Transcript BTEP pre-workshop - National Capital FreeNet

A Success Strategy for
Cross-Jurisdictional Collaboration
October 2004
Mike Giovinazzo &
Joanne Harrington
V 0-2
Agenda
•
•
•
•
The essence of collaboration
The evolution of a common strategy
Key aspects of the approach
A sample case study
– Project Summary
– Approach overview
– Sample exhibits
– Key Findings
•
Question Period
2003-4-7
2
The Essence Of Collaboration
•
Not very easy
– Each party has their own mandate,
priorities and constraints
•
It can be (and has been done)
•
The secret is locating the common
ground, respecting autonomy and
building a value chain that contributes
to common goals
2003-4-7
3
Finding Common Ground
•
•
•
•
•
•
•
•
Contributing to related Outcomes
Exercising related Authorities
Addressing related Target Groups
Meeting related Needs
Delivering related Services
Recognizing related Events
Executing related Business Processes
Using related Information
2003-4-7
4
Alignment Examples
•
•
•
Two programs require alignment when they
recognize the same target groups and/or
needs in overlapping jurisdictions.
They are aligned when their goals and
strategies have been harmonized or
conflicts are reduced to a minimum.
A service is aligned with a program when it
contributes to a program’s goals by
meeting target group needs designated by
the program, in a way consistent with the
program’s strategy
2003-4-7
5
Program Alignment Model
Program Owner: ACOA
Jurisdiction: Atlantic Canada
Outcome Goals: Higher levels
of investment
Program: Access to
Capital and
Information
Program: Supply
Businesses
Program Owner: ACOA
Jurisdiction: Atlantic Canada
Outcome Goals: Increased rate of new business formation
Program: Entrepreneurship and
Business Skills Development
Educational
Institutions
Post-Secondary
Students
Entrepreneurs
SMEs
Program Owner: PWGSC
Jurisdiction: Canada
Outcome Goals: Higher
levels of Canadian supply
Model shows target group
overlaps of three
existing ACOA programs with
economic development goals
2003-4-7
Program: Economic
Development
Rural
Aboriginal
Communities Communities
Program Owner: ACOA
Jurisdiction: Atlantic Canada
Outcome Goals: Community Economic Growth
© Reproduced permission of Chartwell
6
Upper Tier/Lower Tier Program
Alignment Models
Provincial
Agricultural
Program
Provincial
Water Mgt
Program
Farms
Shoreline
Property
Owners
Municipal
Water Mgt
Program
Residents
Flood
Response
Service
2003-4-7
Drinking
Water
Service
© Reproduced permission of Chartwell
High/Low
Water Hazard
Service
7
Getting the job done
A Proven Approach
In the beginning …
– Municipal Government Need
• Sanctioned by MISA (Municipal Information Systems
Association)
• Funded by a federal grant, Chartwell pioneered
groundbreaking techniques
• Generic enterprise model of municipal programs and
services
• Initially licensed to 27 Canadian municipalities and 2
foreign municipalities
– Evolution to the Management Reference Model
(MRM®) for Government Services
• extended to include a broad range of government
services from all tiers (local, regional, provincial,
federal)
2003-4-7
9
Evolution …
•
Provincial Government
– Ontario adopted the approach and evolved the PSRM
(Public Service Reference Model)
– Used in key ministries and agencies
• E.g. Land Resource Cluster (LRC) Water Program - basis
of fundamental business re-engineering Basis of a detailed
architecture framework and standards for the provinces
Enterprise Information Architecture
– Formal architecture methods, planning process and
governance structure for the province
– Stated benefits include:
– provide fully integrated customer-centred service
delivery
– improve communications between business and IT
stakeholders inside and outside the government
– identify opportunities for business change
http://www.cio.gov.on.ca
2003-4-7
10
Evolution …
•
Government of Canada
– Treasury Board’s new Business Transformation
Enablement Program (BTEP) initiative
– Projects include:
• Information Management Enabler (Treasury Board
Secretariat)
• Secure Service Delivery Using E-forms (SSDUE) (Health,
CCRA, RCMP)
• Public Safety Information Sharing (Solicitor General
Canada and Treasury Board Secretariat)
• National Criminal Justice Index (RCMP)
• Services to New Business (Industry Canada)
• Seniors (Veterans Affairs Canada)
• Statutes and Regulations (Justice Canada)
• Business Architecture of Managing the Fisheries
(Department of Fisheries and Oceans)
http://www.cio-dpi.gc.ca/btep-phto/index_e.asp
2003-4-7
11
BTEP Program Synopsis?
•
Why - because the Government of Canada
is committed to achieving a vision of citizen
or client-centric service delivery across the
whole of government.
•
A new way of thinking about and working
collaboratively
Integrated methodology for planning,
designing and implementing business
transformation
Based on business design best practices
and models suited to public sector
organizations
•
•
2003-4-7
12
BTEP Components & Benefits
•
Components
–
–
–
–
•
GSRM (Government Strategic Reference Model)
Enablers (core business capabilities)
Transformation Framework
Transformation Deliverables
Benefits
– Ensure that transformation initiatives across government
are easier to coordinate, manage and sustain
– Compatible business design across departments and
agencies
– More efficient and effective program structures and
service delivery arrangements
– Greater alignment of goals, programs and projects
2003-4-7
13
BTEP – The Bottom Line
“… uses public service language. Senior
executives will see business transformation
proposals using concepts and terminology they
recognize and understand. It will help
executives and program managers better
understand the business processes they are
responsible for and more easily identify the
programs with which they must interoperate to
advance client-centred service delivery.”
2003-4-7
14
BTEP Transformation Framework
Transformation Blueprint
What
Scope &
Context
Things important to
the business
How
Where
Programs
Jurisdictions
Services
Geographical areas
Business locations
Information
Model
Service Integration &
Alignment Model
Logical data
model
Community Model
Logistics Model
Operations Model
Application
architecture
Vision
Cycles
Organization
Responsibility Model
Culture Model
Distribution
architecture
Value statements
Events
Outcomes
Environment things
Events & Cycles
Model
Planning Deliverables
• Business Problem
Assessment
• Target Business Vision
• Target Business Design
Authorities Model
Target Group State Performance Model
Transition Model
Use Cases
(Z - distributed
system architecture)
Processing
structure
Business rule
model
Rule design
Physical data
model
System design
System
architecture
Presentation
architecture
Control
structure
Implementation
Data definition
Program
Network
architecture
Security
architecture
definition
Service requests
Service outputs
Process inputs
Process outputs
Service
instances
Physical
locations
Service recipients
Channels
Service suppliers
2003-4-7
Strategic Design &
• Transformation
Business Case
• Transformation Master
Plan
System Design &
Human
interface
architecture
Process
instances
Authorities
Needs, Targeted needs
Physical
Operational
Why
• Transformation Strategy
Target Group Model
Service level agreements
Logical
Target Groups
Roles
Parties
Communities
Organizations
When
Workforce
Program Service
Alignment Model
Conceptual
Who
Transformation
Roadmap
Workers
Operations Blueprint
Timing
Schedule
Planning Deliverables
e.g. as defined by RUP
(Rational Unified
Process) or UMM
(UNCEFACT Modelling
Methodology)
Rule
specification
Performance
actuals
Operating Plans
15
MRM – PSRM – GSRM Vocabulary
Provider
Organizations
Jurisdictions
Governance
Outcomes
& Impacts
Target
Groups
Programs
Accomplish
Roles
Accountability
Services
Outputs
Responsibility
Individual
Clients
Deliver
Processes
Authority
2003-4-7
Used in
Resources
© Reproduced permission of Chartwell
16
Core
Regulation action
Facilitate &
influence
action
Enhance
Supply
capability to capacity to
act
act
GSRM Service Output Types
2003-4-7
Service Output Type
Funds
(Units of) Resource
New Knowledge
Care & Rehabilitation Encounters
Educational & Training Encounters
Recreational & Cultural Encounters
Movements
Advisory Encounters
Matches, Referrals & Linkages
Advocacy and Promotional Encounters
Periods of Agreement
Periods of Permission
Findings
Rulings & Judgements
Penalties & Periods of Sanction
Periods of Protection
Interventions
Rules (laws, regulations, policies,
strategies, plans, designs, standards)
Implemented changes
Service Type
Acquiring and providing financial resources
Providing resources such as goods, equipment, accommodations
(apart from funds and human resources)
Conducting research
Providing care & rehabilitation to people and things
Providing education and training experiences
Providing recreational & cultural experiences
Moving people and things
Providing information & advice
Brokering, referring, connecting, matching
Influencing, advocating, persuading, promoting awareness
Creating collaborations, negotiating agreements, settling disputes
Regulating, licensing, permitting, certifying, identifying, authorizing
Inspecting & investigating
Applying rules & dispensing justice
Enforcing compliance, meting out punishment, penalizing
Monitoring, warning, guarding, storing, eliminating threats,
reducing risks
Intervening, responding to threats & emergencies, giving aid,
restoring order
Creating and changing rules
Changing existing organization, practices, systems
17
BTEP Service Definition
Service:
– A service is a set of processes that produces and delivers a
service output. Also: a means, administered by a program, of
producing an output to address one or more target group
needs and contribute to the outcomes of one or more programs
Service Output:
– A service output is an output with characteristics that
distinguish it from other outputs in the same context (typically
called intermediate or process outputs). These characteristics
are:
•
•
•
•
•
2003-4-7
Fulfilled purpose, completed production or finality from the service
provider’s perspective;
Fulfilled intent or full obtainable value from the service recipient’s
perspective, and
Repetition from a work designer’s perspective, in the sense that
the service’s processes are designed to produce repeated
instances of the service output.
Must be classifiable as one of the 19 GSRM service output types
Other useful terms for a service output are the “service delivery
unit” or “unit of delivered service”.
18
Services Can Provide Value to
Multiple Programs
MUNICIPAL RECREATION
PROGRAM
Administers
and funds
PROVINCIAL
YOUTH PROGRAM
Supports achievement
of program goals
Supports achievement
of program goals
Swimming Pool
Access
Swimming
Pool
Access
Swimming Pool
Access
Swimming
Pool
Access
Supports achievement
of program goals
FEDERAL HEALTH
PROGRAM
SERVICE PORTFOLIO



2003-4-7
What is the relative contribution to the other programs?
What opportunities exist for co-funding?
How does this influence the “real value” of the service?
© Reproduced permission of Chartwell
19
GSRM - Governments of Canada
Strategic Reference Model
•
•
•
•
•
A set of models that can be used to depict how the
GsOC currently serves Canadians and how it
could in the future.
Provides a standardized approach to support
consistent analysis of business processes across
different types of programs and services.
Key analytical tool for designing business
architecture (Framework Rows 1 & 2).
Features libraries of services and process patterns
tailored to public sector setting and vocabulary, for
alignment with IS design methods.
Features strong architectural specifications for
public service business design - programs,
services, accountabilities, performance measures.
2003-4-7
20
GSRM Structural Context
PROGRAMS
PLM: Horizontal
and vertical
relationships
between programs
PSAM:
Vertical relationships
betwen
target group facing services
and programs
ROLES
SIAM: Horizontal
Relationships;
Accountability
/ Responsibiility
Role responsibility /
Accountability maps
Aggregate
show relationship between
roles and obligations
SERVICES
relationships
between services
Service
proccess model:
Vertical relationships
between processes and
services
PROCESSES
POSITIONS
2003-4-7
21
© Reproduced permission of Chartwell
GSRM - Top Model
He Env Eco
Community
Provider Program
Types
Public Program Types
(Socio-)Economic Development
Science and Knowledge Development
Natural Resources
Environment Protection
42
8
5
11
38
7
4
11
Public Health
13
8
Legal, Collective, Democratic & Human Rights
11 17
Social Development
19 16
Cultural Development
13 16
Public Education
0
1
Public Safety
18 18
Justice
4
6
National Security & Defense
2
4
Public Policy, Planning and Management Services
26 36
Corporate Policy, Planning and Management Svcs
14 34
Human Resources Management Services
16 36
Financial Management Services
17 35
Information Management & Technology Services
13 31
Facilities & Assets Management Services
14 32
Communications Management Services
14 29
Supply Chain Management Services
13 30
Administrative Services
14 30
Professional Services
2
4
Total Business Lines Using 289 443
2003-4-7
1
0
0
0
28
7
5
6
25
6
7
6
23
8
5
8
11
5
1
2
0
9
7
8
6
1 17
9 16
6
0 16 11 11
3
0 14 13 11
3
0
1
0
0
0
0 16
8 13
5
0
7
2
6
1
1
1
1
3
0
0 24 15 21 13
0 18
8
8
6
1 20
5 10
5
0 16
6
7
5
0 16
7
7
7
1 15
6
6
5
0 15
8
6
7
1 14
5
5
5
1 14
5
5
5
0
5
1
2
1
7 284 161 189 102
2
0
0
1
28
4
6
12
21
4
3
4
4
0
0
1
12
0
1
3
18
2
3
7
12
3
4
6
4
0
0
4
7
3
2
4
3
5
4
9
4 12
9 11
1
1
3 11
0
3
1
1
2 11
1
7
1
9
1
7
2
7
1
6
1 10
1
6
1
6
0
2
39 156
6
3
8
1
0
6
0
1
2
1
1
1
1
1
1
1
1
0
40
4
11
2
3
0
5
0
1
6
2
4
3
2
3
2
3
3
0
70
5 14
8
8 18 18
6
9
8
4 14
4
0
0
0
12 23 12
6
8
6
2
3
2
3 15
8
2 10
6
3 14
7
2 11
4
2 10
3
1 11
3
2
9
3
2
9
4
1
9
3
0
2
1
91 239 125
3
0
2
0
0
6
1
1
2
1
2
1
2
1
1
1
1
1
34
1
14
5
2
0
7
6
0
4
1
2
2
1
1
1
1
1
1
66
9
2
4
7
Total Business Lines Using
Implemented Changes
Rules ( laws, policies, strategies, plans,…)
Penalties and Periods of Sanction
Rulings and Judgements
Interventions
Findings
Periods of Protection
Periods of Permission
Periods of Agreement
Care and Rehabilitation Encounters
Education and Training Encounters
Recreational and Cultural encounters
Promotional Encounters
New Knowledge
Advisory Encounters
Movements
Funds
Number of Business Lines (from 2002-2003
Estimates) Producing Service Output Types
Within Context of Program Type
(Units of) Resource
Programs and Services
Model
Matches, Referrals and Linkages
Service Output Types
16
4
4
5
7
4
0
2
308
67
54
100
7
4
10
2
6
7
2
9
0
0
13
8
6
4
1
1
3 22
1 16
0 15
1 13
0 13
0 15
0 14
1 13
0 14
1
3
74 202
2
6
3
1
0
3
1
2
5
3
6
2
2
3
2
3
2
3
62
113
180
148
130
4
187
67
28
218
139
157
134
126
125
125
118
116
29
22
BTEP Phases & Deliverables
Phases 
 Primary Deliverables
Vision
Phase
Strategy
Phase
Design
Phase
Business
Case Phase
Plan
Phase
Business Problem Assessment
Target Business Vision
Transformation Strategy
Target Business Design
Transformation Business Case
Transformation Master Plan
Alignment Assessments
Alignment
Testing
Existing projects
Alignment
Testing
Alignment
Testing
Alignment
Testing
Alignment
Testing
New projects
2003-4-7
24
Sample Case Study
Seniors Service Mapping Initiative
Project Overview – Objectives
•
•
•
•
Define a common shared vision for seniors
Define a senior’s problem statement
Find 2 to3 transformation opportunities
across the jurisdictions to support the
improvement of services to seniors
Set a foundation for describing seniors
programs and services across three
jurisdictions
– Niagara had both regional and local municipal representation
•
Apply and test BTEP methodology and
provide feedback
2003-4-7
27
Seniors Project Team
Participants
Federal Government
Region of Niagara
Veterans Affairs Canada
Joanne Harrington
True Taylor
Myron Kramar
Health Canada
Francine Sicotte
Cathy Bennett
Social Development Canada
Stephane Belanger
Bob Rees
Melanie Rebane
Scott Wallace
Canada Revenue Agency
Mike Hamelin-CRA
Treasury Board Secretariat
Kirk Labelle
Community Services
Jane Beamer
Maureen Shantz
2003-4-7
Province of Ontario
Ontario Seniors
Secretariat
Diane Varga
Anne Marie Radford
Ministry of Consumer
and Business
Services
Karin Fischer
Ann Gabriel
Sponsors
Region of Niagara
Dominic Ventresca
Province Ontario
Ann Gabriel
Federal Government
Pamela Miller – TBS
Joanne Harrington -VAC
28
Putting Next Steps in BTEP Context
Expand Scope (all business types; ongoing businesses),
Participation (e.g., CRA, other provinces), Level of Definition
Phases 
 Primary Deliverables
Vision
Phase
Strategy
Phase
Design
Phase
Business
Case Phase
Plan
Phase
Business Problem Assessment
Target Business Vision
Transformation Strategy
Target Business Design
Transformation Business Case
Transformation Master Plan
Alignment Assessments
StNB and
Seniors
projects to
date
2003-4-7
Alignment
Testing
Existing projects
Opportunities
= early spinoff projects
Alignment
Testing
Alignment
Testing
Alignment
Testing
Alignment
Testing
New projects
29
Planning Phase
Business Case Phase
Design Phase
Strategy Phase
Produce first
iteration of
Vision Phase
The Vision Phase
Primary Deliverables
Business Problem Assessment
Work Products
Target Business Vision
Transformation Strategy
Target Business Design
Supported
by
Work products are associated
with one or more
primary deliverables
Transformation Business Case
2003-4-7
30
SENIOR
Target Group Needs
TARGET GROUP
The participants focused on
three principal target groups:
• Seniors
• Informal Care Givers
• General Public
Acknowledgement
Shelter
Food / Nourishment
Income
Health
Seniors’ needs set the context
for alignment of services to
program outcomes
Safety
SENIOR’S NEEDS
Socialization
Respect
Education
Meaningful Activity / Recreation
Independence
2003-4-7
31
Governments of Canada Top Model Mapping
Standard framework for classifying government activities in terms of outputs (what) and
needs (why); Indicates opportunities for multi-jurisdictional collaboration
Service Output Types
P,R
P
R
P,R
F,R
P,R
P
R
F,R
R
P,R
R
R
R
P,R
P
P
P
P
F,P,R,M
P,R,M
F,P,R,M
P,R,M
P,M
P,R,M
P
P
P,R,M P,R,M P
P,R
M
P
P
Penalties & Periods of Sanction
Rulings & Judgements
P,R,M
P,R,M
P,R,M
R,M
M
R
Findings
F,P,R,M
F,P,R,M
P,R,M
R,M
P,M
R,M
Periods of Permission
Matches, Referrals & Linkages
Advisory Encounters
Movements
Recreational & Cultural Encounters
Educational & Training Encounters
Care & Rehabilitation Encounters
P
P
P
P
P
F,P,R,M
P,R,M
F,R,M
F,P,R,M
R
F,P,R,M P,R,M F,P,R,M
F,P,R
P,R,M
M
F,R,M
R
P,M
F,P,R,M
P,R,M
P,R
P
P,R
P
Periods of Agreement
F,P,R
P
F,P,R
P,R,M
P,R
F,P,R
P,R
P
New Knowledge
Funds
P
P
P
Advocacy and Promotional Encounters
Public Program Fields
Program Fields
(Socio-)Economic Development
Science and Knowledge Development
Natural Resources Development
Environmental Protection
Public Health
Legal, Collective, Democratic & Human Rights Protection
Social Development
Cultural Development
Educational Development
Public Safety
Justice
National Security & Defense
(Units of) Resource
GSRM
GsoC Top Model
Regulation action
Facilitate & influence action
Enhance capability to act
Supply capacity to act
P,R,M
P
P
P
P,R,M
P
Columns - Types of services, Rows – Types of needs (M= Municipality, R=Regional,
P=Provincial, F=Federal)
2003-4-7
32
Program Service Alignment
Model (PSAM) - matrix
•
This model tells us:
– The scope of the transformation initiative wrt
needs and services
– If there are any unmet needs
– If there are dependencies between periods of
permission
– For many outputs of the same type (same colour),
• Can any be consolidated within/across jurisdictions?
• Are multiple jurisdictions providing similar service
outputs? (leads to opportunity for inter-jurisdictional
collaboration)
2003-4-7
33
Project Approach Summary
•
•
•
•
Must be run as a project (e.g., Project Sponsor, Project
Manager, Project Charter, Collaboration Plan)
Project Sponsor ( Seniors – VAC) was responsible for
selecting Federal and provincial departments. The province
selected regional and municipal participation.
Participants were chosen for their breadth of knowledge of
services in the area
Three workshops (6.5 days total) run over 3-4 months;
Significant time and effort expended prior to and between
workshops
•
Seniors
Limited scope at the start – Senior states (covered 5 states, there may be
others
– Participation (e.g., 4 federal departments, and 2
ministries from Ontario )
2003-4-7
34
Root Cause Analysis
Provides context to “get at root of underlying problems / symptoms”
H ealth Problem s
LEG EN D
SEN IO R
Forced
R etirem ent
Language
Barriers
C onfusion
Hearing Loss
Loneliness
O ver
M edicated
M em ory
Loss
G EN ER A L PU B LIC
Loss of
Purpose
C A R E G IVER
Public
C oncern or
Anger
Public
Ignorance
C hange of
R esidence
Lost
C om panion
Dehydration
D epression
Fam ily
Indifference
/ N eglect
2003-4-7
Fam ily
R elocation
ROOT
C A U SE
Fam ily
Burnout
Lack of service
provider
collaboration
Care G iver
Health
Problem s
Service
provider w ork
overlap
Lack of support
system s
Heavy
W orkload
C aregiver
burnout
Increased cost of
senior’s services
Inappropriate
C areer choice /
A ssignm ent
Sym ptom
Interm ediate
cause
A ging w ork
force /
population
Public
R esentm ent
C are G iver
Indifference
Lack of
inform ation
about seniors
Lack of
M obility
Under
resourced
Lack of
knowledge
Expectation
too high
C aregiver
Abusiveness
C aregiver
G uilt
Insufficient
funding for care
provision
Insufficient
training
Caregiver
Victim ized
35
Senior’s Problem Statement
Health problem example
We are currently not
meeting needs of
Senior
For
Addressing Health Related Needs
This is manifested by
Loneliness
Language barriers
Hearing Loss
Over Medicated
Dehydration
Memory Loss
Confusion
Depression
That are indicative of
Lack of support systems for care giver
Insufficient funding for care provision
Aging Population
Increased Cost of Senior’s Services
Aging Work Force / Population
Funding not being directed appropriately
Lack of information about senior’s services
Problems in balancing home-care versus institutional care
2003-4-7
36
Identify Range of Services
Seniors Program and Service Alignment Model
REGION OF NIAGARA
LOCAL MUNICIPALITY
FEDERAL GOVERNMENT
Veterans Affairs Canada
Region of Niagara Police
Region of Niagara Respite Program
Local Municipality
Social Development Canada - Income Security Program
R Wandering Registration
F Veteran Counselling and
Referral
F Veteran Disability
Pension Claim and Support
F Veteran Direct Hospital
Care Funding
F Veteran Emergency Minor
Disbursement Funding
F Canada Pension Plan
(CPP) Retirement
F Allowance for the
Survivor (ALWS)
Veteran Counselled and
Referred
Veteran Disability Pension
Claim Payment
Veteran Direct Hospital Care
Payment
Veteran Emergency Minor
Disbursement
CPP RTR Payment
ALWS Payment
F Veteran Disability
Allowance
F Veteran Home Support
Funding
F Veterans Funeral and
Burial Funding
F Guaranteed Income
Supplement (GIS)
F Old Age Security (OAS)
Basic
L Transit Fare Reduction
for Seniors
L Property Tax Deferral
L Enhanced Garbage
Collection
Property tax deferral
Domestic garbage pickup
Public transit rates
R Respite Companion
Respite
R Respite Companion
Education
R Respite Companion
Recreational Activity
At risk individual registered
MUNICIPAL SERVICES
Caregiver Respite
Respite Companion Course /
Training Session
Recreational Activity
R Crimes Against Seniors
Advisory/Consultation
R Respite Companion
Subsidization
F Veteran Disability
Pension
Veteran Disability Allowance
Payment
Disability Pension Payment
Veteran Home Support
Payment
Guaranteed Income
Supplement Payment
Veteran Funeral and Burial
Payment
L Handi Transit
L Emergency Notification
Handicap Trip
Emergency Contact
R Respite Companion
Recreational Activity
Respite Companion Subsidy
Payment
Crimes against Seniors
advice and consultation
Recreational Activity
OAS Basic Payment
R Senior Abuse Prevention
F Veterans Social and
Medical Transportation
Funding
F Veterans Ambulatory
Health Care Funding
F Veteran Aids for Daily
Living
Veteran Social and Medical
Transportation Payment
Veteran Ambulatory Health
Care Payment
Veteran Aid
F War Veteran Income
Support
F Veteran Home Adaptation
Funding
F Prisoner of War Pension
Compensation
F Veterans Commemoration
War Veteran Income
Payment
Veteran Home Adaptation
Payment
Prisoner of War Pension
Benefit
F Veterans Screening
F Veteran Home Support
Funding
F Veteran Emergency
Assistance Funding
Veteran Screened
Veteran Home Support
Payment
Veteran Emergency
Assistance Payment
ALW Payment
R Niagara Gate Keepers
Seniors at Risk Identification
and Assistance Training
Health Canada
FEDERAL SERVICES
Health Information
F Disease Prevention,
Health Protection and
Promotion
Veteran Health Course
Disease Prevention, Health
Protection Campaign
Legal, Collective, Democratic & Human Rights Protection

F Veteran Long Term Care
Subsidy
F Veteran Emergency
Benevolent and Trust
Funding
F Veteran Direct Hospital
Care
Veteran Long Term Care
Subsidy Payment
Veteran Emergency
Benevolent and Trust
Payment
Veteran Direct Hospital
Treatment
Preventable Disease
Vaccination
Region of Niagara Housing
F Health Information
Awareness
F Veterans Health
Promotion
F Veteran Disability
Pension Appeal
R Vaccine Preventable
Disease Program
SENIOR
Veteran Commemorated
Veteran Disability Pension
Appeal Judgment
Senior Abuse Awareness
Campaign
Region of Niagara Public Health
F Allowance (ALW)
F Veteran Treatment
Benefits
Veteran Treatment Benefit
Award
R Affordable housing for
seniors
R Sexuality and Aging
Sexual Health Education
R Public Health Inspections
and Infectious Disease
Affordable Housing Payment
Sexuality and Aging Sexual
Health Training Session
Public Health Violation
Rectified
R Adult/senior rental
subsidy
R Cancer Prevention and
Early Detection Screening
R Family (of seniors)
Education and Support
Rent Subsidy
Cancer Prevention and Early
Detection Evaluation
Family Support Session
Acknowledgement
Public Health

F First Nations & Inuit
Health Care

Region of Niagara Supportive Housing

R Supportive Housing
Resident Information and
Referral
Income
Public Health

Long-Term Care Reference
R Long Term Care
Enhanced Personal Care
R Long Term Care Palliative
Care
Fee for service personal care
Palliative Care
R Long Term Care
Overnight Stay
R Long Term Care
Nutritional Intake and Meal
Provision
Region of Niagara Adult Day Program
REGIONAL SERVICES
Nutritious Meal
Food / Nourishment
Socio-Economic Development
Canada Revenue Agency - Individual Returns and Payments Processing Directorate
R Long Term Care
Information and Referral
Crime Awareness Course
Long Term Care Overnight
Stay
Shelter
Public Health
Care & Rehabilitation
Region of Niagara Long-Term Care
R Crime Awareness
Education for Seniors
Supportive Housing
Information & Referral
Health
R Supportive Housing
Medication Coordination
R Adult Day Participant
Information and Referral
Medication Coordinated
R Long Term Care Psychosocial Support
R Adult Day Personal Care
R Day Care Overnight Stay
(in Long Term Care Facility)
Personal Care
Day Care Overnight Stay
Psycho-social consultation
Adult Day Participant Referral
Public Safety
F Tax Filing for Seniors
Seniors Taxes Filed
F Federal Age Amount
Transfer
P Ontario Property Tax
Credit
Tax Credit
Tax Credit
F T1S-A Ontario Senior
Personal Income Tax and
Benefits Return
Ontario Senior's Paper Tax
Filing
F Registered Retirement
Saving Plan Advisory
P Ontario Provincial Age
Amount
RRSP Advice
Tax Credit

Safety
R Supportive Housing
Physical & Emotional
Health Counseling
Social Development

Socialization
F Federal Age Amount
Credit
P Ontario Provincial Age
Amount Transfer
P Ontario Sales Tax Credit
Tax Credit
Tax Credit
Tax Credit
R Supportive Housing
Personal Care
R Adult Day Psycho-social
Support
R Adult Day Medication
Monitoring
R Long Term Care
Accommodation
R Long Term Care Pastoral
Care
Personal Care
Psycho-social Support
Session
Medication Monitored
Long Term Care
accommodation
Pastoral care
R Supportive Housing
Recreational Activities
R Supportive Housing
Accommodation
R Adult Day Recreation
Activity
R Adult Day Enhanced
Personal Care
R Long Term Care Basic
Personal Care
R Long Term Care Respite
Care
Recreational Exercise
Supportive Housing Unit
Recreational Exercise
R Supportive Housing
Health Education
R Supportive Housing
Personal Support
R Adult Day Meal Provision
Supportive Housing Health
Education Session
Personal Support
Meal
Supportive Housing Physical
& Emotional Health
Counseling Session
Legal, Collective, Democratic & Human Rights Protection

Respect
Education

Education
Public Health

Enhanced Personal Care
Personal care
Vacation Care
R Adult Day Rehabilitation
R Long Term Care
Medication
R Long Term Care
Rehabilitation
Rehabilitation Session
Medication Administration
Rehabilitation Care
Meaningful Activity / Recreation
Public Health

Clothing
Legal, Collective, Democratic & Human Rights Protection
Is there an opportunity here?

Independence
Ontario Seniors Secretariat
P Retirement Homes Complaint
Response Information Service:
Ontario Residential Care
Association Funding
P Senior Advocacy
Residential Care Association Grant
Seniors Promotional
Campaign
Province of Ontario
Ontario Ministry of Economic
Development & Trade
P Senior Lifestyle
Education
Senior Lifestyle Course
Ontario Ministry of Consumer and
Business Services
P Senior Lifestyle
Education Funding
P Congratulatory Messages
P Life Event Bundles:
Getting Ready to Retire, …
Seniors Lifestyle Education
Payment
Congratulatory Message
Received
New Senior Advice
A In-home Social Work
PROVINCIAL SERVICES
A In-home Physiotherapy
Social Work Counseling
Session
Physiotherapy Treatment
A In-home Occupational
Therapy
A In-home Personal
Support and Homemaking
A In-home Speech
Language Pathology
In-home Personal Support
and Homemaking Visit
Speech Language Pathology
Treatment
A Adult/Senior Information
and Referral
Ontario Ministry of Municipal Affairs and
Housing
P Older & Wiser
P Assisted Public Housing
& Rent Supplement
Ontario Ministry of Health and Long-Term Care
A Co-ordinates Home
Maintenance and Repair
P Seniors Infoline
P Patient Advocate
P Disabled Person Parking
Permit (DPPP)
P Collision Re-Examination
Adult / Senior Information /
Referral
Friendly Visit
Home Maintained / Repaired
Seniors Information
Patient Finding
Disabled Person Parking
Permit
Collision Re-Examination
Licence Issued
A Congregate Dining
A Call and Reassurance
A Meals on Wheels
P Vaccine Preventable
Disease Funding
P Seniors Care Education
P Senior Driver Group
Education
P Driver Licence Renewal
Program for Controlled
Class Drivers
Congregate Dining Meal
Reassurance Call
In-home Meal
Senior Driver Group Course
Controlled Class Driver
Licence Renewed
A In-home Nursing Care
A In-home Dietetics
A Volunteer Transportation
Assistive Device Rental
Subsidy
Nursing Visit / Shift
Dietetics Session
Volunteer Provided Trip
Ontario Ministry of Citizenship &
Immigration
Ontario Ministry of Finance
P Senior Achievement
Award
Vaccine Preventable Disease
Payment
Seniors Care Course
P Community Injury
Prevention Program (CIPP)
Funding
CIPP Payment
Ontario Ministry of Agriculture & Food
P Ontario Tax Credits
System, Property and Sales
Tax Credits for Seniors
P Common Sense Nutrition
for Seniors
Tax Credit
Nutrition Information
P Guaranteed Annual
Income System (GAINS)
P Community Food Advisor
Program
GAINS Payment
Community Food Advice
Senior Achievement Award
Granted
Ontario Ministry of Transportation
A Friendly Visiting
A Assistive Device Rental
Funding
2003-4-7
P SeniorBusters (an
extension of PhoneBusters)
Senior Lifestyle Course
Community Support Services
Public Service
Information Referral
Occupational Therapy
Treatment
P Community Emergency
Response Volunteers
(CERV) Ontario
Assisted Public Housing &
Rent Supplement Payment
Community Care Access Centres
A Public Service
Information and Referral
Ontario Ministry of Community Safety and Correctional Services
Ontario Ministry of the Attorney General
P Property Guardianship
P Guardianship
Investigation
Property Stewarded
Guardianship Investigation
Finding
Common
Case Mgt?
Ontario Ministry of Community and
Social Services
P Substitute Medical Care
Treatment and Admission
to LTC
P Soldiers Aid Commission
Medical Treatment
Soldiers Aid Benefit Payment
P Senior Driver Licence
Renewal Program
P Personal Care
Guardianship
P Ontario Works Funding
Senior Driver Licence Issued
Personal Care Decision
Ontario Works Benefit
Payment
37
Target Group State Transition Model
Senior’s state’s and transitions
LATER STAGE OF LIFE (SENIOR)
Adult
Senior
Criterion
Met
The project focused on 5
“Undesirable” States:
Sick, Inadequately
housed, Abused, Isolated
and Financially Insecure.
Various services are
needed at different times
to help the senior move to
preferred states and to
inhibit the senior from
moving to less desired
states
A senior could be in one
or more of these states at
any one time
2003-4-7
Healthy
Illness
Accident
Diet
Lack of Money
Addiction
Sick
Adequately
Housed
Lack of Money
Relocation
Disrepair
Lack of Support
Physical Inability
Landlord neglect
Inadequately
Housed
Safe
Loss of Competency
Loss of Money
Caregiverstress
Lack of Understanding
Violent Act
Inappropriate use of PoA
Fraud
Abused
Engaged
Loss of Partner / Friend
Loss of Pet
Loss of Relationships
Role Change
Lack of Information
Loss of Activity
Relocation
Languagebarrier
Isolated
Financially
Secure
Loss of employment income
Saving draw dow n threshold reached
Victim of financial fraud
Financially
Insecure
Dies
Deceased
38
SENIOR
Program and Service Alignment Model
Explicitly identifies all
programs & services
directly satisfying one
target group’s needs
Acknowledgement
Supports
shelter options
Identifies
opportunities for
service improvement
e.g. where similar
services meet similar
needs
Adult / Senior
Rental Subsidy
REGION OF NIAGARA
Region of Niagara Police
Region of Niagara Respite Program
R Wandering Registration
F Veteran Emergency Minor
Disbursement Funding
Veteran Direct Hospital Care
Payment
Veteran Emergency Minor
Disbursement
CPP RTR Payment
F Veteran Disability
Pension
F Veteran Disability
Allowance
F Veteran Home Support
Funding
F Veterans Funeral and
Burial Funding
F Guaranteed Income
Supplement (GIS)
Veteran Funeral and Burial
Payment
Guaranteed Income
Supplement Payment
F Canada Pension Plan
(CPP) Retirement
F Allowance for the
Survivor (ALWS)
M Enhanced Garbage
Collection
R Respite Companion
Respite
Caregiver Respite
Property tax deferral
Domestic garbage pickup
M Handi Transit
M Emergency Notification
R Respite Companion
Education
Respite Companion Course /
Training Session
R Respite Companion
Recreational Activity
At risk individual registered
Recreational Activity
ALWS Payment
R Crimes Against Seniors
Advisory/Consultation
R Respite Companion
Subsidization
F Old Age Security (OAS)
Basic
Handicap Trip
Veteran Disability Allowance
Payment
Disability Pension Payment
Veteran Home Support
Payment
R Respite Companion
Recreational Activity
Respite Companion Subsidy
Payment
Emergency Contact
Crimes against Seniors
advice and consultation
Recreational Activity
OAS Basic Payment
R Senior Abuse Prevention
F Veterans Ambulatory
Health Care Funding
F Veteran Aids for Daily
Living
Veteran Social and Medical
Transportation Payment
Veteran Ambulatory Health
Care Payment
F War Veteran Income
Support
F Veteran Home Adaptation
Funding
F Prisoner of War Pension
Compensation
ALW Payment
R Niagara Gate Keepers
Veteran Aid
Health Canada
War Veteran Income
Payment
Veteran Home Adaptation
Payment
Prisoner of War Pension
Benefit
Veteran Screened
F Veteran Home Support
Funding
F Veteran Emergency
Assistance Funding
Veteran Home Support
Payment
Veteran Emergency
Assistance Payment
F Health Information
Awareness
Veteran Commemorated
F Veterans Health
Promotion
F Disease Prevention,
Health Protection and
Promotion
Veteran Health Course
Disease Prevention, Health
Protection Campaign
Legal, Collective, Democratic & Human Rights Protection

F Veteran Disability
Pension Appeal
F Veteran Emergency
Benevolent and Trust
Funding
F Veteran Long Term Care
Subsidy
Veteran Disability Pension
Appeal Judgment
Veteran Long Term Care
Subsidy Payment
Preventable Disease
Vaccination
R Sexuality and Aging
Sexual Health Education
R Public Health Inspections
and Infectious Disease
Affordable Housing Payment
Sexuality and Aging Sexual
Health Training Session
Public Health Violation
Rectified
R Adult/senior rental
subsidy
R Cancer Prevention and
Early Detection Screening
R Family (of seniors)
Education and Support
Rent Subsidy
Cancer Prevention and Early
Detection Evaluation
Family Support Session

F First Nations & Inuit
Health Care
Veteran Direct Hospital
Treatment
Acknowledgement

Region of Niagara Supportive Housing
R Supportive Housing
Resident Information and
Referral
Income
Public Health

Long-Term Care Reference
R Long Term Care
Enhanced Personal Care
R Long Term Care Palliative
Care
Fee for service personal care
Palliative Care
R Long Term Care
Overnight Stay
R Long Term Care
Nutritional Intake and Meal
Provision
Nutritious Meal
Region of Niagara Adult Day Program
Food / Nourishment
Socio-Economic Development

R Long Term Care
Information and Referral
Crime Awareness Course
Long Term Care Overnight
Stay
Shelter
Public Health
Care & Rehabilitation
Canada Revenue Agency - Individual Returns and Payments Processing Directorate
Region of Niagara Long-Term Care
R Crime Awareness
Education for Seniors
Public Health
F Veteran Direct Hospital
Care
Veteran Emergency
Benevolent and Trust
Payment
R Vaccine Preventable
Disease Program
Seniors at Risk Identification
and Assistance Training
R Affordable housing for
seniors
Region of Niagara Housing
SENIOR
F Veterans Commemoration
Health Information
F Veterans Screening
Senior Abuse Awareness
Campaign
Region of Niagara Public Health
F Allowance (ALW)
F Veterans Social and
Medical Transportation
Funding
F Veteran Treatment
Benefits
Veteran Treatment Benefit
Award
Supportive Housing
Information & Referral
Health
R Supportive Housing
Medication Coordination
R Adult Day Participant
Information and Referral
Medication Coordinated
R Long Term Care Psychosocial Support
R Adult Day Personal Care
R Day Care Overnight Stay
(in Long Term Care Facility)
Personal Care
Day Care Overnight Stay
Psycho-social consultation
R Adult Day Medication
Monitoring
R Long Term Care
Accommodation
R Long Term Care Pastoral
Care
Adult Day Participant Referral
Supports
financial viability
of living
independently
Public Safety
F Tax Filing for Seniors
F Federal Age Amount
Transfer
P Ontario Property Tax
Credit
Seniors Taxes Filed
Tax Credit
Tax Credit
F T1S-A Ontario Senior
Personal Income Tax and
Benefits Return
Ontario Senior's Paper Tax
Filing
F Registered Retirement
Saving Plan Advisory
P Ontario Provincial Age
Amount
RRSP Advice
Tax Credit

Safety
R Supportive Housing
Physical & Emotional
Health Counseling
Social Development

Socialization
P Ontario Provincial Age
Amount Transfer
P Ontario Sales Tax Credit
Tax Credit
Tax Credit
Tax Credit
R Supportive Housing
Personal Care
R Adult Day Psycho-social
Support
Personal Care
Psycho-social Support
Session
R Supportive Housing
Recreational Activities
R Supportive Housing
Accommodation
R Adult Day Recreation
Activity
Recreational Exercise
Supportive Housing Unit
Recreational Exercise
R Supportive Housing
Health Education
R Supportive Housing
Personal Support
R Adult Day Meal Provision
Supportive Housing Health
Education Session
Personal Support
Meal
Supportive Housing Physical
& Emotional Health
Counseling Session
Legal, Collective, Democratic & Human Rights Protection

F Federal Age Amount
Credit
Health
Respect
LOCAL MUNICIPALITY
M Property Tax Deferral
F Veteran Direct Hospital
Care Funding
Veteran Disability Pension
Claim Payment
Income
Socialization
Social Development Canada - Income Security Program
F Veteran Disability
Pension Claim and Support
Veteran Counselled and
Referred
Food / Nourishment
Safety
Rent Subsidy
BTEP Program Service Alignment Model – Seniors Services
FEDERAL GOVERNMENT
Veterans Affairs Canada
F Veteran Counselling and
Referral
Provides
income
Shelter
Medication Monitored
Long Term Care
accommodation
Pastoral care
R Adult Day Enhanced
Personal Care
R Long Term Care Basic
Personal Care
R Long Term Care Respite
Care
Personal care
Vacation Care
R Adult Day Rehabilitation
R Long Term Care
Medication
R Long Term Care
Rehabilitation
Rehabilitation Session
Medication Administration
Rehabilitation Care
Education
Meaningful Activity / Recreation
Independence
Respect
Education

Education
Public Health

Enhanced Personal Care
Meaningful Activity / Recreation
Public Health

Clothing
Legal, Collective, Democratic & Human Rights Protection

Independence
Ontario Seniors Secretariat
P Retirement Homes Complaint
Response Information Service:
Ontario Residential Care
Association Funding
Residential Care Association Grant
P Senior Advocacy
Seniors Promotional
Campaign
Province of Ontario
Ontario Ministry of Economic
Development & Trade
P Senior Lifestyle
Education
Senior Lifestyle Course
P Senior Lifestyle
Education Funding
Ontario Ministry of Consumer and
Business Services
P Life Event Bundles:
Getting Ready to Retire, …
P Congratulatory Messages
Seniors Lifestyle Education
Payment
Congratulatory Message
Received
New Senior Advice
Community Care Access Centres
Community Support Services
A Public Service
Information and Referral
A In-home Social Work
A In-home Physiotherapy
Public Service
Information Referral
Social Work Counseling
Session
Physiotherapy Treatment
A In-home Occupational
Therapy
A In-home Personal
Support and Homemaking
A In-home Speech
Language Pathology
Occupational Therapy
Treatment
In-home Personal Support
and Homemaking Visit
Speech Language Pathology
Treatment
A Assistive Device Rental
Funding
A In-home Nursing Care
A In-home Dietetics
A Volunteer Transportation
Nursing Visit / Shift
Dietetics Session
Volunteer Provided Trip
Assistive Device Rental
Subsidy
Ontario Ministry of Community Safety and Correctional Services
2003-4-7
A Adult/Senior Information
and Referral
A Friendly Visiting
P Community Emergency
Response Volunteers
(CERV) Ontario
P SeniorBusters (an
extension of PhoneBusters)
CERV Grant
Victim of Consumer Fraud
Support
Ontario Ministry of Health and Long-Term Care
A Co-ordinates Home
Maintenance and Repair
Adult / Senior Information /
Referral
Friendly Visit
A Congregate Dining
A Call and Reassurance
A Meals on Wheels
Congregate Dining Meal
Reassurance Call
In-home Meal
Home Maintained / Repaired
P Seniors Infoline
P Patient Advocate
Seniors Information
Patient Finding
P Vaccine Preventable
Disease Funding
P Seniors Care Education
Ontario Ministry of Municipal Affairs and
Housing
P Assisted Public Housing
& Rent Supplement
Assisted Public Housing &
Rent Supplement Payment
Ontario Ministry of Citizenship &
Immigration
Seniors Care Course
P Ontario Tax Credits
System, Property and Sales
Tax Credits for Seniors
P Senior Achievement
Award
P Common Sense Nutrition
for Seniors
Tax Credit
Nutrition Information
P Guaranteed Annual
Income System (GAINS)
P Community Food Advisor
Program
GAINS Payment
Community Food Advice
LEGEND
P Collision Re-Examination
Disabled Person Parking
Permit
Collision Re-Examination
Licence Issued
P Senior Driver Group
Education
P Driver Licence Renewal
Program for Controlled
Class Drivers
Senior Driver Group Course
Ontario Ministry of Agriculture & Food
Senior Achievement Award
Granted
Ontario Ministry of Transportation
P Disabled Person Parking
Permit (DPPP)
Ontario Ministry of the Attorney General
P Property Guardianship
Property Stewarded
Vaccine Preventable Disease
Payment
Ontario Ministry of Finance
Controlled Class Driver
Licence Renewed
P Guardianship
Investigation
Guardianship Investigation
Finding
P Community Injury
Prevention Program (CIPP)
Funding
P Senior Driver Licence
Renewal Program
P Personal Care
Guardianship
CIPP Payment
Senior Driver Licence Issued
Personal Care Decision
Ontario Ministry of Community and
Social Services
P Substitute Medical Care
Treatment and Admission
to LTC
P Soldiers Aid Commission
Medical Treatment
Soldiers Aid Benefit Payment
P Ontario Works Funding
Ontario Works Benefit
Payment
Service Name
Service Output
Note: Distributed PSAM matrix
shows all public facing services
versus needs
39
Putting Services in Order
Senior’s Desired State:
Engaged, Healthy,
Safe, Financially
Secure & Adequately
Housed
Outputs that prevent or detect a senior
becoming Financially Insecure
Why is the
Recovery bundle
bigger than the
Prevention bundle?
Prevention
Recovery
SENIOR FINANCES
Funds:
P Senior Lifestyle Education Funding
P Ontario Property Tax Credit
F War Veteran Income Support
F Federal Age Amount Credit
F Federal Age Amount Transfer
F Old Age Security (OAS) Basic
F Canada Pension Plan (CPP) Retirement
P Soldiers Aid Commission
P Ontario Provincial Age Amount
P Ontario Provincial Age Amount Transfer
P Ontario Sales Tax Credit
P Property Guardianship
Can we refocus our
services from Recovery to
Prevention?
Educational & Training Encounters:
P SeniorBusters (an extension of PhoneBusters)
P Senior Lifestyle Education
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
F Tax Filing for Seniors
F T1S-A Ontario Senior Personal Income Tax and
Benefits Return
F Registered Retirement Saving Plan Advisory
Financially
Insecure
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
Multi-jurisdictional Transition Output Bundles for Services to Seniors
Sorted by Service Output Type
SENIOR SAFETY
Funds:
P Senior Lifestyle Education Funding
R Respite Companion Subsidization
Care & Rehabilitation:
P In-home Social Work
R Respite Companion Respite
R Long Term Care Respite Care
Care & Rehabilitation:
R Respite Companion Respite
Educational & Training Encounters:
P SeniorBusters (an extension of PhoneBusters)
R Crime Awareness Education for Seniors
R Respite Companion Education
P Senior Lifestyle Education
Recreational & Cultural Encounters:
R Respite Companion Recreational Activity
Funds:
P Senior Lifestyle Education Funding
P Ontario Property Tax Credit
P Assistive Device Rental Funding
Abused
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Crimes Against Seniors Advisory/Consultation
SENIOR HOUSING
Funds:
P Senior Lifestyle Education Funding
P Ontario Property Tax Credit
F Veteran Home Adaptation Funding
F Veteran Home Support Funding
P Assisted Public Housing & Rent Supplement
P Ontario Tax Credits System,
Property and Sales Tax Credits for Seniors
R Affordable housing for seniors
R Adult/senior rental subsidy
P Assistive Device Rental Funding
P Retirement Homes Complaint Response Information
Inadequately
Housed
Resource (Units of):
R Day Care Overnight Stay
R Supportive Housing Accommodation
R Long Term Care Accommodation
R Long Term Care Overnight Stay
Educational & Training Encounters:
P SeniorBusters (an extension of PhoneBusters)
P Senior Lifestyle Education
SENIOR ENGAGEMENT
Educational & Training Encounters:
R Niagara Gate Keepers
P SeniorBusters (an extension of PhoneBusters)
R Crime Awareness Education for Seniors
R Respite Companion Education
Recreational & Cultural Encounters:
R Respite Companion Recreational Activity
Funds:
P Senior Lifestyle Education Funding
R Respite Companion Subsidization
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Supportive Housing Physical & Emotional Health
Counseling
R Caregiver Education and Information Support
R Crimes Against Seniors Advisory/Consultation
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
Movements:
R Volunteer Transportation
Movements:
M Handi Transit
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
P Family (of seniors) Education and Support
Rulings & Judgments:
F Veteran Disability Pension Appeal
Protection (Periods of):
M,R Emergency Notification
Guardianship Investigation
P Patient Advocate
Isolated
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
R Supportive Housing Volunteer Co-ordination
Educational & Training Encounters:
R Niagara Gate Keepers
P SeniorBusters (an extension of PhoneBusters)
Advocacy & Promotional Encounters:
P Senior Advocacy
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Supportive Housing Physical & Emotional Health
Counseling
R Caregiver Education and Information Support
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
Recreational & Cultural Encounters:
P Friendly Visiting
R Supportive Housing Recreational Activities
R Long Term Care Recreational Activity
R Long Term Care Pastoral Care
R Adult Day Recreation Activity
Recreational & Cultural Encounters:
P Friendly Visiting
P Senior Achievement Award
P Congratulatory Messages
F Veterans Commemoration
Findings:
P Guardianship Investigation Finding
Care & Rehabilitation:
P In-home Personal Support and Homemaking
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
Care & Rehabilitation:
P In-home Social Work
R Long Term Care Psycho-social Support
R Adult Day Psycho-social Support
P In-home Occupational Therapy
Educational & Training Encounters:
R Niagara Gate Keepers
P SeniorBusters (an extension of PhoneBusters)
Educational & Training Encounters:
P SeniorBusters (an extension of PhoneBusters)
P Senior Lifestyle Education
R Sexuality and Aging Sexual Health Program
P Senior Driver Group Education Program
Advocacy & Promotional Encounters:
R Senior Abuse Prevention
Permission (Periods of):
P Disabled Person Parking Permit (DPPP)
P Senior Driver Licence Renewal Program
P Collision Re-Examination Program
P Driver Licence Renewal Program for Controlled
Class Drivers
Permission (Periods of):
P Disabled Person Parking Permit (DPPP)
Rulings & Judgments:
F Veteran Disability Pension Appeal
Permission (Periods of):
P Substitute Medical Care Treatment and Admission to
LTC
Senior’s Desired State:
Engaged, Healthy, Safe,
Financially Secure &
Adequately Housed
Rulings & Judgments:
F Veteran Disability Pension Appeal
Funds:
P Senior Lifestyle Education Funding
P Community Injury Prevention Program (CIPP)
Funding
Adult
Resource (Units of):
P Meals on Wheels
M Enhanced Garbage Collection
SENIOR FINANCES
LATER STAGE OF LIFE (SENIOR)
Healthy
Funds:
P Senior Lifestyle Education Funding
P Ontario Property Tax Credit
F War Veteran Income Support
F Federal Age Amount Credit
F Federal Age Amount Transfer
F Old Age Security (OAS) Basic
F Canada Pension Plan (CPP) Retirement
P Soldiers Aid Commission
P Ontario Provincial Age Amount
P Ontario Provincial Age Amount Transfer
P Ontario Sales Tax Credit
P Property Guardianship
Sick
Educational & Training Encounters:
P SeniorBusters (an extension of PhoneBusters)
P Senior Lifestyle Education
Adequately
Housed
Inadequately
Housed
Safe
Abused
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
F Tax Filing for Seniors
F T1S-A Ontario Senior Personal Income Tax and
Benefits Return
F Registered Retirement Saving Plan Advisory
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
Dies
Engaged
Isolated
Financially
Secure
Financially
Insecure
Financially
Insecure
Funds:
P Senior Lifestyle Education Funding
F Veteran Disability Pension Claim and Support
F Veteran Disability Allowance
F Veterans Social and Medical Transportation Funding
F Veteran Disability Pension
P Ontario Property Tax Credit
F Veteran Home Adaptation Funding
F Veteran Home Support Funding
P Assisted Public Housing & Rent Supplement
P Ontario Tax Credits System, Property and Sales Tax
Credits for Seniors
R Affordable housing for seniors
R Adult/senior rental subsidy
F Veteran Long Term Care Subsidy
F Veteran Direct Hospital Care Funding
F Veteran Home Support Funding
F Veterans Ambulatory Health Care Funding
F Veteran Treatment Benefits
P Vaccine Preventable Disease Funding
F War Veteran Income Support
F Federal Age Amount Credit
F Federal Age Amount Transfer
F Old Age Security (OAS) Basic
F Canada Pension Plan (CPP) Retirement
P Soldiers Aid Commission
P Ontario Provincial Age Amount
P Ontario Provincial Age Amount Transfer
P Ontario Sales Tax Credit
F Prisoner of War Pension Compensation
F Veteran Emergency Assistance Funding
F Veteran Emergency Benevolent and Trust Funding
F Veteran Emergency Minor Disbursement Funding
F Veterans Funeral and Burial Funding
F Guaranteed Income Supplement (GIS)
F Allowance (ALW)
F Allowance for the Survivor (ALWS)
M Property Tax Deferral
P Ontario Works Funding
P Guaranteed Annual Income System (GAINS)
Care & Rehabilitation:
P In-home Occupational Therapy
Educational & Training Encounters:
R Niagara Gate Keepers
P SeniorBusters (an extension of PhoneBusters)
Deceased
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Supportive Housing Physical & Emotional Health
Counseling
R Respite Companion Individual Care Planning
R Caregiver Education and Information Support
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
F Veterans Screening
R Long Term Care Information and Referral
R Adult Day Participant Information and Referral
R Supportive Housing Volunteer Co-ordination
Advocacy & Promotional Encounters:
P Senior Advocacy
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
F Veterans Screening
R Long Term Care Information and Referral
R Adult Day Participant Information and Referral
P Co-ordinates Home Maintenance and Repair
Senior
Criterion
Met
Care & Rehabilitation:
P In-home Occupational Therapy
Resource (Units of):
F Veteran Aids for Daily Living
R Congregate Dining
R Adult Day Meal Provision
Resource (Units of):
F Veteran Aids for Daily Living
R Congregate Dining
R Adult Day Meal Provision
Permission (Periods of):
R Wandering Registration
Advocacy & Promotional Encounters:
R Senior Abuse Prevention
Permission (Periods of):
R Wandering Registration
Findings:
P Guardianship Investigation Finding
Protection (Periods of):
M,R Emergency Notification
P Patient Advocate
Funds:
P Senior Lifestyle Education Funding
P Assistive Device Rental Funding
F Veteran Disability Pension Claim and Support
F Veteran Disability Allowance
F Veterans Social and Medical Transportation Funding
F Veteran Disability Pension
P Community Emergency Response Volunteers
(CERV) Ontario
Funds:
P Senior Lifestyle Education Funding
P Assistive Device Rental Funding
P Community Injury Prevention Program (CIPP)
Funding
P Community Emergency Response Volunteers
(CERV) Ontario
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
F Veterans Screening
R Long Term Care Information and Referral
R Adult Day Participant Information and Referral
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Supportive Housing Physical & Emotional Health
Counseling
R Respite Companion Individual Care Planning
R Caregiver Education and Information Support
F Tax Filing for Seniors
F T1S-A Ontario Senior Personal Income Tax and
Benefits Return
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
F Veterans Screening
R Long Term Care Information and Referral
R Adult Day Participant Information and Referral
Permission (Periods of):
P Personal Care Guardianship
Rulings & Judgments:
F Veteran Disability Pension Appeal
Care & Rehabilitation:
Vaccine Preventable Disease Program
Educational & Training Encounters:
P SeniorBusters (an extension of PhoneBusters)
R Supportive Housing Health Education
P Senior Lifestyle Education
R Sexuality and Aging Sexual Health Program
F Veterans Health Promotion
P Seniors Care Education
Sick
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
P Common Sense Nutrition for Seniors
P Community Food Advisor Program
F Health Information Awareness
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
Advocacy & Promotional Encounters:
F Disease prevention; health protection and promotion
Findings:
R Cancer Prevention and Early Detection Screening
Interventions:
R Public Health Inspection & Infectious Disease
Program
SENIOR HEALTH
Funds:
P Senior Lifestyle Education Funding
F Veteran Disability Pension Claim and Support
F Veteran Disability Allowance
F Veterans Social and Medical Transportation Funding
F Veteran Disability Pension
F Veteran Long Term Care Subsidy
F Veteran Direct Hospital Care Funding
F Veteran Home Support Funding
F Veterans Ambulatory Health Care Funding
F Veteran Treatment Benefits
P Vaccine Preventable Disease Funding
Resource (Units of):
P Meals on Wheels
R Long Term Care Nutritional Intake and Meal
Provision
Care & Rehabilitation:
R Long Term Care Psycho-social Support
R Adult Day Psycho-social Support
P In-home Personal Support and Homemaking
P In-home Nursing Care
P In-home Physiotherapy
P In-home Speech Language Pathology
P In-home Dietetics
F First Nations & Inuit Health Care
F Veteran Direct Hospital Care
R Supportive Housing Personal Support
R Supportive Housing Medication Coordination
R Supportive Housing Personal Care
R Long Term Care Basic Personal Care
R Long Term Care Medication
R Long Term Care Palliative Care
R Long Term Care Rehabilitation
R Long Term Care Enhanced Personal Care
R Adult Day Personal Care
R Adult Day Medication Monitoring
R Adult Day Enhanced Personal Care
R Adult Day Rehabilitation
Educational & Training Encounters:
R Niagara Gate Keepers
P SeniorBusters (an extension of PhoneBusters)
R Supportive Housing Health Education
Seniors Transition Output Bundle
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Supportive Housing Physical & Emotional Health
Counseling
R Respite Companion Individual Care Planning
R Caregiver Education and Information Support
P Common Sense Nutrition for Seniors
P Community Food Advisor Program
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
F Veterans Screening
R Long Term Care Information and Referral
R Adult Day Participant Information and Referral
Permission (Periods of):
P Personal Care Guardianship
P Substitute Medical Care Treatment and Admission to
LTC
Rulings & Judgments:
F Veteran Disability Pension Appeal
Interventions:
R Public Health Inspection & Infectious Disease
Program
Service Output Type Colours
Funds
Funds:
P Senior Lifestyle Education Funding
F Veteran Disability Pension Claim and Support
F Veteran Disability Allow ance
F Veterans Social and Medical Transportation
Funding
F Veteran Disability Pension
P Ontario Property Tax Credit
F Veteran Home Adaptation Funding
F Veteran Home Support Funding
P Assisted Public Housing & Rent Supplement
P Ontario Tax Credits System, Property and Sales
Tax Credits for Seniors
R Affordable housing for seniors
R Adult/senior rental subsidy
F Veteran Long Term Care Subsidy
F Veteran Direct Hospital Care Funding
F Veteran Home Support Funding
F Veterans Ambulatory Health Care Funding
F Veteran Treatment Benefits
P Vaccine Preventable Disease Funding
F War Veteran Income Support
F Federal Age Amount Credit
F Federal Age Amount Transfer
F Old Age Security (OAS) Basic
F Canada Pension Plan (CPP) Retirement
P Soldiers Aid Commission
P Ontario Provincial Age Amount
P Ontario Provincial Age Amount Transfer
P Ontario Sales Tax Credit
F Prisoner of War Pension Compensation
F Veteran Emergency Assistance Funding
F Veteran Emergency Benevolent and Trust Funding
F Veteran Emergency Minor Disbursement Funding
F Veterans Funeral and Burial Funding
F Guaranteed Income Supplement (GIS)
F Allow ance (ALW)
F Allow ance for the Survivor (ALWS)
M Property Tax Deferral
P Ontario Works Funding
P Guaranteed Annual Income System (GAINS)
Educational & Training Encounters:
R Niagara Gate Keepers
P SeniorBusters (an extension of PhoneBusters)
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Supportive Housing Physical & Emotional Health
Counseling
R Respite Companion Individual Care Planning
R Caregiver Education and Information Support
F Tax Filing for Seniors
F T1S-A Ontario Senior Personal Income Tax and
Benefits Return
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
F Veterans Screening
R Long Term Care Information and Referral
R Adult Day Participant Information and Referral
Perm ission (Periods of):
P Personal Care Guardianship
(Units of) Resource
New Knowledge
Care & Rehabilitation Encounters
Educational & Training Encounters
Recreational & Cultural Encounters
Movements
Advisory Encounters
Matches, Referrals & Linkages
Advocacy and Promotional Encounters
Periods of Agreement
Periods of Permission
Findings
Rulings & Judgements
Penalties & Periods of Sanction
Periods of Protection
Rulings & Judgm ents:
F Veteran Disability Pension Appeal
Interventions
Rules (laws, policies, strategies, plans,…)
Service Output Bundles by Service Output Type V0.2 2004.01.29 plot.vsd
2003-4-7
Implemented changes
40
Transition Output Bundles
•
This model tells us:
– How many services are required to move between
states
– How to prioritize looking for solutions.
• Are any problems associated with a bundle?
• Are some bundles more important than others?
– Whether we can eliminate the major steps
– If there are any dependencies
– Whether the services ‘bundled’ together ‘belong’
together
– Where there are many services of the same output type
• Can any be consolidated? Eliminated? Moved to another
transition? Is there an opportunity for identifying a
common process e.g., common application initiation
process, common forms?
2003-4-7
41
Transition Output Bundle
Define “bundles” by identifying services that
detect, help, or prevent transitions
Sets context for co-ordination of efforts and
aligning performance across providers
Shows services by type or jurisdiction that
must “fit together” to make a difference for
the target group
Identifies opportunities for common or
standardized processes to “join up” services
in the bundle
Multi-jurisdictional Transition Output Bundles for Services to Seniors
Sorted by Service Output Type
SENIOR SAFETY
Funds:
P Senior Lifestyle Education Funding
R Respite Companion Subsidization
Care & Rehabilitation:
P In-home Social Work
R Respite Companion Respite
R Long Term Care Respite Care
Educational & Training Encounters:
P SeniorBusters (an extension of PhoneBusters)
R Crime Awareness Education for Seniors
R Respite Companion Education
P Senior Lifestyle Education
Recreational & Cultural Encounters:
R Respite Companion Recreational Activity
Funds:
P Senior Lifestyle Education Funding
P Ontario Property Tax Credit
P Assistive Device Rental Funding
Abused
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Crimes Against Seniors Advisory/Consultation
SENIOR HOUSING
Funds:
P Senior Lifestyle Education Funding
P Ontario Property Tax Credit
F Veteran Home Adaptation Funding
F Veteran Home Support Funding
P Assisted Public Housing & Rent Supplement
P Ontario Tax Credits System,
Property and Sales Tax Credits for Seniors
R Affordable housing for seniors
R Adult/senior rental subsidy
P Assistive Device Rental Funding
P Retirement Homes Complaint Response Information
Inadequately
Housed
Resource (Units of):
R Day Care Overnight Stay
R Supportive Housing Accommodation
R Long Term Care Accommodation
R Long Term Care Overnight Stay
Educational & Training Encounters:
P SeniorBusters (an extension of PhoneBusters)
P Senior Lifestyle Education
SENIOR ENGAGEMENT
Educational & Training Encounters:
R Niagara Gate Keepers
P SeniorBusters (an extension of PhoneBusters)
R Crime Awareness Education for Seniors
R Respite Companion Education
Recreational & Cultural Encounters:
R Respite Companion Recreational Activity
Funds:
P Senior Lifestyle Education Funding
R Respite Companion Subsidization
Care & Rehabilitation:
R Respite Companion Respite
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Supportive Housing Physical & Emotional Health
Counseling
R Caregiver Education and Information Support
R Crimes Against Seniors Advisory/Consultation
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
Advocacy & Promotional Encounters:
R Senior Abuse Prevention
Permission (Periods of):
R Wandering Registration
Movements:
M Handi Transit
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
P Family (of seniors) Education and Support
Rulings & Judgments:
F Veteran Disability Pension Appeal
Protection (Periods of):
M,R Emergency Notification
Guardianship Investigation
P Patient Advocate
Isolated
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
R Supportive Housing Volunteer Co-ordination
Educational & Training Encounters:
R Niagara Gate Keepers
P SeniorBusters (an extension of PhoneBusters)
Advocacy & Promotional Encounters:
P Senior Advocacy
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Supportive Housing Physical & Emotional Health
Counseling
R Caregiver Education and Information Support
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
Recreational & Cultural Encounters:
P Friendly Visiting
R Supportive Housing Recreational Activities
R Long Term Care Recreational Activity
R Long Term Care Pastoral Care
R Adult Day Recreation Activity
Movements:
R Volunteer Transportation
Care & Rehabilitation:
P In-home Personal Support and Homemaking
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
Care & Rehabilitation:
P In-home Social Work
R Long Term Care Psycho-social Support
R Adult Day Psycho-social Support
P In-home Occupational Therapy
Educational & Training Encounters:
R Niagara Gate Keepers
P SeniorBusters (an extension of PhoneBusters)
Recreational & Cultural Encounters:
P Friendly Visiting
P Senior Achievement Award
P Congratulatory Messages
F Veterans Commemoration
Findings:
P Guardianship Investigation Finding
Findings:
P Guardianship Investigation Finding
Protection (Periods of):
M,R Emergency Notification
P Patient Advocate
Resource (Units of):
F Veteran Aids for Daily Living
R Congregate Dining
R Adult Day Meal Provision
Resource (Units of):
F Veteran Aids for Daily Living
R Congregate Dining
R Adult Day Meal Provision
Educational & Training Encounters:
P SeniorBusters (an extension of PhoneBusters)
P Senior Lifestyle Education
R Sexuality and Aging Sexual Health Program
P Senior Driver Group Education Program
Permission (Periods of):
R Wandering Registration
Advocacy & Promotional Encounters:
R Senior Abuse Prevention
Funds:
P Senior Lifestyle Education Funding
P Assistive Device Rental Funding
F Veteran Disability Pension Claim and Support
F Veteran Disability Allowance
F Veterans Social and Medical Transportation Funding
F Veteran Disability Pension
P Community Emergency Response Volunteers
(CERV) Ontario
Funds:
P Senior Lifestyle Education Funding
P Assistive Device Rental Funding
P Community Injury Prevention Program (CIPP)
Funding
P Community Emergency Response Volunteers
(CERV) Ontario
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
F Veterans Screening
R Long Term Care Information and Referral
R Adult Day Participant Information and Referral
Permission (Periods of):
P Disabled Person Parking Permit (DPPP)
P Senior Driver Licence Renewal Program
P Collision Re-Examination Program
P Driver Licence Renewal Program for Controlled
Class Drivers
Senior’s Desired State:
Engaged, Healthy, Safe,
Financially Secure &
Adequately Housed
Rulings & Judgments:
F Veteran Disability Pension Appeal
Funds:
P Senior Lifestyle Education Funding
P Community Injury Prevention Program (CIPP)
Funding
Adult
Resource (Units of):
P Meals on Wheels
M Enhanced Garbage Collection
Healthy
SENIOR FINANCES
Funds:
P Senior Lifestyle Education Funding
P Ontario Property Tax Credit
F War Veteran Income Support
F Federal Age Amount Credit
F Federal Age Amount Transfer
F Old Age Security (OAS) Basic
F Canada Pension Plan (CPP) Retirement
P Soldiers Aid Commission
P Ontario Provincial Age Amount
P Ontario Provincial Age Amount Transfer
P Ontario Sales Tax Credit
P Property Guardianship
Sick
Educational & Training Encounters:
P SeniorBusters (an extension of PhoneBusters)
P Senior Lifestyle Education
Adequately
Housed
Inadequately
Housed
Safe
Abused
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
F Tax Filing for Seniors
F T1S-A Ontario Senior Personal Income Tax and
Benefits Return
F Registered Retirement Saving Plan Advisory
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
Dies
Engaged
Isolated
Financially
Insecure
Financially
Insecure
Funds:
P Senior Lifestyle Education Funding
F Veteran Disability Pension Claim and Support
F Veteran Disability Allowance
F Veterans Social and Medical Transportation Funding
F Veteran Disability Pension
P Ontario Property Tax Credit
F Veteran Home Adaptation Funding
F Veteran Home Support Funding
P Assisted Public Housing & Rent Supplement
P Ontario Tax Credits System, Property and Sales Tax
Credits for Seniors
R Affordable housing for seniors
R Adult/senior rental subsidy
F Veteran Long Term Care Subsidy
F Veteran Direct Hospital Care Funding
F Veteran Home Support Funding
F Veterans Ambulatory Health Care Funding
F Veteran Treatment Benefits
P Vaccine Preventable Disease Funding
F War Veteran Income Support
F Federal Age Amount Credit
F Federal Age Amount Transfer
F Old Age Security (OAS) Basic
F Canada Pension Plan (CPP) Retirement
P Soldiers Aid Commission
P Ontario Provincial Age Amount
P Ontario Provincial Age Amount Transfer
P Ontario Sales Tax Credit
F Prisoner of War Pension Compensation
F Veteran Emergency Assistance Funding
F Veteran Emergency Benevolent and Trust Funding
F Veteran Emergency Minor Disbursement Funding
F Veterans Funeral and Burial Funding
F Guaranteed Income Supplement (GIS)
F Allowance (ALW)
F Allowance for the Survivor (ALWS)
M Property Tax Deferral
P Ontario Works Funding
P Guaranteed Annual Income System (GAINS)
Care & Rehabilitation:
P In-home Occupational Therapy
Educational & Training Encounters:
R Niagara Gate Keepers
P SeniorBusters (an extension of PhoneBusters)
Deceased
Financially
Secure
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Supportive Housing Physical & Emotional Health
Counseling
R Respite Companion Individual Care Planning
R Caregiver Education and Information Support
F Tax Filing for Seniors
F T1S-A Ontario Senior Personal Income Tax and
Benefits Return
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
F Veterans Screening
R Long Term Care Information and Referral
R Adult Day Participant Information and Referral
Permission (Periods of):
P Personal Care Guardianship
Rulings & Judgments:
F Veteran Disability Pension Appeal
Care & Rehabilitation:
Vaccine Preventable Disease Program
Educational & Training Encounters:
P SeniorBusters (an extension of PhoneBusters)
R Supportive Housing Health Education
P Senior Lifestyle Education
R Sexuality and Aging Sexual Health Program
F Veterans Health Promotion
P Seniors Care Education
Sick
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
P Common Sense Nutrition for Seniors
P Community Food Advisor Program
F Health Information Awareness
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
Advocacy & Promotional Encounters:
F Disease prevention; health protection and promotion
Findings:
R Cancer Prevention and Early Detection Screening
Interventions:
R Public Health Inspection & Infectious Disease
Program
SENIOR HEALTH
Funds:
P Senior Lifestyle Education Funding
F Veteran Disability Pension Claim and Support
F Veteran Disability Allowance
F Veterans Social and Medical Transportation Funding
F Veteran Disability Pension
F Veteran Long Term Care Subsidy
F Veteran Direct Hospital Care Funding
F Veteran Home Support Funding
F Veterans Ambulatory Health Care Funding
F Veteran Treatment Benefits
P Vaccine Preventable Disease Funding
Resource (Units of):
P Meals on Wheels
R Long Term Care Nutritional Intake and Meal
Provision
Care & Rehabilitation:
R Long Term Care Psycho-social Support
R Adult Day Psycho-social Support
P In-home Personal Support and Homemaking
P In-home Nursing Care
P In-home Physiotherapy
P In-home Speech Language Pathology
P In-home Dietetics
F First Nations & Inuit Health Care
F Veteran Direct Hospital Care
R Supportive Housing Personal Support
R Supportive Housing Medication Coordination
R Supportive Housing Personal Care
R Long Term Care Basic Personal Care
R Long Term Care Medication
R Long Term Care Palliative Care
R Long Term Care Rehabilitation
R Long Term Care Enhanced Personal Care
R Adult Day Personal Care
R Adult Day Medication Monitoring
R Adult Day Enhanced Personal Care
R Adult Day Rehabilitation
Educational & Training Encounters:
R Niagara Gate Keepers
P SeniorBusters (an extension of PhoneBusters)
R Supportive Housing Health Education
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Supportive Housing Physical & Emotional Health
Counseling
R Respite Companion Individual Care Planning
R Caregiver Education and Information Support
P Common Sense Nutrition for Seniors
P Community Food Advisor Program
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
F Veterans Screening
R Long Term Care Information and Referral
R Adult Day Participant Information and Referral
Permission (Periods of):
P Personal Care Guardianship
P Substitute Medical Care Treatment and Admission to
LTC
Rulings & Judgments:
F Veteran Disability Pension Appeal
Interventions:
R Public Health Inspection & Infectious Disease
Program
Service Output Type Colours
Funds
(Units of) Resource
New Knowledge
Care & Rehabilitation Encounters
Educational & Training Encounters
Recreational & Cultural Encounters
Movements
Advisory Encounters
Matches, Referrals & Linkages
Advocacy and Promotional Encounters
Periods of Agreement
Periods of Permission
Findings
Rulings & Judgements
Penalties & Periods of Sanction
Periods of Protection
Interventions
Rules (laws, policies, strategies, plans,…)
Service Output Bundles by Service Output Type V0.2 2004.01.29 plot.vsd
2003-4-7
Movements:
Niagara Emergency Medical Service Ambulance
Advisory Encounters:
Veteran Counselling and Referral
Life Event Bundles: Getting Ready to Retire, Pursuing
Life's Best After Retirement, Finding Seniors
HealthCare Resources
Seniors Infoline
Family (of seniors) Education and Support
Supportive Housing Physical & Emotional Health
Counseling
Respite Companion Individual Care Planning
Caregiver Education and Information Support
Common Sense Nutrition for Seniors
Community Food Advisor Program
Advocacy & Promotional Encounters:
P Senior Advocacy
Rulings & Judgments:
F Veteran Disability Pension Appeal
Permission (Periods of):
P Substitute Medical Care Treatment and Admission to
LTC
LATER STAGE OF LIFE (SENIOR)
Healthy
Permission (Periods of):
P Disabled Person Parking Permit (DPPP)
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
F Veterans Screening
R Long Term Care Information and Referral
R Adult Day Participant Information and Referral
P Co-ordinates Home Maintenance and Repair
Senior
Criterion
Met
Advisory Encounters:
F Veteran Counselling and Referral
P Life Event Bundles: Getting Ready to Retire,
Pursuing Life's Best After Retirement, Finding
Seniors HealthCare Resources
P Seniors Infoline
R Family (of seniors) Education and Support
R Supportive Housing Physical & Emotional Health
Counseling
R Respite Companion Individual Care Planning
R Caregiver Education and Information Support
Matches, Referrals & Linkages:
P Public Service Information and Referral
P Adult/Senior Information and Referral
R Supportive Housing Resident Information and
Referral
R Senior Service Information Intake & Referral
F Veterans Screening
R Long Term Care Information and Referral
R Adult Day Participant Information and Referral
R Supportive Housing Volunteer Co-ordination
Sick
Funds:
Senior Lifestyle Education Funding
Veteran Disability Pension Claim and Support
Veteran Disability Allowance
Veterans Social and Medical Transportation Funding
Veteran Disability Pension
Veteran Long Term Care Subsidy
Veteran Direct Hospital Care Funding
Veteran Home Support Funding
Veterans Ambulatory Health Care Funding
Veteran Treatment Benefits
Vaccine Preventable Disease Funding
Resource (Units of):
Adult Day Meal Provision
Congregate Dining
Meals on Wheels
Long Term Care Nutritional Intake and Meal Provision
Care & Rehabilitation:
Long Term Care Psycho-social Support
Adult Day Psycho-social Support
In-home Personal Support and Homemaking
In-home Nursing Care
In-home Physiotherapy
In-home Speech Language Pathology
In-home Dietetics
First Nations & Inuit Health Care
Veteran Direct Hospital Care
Alzheimers Diagnosis & Treatment
Supportive Housing Personal Support
Supportive Housing Medication Coordination
Supportive Housing Personal Care
Long Term Care Basic Personal Care
Long Term Care Medication
Long Term Care Palliative Care
Long Term Care Rehabilitation
Long Term Care Enhanced Personal Care
Adult Day Personal Care
Adult Day Medication Monitoring
Adult Day Enhanced Personal Care
Adult Day Rehabilitation
Educational & Training Encounters:
Older & Wiser
SeniorBusters (an extension of PhoneBusters)
Supportive Housing Health Education
Implemented changes
Matches, Referrals & Linkages:
Public Service Information and Referral
Adult/Senior Information and Referral
Supportive Housing Resident Information and Referral
Senior Service Information Intake & Referral
Veterans Screening
Long Term Care Information and Referral
Adult Day Participant Information and Referral
Advocacy & Promotional Encounters:
Seniors Month
A Guide to Programs and Services for Seniors in
Ontario
Niagara Gate Keepers
Permission (Periods of):
Personal Care Guardianship
Substitute Medical Care Treatment and Admission to
LTC
Rulings & Judgments:
Veteran Disability Pension Appeal
Interventions:
Public Health Inspection & Infectious Disease Program
42
Vision Template
Organizes key vision information
Vision for
Seniors
Seniors need to
Have health, recognition, financial security, respect, adequate
housing, safety and engagement
Seniors will be able to
Have the right to choose the care and support they need to maintain
quality of life.
This will be enabled by






Made possible by






We’ll know we’ve
achieved this when





2003-4-7
Community support
Adequately funded
Specialized, competent service providers
Seamless integrated service delivery
Relevant & timely information & services
Participation in the care giving process
Rewarding seniors who care for themselves
Adaptable to changing needs of seniors – individually &
collectively
Changing emphasize on home based care
Securing funds from external sources
Redirecting scarce resources to best value
Information packaged for “senior consumption”
 Integrate
 Shared
 Cohesive
 Complete
Reduced costs, participation, waiting….for long-term care (“all
bed reduction”, “crisis list wait time reduced”)
Reduced wait times for home care/support services
Increased percentage of age weighted home resident seniors
Reduced complaints/increased senior satisfaction
Increased supply of service providers meets/converges on
demand
43
Three Transformation Opportunities
•
Client Record for Seniors Programs and
Services
•
Common Mail out for Seniors
•
Collaborative Case Management
2003-4-7
44
Mini-Business Case
Shows participants consensus on key factors for 3 opportunities
Business Case
Criteria
Benefits Analysis
(from Seniors
Perspective)
Cost Analysis
(to implement)
Time Analysis
(to implement)
Risk Analysis
(to implement)
2003-4-7
Opportunity 1 - Client
Record for Seniors
Programs & Services
Opportunity
Opportunity 2 Senior's Common
Mailout
Opportunity 3 Collaborative Case
Management
Colour Coding Legend
Red = Little Improvement
Yellow = Some Improvement
Green = Significant Improvement
Red = $100M Plus
Yellow = $10M - $100M
Green = $10M or less
Red = 2 Years plus
Yellow = 1-2 Years
Green = 1 Year or less
Red = Big and Likely to Materialize
Yellow = Big or unlikely to Materialize
Green = Small or Easily Mitigated
45
SIAM Example Common Mail-Out
•
•
•
In this example, a
service provider has an
agreement to provide a
common mail out on
behalf of a number of
seniors service
providers
The common mail out
service provider in turn
has an agreement to
ensure that the required
information and
channels are in place to
support the common
mail out
Each line represents a
required agreement!
2003-4-7
Senior
Information
Service
Senior’s information
(Information
Advisory Encounter)
Common Mailout
Service
Channel
(Use of a resource)
Who will be
accountable to
provide
common mail
out provider
with required
information?
Seniors mailout
(Information Advisory Encounter)
Who will be
accountable
for common
mail out
service?
Channel Service
Who will be
accountable
for providing
channel
services?
Which service
providers will
require a
common mail
out?
Any Seniors
Service
Any seniors service's
final valued output
Legend
Multiple
providers
Common
provider
Service Output
(GSRM service pattern)
46
Service Process Pattern Analysis
Monitor period of permission serv ice
resource consumption
Monitor period of permission serv ice
resource av ailability

•
Conf igure period of permission serv ice
processes to respond to demand or
supply lev el limits
Conf igure period of permission serv ice
processes to respond to contingency
ev ent

Source period of permission serv ice
resources
Register and equip period of permission
serv ice suppliers
Acquire and register period of permission
serv ice resources
Pay f or period of permission serv ice
resources
Maintain period of permission serv ice
resources
Is there an opportunity
to pull out common
processes into a
common provider
service (i.e.,
outsourcing or insourcing)?
Provis ioning

Register request f or period of permission
serv ice deliv ery

Qualif y request f or period of permission
serv ice deliv ery

Open period of permission case
Allocate resources to period of
permission serv ice output

Produce period of permission serv ice
output
De live ry
Deliv er period of permission serv ice
output
Deploy period of permission serv ice
resources geographically

PERIOD OF PERMISSION
Service Processes
Set period of permission serv ice
schedule

Prepare period of permission serv ice
specif ication

Promote period of permission serv ice
Monitor and mitigate period of
permission serv ice risks


2003-4-7
Process period of permission serv ice
complaints
Register and equip period of permission
serv ice target group members
•
Is there an
opportunity for new
policy standards and
best practices?
Collect and account f or a period of
permission serv ice output f ee
Process period of permission serv ice
exceptions
Conf igure period of permission serv ice
resources
Protect period of permission serv ice
resources
Deploy resources f or period of
permission serv ice output

Register period of permission serv ice
output

Maintain period of permission serv ice
output
47
Results
Participant Feedback
and Summary
Participant Feedback on BTEP process
Strongly
Disagree
Don't
Agree
No
Opinion
Agree
Strongly
Agree
The workshop objectives were met.
5
5
The workshop process was effective.
5
5
6
3
The facilitator(s) communicated clearly.
5
5
I feel as though I had an opportunity to
contribute.
1
9
The workshop was worth my time.
4
6
Workshop materials, including handouts,
were useful.
1
The workshop duration was appropriate.
1
6
3
The right people participated in the
workshop.
1
8
1
2003-4-7
49
Participant Feedback
•
100% of participants from the 4 jurisdictions felt:
– Workshop objectives were met
– Workshop process was effective
•
2003-4-7
Participant comments – things found most
useful:
–
–
–
–
–
–
–
“ability to debate, test ideas”
“problem statement”
“evaluation, alignment and ranking of opportunities
“State transition output bundles and SIAM”
“program logic model”
“implementation strategies”
“brainstorming”
50
Summary
•
•
•
If we want to deliver these outcomes across
government, we need a transformation process
that works across government jurisdictions and
programs.
The Business Transformation Enablement
Program (BTEP) will help us do that - by providing
strategies, methods, models and framework as
common design and alignment tools.
Using Service Vision for Canadians principles to
demonstrate how a service strategy geared to
seniors can bring about transformation in
programs, policy and service delivery channels.
2003-4-7
51
Your Presenters
•
Joanne Harrington, Director, Seniors
Cluster, Veterans Affairs Canada
[email protected]
(613) 996-2470
•
Mike Giovinazzo, President
We4C Solutions
[email protected]
(613) 863-9342
2003-4-7
52