rehab process final exam

The legislative and policy framework which supportBest practices in VRS Globally

"Disability Rights" Globally and Nationally The World Health Organization (WHO, 2019) Setting Global Standards: Rehabilitation is an essential part of health care and is integral to achieving universal health coverage. Rehabilitation needs areincreasing globally, along with rising prevalence of noncommunicablediseases and ageing populations. National efforts must strengthen health systems to provide rehabilitation,making it available to everyone at all levels of health care, wheneverneeded. Rehabilitation in Health Systems: Guide for Action InformationSheethttps://www.who.int/health-topics/rehabilitation#tab=tab_2

Key Concepts - Dynamics of the Referral

1. For Referral purposes, the VR professional should be familiar with available and accessible resources 2. Additional education/or training for career/skills transition maybe needed 3. Clients may require a diverse array of services in addition to training or education 4. Clients may need counselling to determine decision making or best criteria for "successful employment"

Economic Factors Questions To Determine if Assessment/Referral Warranted

1. will income maintenance need to be provided or maintained for the client? 2. if the client has significant outstanding debts, could they impede rehab plan completion? 3. if the client is receiving disability related financial support such as WSIB, ODSP, does it appear to be presenting a significant disincentive to create a significant barrier to rehabilitation? If yes, how much of a barrier can be reduced? 5. is the client capable of independently managing personal finances?

(New) Considerations due to: COVID ADVISORYImplications for the Rehab ProcessApplying new concepts - RTW versus Return to Office

COVID-19 Gov. Advisory For Business 1. Mitigate the risks of COVID-19 Implement measures to cut down on interaction times (telecommuting, video-conferencing, home delivery). 2. Follow InstructionsHealth Authorities provide FAQs, guidelines 3. Be guided by LawsI. Human Rights Laws (undue hardship)II. Employment Standards (regulations)III. WSIB Right to Refuse Work (safety)IV. Privacy Legislation (person, Admin.) 4) Manage Remote Teams - 11 Tipshttps://www.williamslake.ca/DocumentCenter/View/3037/COVID-19-Business-ResourcesON Ministry of Labour, Training and SkillsDevelopment Guidelines (NEW) Pandemic related Approaches to AccommodationResources to guide plans and decisionConsider COVID-19 andDisability Accommodation CONSIDER DIRECTIVES IN COVID-19PUBLIC HEALTH CONCERNS lecture 3 slide 29

Rationale for assessment and referral

Key Concepts - Dynamics of Assessment - vocational assessment is aimed at identifying the most optimal vocational outcome - vocational professional must be familiar with vocational and community resources - assessment incorporates more in-depth evaluative procedures - Examines complex social, emotional, physiological, vocational factors

Part 3 - Progressing towards RTW PlanningCase Management Functions in RTW PlanningThe Case Manager:

Part 3 - Progressing towards RTW Planning Case Management Functions in RTW Planning The Case Manager: Sets RTW goals in conjunction with the worker and workplace stakeholders(employee, union, management) and makes effective decisions based uponlegislation, HR policy and best practices Coordinates activities in collaboration with the workplaceparties to support achievement of successful outcomes by: Establishing a plan which includes, timelines for completion, milestones, follow-up and monitoring to case closure Ensuring effective communication of information and remains accountable for activities within scope of responsibilities Identifying potential barriers to the RTW and undertakes appropriateactions (referral, consultation, use of resources such as EAP asappropriate)

Case Management skills and competencies

Pursuing Professional Certification(separate preparation for pursuit of case management) https://ccmcertification.org/courses/case-management-canada #1"The most important number in case management, however, is "one"—the individual professional case manager who pursues this profession as an advanced practice in health and human services. As a CCM, the board-certified case managermakes a powerful statement about possessing the requisite knowledge and his orher competence in performing the essential activities of case management. Asindividuals dedicated to the highest professional and ethical standards, board-certified case managers play a crucial role in health care and achievement of thegoals of health care reform. Evident across the health care spectrum is a greater emphasis on care coordination and care transitions to improve care for the most complex and chronically ill patients, while helping deliver more efficient, cost effective services"(CCMC, 2015, cited in Patrice V. Sminkey, 2015, p. 260)

The National Case management Network of Canada (NCMN) Assessment Standard

Standard: In conjunction with the client, the Case Manager conducts and documents an individualized assessment using a structured process Rationale: Information generated by the assessment process serves as the foundation for planning Interpretation: Assessment is a dynamic and ongoing collaborative process that actively involves the client and others to secure information in a timely manner and to identify the client's values, goals, functional and cognitive capacity, strengths, abilities, preferences, resources, supports and needs

Elements of the Case Manager's Role~ Disputes and Risk Management in the RTW Process~

Steps in WSIB Model for Dispute resolution "In cases where the workplace parties cannot agree on whether an offered job is suitable, whether the worker has attempted to perform the offered job or not, the following steps should take place whenever reasonably possible: 1.The worker notifies the employer that the offered job is not suitable and provides reasons 2.The employer considers the reasons, and through dialogue with the worker,considers further accommodations if appropriateIn the event that agreement cannot be achieved, both workplace parties promptlynotify the WSIB and provide all information relevant to the dispute, e.g., jobdescriptions, physical demands analyses, and/or functional abilities information"Source: WSIB Ontario Operational Policy: Work Reintegration (19-02-02). Responsibilities ofthe Workplace Parties(Let's Review application of model to the Government of Canada CM process

The legislative and policy frameworks which supportBest practices in VRSWHO Instruments: CRPD "Disability Rights"

The CRPD• The Convention on the Rights of Persons with Disabilities (CRPD) and its Optional Protocol (OP) were adopted on 13 December 2006, as the first comprehensive human rights treaty of the 21st century. It entered into force on 3 May 2008.2016 marks the 10-year anniversary of the CRPD.• International Day of People withDisability (IDPWD) is a United Nations-sanctioned day that is celebrated each year internationally on 3 December slide 24 lecture 1

Part 3 What is the Rehabilitation ProcessAn evolving model(Review the Rehabilitation Process Flow Doc)[Since the 1960's]

The Office of Vocational Rehabilitation detailed six basic and underlying principles that guidethe vocational rehabilitation process that included:1. Action must be based upon adequate diagnostic information and accurate and realistic interpretation of the information that is secured;2. Each rehabilitation client must be served on the basis of a sound plan;3. Guidance and counseling of clients and close supervision of all services are essential at each step of the process;4. Each service must be thoroughly rendered and followed-up;5. The cooperation and involvement of the client and all others concerned with his/her rehabilitation is necessary and must be secured before adequate rehabilitationcan be accomplished; and6. Adequate records must be kept (McGowan, 1960, p. 41).Source: Rick H. Robinson, R.H. (ed.). Foundations of Forensic Vocational Rehabilitation

CORE PRINCIPLES OF REHABILITATION & VR Professional Proactive Role In Rehabilitation Process

The Ontario Provincial Rehabilitation Reference Group (August 2000), Identifies the following core principles: • Rehabilitation is focused on enhancing the quality of life of people with impairments, activity limitations or participation restrictions resulting from illness or injury, and fostering full their participation in all areas of life/society •The achievement of rehabilitation goals related to full participation, and access to services means addressing individuals' bio-psycho-social needs, as well as their social and environmental contexts. •Client-centred rehabilitation services - in which clients are active participants ingoal-setting - are more effective than those which are solely defined and prescribedby professional care providers • Rehabilitation is a dynamic process. The rehabilitation process happens bothwithin and beyond walls and institutions: rehabilitation services therefore need to bebuilt around "spaces" or "places" within a system, rather than beds.

SUMMARY/Conclusion of Initial Evaluation of the Rehabilitation Process-

The efficacy of the vocational rehabilitation process has undergone critical analysis, primarily in the examination of its return on investment- RC's entering the field are working within time-sensitive and cost-sensitive concerns- The system of financial compensation programs such as LTD, WSIB Veterans Disability can contribute to a push/pull system of eligibility, entitlement and tensions in loss of income replacement- VR Counsellors work within the system in a collaborative manner to facilitate successful outcomes for the client and stakeholders involved in the process

Federal Public Service FindingsIMPLICATIONS AND COMPETENCIES BASED CASE MANAGEMENT

The majority of cases of non-occupational illness or injury in the federal publicservice are due to two main causes: psychological and musculoskeletal. Evidence support that the major causes of illness or injury can be prevented In the workplace, encouraging individuals with early symptoms to take remedialaction is one of the most effective and least costly ways to support health andwell-being The workplace parties (Employer, Employee, Union) demonstrate co-operation insupport of RTW Other significant but less prevalent causes of disability are cancer, accidents andcardiovascular illness

VRDP ACT

Vocational Rehabilitation of Disabled Persons AcRepealed, 2005, c. 35, s. 69]Image of act and some wording to describeits intentions Policy Resulted in TracingPrevalence of Disability in Canada - slide 17 lecture 1, statistics, prevalence of disability

Key Concepts DisabilityDisability....not a unified definition....but a contested field

"Disability is complex, dynamic, multidimensional, and contested. Over recent decades, the disabled people's movement - together with numerous researchers from the social and health sciences - have identified the role of social and physical barriers in disability. The transition from an individual, medical perspective to a structural social perspective has been described as the shift from a "medical model" to a"social model" in which people are viewed as being disabled by society rather than by their bodies. The medical model and the social model are often presented as dichotomous, but disability should be viewed neither as purely medical nor as purely social: persons with disabilities can often experience problems arising from their health condition. A balanced approach is needed, given appropriate weight to thedifferent aspects of disability" (WHO & World Bank, 2011, pp. 3-4

Elements of the Case Manager's Role~ Disputes and Risk Management in the RTW Process~Steps in WSIB Model for Dispute resolution

"In cases where the workplace parties cannot agree on whether an offered job issuitable, whether the worker has attempted to perform the offered job or not, thefollowing steps should take place whenever reasonably possible: 1.The worker notifies the employer that the offered job is not suitable and providesreasons 2.The employer considers the reasons, and through dialogue with the worker,considers further accommodations if appropriateIn the event that agreement cannot be achieved, both workplace parties promptlynotify the WSIB and provide all information relevant to the dispute, e.g., jobdescriptions, physical demands analyses, and/or functional abilities information"Source: WSIB Ontario Operational Policy: Work Reintegration (19-02-02). Responsibilities ofthe Workplace Parties(Let's Review application of model to the Government of Canada CM process)

Part 2. The legislative and policy framework which supports best practices in VRS

"The International Year of Disabled Persons—1981—is often citedas the landmark date for tracing the history of disability studies inCanada".But In Unison set the policy framework for numerous policyinitiatives concerning Persons with Disabilities including vocationalservice delivery•In 1998, In Unison outlined the importance of intergovernmentalcooperation to improve service delivery, reduce administrativeduplication and enable the portability of supports across Canada•In Unison outlined facts and figures that paint a portrait of life witha disability in Canada•In Unison 2000, the Federal-Provincial-Territorial MinistersResponsible for Social Services conducted consultations withCanadians with disabilities to report on their experiences.•In Unison sets the policy structure for informing on the profilesindividual Canadians with disabilities - which currently continuesto illustrate both their successes and the barriers they face.(In Unison: A Canadian Approach to Disability Issues

Rehabilitation Process under Service Canada: VR VETRAN'S ASSISTANCE

"When applying for a disability make sure that your story (your history of what happened) covers these areas.You may need witnesses to write a letter or testify in front of the VRAB". --2. "Demonstrate that the claimed condition"arose out of or was directly connected with"his or her service as a member of the CF; yourstory VIA YOUR RECORDS, YOURTESTIMONY, WITNESS STATEMENTSETC." b. "Disability is defined as: Disability means the loss or lessening of the power to will and todo any normal mental or physical act". --3. "Establish that he or she suffers from a"disability" (a defined term in the PensionAct); andFrom the VAC Table of Disabilities (weblink) c. "To win an award you must:demonstrate that he or she has a claimed condition—an injury or disease, or an aggravation thereof; YOU CAN DO THIS WITH A DRS REPORT WHICH SUPPORTS THE FACT THAT YOU ACTUALLY HAVE THIS PROBLEM still and it will be a long term problem not fixed in 2 months" --4. "Establish that the disability resulted from a military service-related claimed condition.ONCE AGAIN IS YOUR CLAIMED DISABILITY A DISABILITY ACCORDING TO VAC AND LAWS OF CANADA. If a PTSD claim review this"

Enabling competencies in the Rehabilitation Process Requires Knowledge of:

- The legislative framework (e.g.AODA) - Occupational Demands - Human factors - Physical factors - Educational/vocational factors - Psychosocial Factors- Medical Condition (s) and/orimpairments affecting workingconditions - Economic Factors - Choice (consequence) factors in occupational demands including analysis and development of written work accommodation plans "The Employment Standard under the AODA states that all public sector organizations, and private or non-profit organizations with fifty or more workers, must develop and document a process for writing individual accommodation plans"

REHABILITATION COUNSELLORSPROACTIVE ROLEIN INCLUSIVE WORKPLACE

- dignity: promote a culture of excellence and achievement and behaviour with full participation of all - opportunity: creates opportunities that build on inclusion and full participation for all members - exclusion is not guilty - diversity: work in partnership on initiatives for accommodation and support inclusion - respect: embrace and celebrate diversity in all dimensions

SUMMARY: ENABLING COMPETENCIES IN THE EVALUATION PHASE OF THEREHABILITATION PROCESS

1. By building awareness of the employment barriers and discrimination faced bypersons with disabilities the rehabilitation counsellor approach to case managementrequires knowledge the sources of support to facilitate effective case management • Reflect on the learnings regarding historical experience of discrimination and marginalization as experienced by PWD• Reflect on the legislative framework and roles and responsibilities of the workplace stakeholders • Reflect on potential areas of support that may be presented by the client 2. By building awareness of the elements of case management workflow process, the casemanager builds competencies in carrying out their professional roles • Reflect on the functional definition of case management • Reflect on the process flow of case management • Reflect on how the case manager may engage in the process with the client 3 By building awareness of the functional tasks of the CM • Reflect on the tasks that the CM will perform at each stage of the process • Reflect on use of counselling and collaboration skills as tool in facilitating effectivecase managemen

Part 1: Competencies identified byNCMN, 2012

1. Case management expert: Case Management(CM)Providers demonstrate expertise in complex health 2. Communicator: CM Providers use effective communication to develop and enrich the client's health and social networks 3. Collaborator: CM Providers facilitate the achievement of optimal client and system outcomes; CM skillfully engage individuals and groups to reach consensus 4. Navigator: CM providers help clients navigate health and social systems by working with their networks 5. Manager: Case Management Providers are integral participants in making decisions 6. Advocate: Case Management Providers usetheir expertise and influence to speak on behalfof their clients 7. Professional: Case Management Providers demonstrate professional behaviour in the best interests of clients and society

Part 1: Rationale for Assessment and Referral Knowledge base competencies linked to the collaborative role of the RC Professional

1. Formulating rehabilitation plansand service goals 2. Interviewing clients to obtain background information 3. Participating in caseconferences 4. Identifying communityagencies and resources 5. Ensuring Continuity of services to clients 6. Conducting effective counselling human service system consists of: -- counselling theories and modalities and theories of personality -- medical terminology and services and use/effects of medications, (dominance medical model) -- characteristics of impairments (disabling conditions) -- behaviour change, modification techniques, -- legal and ethical issues related to rehabilitation practice -- the effects of socioeconomic factors on the rehabilitation process

PART 1: CONTEXTUALIZING The Role and Function of the VR Professional The Big Picture - Need for Meetings/Coordination" Managing The Seams"

1. Multiple, identified access points 2. Universal screening and referral mechanisms (within the rehabilitation system, or to other appropriate services) 3. Universal assessment of client-need tools (based on the ICIDH-2 framework - International classification of functioning and disability) 4. Service coordination function 5. Monitoring, Evaluation and Follow-up (client and system levels) 6. Transition out of rehabilitation services 7. Information Production and development ofManagement Tools and Practices

Psychosocial Factors Questions To Determine if Assessment/Referral Warranted

1. has the client manifested psychological reactions toward their disabilities that would inhibit adequate vocational adjustment? if yes how can they be ameliorated? 2. is the client's disability being used as justification for failure to eliminate to fulfill expectations for self or others? If yes, how can their motivation for rehab be increased? 3. would the client work well under a job that demand a lot of collaborative effort with other workers? 4. is the client overly concerned about their general health? 5. Esther any reason to believe that the client's symptoms are psychologically based? 6. are there cultural factors that should be taken into the consideration in the formulation of the rehab plan?

Educational-Vocational Factors Questions To Determine if Assessment/Referral Warranted

1. is the client's educational record an accurate reflection of capacity? (i.e. did client quit school due to financial or other barriers/reasons?) 2. has the client developed vocationally relevant skills that limit the functional impact of the disability? 3. does the client's vocational or work history suggest that certain types of training and contraindicate others? -- which does it suggest and which does it contraindicate 4. does the client have a good picture of personal skills and abilities? 5. is there any evidence of underdeveloped talents that have vocational relevance? Can and/or should these potentials be developed? 6. did the client have a positive work history (ie. regular employment) 7. what work skills does the client currently possess? 8. what information from the client's work history can be of value with respect to current vocational choice considerations? in what specific ways is that information useful?

Physical Factors Questions To Determine if Assessment/Referral Warranted

1. is the clients disabling condition progressive or stable? 2.a) if the client is restricted in respect to activities of daily living: can their capacity for carrying out such activities be increased? b) how much assistance will the client need from others to carry out activities of daily living? 3. if mobility is restricted by the client's physical disability can the mobility be increased? 4. are there any technological devices that can help the client overcome physical barriers? 5. in what ways is utilization of the client's vocational skills blocked by environmental or human factor barriers due to impairments -- can the barrier be moved or reduced? -- (intervention through advocacy. technological adaptations

Personal Vocational Choice Considerations Questions To Determine if Assessment/Referral Warranted

1. regarding current goals, does the client have an understanding of the employment outlook in the field they're considering 2. regarding potential goals, are there job redesign possibilities that can increase the client's employability? 3. regarding job acquisition, does the client's specific disability preclude consideration of certain work settings?

Canadian Human Rights Commission Report

2016 Annual Report • In 2016, the Commission received 1,488 discrimination complaints from people inCanada seeking human rights justice • 60% of complaints received by the Commission in 2016 were disability related • 48% of the disability type complaints received by the CHRC were related to mental health issues • 29% of the total complaints received by the CHRC in 2016 were related to mentalhealth • 48% of the disability complaints received by the CHRC were related to mental healthissues. • This means that 29% of the complaints received by the CHRC in 2016 were related tomental health.Source: https://www.chrc-ccdp.gc.ca/eng/content/departmental-plan-2017-18

Extending the Initial Evaluation Phase

A potential outcome: Follow procedure for obtaining additional medical Information-A finding of insufficient information during the initial evaluation to validate or determine vocational services/next steps: 1. Follow protocols for obtaining confidential Health informant from sources(e.g.: doctors, hospitals, clinics and referring agencies). 2. Obtain any specialist examinations and assessments that have beenrequested by the medicalconsultant or that the counsellor feels are necessary to determine eligibility 3.Obtain required psychiatric/psychological examination if applicant's mentalhealth disability claim is a factor - potentially dual diagnoses of physical/mentalhealth, addictions may be a factor in disability claim 4.Be mindful of the requirement of having signed consent in keeping privacy laws

OHRC - Training Supportson the "Duty to Accommodate"

A tool for you, the employer and clients engaged in the statutory obligations in Case Management/RTW: Learning about the duty to accommodate This eLearning module on "The Code, Accommodation and Undue Hardship" is designed for the public, private and not-for-profit sectors. It has been divided into 2parts, and takes about 20-30 minutes to complete

Today...Removing Structural and Environmental Barriers for Full Participation

According to the Ontario Human Rights Commission:On average, 30-50% of human rights claims cite the ground of disability. Mostare in the area of employment, For this reason, the Policy [Policy andguidelines on disability and the duty to accommodate] focuses on theworkplace with specific guidance to support employers, unions and employeesin the fulfillment of their duties and rights under the Code (OHRC, 2009, p. 4)

OHRC Duty to ACCOMODATE

As stated by Lynk (2008): The duty to accommodate is a fundamental legal obligation. It comes fromthree sources: (i) the applicable human rights legislation; (ii) rulings from the Supreme Court of Canada; and (iii) rulings of labour arbitrators and human rights tribunals.The Duty to Accommodate in the Canadian Workplace: Lynk (2008). U of Western Ontario

Occupational Health and Safety Act(OHSA

Be Aware of WSIB Timelines For injury reporting. VR Professionals best practice includes compliance with WSIB reporting timelines (WSIB form 82) Occupational Health and Safety Act(OHSA): Employers must display a copy of the OccupationalHealth and Safety Act in their workplaces. •A Required practice: Post the OHSA andits Regulations (The Green Book) and OHSformCollaborations with the JHSC on mattersof workplace safety including: • Workers rights• Workplace training • Hazardous materials labelling• Reporting • Employer ObligationsPlease refer to the OH&S Bulletin Boardfor an accessible view of the poster at:

HUMAN FACTOR IMPLICATIONS

Be aware of "presenteeism," "When employees come to work, but for a range of reasons(including poor health) are not working to capacity, if at all. According to experts on health and productivity, presenteeismmay be a greater threat to workplace productivity thanabsenteeism. Some associated conditions include headaches, allergies, arthritis, asthma, diabetes, mental health issues and other pressures causing sleep deprivation, exhaustion and difficulty concentrating"

Canadian Business Directory e-Resources Government of Canada

Business Directoryhttps://beta.canadasbusinessregistries.ca/search •Provides a listing of service providers forthose who have chosen to register •An alpha tab listing is provided for a quicksearch to reveal details about a company: - Full Profile (official/alt name,address - Contacts (names tele #) - Description (ownership, yearestablished etc.) - Products/Services/Licensing • These services are but some ofthe available services -registration is voluntary and not all Canadian Service Providers are listed in the Directory • All of the information on these Canadian Companies are provided by the Companies • Gov. website provides a disclaimer which does not hold the government responsible for contents. It is not an "enforced"registration, but validates the existence, ownership and responsibility of business entity

MENTAL HEALTH RESOURCES

Canadian Mental Health Association CMHA Quick Guide to Mental Health Resources Serving Toronto Mental Health Resources Some of the categories of services are indicative of the broad spectrum of referral resourcing required in rehabilitation process: •Abuse•Addictions•Anger Management•Assertive Community Treatment (ACT)•Case Management Services•Community Health Centers•Consumer Initiatives•Counselling•Crisis Support/Distress Lines• Developmental Disabilities• Drop-in Clinics for Primary Care and/orPsychiatry Services• Early Intervention in PsychosisPrograms• Eating Disorders• Employment Vocational• Family Support• Financial Support• Food Banks• Government/Health System• Health Care• Health Clinics• Homelessness Shelters/Outreach• Hospitals• Housing & Housing Help Centres• Information Referral• Justices of the Peace• LGBTQ+Services

WSIB Framework which guides the process

Case Management and the Legal Framework to support Early and Safe RTW/AccommodationEarly and safe return to work of workers following injury/disability is required under s. 40 ofWSIA Workplace Safety and Insurance Act s.40 A plain language guide is provided for employers to create awareness of the legislative duties ofthe workplace parties: Employer, Employee, Unions and Coworkers (Employer's Guide to WSIB)In summary: ---The workplace parties (Employer, Employee, Union) demonstrate co-operation in support ofRTWThe Employer /rep contacts the Employee as soon as possible after the injury occurs andmaintains communication throughout the period of the worker's recovery The employer provides Safe & Suitable work and the worker assists to identify "safe andsuitable work" that is consistent with the worker's abilities (safe) and restores their pre-injuryearnings (suitable) Employer & Employee provide the WSIB with information as requested concerning the RTW

Elements of the Case Manager's Role

Case Managers as Advocate: •"As case managers, we are [patient] advocates who seek the best resources for our clients, which means drawing upon the strength and expertise of others. For example, if I am the case manager assigned to a patient with a complex medical condition, I will need to go to someone with more of a clinical background, such as a nurse case manager. This illustrates my commitment as patient advocate and demonstrates my knowledge by knowing what I do not know and seeking input and assistance from someone better versed in the dynamics of the specific situation. There will be other times when a[patient] has psychosocial issues that are best served by my social work background" (Kim Schuetze, 2006) Collaboration with a range of diverse Professionals Practices: "For all case managers who interact with colleagues from any number of healthcare backgrounds, the focus on outcomes is the deciding factor. As we emphasize clinical outcomes andthe satisfaction of the client (meaning the individual receiving services), as well as financial outcomes for payers, our egos are subordinate to the greater good" (Kim Schuetze, 2006).

Characteristics of Previous System - Medical Model

Charity Institutions Pity & Sickness Eugenics Mental Hygiene Sterilization Disability is within the person: a"cure/fix"approach

The advocacy for change frominstitutionalization to Community Living

Close institutions• Full Citizenship Participation• A shift to advocacy movement and rights protection• 1981 BC: Due largely to the advocacy efforts of families, in 1981 the provincial government announced plans to closeWoodlands citizens, and created the "self advocacy movement."• 2009 ON: Premier Wynne apologized to survivors• The province shut down its three largest facilities (Huronia, Rideau Regional,Southwestern Centre• Alberta issued an apology for the forced sterilizations carried out in many institutions under the notorious Sexual Sterilization Act

Elements of the Case Manager's Role

Collaboration with a range of diverse Professionals Practices: "For all case managers who interact with colleagues from any number of healthcare backgrounds, the focus on outcomes is the deciding factor. As we emphasize clinical outcomes andthe satisfaction of the client (meaning the individual receivingservices), as well as financial outcomes for payers, our egosare subordinate to the greater good" (Kim Schuetze, 2006). How does this apply to the WSIB or LTD process? Reflect on the application and Eligibility for WSIB/LTD Fostering Effective Working Relationships: 1.Maintain harmonious working relationships 2.Understand and respect the professional expertise of alignedcolleagues 3.CM's develop and maintain a body of knowledge, skills, corecompetencies and utilize different strengths "as positive not negative""The beauty of the case management is there is no one, single way toview a problem. Rather, there are many different paths that may bepursued to reach a solution. As I see it, we can reach similar outcomes by traveling different paths, and if we travel together, we can cover more territory, more effectively" (Kim Schuetze, 2006).

Canadian Core Competency Profilefor Case Management Providers

Core competencies --A repertoire of: oMeasurable skills oKnowledge and abilities oRequired by Case Management Providers throughout their career Other competencies Key Competencies: oImportant outcome objectives, i.e., what is to be achieved or performed Enabling Competencies: osub-elements or key ingredients toachieving the key competencies o Knowledge of relevant policies

Key Concepts

Disability as defined by the Ontario Human Rights Code: Section 10 (1) of the Code defines "disability" as follows:"because of disability" means for the reason that the person has or has had, or is believed to have or have had, 1. any degree of physical disability, infirmity, malformation or disfigurement that is caused by bodily injury, birth defect or illness and, without limiting the generality of the foregoing, includes diabetes mellitus, epilepsy, a brain injury, any degree of paralysis, amputation, lack of physical co-ordination, blindness or visual impediment, deafness or hearing impediment, muteness or speech impediment, or physical reliance on a guide dog or other animal or on a wheelchair or other remedial appliance or device, 2. a condition of mental impairment or a developmental disability, 3. a learning disability, or a dysfunction in one or more of the processes involved in understanding or using symbols or spoken language, 4. a mental disorder, or 5. an injury or disability for which benefits were claimed or received under the insurance plan established under the Workplace safety and insurance act

United Nations Disability Framework"

Disability is an evolving concept and that disability results from the interaction between persons with impairments and attitudinal and environmental barriers that hinders their full and effective participation in society on an equal basis with others Rehabilitation Defined Rehabilitation - Contextualized by WHO (2011):Rehabilitation is a set of measures that assist individuals who experience, or are likely to experience disability, to achieve and maintain optimal functioning in interaction with their environments. A distinction is sometimes made between habilitation, which aims to help those who acquire disabilities congenitally or early in life to develop maximal functioning; and rehabilitation, where those who have experienced a loss in function are assisted to regain maximal functioning...although the concept of rehabilitation is broad, not everything to do with disability can be included in the term. Rehabilitation targets improvements in individual functioning - say by improving a person's ability to eat and drink independently. Rehabilitation also includes making changes to the individual's environment - forexample, by installing a toilet handrail. But barrier removal

Disability: Conceptualized as a deterministic model variously defined based on contractual definitions

Disability: Conceptualized as a deterministic model variously defined based on contractual definitions"Insurance" - Various Contractual terms define meaning of Disability •The definition of "any occupation" plan means you'll receive disability benefits only if you're unable to work at all. This mean your illness or injury prevents you performing the duties ofany job for which you're reasonably suited. •You don't qualify for benefits if you can work in a different job from the one you had beforeyour disability, based on your training, experience and education .•The definition of "regular or own occupation" plan means you'll receive benefits if you'reunable to perform the main duties of the job you had at the time the disability started. •You'll still receive benefits even if you can work in a different job from the one you hadbefore your disability, based on your training, experience and education. Some policies don'tallow you to get benefits, or may reduce your benefits, if you begin working in a different job .•In group policies, it's common that policies have regular or own occupation plans for aspecified period of time. At the end of the specified period of time, usually after the first 2 or5 years, the disability policy will often change to the any occupation definition .•Own occupation plans that never change in definition are often purchased individually andusually cost more than any occupation plans.•You may want to consider an own occupation plan if you have a specialized occupation that would require you to take a significant pay cut in order to work in another field. Government of Canada Financial Consumer Agency of Canada (2018). Disability Insurance.https://www.canada.ca/en/financial-consumer-agency/services/insurance/disability.html#toc3

Disability: Conceptualized as a deterministic model variously definedbased on based on contractual definitions

Eligibility for benefits from the Canada Pension Plan (CPP) and Quebec (QPP): The CPP disabilitybenefit and QPP disability benefit are available to people who have contributed to those plans andaren't able to work regularly at any job because of a disability. In the Rehabilitation Process: •Determine eligibility for the CPP/QPP disability benefit •Determine eligibility for WSIB Public Insurance Plan•WSIB coverage provides employers with legal protection if a workplace injury occurs, and providesinjured workers a variety of benefits and services. •(In Ontario) Employers who have business activities covered under Schedule 1, Part I and Schedule2 of Ontario Regulation 175/98 (the regulation) require coverage (Jan 2, 2020)Mandatory Coverage - Schedule 1 (Educational services, Public administration Hospitals) Workers of Schedule 1 and Schedule 2 industries are automatically covered by the WorkplaceSafety and Insurance Act, 1997 (WSIA) unless the industry is excluded by Schedule 1, Part II of the regulation .•Schedule 1 employers are protected by a system of collective liability. Since the WSIB pays benefitsto injured workers out of money pooled in the insurance fund, Schedule 1 employers are relieved ofindividual responsibility for accident costs. •Temporary employment agencies An employer who supplies workers to perform work for anotheremployer on a temporary basis for a fee is subject to mandatory coverage, regardless of thecoverage status of the client employer

Legislative framework which supports VR Process

Employers should consult these areas of law when considering what is required toassist employees to return to work: 1. Ontario Human Rights Code/Duty to AccommodateOHRC Policy and guidelines on disability and the duty to accommodate 2. Workplace Safety and Insurance Act Workplace Safety and Insurance Act, 1997 3. Occupational Health & Safety Occupational Health and Safety Act, R.S.O. 1990, c. O.1 4. Employment Standards Act Employment Standards Act, 2000, S.O. 2000, c. 41 6. Freedom of Information and Protection of Privacy ActFreedom of Information and Protection of Privacy Act 7. Personal Health Information Protection Act Personal Health Information ProtectionTheme 1 Initial Evaluation: Module 2 - Preparing for a VR Focused Interview Y. SIMPSON YSR 825 10

Part 2: WSIB and LTD Insurance SystemsMedical Deterministic ModelsOperating within systems of legislation

Example of LTD form • Sun Life Long Term DisabilityClaim Packagehttps://www.sunlife.ca/static/canada/Sponsor/About%20Group%20Benefits/Forms/PDF%20static%20files/Package-Standard-PM-LTD-E.pdf WSIB FormsWorker's report of injury/disease(Form 6)Employer's Report ofInjury/Disease (Form 7)WSIB Health Professional's ReportForm 8https://www.wsib.ca/sites/default/files/2019-03/form8.pdf

Privacy and ConfidentialityImportant dimension of the Rehab process(review the Rehab flow process wk. 1)

FOR BEST PRACTICES TIPS TO AVOID COMPLAINTS GOING TO THE PRIVACY COMMISSIONER https://www.priv.gc.ca/en/privacy-topics/privacy-laws-in-canada/the-personal-information-protection-and-electronic-documents-act-pipeda/pipeda-compliance-help/02_05_d_55_tips/ Most significant to the Rehabilitation Professional: #3. "Take responsibility for employee actions. Sometimesemployees disregard policies related to privacy (deliberatelyor by accident). Organizations must be aware that employeeerror is not an excuse for PIPEDA violations; it is not enoughto just have privacy sensitive policies..."#8. "Protect personal information If you decide to collectpersonal information, you should use safeguards proportionalto the sensitivity of the information. For example, beparticularly careful with health and financial information, orinformation that would facilitate identity theft.. which entities come under HIPPA compliance slide 26 lecture 3

Part 3 - the Current Paradigm of ProfessionalizationRehabilitation and the Critical Discourse

Finkelstein's (1984) critique and arguments:"The 'expert' or professional becomes a resource to be used by disabled people. Under theseconditions the 'expert' or professional becomes a teacher rather than a therapist or someonewho does things to and for disabled people. With the advent of good medical practice andactive involvement of disabled people in social affairs in their own interest the whole needfor a rehabilitation medicine then falls away" (p. 4). 1.Chronic Problems with the concept of Rehabilitation - a specialized practice 2.Adjusting the limits of Medical Science - medical science is centred on cure & diagnosis 3.Who decides what it means to be Rehabilitated - Professionals focus on "brainwashing disabled people into accepting that the present able-bodied world is the only world that one can fit into" 4.Rehabilitation or Integrated Living Services - direct action is required in the elimination of barriers

INFORMATION COLLECTION PRIVACY IN THE VIRTUALSPACE

General Provisions of Canada's Privacy Laws Under federal and provincial privacy laws, personal medical information is private, and individuals have the right of control to access CMs and Workplace Stakeholders must respect the privacy of medical information even insituations where an employee voluntarily shares this information Workplaces must have policies in place to support the framework of "respecting the confidentiality and privacy" of medical information "The CMs role is not to diagnose illness or to adjudicate a disability claim. The word of a treatingphysician is sufficient to verify whether an employee is unable to work for medical reasons". The insurers and/or Workers' Compensation Board will, with the employee's consent, collect themedical information required to process a claim. Employers have the right to know what functional limitations, if any, the employees have in order to fulfill the duty to accommodate and make the appropriate adjustments to enable the employee to remain at work if possible, or to return to work as soon as they are safely a able to do so

Generating Progress of findings

General minimal outline oftopics for progress reportRubin & Roessler (2008): 1.A brief discussion of thereason for referral 2.Background information 3.Impairment related(abilities restrictions, limitations) 4.Transferrable/Skills (orocc analysis information) 5. Behavioral Observationsas they relate to vocationalfunctioning6. Results of any formaltesting (psychometrics,voc eval etc.) 7. Status of current activities,psychosocial elements. 8. Specific recommendationsfor voc rehabilitation plan,next steps, options toconsider

Summary•

If a referral to alternative sources of support which will enhance the potential for successful outcomes the VR Professional should: - Refer the client for the most appropriate service and service provider, resource, practitioner or agency. - Inform on any provisional vocational, work reintegration goals and seek clarifications or recommendations as needed- Prepare a list of questions to the referral source based on present and future implications of impairments, any residual medical conditions, effects on occupational performance and specific job functions- Overall, the VR professional considers an integrative model of support for the client's future needs, after service contract had ended

Characteristics of Current System

Inclusion, Citizenship Rights, Charter of Rights protection Accessibility, Duty to Accommodate, A social model of disability: emphasis on accessibility, structural changes for equity, and full participation "While there is much broader public acceptance of disability today,there is sensitivity to the images and language used in public, much ofthis could probably be ascribed to 'politically correct' behavior. A realquestion is whether the underlying prejudices and images associatedwith disability and disabled people have fundamentally altered"(Neufeldt, 2004, p. 28)

Intersectionality Disability and demographic identity Pandemic and impact on Health and Rehabilitation Services

Intersection of Pandemicand disability • How are Canadians with long-term conditions and disabilities impacted by the COVID-19 pandemic? • The currently available data paints a picture of concern and unchartered future directions for persons with long-standing chronic conditions and newly emerging COVID-19 related complications

Advocacy and impact of lived experience•

Leilani (O'Malley) Muir, a survivor of theSexual Sterilization Act of Alberta,Canada, passed away on the weekend ofMarch 12 at the age 71.• In 1996, Ms. Muir became the firstindividual to sue the Alberta governmentfor wrongful sterilization• Leading to the government compensationof more than $80 million to over 800survivorsThe Sexual Sterilization Act of Albertaallowed the province to sterilize any wardof a mental health institution whom itsEugenics Board considered "mentallydefective" and at risk of transmitting"defective genes" to future children.Under this act, nearly 3,000 residents ofAlberta were sterilized between 1928 and1972, when the law was finally repealed"

Part 3-Managing the referral processe-resources and third-party vendors

Manage contracts responsibly •"The agreement between the organization and the successful vendor- service provider should be formally set out in a -- :Signed agreement between the parties, usually in the form of a service contract designed by the referring agency •The contract should include items specified in the procurement documents, e.g., the parameters of service delivery, cancellation and termination clauses, any options to extend the agreement and a *biddispute/appeal mechanism [*applies for bidding process]. •The organization should monitor the vendor's performance and verify all invoices and payments against the terms of "the contract"

xample OF 'Vocational Rehabilitation Counsellor"Breakdown of NOC Code - NOC version 2016

NOC Code 4153 breaks down as follows: 4 - first digit denotes the broad occupational category - Occupations in education, law social, community and government services. Skill level A usually require university education 41 Major group - Represents professionaloccupations in law and social, community andgovernment services 415 Represents all jobs classified in social andcommunity service profession 4153 Represents the "Unit Group", or the code for "Vocational Rehabilitation Counsellor" and other aligned professionalsYou know this bc more than one job title is under this NOC code - they are listed among the 50 or more available job titles in this Occ category of Family, marriage and other related counsellors

what is a case manager

National Case Management Network (NCMN) 2012, pp. 5-18, for listing of Core Competency "Profiles for Case Management Providers Case Management Providers demonstrate expertise in complex health and social needs planning. as leaders in coordination and facilitation, Case Management Providers integrate all Case Management roles to promote and optimize the health and well-being of targeted client populations" (p.7) The National Case Management Network of CanadaDefinition of case management: "Case Management is a collaborative, client-driven process for the provision of quality health and support services through the effective and efficient use of resources. Case Management supports theclients' achievement of safe, realistic, and reasonablegoals within a complex health, social, and fiscalenvironment"

Disability Rights and Advocacy

Neufeldt (2004) identifies "ThreeWaves" of disability history in Canada The First Wave: Mid to late 1800s-Emerging programs and policies in CanadaSchools and provincial associations of/for deaf peopleResidential schools for "feebleminded"First Worker's Comp laws 1909 QC & 1914 ONService Clubs & Rehab: Shriners, Rotary and Lions The Second Wave: 1920's to post WWII-Efforts in coordinated community services-Innovations: wheelchairs, drugs, prostheses The Third Wave:1970's Pursuit of Civil Rights & Inclusion Two Major Organizations Formed in 1918:Canadian National Institute for the Blind (CNIB)Canadian Mental Health Association (CMHA) "Advocacy: speaking up for yourself or for an Individual, family or community in a situation that is viewed as undesirable unfair and changeable." according to Stienstra & Wight-Felske (2003, p. 2

The legislative and policy framework which supportBest practices in VRS - an approach to services(source for below chart, In Unison Canada)

Old Approach Disability Issues • Recipients• Passive Income Support• Dependence• Government Responsibility• Labelled as "unemployable"• Disincentives to leave income support• Insufficient employment supports• Program-centered approach• Insufficient portability of benefits andservices• Multiple access requirements New Approach to Disability Issues• Participants• Active measures to promoteemployment in addition to providingnecessary income support• Independence• Shared Responsibility• Identification of work skills• Incentives to seek employment andvolunteer opportunities• Opportunities to develop skills andexperience• Person-centered approach• Portable benefits and services• Integrated access requirements

Mapping the historical evolution ofdisability rights and the need for vocationalrehabilitation services (VRS) in Canada

Part 1: Mapping the historical evolution ofdisability rights and the need for vocationalrehabilitation services (VRS) in CanadaAccording to Prof. Neufeldt, Disability Historian:"Anyone travelling Canada's forest and lake country, the prairies or thenorth, far from population centres and modern transportation, canimagine the difficult situation of disabled people in Canada for most ofits history"- Pre-European Contact, Aboriginal peoples addressed disease andisability within the context of their beliefs. No term for 'disability'-Colonization brought new structures: main priority from the 17ththrough 19th centuries was on those with cognitive impairments(psychiatric and developmental disabilities)-System of segregation followed the pattern as established by France -People housed in one of France's residential institutions with little ornone of what would be considered treatment, housed in filthy cells withhundreds of others, poorly fed, and punished when behaving in waysconsidered unacceptable.-Early settlers in New Brunswick, Newfoundland and Nova Scotia, all ofwhich date from the early 1600s, followed the system set in France(Neufeldt, 2003, p. p.25

Key Concepts Meetings and Networks

Practices for Meeting Facilitation •Consider the process rather than content •Have an identified facilitator during your meeting - whose role is to keep the group on task while paying attention to the needs of each group member •If the same participants meet regularly consider rotating roles so that everyone shares in the responsibility and develop their meeting facilitation skills.FIVE KEY ELEMENTS TO CONSIDER 1. Opening - frame the meeting: Reviewing the agenda, clarify roles and responsibilities 2. Establishing ground rules: Establish a common agreement on the professionals will work together. 3. Time management: Keep track of time to ensure agenda items are covered, tasks assigned 4. Evaluation of the meeting: Take 4-5 minutes to get feedback to improve meeting process. Follow upon these ideas for action in the next meeting. 5. Closing. Clarify and review actions and commitment of participants Client Individual who has a need for rehabilitation services, associated with a health condition, at the impairment, activity limitation, or participation restriction level • An individual's designated decision-maker(s) • Acknowledges that the individual client requiring rehabilitation is located within a social network • Prioritization is given to individual requiring rehabilitation services Client-Centred •The client is an active member of the team, involved in identifying their needs and goals •Programs are defined, focused, and designed around client needs, abilities and goals (Provincial Reference Group, 2000)

Resourcing and Procurement Guidelines

Procurement Guidelines for Publicly Funded Organizations in Ontario Requires that: •Every organization, regardless of size ,should have procurement policies and procedures in place •Staff should be made aware of these policies and procedures and how they should be carried out to establish a point of reference for effective decision making.‐Source:Procurement Guideline for Publicly Funded Organizations in Ontario Best Practices Procedures include: 1.Establish internal controls 2.Plan before purchasing services 3.Develop criteria (must publish bidding - for public sector) 4.Canvas the Market 5.Service or vendor of record 6.Document the transaction 7.Maintain Correspondence/Records8 .Manage contracts responsibly 9.Review and improve 10.Criteria for service satisfaction

Examples of e-Resources

Publicly-Funded Physiotherapy Clinics: https://www.health.gov.on.ca/en/public/programs/physio/pub_clinics.aspx Note: Listing of publicly funded clinics. Click/find the closest publicly funded clinic Central, Central East, Central West, Champlain, Erie St. Clair, Hamilton Niagara Haldimand Brant, Mississauga, Halton, North East, North Simcoe, Muskoka, North West, South East, South West, Toronto, Central, Waterloo Wellington Ontario Mental health and addiction services in your community: https://www.ontario.ca/page/mental-health-services Note: Get free, confidential support for depression, anxiety, addiction, gambling and other problems e- MentalHealth.ca: https://www.ementalhealth.ca/Ontario/Counselling-and-Therapy/index.php?m=heading&ID=84Note: Find Mental Health Help in Your Area -private and public funded listings; resources by topics, specific population groups (e.g.,immigrant/newcomers), therapeutic intervention; mental health professionals, crisis and emergency, self help, mutual Aid and Support groups etc.

Examples of Referral Forms

RC may be advocating/providing input for Referrals South Lake Diabetes Education Program (DEP) Referral FormSouth Lake Regional Referral - Arthritis . Physio . Occupational Therapy South Lake Regional Outpatient Neurological Rehabilitation Referral

Why Study the Rehabilitation Process?Consider Learning about the value of advancing"Disability Rights"

Recognition of a history of exclusion and oppression •Advocacy for enactment of legislation: "civil rights", "Human Rights" •Recognition that persons with disability make up the largest minority groupglobally: "800 million of the world's 1 billion people with disabilities live in the countries ofthe global South. People with disabilities also comprise 20 percent of the world'spoorest. People with disabilities are not only more vulnerable to poverty but theirpoverty is further compounded by other inequalities"(CCDO, Sept. 2013) website:http://www.ccdonline.ca/en/publications/chairpersons-update/2013/september

The NOC - The National Occupational Classification

Regarded as the the authoritative resource on occupational information in Canada - It is used daily by VR counsellors, education and training organizations, Immigration Canada (immigrant skill selection) among others, to analyze and understand the human and environmental requirements of jobs. It hosts over 30,000 occupations. The NOC is is revised regularly, usually aligned to census years, and incorporates labour market information gathered from census data among other sources. The next structural revision of the NOC is planned for 2021. The NOC system is based on categorizing of I. Skills -Skill Type - That is the type of work performed -Skill Level - The type and amount of training or education that is typically required - Skill Level O, A, or B are considered "High-Skilled." C, D are considered "Low-Skilled". II The Hierarchal structure of Occupational groups-A four-tiered hierarchical arrangement of over 30,000 occupational groups including :• 10 broad occupational categories (Represented by a unique one-digit code) • 40 major groups (Represented by a two-digits code) • 140 minor groups (Represented by a three-digits code) • 500 unit groups - (Represented by the fourth digit the unit group to which the Occbelongs (e.g., Vocational Rehabilitation Counsellor NOC Code is under 4153).

Activity Search e-Resources

Search for your placement organization in the Gov ofCanada Business Directory• Consider a client in your placement - find an e-mental health resource for the population group served by your placement• Find a free physio care location for the client from your placement

Comparing the historical progressionThe Traditional Model vs Current Best Practices Model for theRehabilitation Process

Some Common Conceptions of disability • The person is described/classified/labelledand talked about strictly in context ofmedical model of professional work, e.g.,abilities, restrictions limitations,dysfunction, duration, severity, diagnosis • Stereotypes and dominant media images super abilities and negative perceptions) • The person is categorized and ascribed an illness role, and identified as 'a medical condition' • The person is believed to be and is treated as if they are the manifestation of a visible(evident) or non-evident impairment -therefore "not able" to... VR Engage Best Practices • Discuss/describe/ the person in context ofenvironmental barriers, accessibility supportsneeds for the workplace or independentcommunity living arrangements • For planning purposes use a biopsychosocial lived experience model which takes into consideration the complexities of interactions between factors such as health, age, environment, race, gender, socio-economic conditions, among others • Focus on a person centred approach whichrecognizes strengths and empowered decisionmaking • Facilitate access to employment, independentliving with dignity, human or other supports

Part 1- The Significance of the Evaluation Phase:

The best preparation begins with the end in mindAccording to Rubin and Roessler (2008): The vocational rehabilitation process begins with the evaluation phase thatinvolves •An intake interview •General medical information •Medical Specialist examination/psychological evaluation •Vocational Evaluation . •The client's functional capacity is determined by information obtained directlyfrom the client as well as from observations by others. The primary source of information from the individual with a disability is the rehabilitation counselling interview.The initial interview is generally considered one of the most important aspects of the evaluation phase. It is where the vocational counsellor beginsto collect data related to client-focused factors that influence all remainingaspects of the vocational rehabilitation process" (p.939)

The Historical Context of Disability Stigma and Exclusion

The experience of people with disabilities is marked by exclusion, institutionalization becauseof "difference based on disability"• People with disabilities were treated as "less than"• Advocacy was a response by disability organizations• In the 1980's and 1990's disability rights organizations advocated for equality rights andargued that people with disabilities have the same rights and responsibilities as otherCanadians and should be treated as full citizens.• 1982 Charter of Rights and Freedoms became a "model of democracy and individual rights" Wright Felske & Steinstra, 2003

FINDING CERTIFIED PROFESSIONALS THROUGH COLLEGES AND ASSOCIATIONS

The guidelines as set out by the CPSOare similar to those that apply to otherregulated professionals:Within policies, the terms 'must' and'advised' are used to articulate theCollege's expectations. When 'advised' is used, it indicates that physicians can use reasonable discretion when applying this expectation to practice... "When handing over primaryresponsibility for patients to anotherhealth-care provider, physicians mustfacilitate a comprehensive and up todate exchange of information and allowfor discussion to occur or questions tobe asked by the health-care providerassuming responsibility" Find a Psychologist in Ontario. Use this search tool to find a psychologist or psychological associate https://www.psych.on.ca/Public/Find-a-Psychologist DOCTOR SEARCH https://doctors.cpso.on.ca/RC can provide clients with the doctor search tool for clients to select their own physician's.Clients may need assistance in finding their own doctors This public register contains detailed information about all licensed physicians practicing in the province ofOntario. Search by name, CPSO number, or specificdetails of their practice (including if there are anycomplaints/restrictions on their practice) College of Occupational Therapist of Ontariohttps://occupationaltherapist.coto.org/coto/COTOWEB/DirectoryRD/COTOWEB/OT_Directory_RD/Directory.aspxFind an Occupational Therapist is an online list of occupational therapists (OTs) in Ontario

Transitions Standards

Transitions: A process that supports disengagement or shift in the mechanisms for achieving client goals. Rationale: the dynamic nature of the client's state or journey often necessitates movement to alternate settings, care, and roles. Interpretation: A redefinition occurs regarding the professional relationship between the client and Case Manager in the evolution of the client's journey. The relationship may be completed with achievement of agreed upon goals or concluded with goals unfulfilled CMs Transition/Referral Actions o Discuss disengagement, the criteria fordisengaging services early in relationship o Determine if disengagement criteria are understood by the client o Provide clients with information or links to alternative community resources o Support the client in his or her efforts to secure other appropriate or alternate resources, if the client so desires o Maximize client independence by supporting the development of self-advocacy skills o Ensure the transfer of timely and accurate information across settings when it is needed for the execution of transition o Provide contact information about re-accessing services or support o Address concerns about disengagement before the finalizing the disengagement

Disability: Conceptualized as a deterministic model variously defined based on"Insurance" contractual definitions WSIB Coverage

WSIB Schedule 2 Employers •Employers under mandatory coverage as part of Schedule 2 must individually pay the totalcosts of WSIB benefits for their injured workers. •The WSIB also charges each Schedule 2 employer for the cost of administering their claims.Each year administration rates are calculated and applied as a percentage added toemployers' benefit costs. [What are the implications for Rehabilitation Specialists who aremanaging the Rehabilitation Process in Employer settings?] WSIB and Federal government EmployeesFederal government workers are covered under the Government Employees CompensationAct. These workers are entitled to the same benefits as any worker covered by the WSIA.Their claims are administered as if the federal government were a Schedule 2 employer. Exemption from mandatory coverageAn operation that is otherwise in Schedule 1, Part I is exempted from mandatory coverage ifthe operation forms part of a non-mandatory business activity and meets both the following:The entirety of the operation supports a non-mandatory business activity,And The operation is not organized as a business in its own right to make a financial profit orgain.(See: Workplace Safety and Insurance Act, 1997-Consolidated from Jan. 1, 2020 to the e-Laws currency

Government of Canada OverviewManaging for Wellness- Disability Management Process

accommodation: - accessibility standards - duty to accommodate - assistive technologies leads to support for recovery support for recovery: - sick leave/injury on duty leave - disability benefits/ workers compensation - early intervention, case management and remain/return to work plan prevention - employee assistance programs and wellness programs - special working arrangements - occupational health and safety legislation and standards - emergency and business continuation plans

MEMBERS' ROLESIN (REASONABLE) DUTYTO ACCOMMODAE

employee - participates in their RTW process, collaborates in seeking appropriate accommodation Employers and workforce - create opportunities that build on inclusion and full participation for all members - "exclusion (separated) is not equity unions - union work in partnership to on initiatives for accommodations and support inclusion Physician - AP identifies information on the employees medical restrictions, limitations, recovery, and prognosis.

Knowledge about the importance of early interventionand case management in the Rehabilitation Process

if the person is sick for: - 20 days: the chance of getting back to work is 70% - 45 days: the chance of getting back to work is 50% - 70 days: the chance of getting back to work is 35%

managing our injured worker

immediately after injury: medical treatment, do not lay blame, info pack to worker, contact work cover insurer, injury register, investigate incident, inform worker of results of investigation and follow up actions during initial recovery period: keep in touch with worker and insurer, check workers concerns, discuss suitable duties options, encourage worker-insurer contact, encourage co-workers to keep in touch with worker, consider early screening (CMPQ) finalize the RTW plan: worker input, suitable duties, ask for help, decide how to monitor progress, confidently, consider RTW risks, RTW plan actual RTW: supportive co-workers and line manager, suitable duties, regular breaks, monitor progress, implement and review RTW plan Improvement planning: measure RTW progress, compare original results to benchmarks, review strategies and make changes

potential impacts of time off work due to workplace injury

impacts of time off work due to workplace injury on INJURED WORKER: financial and emotional stress, loss of self esteem and confidence, dependence on disability payments or unemployment benefits, loss of social networks impacts of time off work due to workplace injury on EMPLOYER: increased workers compensation premium, reduced productivity, increased recruiting/training costs, a drop in staff morale

OHRC Duty to Accommodate

in plain language • Human rights legislation has a quasi-constitutional place in Canadian law, and cannot be in consistent with other statutes, policies and practices - public and private • Discrimination may be entirely unintentional, yet it will be in violation of human rights statutes if a person under a protected ground is treated differentially and adversely for no justifiable reason .• Accommodation is a significant human rights obligation, and must be a central feature in the Canadian workplace. • The duty rests on three sets of shoulders, with employers, unions and the employee seeking the accommodation - all assuming legal responsibility for ensuring the success of an accommodation request .• The primary responsibility rests with the employer, because it has the ultimate control overthe workplace. Once it receives a request, it must initiate the accommodation search. • The union must co-operate with the accommodation process, and not unreasonably block aviable accommodation option .• The employee is expected to participate in the accommodation process, and cannot refuse areasonable accommodation offer. • Collective agreement provisions are to be respected, but they may have to be waived if theyunreasonably block a viable accommodation option or if they treat individuals who areprotected by human rights legislation differently without a compelling justification (Lynk,2008, p.4)

key areas of the return to work program

is the employer's written system for managing workers who encounter a workplace injury and is consistent with the insurer's injury management program - prevention of workplace injury/illness - consultation with workers/unions - suitable duties - developing and implementing the RTW program - early commencement of injury management and RTW - RTW not to disadvantage injured workers

Distinguishing Vocational Evaluation (process & phase)AndVocational Assessment

key outcome of vocational evaluation: information about the individual's vocational (occ/job), rehabilitation situation, readiness, too RTW. - abilities, restrictions, limitations, capacities, Occ, MMR information to support effective planning: validated information from various sources. Formal testing: psycho voc evaluation, interests, aptitudes), medical specialists reports observation from intake interviews and consultations: a RTW plan goal or alternatives Formal Vocational Eval Assessment According to Rubin and Roessler (2008): •Not necessary in every case but essentialin in some cases to better understandspectrum of impairments, e.g., learningdisabilities, mental health and emotionalimpairments, vocational strengths andeducational gaps, etc., •Assessments can be performed viaminimal screening (interview) or more in-depth formal testing by certifiedprofessionals, e.g.: a Certified VocationalEvaluator, Psychologist•Rehabilitation Counselor may use in-depth interview formal or situationalassessments for goal setting, planning

the legislative and policy frameworks which supports best practices in VRS

lecture 1 slide 27 WHO 2030 sustainable goals: promotion and monitoring phases of VRS systems

Part 3: Evolving Models Of Disability

moral model medical/rehab model biopsychosocial model social model lecture 1 slide 32

slide 26 lecture 1

related classifications, foundation, shared technology iCD ICF ICHI

Prevalence of Disability in CanadaMental Health-Related and Stigma

slide 21 lecture 1 4/5 63% over 2 million

The WHO Framework: An Interlocking dimensions of the biopsychosocial model

slide 33 lecture 1

the WHO Framework: An Interlocking dimensionsof the biopsychosocial model

slide 34 lecture 1 person and disability interaction - environment - illness injury SDoH - workplace and public spaces - accessibility and attitudinal barriers

The legislative and policy frameworks which supportBest practices in VRS: ICDC Instruments

the ICD has evolved over the past 150 years from an international list of causes of death to a comprehensive classification system for morality, morbidity, casemix, quality measurement and patient safety the ICD is used to allocate the majority of global health resources the ICD users include physicians, nurses, researchers, and other health care providers, HEALTH INFORMATION MANAGEMENT PROFESSIONALS, coders, HEALTH INFORMATION MANAGEMENT PROFESSIONALS , health information technology workers, analysts, policy makers, insurers, patient organizations, etc. All WHO member states are expected to use the most current version of the ICD for reporting death and illness (according to an international treaty, the WHO nomenclature regulations, adopted by the world health assembly in 1967.

Part 2: Questions to address to Assessment/Referral

the information collection process begins with the intake interview, which generates a social-vocational history based on questions that the person can answer directly. this is required by all public state rehabilitation agencies. - medical information from physicians, specialists, practitioners, aligned professionals, LTD and WSIB forms, establishes the presence and extent of impairment - physical functioning from functional capacity evaluations (FCE), determines the types of activities precluded (restricted from doing), due to nature/type (episodic?), determines severity of impact and impairment psychological and vocational from registered psychologist, VR professional, certified vocational evaluator, provides insight into the relationship of environment and the person's skills, mental abilities (processing), personality characteristics tolerances, and job performances

HR/Workplace Organization Considerations

utilize health and safety RTW questionnaire to gauge safety psychosocial risks 13 psychosocial risk factors 1. psychological support: a workplace where supervisors and coworkers are supportive of employee's psychological and mental health concerns, and respond appropriately as needed. For some organizations, the most important aspect of psychological support may to protect against traumatic stressors at work 2. why is it important? Employees that feel that have psychological support have greater job attachment, job commitment, job satisfaction, job involvement, positive work moods, desire to remain with the organization, organizational citizenship behaviours, (behaviours of personal choice that benefit the organization) and job performance 3. what happens when it is lacking? employee's perception of a lack of psychological support can lead to: - increased absenteeism, withdrawal behaviours, conflict, strain - which can lead to fatigues, headaches, burnout and anxiety, turnover, loss of productivity, created costs, greater risk of accidents, incidents, and injuries.

The Canadian Standards of Practice~ Guiding Principles & Standards

~The National Case Management Network - identifies 7 Guiding Principles : 1.Case management supports client rights 2.Case Management is Purposeful 3.Case management is Collaborative 4.Case management supports Accountability 5.Case management strives for cultural competency The Case Management Standards of Practice: 1.Client identification And eligibility for case management services 2.Assessment 3.Planning 4.Implementation 5.Evaluation 6.Transitions

Part 3: The Canadian Standards of Practice~ Guiding Principles & Standards

~The National Case Management Network - identifies 7 Guiding Principles : 1.Case management supports client rights 2.Case Management is Purposeful 3.Case management is Collaborative 4.Case management supports Accountability 5.case management strives for cultural competency The Case Management Standards of Practice: 1.Client identification And eligibility for case management services 2.Assessment 3.Planning 4.Implementation 5.Evaluation 6.Transitions

The initial phase initiates activities for Case ManagementTriggered by: Injury/Illness/disability related events

• The following (minimum) information isprovided in written correspondence tocommence the process and forms thedocumentation of the file: 1. Letter/Form of referral (outlineparameters of service, service providerguidelines for deliverables 2. Client's basic demographic data:(name, DOB, address, tele#) 3. Disability related(medicalreports/assessments/diagnostics)4. Employer/Occupational RelatedJob descriptionWorkplace documents(eg., WSIB forms, LTD forms) individuals goals: --intake, assessment, planning, referral/linking, advocacy, monitoring and evaluating, transition

Knowledge about the importance of early intervention and case management in the Rehabilitation Process

• Tool Kit resource for managing the costs associated with disability related absences in Canada: --Statistics Canada reporting on Trends in Canada's WorkAbsences are indicative of absence rates of employee absence which affect the bottom line of disability costs. StatisticsCanada. Table 14-10-0190-01 Work absence of full-timeemployees by geography, annual. DOI:https://doi.org/10.25318/1410019001-eng • Please familiarize yourself with this resource. It is a resource used bymany employers in calculating benchmark for attendance managementprograms.