OUTCOMES MANAGEMENT 2016 - Results and Analysis - Richmond Society for ...
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OUTCOMES MANAGEMENT
2016
Results and Analysis
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Contents
INTRODUCTION .................................................................................................................................4
METHOD.................................................................................................................................................... 6
SURVEYS ................................................................................................................................................ 6
INTERVIEWS .......................................................................................................................................... 7
DOCUMENTATION REVIEWS ................................................................................................................. 7
SUMMARY OF RESULTS............................................................................................................................. 7
PARAMETERS and OMISSIONS .................................................................................................................. 8
DEMOGRAPHIC SUMMARY ................................................................................................................9
QUALITY OF LIFE DOMAINS .............................................................................................................. 10
External Stakeholders Feedback ....................................................................................................... 12
Infant Development Program ................................................................................................................. 16
Supported Child Development Program ................................................................................................. 22
Treehouse early Learning Centre ............................................................................................................ 32
Youth Connections .................................................................................................................................. 38
Respite .................................................................................................................................................... 44
Life Day Services...................................................................................................................................... 50
Outreach ................................................................................................................................................. 58
Independent Living ................................................................................................................................. 61
Home Share............................................................................................................................................. 62
Supported Living ..................................................................................................................................... 70
Employment Services/HandyCrew Cooperative ..................................................................................... 76
APPENDIX ........................................................................................................................................ 84
SUMMARY OF RECOMMENDATIONS 2016............................................................................................. 84
CITY OF RICHMOND POPULATION HOT FACTS ....................................................................................... 86
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INTRODUCTION
Richmond Society for Community Living (RSCL) has produced an Outcomes Management Report each year
since 2003. This is our 14th report which tracks the identified outcomes of our programs and services. The
information and analysis derived from the Outcome Management process is used to highlight areas of
strengths and identify areas requiring improvements. The annual Outcomes Management Report is part
of RSCL’s continuous Quality Improvement and Performance Management System.
The Outcome Management System is designed to provide essential information to RSCL’s Management
and Board of Directors in order to monitor and make improvements to service delivery. The results
reported through the Outcomes process supports RSCL’s Mission, Values and Vision Statements. It is
expected that the results will assist the staff at RSCL to be more responsive to the needs of the children,
youth and adults who live with a disability and their families who are served by the Society.
Throughout the years, the Outcome Management System has been refined: outcomes changed; survey
questions updated; indicators adjusted; processes for collection revised. In 2013, RSCL moved all of its
documentation to a new electronic system called Sharevision. This system is referenced many times
throughout this report as it serves as the main source for file reviews and data collection from daily
documentation.
The Outcome Management System was re-developed in 2014 using a self-assessment process which
identified areas of strengths, weaknesses, opportunities and possible threats to the services provided by
the Society. As well the internationally validated Quality of Life framework, developed by Dr Robert
Schalock, was referenced when developing the new outcomes and indicators for RSCL. This framework
measures quality of life in 3 areas:
Independence
Social participation
Well-being
These are further broken down into 8 domain areas of quality of life:
Emotional well-being – contentment, self-concept, lack of stress;
Interpersonal relations – interactions, relationships, supports;
Material well-being – financial status, employment, housing;
Personal development – education, personal competence, performance;
Physical well-being – health and health care, activities of daily living, leisure;
Self-determination – autonomy/personal control, personal goals, choices;
Social inclusion – community integration and participation, roles, supports;
Rights – legal, human (respect, dignity, equality).
Over the years indicators have been added to assist with a deeper level of analysis. However, during the
writing of this report it became apparent that the volume of information being gathered has become so
complex and overwhelming that it is impeding the ability to:
manage the workload required to input and follow through on all the data collection
analyze and respond to the volume of data collected
Consequently, it is recommended that the Outcomes System be re-evaluated with the intention of
simplifying and reducing the workload attached to data collection.
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RSCL’s vision is “a welcoming and connected community where everyone belongs. Each person is
confident sharing their gifts and contributions; living rich and fulfilled lives”. This vision is represented in
the outcomes for each of our 11 program areas:
Infant Development Program for families with babies and toddlers (0-3 years);
Supported Child Development for families with children and youth using child care (0-19 years);
Treehouse early Learning Centre – Preschool & Daycare (3 - 5 years);
Youth Connections – recreational program for school-aged children with special needs (6-19
years);
Respite for adults with developmental disabilities and children/youth with special needs (all ages).
LIFE Day Services for adults with developmental disabilities (19 years and older) ;
Outreach
Independent Living
Home Sharing for adults with developmental disabilities (19 years and older);
Supported Living (Residential Services) for adults with developmental disabilities (19 years and
older);
Employment Services and the Richmond HandyCrew Cooperative (19 years and older);
For each of these program areas, outcomes were identified and information collected in the following
four domains:
Satisfaction – what the people using RSCL programs think about the services they receive
Effectiveness – how well things work compared to the results expected
Efficiency – how well RSCL makes use of the resources available
Service Accessibility – how easy it is for people to get the services they need
Information is collected from all stakeholders (families, individuals, caregivers, funders, employers,
customers, professionals) through surveys, interviewing people and reviewing documentation.
Each year, the Board of Directors reviews the outcome results and approves all recommendations that
arise from the analysis and results. The outcome results are reported to the Society membership and
included in the RSCL Views (the Society’s newsletter), as well as an annual Quality of Life Report Card.
Recommendations from the Outcome Management process are included in the Business Improvement
Plan and addressed throughout the year by Society staff.
As a result of information gathered and analyzed over the years, we have made the following
improvements to RSCL Services:
Improved personal planning processes;
Established an Employment Service Department, including Supported/Customized Employment,
the Richmond HandyCrew Cooperative, and the Richmond Youth Employment Project;
Advocated for the expansion of early intervention supports for families, and explored alternative
funding sources for children’s services;
Modified programs to accommodate the unique and changing needs of the people we support;
Created and sustained regular communication with families and stakeholders, e.g. RSCL
Newsletter, Program Specific Newsletters, RSCL website, Facebook, etc.;
Developed a better understanding of the demographics of the people who access our services;
Offered a variety of assistance and support in the areas of life-skills, leisure and recreation,
volunteerism and job placements, with a focus on community and social inclusion;
Redeveloped Day Services and created LIFE Services where individuals have more flexibility in the
activities they engage in and the support they receive.
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Developed and improved data management processes in Sharevision.
METHOD
Three different methods were employed to gather information regarding supports and services provided
by RSCL: Surveys, Interviews and Documentation Reviews.
SURVEYS
Surveys were developed to solicit the opinions and perspectives of parents, relatives and/or long-term
caregivers who were involved in the life of a child, youth or adult who received services from the Society
within the 2016 calendar year. In order to solicit the input from as many people as possible, surveys for
applicable program areas were available in two languages (English and Chinese). Over the years, RSCL has
adopted different techniques in an attempt to increase the response rate. These include hand delivering,
emailing, mailing, and conducting on-line surveys.
Child care centres involved with RSCL through the Supported Child Development Program are also
surveyed.
73 External Stakeholders of RSCL were also surveyed to solicit their input. 24 responded giving a response
rate of 33% (19% in 2015).
In 2016, RSCL sent out a total of 763 surveys, with 279 returned. Although the response rates vary from
year to year for each program, there has been a steady decline in response rates in the last 5 years. The
agency response rate in 2016 was 37%. The survey results must be viewed as possible trends, but not
conclusive results.
Survey Response Rates per Program:
Program Surveys Surveys Response Response Response Response Response
Given Returned rate 2016 Rate 2015 Rate 2014 Rate 2013 Rate 2012
IDP 243 66 27% 21% 27.5% 48% 47.28%
SCDP – families 195 46 23.5% 28.5% 23.9% 32.9% 23.53%
SCDP – child care providers 46 12 26% 40% 23.3% 35% 39.53%
Treehouse 42 40 95% 63% 100% 89.8% 79.63%
Youth Connections 22 22 100% 100% 95.8% 100% 70.37%
Respite 56 8 14% 32.7% 26% 26.7% 27.12%
Respite Caregivers 20 interviewed 18.5% n/a n/a n/a
LIFE Day Services 91 57 63% 68% 84% 65% 50.91%
Outreach Included with LIFE Day Services 38% n/a n/a n/a
Independent Living 0 0 0 0 n/a n/a n/a
Supported Living 22 13 59% 33% 66.7% 50% 37.5%
Home Share 18 6 33% 40% 31.8% 47% 23.81%
Home Share Caregivers 16 interviewed 36% 33% n/a n/a
Employment Services/ RHCC 28 9 32% 20% 26.7% interviewed 38%
TOTAL 763 279 37% 35% 41.6% 47.7% 40.69%
External Stakeholders 73 24 33% 19% Interviewed
Surveys are submitted either in paper form or online. RSCL staff follow up with all surveys received that
have a less than favourable responses (below neutral). The purpose of the contact is to determine the
reason for the response and explore options to improve the respondent’s service experience, if possible.
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The timeline set for follow up was 30 days. Overall, the agency staff have met these targets. However,
not all surveys can be followed up on, as many are returned anonymously.
The time required to complete the Outcomes Management Report each year can take several months
(collecting and analyzing data). Surveys for the new calendar year are not available until the report is
complete in order to accommodate any recommendations for changes to the surveys. Therefore, there
is a period of time at the beginning of the year when surveys are not available to be distributed at planning
sessions. It is then the responsibility of the program supervisors to follow up with families that did not
receive a survey during the planning session to ensure that all families have the opportunity to provide
feedback.
INTERVIEWS
All adult individuals that were able to indicate their preference, verbally or by using any other
communication system (e.g. pictorial symbols) were interviewed. Both interviewers and participants
enjoyed this new format and the individuals indicated that they were comfortable and at ease with the
process. Although this process was successful, it is recommended that Supported Living explores more
options to customize the interview process in order to facilitate more fulsome feedback from individuals.
Customers of the Richmond HandyCrew Cooperative were telephone interviewed. Respite and Home
Share caregivers were also interviewed.
DOCUMENTATION REVIEWS
Existing documentation within the organization was used in some situations as the sole measure and in
other cases as an additional measure in conjunction with a survey/interview question. Sharevision is used
as the primary source of documentation for all individuals, programs and administrative documentation.
SUMMARY OF RESULTS
The RSCL Outcome Management System for 2016 included 112 indicators. 88 indicators had pre-
established targets of which 65 were met giving a 74% achievement rate. Not all indicators require targets
or analysis, some are for informational reporting only. In cases where it is appropriate for the indicator
to have targets, yet the indicator is new, targets are typically set after a minimum of 1-2 years of data.
Analysis and recommendations for improvements to the system are included for each program area,
including targets for indicators with no benchmarks.
PROGRAM # indicators # indicators # targets met
with targets in 2015
IDP 7 6 6
SCDP 13 8 6
Treehouse 5 4 3
YC 9 9 7
Respite 15 11 9
LIFE 12 10 6
Outreach 7 5 5
Independent Living - - -
Home Share 13 10 7
Supported Living 12 10 5
Employment Services /HandyCrew 19 15 11
TOTAL 112 88 65
74%
7|P a g eConsistent with previous years, RSCL proves to be an efficient, effective, and
accessible organization with whom all stakeholders are highly satisfied.
As a result of data collected and analysis conducted,
RSCL has made a positive difference
recommendations have been cited to adjust the outcomes
disagree/strongly 3% 3%
system as well as to help RSCL improve its effectiveness, disagree
efficiency, and accessibility. neutral
27%
The majority of families and individuals appear more than agree
satisfied with RSCL programs and services. Of the 279 67%
strongly agree
families that responded, 94% indicated agree or strongly
agree when asked if RSCL has made a positive difference in
the lives of their family member:
As a result of feedback from supported individuals over the years, in 2014 and 2015 an Easy Read Quality
of Life Report card was produced which summarized the results of the outcomes. This report card was
reviewed with individuals in their program areas and was appreciated by the individuals. This report
enabled the people we support to see how the feedback they provided is used to change or improve
services. A 2016 Easy Read Quality of Life Report Card will also be produced and again shared with the
individuals supported in all program areas.
PARAMETERS and OMISSIONS
Although the process was designed to solicit input from a broad range of people in order to capture the
opinions of a representative group, it is important to mention that some people may not be well
represented. Specifically, individuals who are not able to speak or communicate in ways that can be
clearly understood by others do not have a strong voice in the report. A second group of people that are
not well represented in the report are those individuals that do not have family involvement – especially
if the individual is also unable to communicate in ways that can be clearly understood.
Although the process adopted methods and practices consistent with empirical research, the process and
report do not conform to the stringent guidelines of empirical research practices. The final conclusions
contained in the report are based largely on information and opinions gathered from the surveys,
interviews and a review of specific documentation. That said, given that four stakeholder groups were
consulted by way of survey or interview and three methods were used to obtain information, RSCL is
confident that the results and conclusions do represent many commonly held beliefs and opinions of self-
advocates, families and other stakeholders regarding services provided by RSCL and, therefore can be
used to inform the Society of practices that successfully respond to the needs of the people we support
and highlight areas that require some improvement.
8|P a g eDEMOGRAPHIC SUMMARY
Gathering demographic information such as age, ethnicity, and medical RSCL Age Breakdown
diagnosis of all the individuals served throughout the organization 10%
3%1% 0-3
provides valuable information which helps to identify areas where 4-5
32%
perhaps more focus should be made as well as to ensure that we are 13%
6-19
meeting the needs of the cultural diversity of the city in which we provide
20-29
service.
30-49
Richmond has a diverse ethnic population. According to the Statistics 23%
18% 50-65
Canada 2011 National Household Survey, Chinese is still the prevalent
ethnic origin.
RSCL Ethnicity Breakdown
The ethnicity and first language breakdown for RSCL individuals is in line
with the city’s statistics. Caucasian 10%
Asian/Caucasian
Asian 6%
The variety of medical diagnosis of the individuals supported at RSCL is 30%
Aboriginal 3%
broad. Autism and Developmental Disabilities continue to be the most 1%
Indo-Canadian
common diagnosis for individuals supported through RSCL services. Chinese
Arabic 17%
Note: some individuals have more than 1 medical diagnosis therefore Unknown 6%
percentage is based on total served, not total number of diagnosis. Filipino
Other 5%
3% 19%
RSCL served 976 individuals in 2016. Some individuals attend more than
one RSCL program, therefore the total of individuals served per program
area is 1099. The overall growth of the agency has increased in terms of Medical Diagnosis of Individuals
served at RSCL
services delivered and funding received. However, demand for service
continues to outplace the increase in funding to provide new services. Prematurity
Autism
Moreover, the support needs for children services compared to support Developmental Disability/Delay
needs for adult services varies. Adults services typically require a much Cerebral Palsy
higher staff:client ratio. Consequently, a small number of new referrals Epilepsy
Challenging Behaviours
to adult services can have a greater impact on the agency and require Hearing Impairments
more funding than the equivalent number of referrals to children’s Mental Health
Mobility Issues
services. Visual Impairments
Down Syndrome
The following charts show the numbers served by the agency over a 6 Speech Delay
Gross Motor Delay
year period. These also appear in the RSCL Operations Report with a Pre-natal Substance Abuse
more complete analysis on the growth of the agency. Not Specified
Other
Program Area Breakdown 8%
Agency Gender Breakdown 26%
24%
45
24 43
IDP 331 303
20 8%
SCDP Females
105 2%
Treehouse 39% 5%
YC 22%
60
respite 31 19%
LIFE 46 Males 4%
Outreach 61% 4%3%
386 6%4% 3%
Independent Living 7% 7%
Home Share
Supported living
Employment Services
HandyCrew
9|P a g eTotal Program Count of Individuals Served 2011 – 2016:
1yr 6yr
2011 2012 2013 2014 2015 2016 change change
IDP 393 330 319 309 306 303 -3 -90
SCDP 374 329 334 386 367 386 19 12
Treehouse 55 55 51 51 54 46 -8 -9
YC 34 31 27 25 25 31 6 -3
Respite Children 42 42 39 36 32 35 3 -7
TOTAL CHILDREN 898 787 770 807 784 801 17 -97
Respite Adult 16 16 20 20 23 25 2 9
Avenues 27 26 28 29 25 25 0 -2
Quantum 14 23 28 31 28 28 0 14
Synergy 0 0 0 22 22 26 4 26
Pendleton 7 7 7 8 0 0 0 -7
Transitions 28 29 30 34 24 26 2 -2
LIFE Services* 76 85 93 97* 99 105 6 29
Outreach 0 0 14 14 18 20 2 20
Independent Living 0 0 0 0 3 3 0 3
Home Share 27 29 30 33 31 31 0 4
Supported Living 11 12 14 16 23 26 3 15
Employment
17 25 35 35 36 43 7 26
Services
HandyCrew 19 27 27 38 38 45 7 26
TOTAL ADULT 166 194 233 253 271 298 27 132
TOTAL 1064 981 1003 1060 1055 1099 44 35
* LIFE services is total count of 5 day services. In 2014, a reshuffling of individuals in each day service occurred with the opening of Synergy.
Total served in 2014 for LIFE services removed the duplicate program counts.
6yr change in Adult Services 6yr change in Children Served
multiple program count removed multiple program count removed
250 900
200 850
150 800
100 750
50 700
0 650
2011 2012 2013 2014 2015 2016 2011 2012 2013 2014 2015 2016
QUALITY OF LIFE DOMAINS
Many outcomes and indicators relate to the quality of life of supported individuals; the following
indicators are summarized in the 2016 Quality of Life Report Card that is produced in conjunction with
this Outcomes Management Report.
10 | P a g eEmotional Well Being Material Well Being
Individuals are satisfied with programs Employment Services helps individuals find jobs
and services. (satisfaction) (effectiveness)
Amount of time to get service. (service Employed individuals like their jobs (satisfaction)
access) Individuals are happy with their homes
Families trust RSCL staff. (satisfaction) (satisfaction)
Physical Well Being Self Determination
Individuals are safe at RSCL. (satisfaction) Individuals make choices in their homes
Individual’s needs are accommodated. Individuals are participating in activities that they
(service access) like
Personal Development Individuals enjoy the activities/families are happy
RSCL programs make things better for with the choices of activities
individuals and families. (satisfaction) Social Inclusion
Goal accomplishment (effectiveness, Individuals are involved in the community
efficiency) Youth have friends
Families know more about their child’s SCDP helps child care centres support children
growth and development (effectiveness) with extra support needs
Individuals have learned more about Children in child care centres are included with
available jobs (effectiveness) their peers
Interpersonal Relations Rights
Individuals like the people they live with Individuals/families get help when they need it
(satisfaction) (satisfaction)
Individuals like the staff that they work RSCL staff work with individuals and families in a
with (satisfaction) respectful way (satisfaction)
RSCL staff listen and communicate with Families are happy with staff skill and knowledge
families (satisfaction) (satisfaction)
11 | P a g eExternal Stakeholders Feedback
RSCL provides support and services to a variety of Respondent Relationship with RSCL
individuals and families in the Richmond community as 4% 4%
25%
demonstrated in each annual Outcomes Management Makes Referrals to RSCL 13%
Report. RSCL also works closely with other Service Provider
stakeholders that interact with the organization in a Professional Services
variety of ways including funders, other providers, 17%
Sit on a committee with RSCL
related professionals, community partners, CSSEA staff
contractors, etc. 73 professionals were emailed a City of Richmond staff 37%
satisfaction survey, 24 responded, giving a response
rate of 33% (19% in 2015). This is an increase from
previous years.
Overall, the responses were positive.
RSCL continues to be a community
organization that improves
everyday life for everyone in the
Richmond area.
Stakeholders were asked to rate their
agreement on the following statements:
1. RSCL is an effective advocacy
organization on behalf of children,
youth, adults and their families;
2. RSCL is continually improving the
services provided;
3. RSCL is well known in the community as
a high quality service provider and
leader;
4. RSCL staff are responsive in meeting
the needs of individuals and families
served by the organization;
5. Individuals and families rights are
respected by RSCL staff;
6. Communication with the RSCL program
staff is respectful and courteous;
7. RSCL program staff are professional
and demonstrate knowledge and
expertise.
All respondents, agreed or strongly agreed
or indicated neutral to the above
statements.
12 | P a g eSatisfaction was measured by the following questions:
1. Accessibility to RSCL services
2. RSCL communication regarding events and/or changes
All respondents indicated neutral, satisfied or very satisfied (5) with the above, with the exception of 1
indicating dissatisfaction with accessibility to RSCL services. The surveys were anonymous and follow up
could not be completed, however the comments were the following:
“Not enough access to services because of financial limits”
There were 6 respondents to satisfaction regarding the RSCL referral process; all indicated satisfied/very
satisfied.
“RSCL is a stellar agency and community leader and developer” ~ external stakeholder
When prompted to provide any areas where RSCL should apply more focus, or if there was anything
regarding their experiences with RSCL that were concerning, all 24 respondents indicated “no”.
Stakeholders were asked to describe RSCL using 3 words. The following words were provided:
Collaborative Effective Supportive Advocacy-oriented
Knowledgeable Inspiring Responsive Comprehensive
Professional Connecting Meaningful Value Based
External Stakeholders were also asked if there is anything that they felt RSCL should put more focus on
or attention in the coming years. Two responses were provided. Both responses were related to
advocacy and advocacy training.
When considering RSCL’s role in the community and the many ways in which RSCL staff work
collaboratively with the community, it is noteworthy to report the number of external committees in
which RSCL staff participate. Working on these committees helps create awareness in the community,
provides RSCL staff with an opportunity for additional training, knowledge acquisition and networking as
well as an avenue to share RSCL knowledge with the broader community.
Richmond Children First
Regional IDP Supervisors
Richmond Parent Support Group
IDP Local Advisory Committee
SCDP Local Advisory Committee
Richmond Advisory Council on Perinatal Issues
Western Canada Association of Infant Mental Health
Child Care Development Advisory Committee
Sharevision Lower Mainland User Group Committee
BC CEO Network
Richmond Community Services Advisory Committee (RCSAC)
Inclusion BC ED Network
BC Employment Development Strategy Network
University of BC, Centre for Inclusion and Citizenship
13 | P a g e University of BC Medial School
Community Social Services Employers Association (CSSEA) Board of Directors
Family Focus Planning Committee
Grade 13 Project Committee
Richmond Child Care Training Committee
Transition Committee
Networking Group
Richmond Autism Inter-Agency Committee
HR Practitioners
BC Coalition of Persons with a Disability Emergency Preparedness
Provincial Home Share Committee
Chamber of Commerce
It was recommended in the 2015 Outcomes Management Report to broaden the list of external
stakeholders to include members of these committees to provide feedback on their relationships with
RSCL. This was completed and an additional 12 professionals were added to the list.
14 | P a g e15 | P a g e
Infant Development Program
Infant Development provides support for families with infants and toddlers who have extra support needs,
a delay in their development, or who may be at risk of a delay.
In 2016, the Infant Development Program served 303 children IDP Referral Sources for children
age’s birth to three years. The program has a high turnover rate of served in 2016
children served, as many families only require service for brief
periods of time. On average, the program served 179 children in Community Agency (9)
any given month (ranging from 165 – 204 per month). In 2016 Family Dr (7)
MCFD (10)
there were 170 referrals, 155 intakes (139 intakes in 2015, 143
Other (2)
intakes in 2014, 241 intakes in 2013, 155 intakes in 2012) and 115 Other IDP (14)
discharges from the program. At the end of December 2016, there Pediatrician (57)
Self-Referral (37)
were 5 children waiting for service.
VCH - Children's hospital (27)
VCH - Women's Hospital (6)
IDP has an open referral policy and therefore, referrals are
VCH-Richmond Hospital (8)
received from doctors, hospitals, parents, etc. The adjacent chart Public Health Nurse (113)
summarizes the sources for the 2016 referrals. The majority of VCH-Audiology (2)
referrals are received from clinics, public health nurses and self- VCH-speech/language (5)
VCH-NICU (6)
referrals; referral sources will continue to be tracked to identify
1%2% 2% 3% 2%
trends. 3%
1%
4%
The average age of a child referred to IDP in 2016 was 10.5 months
(12.6 months in 2015) with 38% of them being 0-3 months old.
The age of children referred to IDP will continue to be tracked to
identify trends. 37% 19%
There were 243 satisfaction surveys distributed to families, 66
responded giving a response rate of 27%. With improvements
made to the survey process and more families providing email
addresses, we are hoping for higher response rates in the future. 12%
3% 2%
Demographic Information for the Infant Development Program: 9%
A random sampling of postal codes
(197 postal codes) were used to
Age at time of Referral
determine the areas of the city that
IDP families live. Comparing the unknown,
adjacent map with the City of 42, 14%
Richmond population density over
0-3mo,
information (see appendix), it appears 24mo, 34,
116, 38%
11%
that RSCL’s delivery of services reflects
the same density distribution as the city.
18-24mo,
36, 12%
11-17mo, 4-6mo, 23,
29, 9% 7-10mo, 8%
23, 8%
16 | P a g eGender Prematurity Medical Diagnosis
Autism
Challenging Behaviours 27%
29%
Hearing Impairments
Females, Mobility Issues
131, 43% Down Syndrome
Males,
Speech Delay
Gross Motor Delay 1%
172, 57% 2% 2%
Global Delay 1% 1%
1%
2%
Waiting for Diagnosis 1%
Not Specified 14%
Other 19%
Ethnicity First Language Program Status as at
8% Dec 31, 2016
19%
8%
8% 4%
2% 14%
6% 1%
1% 6%
17%
35%
7%
5% 61%
2%
38%
58%
Caucasian Asian/Caucasian
Asian Aboriginal Cantonese English Active
Indo-Canadian Chinese Follow Up
Mandarin Chinese
Arabic Unknown
On Hold
Filipino Other Tagalog Other
EFFECTIVENESS
OUTCOME INDICATOR(S) TARGET DATA SOURCE RESULTS
Families will gain knowledge of their child’s % of families who report increased 80% Family Survey 98%
development, strengths and areas where understanding of their child’s Target met
support is needed development
Families will gain knowledge of activities % of families who report increased 80% Family Survey 97%
and community resources that will awareness of services and resources Target met
promote their child’s development available to them.
Typically, families in the Infant Development Program are new to Community Living. Parents are often
overwhelmed with the knowledge that their child has or may have a disability. The IDP consultant plays
an important role for the family; just knowing they are not alone can comfort a new parent. The consultant
also helps by providing necessary knowledge and resources to better support their child. If families can
report that their knowledge and ability to support their child has increased, then the IDP program is
deemed to be effective.
66 families responded to the following questions: Since being involved with the RSCL IDP program I…
am more aware of what services and resources are available to my family – 97% agreed or strongly
agreed, 3% were neutral.
17 | P a g e know how to access the services I want for my
family – 92% agreed or strongly agreed. 6%
were neutral. 2% indicated N/A.
have more understanding about my child’s
development (strengths and areas where
additional support is needed) – 98% agreed or
strongly agreed. 2% were neutral.
have knowledge on how to adapt activities and
routines to my child’s development level – 94%
agreed or strongly agreed. 3% were neutral. 3%
indicated N/A.
Based on the survey responses, it appears that families feel better able to support their children as a result
of the Infant Development Program.
“We absolutely love Our IDP Consultant! She's been a great resource for our son's needs and has helped us understand ways to
help him. We are thankful for this service!” – IDP parent
“[Our Consultant] is a very reliable, patient person. She always gives us useful information and lets us know what our baby
needs. We learn how to improve our parenting skills and make everything better.” – IDP Parent
EFFICIENCY
OUTCOME INDICATOR(S) DATA SOURCE TARGET RESULTS
Maintain direct Number of total time Sharevision Family No year Direct Service All contact
service hours that is direct service. Contact Record benchmark (visits/phone calls) types
2014 1221.52 hrs 2193.37 hrs
2015 846.25 hrs 1456.65 hrs
2016 1183.47 hrs 1532.88
The Infant Development Program is contracted to provide support to 150 children annually. This year it
exceeded the expectations of the contract with the Ministry for Children and Family Development by
serving a total of 303 children. Given the unique needs of each family, consultants provide a variety of
services. Direct service includes face-to-face contact and phone calls, however there are many other ways
in which consultants engage with families including centre/clinic visits, emails, family workshops, etc. In
addition to direct engagement with families, some of a consultant’s time is spent on administrative work
such as report writing, research, home visit records, etc.
To distinguish the varying service requirements for families, IDP categorizes the level of service
requirement as the following:
Active – contact (email, home visit, telephone) with families at minimum once per month;
Follow Up – contact with families every two to six months;
On Hold – families away from Richmond for over 6 months, but would still like IDP services
when they return.
18 | P a g eThe outcome to determine efficiency in the
Service Hours IDP
program is to maintain direct service hours. The
PROGRAM STATUS
majority of service hours are provided to CONTACT TYPE FOLLOW ON
children/families who are categorized as active. (*=direct) ACTIVE UP HOLD unidentified TOTAL
Centre Visit* 33.50 1.08 0.00 0.00 34.58
The total number of service hours provided in
Clinic Visit* 42.33 0.00 0.00 2.00 44.33
2016 was 1532.88 hours (1456.65 hours in 2015).
Documentation 0.75 0.00 0.00 0.50 1.25
The adjacent chart summarizes the division of the
Email* 130.75 40.22 1.75 14.07 186.78
hours in terms of direct/indirect and contact
Fax 9.92 2.25 0.25 4.58 17.00
types. Prior to 2016, consultants were not
First Contact* 1.92 0.00 0.00 6.17 8.08
required to track all types of indirect service. In
Home Visit* 541.58 108.67 6.75 20.17 677.17
2016, an adjustment was made to the way in
Initial Visit* 68.17 1.00 1.50 41.17 111.83
which service records were recorded separating
indirect from direct service. This change was Letter 16.92 3.42 0.33 5.08 25.75
made in the latter half of the 2016 year and the Meeting 10.17 1.83 1.00 0.25 13.25
contact type category “other indirect” accounts Other 3.33 1.83 0.00 0.75 5.92
for this change in data collection. This includes Phone Call* 80.27 17.95 0.17 22.30 120.68
visit preparation, travel, writing records, Text Msg 0.58 0.67 0.00 0.08 1.33
reflective practice, resources, file set up and Other Indirect 248.58 33.83 2.50 0.00 326.25
other tasks not necessarily related to service. TOTAL hrs 1188.77 212.75 14.25 117.12 1532.88
In 2016, the funders adjusted the reporting
Direct hrs 898.52 168.92 10.17 105.87 1183.47
requirements; as a result of this it was difficult to
Indirect hrs 290.25 43.83 4.08 11.25 349.42
determine best practices in terms of service level
hours. The recommendation to do some research
regarding this was deferred to 2017 in hopes that more Service hour division of contact type
comparable data could be used. 2% 3% 0%
19%
12%
Another type of service provided that is not included in
1%
the direct service hours are workshops and events in 0%
1%
which families participate. These events help the families 8%
0%
learn new skills and meet other families in their 1%
2%
community. In 2016, the program hosted various
7%
workshops for families, such as:
44%
Make the Connection
Centre Visit (2.3%) Clinic Visit (2.9%)
Song and Rhyme Group Documentation (0.1%) Email (12.2%)
Visit at Community Drop-in play times to speak to Fax (1.1%) First Contact (0.5%)
Home Visit (44.2%) Initial Visit (7.3%)
families and answer questions they have about their Letter (1.7%) Meeting (0.9%)
children Other (0.4%) Phone Call (7.9%)
Text Msg (0.1%) Other indirect (18.6%)
Workshops on development and discipline in
partnership with community partners
RSCL Family Picnic
RSCL Holiday Party
19 | P a g eSERVICE ACCESS
OUTCOME INDICATOR(S) TARGET DATA SOURCE RESULTS
Families will have adequate Full time consultants maintain a caseload Caseload 25-35 Sharevision 31.03
access to their consultant of 25-35 families at any given time. Target met Consultant Report
Minimize wait time for Time from referral to intake 30 days Sharevision Program 32.85 days
accessing the program Target met History
Time from referral to start date 30 days Sharevision Program 9.6 days
Target met History
In order for a program to be accessible, families will have adequate access to their consultant and the wait
time for service is minimal. The average consultant caseload for 2016 was 31.03 (33.08 in 2015) children
served per consultant. The industry standard is 25 children per consultant. The RSCL IDP team has
consistently been able to manage a higher caseload than the industry standard.
The process of entering the Infant Development program consists of 4 specific dates:
Referral date – date the child is referred to IDP as defined on the referral form
First contact – date IDP contacts the family, typically by phone, to initiate service
Start Date – date an IDP consultant is assigned to the child/family
Intake Date – date the IDP consultant meets with the family to complete intake documentation
and determine service level
The average wait time for accessing IDP services is measured in the following ways:
1. Time from referral to first contact – 13.5 days (9.87 days in 2015)
2. Time from referral to start – average 9.6 days (6.64 days in 2015)
3. Time from referral to intake – average 32.85 days (25.66 days in 2015)
Of the 170 referrals, only 9 took more than 30 days before start of service. Although there was a slight
increase in the average number of days between referral and start, 9.6 days is well under the target and
the program should be commended for their ability to support families within short periods of time.
For the last several years, IDP has not had to maintain a waitlist for service. In 2016, the number of
referrals increased and at the end of the year there were 5 children waiting for service. In prior years,
Public Health Nurses were asked (refer to referral sources chart on page 14) to postpone referrals of
premature infants (with gestational ages of 33-36 weeks) to alleviate waitlists. In 2015, this referral
criteria was removed and therefore referral numbers saw an increase. The IDP waitlist will continue to
be monitored closely; advocacy efforts are also a priority for RSCL to increase funding for early
intervention services.
SATISFACTION
OUTCOME INDICATOR(S) TARGET DATA SOURCE RESULTS
The program will deliver services consistent % of families that report 80% Family Survey 100%
with a family centered practice approach satisfaction Target met
The Infant Development Program follows a family centered approach which entails respect, flexibility,
responsiveness, observance and understanding of the family’s needs. Families were asked the following
questions in order to determine their level of satisfaction with the program:
20 | P a g eMy IDP consultant:
Recognizes my child and family
strengths
Really listens to me when I have
concerns or make requests
Is flexible when my family’s situation
changes
Is responsive to my requests for
assistance in a timely manner
Provides me with the information I
need to be able to make informed
decisions
Helps me learn how to get the
resources I need/want for my child(ren)
Seems to have the skills and knowledge
to do the job well
98.5% of the families responded some,
most or all of the time to the above
questions. 1 family indicated rarely. A
name was not provided therefore follow up
could not be completed.
Families were also asked if the IDP services
have made a positive difference in their
lives. 94% agreed or strongly agreed, with 3% responding neutral and 3% (2 people) strongly disagreed.
One of the respondents did not provide a name, yet all other responses on the survey were favourable.
The other respondent indicated during the follow up that they had meant to say strongly agreed. 97% of
families would recommend IDP services to someone close to them, 3% said maybe.
“I'm impressed that this service exists and am grateful that it is so accessible.” – IDP Parent
“I really value IDP services and believe it's had a positive impact on my child's life. They are very flexible and accommodating to
my schedule.” – IDP Parent
Recommendations from 2015
1. Compare the population density in Richmond communities to ensure that RSCL is Completed
reaching out to all areas of the city.
2. Research with other community Infant Development Programs to determine what Deferred
appropriate level of direct service hours equates to best practice.
3. Adjust the efficiency outcome and indicator for IDP to track the varying levels of Completed
contact types.
Recommendations for 2016
1. Research with other community Infant Development Programs to determine what appropriate level of
direct service hours equates to best practice.
21 | P a g eSupported Child Development Program
RSCL’s Supported Child Development Program (SCDP) helps families of children with developmental
delays/disabilities to access inclusive child care. The program serves families with children from birth to
age 19 years, partnering with community licensed child care programs to offer a range of options for
Richmond families whose children require additional supports to attend preschool, day care and out-of-
school care.
In 2016, the program supported 386 children and approximately 82 child care programs in Richmond. As
at December 31, 2016 there were 288 children being served. Input from both families and child care
centres were solicited to report on the outcomes. 195 (235 in 2015) surveys were given to families in
2016 with 46 returned, giving a 23.5% response rate. At times, more than 1 child in a family receives SCDP
services; in these situations only 1 survey is provided. 46 Child Care Providers were also surveyed, with
12 returned, giving a 26% response rate. There are several child care programs in Richmond which are
operated by a single agency; in these cases a survey was sent to the managing agency and not each specific
child care program. However, the agency can decide to complete individual surveys per program if the
feedback being provided differs.
SCDP has an open referral policy. Consequently, parents may self-refer or referrals can come from
community professionals such as Infant Development Consultants, Speech Language Pathologists, Early
Childhood Mental Health Program, Occupational Therapists, Physiotherapists, Doctors, Psychologists,
Public Health Nurses and Social Workers. When a referral to the program is received, an initial intake is
completed to determine the need. The SCDP received 129 new referrals in 2016, of which 116 started the
program in the year. 104 children were discharged from SCDP (aged out of service, caught up to norm,
family decision, moved out of service area, moved onto Kindergarten or other reasons). At the end of the
year, 115 children were waiting for funding for extra support in a child care program and 104 children
were waiting for service from a Consultant.
Demographic information for the Supported Child Development Program:
A random sampling of SCDP families’ postal codes (250
postal codes) was used to determine the areas of the city
that SCDP families live. Comparing the adjacent map with
the City of Richmond population density information (see
appendix), it appears that RSCL’s delivery of services reflects
the same density distribution as the city.
It is recommended to extend the population density
information to include the locations of child care centres.
22 | P a g eGender Ages Ethnicity
Caucasian
0-3, 55, Asian/Caucasian 15%
Females, 6-19, 177, 14% 21%
94, 24%
Asian
46%
Aboriginal 8%
Indo-Canadian
5% 5%
Chinese
2%
Males, Arabic
291, 76% 4-5, 153,
40% Unknown
13%
Filipino 26%
Other 3%2%
Developmental Disability/Delay Medical Diagnosis
First Language
11% 14% Cerebral Palsy
9%
4% Epilepsy 1%
2% 1%
Challenging Behaviours 25% 4%
Hearing Impairments 2%
14% 3% *Note: Some
Mental Health
3% children have
Mobility Issues multiple
Visual Impairments 3%
diagnosis,
Down Syndrome 4% percentage is
55% Speech Delay 10% based on
Cantonese English number of
Waiting for Diagnosis children, not
Mandarin Chinese Not Specified 4% total number of
Tagalog Other Other diagnosis
31%
EFFECTIVENESS
OUTCOME INDICATORS DATA SOURCE TARGET RESULT
Child care provider’s capacity % of child care providers who Child Care Provider 80% Very Great Extent: 40%
to include children requiring report that SCDP’s involvement Survey Target met Great Extent: 30%
extra support will be has positively impacted their Moderate Extent: 20%
increased. ability to serve children No Extent: 10% (1 centre)
requiring extra support
Skills and abilities of the child % of families who report that Family Survey 80% Strongly Agree: 61%
will be increased as a result their child has increased their Target met Agree: 32%
their involvement with the skills and abilities as a result of Neither agree/disagree: 5%
SCDP program. their involvement with SCDP. Strongly Disagree: 2% (1
family)
Children will experience % of children that experience an Childcare inclusion 10% increase See below chart
inclusion in their childcare increased level of inclusion in Survey In
setting their childcare setting Sharevision
SCDP Consultants work collaboratively with child care programs as well as early intervention professionals
to ensure that every child receives the support required. Child Care Providers were asked to what extent
their involvement with the Supported Child Development Program had increased their ability to support
children requiring extra support. 90% (95.5% in 2015) indicated to a moderate, great or very great extent.
1 Centre indicated to no extent however no name was provided for follow up. Although there was a slight
decline in the results, no recommendation is cited.
SCDP Consultants offer planning, training, resources and hands-on support to Child Care Centres in an
effort to increase their ability to serve children requiring extra support needs. As summarized under
Service Access, Centres are making use of these services.
23 | P a g eAnother outcome of the program is that skills and abilities of the children served will increase. Families
were asked if their involvement in SCDP had a positive effect on their child’s lives. 91% strongly agreed,
agreed or indicated neutral. 1 family strongly disagreed with this statement, however upon follow up it
was determined that this family completed the survey twice indicating different responses. All other
responses were favourable, so it was assumed that it was a mistake.
This past year, consultants conducted a survey in the Child Care Centers to measure the level of inclusion
the children experience in the Centre. To measure any improvements, the survey was intended to be
conducted twice per year. The following chart summarizes the results from the initial survey conducted
in the fall of 2015 (22 checklists completed) and in the spring of 2016 (7 checklists completed). Given the
limited number of surveys completed, an improvement rate cannot be determined. It is recommended to
explore how to increase the number of checklists being completed each year.
Observation 2015 (22 surveys) 2016 (7 surveys)
Yes No Yes No
The Centre adapts their program and activities to include children receiving SCDP 100% 100%
services
Staff interact with all children, including those requiring extra support 100% 100%
Centre provides daily opportunities to foster peer interactions 100% 100%
Centre works in partnership with families and community professionals 100% 100%
Each child receiving extra support in the Centre has an active Child & Family Support 76% 24% 43% 57%
Plan (CFSP)
The Centre was included in the planning of each CFSP 96% 4% 100%
All staff at the centre understand the contents of all CFSP’s 84% 16% 71% 29%
The Centre has an inclusion policy 76% 24% 71% 14%
From observations in the Centres, some examples of how the Child Care Centres create a place of
inclusion are:
Seating some children in smaller groups where there is less distraction
Sensory activities
Providing extra space for additional activities
Removing items from the classroom that are overwhelming
Visuals for routines and schedules
Warnings before transitioning between activities
Using resources provided by SCDP
Having a flexible routine
Adjusting lighting in the space
Taking regular breaks when needed
EFFICIENCY
OUTCOME INDICATORS DATA SOURCE TARGET RESULT
Maintain adequate Number of total hours provided Sharevision Family Record No benchmark Total 2397.10
service levels per service category hours
Number of hours per contact Sharevision Family Record No benchmark See chart below
type
The Supported Child Development Program is contracted to support 270 children annually. This year it
exceeded the expectations of the Ministry for Children and Family Development by serving a total of 386
children. An efficient program is one where adequate service level hours are maintained; where families
and Child Care Centres are receiving sufficient amounts of service despite funding limitations.
24 | P a g eDirect Service hours include contact with families, Centre visits, meetings with professionals and more. In
2016, 2397.10 hours (1981.28hrs in 2015) were recorded by the Consultants as Direct Service Time. The
adjacent chart summarizes the types of contacts made in 2016. In some cases, SCDP is simply the funding
source and direct service is not provided by the Program.
Given that every child served requires a different level of service, Service Hours per Contact Type
SCDP categorizes the requirement level (program status) as the Centre Visit
following: Email 3% 5%
5% 21%
Home Visit
Active – a child and family who is currently receiving services 11%
Meeting
from the program on a regular basis
Other
Monitoring/follow up –a child and family who is currently 3%
Phone Call
receiving services or consultation from the program on an
Intake 26%
occasional basis usually initiated by a consultant.
Report Prep 25%
On-Hold – children who are currently not accessing child care, 1%
Resources
are waitlisted for funding and/or a child care space, or the family
is taking an extended break from
child care and/or who only need Service Hours per Category
transitional support.
2000.00 1853.70
Summer/School Breaks Only – 1800.00
children who access services only 1600.00
during school breaks 1400.00
1200.00
The adjacent chart demonstrates that the 1000.00
800.00
majority of Direct Service Time is for active
600.00
children. Direct Service time is also 400.00
162.46 151.61
recorded for children waiting for SCDP 200.00 15.88 45.45 66.32 26.15 75.53
0.00
services (program status not specified) as Active Follow Up Monitoring On Hold Not Yet School Summer Not
communication with family and some Receiving Breaks Only Specified
Service Only
documentation is still required.
It is difficult to determine what constitutes an adequate amount and type of
Program Status as at
service given the complexities of the types of services needed. It is also Dec 31, 2016
challenging to compare the different levels of service between children given 12%
the varying service needs of each child. Consultants will continue tracking
11%
service requirement levels and service hours. A target will not be established
until additional years of data are acquired to see if there are any trends. It was
recommended in the 2015 Outcomes Management Report to do some research 14% 60%
with other community Supported Child Development Programs to determine
3%
what appropriate level of direct service hours equates to best practice; an
Active
inquiry was made, however a fulsome discussion was not completed. Therefore Follow Up
it is recommended to glean more fulsome information from other community On Hold
SCD programs regarding appropriate amounts of direct service hours. Monitoring
Breaks Only
Early Intervention Services in BC are significantly under-funded, as evidenced
by the waitlist numbers, and even those receiving services often are in need of additional supports. The
average caseload for Supported Child Development in 2016 was 53 children per consultant, consistent
25 | P a g ewith the previous year, but an increase from subsequent previous years. As per the Program Status chart,
40% of children were not active (at December 31), therefore these children require less consultant time
which helps alleviate the demand of carrying a heavy caseload. That said, the high caseloads put an
increased demand on consultants and led to less direct support. RSCL has been in the forefront of a
provincial advocacy campaign to increase funding for early intervention services.
SERVICE ACCESS
OUTCOME INDICATORS DATA SOURCE TARGET RESULT
Minimize time to enter Wait time between initial referral and first visit Sharevision No benchmark 187 days (171 in 2015)
program from SCD to family and/or child care program
Child care provider’s % of child care providers who access resources File Review 80% 43 child care centres = 52%
access to requested / including toys, equipment, information Target not met X
needed resources as % of child care providers who access File Review No benchmark 24 child care centres = 29%
appropriate to the training/workshops
child’s needs will be % of child care providers that receive extra File Review No benchmark 63/82= 82%
increased. staffing resources.
Due to funding limitations, Supported Child Development carries a waitlist. At the end of 2016, 115
children were waiting for funding (has been seen by a consultant yet waiting for funding for extra support
in a child care program) and 104 children were waiting for service (consultant support).
The outcome to measure accessibility into the program is the time between referral and intake (start date)
into the program. Of the 116 children that started SCDP services in 2016, the average time from referral
date to start date was 187 days (171 in 2015, 213 in 2014). Limited funding is the primary cause of the
delay. There may be spaces available in a child care program yet no funding to provide the extra support
needed and therefore the child remains on the waitlist. As indicated above, RSCL has been in the forefront
of a provincial advocacy campaign to increase funding for early intervention services.
Another measurement used to determine accessibility of the program is the extent Child Care Centres are
accessing resources available to them from the Supported Child Development Program:
1. Child Care providers accessing resources
43 of the 82 Child Care Centres served by SCDP accessed various resources (including the lending
library) in 2016. In 2016, SCDP made use of a lending library software application to assist in the
management of the inventory. It is recommended to explore options within this application to
retrieve statistical data regarding the number of centres making use of the library.
Child Care providers were asked on the survey if they were satisfied with the physical resources
available to them by the SCDP, of the 11 respondents 73% were satisfied or very satisfied and 9%
were neutral and 18% indicated N/A.
2. Child Care providers attending training/workshops
In 2016, the Consultants hosted 19 workshops for Child Care providers (13 in 2015). Total number
of participants was 369 (187 in 2015). SCDP provides workshops based on identified needs of the
child care centres including building capacity so that they can support more children in the future.
In 2016, additional consultants were trained to provide specific training to child care centres.
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