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Perspectives on Occupancy and Population Mix in Group Care

The maximum occupancy for group care programs outside of youth justice custody is dictated by the operator license issued by MCYS (MCYS, 2015c). In most cases, the Panel found that the maximum occupancy for group care programs ranges from a low of six to a high of 10, but can at times be as low as four and as high as 12 (MCYS indicated to the Panel that licensed occupancy ranges from a low of 3 to a high of 20, however, the Panel did not encounter these outliers and MCYS did not identify them). The Panel found significant variations in the occupancy trends across the group care sector (see Chapter 7, Youth Justice for comments on open and secure custody). For example, occupancy in some children and youth mental health operated residential care is low and in private residential services, occupancy is high in some instances. However, the occupancies are falling in most cases, resulting in a rationalization of traditional privately operated group homes and an emergent trend for new, often unlicensed, smaller programs for young people with complex special needs. The Panel heard from both service providers and placing agencies that such unlicensed small programs are increasingly ubiquitous and provide an option for customized service for particularly challenging placement needs. The Panel is very concerned that such unlicensed programs often have untrained live-in staff supported by one to one workers under Special Rate Agreements, with limited oversight over quality of care or even safety considerations. The Panel notes that a young person died in one such program in Sparing 2015 during a physical restraint.

The Panel heard consistently from all service providers that the profile of their clients has changed over the course of time, and all service providers without exception suggested that they serve only ‘the most complex young people in the system’, a phrase that was often followed up with ‘the ones that no one else is able to serve’. The logical improbability of these claims notwithstanding, the Panel is troubled by the mix of young people being served in group care. We found no evidence that group care programs are prepared for, qualified for, or in any way suitable for all of the clients they admit. During site visits at several agencies, the Panel encountered young people impacted by autism, FASD, developmental challenges, emotional disturbances, suicidal ideation, externalizing behaviours, various psychiatric disorders and also young people simply unable to receive care in their biological families all living together under the same program rules, routines, services, and supports, cared for by staff with limited training and pre-service education, and attending section 23 or private school programs on the premises or operated by the service provider in the community. While there is no comprehensive data available on client profiles in particular settings, the Panel believes that such a mix of young people is common practice across residential services. Further complicating the issue is what MCYS reports to be nearly 50% of youth beds being occupied by adults.

Explanations provided by management, supervisory or front line staff as to the relevance of therapeutic services to each of the young people residing in a particular program were altogether not compelling. CAS workers as well as case workers associated with young people identified as having complex special needs frequently used the term ‘warehousing’ as their way of describing the placements for the young people in their care. The Panel also received no meaningful explanation of how section 23 classrooms could meet the education needs and learning potentials of such a diverse group of young people.