The Centralized Wait List

Toronto now has a centralized wait list system for people who have indicated that they need a residential placement (group home, supported independent living, etc.), a structured day setting of some sort (known as Community Participation Supports or day programs) and a need for a Family Services Worker (also known as a case manager, a case coordinator or other similar titles).  All the services which one can access through the centralized list are funded by the Ministry of Community and Social Services.

Toronto has long wait times for all of the above services.  This is because none or very few new spots are being funded in day programs or housing.  As people in the children's sector of developmental services become adults, they are assessed by the DSO and then put on the wait lists.  Additionally, when people with developmental delays move to Toronto, they are also placed on the wait lists.  The only way that spots in residential settings or day programs become available is either when a current resident/participant passes away or if they move out of town or, in the case of day programs, they quit attending.

The centralized wait list was known as the Resday list.  It is now known as the Community Needs List (CNL).  Fortunately, when it comes to housing, the List is prioritized based on a client's needs and not on a first-come-first-served basis.  This means that a person who is living with his elderly parents could be somewhere in the middle of the list for a long time.  However, if his elderly parents passed away tomorrow, there is a way for the list to take this changed situation and need into account and consequently, the person's name would move towards the top of the list.  So the needier a client is for supports, the higher their name goes on the list.  This is a simplified explanation of the wait list system because it is only a part of the equation which matches an individual to a residential or day program opening.

The other side of the equation is that, not only does a client have to have a demonstrated need for a placement, but a client must also be a good match for the spot that has opened up.  In other words, putting a client who is vulnerable by virtue of being confined to a wheelchair and being non-verbal, in a group home with one or more aggressive clients would not be a good match as it would leave the person in the wheelchair open to being the target of aggression.

In order to make the matching of clients to vacancies as fair as possible, there is a scoring system or matrix which assigns a certain number to each relevant piece of information in the client's personal profile which informs the List.

In order to check the details of a profile or to update information of a profile, a person needs to call their lead agency and ask for their, or the profile of the person under their care, to be updated.  Keeping the information on the profile which informs the list up-to-date is the job of the lead agency.  Most agencies probably don't get around to updating this profile as often as they should due to a large number of clients for whom they are responsible and a shortage of staff to complete such a large task.  So, it is better for you or a family member to update the profile with the help of your lead agency once a year or when a significant change takes place.

List of Toronto Agencies

There are thirty-seven agencies which are officially listed as belonging to the developmental services sector in Toronto.  These agencies are funded for the most part by the Ministry of Community and Social Services.  A list of these agencies can be found at the Developmental Services Ontario (Toronto Region) web site. Here is a copy of the list with links to their own web sites:

1. addus
2. Bob Rumball Centre for the Deaf
3. CARD
4. Christian Horizons
5. Common Ground Cooperative
6. Community Association for Riding for the Disabled
7. Community Living Toronto
8. Corbrook
9. CORE
10. COTA Health
11. Family Service Toronto
12. Frontier College
13. Geneva Centre
14. Goodwill
15. Griffin Centre
16. Harmony Place
17. JVS Toronto
18. Kerry’s Place Autism Services
19. L’Arche Toronto
20. Mary Centre
21. Meta Centre
22. Montage
23. Muki Baum Treatment Centres
24. New Leaf
25. New Visions Toronto
26. Operation Springboard
27. Participation House
28. Pegasus
29. Reena
30. Salvation Army Booth
31. Salvation Army Broadview Village
32. Society of St. Vincent DePaul
33. Surex Community Services
34. Surrey Place Centre
35. Unison Health and Community Services
36. Vita Community Living Services
37. Woodgreen Community Services

Services? What Services?

While there is a dearth of resources in the developmental services sector in Ontario, there are also many services already present that other less fortunate areas of even the developed world do not have. And, more importantly, there a great many good people working to make the present system responsive to people's needs.
So now that you have managed the first hurdle of passing eligibility with the Developmental Services Ontario (DSO) office, what kinds of services are available for a developmentally delayed adult in Toronto?

Follow this link for a list of the different Categories of Services. If you follow this link, you can look at the complete list of services on the left hand side, under the "developmental services in Ontario" tab.
Broadly, services can be broken down into 5 areas:

1. Residential Supports -- These include group homes, Supported Independent Living (SIL) arrangements, individually funded placements, creative placements which rely of several individuals pooling resources funded by the Ministry of Community and Social Services)
2. Respite Supports -- These include overnight stays in designated group homes, day time stays at group homes or designated day programs (Community Participation Supports), individually funded (again, by the Ministry) respite worker support paid by families directly to workers. There are supports/guidance available from the office of respiteservices.com.
3. Community Participation Supports -- This includes the use of any daytime agencies or activities for a developmentally delayed individual. Services such as attending a program with Parks and Recreation Toronto, supported or competitive employment, attending daytime programs for work, recreation and/or skill building, etc.
4. Professional and Specialized Services -- This category of services is handled by a few of the agencies in Toronto (37) in the developmental services sector. Agencies that provide clinical services (psychologists, psychiatrists, occupational therapists, behaviour therapists, etc.) do this in either in an office setting, at a day program, in a hospital or at a group home and lastly, in the "community." Community being a persons home or anywhere else that is private and appropriate to meet a person to conduct an assessment or follow through on treatment.
5. Lastly, Person Directed Planning: This is another service which is delivered by a small number of agencies with people trained to meet with and help direct a process of planning with a delayed individual and their support circle (family/friends/service providers) to help plan for the future of that individual. These plans are usually graphically based (drawn on large sheets of paper, with only the most necessary use of words) to make the plan as client directed and understandable for the individual for whom the plan is being drawn-up.
6. There are other categories of support offered but these are for a very narrow proportion of the people served in developmental services and I will leave an explanation of that topic for another post.

Developmental Services Ontario

Developmental Services Ontario (DSO) is an agency run by the Ministry of Community and Social Services. In Toronto, the agency happens to be located at Surrey Place Centre in downtown Toronto. There are 8 other DSO centres. To find the DSO centre which serves your area you can follow this link.

What does the DSO do? If you or a person you care for has not had any contact with the developmental services sector in Ontario then you will have to begin by contacting a DSO centre in your area. If you receive ODSP, have received services through a community living agency or other agencies funded by the Ministry of Community and Social Services before July 1, 2011, then you do not have to go through the DSO. Simply call the agency you were last in touch with and they should be able to help you access any services you require. Usually, this is an agency known as your lead agency. Lead agencies are your first point of contact for any services you or someone you care for is looking to access. Anyone entering adult developmental services through the DSO in Toronto is considered to have the DSO as their lead agency.

The DSO -- Step-by-Step:

1. You (or someone you care for) call a DSO centre, they respond by taking your basic information; a critical piece of information requested at this stage is evidence that you or a loved one are eligible for services. Usually a Psychological Assessment is needed to determine if someone meets the definition for having a developmental disability. The document responsible for setting the criteria for eligibility for services is the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act (2008).

2. At your first meeting with a DSO worker you will be asked a lot of basic questions and these will be added to your previous information. The form being filled out at this stage is called an Application for Developmental Services and Supports (ADSS) form. To learn the more details about the ADSS go here.
3. At your second meeting with a DSO worker they will help to complete a form known as the Supports Intensity Scale (SIS). This form is to help the DSO to find out what kinds of supports are needed by an applicant. Do you need a day program? Do you have complex medical needs? Will you need to apply for ODSP and then additional funding? This is what the SIS is supposed to determine. You can find more details about this form here.
4. Last Step -- A report known as Assessor Summary Report (ASR) is prepared from all the information gathered highlighting the most significant details/needs from your previous meetings.
5. A worker from the DSO will be responsible for directing you to agencies that will connect you with needed services.

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