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9.0 Local Roles and Functions

Effective service responses at the local/regional level are the product of strong and meaningful linkages across the sectors. MOHLTC will continue to provide funding to Local Health Integration Networks (LHINs) and MCSS will continue to provide funding to Regional Offices for delivery of services at the community level by transfer payment agencies. Responsibility for planning, building capacity and linkages across both sectors will rest primarily with the following structures:

  • The Ministry of Health and Long-Term Care funded Local Health Integration Networks (LHINs)
    for mental health services and,
  • The Ministry of Community and Social Services Community Networks of Specialized Care (CNSCs) for developmental services with the support of the Ministry Regional Offices.

9.1 Local Health Integration Networks (LHINs)

Effective April 1, 2007 LHINs assumed planning and funding responsibilities for most community and hospital-based mental health services in their jurisdictions. LHIN Integrated Health Service Plans are consistent with the strategic planning directions for MOHLTC. The responsibilities of LHINs are to:

  • Support and facilitate the development of cross LHIN boundary and cross-sector planning at a LHIN level;
  • Facilitate integration of the local health system and develop strategies to integrate services;
  • Facilitate case resolution linkages, consistent with reforms in both sectors;
  • Develop a process with local communities to assess the mental health and other resources needed to serve persons with a dual diagnosis and establish cross-sector partnerships to implement effective solutions;
  • Plan and consult with the MCSS Community Networks of Specialized Care (CNSCs) so that persons with a dual diagnosis have access to a range of mental health services, consistent with the ministry’s mandate, that are responsive to individual needs, including clients who will be affected by institutional closures of either ministry.

9.2 Community Networks of Specialized Care (CNSC)

The Community Networks of Specialized Care funded by MCSS are partnerships of specialized Developmental Services and other community agencies, including LHIN funded mental health service providers and organizations, working together to improve and coordinate specialized services for people who have a developmental disability and mental health issues and/or challenging behaviour. The CNSCs were created with a mandate to build capacity and linkages across local planning groups in relation to serving persons with a dual diagnosis.

In their leadership role on behalf of service provision for persons with a dual diagnosis the four Networks (East/North/Central/West) will coordinate a Specialized Service System to:

  • Streamline access to specialized services:
    • break down barriers between the developmental services specialized and mental health service systems;
    • function at a local level and facilitate the development of protocols and agreements between service providers involved in serving people with a dual diagnosis;
    • expand partnerships and strengthen linkages with specialized mental health service providers such as LHIN funded Assertive Community Treatment Teams;
    • better coordinate scarce resources and improve the case resolution process for the most challenging individuals.
  • Enhance service delivery:
    • improve capacity of Network members to develop a broader range and increase the volume of services that both specialized and developmental services service providers can offer;
    • assess community needs and opportunities and provide advice to MCSS and LHINs about the allocation of resources to meet priorities and support restructuring in their communities.
  • Train and build capacity in the community:
    • develop relationships with the academic and research community; – improve access to research/best practices;
    • increase expertise in specialized services through professional development;
    • train general health and social service practitioners;
    • develop plans to recruit and retain more specialized professionals. These actions will be undertaken in partnership with local dual diagnosis planning and/or advisory groups and LHINs with the support of the MCSS Regional Offices.

9.3 MCSS Regional Offices

In relation to the CNSCs, the Regional Offices will work with the Networks to:

  • Develop cross-sector linkages that strengthen the capacity for the planning and coordination of services and supports for persons with a dual diagnosis;
  • Help coordinate, support and build upon the existing continuum of services and supports in local communities, in partnership with institutional and community mental health and developmental service providers;
  • Address unmet service needs and pressures in local communities by identifying and prioritizing the gaps and barriers to access throughout the developmental services system based on individual needs;Enable planning and coordination in local communities for persons with a dual diagnosis that is consistent with MCSS policy direction.

In addition, the Regional Offices will work with the LHINs with respect to initiatives in the mental health service sector related to:

  • MCSS Schedule 1 Facility closures and downsizing (i.e., Rideau and Huronia Regional Centres);
  • Development of appropriate community program strategies for inpatients of hospitals in order to support community living options for these individuals;
  • Participation in education and training initiatives within and across mental health and developmental services.

10.0 Next Steps

Implementation of this Guideline at the local level will be the responsibility of the regional/local structures and service providers to work together to enhance the capacity across both sectors to serve this population. Specifically:

  • It is the expectation of both ministries that the LHINs and the appropriate local developmental services planning forum (Networks or other forums as defined by the local community) will link to define how the local system will implement this Guideline;
  • LHINs and Networks will take the appropriate steps to recognize and address the service needs for this population by building local cross-sectoral relationships and defining expectations for local service providers in both the health and social service sectors.

Ministry of Health and Long-Term Care, Mental Health and Addictions Unit
Ministry of Community

and Social Services, Developmental Services Branch
December, 2008