DEFINITIONS
For
the purpose of these guidelines, the following definitions apply:
Agreement
for service: refers to an agreement between the transfer payment
agency and the Familyhome provider prepared by the agency, pertaining
to the provision of service for the client.
Client:
refers to a child or adult with a developmental disability planning
to reside or residing with a Familyhome provider (often referred to
as a “Homesharer” by some agencies).
Familyhome:
refers to the Familyhome provider’s home, and members of the
Familyhome provider family and the client(s) who reside in the home.
Familyhome
provider: refers to an adult person and/or family, who provides
accommodation, care, support and supervision for a client (child or
adult with a developmental disability), and has a relationship with
a transfer payment agency coordinating the Familyhome program.
Individual
plan: refers to an agreement between a client and/or family
and service provider which describes the client's goals and action
required in order for the client to be able to attain these goals.
Ministry:
for adult clients, refers to the Ministry of Community and Social
Services and for child clients, refers to the Ministry of Children's
Services.
Program
staff: refers to the employees of the transfer payment agencies
who may set up and supervise program arrangements for clients and
Familyhome providers.
Transfer
payment agency: refers to a ministry-funded developmental
services provider or a ministry-funded children's services provider,
including Children's Aid Societies, which have Familyhome placements.
INTRODUCTION
The
purpose of these guidelines is to assist service providers that administer
the Familyhome program to develop policies and procedures that promote
the purpose and goals of the program. They are intended to be a tool
for agencies currently operating a Familyhome program, or for those
interested in developing a program. These guidelines do not prescribe
requirements for agencies, but rather represent best practices that
can be used by transfer payment agencies to examine their current
policies and procedures and revise and update them as they consider
necessary.
PROGRAM DESCRIPTION
The
Familyhome program is one option within a range of accommodation programs
funded by the ministry. The setting of a Familyhome placement is located
in a family home, and care, support, and supervision are provided
by a Familyhome provider. The Familyhome program was introduced in
1984. Initially, the program was developed for adults with a developmental
disability, but it was later expanded to meet the needs of children
with a developmental disability.
Typically,
the Familyhome program goals are:
• To provide a safe and secure place to live in a family home
setting;
• To promote a high quality of life; and
• To support and promote community inclusion.
The
program expands the range of residential options available in the
community and allows individual needs to be met in a more flexible
and personal manner. The program provides a family setting for those
clients who may require supervision, prefer living with a family,
and who may need the additional support that a family environment
can provide. Children and adults with a range of functional abilities,
including those who have additional physical, behavioural, and/or
medical complications, may be served in the Familyhome program.
APPLICATION/SCOPE
There
are no specific provisions contained in the Developmental Services
Act (DSA) regulation for agencies with a Familyhome program for adults,
however, all transfer payment agencies or homes providing, directly
or indirectly, residential care to three or more children not of common
parentage must comply with the Child and Family Services Act, applicable
regulations and policies with respect to foster care licensing.
These
guidelines are intended for all transfer payment agencies funded under
the Developmental Services Act (DSA) and/or the Child and Family Services
Act (CFSA), including Children’s Aid Societies, that arrange
and supervise Familyhome placements.
GUIDELINE 1: SCREENING PROCESS OF THE FAMILYHOME PROVIDER
Transfer
payment agencies typically develop written policies and procedures
that identify key characteristics of a Familyhome provider and a process
for making a decision concerning the acceptance or rejection of an
applicant Familyhome provider.
Individuals
may not need to discontinue employment to become Familyhome providers,
however, the financial status of Familyhome providers should be secure,
with an adequate income to care for the family’s needs. Single
individuals may also qualify as Familyhome providers.
When
assessing potential Familyhome providers, a key consideration is that
the Familyhome providers are willing to accept a child and/or adult
as part of their family and that they are capable, physically, mentally
and emotionally, to provide care and opportunities to enhance the
client’s skills, as needed. There are other qualities and characteristics
that the transfer payment agency staff look for, when considering
potential Familyhome providers. Some of these characteristics are:
patience, adaptability, understanding, warmth, open-mindedness, acceptance,
maturity, stability, commitment, integrity, cooperativeness, and flexibility.
Key
characteristics:
Familyhome
providers typically have the following characteristics:
• Be available and willing to participate in Familyhome orientation,
training and ongoing activities as outlined in agency policy and procedures
and service agreement;
• Demonstrate ability to meet the special needs of clients;
and
• Be willing to learn new skills.
The
selection of Familyhome providers usually involves a screening process.
Previous experience is not necessarily required since people often
have skills acquired in raising a family, in their own job, or in
their volunteer work or other community involvement which are valuable
assets in becoming Familyhome providers. The transfer payment agency
administering the Familyhome program generally arranges for the training
and support that applicants need to effectively care for a child and/or
adult with a developmental disability in their home.
Where
local coordinated access mechanisms exist, transfer payment agencies
should use this mechanism to identify eligible clients.
Screening
and Approval Process:
Transfer
payment agencies generally approve Familyhome providers based on a
process that includes a thorough home study and written report on
each home.
The
home study applicant screening typically includes:
• A series of family interviews to determine the family’s
motivation to become a Familyhome provider, and to assess the nature
and quality of family relationships, and each family member’s
willingness to participate;
• Verified unrelated character references;
• Confirmation that the potential Familyhome provider is able
to physically, mentally and emotionally provide care and cope with
stress;
• A current verified criminal reference check of all adults
living in the Familyhome;
• Home meets the requirements of policies and procedures developed
by the transfer payment agency that are based on the requirements
for a residence outlined in the Building Code and any applicable municipal
requirements for a residence;
• Water testing compliance (for Familyhomes where water is not
supplied by the municipal water system) appropriate for the local
area, according to policies and procedures developed by the transfer
payment agency in consultation with the local public health department
and/or the Ministry of the Environment;
• Fire safety checks/compliance, according to policies and procedures
developed by the transfer payment agency that are based on the requirements
for a “dwelling unit” outlined in the Fire Code and applicable
municipal by-laws; and
• Any other checks to promote safety, for which the agency has
developed policies and procedures.
Terms
of Placement:
Transfer
payment agencies usually have processes in place to see that the Familyhome
provider agrees to meet the terms of the Familyhome placement, as
outlined by the agency's policies and procedures.
As
one of the goals of the Familyhome program is to provide a safe and
secure place to live in a family-like environment, transfer payment
agencies typically place no more than two child or adult clients unrelated
to the Familyhome provider from any transfer payment agency in the
Familyhome. Similarly, Familyhome providers do not enter into agreements
with other agencies without informing the agency that first placed
a client in the Familyhome.
Some
of the areas that transfer payment agencies may wish to consider in
developing policies and procedures to guide the terms of the Familyhome
placement include:
• Individual
and/or group program orientation by the agency;
• Involvement from the client’s family, if appropriate,
in the client-Familyhome provider matching processes;
• A series of pre-placement visits prior to the placement. The
frequency and duration of these visits to be based on the assessed
needs of the client with input from the Familyhome provider, the client,
agency, and the client’s family (if appropriate);
• Reasonable accessibility of agency staff to the client and
the Familyhome provider, and to the client's family, as appropriate;
• Agreement from the potential Familyhome provider to ongoing
monitoring of the placement, as well as a written annual review of
the Familyhome noting significant changes and compliance with agency
policies and procedures, including, relationship with client, ability
to meet ongoing needs of client, Familyhome perception of placement,
client's perception of placement, building, fire and health requirements,
and recommendations regarding placement;
• A method for determining suitable placement selection, including
consideration of compatibility of interests; cultural and linguistic
background; developmental, social, emotional, medical, spiritual,
education/daytime activity needs; client's abilities, strengths and
challenges; availability of recreational facilities and other services
as required;
• Problem resolution processes;
• Procedures for terminating the placement and/or service agreement
with the Familyhome provider (i.e., a provider’s retirement,
revaluation of the needs of the client); and
• Any other terms of the placement that the transfer payment
agency may consider appropriate.
GUIDELINE 2:
ROLES AND RESPONSIBILITIES
Transfer
payment agencies usually develop their own policies describing the
roles and responsibilities for the agency, the Familyhome provider
and the client. Some suggested roles that agencies may wish to consider
in developing these policies are noted below.
The
transfer payment agency is typically responsible for:
1.
Support:
• Providing
service/case coordination for the client;
• Developing, coordinating, and implementing an individual plan
for the client each year;
• Supporting the client to maintain contact with their family,
as appropriate;
• Meeting regularly with the Familyhome provider;
• Providing 24-hour emergency back-up to the client and Familyhome
provider;
• Assisting in the arrangement of planned and emergency respite
for the Familyhome provider;
• Providing respite or setting policies with respect to providing
respite to other Familyhome providers ; and
• Providing ongoing training and support to the Familyhome provider
and to the client's family, as appropriate.
2.
Supervision:
• Determining with the Familyhome provider the amount of supervision
and support to be provided to the client;
• Monitoring the use of the client’s personal funds on
a regular basis;
• Identifying/describing to the Familyhome provider acceptable
and unacceptable means of managing client behaviour ;
• Supervising and evaluating individual Familyhomes; and
• Assisting in the resolution of any concerns in the placement.
3. Administering
the program:
• Developing policies and procedures;
• Preparing and administering the program budget;
• Promoting the program;
• Reporting serious occurrences to the ministry;
• Approving and monitoring certain financial expenditures incurred
by the Familyhome provider and the client;
• Maintaining Familyhome provider and client files;
• Developing an individual plan for the client, in discussion
with significant parties;
• Liaising with ministry staff, community service providers,
health care personnel, educators, and other professionals; and
• Negotiating, facilitating, and promoting contact with the
client’s family.
4.
Recruitment and Placement:
• Recruiting and screening potential Familyhome providers;
• Identifying and screening potential clients;
• Making an appropriate match between the client and the Familyhome
provider; and
• Assisting the client and Familyhome provider in their initial
adjustment, through orientation, training, and regular contact.
Other
responsibilities as determined by the transfer payment agency, the
Familyhome provider, and/or the unique needs of the client.
The
Familyhome provider is typically responsible for:
• Providing a safe and secure living environment on a continuous
basis for the client;
• Providing a furnished bedroom (recognizing that the client
should have the opportunity to use his/her own furnishings in the
bedroom, if he/she wishes);
• Providing nutritious meals;
• Offering the client the opportunity for privacy;
• Assisting the client with health care, basic needs, and other
activities of daily living;
• Assisting the client to attend school, work and/or other daytime
activities, extra-curricular activities, and medical appointments;
• Providing a caring and supportive atmosphere that encourages
the client to participate in day-to-day activities in the home as
a member of the family;
• Providing opportunities, guidance, and direction that encourages
the client to become involved in the surrounding community;
• Enabling visits with the client’s family and friends,
as appropriate;
• Arranging for appropriate supervision for the client when
the Familyhome provider is absent from the home;
• Maintaining financial and program records for the client,
as required, and submitting receipts for purchases and/or services
made on behalf of the client, as required by the transfer payment
agency;
• Keeping all client information and records confidential;
• Participating in initial and ongoing training, Familyhome
meetings, and annual reviews of the Familyhome as requested by the
agency;
• Participating in the person-centred planning process and implementing
parts of the plan related to the client’s Familyhome placement;
• Advising agency staff of changes in the client’s behaviour,
medical or other care needs;
• Advising agency staff of serious occurrences;
• Informing the agency of any change in the family status; and
• Other responsibilities based on the Familyhome arrangement
and the unique needs of the client.
To
the extent possible, the client:
• Participates in pre-planning activities, the identification
of their individual needs, goals and supports required;
• Is involved with their family, as desired and/or appropriate;
• Participates in the activities of daily living agreed upon
with the Familyhome provider;
• Participates in planning meetings;
• Participates in the annual review of the Familyhome placement;
and
• Other responsibilities based on the Familyhome arrangement
and the client’s unique needs.
GUIDELINE 3:
ORIENTATION AND PRE-PLANNING PROCESS
It
is a best practice for transfer payment agencies to have written policies
and procedures in place that describe the orientation and pre-planning
process for Familyhome applicants, providers, and clients. The orientation
and pre-planning process provides essential information about the
special needs of the client and further screening for agency staff
and the potential Familyhome provider. Approval of a Familyhome provider
is generally facilitated when agencies require applicants to participate
in the agency’s orientation and pre-planning process. Orientation
programs will differ between Familyhome programs, however, the following
lists give examples of topics that could be addressed with potential
Familyhome providers and clients.
For
the Familyhome applicant/provider:
Review
of:
• A description
of the Familyhome program, including philosophy and goals, organizational
structure, regulations and procedures, the role of the agency, and
services provided;
• Agency policies and procedures, including complaints procedures,
serious occurrence reporting procedures, the Developmental Services
Act and its regulation, Child and Family Services Act and its regulations,
and the Children’s Foster Care licensing standards;
• Information on developmental disabilities, including what
a developmental disability is, causes, level of functioning, understanding
and awareness;
• Information regarding behavioural problems, medical concerns,
and sexuality issues;
• Understanding the importance of developing independence skills
and initiating community involvement for the client;
• Developing awareness of legal issues, such as liability and
the importance of confidentiality;
• Roles and responsibilities of the Familyhome provider;
• Impact of the client’s presence on the entire family;
• Working relationships with the transfer payment agency, other
service providers, the client's family, and significant others;
• Process for identifying supports required to assist with initial
adjustment such as pre-placement visits;
• Process and expectations to determine amount and type of initial
and ongoing supervision and support that will be provided, including
backup supervision and emergency and planned respite;
• Process and expectations for developing, implementing and
reviewing the individual plan for clients and agreements for service;
• Problem resolution process; and
• Client’s relationships with their family, peers, and
involvement in other community activity programs.
For
the client:
Review
of:
• Purpose
and goals of placement/program;
• Rights and responsibilities;
• Process and expectations concerning client input on activities
required to support:
- selection of placement;
- pre-planning process;
- initial adjustment; and
- ongoing participation in placement/program ;
• Problem resolution process; and
• Relationship to their family, significant others, and peers.
GUIDELINE 4:
INITIAL AND ONGOING SUPPORT
The
transfer payment agency typically provides initial training and ongoing
support to Familyhome providers. Such training may be provided on
an individual or group basis using techniques such as seminars, ongoing
consultation by transfer payment agency staff, Familyhome provider
meetings, information packages, use of other community resources,
and other appropriate means.
Transfer
payment agencies generally have written policies and procedures in
place that describe the initial and ongoing support that they will
provide to the Familyhome provider that could include:
For
the Familyhome provider:
• Assistance
in the initial adjustment of the client in the Familyhome setting;
• Types of, and the amount of supervision by agency staff;
• Regular and emergency contact with agency staff;
• Initial training, and ongoing training and support;
• Planned and unplanned (emergency) relief, including the roles
and responsibilities of the agency in responding to urgent calls for
assistance from the Familyhome provider;
• Networking with other Familyhome providers;
• Regularly scheduled visits to monitor and support the placement;
and
• Other supports to meet the unique needs of the Familyhome
provider and/or the client.
For
the client:
• Assistance
in the initial adjustment;
• Development of an individual plan;
• Service coordination with supports provided by the agency
(e.g., day programs, access to professional services, referrals) and
with other supports in the larger community;
• Monitoring the use of the client’s personal funds;
• Contact with their family, as desired and appropriate;
• Regularly scheduled visits to monitor and support the placement;
and
• Other supports to meet the unique needs of the client.
GUIDELINE 5: INSURANCE
Transfer payment
agencies may want to develop policies and procedures regarding expectations
for basic home/liability insurance for Familyhome providers. Generally,
the agency provides a letter of acknowledgement to the insurer to
confirm the number of clients residing in the Familyhome. A letter
of acknowledgement may also be provided by the insurer to the agency
to confirm that the Familyhome provider has home liability insurance
for the client(s).
GUIDELINE
6: CLIENTS' INVOLVEMENT WITH THEIR FAMILY
As
the client may continue to have a relationship with his/her family,
transfer payment agencies may want to develop written policies and
procedures that describe the nature of this involvement that could
typically include:
• Retaining involvement as desirable and appropriate in:
- selection of placement;
- pre-planning process; and
- ongoing planning and participation (i.e., visitation, communication,
participation in planning, and decision making);
• Ongoing support as negotiated with the agency (i.e., respite
to the Familyhome provider); and
• Agreement on roles, responsibilities, and expectations .
GUIDELINE
7: COMPLAINTS PROCEDURE FOR CLIENT AND FAMILYHOME PROVIDER
It
is a best practice for transfer payment agencies to have written policies
and procedures in place that describe complaints procedures for the
client and Familyhome provider. The policies and procedures need to
reflect relevant policy, legislation, and regulatory requirements
. Topics typically covered in a complaints procedure policy include:
• Circumstances that would warrant a complaint;
• Who is to be involved;
• How a review would be conducted, including timelines;
• Reporting requirements; and
• Process for informing individuals of the outcome.
GUIDELINE 8: ABUSE PREVENTION/PERSONAL SAFETY PROTOCOLS
Transfer
payment agencies should be concerned about the prevention of abuse
and would generally have written policies and procedures in place
that describe abuse prevention/personal safety protocols. Agencies
may wish to refer to the Ministry of Community and Social Services'
Prevention and Management of Abuse bulletin, legislation and regulatory
requirements when developing their policies. When abuse occurs, agencies
should have processes to deal with the situation and to address the
needs of the client and concerns of their family. Areas to consider
include:
For
abuse prevention:
Processes for:
• Screening and training of new staff;
• Investigating abuse allegations;
• The duty to report (for children);
• Informing individuals about abuse investigation;
• Risk assessment;
• Care policies (e.g., how to assist someone with the activities
of daily living in an appropriate way);
• Supporting client, Familyhome provider, client's family, and
others during an abuse investigation; and
• Informing individuals of the outcome of abuse investigation.
For
personal safety:
• Access to advocates (for children), guardians and complaints
process; and
• Process and method for determining appropriate level of supervision
and service required to promote the safety of the client.
GUIDELINE 9: PAYMENT TO THE FAMILYHOME PROVIDER
The
ministry supports the Familyhome program by providing funding to transfer
payment agencies that administer the Familyhome program and for adults,
by providing income and employment supports to eligible clients, as
appropriate.
Typically,
the adult client pays the Familyhome provider for accommodation and
basic needs (e.g., clothing, food). The transfer payment agency generally
tries to see that the client has funds to cover the cost of their
care, support, supervision, and related personal living expenses (e.g.
transportation, social and recreational outings).
It
is recognized that there are a range of agreements that transfer payment
agencies may have to reimburse their Familyhome providers. In appropriate
circumstances, a transfer payment agency may pay the Familyhome provider
on behalf of an adult client.
For
child clients, the transfer payment agency funds the Familyhome provider.
Additional financial support may also be provided by the child’s
family.
In
cases where the transfer payment agency is making payments on behalf
of the client they should have written policies and procedures in
place that describe payment for the Familyhome provider for the care
and supervision that they provide to the client. These policies and
procedures could include:
• The contribution to the payment made by the client (where
the client is an adult), or by the client’s family (where the
client is a child under 18);
• The daily or monthly payment rates to the Familyhome provider
by the transfer payment agency;
• Anything else specific to the agency (e.g., reimbursement
of the Familyhome provider for other costs, such as travel to client
medical appointments or out-of-pocket expenses).
GUIDELINE 10: MONITORING
Transfer
payment agencies will be concerned about the success of the Familyhome
placement and generally have written policies and procedures in place
that describe the ongoing review and monitoring process. These policies
and procedures could outline roles and responsibilities for the parties
involved in the Familyhome program. Agencies may wish to consider
the following roles when developing these policies and procedures:
The
Familyhome provider’s role typically includes:
Participation in an annual review of the home, that could include
discussion of the following topics:
• Interviews with all family members;
• An assessment of the support and training needs of the Familyhome
provider;
• Significant changes in the Familyhome;
• Supervision and care of the client;
• Involvement in the implementation of the client’s individual
plan, related to the Familyhome placement;
• Relationships with the client and agency staff;
• Compliance with the agency policies and procedures, and/or
the Children’s Foster Care Licensing Requirements (as applicable);
• Perception of the placement and feedback regarding the Familyhome
program;
• Renewal of the service agreement; and
• Other topics as determined by the transfer payment agency.
The
transfer payment agency's role typically includes:
• Review of the client’s individual plan and development
of a plan for the following year;
• Review of the Familyhome provider;
• Review of serious occurrence reports regarding any client
or Familyhome provider associated with the agency;
• Conducting an annual review as described above, home inspection,
and renewal of service contract with the ministry; and
• Other topics as determined.
The
client’s role typically includes:
Participation in an annual review, including:
• An assessment of the client’s needs and goals;
• Review and evaluation of the individual plan;
• Relationships with the Familyhome provider and agency staff;
• Relationships with their family and/or significant others;
• Perception of the placement and feedback regarding the Familyhome
program; and
• Other topics as determined by the transfer payment agency.
APPENDIX
A
USEFUL WEBLINKS
• Ministry
of Community and Social Services (for information on ministry programs
and contact information for regional offices):
http://www.cfcs.gov.on.ca
• Ministry
of Children's Services (for information on programs for children and
contact information for regional offices):
http://www.children.gov.on.ca
• Disability
Weblinks (for information on federal and provincial programs and supports
for people with a disability):
http://www.disabilityweblinks.ca
• Canada
Benefits (for information on federal and provincial financial assistance
programs):
http://www.canadabenefits.ca
• NADD
Ontario - Habilitative Mental Health Resource Network:
http://www.dualdiagnosisontario.org
• Fire
Marshal’s Public Fire Safety Council – Fire Safety Information:
http://www.firesafetycouncil.com/english/pubsafe.htm
• Ministry
of Municipal Affairs and Housing – Ontario Building Code Information:
http://www.obc.mah.gov.on.ca/scripts/index_.asp
• e-Laws
(access to provincial legislation and regulations, including the Child
and Family Services Act and the Developmental Services Act):
http://www.e-laws.gov.on.ca
ADDITIONAL
REFERENCE DOCUMENTS
Agencies
may request from their ministry regional office copies of the following
documents:
A. Prevention
and Management of Abuse Bulletin
B. Children’s Foster Care Licensing Requirements
C. Serious Occurrence Reporting Procedure
