1. OCAN Education Core Training

2. First, a little bit of background…

3. 3 Why the OCAN Aboriginal Support Validation? The Evaluation of OCAN in Aboriginal Programs in the North East LHIN (Sutherlaand Maar) recommended improvements to the use of OCAN in Aboriginal settings. An Aboriginal Working Group was formed to address the evaluation findings. The Evaluation of OCAN in Aboriginal Programs in the North East LHIN is available online at www.ccim.on.ca !

4. 4 Recommendations The Aboriginal Working Group developed recommendations related to the following categories*: –Aboriginal Engagement –Education and Training –Administrative Supports and Processes The Aboriginal Working Group Report is available online at www.ccim.on.ca !

5. 5 Recommended OCAN Aboriginal Supports The OCAN Aboriginal supports include: –Aboriginal-specific training materials, such as case studies, training binders, consumer pamphlet, etc –Aboriginal Education Specialist to deliver training and support to validation participants –Aboriginal Subject Matter Expert to address questions pertaining to Aboriginal landscape and issues

6. 6 What is the OCAN Aboriginal Support Validation? The purpose of the OCAN Aboriginal Support Validation is to evaluate the recommended OCAN Aboriginal supports to determine their impact on the cultural appropriateness of OCAN delivery within Aboriginal populations

7. 7 Guiding Principles for the Validation Culturally appropriate –Respects Aboriginal culture and incorporates the principles of cultural competency and cultural safety Consumer-centred –Acknowledges the Aboriginal consumer’s role in the assessment process; takes a ‘wholistic’ approach Flexible to accommodate cultural diversity –Aware of the distinctiveness of each Aboriginal population (e.g., First Nations, Inuit and Métis; on-reserve and off-reserve; urban, rural and remote) Collaborative –Guided by Aboriginal Health Service Providers and transparent to the Aboriginal population in general; respects the spirit of principles related to ownership, control, access and possession of data (OCAP)

8. 8 As participants in the validation, you will… Contribute to the development of Aboriginal-specific training materials and supports for OCAN Guide recommendations for future OCAN implementation in Aboriginal settings Network with other community mental health organizations providing service to the Aboriginal community Take advantage of the implementation supports available through CMH CAP

9. 999 Objectives Upon completion of this OCAN training session, the participant will: Be able to define the type(s) of OCAN and understand which type will be used by their Health Service Provider (HSP) Be able to accurately complete the core elements of OCAN Be able to communicate the importance and benefits of accurate completion of Core to Aboriginal stakeholders

10. 10 OCAN Training Agenda Welcome & Introductions –Objectives –Agenda –Icebreaker –Orientation to materials Introduction to OCAN Types of OCAN Mental Health Functional Centre Use Benefits of Core OCAN Elements of the Core OCAN Q & A Evaluations

11. Icebreaker

12. Orientation to Materials

13. Introduction to OCAN

14. 14 OCAN Vision Every Door is the Right Door – Towards a 10-Year Mental Health and Addiction Strategy, July 2009

15. 15 Aboriginal Working Group Vision / Principles Culturally appropriate Consumer-centered Flexible to accommodate cultural diversity

16. 16 What is OCAN? Ontario Common Assessment of Need (OCAN) is a standardized, consumer-led decision making tool that allows key information to be electronically gathered in a secure and efficient manner. Assists consumer-led decision-making at an individual level Identifies consumer needs and helps match these to existing services and identifies service gaps Provides aggregate data to inform organizational, regional and provincial level planning and decision making that is consistent with a recovery approach Further facilitates communication among HSPs through common data standards 16

17. 17 Phase 1 – Initiation (with stakeholder representation) Analysis of many assessments tools Selection of a core tool – Camberwell Assessment of Need Province-wide consultations to introduce the tool Formation of working groups Phase 2 - Pilot Piloting of the automated OCAN in 16 community mental health service providers Early learnings gatherings NE LHIN Implementation pilot Evaluation of OCAN in Aboriginal Mental Health Programs (Sutherland-Maar) Phase 3 - Implementation Formation of Aboriginal Working Group (AWG) Provincial roll-out Integration with a changing CMH landscape Powerful reporting to drive enhanced consumer-centered service and system planning Validation process for AWG recommendations 2006 2008 Project Overview and Development 2010 2009 2011 2012 17

18. Types of OCAN

19. 19 OCAN 2.0 There are three (3) “types” of OCAN: The CORE OCAN consists of the Consumer Information Summary and the Mental Health Functional Centre Use The CORE + Self OCAN consists of the Consumer Information Summary elements, the Consumer Self- Assessment and the Mental Health Functional Centre Use The Full OCAN consists of the Consumer Information Summary, the Consumer Self-Assessment, the Mental Health Functional Centre Use and the Staff Assessment The CORE OCAN consists of the Consumer Information Summary and the Mental Health Functional Centre Use The CORE + Self OCAN consists of the Consumer Information Summary elements, the Consumer Self- Assessment and the Mental Health Functional Centre Use OCAN-BR-1OCAN-BR-1.1OCAN-BR-1.2

20. Do you know your OCAN type

21. 21 Full OCANCore OCAN Assertive Community Treatment Case Management Clubhouse Early Intervention Social Rehabilitation/ Recreation Support within Housing Short-term Residential Crisis Support Beds Peer/Self-help Initiatives Crisis Intervention Community Mental Health Clinic Eating Disorders Day/Night Care Counseling and Treatment Diversion and Court Support Dual Diagnosis Psychogeriatric Forensic Vocational Employment Concurrent Disorders Functional Centre Use of OCAN T he Provincial Consumer Working Group recommends the use of Core + Self OCAN for Peer / Self-Help initiatives as a peer-to-peer recommendation ! OCAN BR-4

22. 22 Benefits of Core OCAN Collecting Core OCAN information in a consistent way creates richer data to: Better understand the Aboriginal consumer and their situation Provide a common understanding of Aboriginal consumer information for all HSPs to describe service recipients and progress Acknowledge the involvement of all functional centres within an HSP that provide services to the consumer Understand changes in an Aboriginal consumer’s circumstances over time by completing reassessment every six months

23. Core Elements

24. 24 Core OCAN Elements - Overview Consumer Demographic Information Mental Health Functional Centre Use Contacts Consumer Capacity Culture, Aboriginal Origin and Citizenship Current Legal Status Accommodation Employment Status Education level Psychiatric History Income Presenting Issues COMP-BR-1, 2

25. 25 Core OCAN Elements Within an OCAN there can only be one OCAN Lead The OCAN Lead can be decided by your HSP. It may be the person most involved with the consumer, the one selected by the consumer or the one completing the fullest OCAN If a consumer is involved with more than one functional centre within the HSP, only the OCAN Lead would complete the Core OCAN The other functional centre(s) provide input to OCAN Lead to facilitate completion of Core OCAN These other functional centre(s) are called Contributing Providers DATE-BR-1,2 OL-BR-1, 4, 5, 6

26. 26 Reason for OCAN

27. 27 Initial OCAN An “Initial OCAN” is only completed by the OCAN Lead An Initial OCAN is completed when: –the consumer is new to the Community Mental Health system –the consumer has re-entered the Community Mental Health system more than 3 months after a discharge –an existing consumer has been in your HSP less than 3 months An “Initial OCAN” starts the 6-month reassessment cycle 27 IA-BR-1OCAN-BR-5REAX-BR-6

28. 28 Reassessment A “Reassessment” OCAN is completed every 6 months by the OCAN Lead – This is referred to as the Reassessment Cycle It is also completed: –On the six-month reassessment cycle if consumer has re-entered the Community Mental Health system less than 3 months after a discharge –When an existing consumer has been in your HSP more than 3 months and has not completed a previous OCAN –When a consumer is receiving CMH services elsewhere and you are starting OCAN for that consumer. 28 REAX-BR-1-6 HB-BR-1, 2 OT-BR-3, 4, 5

29. 29 (Prior to) Discharge (from HSP) 29 HSPs are encouraged to have a conversation with the consumer just prior to discharge to ensure their most up to date needs are documented A (Prior to) Discharge OCAN is conducted by the OCAN Lead when the consumer is discharged from ALL the functional centres within an HSP When completing a (Prior to) Discharge OCAN, the exit disposition and exit date should be captured in the Mental Health Functional Centre Service Use DX-BR-1, 2, 5 DX-BR-3, 4 HB-BR-1, 2 DX-BR-6OT-BR-7

30. 30 Significant Change This is optional. The choice about doing a Significant Change assessment resides with the HSP A Significant Change OCAN does not change the assessment cycle A Significant Change is not included in aggregate system level reporting It is completed by the OCAN Lead OCAN may be completed when up-to-date collateral information is required to make a referral 30

31. 31 Other This is optional. The choice about doing an “Other” assessment resides with the HSP An example of an “Other” reason for assessment could be ‘consumer request’ For any “Other” reason for assessment, the staff records the reason 31

32. 32 Review or Re-key? Review You receive a paper copy of a consumer’s OCAN –You are entering information from OCAN but are making updates to the consumer’s current situation –The reassessment cycle remains the same Re-key You receive a paper copy of a consumer’s OCAN –You are entering information exactly as it appears on the OCAN –You are rekeying to have an electronic copy of the assessment in your local system –The reassessment cycle remains the same

33. 33 Review A Review OCAN does not change the reassessment cycle. It can be conducted when a functional centre receives an OCAN from another functional centre within the same HSP and updates fields to reflect the current consumer situation when they enter it into the system Important: When entering a Review OCAN into the system, the start and end dates should be the dates that the “Review” was entered in your system and not the start and end dates of the original assessment 33 CFC-BR-1

34. 34 Re-key A Re-key OCAN is completed within a contributing functional centre and it does not change the reassessment cycle Re-key OCAN is conducted when a functional centre receives an OCAN from another functional centre and does not update any of the fields when they enter it into their own system Important: Original start and end dates do not change 34 CFC-BR-1

35. 35 Summary: Reason for OCAN Completed by OCAN Lead and data submitted –Initial OCAN –Reassessment –(Prior to) Discharge –Significant Change –Other Completed by Contributing Provider and data not submitted –Review –Re-key

36. 36 POP QUIZ 1.Steve was discharged from your program five months ago. To your knowledge, no other HSP has been doing OCAN during this time. You are about to complete an OCAN. Which reason for OCAN would you choose? 2.You have been seeing Mary in your case management program for the last year. You are now implementing OCAN in your HSP. Which reason for OCAN would you choose?

37. 37 POP QUIZ 3.George is referred to your Functional Centre from another service within your HSP. His OCAN Lead had provided George with a copy of his most recent OCAN. George brings this OCAN to your first meeting. Your HSP’s policy is for you to have an electronic version of OCAN in your system. Your service uses a different software. Unless you enter this OCAN you won’t have access to view it on your system. Which reason for OCAN would you choose?

38. 38 Reassessment Cycle

39. 39 Start Date Assessment 1 May 1/11 30 Days Max 6 M O N T H S Initiating the Reassessment Cycle Once the start date is chosen, the end date is 30 days from the start date. The next assessment happens 6 months from the start date of the previous assessment. End Date Assessment 1 May 30/11 Start Date Assessment 2 Nov 1/11 End Date Assessment 2 Nov 30/11 DATE-BR-1REAX-BR-2OCAN-BR-3UP-BR-1 Initiating

40. 40 Start Date Assessment 1 May 1/09 Sustaining the Reassessment Cycle Regardless of any “Other” or “Significant Change” OCANs completed between scheduled reassessments, the reassessment cycle remains the same. Start Date Reassessment 1 at 6 months Nov 1/09 Start Date Reassessment 2 at 12 months May 01/10 Start Date Reassessment 3 at 18 months Nov 1/10 “Other” “Significant Change” DATE-BR-1REAX-BR-2OCAN-BR-3UP-BR-1 Sustaining

41. 41 Resetting the Reassessment Cycle The reassessment cycle follows the completion of the fullest OCAN. The reassessment cycle is reset when a new service begins with a second functional centre that must complete a Full OCAN – the reassessment cycle remains the same even if the consumer exits service from the second functional centre – the Core/Core + Self assessor would maintain the new reassessment cycle. Start Date Reassessment 1 at 6 months Nov 1/09 Start Date Other Assessment 1 Nov 15/09 Referral to a 2 nd functional centre that is required to complete a Full OCAN Ax Cycle is Reset Start Date Reassessment 1 May 15/10 6 month Ax Cycle continues as initiated by 2 nd FC through to service completion* Start Date Reassessment 2 Nov 15/10 6 month Ax Cycle continues as initiated by 2 nd FC through to service completion* 6 M O N T H S 15 DAY GAP Start Date Assessment 1 Core Ax or Core + Self Ax May 1/09 OT-BR-1, 2 Resetting

42. 42 Change in type of OCAN 42 Start Date Assessment 1 May 1/09 FULL OCAN Start Date Reassessment 1 at 6 months Nov 1/09 FULL OCAN Start Date Reassessment 2 at 12 months May 01/10 FULL OCAN Start Date Reassessment 3 at 18 months Nov 1/10 CORE OCAN Consumer ends service from Full OCAN FC. The Core OCAN FC continues to provide service and completes a Core OCAN from this point forward. Reassessment cycle remains the same. The reassessment cycle is maintained even if a consumer does not continue a service with Full OCAN or Core + Self. If a consumer no longer accesses service from the Full or Core + Self functional centres and only maintains service from the functional centre that completes a Core OCAN the reassessment cycle stays the same. Full to Core OCAN Reassessment Cycle Consumer also receives service from Core OCAN FC. This FC is a contributing provider to the Full OCAN Consumer also receives service from Core OCAN FC. This FC is a contributing provider to the Full OCAN

43. 43 POP QUIZ 1.You start an OCAN for Mary on January 15th 2010. When is the start date for her 6 month reassessment? 2.You complete an OCAN for Cynthia on July 15th. Her next 6 month reassessment is scheduled in January. Cynthia drops out of your HSP on August 1. She decides to return to your HSP at the end of November. When do you complete her next OCAN ? What other information do we need to decide what reason for assessment to choose?

45. 45 Core OCAN Elements DATE-BR-4

46. 46 Core OCAN Elements SUB-BR-1 OL-BR-2, 3 MHFCU-BR-1, 2, 3

47. 47 Core OCAN Elements My Cheat Sheet My Organization LHIN : My LHIN My Organization Name: Sunny Community Centre My Organization Number: 1234 My Program Name:Sunny Days My Program Number:6789 My Functional Centre Name:Social Recreation My Functional Centre Number:725 10 76 81 CFC-BR-2OT-BR-6 EXIT-BR-1, 2

48. 48 ACTIVITY – Functional Centre Use Read the Scenario 1 in the user manual Complete the Functional Centre Use form in the user manual Using Scenario 1 information supplied Debrief as a large group

49. 49 Core OCAN Elements

50. 50 Core OCAN Elements OT-BR-1, 2

51. 51 Core OCAN Elements

52. 52 Core OCAN Elements

53. 53 Core OCAN Elements

54. 54 Core OCAN Elements

55. 55 Core OCAN Elements

56. 56 Core OCAN Elements

57. 57 ACTIVITY – Housing Definition Scenario 1 Joe is new to your HSP and he tells you about various parts of his life. Joe also tells you that he lives with his parents in their home and does not pay rent. Refer to the User Reference Guide to identify the housing type in the scenario above

58. 58 ACTIVITY – Housing Definition Scenario 2 Susan has been in your HSP for several years. You are now completing Core OCAN in your HSP. Susan lives in ValleyView Adult Care facility which is funded by the Municipality and privately owned and operated. Refer to the User Reference Guide to identify the housing type in the scenario above

59. 59 Core OCAN Elements

60. 60 Core OCAN Elements

61. 61 Core OCAN Elements

62. 62 Test your Knowledge: Mike had worked in the past, but is unable to at present, so receives Canada Pension Plan Disability (CPP-D). His medications are expensive, so he has been able to receive a top-up from Ontario Disability Support Program (ODSP). What is his primary source of income ? Core OCAN Elements

63. 63 Core OCAN Elements

64. 64 ACTIVITY – Wrap Up Read the Core OCAN in the User Manual In small groups, using the information in the Core OCAN, create an understanding of the consumer’s situation from Core OCAN Debrief as a large group

66. 66 Available OCAN Aboriginal Support Validation Resources Resources Your Change Team OCAN Implementation Guide OCAN Learning Materials –For Staff –For the Coordinator Train the Trainer Manual Quick reference guides Consumer support materials Supports Member section on CCIM website www.ccim.on.cawww.ccim.on.ca Project Support Centre 1-866-909-5600 cmhcap@ccim.on.ca cmhcap@ccim.on.ca OCAN Knowledge (OK) Café 66

67. Evaluations

68. 68 Thank You!