A Call for Greater Interdepartmental Delivery of Services to Youth and Families in Nova Scotia

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1 A Call for Greater Interdepartmental Delivery of Services to Youth and Families in Nova Scotia NSSBA Nova Scotia School Boards Association Submitted by: V. Fleury Chair, NSSBA Education Committee March, 2010

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3 Inter-agency Issues Introduction The Nova Scotia School Boards Association (NSSBA) education committee has selected interagency issues as a key priority/focus for this year (2010). The NSSBA has lobbied on this issue for the past 20 years and throughout that time period, interdepartmental collaboration has regularly been part of the association s policy resolutions that go forward to government. This year the education committee was definitely influenced by anecdotal feedback from boards. They strongly believe that a more integrated approach by government agencies would provide a wider variety of options and solutions to school and community-related issues. The committee gathered background data from the boards on their experience and practices of dealing with students at risk. Once the information was summarized, the committee met to develop a response to the data and to advise government on the matter. That background data, the committee s response, and our recommendations are included in this paper. Overall, we need to determine the adequacy of the government s current model and make proposals for improvement. But first, what others have said I. Report of the Special Education Implementation Review Committee (2001): Participants in the review process, both those from within the education system and parents, identified issues surrounding resources and supports from other service systems government should insure inter-agency collaboration to enhance access to programs and services for children and youth with special needs. (Inter-agency Collaboration, Recommendation #13) II. The Hon D. Merlin Nunn: The Province should immediately begin the development and implementation of a public, comprehensive, collaborative and effective interdepartmental strategy to co-ordinate its programs, interventions, services and supports to child and youth at risk and their families. (Nunn Commission of Inquiry (Dec 06), Recommendation #25) III. Council for Early Child Development: CECD encourages provincial governments to develop an integrated policy framework and system focused on ensuring equity and opportunity from the start for all Nova Scotia children and their families (NS Chapter of CECD, Oct 09 Conference Roundtable) IV. NS Department of Community Services: NS Department of Community Services: We need to work better internally as government. On top of that, we need to work better together. Community, stakeholders, partners really need to establish a network of services that works best for all of the Nova Scotians we deliver services to. Times are changing, needs are changing, ways of delivering are changing No single department can do it alone. It s through partnerships, collaborations, networking, trying to work better between ourselves within departments that works best for resolving issues and addressing community-based challenges (Opening Address, Provincial Conference, Nov 09) Nova Scotia School Boards Association 1

4 V. Our Kids Are Worth It: Strategy for Children and Youth: NS Gov 07 Policy Paper First and foremost, the clearest recommendation from Commissioner Nunn and the clearest message we repeatedly hear from Nova Scotians is to work more effectively together based on real life needs. This involves a meaningful and effective collaboration across government, between government and communities, and among people directly delivering services to children, youth and families; as well as an effective co-ordination of programs and services more commonly described by Nova Scotians as breaking down the silos. (Response to Nunn Recommendation #25) What the boards have said: AVRSB While schools are working hard to meet the diverse needs of today s youth (e.g. families in crisis, addictions, etc.) it is the co-operation and sharing of resources among different agencies that will make a difference. CBVRSB The largest overall concern about the current model is the lack of resources available to address many of the issues. CBVRSB provides many programs that reflect the will, desire and commitment to inter-agency partnerships, but to reiterate, lack of resources appears to be the largest constraint. SRSB Inter-agency partnerships have been happening in the Strait since Networks are in place, but dedicated services for students and youth are not another problem is that often when the need for a particular service is identified and partnership arrangements are made, obstacles surrounding confidentiality arise. Each agency has a different boundary system. These types of logistics are very important. CCRSB Experience in this region concludes that education is the lead facilitator/organizer of inter-agency collaboration, and struggles to get commitment from other partners. CCRSB s experience has not been overly positive, and suggests that it is necessary to secure greater commitment to the model from other agencies with the necessary resources to be effective. SSRSB The education system puts a lot of effort into preventive interventions and alternative programs; however, there are long term solutions that require the services and resources of other provincial departments. There is currently a mish-mash of departmental partnerships among the various boards of the Province but there needs to be a more hands-on, well-defined, sustainable interagency model to establish consistency of effort on a provincewide basis. 2 Nova Scotia School Boards Association

5 CSAP Regarding the Child and Youth Strategy program, the Conseil scolaire acadien provincial was not privileged to be part of this initiative. We strongly believe in the concept of inter-agency support in our school system as it is an excellent initiative to support students and families. The CSAP has been working at trying to establish health centres in a number of our schools in order to address some of the ongoing needs of students, parents and school communities. HRSB Implemented effectively, the Schools Plus model of inter-agency co-operation, collaboration and co-location has the potential to significantly increase the efficacy of resource utilization across several governmental departments. The resulting early intervention, wrap-around support and whole family involvement would provide many at-risk youth and their families with the necessary tools, services and ongoing supports to make meaningful, long-term positive life changes. TCRSB Interdepartmental collaborations have resulted in occasional success stories in the Tri-County region, but they have often been hampered by a lack of adequate resourcing. Even where successes have been achieved, they are not often replicated in multiple locations and because of this, serve to enhance the outcomes of limited numbers of children, youth and families. Existing Programs with Inter-agency Affiliations Comments about the need to improve co-ordination should not detract from the extensive collaboration that goes on every day right across the province. (Our Kids are Worth It) The Children and Youth Action Committee (CAYAC) CAYAC is/was a predecessor of the Child and Youth Strategy. As such, it had the mandate to formalize protocols and policies that support a coordinated, multidisciplinary approach to services that involve children. Established in 1996, committee membership included senior representatives from the four departments and representatives from the Nova Scotia Youth Secretariat and Nova Scotia Sport and Recreation. The departments represented on the committee were: Community Services, Culture and Education, Health and Justice. The goal of the CAYAC was to formalize an interdepartmental approach to facilitate the evolution of services that would improve outcomes for all children, including children and youth at risk. The committee met bi-weekly and reported to the deputy ministers of each department. Four regional committees were in place by It has served a purpose but results were variable. A review of CAYAC was commissioned in That review recommended, among other things, that government develop a provincewide youth strategy and that there be regional input into policy and program priorities. One result of this review is the Our Kids Are Worth It government paper referred to previously. Nova Scotia School Boards Association 3

6 CAYAC addressed the development of a more comprehensive and effective continuum of services for children and youth through the harmonization of provincial policies and protocols related to children and youth, as well as information sharing/cooperation with regional and federal colleagues. CAYAC was not involved in direct service delivery, nor did it fund projects or services. CAYAC does, however, represent an important initial step in promoting inter-agency cooperation in the delivery of programs and services. Remnants of CAYAC continue to exist in those regions not currently served by Schools Plus projects. Child and Youth Strategy The formation of the Child and Youth Strategy was also a key recommendation of the Nunn Commission of Inquiry. The Strategy includes community-based programs with the goal of bringing services closer to children, youth and families. Government appointed an executive director (Robert Wright) to head it up. The Strategy is an initiative to improve services through greater collaboration among five key government departments: Health, Education, Community Services, Justice and Health Promotion and Protection. Under this mandate a Child and Youth Social Policy Committee was struck with membership made up of senior officials from the five aforementioned departments, accountable to the five respective deputy ministers. The committee s mandate is to provide leadership and to assume collective responsibility in developing and implementing recommendations from Our Kids Are Worth It: Strategy for Children and Youth. Four regional specialists and five youth navigators (case planners) have been hired to facilitate a strengthening of relationships with community agencies, families and individuals. A number of programs/ services have been initiated or augmented as a result of their efforts: Schools Plus, Early Learning and Child Care Plan, Early Developmental Instrument for Primary Children, Parenting Journey, Family Help, Kids Help Phone, A Place to Belong, Provincial Youth Advisory Network, Well Child System, etc. * (*See: Our Kids Are Worth It: Our First Year) Schools Plus The Child and Youth Strategy s efforts have resulted in a particularly effective pilot program: Schools Plus. Schools Plus is a collaborative inter-agency approach to supporting the whole child and family. Schools Plus addresses Commissioner Nunn s recommendation of support for children, youth and families. There are four school boards with Schools Plus pilots in Nova Scotia. (Halifax, Strait, South Shore, Chignecto-Central) Each board has a Schools Plus facilitator who is the liaison between the schools and their community. The role of the facilitator is to advocate, coordinate and expand services for students and children. The services promote respect and address the unique needs of each community. Schools Plus promotes the co-location of services within schools, such as: Community Services, Justice, Mental Health, Addiction Services, Health and others. Schools Plus is designed to support all children, youth and families, particularly those for whom additional supports and services are needed for their success, even where their issues may not fall under any traditional category of service from an agency. Chignecto-Central, one of the four pilot sites for the program, reports many success stories. The vision for the program is to have the schools become a convenient place for government and other services to be delivered to families. The approach is designed to make it easier for professionals to collaborate with each other on behalf of children, youth and families. It is also set 4 Nova Scotia School Boards Association

7 up to make all service providers more accountable in responding to the needs of their clients. It s a whole new shift in approaching issues we deal with. We re seeing systemic changes and we re beginning to adjust practices within Community Services, Justice, Health, and Education. We re starting to work differently as adults to better service the youth, children and families in our area. -- Scott Milner Chignecto Family of Schools Supervisor Youth Navigation Service The Youth Navigation Service is a pilot project of the Child and Youth Strategy and is based on the recommendations of the Nunn Commission. While located in the department of community services, it works in collaboration with community organizations and other government departments (primarily Justice, Health, Education and Health Promotion and Protection) who serve children, youth and families. The service is delivered across Nova Scotia regionally. This service is open to youth living in Nova Scotia who are experiencing challenges in one or more areas of their lives. The current focus will be on young people ages who are not already connected to a service provider. Youth Navigation Service is: a voluntary, flexible, youth-centered, strengths-based, solution-focused approach. a supportive service that offers guidance to young people and enhances the likelihood of a service connection. a collaborative service delivery model that facilitates awareness and access to services and resources in government and the community. The Youth Navigator has two core functions: inquiry, consultation, education and information services o Youth Navigators will respond to inquiries from youth, families, service providers and other professionals. o Navigators will educate youth, families, service providers and professionals about how the service system works and how they may access potential service options. full Navigation services o Preliminary information will be collected by the navigator to better understand the youth s situation and their service needs. o After gathering the information, Navigators will work with the youth on an action plan. The plan is intended to engage youth, the navigator and others supportive of the youth, in a process that will enable him/her to attach to services more easily. This may take more than one session. o The purpose of the Navigation activities is to enhance the likelihood of a service connection. The Youth Navigator will guide and support these youth, recognizing that they may be at various stages of readiness for engagement and change. o Navigators will develop a thorough knowledge of and relationship with services, resources, programs, agencies, new initiatives, eligibility/referral requirements, intake processes and key contacts available to youth and their families in their community. Nova Scotia School Boards Association 5

8 Youth Navigation is not: a service for accessing residential placements. an after-hours or crisis management service. a case manager or primary worker. a means to obtaining preferential service or jumping the queue rather than following the established policies, processes and lines to access services. intended to duplicate existing services. In co-operation with other service providers, the Youth Navigator can: help make connections for youth clients to appropriate services. help develop options for youth clients. be a source of information, resources and supportive consultation. inform the service provider of new initiatives, services and programs from other areas as they become available. Additionally: AVRSB The board has partnered (via MOU) with the District Health Authority. The partnership has resulted in the establishment of some Youth Health Centres; however a lack of funding and resources remains the major impediment to region-wide implementation. CBVRSB The IWK Project, which includes the Family Health Program, was operating effectively; however, due to lack of resources, the program was unable to accept new entrants. Also, a wraparound service was developed and piloted by the department of justice, but the Island justice community was limited due to lack of funding. CCRSB The inter-agency experience at East Hants, which involves partners from the HRM region, has a new structure with two projects identified, but no new monies to fund. The plan will fail due to lack of funding commitment. It has proven frustrating also because education is the only member consistently at the table. SRSB With declining enrolment, rural communities are losing their infrastructure and often the school is a last resort for service delivery when there are no other agency resources such as a community health centre, or access to social workers. There is one Schools Plus program serving schools in Guysborough and Canso. SSRSB There are many great programs but communication and the flow of information are problematic. 6 Nova Scotia School Boards Association

9 Programs include Kids Help Phone, PEBS, Child and Youth Mental Health, Schools Plus, STEP, O 2, A Place to Belong, and Youth Navigator. Sustainability and resources are issues. There are severe privacy and confidentiality obstacles when agencies come together and there are agencies operating which cannot be accessed. Services are not reaching the people who need them in spite of everyone s best efforts. TCRSB The Tri-County region has demonstrated successes through restorative justice and in partnership with the department of justice are providing educational alternatives to youth who are incarcerated. The Tri-County Child and Youth Action Committee (CAYAC) has been working to identify gaps in services to children and youth and has been struck by the relative lack of services due to the lack of resources in the Tri-County region as compared with other jurisdictions in Nova Scotia. Even when services are advertised as being available within the region they often cannot adequately serve the needs of the region s children and youth. An example of this is the existence of a Youth Navigator who works out of the Kentville office of the Nova Scotia department of community services, but who is expected to serve the needs of children and youth in our area. The Tri- County Regional School Board was very disappointed with the cancellation of the wrap-around service slated for the Tri-County region. An Existing Provincial Model Healthy Child Manitoba (HCM) represents a new way of working together across government departments and, with the community, develops procedures, programs and services that promote the best possible outcomes for Manitoba s children. The Healthy Child Committee of Cabinet, which consists of seven provincial ministers, meets regularly to discuss cross-cutting issues related to children and families. They meet every other month for three hours, and issue an annual report detailing progress. The structure motivates departments to work with HCM as coordinator, and this ensures an interdepartmental approach to issues. There is a corresponding deputy ministers committee which meets in the off-month when the ministers are not meeting. Deputies work on administrative, budgetary matters and act as a sounding board for ideas that will be presented to the ministers. Supporting structures include multiple inter-departmental committees, the HCM secretarial office, the Healthy Child Provincial Advisory Committee and the Council of Coalitions. All of theses committees share and contribute to the ultimate goal of HCM: successful inter-agency partnerships responding to the needs of youth and families in Manitoba. Comments and Conclusions: The NS Government delivers or supports more than 150 programs and services related to children, youth and families. This entire strategy is based on the principle that there must be effective co-ordination among those programs and services and the people delivering them. In order for that co-ordination to be effective, a stronger integrated approach must occur among government departments, between government and community agencies and among the people and organizations directly delivering services to child, youth and families. Nova Scotia School Boards Association 7

10 Commissioner Nunn s most significant recommendation with respect to children and youth was to improve co-ordination among those programs and services, and among the people delivering them. He went on to discuss the obstacles to this co-ordination. Specifically, he spoke about the structure and mandates of individual departments focused on one time in, or some factors affecting a child s life with no single department mandated to look at all needs of the child, at all ages. (Our Kids Are Worth It 07) A new way of working not a new place to work is required, so that professionals who care about children, youth and families are not limited by their departmental or organizational mandates. They must have opportunities to meet and share information and ideas. They can, and should bring expertise and perspectives they have from their home department to the table, but the starting point for each discussion must be the needs of children, youth and families. Collectively, the resources and programs they commonly represent can then be used to create new opportunities as well as meet challenges. For example: The provincial education department deals with children in school. What happens in the critical years before they arrive at school is largely outside their mandate. Once children arrive in school, a teacher s job is to teach. Yet children do not leave family, health or justice problems outside the classroom. Teachers are very conscientious but they cannot, and should not, be expected to fill the role of a nurse, social worker, or other professionals. A way must be found to bring more professionals outside of the school into the school setting, to benefit children and allow teachers to focus on the critical job of teaching. Challenges Facing Greater Inter-agency Collaboration There appears to be regional disparity in the effectiveness of inter-agency collaboration. In some areas it is working well, but not in others. Agencies often do not understand the exact mandate, culture, and operational guidelines of other agencies. Privacy and confidentiality issues have become major barriers. Trying to obtain information often becomes a lengthy, complex process. There is a mish-mash of departmental partnerships among the various regions in the province. Not all agencies and services are accessible throughout the province, because of boundary issues or distances involved. Funding and resource issues are often impediments to establishing and maintaining interagency partnerships. There is an absence of protocols, guidelines and structures for fostering and supporting inter-agency collaboration. 8 Nova Scotia School Boards Association

11 Inter-agency networks are firmly in place in some areas, but there is a lack of provincebased inter-agency affiliations guaranteeing coordinated service for youth and families. A hands-on well-defined sustainable inter-agency model to establish consistency of effort on a provincewide basis does not exist. Breaking down the silos : Individual departments offering services to a common client still resist any challenge to their operating autonomy. Determining how the different programs and services can be interwoven is a daunting challenge. There are many programs but communication and flow of information is problematic. The goal must be to emulate inter-agency programs that work well: notably, those based on personal relationships with the youth and those that are on site where the youth are. Ministers and deputy ministers need to be on board. There are many good relationships in place at a case management level, but a strong more clearly defined interdepartmental approach is not systemic in this province. To ensure consistency of inter-agency effort and structure there is a pressing need to formally establish provincial and regional committees: define their relationship to one another, articulate their mandate, specify their composition, and provide adequate budget and resources. When inter-agency meetings happen, there must be clear agendas, recognition of time constraints and timely sharing of information throughout the process. Recommendations Recognizing there is a Child and Youth Strategy division in the community services department, and additionally there are interdepartmental child and youth social policy committees representing five departments (Justice, Health, Health Promotion, Community Services, and Education), we respectfully submit the following: Recommendation 1: Enhance Nova Scotia s Child and Youth Strategy with the formal establishment of a ministerial committee to lead and oversee the various agencies and programs for children, youth and families Recommendation 2: Conduct an inventory, by region, of services and programs currently offered so that overlap and redundancy can be reduced. Recommendation 3: Establish provincially, service delivery for children and youth by government agencies and departments in community schools. Nova Scotia School Boards Association 9

12 Recommendation 4: Convene a symposium for professionals working in the field on youth and family issues to generate discussion and ideas on how best to integrate those services. Recommendation 5: Appoint an interdepartmental commission to develop the organizational framework for integrating programs and services on a provincewide basis. Recommendation 6: Investigate privacy issues and other existing roadblocks with the aim of making inter-agency cooperation and coordination more tenable. Recommendation 7: Ensure long-term stability of inter-agency cooperation through adequate budget and resource allocations. Recommendation 8: Review and study Healthy Child Manitoba and other delivery models for ensuring inter-agency collaboration throughout Nova Scotia. In summary: Establish, through policy and action, effective interdepartmental delivery of integrated services to children, youth and families in Nova Scotia. 10 Nova Scotia School Boards Association

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