Let’s Talk About Making Developmental Services Better in Ontario

Welcome to the Ministry of Children, Community and Social Services engagement on developmental services reform.

We want to hear your ideas, comments and feedback to help us improve supports for people with developmental disabilities across Ontario. The survey takes about 45 minutes to complete and will close on December 4, 2020.

You may answer as many of the questions as you want. Once you have answered all the questions you would like to, please click the ‘Submit your answers’ button at the bottom of the page.

To protect your privacy, please do not provide any personal information, such as your name, phone number or address, in any of your answers. We will keep all the information you submit private. Also, we will review all the submissions we receive together to help keep them anonymous.

On this page

MCCSS - DS Reform Plain Discussion Guide

question mark in a circle Why we are doing this

The Government of Ontario wants to improve supports for people with developmental disabilities. We want people to:

  • have choices and have an easier way to get the supports they need
  • feel like they belong and be a part of their communities
  • have better outcomes

To help make this happen, we will need to make changes to the system.

This paper shows lots of things we can talk about to make services better. There are also some questions in this paper we would like to hear from you about.

There are lots of ideas to think about. We need your help to try and get these changes right.

You could to talk to a family member, friend or someone else you trust if you need help with the information and questions in this paper.

You don’t need to answer all the questions in this paper if you don’t want to. You can give answers to the ones you want to and leave the others blank.

Thank you for your time and sharing your ideas.
 

three person figures with two speech bubbles above the figures What we have heard from people before

The government has talked to lots of people about developmental services over the years. Here is what they told us.

People are confused. They want an easier way to get the help they need
They want more choices and for things to be simpler.

People are tired of waiting for supports.
People feel it’s too hard to get an assessment. They also think it takes too long to get supports.

People want more control over money
People want to get the help that works best for them. They want to use the money they get for what they really need.

Service providers want to know what will happen
They want enough money to pay their bills and provide services.

Finding and hiring staff is not easy
People and families have said it can be hard to find support workers. Sometimes they don’t get enough money to hire a worker.

The government has made some changes to fix these problems. We want to do more. We need your help to do that.
 

face outline wearing a medical mask How COVID-19 has affected services and supports

COVID-19 has changed how people take part in activities or get help. This is mostly done by computer or on the phone. Some people may feel more lonely now. This can be hard for them and their families. Some of these changes will go on for some time.

COVID-19 has made us think about services in different ways. For example, some agencies are using things like FaceTime and Zoom for activities and to keep in touch with people and their families.

To help people deal with COVID-19, the government has made changes to programs. People can now use their Passport funding for more things. The government has also given more money to agencies to try and stop the spread of COVID-19.
 

road with a location pin sign attached above road Draft vision and principles

The government has some ideas about how to make the system better.

Our vision

We want people with developmental disabilities to be included and feel like they belong in their communities. We want them to have choices and the right supports to live more independently.

Principles to guide our work

These are some ideas that can help us think about making changes to the system

  1. People should get support based on their needs.
  2. Services should build on the help people get from their families and in their communities.
  3. People should have more control over their funding and supports.
  4. People should get help with problems before they start. This can mean helping people earlier.
  5. Services should be high quality. People should be able to share ideas on how to improve services.
  6. The government should make sure the system can continue to provide supports people need.
  7. Services should help people stay healthy and safe.

Some questions we can talk about

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icon of a globe What Ontario can learn from other countries

Many countries are working to make services better for people with developmental disabilities. People’s needs are changing, and they want different types of services.

Many countries are using new ways of doing things to make things better. For example, New Zealand gives people with disabilities more choice and control over their supports. This helps them plan for the lives they want.

Each place is different. So, we can’t just copy ideas from other countries. However, we can learn from others.

The government worked with an outside company to help us learn about the good things other places are doing. Then they compared this with what we are doing in Ontario.

Next, we will show what we have learned from other places. We will also talk about how things are right now in Ontario and how we could make them better.

 

1. Delivering supports that meet people’s changing needs

circle with a check mark inside circle Good ways of doing things

A good practice is to let people make their own decisions. Each person needs different kinds of help. People should have more choice about the services they get.

Some countries look at all the services people will need through their lives. They also try to help with problems before they become serious.

clipboard with checkmarks on left-hand side of clipboard, and horizontal straight lines on right-hand side of clipboard How is Ontario doing?

Ontario is giving people more choices about how they get their supports. The Passport program gives money to people and their families. Everyone in the program gets at least $5,000 per year. They can get up to $40,250 per year. How much money they get depends on how much they need based on the assessment.

People are using their Passport money in different ways. For example, people are:

  • hiring support workers
  • taking classes
  • joining activities at recreation centres
  • getting planning services

The government wants to do better to help people get the supports they need. It wants to help them get supports that are right for them at different times in their life.

square speech bubble with horizontal straight lines in bubble, with a question mark How can we make things better?

  • Make sure people get help when they really need it.
  • Try to stop problems before they start.
  • Help people become a part of their communities.

One way we can make things better is to help people get more involved in their community. They can do this using money from Passport. They don’t always have to go through an agency. The government could think about ways to give people more choice with direct funding like Passport.

If people get help early, they could deal with problems sooner. If they get more help with planning, they could get more of the services they need in the community.

The government also wants to better help people when they turn 18 and become adults. They may need more help in finding a place to live, or a job, or new activities.

Some questions we can talk about

Q2. Think about things like housing, recreation, education, jobs, and volunteering:
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Q3. Think about the big things that happen in everyone’s life, like leaving home or finishing school:
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2. Getting better assessment and planning

circle with a check mark inside circle Good ways of doing things

Different countries use different ways to find out more about people’s needs. They want to make it easier for people to apply for supports. They look at a person’s abilities and their life situation. They find out where people need support. This can be at home, in the community or through an agency. In New Zealand, people can fill out a form themselves to show why they need funding. They explain what supports they need and what this will cost.

clipboard with checkmarks on left-hand side of clipboard, and horizontal straight lines on right-hand side of clipboard How is Ontario doing?

All adults with developmental disabilities have their needs assessed at their Developmental Services Ontario (DSO) office.

The assessment looks closely at people’s needs, and what they want. Some people have said that this can take too long or has too many questions. Some people feel they have to tell their story many times to different people.

square speech bubble with horizontal straight lines in bubble, with a question mark How can we make things better?

Create an easier way to find out what people need and how to help them.

We want to think about ways to make assessments better for people. We want people to get the help they need as their lives change. We also want to make things easier through self-serve or online options.

We want to link the services people get with their needs. We also want to help people better plan for the future.

Some questions we can talk about

Q4. Think back to when you contacted a DSO and started to get services:
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Q5. Think about the application package, and what questions you were asked:
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Q6. Some people getting services and supports may not get re-assessed very often:
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3. Making funding fair and transparent

circle with a check mark inside circle Good ways of doing things

In some countries, people have their own budgets for supports. This gives them more choices and better control to meet their needs.

In some places, funding is given directly to people. In others, funding goes to the agencies. In both cases, the funding is based on the person’s needs.

clipboard with checkmarks on left-hand side of clipboard, and horizontal straight lines on right-hand side of clipboard How is Ontario doing?

The government funds different types of services for people with developmental disabilities. People mainly get these services through agencies. For example, this can be a group home or day activities.

Agencies usually get funding based on what they got in the past. This may not be based on the needs of the people they support.

There is some funding that is linked to a person’s needs. Under the Passport program, people can use the direct funding they receive to pay for supports.

square speech bubble with horizontal straight lines in bubble, with a question mark How can we make things better?

  • Provide funding that is directly linked to people’s needs.
  • Give people more choice and control over their supports.

The government is thinking about new ways to fund supports. One way is for people to have a personal budget, based on their needs. This way people can choose and control their own supports.

This is already being done in other places. For example, in Australia people have their own budgets. They can use their budgets to buy services related to their disability and support needs. The government in Australia has made rules about the services people can buy with their budgets. The rules help make sure that the services people buy are ‘reasonable and necessary.’ This means the services are needed to help people.

Some questions we can talk about

Q7. Some places focus on funding supports that are 'reasonable and necessary':
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Q8. Many people and families receive direct funding (such as through the Passport or Special Services at Home programs). This lets them manage their own budgets:
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4. Improving service quality and getting better outcomes for people

circle with a check mark inside circle Good ways of doing things

High quality services help people and families feel supported. People have more choice and control over their supports. In some places, funding is also based on getting good outcomes for people. In other places people can find out how well providers are doing before they get services from them. For example, in England, service providers get ratings for things like safety and how well they meet people’s needs. These ratings are then posted on a website.

clipboard with checkmarks on left-hand side of clipboard, and horizontal straight lines on right-hand side of clipboard How is Ontario doing?

In Ontario, all ministry-funded providers must meet health and safety rules. Ministry staff inspect agencies to check this. Agencies must also have an Individual Support Plan for every person. The plan must show the person’s goals and needs. However, it doesn’t usually ask the person if they are happy with the services. Finding ways to hear directly from people getting services could help make these better.

The government has worked with partners to help improve the skills and training of staff in the sector. However, there is more that could be done to make the quality of services better.

square speech bubble with horizontal straight lines in bubble, with a question mark How can we make things better?

  • Make the quality of services better by looking at how well agencies are doing.
  • Make outcomes better for people.

A good practice is to measure how well services are helping people. This means looking at things like:

  • Are people happy with the service they are getting?
  • Is the service of good quality?
  • Are they getting good outcomes?

For example, Community Living Algoma is already doing this. They interview people to see how well they are doing. They set goals to help people in different areas of life. This lets them measure the quality of supports based on what the person thinks.

Personal budgets can also help make service quality better. If people can use their money to pick their own provider, services could become better. Providers would compete with each other to get people to choose their services.

Providers can help their staff by giving them the right skills to meet people’s needs. The ministry can work with providers and other partners on ideas to build better skills in staff.

Some questions we can talk about

Q9. Think about the things people want to know before they choose a program or service provider:
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Q10. There are many ways to think about service quality:
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Q11. Think about the people who deliver services and supports:
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5. Using technology to deliver better services

circle with a check mark inside circle Good ways of doing things

New technologies like computers, apps and cell phones can be very useful for people with developmental disabilities. New technologies can give them new ways to live more independently, learn skills, and communicate. They can help them get more involved in their community. Technology also helps governments and service providers share information and deliver better services.

clipboard with checkmarks on left-hand side of clipboard, and horizontal straight lines on right-hand side of clipboard How is Ontario doing?

The government has funded some projects to test how technologies can give people more support options. Some examples include giving people computers/tablets, using medication dispensers, meal planners, and banking apps. Websites can give people the information they need to find out about local services.

PassportONE makes it easier for people to send their invoices and get paid for their expenses under Passport. An app called MyDirectPlan lets people manage their funding on their phone or computer.

square speech bubble with horizontal straight lines in bubble, with a question mark How can we make things better?

  • Help people get the technology that will let them be more independent.
  • Give people a better service experience.

Technology can be used in many ways. It can support people with their daily living, improve service delivery and make services more user-friendly. It can also help organize information to support better decision-making.

For example, Community Living Essex County added new devices to people’s homes to help them become more independent. Devices give step-by-step instructions for daily tasks, provide schedule reminders, and contact family members. The project helped several people shift from group homes to living on their own. The project was also very cost-effective. It can be duplicated in other parts of the province as well.

The ministry can also improve its information technology (IT) system. This could help provide better service delivery.

Some questions we can talk about

Q12. Think about virtual service delivery, where people get supports or information on their phone or computer:
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Q13. People use technologies like phones, tablets, computers, and assistive devices every day:
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Who is filling out this survey?
Please select the option you most identify with:

arrow pointing to the right inside a circle Next steps

We have heard about the issues that people and their families face. There is an opportunity to make changes to the whole system. We believe this is the right time for us to look closely at the developmental services system and how it is working for people.

The vision and principles to guide changes are based on what people, families and sector partners have told us over the years. This is just a starting point.

It is now time to make some real changes to developmental services and supports in the province. These changes will take time. The ministry will continue to work with people, families and sector partners to get their ideas and support.

We are interested in hearing your thoughts and feedback on how to improve services for people.