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Promising Sources of Data
There are a growing number of promising sources of clinical data and potentially useful administrative data available in Ontario. A collection of these data sources is listed below with a short description and consideration of the strengths and limitations of each.
The Ontario Association of Residences Treating Youth (OARTY) reports on clinical data from approximately one quarter of children served by member agencies. The OARTY database includes numerous outcome measures for children and youth that are measured at various time points. However, the specific research methods employed by OARTY are not described in detail, and it is unclear whether outcome measures are collected on a representative sample of children and youth or instead a convenience sample. Further, there is no third-party validation of the outcomes reported by OARTY, which is concerning given that the reports on outcomes are used as marketing tools.
The Ontario Looking After Children (OnLAC) project uses an approach aimed at raising the standard of care for children receiving residential services. It focuses on seven key developmental areas for children: health, education, identity, family, social presentation, emotional and behavioural development, and self-care skills. OnLAC involves collecting information from young people in out-of-home care in these key areas using the Assessment and Action Record (AAR) data collection instrument. This review is conducted for all young people who are in child welfare care for a continuous 12 months. The Panel heard that the AAR questionnaire is very lengthy, which led to poor response rates and a feeling of burden among professionals, caregivers, and young people who completed them. The Panel also heard anecdotal evidence indicating that appropriate data collection procedures are rarely followed.
The Ontario Child Abuse and Neglect Data System (OCANDS) is a provincial database composed of administrative data from child welfare agencies. The database is child-specific, event-level, and longitudinal. It is designed to track children from initial report through termination of services. It is currently used to generate data for three of Ontario’s five publicly reported performance indicators. At present, 44 of 47 children’s aid societies have signed on to participate. However, the database requires complex programming in order to conduct even basic analysis.
The Crown Ward Review (CWR) is an annual legislated review conducted at CASs across Ontario. A comprehensive file review is completed and young people are provided an opportunity to complete a questionnaire and interview. There is generally a low response rate for questionnaires and interviews, and the review is limited to only those children who have been crown wards for 24 consecutive months. The Panel heard in our consultations that the data produced through the Crown Ward Review is cumbersome and difficult to analyze.
Serious Occurrence Report (SOR) forms are completed if there is a death, serious injury, physical restraint, missing person, abuse/neglect, complaint, or disaster in a residential service funded by the province. MCYS has developed a new tool that aims to enhance the capacity to examine SORs from across the province. However, the data collection process for SORs is outdated and impedes the ability for province-wide analyses. Residential service operators are required to fax SORs and then MCYS regional offices must manually enter the data to send to MCYS. It is an inefficient and burdensome data collection and management process.
MCYS developed the Child Protection Information Network (CPIN) to enable timely sharing of critical child protection information among children’s aid societies. The Auditor General recently reported that “CPIN implementation has suffered significant cost overruns and delays due to poor project planning” (Office of the Auditor General of Ontario, 2015, p. 161). The Auditor General also found that other jurisdictions using the same case management software have experienced positive results. CPIN has been implemented in only five of Ontario’s 47 children’s aid societies and six additional CASs are planning on implementing CPIN in 2016. While CPIN holds great potential for collecting and analyzing data about children and youth in the care of a children’s aid society, it does not appear that the Ministry has built infrastructure to ensure this occurs. In addition, there are issues of data ownership that will need to be resolved in order for the province to meaningfully analyze trends in the characteristics and outcomes of young people in care at the aggregate level. At present, children’s aid societies who have implemented CPIN have agreed that while the information system belongs to MCYS, case-level data belongs to the agency.