Component: IHWS – Curative and Rehabilitative Care

Legislation: Ministry of Community and Social Services Act

Program Goals

  • Indigenous youth, adults, and families can access culturally safe bed-based treatment closer to home, in a timely manner
  • Service providers increasingly offer access to Indigenous healing methods and cultural practices in their mental health and addictions supports for clients
  • Improved mental health and wellness in Indigenous communities

Service Objectives

  • Provide culturally safe bed-based mental health and addictions treatment services for First Nations, Métis, and Inuit peoples using a combination of Indigenous healing and therapeutic approaches to improve the overall health and wellness of individuals, families and communities
  • Indigenous MHA Treatment & Healing Centres form part of Ontario’s multi- Ministry response to the Truth and Reconciliation Commission (TRC) Report and to priorities raised by Indigenous partners in Ontario

Service Description

  • Indigenous MHA Treatment & Healing Centres provide culturally relevant and trauma-informed care using a combination of Indigenous healing and clinical approaches, connected to a bed-based treatment model
  • Treatment models vary according to the needs of the community served, although each Centre must provide access to a medically supervised or traditional detoxification (detox) or withdrawal management option for people withdrawing from substances who require a safe and supportive environment (either through direct provision of services or through a partnership with another service provider)
  • Programs may include the addition of mobile, land-based, and/or community- based programs connected to an existing bed-based treatment model
  • Programs address one or more of the following priorities identified by Indigenous partners:
    • Community Healing Models to Address Sexual Abuse
    • Community Wellness, including programming that addresses or leads to community wellness, prevention and early intervention programming, wellness promotion and education programs
    • Addressing Gaps in the Continuum of Opioid Replacement Therapy, including addressing gaps in the continuum of treatment for individuals withdrawing from the use of opiates, Indigenous approaches to withdrawal management and stabilization, and cultural supports for individuals in withdrawal management programs
    • System Transformation and Coordination, including programming that addresses the broader social determinants of health, interdisciplinary approaches to healing, programs that support coordinated systems of care built around client needs and strengths, and programs that support partnership and collaboration
    • Workforce Development and Continuity, including programs that support workforce continuity, programs that support and promote the wellbeing of front-line workers, and staff training opportunities
    • Responding to Gaps in Service Across Lifecycle, Geography, and Jurisdiction, including programs targeted towards a specific age group, population segment, or geography

People Served

  • First Nations, Métis, and Inuit youth, adults and/or families

Program / Service Features

The program/services contracted by the Ministry will reflect the following features

  • Indigenous MHA Treatment & Healing Centres are designed, managed and delivered by and for Indigenous peoples
  • Indigenous knowledge and practices provide the foundation for the development of programming and the delivery of care
  • Treatment for mental health and addictions issues is provided using a combination of Indigenous healing and therapeutic approaches
  • Treatment models are aligned with relevant First Nations, Métis, and Inuit Mental Wellness Models and Frameworks
  • Programs are connected to a bed-based service delivery model, which involves the provision of safe temporary residence (accommodation and food) and support services
  • Individuals who are withdrawing from substances have access to a medically supervised or traditional detox or withdrawal management option, either on-site or through partnerships with local service providers
  • Treatment models will reflect the following principles:

    Family and Community: Services for individuals are considered in the context of family and community. Family and community members are involved in the healing journey of clients to support return to a positive family and community environment and sustain the gains made through treatment
    Community Development: Programs help to build capacity within communities and contribute to long term wellness within Indigenous populations in Ontario

    Trauma Engaged: Programs support clients to heal from historical, current, and intergenerational trauma they have experienced

    Land Based: Programs use land-based healing methods to deliver care and address client needs

    Strengths Based: Programs and services utilize and build on the strengths of Indigenous individuals, families and communities to deliver care and address client needs

    Continuity of Relationships: Programs and services support the continuity of relationships over time and across jurisdictional, geographical and service divides

Specific services may include

  • Intake, screening, and assessment services
  • Pre-treatment programming
  • Treatment models specialized for families, youth and adults
  • Bed-based services, defined as the provision of safe temporary residence (accommodation and food) in conjunction with support services
  • Substance use disorder services and treatment
  • Medically supervised detox or withdrawal management services delivered on-site or through partnerships
  • Wholistic mental health counselling Individual, family and group therapy
  • Indigenous healing practices and cultural supports, including teachings, traditional medicines, ceremonies, healing circles and support groups, and land- based activities
  • Coordination of care and care planning, including referrals
  • Post-treatment supportive programming and aftercare
  • Expanded day programming
  • Community wellness activities focused prevention and health promotion, such as workshops, community and cultural events, land-based activities, and public awareness and education campaigns
  • Training and capacity building opportunities for front-line workers, including programs that support and promote the wellbeing of front-line workers and assist them in meeting their own healing needs

Reporting Requirements

Year-end narrative report

  • MHA Treatment & Healing Centres are required to submit a year-end narrative report to the ministry. The template is available for download in Transfer Payment Ontario
  • Service partners can highlight participant feedback on programs and services and use participants’ own words when possible
  • Narrative reports can include creative forms of communication and reporting, including audio, visual, oral and/or written formats

Service Data

  • The following service data will be reported on at an Interim and Final stage. Please refer to your final agreement for report back due dates and targets.
Service Data Name Definition

# of Individuals: Received Bed-Based Services: MHA T&HC

Unique, or unduplicated, count of individuals (including dependents/children) that received bed-based services during the reporting period, which includes safe, temporary residence (accommodation and food) and support services (e.g., substance use services and treatment, on-site medically supervised or traditional withdrawal management (detox), mental health counselling, referrals, traditional healing services and cultural supports).

Each unique individual is counted only once per reporting period even if they received multiple services. If the individual carries into the next fiscal year, the individual is counted again in the new reporting period. Only individuals accessing bed-based, client-specific services provided through the Indigenous MHA Treatment & Healing Centre program are counted under this data element. Individuals who only access non-bed-based, client-specific services are excluded from this data element.

# of Individuals: Received Non-Bed-Based Services: MHA T&HC

Unique, or unduplicated, count of individuals (including dependents/children) who received non-bed-based treatment and healing services.

Non-bed-based services may include intake, screening, and assessment services; pre-treatment programming; day programming; post-treatment supportive programming and aftercare.

Each unique individual is counted only once per reporting period. If the individual carries into the next fiscal year, the individual is counted again in the new reporting period. Only individuals who access non-bed-based (day programming) provided through the Indigenous MHA Treatment & Healing program are counted under this data element. Individuals who access bed-based, client-specific services are excluded from this data element.

# of Group Activities: Non-Bed-Based Programming: MHA T&HC

The total number of group activities for individuals participating in non-bed-based programming supported through the Treatment and Healing Services Program during the reporting period. Each activity held in the reporting period should be counted as 1.

If a group activity for individuals participating in non-bed-based programming is jointly organized/funded with another IHWS program, only one program should report the group activity (to be decided by the service provider). The program that reports the group activity for individuals participating in non-bed-based programming should also report the total number of individuals who attended that group activity under the “Number of Non-Bed-Based Individuals: Accessed Group Activities: MHA T&HC”.

If group activities for individuals participating in non-bed-based programming are not provided through your IHWS-funded program, put “0”. See Service description for further details and examples of group activities.

# of Non-Bed-Based Individuals: Accessed Group Activities: MHA T&HC

The total number of non-bed-based individuals who took part in group activities offered through the Treatment and Healing Services during the reporting period. The same individual can be counted more than once if they participate in more than one group activity in the same reporting period. The total number of unique participants for each group activity is added to calculate the total number of individuals who took part in non-bed-based, group activities in the reporting period. For example, if an individual attends four group activities in a reporting period, count four (4).

If a group activity for individuals participating in non-bed-based programming is jointly organized/funded with another IHWS program, only one program should report the group activity (to be decided by the service provider). The program that reported the group activity for individuals participating in non-bed-based programming (to be decided by the service provider) is responsible for reporting the total number of individuals who accessed the group activity for individuals participating in non-bed-based programming under this data element. Do not include participants of the group activities that were not reported in “Number of Group Activities: Non-Bed-Based Programming: MHA T&HC”.

If group activities for individuals participating in non-bed-based programming are not provided through your IHWS-funded program, put “0”. See Service description for further details and examples of group activities.

# of Beds: MHA T&HC

The total number of beds dedicated for bed-based services to the MHA Treatment & Healing Centre program during the reporting period. The total number of beds includes the spaces that are and are not occupied at the time of count, including IHWS-funded withdrawal management/detox services. The following types of beds are counted:

  • Beds funded by MCCSS; and
  • Beds funded by other revenue (e.g., fundraising) but dedicated for use for IHWS clients

The following beds are NOT included in the count:

  • Beds funded by other programs (e.g., homelessness); and
  • Alternate settings (e.g., overflow beds, cots, hotel rooms, cribs, etc.)

# of Bed Days Available: MHA T&HC

The cumulative number of spaces available and staffed each day to provide services during the reporting period. The total spaces available each day of the reporting period are added to find the cumulative number of bed days available during the reporting period. The following types of beds are counted:

  • Beds funded by MCCSS; and
  • Beds funded by other revenue (e.g., fundraising) but dedicated for use for IHWS clients

The following beds are NOT included in the count:

  • Beds funded by other programs (e.g., homelessness); and
  • Alternate settings (e.g., overflow beds, cots, hotel rooms, cribs, etc.)

This data element is intended to show the organization’s capacity to provide service. Spaces or beds that cannot be staffed or spaces closed for renovations or other reasons, such as public health, that are unavailable for service should not be included.

Note: To track this data element, use one of the following two methods:

  • Multiply the number of beds by the number of operating days. For example, for the year-end reporting, in a ten bed Healing Lodge that operated for 5 cycles of 60 days, the total number of operating days will be 5 cycles * 60 days = 300 operating days. Therefore, the year-end total count of bed days available will be 10 beds * 300 operating days which is 3,000 bed days available for the reporting period

or

  • Take a daily census (during the days bed-based programs are provided) of all open or occupied Healing Lodge beds funded by MCCSS or other revenue (those represented in the Beds data element). For this census, exclude alternate settings (e.g., overflow, cots, hotel, and cribs) and beds dedicated for use by another service (e.g., homelessness). Add up the total daily bed count to report the Number of bed days available for the reporting period

# of Resident Days: MHA T&HC

The number of 24-hour periods for which an individual (including dependents/children) is provided bed-based care. The day on which an individual is admitted is counted as one day of service. The day on which a client is discharged is not counted. Each occupied bed counts as one day of bed-based care, which includes overflow beds, such as cots/hostel beds. When the individual enters and leaves the service on the same day, one day is counted. Beds occupied by a dependent or child are included in this count.

Note: The day of exit is not counted to allow accurate calculation of occupancy rates. Otherwise, the same bed would be counted twice for two different individuals on the same day.

In order to track resident days, take a daily census of occupied beds (including alternate settings if used) and add up the census to calculate the total number of resident days for the reporting period. To prepare annual targets for this data element, calculate the anticipated number of bed-based clients by the number of days in your bed-based program [Number of clients X Number of days in bed-based program]. For example, if you are expecting to serve 30 bed-based clients during the fiscal year and your bed-based program is 60 days; you would project 1,800 resident days. When reporting on this data element, please include the total actual number of days that each unique individual accessed bed-based care (for example, this may be less than projected if a participant does not complete a full bed-based program cycle).

# of Requests for Service: Unfulfilled: MHA T&HC

This data element includes unfulfilled requests for MHA Treatment & Healing Centre services that were:

  • Referred elsewhere because the service was at capacity; or Placed on a waitlist

The same individual may be counted more than once if they requested service at different points in the reporting period. Reporting is based on the initial response that takes place following the request for service. For example, if an individual requests service and is placed on the waitlist and receives the service within the same quarter, their request for service should still be reported once under this data element.

Dependents are not counted under this data element.

# of Requests for Service: Referred to Other Services: MHA T&HC

The total number of referrals to other services (either within the organization or to another agency) to support individual needs and continuum of care (e.g., more intensive supports for acute cases, aftercare support, withdrawal management).

The same individual may be counted more than once if they requested service at different points in the reporting period. Reporting is based on the initial response that takes place following the request for service. Dependents are not counted in this data element.

# of Individuals: Completed Treatment Cycle: MHA T&HC

The total number of individuals who fully completed the program or treatment cycle, including IHWS-funded bed-based, non-bed-based, and detox/withdrawal management programs. IHWS service providers may provide further information in the year-end narrative report (e.g., average completion rate, number of individuals who completed the majority of the program, success stories, challenges encountered).

This data element is used as a numerator to calculate the rate of program completion. The sum of “Number of Individuals: Received Bed-Based Services: MHA T&HC” and “Number of Individuals: Received Non-Bed-Based Services: MHA T&HC” is the denominator in the calculation.

# of IHWS-Funded FTE Staff: MHA T&HC

The number of IHWS funded staff (full-time equivalent), including program delivery and program administration.

Ministry- funded Agency Expenditures: MHA T&HC

Total ministry-funded expenses for the Transfer Payment Recipient to administer and/or deliver the Mental Health and Addictions Treatment and Healing Centres program in the reporting year (cumulative).