outreach program guideline philosophy & approach...
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OUTREACHPROGRAMGUIDELINE
Philosophy&Approach
WearebuildingacommunityresponsemechanisminWindsor-Essex;anon-emergencymechanismthatnotonlynotices,butpaysattention,topeoplewhoarevulnerableorlivingatrisk.Wearebuildingasystemwhereourcommunity–whetheritisserviceproviders,institutions,orconcernedneighbours–willbeabletonoticeandoffermeaningfulsupportBEFOREacrisishappens.
RegistrationforOutreachSupport
Therewillbetwophonenumbersthatwillbeavailableforpeopleinthecommunity:
1) TheCompassionateCareRegistrationOfficeforinformationonneighbourhoodexchanges,intentionalcommunities,andtoregisterforCompassionateCareCoaching.
2) TheDistressCentreforpeoplewhoareindistressorareconcernedforsomeonetheynoticeinthecommunity
Eachofthesenumberswillprovideaccesstobothinformalandformalcommunityoutreach,andanyone-peopleneedinghelp,family,friends,neighbours,agencies,etc.-iswelcometocall.
OutreachResponse
Thefollowingmodelillustratesthecommunityresponseandoutreachoptions:
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TheCommunityResponseandOutreachOptionsdiagram(above)willbeusedasatoolfornavigatingwhichservicetheWECCCRegistrationOfficewillrefertobasedontheperson’ssituation:
• Forindividualslivinginpoverty,theywillbereferredtothepovertynetworkthroughtheleadcontact.1
• Forindividualswhoarechallengedbycultureandlanguagebarriers,theywillbereferredtotheRegistrationOfficetobelinkedtoanappropriateculturalTimeBanksorreferredtothemulticulturalnetworkthroughtheleadcontact(whowillutilizetheHealthEquityforNewcomersandImmigrants[HENI]serviceinventory)2
• Forindividualswhofrequentlyuseemergencyservicessub-optimallyordemonstratechallengingbehaviours,theywillbereferredtoservicesavailableintheircommunitythataredesignedtosupportthemtocontinuefunctioningassafelyandindependentlyaspossible,suchastheEmergencyMedicalServicesVulnerablePersonNavigator(EMSVPN).
1Theleadcontact,process,andresponseeachnetworkwillorganizetooffersupporttoapersonhasbeenoutlinedineachagenciespartnershipagreementwiththeWECCC.2TheHENIserviceinventoryisastandardizedandgovernedcollectionofcomplementaryservicesofferedwithinWindsor-EssexforNewcomersandImmigrants.
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Oncetheservicesreceiveareferral,theywillfollowoutreachprotocoltoconnectwiththepersonandoffertoreferthemtothelife-longcompassionatecarecoachingprogram,ortolinkthemtoothercommunityhelp.
OutreachPathway
FormalResponse
Formalservices(e.g.,communityprogrammingandsupportservices)willcomeintocontactwithpeoplewhoneedadditionalhelpinthedeliveryoftheirdaytodaywork.Thesearepeoplethat:
• Haveneedsthatextendbeyondthescopeofregularcasemanagementfunctions• Areisolated• Arelivingatapossibleriskforharmtothemselvesorothers• Frequentlyuseemergencyservices
FormalservicestaffwillcalltheCompassionateCommunityRegistrationOfficetoregistersomeonewhohasagreedtocoachingsupportorconnectthemtooutreachsupport.OncetheRegistrationCoordinatorreceivesareferral,theywillcontactthepersonandregisterthemtothecoachingprogramoroffersocial/practicalhelpfromtheirneighbourhoodiftheyhaverefusedcoaching.ForpeoplewhochoosenottobelinkedtoWECCC,theprovidercancontactFamilyServicesWindsortomakeareferraltotheSituationTable.
ReviewingCaseload
Formalserviceproviderswillreviewtheircaseloadtoidentifypeoplewhoare:a)inoneofthethreetargetpopulations,orb)haveneedsthatarenotbeingadequatelymetbecausetheyfalloutsidethescopeortimeframeofusualservices.Onceidentified,theproviderwilloffersupportasusualandoffertomakeareferraltocoachingsupport.Iftheclientchoosesnottoregisterforcoaching,theproviderwillinformtheRegistrationOfficewhowillsupporttheproviderwithcommunityhelpoptions(e.g.,neighbourhood-exchangesandintentionalcommunitycoordinators).
Referringpeopleincontact
Existingservices(e.g.,COAST,VPN,theDistressCentre,emergencyroomstaff,etc.)thatfrequentlycomeintocontactwithpeoplewhouseprogrammingoremergencyservicessub-optimallywilloffertoreferthevulnerablepersontotheWECCCRegistrationOfficeforcoachingortobelinkedtoothercommunitysupports.
InformalResponse
Neighbours,friends,family,andothercommunitymembersmaynoticesomeonewhoneedsextrahelporsupport.Iftheconcernedpersondoesnotfeelcomfortableorcapableofferinghelp,theycancalltheDistressCentreorvisittheWECCCwebsiteforcommunityresources.
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CallingtheDistressCentre
Usingtheinformationavailable,theDistressCentrewilltriagethereferraltothemostappropriatefirstcontact.Appropriatefirstcontactsareoutreachservicesthatcanknockontheperson’sdoorandcheck-inoroffersupport.Someoftheseoutreachservicesarewithinbuildingsalready(e.g.,LifeafterFiftyandAssistedLivingSouthwesternOntariooutreachbuildingsandCommunityUniversityPartnership)andsomeoftheseoutreachservicesarecommunity-based(e.g,COASTandEMSVulnerablePersonsNavigator).
TheoutreachservicewillreceivethereferralfromtheDistressCentreanddecideontheappropriatefirstcontactaction.Foroutreachservicesinbuildings,theoutreachworkerassignedtothebuildingwillvisitwiththepersontooffersupport.Community-basedoutreachserviceswillassignaworkertoconnectwithpeoplewhodonotliveinbuildingswithexistingoutreachstafforpeoplewholiveinhouses.Outreachworkerswillcheck-inontheperson,offertoreferthemtothelife-longcompassionatecarecoachingprogram,ortolinkthemtoothercommunityhelp.
UsingtheWECCCWebsite
TheProjectManagementOffice(PMO)willdevelopalistofneighbourhoodexchanges(TimeBanks)andIntentionalCommunityCoordinatorsservingeachpilotgeographythatwillbeavailableontheWECCCwebsitewithinstructionsonhowtoaccess.IfyouarereferringapersontotheneighbourhoodexchangesonTimeBanksoranintentionalcommunity,youcaneitheraccesstheinformationonthewebsiteorcontacttheRegistrationOffice.
ThePMOwillalsodevelopabrochurewhichwillincludeinstructionsonhowtoaccesstheavailableneighbourhoodexchanges(TimeBanks)andintentionalcommunitycoordinatorsineachpilotgeography.Thesebrochureswillbedisplayedinlocallibrariesandcommunityagenciessuchas:
• TheHospiceofWindsor-Essex• AssistedLivingSouthwesternOntario• Alzheimer’sSociety• CanadianMentalHealthAssociation• CommunityLiving,FamilyServicesWindsor-Essex• LifeAfterFifty• SouthEssexCommunityCouncil• Localmunicipalbuildings
SituationTable
HostedbyFamilyServicesWindsor,theSituationTableisacollaborativeresponsebetweenlocalservicesthatwillconsiderthecaseandcreateaplanforanappropriateengagementstrategy.Thisresponseexistsforwhenallotherattemptsatofferinghelpontheinformalandformaloutreachlevelsisnothappeningornothelping,orincaseswhereexistingcoordinationmaynotbeappropriateforlong-termsolutions.ThefocusoftheSituationTableistocreateacollaborativeresponsethatenhances
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theeverydaysupportthevulnerablepersonisreceiving(bothformallyandinformally),andisnotresponsibleforofferinganyintervention.
IntentionalcommunitycoordinatorsandotherinformalsupportswillcontacttheRegistrationOfficetorefersomeonetotheSituationTable.Formalsupports,likeusualservicesandothernetworkpartnerscancontacttheSituationTablecoordinatoratFamilyServiceWindsordirectlytorefersomeone.Onceareferralisreceived,theSituationTablecoordinatorwillopenarecordforthecase(identifiedbyinitials),determinetheappropriateattendees,andcallameetingwhereeveryonerelevanttothecasecontributestoaroundtablediscussioninordertoaddressthesituationanddevelopacoordinatedresponse.Participantswillincludetheinitialreferralsourceandmayincluderepresentativesfromfire,police,communityservices,publichealth,andothernetworkstaffthatareappropriatebasedonthesituation.Thesituationwillbebroughtforwardasacase,andnoidentifyinginformationwillbesharedatthetable.
OncetheSituationTablereviewsallpreviousoutreachattemptsanddiscussesanappropriateresponse,theywillupdatetheircaserecordandsupporttheworker(representingtheprogramorservicethepersonisattachedtoalready)toworkwithintheirprogramtorespondtotheneedsofthevulnerablepersonusingnewideasfromthecollaborativediscussion.Thisnewresponsemayincludesupportfromotherservicesthepersonhasnotbeenattachedtoyet.TheSituationTablecoordinatorwillestablishtheReportBackProtocol-taskingthepersonresponsibletoreportbacktotheSituationTablewiththeresultsoftheirdecideduponoutreach.
*Green=follow-upsupport(i.e.,originalreferringagency,VPN,COAST,etc.)
AttheSituationTable,discussionswillincludethingssuchas:
• Riskfactors• NeedforIntervention
o Purposeofintervention
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o Approacho Whowillleado Whichagencieswillbeinvolvedo Timeframetoreportback
• ReportBackProtocol
Movingforward,criteriawillbedevelopedthatwillhelpdeterminewhenasituationiseligibleforaSituationTableresponse.FigureCbelowillustratestheSituationTableProcess.
TheSituationTableProcess
• PROGRAMSANDSERVICESRECEIVEREFERRALSTHROUGHREGULARCHANNELSANDADDRESSTHEMTHROUGHREGULARMEANSINCLUDINGCOORDINATIONWITHOTHERS
IniaalResponse
• ANYUSUALSERVICECANSUBMITSITUATIONSTHATMEETELIGIBILITYCRITERIATOTHESITUATIONTABLE.PARTICIPANTSMUSTCOMEPREPAREDTOEACHMEETINGWITHUPDATESONALLTHEINTERVENTIONSPREVIOUSLYATTEMPTED.
• WECCCREGISTRATIONOFFICECANREFERTOSITUATIONTABLEIFPERSONREFUSESCOACHINGOROTHERCOMMUNITYSUPPORT.
ReferraltoSituaaonTable
• SITUATIONSAREPRE-SCREENEDBYSTAFFANDPRESENTEDTOSITUATIONTABLE.
SituaaonTableMeeang
• THESITUATIONTABLEREVIEWSPREVIOUSATTEMPTS
• THESITUATIONTABLEDECIDESONACOLLABORATIVERESPONSE
• THESITUATIONTABLERECORDSTHEIRDECISION
CoordinatedResponse
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