during the fiscal year for a particular service. "Direct" Hours: The hours spent interacting, whether in a group or individually; face to face or on the phone. It does not include work done "on behalf of" clients, such as telephone calls, advocacy, etc. Administrative support to the service is not to be included. For group service, one hour of service equals one hour of service for the entire group. For example: one hour of group service with five participants equals one Hour of Direct Service. (Note: each individual in the group is recorded under ’no. of individuals served’ where there is a record).
# of hours of indirect service: Access intake service planning: Former CYMHThe total number of hours of service provided by staff "on behalf of" clients, such as telephone calls, advocacy, and administrative support to the service.
# of initial needs assessments: Access intake service planning: Former CYMHNumber of children/youth with an initial needs assessment performed at or following intake, using a standardized tool to identify strengths and needs to inform service/treatment planning. If a child/youth has two or more needs assessments completed during service, only the initial needs assessment would be counted in this data element
Access intake service planning: Ministry-funded agency expendituresTotal ministry-funded expenses for the Transfer Payment Recipient to administer and/or deliver this service in the reporting year (cumulative)