1. OCAN Education Training for OCAN Users Day 1

2. 22 Objectives Upon completion of the 2 day OCAN training session, you will learn: OCAN is a consumer-centred, recovery based assessment How to complete an OCAN assessment How to interpret and make use of information from OCAN in a variety of ways How to incorporate OCAN into the business process of your HSP organization

3. 33 Units of Instruction Instruction is standardized and consists of the following units: Unit 1: Overview Unit 2: OCAN Tools Unit 3: OCAN Outputs Unit 4: Reassessment Unit 5: Shared Assessment Unit 6: Business Process

4. 44 OCAN Training Agenda - Day 1 Welcome & Introductions Objectives Agenda Icebreaker Orientation to materials Unit 1 Overview Recovery Unit 2 OCAN Tool Application of OCAN Introduce to consumer Self-Assessment Conversation Staff assessment Wrap-up

5. 55 OCAN Training Agenda - Day 2 Welcome & Introductions Objectives Unit 2 –Application of OCAN cont’d –Staff Assessment – Scoring Activity Unit 3 –Outputs - Actions, Referrals, Reports Unit 4 –Timelines and Reassessment Unit 5 –Business Process Unit 6 –Shared Assessment Next Steps Evaluations

6. Icebreaker

7. Unit 1 Overview

8. 8 OCAN Vision

9. 9 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 client-led decision-making at an individual level Identifies individual needs and helps match these to existing services and identifies service gaps Provides aggregate data to inform agency, regional and provincial level planning and decision making that is consistent with a recovery approach Further facilitates inter-agency communication through common data standards 9

10. 10 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 Phase 3 - Implementation Provincial roll-out Integration with a changing CMH landscape Powerful reporting to drive enhanced consumer-centered service and system planning 2006 2008 Project Overview and Development 2010 2009 2011 2012 10

11. 11 Vision Health service providers are attributed to a consumer Track quantity of consumers receiving services Reports on Functional Centre Productivity / Efficiency Current Situation Consumer is attributed to each health service provider Reports on Consumer Outcomes / Effectiveness of Services Track quality of services accessed by consumers (met needs) OCAN Vision

12. 12 OCAN Benefits Healthier Ontarians Holistic consumer based approach Health conditions flagged Relevant information available for service planning Improved delivery of service Equitable Access Every door leads to service Standard approach to information gathering and sharing Sustainability Resource stresses and gaps identified Improved sharing of financial and statistical information

13. 13 Relevant Research Consumer defined unmet needs Focus on meeting needs Better clinical relationship

14. 14 Philosophy of Needs Assessment “If you only have a hammer, you tend to see every problem as a nail.” Abraham Maslow Maslow’s Hierarchy of Needs

15. Peer Educator Recovery and Assessment

16. 16 What is Recovery? A deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and roles. It is a way of living a satisfying, hopeful and contributing life even with limitations caused by the illness Anthony WA (1993) Recovery from mental illness: the guiding vision of the mental health service system in the 1990s Psychosocial Rehabilitation Journal, 16, 11-23

17. 17 Canada Goal 1: The hope of recovery is available to all A person-centred mental health system makes promoting recovery for people living with mental health problems and illnesses the focus of the organization and delivery of mental health services and supports. Through genuine partnership…all service providers share the hope and expectation that people they are working with can achieve a meaningful life in the community. Mental Health Commission of Canada (2009) Toward recovery and well-being, Calgary, AB: MHCoC.

18. 18 The Foundation: Beliefs and Values of Recovery Values Empowerment Consumer perspective and input is central to information gathered in OCAN and the determination of priority areas to work on. Values and Elicits Hope The OCAN tool includes open ended questions where consumers share and later discuss hopes and dreams. Values Self Determination OCAN focuses heavily on consumer-voiced needs, through the assessment of 24 concrete life domains. Works Toward the Elimination of Prejudice and Discrimination The OCAN approach views a consumer as a whole person and an active participant in the assessment process, not as a diagnosis (“patient”) Values Meaningful Choice Consumers engage with their workers to focus on their perspective in preparation for action and service planning. Source: Based on recovery principles from the Self Help Alliance

19. 19 BREAK

20. Unit 2 OCAN Tools

21. 21 Three Types of OCAN Full OCAN: This OCAN assessment contains the most elements of information in order to paint the most accurate picture of the consumer as possible

22. 22 Three Types of OCAN Core + Self OCAN: This subset contains both Consumer Information Summary elements, CDS elements, the Consumer Self-Assessment and the Service Use Record

23. 23 Three Types of OCAN Core OCAN: This subset of the assessment primarily consists of the Consumer Information Summary which includes CDS elements and the Service Use Record

24. 24 Consumer Information Summary Reason for OCAN Consumer Self-Assessment Completion (except core) Consumer Information

25. 25 Service Use Record Present situation The Current Service Use will be used to capture all internal programs that are supporting one consumer Vision The Service Use Record will provide information about all of the community mental health services, internal and external, that are supporting one consumer

26. 26 ConnexOntario Provides information to vendor to pre-populate the Service Use Record HSP organizations are responsible for keeping this information up to date: –Data and Information Services at ConnexOntario: Phone: (519) 439-0174 or 1-866-531-2600 Email: data_info_services_mhsio@connexontario.ca

27. 27 Application of Full OCAN

28. 28 Assessment completion period The assessment start and completion date should be within 30 days of each other Start date of assessment in the system is whichever is started first: consumer Self-Assessment or Staff Assessment

29. 29 OCAN Process Introduce OCAN - introduce the assessment to the consumer Introduction OCAN Part I Conversation OCAN Part II Introduce OCAN Part I Conversation OCAN Part II OCAN Part I - enable the consumer to complete the self- assessment Begin your conversation around the consumer’s needs OCAN Part II - complete the staff assessment with all the necessary information.

30. 30 LUNCH

31. 31 Introduction to Consumer Benefits for Consumers Provides opportunity for consumers to participate in assessment process and to voice their goals, hopes and dreams in a comprehensive assessment Links consumers to the most appropriate services based on their needs Ensures that individual risk has been assessed in a timely manner Reduces duplication of assessments

32. 32 Introduction to Consumer Review purpose of OCAN with focus on recovery Offer support Discuss confidentiality and consent Inform how assessment information will be used by health care worker, health service provider and system NB: Inform client when and where his comments will be used now and in the future

33. 33 Consumer Self-assessment Rating need

34. 34 Consumer Self-assessment Additional Questions Please write a few sentences to answer the following questions: What are your hopes for the future? What do you think you need in order to get there? How do you view your mental health? Is spirituality an important part of your life? Is culture (heritage) an important part of your life?

35. 35 Consumer Orientation As a group, brainstorm… What are the factors to consider when preparing to orient a Consumer to OCAN? 35

36. 36 Consumer Orientation Factors you may have considered: Language UsedLiteracy Level Mental StatusCognitive Status Privacy IssuesAvailable Supports Length of ExplanationTheir starting point Many others… 36

37. 37 Introduction Divide into groups: Come up with a script that you can use when introducing each other to the OCAN Assessment, considering these factors Debrief using questions provided and flip chart 37

38. 38 Let’s Practice! Individually: –Complete OCAN Self Assessment In a group: –Discuss debrief questions –Record on flip chart paper –Discuss with large group OCAN Part I Consumer Self-Assessment Practice! 38

39. 39 Engages the person with lived experience and the person with assessment knowledge in a conversation focused on the consumer’s strengths, weaknesses and goals for recovery. Assessment Conversation

40. 40 The Assessment Conversation Tips for successful assessment conversations: Create a mental map Be familiar with navigation & taking notes Variances Create safe, private supportive space Unfold naturally Summarize key points

41. 41 Assessment Comparison Self Staff Need rating 24 domains Help rating 24 domains Comments Additional questions Consumer information summary Actions and referrals Current Service Use Additional Data Elements

42. 42 BREAK

43. 43 OCAN Part II: Staff Assessment Score Need Score Help

44. 44 Scoring Need/Staff Assessment 0 = No need 1 = Met need 2 = Unmet need 9 = Not known OCAN Part II: Staff Assessment

45. 45 Scoring informal and formal help based on frequency and intensity of help 0 = No help 1 = Low help 2 = Moderate help 3 = High help 9 = Not known OCAN Part II: Staff Assessment

46. 46 Scoring Help, Question 2, 3a/b OCAN Part II: Staff Assessment

47. 47 Comments: Include all pertinent, “need to know” information Ensure that the information is thorough, objective, concrete and descriptive Comments should follow your guidelines for electronic documentation Comments are written for viewing by other service providers involved in supporting consumers Comments may capture historical information and collateral information OCAN Part II: Staff Assessment

48. 48 Actions: Actions are only recorded in the Staff Assessment Actions can be identified by the consumer or staff on either assessment or during the conversation The Actions field allows you to capture information about: mutually agreed actions in each domain who is responsible for completing the action timelines for completing and reviewing agreed actions OCAN Part II: Staff Assessment

49. 49 Hopes and Dreams: The staff summarizes or elaborates on the hopes and dreams that the consumer expresses in their self assessment or during the therapeutic conversation OCAN Part II: Staff Assessment

50. 50 Summary of Referrals At the end of the assessment referrals and status of the referral can be documented in this chart Optimal Referral SpecifyActual Referral SpecifyReason for Difference Status of Referral Drop down of functional centres Name ProgramDrop Down of functional centres Name ProgramSee Data Elements OCAN Part II: Staff Assessment

51. Examples of Domain Scoring of NEED

52. 52 Scoring Need Person is “couch surfing” and has been asked to move tomorrow Buys food and cooks nutritious meals at his apartment Irregular housekeeping has attracted vermin in otherwise clean building Client showers at YMCA and does laundry at peer support drop-in centre Client is afraid to leave their apartment & spends most of day smoking and watching television Type 2 Diabetes, client overweight, doesn’t follow diet or med. regime Chronic symptoms, moderately well controlled by meds dispensed daily by family Person has a good understanding of their illness and its treatment based on learning acquired after several years of living with illness 2 0 2 1 2 2 1 0

53. 53 Client effectively calls telephone distress centre several times per week Scheduled supervision for daily in home risk assessment & monitoring Receives 1-1 supportive therapy to identify triggers and coping strategies Caught driving while impaired after taking meds and too much alcohol Unconfirmed reports of client observed smoking crack cocaine Meets with court diversion since caught stealing re “pro-line” gambling habit Person frequently expresses intense feelings of being lonely and isolated Happy with life-long “best friend” who serves as her confidante Client and partner receiving counseling re: connection between, communication intimacy and sexuality in relationships; both acknowledge progress occurring Scoring Need 1 1 1 2 9 1 2 0 1

54. 54 Scoring Need ACT providing child care instruction, arranging for respite care & coordinating enrichment opportunities for children, Person receives support for respite time Extent of cognitive deficits unknown; awaiting psychometric testing Phone company will not provide service due to past debts Cognitive impairments cause him/her to get lost when using public transit Person under Public Guardian and Trustee services provided Person’s citizenship status in question; not eligible for many forms of aid 1 1 9 2 2 1 2