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Oversight

Within the Ministry’s structure, there is no overarching governance mechanism for residential services. Corporately, residential services are overseen as one of many functions within a much broader range of responsibilities in each of three separate Divisions: Policy Development and Program Design, Service Delivery, and Youth Justice Services.

In turn, responsibility for oversight and accountability of residential services is cascaded down at the operational level to five regional offices. In addition, Youth Justice Services has a “Direct Operated Facilities Branch Director” who oversees the six directly operated secure custody/detention facilities. This Director’s responsibilities do not include oversight of the 14 transfer payment (TP) operated secure custody/detention facilities, nor the 41 TP operated open custody facilities (including the 2 open custody facilities being re-profiled to reintegration facilities, and 1 being co­operated with the Ministry of Health and Long-Term Care for addictions treatment). Three of these facilities are for-profit operations.

The transfer payment operations are monitored through the five regional offices. The regional offices are entrusted with the contract management of residential services within their own regions, however, reported that they see themselves as having limited authority over these services, particularly in relation to private per diem funded operations. Regional offices expressed that they had some confidence in the exercise of their authority and visibility into services provided by transfer payment contracted services as a result of Transfer Payment Accountability Agreements. They had less confidence in this respect in relation to private per diem funded operations in the absence of accountability agreements.

The Panel heard from both Ministry personnel and many stakeholders that there is significant variation among regions in practices and in the exercise of oversight provided in relation to residential services for children and youth. In some cases, private per diem funded operators have residences in more than one region, potentially resulting in uncoordinated oversight by multiple regional offices, none of whom have “the big picture”. Communication and information sharing among regional offices was reported to be inconsistent and sometimes also between regional offices and corporate office. Regional offices expressed the view that, in the absence of an integrated corporate governance mechanism for residential services, the exercise of their oversight was not optimal.

A significant barrier to oversight is the lack of a meaningful way of counting the number of beds available at both a provincial and regional level, with a corollary understanding of the typology of services provided for those beds (see Chapter 5 on Data and Information). Youth Justice Services has data in relation to open and secure custody/ detention residences under their purview, including capacity, counts and utilization rates. The Ministry has indicated that it is working to develop similar consolidated information on the numbers and types of beds and service providers in child welfare residential services and children and youth mental health services by region, and indeed provided the Panel with a 2014 map depicting group and foster homes by region. Building on this inventory will enable the Ministry to begin to plan for the capacity and configuration of services that are required. A supply and demand analysis is required in order to ensure the right distribution of resources. It will also enable the Ministry to move forward in ensuring the right investment of residential resources by sector as the best use of the current excess bed capacity in open custody is assessed (see Chapter 7 on Youth Justice).

Concerns were also expressed that there is a lack of clarity and a shared understanding among all players about accountability. As a result, accountability is sometimes blurred. This is particularly the case in the responsibility for quality of care issues in residential services in the province. The Panel heard from a number of Children’s Aid Societies that they presume the Ministry has accountability for quality of care in group and foster homes through its licensing process, while the Ministry saw the Children’s Aid Societies as accountable for monitoring the quality of care provided by providers with whom they hold contracts.

Children’s Aid Societies expressed some confidence in their ability to assess quality in their society-operated homes (foster and group) and a select number of frequently used resources in their jurisdiction. Less confidence was expressed in having a window into private per diem funded operations and children and youth mental health facilities as they have limited ability to inspect or monitor these residences. CASs report that they believe that licensing is the only leverage the province has with private per diem funded operators. In some cases, generally in larger Children’s Aid Societies, efforts are made to assess quality of care through both a dedicated staff role related to quality assurance and outcomes measurement (though this position does not exclusively work with residential services). The Panel also heard some good examples of several CASs coming together in a shared service model (for example, in the GTA) to try to address program inspections by dividing up the tasks. It was observed that having Ministry licencing inspections as well as CAS inspections is potentially duplicative and efficiencies could be achieved if the Ministry expanded their inspections to assess quality.

In smaller Children’s Aid Societies, we heard that there were insufficient resources to perform this function and they “hope” that the Ministry is ensuring quality through the licencing function. As will be discussed under “Accountability”, this is problematic as the Panel heard overwhelmingly, that quality is not assessed as part of the licencing function.

The Ministry’s oversight function is also affected by the lack of good data and/or the absence of strong analysis of existing data sources. The Panel is pleased to note that performance indicator frameworks have been developed for both the child welfare and youth justice sectors. It is, however, unclear whether the application of these frameworks will sufficiently address the governance and quality of care issues identified during our consultations. Supporting this concern, the Auditor General review (2015) found that despite a clear need to better assess outcomes following child welfare services, the Ministry “does not have sufficient information to monitor the performance of the Child Protection Services Program,” further noting that the data collected for the newly established child welfare performance indicators “is not sufficient to adequately monitor and assess” performance. This is outlined more fully in Chapter 5 of our report on Data and Information.