Maximizing Community Respite

1. Maximizing Community Respite Chantal Krantz Manager Care Transitions

2. Accessing Services in Ontario and Quebec • Ontario and Quebec • Government funding: • MOHLTC/CSSS • MCYS/CSSS • Non- government funding • Private Health Insurance Funding • Motor Vehicle Insurance/LaSAQ • School insurance • Other: • City funding (Ottawa, Quebec) • Charity/foundations

3. Ontario Government Funding MOHLTC • Acute Care Hospitals, long term care facilities (St Vincent’s Hospital/ EB, Holland Bloor view). • Rogers House • ADP • Community Care Access Centers • CACC (Central Ambulance Communication Center)

4. Ontario Government FundingMCYS • Ontario Treatment Centers (OCTC) • Service Coordination (ex: Ottawa SC, Valeris, Kingston each have the equivilant) • Coordinated Access • Early Development Programs (Infant Stim.) • Assistance for Children with Severe Dis. • Special Services at Home • Enhanced Respite (CCAC triages) • Ottawa Rotary Home • Level 4 Application/Extraordinary funding

5. Access to non- governmental funding • Family Extended Health Insurance Plans • What is the maximum respite, level of respite covered? • Motor Vehicle Insurance Plans • Catastrophic vs. non-Catastrophic • How much attendant care= form 1 • Credit-Card Plans and/or School Insurance • Andrew Fleck centralized Day Care (City of Ottawa funded) • Children’s Integrated Services CISS

6. How to get started (Ontario) • Explore CCAC-request for assessment for maximum eligibility to in-home respite. Request Enhanced Respite at d/c. • Assess maximum nursing respite coverage from Extended Insurance and send supporting documents/forms • Start Process for ACSD/SSatH (SW) • Day Care Center vs. Home day Care/School • Build in: Out of home respite Rogers/Rotary home

7. How to get started (Quebec) • Consult to the CLSC requesting SW involvement and assistance with Cheque Employ Service (CES) application (usually takes 2 weeks to approve). • Ask CHEO nurses to prepare a daily care plan of needs. CDT must stress complexity, frequency of care and impact on family with no respite. • Access family extended health insurance • Regie Des Rentes/Cheque employ service

8. How to get started (Quebec) • Coach parents to find friends/family, neighbor to hire with CLSC money (i.e: adds in paper) • Help them find nurses via PQ agencies-ins • Case conference at CHEO with family, CLSC requesting applications to: • CES (funds for parents to hire someone) • Club Optimist • CLSC foundation • Aide ménage • Gardienage • Keep following up with CLSC access to respite funding applications hold a 2nd case conf. as needed.

9. How to get buy in with families • Present plan/cost breakdown on paper • Prepare a calendar with potential respite services • Honey moon phase first 1-3 months • Fatigue/burnout (3, 6 and 9 months, 1 year) • Ask parents to put wishes on calendar • Parents should take lead to visit Rotary home, Rogers House and book respite

10. Take Home Message • Make sure that care is compatible with home setting. • Ensure that daily care is realistic for home/ home friendly and encourage change during the hospital stay • Feeding schedules, daily treatments? • Hold a case conference internally if you need specialist to change care

11. Questions and Comments?