The background of common assessments and OCAN The types of OCAN and which types to use in your Health Service Provider HSP organization Orientation to the training materials How to accurately complete the Core OCAN elements ID: 927863
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Slide1
Module 1:Ontario Common Assessment of Need (OCAN) Training
Slide2The background of common assessments and OCAN
The type(s) of OCAN and which type(s) to use in your Health Service Provider (HSP) organization
Orientation to the training materialsHow to accurately complete the Core OCAN elementsDifferences in Core OCAN elements between versions 2.0 and 3.0
2
Objectives
Increase understanding about:
Slide33
Background
Slide4Internationally recognized sector specific standardized assessment tools that facilitate the collection and use of client informationThe assessment information identifies clients’ needs, strengths and preferences to support client centred service delivery and planning
Facilitates a common language between HSP organizations and provides the foundation for policy development, sector planning as well as a platform for research and evaluation
4Common Assessment
Slide55
Standardizing Assessment within Community Care Sectors
Ax:
C
Ax:
B
Ax:
A
After: One standard assessment used within the sector
Before: Multiple assessments within Community Care sectors
Single Standardized Assessment
S
T
A
N
D
A
R
D
I
Z
E
Slide6A dynamic and ongoing collaborative process Actively involves the client to gather information in an individualized manner
Uses a standardized format to identify client needs and priorities
Information gathered drives service planning 6What is an Assessment?
Slide7“I'm a great believer that any tool that enhances communication has profound effects in terms of how people can learn from each other, and how they can achieve the kind of freedoms that they’re interested in.”
Bill Gates 7Assessment: Communication Tool
Slide8Engages the person with lived experience and the person with assessment knowledge in a conversation focused on a person’s needs and strengths
8
Assessment Conversation
Slide9Include pertinent, “need to know” information Ensure that the information is objective, concrete and descriptive
Capture comments for viewing by other service providers involved in supporting clients
Follow your HSP’s policy and procedures on documentation 9Documenting Assessment Information Using Technology
Slide1010
Introduction to OCAN
Slide11In 2008, the sector selected what would become known as the Ontario Common Assessment of Need (OCAN)Based on the Camberwell Assessment
of Need (CAN)
Elements added to reflect Ontario’s community mental health sector2009 – 2013: OCAN was implemented201 Health service providers (HSPs) implemented OCAN in a wide range of service typesCurrent focus: quality, utility and sustainability for HSPs that implementedImplement interested HSPs11OCAN
Slide1212
OCAN Vision
Every Door is the Right Door – Towards a 10-Year Mental Health and Addiction Strategy, July 2009
Slide13Main purpose of OCAN is to enhance conversations Enter the information using the “template” of the OCAN
Follow the standards using an approach that fits:
your style of practice where the consumer is at the context of the service“Unknowns” are OKEmbed OCAN into your workflow so it becomes a routine process that supports your work“You know you’re doing OCAN well when it doesn’t look like you’re doing OCAN”13Flexibility of OCAN
Slide14Ontario Common Assessment of Need (OCAN) is a standardized assessment that
Supports a
consumer driven approach with the inclusion of a self-assessmentSupports conversations with consumers about needs, strengths and actionsFurther facilitates inter-agency communication with the use of a common tool and standardsProvides aggregate data to inform planning and decision making that is consistent with a recovery approach14What is OCAN?
Slide1515
Components and Types of OCAN
Slide1616
Sections of OCAN
What?
(are your
needs)
Who?
(are you)
Where?
(do you receive
services)
Slide17Dr. Mike Slade video
17
Interview With The Developer of the CAN Tools: Dr. Mike Slade
Slide18There are three “types” of OCAN:
The CORE OCAN consists of the Consumer Information Summary and the Mental Health Functional Centre UseThe CORE + Self OCAN consists of the Consumer Information Summary elements, the Consumer Self-Assessment and the Mental Health Functional Centre Use (MHFCU) The Full OCAN consists of the Consumer Information Summary, the Consumer Self-Assessment, the Mental Health Functional Centre Use and the Staff Assessment18
OCAN Assessment
Slide1919
Functional Centre Use of OCAN
Full OCANCore OCAN
Assertive Community Treatment
Case Management
Clubhouse
Early Intervention
Social Rehabilitation/ Recreation
Support within Housing
Short-term Residential Crisis Support Beds
Peer/Self-help Initiatives
Crisis Intervention
Community Mental Health Clinic
Eating Disorders
Day/Night CareCounseling and TreatmentDiversion and Court SupportDual Diagnosis*PsychogeriatricForensicVocational EmploymentConcurrent Disorders*
The Provincial Consumer Working Group recommends the use of Core + Self OCAN for Peer/Self-help Initiatives as a peer-to-peer recommendation *These programs still complete OCANs, but the Ministry has retired the functional centre categories. These programs now fall under the functional centre that best describes the service activity provided to that population. E.G. Case Management
Slide2020
Orientation to materials
Slide21Training Materials:
OCAN 3.0 Forms
Core OCAN User Manual User Reference Guide * data dictionary for OCAN 2.0. Being updated for OCAN 3.0OCAN 3.0 Data Elements spreadsheet with all 3.0 elements and value options21
Training Materials
Slide2222
Core Elements
Slide23Within an OCAN there can only be one OCAN Lead
The OCAN Lead is the person responsible for completing and documenting the assessment
If a consumer is involved with more than one functional centre within the HSP, only the OCAN Lead would complete the OCANThe other functional centre(s) provide input to the OCAN Lead These other functional centre(s) are called Contributing Providers23Core OCAN Elements
DATE-BR-1,2
OL-BR-1, 4, 5, 6
What does this mean? Business rules in the URG
Slide2424
Core OCAN Elements
*mandatory fields
Mandatory fields:
Have a * at the end
Means that the system doesn’t allow you to complete the assessment until you have entered a response
Does not always mean you need to get an answer as many field include options such as “Prefer not to answer” or “Do not know”
Have been recommended by stakeholders working with OCAN information
Non-mandatory fields:
Can be left blank (e.g. medication list – if you don’t collect this information)
Where options exist such as “Prefer not to answer” or “Do not know”, select the appropriate option rather than leaving it blank
Slide25What are the reasons you would do an OCAN? To identify needs when a client enters services
Every time circumstances change for a client E.g. hospitalization or housing
To periodically do an overall review with a clientTo make sure no more services are required25When do I do an OCAN: True or False?TrueTrueTrue
False
Slide2626
Reason for OCAN
Reason for OCAN identifies at what point the OCAN is being completed through the course of their involvement with servicesInitial, Reassessment and (Prior to) Discharge
are regularly used as part of the standards (definitions to follow)
Significant change
is an additional optional assessment OCANs completed outside the reassessment cycle
Slide27An
Initial OCAN
is completed when:the consumer is new to your HSP organizationthe consumer has re-entered your HSP organization more than 3 months after a discharge. A Reassessment OCAN is completed:every 6 months
If a consumer has re-entered your
HSP organization less than 3 months after a discharge
*Exception
:
The reference point for Initial and Reassessment can be expanded from within an organization to across partner organizations if you use a
shared assessment model:
An agreement between 2 or more organizations contributing to a single OCAN
This is for organizations that have agreed to use this model and established a process for collecting the relevant information to be entered into the OCAN
27
Initial and Reassessment OCAN Definitions
Slide28HSPs are encouraged to have a conversation with the consumer just prior to discharge to ensure their most up to date needs are documented
A (Prior to) Discharge OCAN is conducted by the OCAN Lead when the consumer is discharged from
ALL the functional centres within an HSPWhen completing a (Prior to) Discharge OCAN, the exit disposition and exit date should be captured in the Mental Health Functional Centre Service Use28(Prior To) Discharge (From HSP)
Slide29This is
optional
. The choice about doing a Significant Change assessment resides with the HSP organizationIf an organization decides to use Significant change, guidelines should be set specifying the circumstances for completing a significant change (e.g. client hospitalized) If significant change is selected, there is a free text field where the reason for completing the OCAN is documentedA Significant Change OCAN does not change the reassessment cycle29Significant Change
Slide302.
You have been Mohamed’s case manager for the past 4 months and you completed an OCAN with him 3 months ago.
Despite your attempts to contact him, he stopped meeting with you for case management services and you are now discharging him.Do you need to do a (Prior to) Discharge OCAN?YesNo30
Answer
: Yes
Slide313.
Steve was discharged from your program five months ago.
Steve has returned and you are about to complete an OCAN. Which reason for OCAN would you choose?ReassessmentInitial(Prior to) Discharge31
Answer:
B. Initial
Slide3232
Reassessment Cycle
Slide33Once the start date is chosen, the end date is 30 days from the start date. The next assessment happens 6 months from the start date of the previous assessment.
33
Initiating
Initiating the Reassessment Cycle
Start Date
Assessment 1
May 1/11
30 Days Max
30 Days Max
6 M O N T H S
End Date
Assessment 1
May 30/11
Start Date
Assessment 2
Nov 1/11
End Date
Assessment 2
Nov 30/11
Slide34Regardless of any “Significant Change” OCANs completed between scheduled reassessments, the reassessment cycle remains the same.
34
Sustaining
Sustaining the Reassessment Cycle
Start Date
Assessment 1
May 1/09
Start Date
Reassessment 1 at 6 months
Nov 1/09
Start Date
Reassessment 2
at 12 months
May 01/10
Start Date
Reassessment 3
at 18 months
Nov 1/10
“Significant Change”
“Significant Change”
Slide35The reassessment cycle follows the completion of the fullest OCAN. The reassessment cycle is reset when a new service begins with a second functional centre that must complete a Full OCAN.
35
Change in Type of OCAN: When the Reassessment Cycle is Reset
Resetting the Reassessment Cycle
Start Date
Reassessment 1 at 6 months
Nov 1/09
Start Date
Other Assessment 1
Nov 15/09
Referral to a 2
nd
functional
centre
that is required to complete a Full OCAN
Ax Cycle is Reset
Start Date
Reassessment 1
May 15/10
6 month Ax Cycle continues as initiated by 2nd FC through to service completion*
Start Date
Reassessment 2
Nov 15/10
6 month Ax Cycle continues as initiated by 2
nd FC through to service completion*
6 M O N T H S
6 M O N T H S
6 M O N T H S
15 DAY GAP
Start Date
Assessment 1
Core Ax or
Core + Self Ax
May 1/09
Slide36The reassessment cycle is maintained even if a consumer does not continue a service with Full OCAN or Core + Self. If a consumer no longer accesses service from the Full or Core + Self functional centres and only maintains service from the functional centre that completes a Core OCAN the reassessment cycle stays the same..
36
Full to Core OCAN Reassessment Cycle
Start Date
Assessment 1
May 1/09
FULL OCAN
Start Date
Reassessment 1 at 6 months
Nov 1/09
FULL OCAN
Start Date
Reassessment 2
at 12 months
May 01/10
FULL OCAN
Start Date
Reassessment 3
at 18 months
Nov 1/10
CORE OCAN
Consumer ends service from Full OCAN FC. The Core OCAN FC continues to provide service and completes a Core OCAN from this point forward. Reassessment cycle remains the same.
Consumer also receives service from Core OCAN
FC. This FC is a contributing provider to the Full OCAN
Change in Type of OCAN: When the Reassessment Cycle is Maintained
Slide374a.
You start an OCAN for Mary on January 15th 2017.
When is the start date for her 6 month reassessment?4b. You complete the Reassessment OCAN for Cynthia. Cynthia drops out of your HSP on August 1st. She decides to return to your HSP at the end of November. What reason for OCAN do you complete?:InitialReassessment37
Answer:
July 15, 2017
Answer:
A. Initial
Slide38The following crisis services are exceptions to the “reason for OCAN” and “reassessment cycle” rules :
Short Term Residential Crisis Support Beds
Crisis Intervention38Crisis Service Functional Centres: Exceptions to the Rules
Slide39If the consumer is involved with only one functional centre, do the following:
Conduct an Initial OCAN including the exit date and exit disposition
A new Initial OCAN is completed each time a client is admitted. If the consumer is involved with more than one functional centre, do the following:Complete the Mental Health Functional Centre Use Section information and provide it to the OCAN Lead to be included in the next OCAN39Standards for Crisis Services
Slide405.
Should I do an OCAN when …
I’m in the process of completing an OCAN that I started 3 weeks ago and the client then left the service? Yes or No? 40Answer: Yes.
*If client exits while worker is in the process of completing an assessment there is no need to complete a discharge OCAN - URG EXIT-BR-3
Slide41Consumer Demographic Information
Mental Health Functional Centre Use
ContactsConsumer CapacityCulture and CitizenshipCurrent Legal StatusAccommodationEmployment Status
Education level
Psychiatric History
Income
Presenting Issues
41
Core OCAN Overview
COMP-BR-1, 2
Slide4242
What can you learn about a person by collecting Core OCAN information?
Slide43When you first meet me….
BLANK
SLATE
Slide44Using information from
CORE OCAN
Start creating a picture
Slide45SUSAN
50
s
married
female
Find out:
Slide46My
burdens
unemployed
legal
symptoms
ER visits
Slide47My
supports & strengths
peers
partner
doctor
employment
program
Slide48HELP!
My
issues
financial
Sexual abuse
Substance
use
symptoms
Slide49Help
THE SYSTEMbegin to get a picture of :
Who
I am
What
are my issues
where
I’ve been
Slide5050
Core OCAN Elements
Expanded gender options aligned with the socio-demographic questions developed by the Health Equity Data Collection Research ProjectHere are links for more information
Gender identity is your sense of self, specifically your sense of being male, female, both, or neither. It may be different from your biological sex (i.e.. anatomy, physical body) and includes:
Intersex
describes people whose bodies, reproductive systems, chromosomes and/or hormones are not easily grouped as male or female.
Trans Female to Male
is a person who identifies as male but was born as a biological female.
Trans Male to Female
is a person who identifies as female but was but was born as a biological male
http://torontohealthequity.ca/training/
and
Tri-Hospital and TPH Health Equity Data Collection Research Project
.
Slide5151
Some fields have been changed to mandatory
Mandatory fields: Have a * at the endMeans that the system doesn’t allow you to complete the assessment until you have entered a responseDoes not mean you need to get an answer as they include options such as “Prefer not to answer” or “Do not know”Note: “Decline to answer” language softened to “Prefer not to answer”
Have been recommended by stakeholders working with OCAN information
Non-mandatory fields:
Can be left blank
Where options exist such as “Prefer not to answer” or “Do not know”, select the appropriate option rather than leaving it blank
Slide5252
Mental Health Functional Centre Use Section
Important Tips:Only include functional centres
within your organization
, unless using a
shared assessment model
If you are using a
shared assessment model
, the OCAN Lead must include all the information of the partner organization(s) – name, numbers and relevant dates
Only one section should have OCAN Lead = Yes
If other functional
centres
are involved, other sections should have OCAN Lead = No
Captures the type(s) of service that the client is accessing within your HSP organization unless you have a shared assessment approach*
Captures dates* when client was:ReferredAccepted or notActively receiving the serviceDischarged*dates reflect for:Initial OCAN: the status at the point the assessment is taking placeReassessment OCAN: the client’s involvement in services since the last OCAN assessment
Slide53My Cheat Sheet
My Organization LHIN :
My LHINMy Organization Name: Sunny Community CentreMy Organization Number: 1234My Program Name: Sunny Days My Program Number: 6789My Functional Centre Name: Social RecreationMy Functional Centre Number: 725 10 76 81*Use information from ConnexOntario. Ensure ConnexOntario
has up to date information on your organization
53
Core OCAN Elements
Slide5454
Core OCAN Elements
Slide5555
Core OCAN Elements
OT-BR-1, 2
Slide5656
Core OCAN Elements
Slide5757
Core OCAN Elements
Intent: To capture the first date of the consumer’s most recent episode of continuous care
How to use the User Reference Guide: OCAN Dictionary. Use “CTRL” “F” to search
Slide5858
Core OCAN Elements
OCAN 3.0 Update:Q13,14,16 aligned with the socio-demographic questions developed by the Tri-Hospital + Toronto Public Health (TPH) Health Equity Data Collection Research Project.
Slide5959
Racial or Ethnic Group
Socio-demographic question from the Health Equity Data Collection Research ProjectRefer to slide 50 for links to more information
Slide60Sexual orientation is who you are attracted to romantically. People define their sexual orientation in various ways including:
Bisexual
is a person who is attracted to both men and women. Gay is a person who is attracted to people of the same gender; for example, a man who is attracted to men or a woman who is attracted to women. This term is used by both men and women although many women prefer to be referred to as ‘lesbian’. Heterosexual (“straight”) is a person who is attracted to the opposite gender; for example, a man who is attracted to women or a woman who is attracted to men. Lesbian is a woman who is attracted to other women.Queer is a positive term used by some non-heterosexual people. Two-Spirit refers to Aboriginal lesbian, gay, bisexual and trans people. It means having both female and male spirits within one person. 60Sexual Orientation
Slide6161
Citizenship
Slide62Recommended by the French Language Health Services Network of Eastern Ontario:
For more information click
HEREAlso used in Addictions sector62Language Questions Official LanguagesEnglish & French
Slide6363
Core OCAN Elements
OCAN 3.0 Update:
“Incarceration” added as an option.
Slide6464
Core OCAN Elements
Slide65Where Do You Live? E.G.
Domiciliary Hostel
: Municipally-funded, privately owned and operated accommodation providing room and board.No fixed address: Includes living in the streets, rooming with a friend, etc.Hostel/Shelter: Temporary housing for the homeless.Private Non-Profit Housing: Units in shared or self-contained apartments owned and managed by community based non-profit corporations. Excludes rooming/boarding homesSupportive Housing –Congregate Living: Residence of mental health service consumers with varying levels of supervision and support services65User Reference Guide:IF In Doubt – Look it Up
Use “CTRL” “F” to search the OCAN User Reference Guide - Dictionary
Slide6666
6.
Where does Susan live?
Susan has been in your HSP for several years. You are now completing Core OCAN in your HSP. Susan lives in
ValleyView
Adult Care facility which is funded by the Municipality and privately owned and operated.
Refer to the User Reference Guide to identify the housing type in the scenario above
Answer:
Domiciliary
Hostel
Slide6767
7.
Where does Joe live?
Joe is new to your HSP and he tells you about various parts of his life. Joe also tells you that he lives with his parents in their home and does not pay rent.
Refer to the User Reference Guide to identify the housing type in the scenario above
Answer:
Private House/Apt. – Other/Subsidized
Slide6868
Core OCAN Elements
Slide6969
Core OCAN Elements
Slide7070
DSM 5 Diagnostic Categories + Source
Slide7171
Disabilities
Disability: A broad range of physical, mental or intellectual conditions that limit your movements, senses or activities. including: Chronic illness is a disease or other health condition that is persistent or long-lasting in nature (e.g. asthma, cancer, diabetes and HIV/AIDS).
Developmental disability
(also known as intellectual disability) affects your ability to reason, plan, think, communicate, and do everyday social and practical activities/tasks.
Drug or alcohol dependence
occurs when a person develops a physical or emotional “need” for a drug or for alcohol and is unable to control its use despite the negative impact it has on their life.
Learning disability
affects the way your brain understands, remembers, organizes or uses information. It can create difficulty in the way you listen, speak, read, write and/or do math.
Mental illness
refers to a significant pattern of changes in thinking,
behaviour
or emotions that may affect a person’s ability to work or function socially (e.g. depression, bipolar disorder). Physical disability is a condition that limits physical movement. It also includes impairments which limit other facets of daily living, such as respiratory disorders and epilepsy.Sensory disability is a condition that affects what you can hear or see (e.g. hearing or vision loss). Socio-demographic question from the Health Equity Data Collection Research ProjectRefer to slide 50 for links to more information
Slide7272
Income
Purpose of income questions:To support direct service by understanding if client’s financial situation may be impacting mental healthTo support planning by identifying needs among low income client populations
Slide7373
8.
Mike
had worked in the past, but is unable to at present, so receives Canada Pension Plan Disability (CPP-D). His medications are expensive, so he has been able to receive a top-up from Ontario Disability Support Program (ODSP).
What is his primary source of income ?
Answer:
Pension
Slide7474
Core OCAN Elements
comments can apply to any of the information gathered in the assessment
Slide75Read the Core OCAN in the Core User Manual. Activity 3, Page 25This Core OCAN is about a mock client, Tiffany
The Core OCAN was completed by a Peer Support Program worker within a Community
Consider what you learn about Tiffany and her current situationHow does this information help support the work you would do with Tiffany? 75ACTIVITY – Homework
Slide7676