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CCAC School Services*
9.1 Overview of CCAC School Services
Community Care Access Centre (CCAC) school services are provided to children/youths in
publicly funded and private schools and to children/youths who are being home schooled to
assist them in pursuing their education. The student must require the services in order to be able
to attend school, participate in school routines and receive instruction, including receiving
satisfactory instruction at home. In other words, in the absence of school services, the
child’s/youth’s school attendance, instruction or participation would be significantly disrupted.
CCAC school services include professional school services and personal support school
services. Professional school services are provided to children/youths in publicly funded and
private schools and to children/youths who are being home schooled. CCAC personal support
school services are only provided to children/youths in private schools and to children/youths
who are being home schooled
9.1.1 Children/Youths in Publicly Funded Schools
Children/youths enrolled in publicly funded schools have access to a range of professional
school services: nursing, physiotherapy, occupational therapy, speech-language pathology and
dietetics. These services are provided through CCAC contracted service providers and include
the training of school personnel and provision of necessary medical supplies, dressings and
treatment equipment.
The CCAC provides access to these professional school services for children/youths with
medical and/or rehabilitation needs to enable them to attend school, participate in school
routines and receive instruction.
Personal support school services are not provided by the CCAC to students in publicly funded
schools. School boards are responsible for accommodating the needs of public school students
for assistance with routine personal activities of living. Social work services are not provided
through the CCAC in publicly funded school settings. Public school resources deal with
psycho-social needs of students that need to be addressed while attending public school.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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CCAC professional school services are provided in publicly funded schools by the Ministry of
Health and Long-Term Care (MOHLTC), the Ministry of Education and Training (EDU), and
the Ministry of Community and Social Services (MCSS), pursuant to the following:
1. Policy/Program Memorandum No. 81 (PPM81), July 19, 1984, available at:
[http://www.edu.gov.on.ca/extra/eng/ppm/81.html]. This policy memorandum sets out the
responsibility of the MOHLTC for funding the provision of health services for
children/youths with special needs who would have difficulty attending school, if at all,
were they not to receive these services. The policy also addresses joint responsibilities of
the MOHLTC and school boards for medications, lifting, positioning, general maintenance
exercises, feeding and toileting.
2. Memorandum regarding Catheterization and Suctioning, August 14, 1989; Clarification of
Policy/Program Memorandum No. 81. This memorandum was issued in response to
questions raised about PPM81, in order to clarify the responsibilities for different types of
catheterization and suctioning, as follows:
•
•
Clean catheterization and shallow surface suctioning are recognized as part of a child’s
normal toileting and oral hygiene needs and can be administered by the child or school
board staff. Training and direction for these procedures may be provided by the parent
or the CCAC.
Sterile intermittent catheterization and deep suctioning are administered by a health
professional provided by the CCAC.
3. Interministerial Guidelines for the Provision of Speech and Language Services 1988
(MCYS, EDU, MOHLTC), available at:
[http://www.edu.gov.on.ca/extra/eng/ppm/81.html]. This memorandum clarifies the shared
responsibilities of CCACs and school boards relating to the provision of speech therapy, as
follows:
•
•
•
1
The school board is responsible for the initial assessment to determine if the primary
concern is speech production or a language disorder.
The CCAC is responsible for children/youths who have problems because speech
production is difficult.
The Interministerial Guidelines for the Provision of Speech and Language Services
were developed in 1985 and revised in 1988 to provide direction to public schools and
home care programs1about their responsibilities in the provision of speech and language
services. This 1988 version also supercedes references to speech and speech
pathology/therapy in PPM81.
Precursors to the CCAC.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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•
Medical disorders that the CCAC manages fall primarily under the following diagnostic
areas:
•
•
•
•
•
•
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articulation/speech sound production problems caused by motor speech disorders
including dyspraxias and dysarthrias;
non-speech communication (assessment for and prescription of and orientation to
augmentative and alternative methods of communication);
fluency disorders such as stuttering;
voice disorders (e.g., hoarseness and/or nasal speech due to vocal nodules and cleft
lip palate); and
swallowing disorders.
CCACs do not provide speech therapy for children/youths who primarily have a
language disorder. School boards are responsible for providing these services to
children/youths who have a language disorder (i.e., do not have the ability to translate
thoughts into verbal expression and to understand others, and do not have reading and
spelling skills that are prerequisite for acquiring literacy skills).
CCACs must provide professional school services in accordance with PPM81 and all other
relevant memoranda and guidelines. CCACs must not assume any of the responsibilities of
school boards as outlined in PPM81 and all other relevant memoranda and guidelines.
9.1.2 Children/Youths in Private Schools and Home Schooling Situations
Children/youths enrolled in private schools or receiving instruction at home have access to a
range of professional school services and personal support school services: nursing,
physiotherapy, occupational therapy, speech-language pathology, dietetics, and personal
support services such as personal hygiene activities and routine activities of living. These
school services can be purchased directly2 or accessed through CCAC contracted service
providers.
Social work services are not provided through the CCAC in private schools and home
schooling situations.
The CCAC provides access to these professional school services and personal support school
services to children/youths with medical and/or rehabilitation needs to enable them to attend
school, participate in school routines and receive satisfactory instruction at home. In other
2
Purchased services means that the CCAC provides funding directly to a transfer payment agency. The agency in turn
provides funding to the private school or the parent/guardian in home schooling situations, who is then responsible for
locating and hiring the service provider.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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words, in the absence of school services, the child’s/youth’s school attendance, instruction or
participation would be significantly disrupted.
CCACs are required to provide the initial assessment for speech-language pathology for
children/youths in private schools or receiving home schooling. The CCAC funds private
schools and parents/guardians providing home schooling (through an agency) for the treatment
of speech disorders primarily in the diagnostic areas listed above in subsection #9.1.1, point “3”
in this manual.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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9.2 Eligibility for CCAC School Services
Community Care Access Centre (CCAC) school services are governed by the Long-Term Care
Act, 1994 (LTCA). The regulations under the LTCA refer to the terms “school” and “private
school” as they are defined under the Education Act (EA). The following are the definitions of
these terms under the EA:
s. 1(1)“school” means,
(a) the body of elementary school pupils or secondary school pupils that is organized as a unit
for educational purposes under the jurisdiction of the appropriate board, or
(b) the body of pupils enrolled in any of the elementary or secondary school courses of study in
an educational institution operated by the Government of Ontario,
and includes the teachers and other staff members associated with the unit or institution and
the lands and premises used in connection with the unit or institution;
“private school” means an institution at which instruction is provided at any time between the
hours of 9 a.m. and 4 p.m. on any school day for five or more pupils who are of or over
compulsory school age in any of the subjects of the elementary or secondary school courses of
study and that is not a school as defined in this section;
In addition, the regulations under the LTCA refer to subsection 21(1)(a) of the EA relating to
home schooling. Subsection 21(1)(a) of the EA states:
s. 2(2) A child is excused from attendance at school if,
(a) the child is receiving satisfactory instruction at home or elsewhere; …
9.2.1 Eligibility for Professional School Services
Section 5 of regulation 386/99 of the LTCA states:
s. 5(1) “school” means a school as defined in subsection 1 (1) of the Education Act and
includes a private school as defined in subsection 1 (1) of that Act.
“school services” means the following professional services that are provided to a person who
is enrolled as a pupil at a school on the school premises or while the pupil is being transported
to or from the school on a school bus or other school vehicle or participating in a school trip
or activity outside the school premises or that are provided to a person who is receiving
satisfactory instruction at home in accordance with clause 21 (2) (a) of the Education Act and
are necessary in order for the person to be able to receive instruction:
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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1. Nursing services.
2. Occupational therapy services.
3. Physiotherapy services.
4. Speech-language pathology services.
5. Dietetics services.
6. Training of school personnel to provide the services referred to in paragraphs 1 to 5 to
persons enrolled as a pupil at the school.
7. The provision of medical supplies, dressings and treatment equipment necessary to the
provision of the services referred to in paragraphs 1 to 5.
Clarification: Professional school services are defined in regulation 386/99 of the LTCA as
nursing services, occupational therapy services, physiotherapy services, speech-language
services and dietetics services. These services include the training of school personnel and
provision of necessary medical supplies, dressings and treatment equipment.
s. 5(2) A community care access centre shall not provide school services to a person unless the
person meets the following eligibility criteria:
Clarification: A CCAC does not have the authority to provide professional school services to a
person unless the person meets the following eligibility criteria:
s. 5(2)1. The person must be enrolled as a pupil at a school or be receiving satisfactory
instruction at home in accordance with clause 21 (2) (a) of the Education Act.
Clarification: A child/youth up to the age of 21 must be either enrolled in a publicly funded
school or private school or receiving satisfactory instruction at home in order to be eligible for
these professional school services. More information is available on the Ministry of Education
and Training (EDU) website at: [http://www.edu.gov.on.ca/eng/funding/].
s. 5(2)2 The person must require the services,
i. in order to be able to attend school, participate in school routines and receive instruction, or
ii. in order to be able to receive satisfactory instruction at home in accordance with clause 21
(2) (a) of the Education Act.
Clarifications:
•
3
The CCAC may provide professional school services at the school or while the pupil is
being transported to or from publicly funded school or private school or participating in
publicly funded school or private school related activities (see subsection #9.5 in this
manual for additional information) in other locations3. The professional school services
For example, early screening may be done in a clinic setting.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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•
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must be necessary in order for the child/youth to be able to attend publicly funded school or
private school, participate in publicly funded school or private school routines and receive
instruction. In other words, in the absence of professional school services, the
child’s/youth’s publicly funded school or private school attendance, instruction or
participation would be significantly disrupted.
The CCAC must not assume responsibility for determining what constitutes “satisfactory
instruction at home.” In order for a child/youth who is receiving home schooling to be
eligible for professional school services, the parent/guardian must provide the CCAC with a
letter from the relevant school board indicating that the child/youth is excused from
attendance at school because he or she is receiving “satisfactory instruction at home.”
Policy/Program Memorandum No. 131 (PPM131), dated June 17, 2002, addresses the
services offered by the MOHTLC and sets out the process a parent/guardian should follow
in order to obtain the appropriate documentation, including a sample letter. PPM131 and
the sample letter are available on the EDU website at:
[http://www.edu.gov.on.ca/extra/eng/ppm/131.html].
s. 5(2)3 The person must be an insured person under the Health Insurance Act.
(See chapter #3 in this manual for Ontario Health Insurance Program (OHIP) eligibility
criteria.)
s. 5(2)4 The school or home in which the service is to be provided must have the physical
features necessary to enable the service to be provided.
Clarifications:
•
•
The setting in which the professional school services are to be provided must be conducive
to providing the service such as having enough space to allow the use of necessary
equipment and supplies, and privacy to allow appropriate treatment to be given.
The CCAC must use their best efforts to adapt their service provision to the available
surroundings. However, when such adaptations cannot be made, the CCAC must discuss
alternative courses of action with the child/youth/parent/guardian and/or publicly funded or
private school in order to avoid declaring a child/youth ineligible for professional school
services on this basis.
s. 5(2)5 The risk that a service provider who provides the school service to the person who
requires the service will suffer serious physical harm while providing the service,
i. must not be significant, or
ii. if it is significant, the service provider must be able to take reasonable steps to reduce the
risk so that it is no longer significant.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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Clarification: The CCAC must use their best efforts to mitigate any risk to the point where it is
no longer a serious risk to the contracted service provider in order to avoid declaring a
child/youth ineligible for professional school services on this basis.
9.2.2 Eligibility for Personal Support School Services
Section 7 of regulation 386/99 of the LTCA states:
s. 7(1) “school” means a private school as defined in subsection 1 (1) of the Education Act;
s. 7(1) “personal support school services” means the following personal support services that
are provided to a person who is enrolled as a pupil at a school on the school premises or
during a school trip or activity outside the school premises or that are provided to a person
who is receiving satisfactory instruction at home in accordance with clause 21 (2) (a) of the
Education Act and are necessary in order for the person to be able to receive instruction:
1. Personal hygiene activities.
2. Routine personal activities of living.
3. Training of school personnel to provide the services referred to in paragraphs 1 and 2 to
persons enrolled as pupils at the school and assisting the personnel in providing them.
4. The provision of medical and personal equipment necessary to the provision of the services
referred to in paragraphs 1 and 2.
Clarification: Personal support school services are defined in regulation 386/99 as personal
hygiene activities and routine personal activities of living. These services include the training
of school personnel and provision of treatment equipment necessary to the provision of the
services. Personal hygiene activities and routine personal activities of living in the context of
private and home schools include assistance with eating, dressing and toileting (including clean
catheterization), personal hygiene (including shallow suctioning), mobility, transferring,
positioning, and routine exercises taught by a therapist (physiotherapist, occupational therapist,
speech-language pathologist).4
s. 7(2) A community care access centre shall not provide personal support school services to a
person unless the person meets the following eligibility criteria:
Clarification: A CCAC does not have the authority to provide personal support school services
to a person unless the person meets the following eligibility criteria:
s. 7(2)1 The person must be enrolled as a pupil at a school or be receiving satisfactory
instruction at home in accordance with clause 21 (2) (a) of the Education Act.
4
MOHLTC Memorandum regarding Personal Support Services and Equipment in Private and Home Schools, January 8,
2001.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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Clarification: A child/youth up to the age of 21 must be either enrolled in a private school or
receiving satisfactory instruction at home in order to be eligible for these personal support
school services. More information is available on the EDU website at:
[http://www.edu.gov.on.ca/eng/funding/].
s. 7(2)2 The person must require the services,
i. in order to be able to attend school, participate in school routines and receive instruction, or
ii. in order to be able to receive satisfactory instruction at home in accordance with clause 21
(2) (a) of the Education Act.
Clarifications:
•
•
The CCAC may provide personal support school services at the private school or while the
pupil is being transported to or from private school or participating in private school related
activities (see subsection #9.5 in this manual for additional information) in other locations5.
The personal support school services must be necessary in order for the child/youth to be
able to attend private school, participate in private school routines and receive instruction.
In other words, in the absence of personal support school services, the child’s/youth’s
private school attendance, instruction or participation would be significantly disrupted.
The CCAC must not assume responsibility for determining what constitutes “satisfactory
instruction at home.” In order for a child/youth who is receiving home schooling to be
eligible for personal support school services, the parent/guardian must provide the CCAC
with a letter from the relevant school board indicating that the child/youth is excused from
attendance at school because he or she is receiving “satisfactory instruction at home.”
Policy/Program Memorandum No. 131 (PPM131), dated June 17, 2002, addresses the
services offered by the MOHTLC and sets out the process a parent/guardian should follow
in order to obtain the appropriate documentation, including a sample letter. PPM131 and
the sample letter are available on the EDU website at:
[http://www.edu.gov.on.ca/extra/eng/ppm/131.html].
s. 7(2)3 The person must be an insured person under the Health Insurance Act.
(See chapter #3 in this manual for Ontario Health Insurance Program (OHIP) eligibility
criteria.)
s. 7(2)4 The school or home in which the service is to be provided must have the physical
features necessary to enable the service to be provided.
5
For example, early screening may be done in a clinic setting.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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Clarifications:
•
•
The setting in which the personal support school services are to be provided must be
conducive to providing the service such as having enough space to allow the use of
necessary equipment and supplies, and privacy to allow appropriate treatment to be given.
The CCAC must use their best efforts to adapt their service provision to the available
surroundings. However, when such adaptations cannot be made, the CCAC must discuss
alternative courses of action with the child/youth/parent/guardian and/or private school in
order to avoid declaring a child/youth ineligible for personal support school services on this
basis.
s. 7(2)5 The risk that a service provider who provides the service to the person who requires it
will suffer serious physical harm while providing the service,
i. must not be significant, or
ii. if it is significant, the service provider must be able to take reasonable steps to reduce the
risk so that it is no longer significant.
Clarification: The CCAC must use their best efforts to mitigate any risk to the point where it is
no longer a serious risk to the contracted service provider in order to avoid declaring a
child/youth ineligible for personal support school services on this basis.
9.2.3 Overview of Services Offered by CCAC
Publicly Funded Schools
Private Schools
Home Schooling
Situations
Nursing, physiotherapy,
occupational therapy,
specified speech-language
pathology after school board
provides initial assessment,
dietetics
Nursing, physiotherapy,
occupational therapy,
specified speech-language
pathology (including initial
assessment), dietetics
Nursing, physiotherapy,
occupational therapy,
specified speech-language
pathology (including initial
assessment), dietetics
Personal support services
Personal support services
Training of school personnel
Training of school personnel
Training of parent/guardian
The provision of medical
supplies, dressings and
treatment equipment relating
to professional school services
The provision of medical
supplies, dressings and
treatment equipment relating
to professional school services
as well as the provision of
medical and personal
The provision of medical
supplies, dressings and
treatment equipment
relating to professional
school services as well as
the provision of medical
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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Publicly Funded Schools
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Private Schools
Home Schooling
Situations
equipment relating to personal
support school services
and personal equipment
relating to personal support
school services
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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9.3 Service Maximums
Service maximums for CCAC school services are regulated under the Long-Term Care Act,
1994 (LTCA).
9.3.1 Private and Publicly Funded Schools – No Service Maximums
There are no service maximums for Community Care Access Centre (CCAC) school services
provided in public and private schools. However, subsection 4(3) of regulation 386/99 of the
LTCA states:
s. 4(3) In determining the maximum amount of nursing services that may be provided to a
person under this section, a community care access centre shall not include any nursing
services that are provided as school services under sections 5 and 6.
Clarification: Subsection 4(3) of regulation 386/99 provides that the CCAC must not include
the hours of nursing services provided to a child/youth in a publicly funded school, private
school or in a home schooling situation through CCAC school services when determining the
maximum amount of nursing services that can be provided to a child/youth as part of in-home
nursing services. Children/youths who receive CCAC school services may also receive
professional services at home.
9.3.2 Home Schooling Situations – Service Maximums
There are service maximums for children/youths receiving professional school services and
personal support school services while being home schooled. regulation 386/99 of the LTCA
states:
s. 6 A community care access centre that provides school services to a person who is receiving
satisfactory instruction at home in accordance with clause 21 (2) (a) of the Education Act shall
not provide more than six hours of school services a day to that person, five days a week.
s. 7(3) A community care access centre that provides personal support school services under
this section to a person who is receiving satisfactory instruction at home in accordance with
clause 21 (2) (a) of the Education Act shall not provide more than six hours of those services a
day to that person, five days a week.
Clarification: The CCAC must not provide more than six hours of professional school services
or personal support school services a day, five days a week to a child/youth who receives home
schooling. However, regulation 386/99 of the LTCA states:
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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s. 3(4) In determining the maximum amount of personal support services that may be provided
to a person under this section, a community care access centre shall not include any personal
support school services provided under section 7.
Clarification: Subsection 3(4) of regulation 386/99 provides that the CCAC must not include
the hours of personal support school services provided to a child/youth in a private school or in
a home schooling situation through CCAC school services when determining the maximum
amount of personal support services that can be provided to a child/youth as part of in-home
personal support services.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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9.4 Equipment Relating to School Services
9.4.1 Medical Supplies, Dressings and Treatment Equipment Relating to
Professional School Services
Professional school services include the provision of medical supplies, dressings and treatment
equipment necessary to the provision of nursing services, occupational therapy services,
physiotherapy services, speech-language pathology services, and dietetics services to eligible
children/youths. Subsection 5(1)7 of regulation 386/99 of the Long-Term Care Act, 1994
(LTCA) states that “school services” include “the provision of medical supplies, dressings and
treatment equipment necessary to the provision of the services referred to in paragraphs 1 to
5.” The eligibility criteria and case management functions set out in subsection #9.2.1 in this
manual apply to these medical supplies, dressings and treatment equipment.
Clarification: The child/youth or his or her parent/guardian is responsible for the provision and
transportation of any specialized long-term treatment equipment required for the child/youth to
participate in school which is not related to the provision of school services, for example, a
wheelchair.6
The Community Care Access Centre (CCAC) case manager may authorize the provision of
treatment equipment to an eligible child/youth through the CCAC school services when one of
the following conditions applies:
•
•
•
the treatment equipment is required for a trial period prior to purchase and requires
monitoring and evaluation by an Assistive Devices Program (ADP) authorizing
professional;
the treatment equipment is not available through ADP and is essential to support the
child’s/youth’s medical treatment/rehabilitation needs (as opposed to education related
needs, such as a communication device or customized desk, which is the responsibility of
the school board); or
the child/youth has a short-term need for the treatment equipment.
Note: The CCAC does not provide Ontario Drug Benefits (ODBs) to children who are only
receiving school services.
Treatment Equipment Selection
To facilitate the provision of treatment equipment, the CCAC case manager must:
6
A child/youth may be eligible to receive assistance to obtain equipment for long-term use from the Ministry of Health and
Long-Term Care (MOHLTC) as per Assistive Devices Program (ADP) requirements.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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•
•
•
•
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assess a child’s/youth’s need for equipment or request a therapist to do the assessment for
this equipment;
select the most cost effective equipment;
authorize the price of equipment which may include applicable taxes and delivery charges
or monthly rental charges; and
reassess the child/youth if different equipment is subsequently required.
Purchase, Maintenance and Disposal of Treatment Equipment
The purchase, disposal and maintenance of treatment equipment are the responsibility of the
school or the home schooling parent. When the child/youth no longer requires the treatment
equipment, it is the responsibility of the school or parent to determine the best use of the
equipment (e.g., donate to charity).
9.4.2 Medical and Personal Equipment Relating to Personal Support School
Services
Personal support school services include the provision of medical and personal equipment
necessary to the provision of routine hygiene activities and routine personal activities of daily
living. Subsection 7(1)4 of regulation 386/99 of the LTCA states that “personal support school
services” include “the provision of medical and personal equipment necessary to the provision
of the services referred to in paragraphs 1 and 2”. The eligibility criteria and case management
functions set out in subsections #9.2.1 and #9.2.2 in this manual, respectively apply to these
medical supplies, dressings and treatment equipment.
The medical and personal equipment required must be necessary to the provision of personal
support school services. Examples include standers, grab bars, lifts, adaptive seating equipment
(e.g., wedges, wrist weights and weighted vests), commode chairs, change tables, suction
machines, adaptive feeding equipment, lifts and wheelchair tables.
The CCAC case manager must authorize the purchase of the following medical and personal
equipment:
•
equipment that is covered by the Ministry of Health and Long-Term Care (MOHLTC) ADP
required for the home and the school setting and problematic to transport, (e.g., suction
machine)7; and
7
In this case, a second piece of equipment may be necessary. The second piece of equipment does not have to be identical
to the original piece but must be functionally appropriate for the purpose for which it is required, e.g., more conducive to
travel or accommodated to functioning in a smaller space.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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equipment that is not covered by the ADP but is needed to support the provision of personal
support school services as determined by a professional assessment (e.g., transfer boards).
Medical and Personal Equipment Not Provided
The CCAC does not provide the following medical and personal equipment:
•
•
educational equipment that allows the child/youth to access the curriculum (e.g., frequency
modulation (FM) systems for children/youths who are hard of hearing, Braille printers and
custom designed desks); and
equipment associated with modifying the school or home infrastructure. This may include,
elevators, stair glides, special toilets, handrails for stairs, ramps, locked medication
cupboard and cardio-pulmonary equipment.
Medical and Personal Equipment Selection
To facilitate the provision of medical and personal equipment, the case manager must:
•
•
•
•
assess a child’s need for equipment or request a therapist to do the assessment for
equipment;
select the most cost effective equipment;
authorize the price of equipment which may include applicable taxes and delivery charges
or monthly rental charges; and
reassess the child/youth if different equipment is subsequently required.
Purchase, Disposal and Maintenance of Medical and Personal Equipment
The purchase, disposal and maintenance of medical and personal equipment are the
responsibility of the school or the home schooling parent/guardian. When the child/youth no
longer requires the equipment, it is the responsibility of the school or parent/guardian to
determine the best use of the equipment (e.g., donate to charity).
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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9.5 Transportation Relating to School Services
It is the not the responsibility of the Community Care Access Centre (CCAC) to transport
children/youths to publicly funded or private school. The CCAC provides school services to
eligible children/youths while they are being transported to or from school on a school bus or
other school vehicle or are participating in a school trip or activity outside the school premises.
The CCAC may only provide school services when the child/youth being transported:
•
•
is at risk of significant physical injury during transportation; and
the skills of a nursing professional are required within scope of practice.
A child/youth who is home schooled is also eligible for nursing services while being
transported in a private vehicle to attend an organized activity directly related to the education
of the child/youth as long as the child/youth meets the above criteria. The CCAC does not
provide school services in relation to casual activities that are not related to the child’s/youth’s
education.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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9.6 Case Management Function Relating to the Provision of
CCAC School Services
The Community Care Access Centre (CCAC) case manager must assess the child’s/youth’s
requirements, determine eligibility for school services and for each eligible child/youth,
develop and authorize a plan of service that sets out the amount of service to be provided in
accordance with the Long-Term Care Act, 1994 (LTCA).
When required by the school board, the CCAC is responsible to ensure that case managers have
police clearance/criminal checks in order to be able to access schools/school property.
The CCAC case manager must manage the plan of service between the child/youth, the
parent/guardian, the school and the contracted service provider as well as:
•
•
•
•
•
interpret CCAC school service policies and guidelines;
collaborate in planning for the integration of school services to complement existing school
programs;
make recommendations about specific supplies and dressings and facilitate access to certain
specialized equipment to meet the program goals;
track units of service for these services, as required by the Management Information System
(MIS); and
facilitate harmonious relationships among the parties.
The CCAC case manager must review the child’s/youth’s requirements when appropriate.
Depending on the child’s condition and circumstances, the review can be in consultation with
the contracted service provider, parent/guardian and school personnel as appropriate. It is
recommended that the CCAC conduct a review at least once a year. During the course of the
review, the CCAC must evaluate the child’s/youth’s plan of service (outcomes, goals and
timeframes) and revise the plan of service as necessary when the child’s/youth’s requirements
change.
9.6.1 Specific Processes Relating to Provision of CCAC Professional School
Services to Children/Youths Enrolled in Publicly Funded Schools
•
•
For a child/youth enrolled in a publicly funded school, the child’s/youth’s parent and/or an
outside health care professional, if one is involved, should first discuss any need for
professional school services with the principal of the school.
If it is agreed that CCAC professional school services would be appropriate in the situation,
the parties should designate one person to contact the CCAC.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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•
•
•
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The CCAC case manager must contact the school for an appointment to see and assess the
child, with the parent’s consent.
The CCAC must then assess the child’s/youth’s needs, determine whether the child/youth is
eligible for professional school services and if so, develop and authorize a plan of service.
The CCAC provides the professional school services to children/youths in publicly funded
schools through their service providers.
9.6.2 Specific Processes Relating to the Provision of CCAC Professional School
Services and Personal Support School Services to Children/Youths Enrolled
in Private Schools
•
•
•
•
•
•
For a child/youth enrolled in a private school, the parent/guardian should first discuss with
the principal of the school:
• the need for professional school services or personal support school services; and
• the request for a referral.
If it is agreed that CCAC professional school services or personal support school services
would be appropriate in the situation, the principal or parent should then contact the CCAC.
The principal must provide express permission to the CCAC to provide service on school
property.
The CCAC case manager must contact the school for an appointment to see and assess the
child, with the parent’s consent.
The CCAC must then assess the child’s/youth’s needs, determine whether the child/youth is
eligible for either professional school services or personal support school services, or both,
and if so, develop and authorize a plan of service.
The private school may:
• receive funding directly from the CCAC and hire the service provider itself; or
• request in writing that the CCAC arrange the professional school services or personal
support school services on the school’s behalf. The CCAC then refers the matter to the
appropriate contracted service provider.
Where the private school receives funding directly from the CCAC, the following
responsibilities arise:
The CCAC case manager must:
•
•
enter into a memorandum of understanding with the principal/chief administrator of the
private school;
receive quarterly reports from the private schools and include this information in the
quarterly reports submitted to the Ministry of Health and Long-Term Care (MOHLTC);
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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•
•
•
ensure the private school’s quarterly reports identify all expenditures related to the
provision of professional school services and personal support school services (Private
schools may charge the CCAC up to 3% as an administration fee.);
receive annual reconciliation reports from the private schools and provide this information
in the annual reconciliation reports (ARRs) submitted to the MOHLTC (When the amount
of funding is limited, the CCAC may use its discretion regarding the requirement for an
ARR. In these cases, the submission of invoices with the quarterly report may be a less
expensive and a more reasonable accountability mechanism.); and
monitor and be satisfied based on the claims and reports submitted by the CCAC that the
private school has spent the funding provided by the CCAC for approved services,
including the purchase of services and equipment in accordance with the plans of service
for the children/youths enrolled in the private school.
The private school must:
•
•
•
•
•
•
•
enter into a memorandum of understanding with the CCAC;
use the funding provided by CCAC only for approved services, including the purchase of
services and equipment in accordance with the plans of service for the children/youths
enrolled in the private school;
assume all liability related to the provision of services;
hire service providers (When the private school hires staff to provide the approved services,
the private school must use a standard job description and have policies for screening and
supervision of staff. Any staff hired must comply with the requirements set in the Regulated
Health Professions Act, 1991 (RHPA).);
provide a quarterly report to the CCAC;
provide an annual audited reconciliation report at year-end that indicates how their funding
was spent for the provision of approved services in accordance with the plans of service for
the eligible children/youths; and
return any unspent funds to the CCAC.
9.6.3 Specific Processes Relating to the Provision of CCAC Professional School
Services and Personal Support School Services to Children/Youths in Home
Schooling Situations
•
•
For a child/youth in home schooling, the parent/guardian should contact the CCAC directly.
Once the CCAC has assessed a child’s/youth’s needs, determined his or her eligibility and
developed and authorized a plan of service, the CCAC must flow funds for children/youths
schooled at home through a local community agency that is a transfer payment agency of
either the MOHLTC or Ministry of Community and Social Services (MCSS). The CCAC
must flow funding directly to the agency and the agency must agree to act as a banker and
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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flow funds to the parent/guardian who will then purchase the approved services. The CCAC
is responsible for the reconciliation process.
Where the parent/guardian receives funding from the agency, the following responsibilities
arise:
The CCAC case manager must:
•
•
•
•
•
enter into a memorandum of understanding with the parent/guardian;
enter into a memorandum of understanding with the agency;
receive quarterly receipts from the parent/guardian and include this information in the
quarterly reports submitted to the MOHLTC;
ensure the quarterly reports identify all expenditures related to the provision of professional
school services and personal support school services approved by the CCAC
(Parents/guardians are not permitted to charge an administration fee.); and
monitor and be satisfied based on the claims and reports submitted by the parent/guardian
that the parent/guardian has spent the funding provided by the agency for professional
school services or personal support school services approved by the CCAC, including the
purchase of services and equipment in accordance with the plan of service for the
children/youths being home schooled.
The parent/guardian must:
•
•
•
•
•
•
enter into a memorandum of understanding with the CCAC;
use the funding provided by the agency only for professional school services and personal
support school services approved by the CCAC, including the purchase of services and
equipment in accordance with the plan of service for the child/youth being home schooled;
assume all liability related to the provision of services;
directly hire appropriate and competent service providers (non-family members only) or
contract with an appropriate service provider;
provide quarterly reports identifying all expenditures related to the provision of
professional school services and personal support school services approved by the CCAC
for the child/youth being home schooled; and
return any unspent funds to the CCAC.
The agency must:
•
flow the funds provided to the agency by the CCAC to the parent/guardian.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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9.7 CCAC Approaches to Service Delivery for School Services
Since the introduction of Community Care Access Centre (CCAC) school services, there has
been a dramatic increase in the demand for these services. School children/youths are a unique
client group because of the settings in which they receive school services and the need for their
treatment and care to be integrated into their academic program. These factors have prompted
each CCAC to pursue different approaches to service delivery in order to efficiently serve as
many children/youths as possible. Regardless of the method of intervention or the type of
therapist employed, the CCAC must ensure that:
•
•
•
all procedures are within the scope of practice outlined under the Regulated Health
Professions Act, 1991 (RHPA);
all contracted service providers are trained and competent in the procedures used; and
the procedures offered are in keeping with any site restrictions.
9.7.1 Acceptable Approaches to Service Delivery
The following approaches are acceptable only when deemed to be appropriate by the CCAC
and the school principal (where applicable):
1. Mediator Training: involves demonstrating and teaching tasks to school staff and
volunteers (including the home schooling instructor). Teachers can assist in the supervision
of students in regards to tasks that support the learning process. 8(The role or involvement
of school staff may depend on school policies.)
2. Group Treatment: involves treating children/youths with similar therapy needs in a group.
For example, children/youths requiring life skills teaching can be taught in a group setting
by therapists. Children/youths with similar difficulties may benefit from intensive treatment
programs such as a writing program held in the summer months or a dysfluency treatment
group.
3. Block Treatment/Cycling Model: involves use of a scheduling model based on a cycle of
time when therapy is provided and not provided. Lengths of the interval can also be varied
by cycling the variations (staggering cycle blocks, or staggering the length of blocks or
intervals). After the initial block of treatments, teachers and parents/guardians are trained
on a remedial program for the child/youth. The model can be used for individual or group
treatments.
8
For example, the CCAC may agree to provide some training to teachers so that they would become more adept in
recognizing the level of handwriting/printing difficulties which would benefit from a therapist’s assessment.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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4. Periodic Sessions: involve scheduling of individual treatments at appropriate intervals
(e.g., monthly, every three months). Treatment programs are designed for use at school and
home.
5. Direct Service: involves treatment on a one-to-one basis.
6. Consultation: to exchange knowledge or information in a general, informative way
between the CCAC and the school staff/instructor, as appropriate, i.e., a service care plan
cannot be developed solely based on consultations.
7. Sharing Resources/Cost Sharing Staffing: where the health professional and educational
assistant are working with the same child/youth and it is possible for one person to provide
all the assistance, in cases where appropriate. This promotes continuity of care for the
child/youth.
Once the CCAC and the school principal have agreed on the split responsibilities, the cost
of providing both services by one staff person must be shared between the CCAC and the
public or private school. For example, a medically fragile child/youth with gastric tube
feeds who has an educational assistant for educational needs and a nurse for tube feeds
could have one dually-trained professional to provide both services.
8. Conferences: where case managers and/or contracted service providers may be required to
attend case conferences or meetings to develop or explain plans of service. This is a normal
expectation for the effective delivery of service. The case manager authorizes who attends
case conferences, especially if the CCAC is paying for a contracted service provider to
attend these meetings. Attendance at case conferences may be a service provider contractual
obligation.
9. Service Sites: where the primary service site for the child/youth attending a public or
private school is the school, the child/youth receiving instruction at home has home visits.
Occasionally, a contracted service provider may need to visit a child/youth in locations
other than the school setting. For example, a contracted service provider may be required
to:
•
•
•
•
participate in school day trips;
attend case conferences and meetings not on school property;
attend a specialized assessment requiring the presence of the student’s CCAC therapist
or other contracted service provider;
access specialized equipment not available in the school;
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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•
•
•
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provide specialized support during the student’s transportation to and from school or a
school-related activity;
attend co-op placement sites; and/or
conduct assessments in the child’s/youth’s home.
Off-site service would be provided in accordance with the goals of CCAC professional
school services and personal support school services.
10. General Training: while not a primary function of CCAC school services, the CCAC may
authorize training and consultation to parents/guardians, and groups of school staff
regarding provision of school services for eligible children/youths. Examples are training
sessions on proper body mechanics for lifting, positioning and transferring.
Many children have fine motor difficulties that affect their printing skills. CCACs could
provide information to teachers on their professional development days or CCACs could
approach school boards to ask whether they would like information sessions on
professional activity days. While school services may include training on some occasions,
schools have the primary responsibility to teach printing/handwriting skills to their
students. The CCAC may agree to provide some training to teachers so that they would
become more adept in recognizing the level of handwriting/printing difficulties which
would benefit from a therapist’s assessment.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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9.8 Service Termination in Public, Private and Home Schools
The Community Care Access Centre (CCAC) may terminate a child’s professional school
services or personal support school services if:
•
•
the child/youth and/or parent/guardian are repeatedly not available for scheduled
appointments; or
the provision of continued therapy will not further clinical progress.
The CCAC must terminate professional school services and personal support school services if:
•
•
•
•
the child/youth moves from Ontario;
any of the eligibility criteria cease to be met (for example, if the child/youth receiving
services is no longer an insured person under the Health Insurance Act (HIA);
the child is not enrolled in a publicly funded school or private school or is not being home
schooled; or
the child/youth has reached the age of 21.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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9.9 CCAC Liaison Activities
The Community Care Access Centre (CCAC) must liaise with publicly funded schools, private
schools and community service agencies to ensure that these groups are fully informed about
the professional school services and personal support school services provided by the CCAC.
During the course of these liaison activities, the CCAC must ensure that they comply with the
laws governing the confidentiality of personal health information.
9.9.1 Publicly Funded Schools and Private Schools
The CCAC, schools and contracted service providers should have regular meetings to discuss
the roles of CCAC staff, school staff and contracted service providers relating to the provision
of services to pupils in schools (e.g., private treatment space, record keeping and information
sharing) and other issues of mutual concern.
Note: Every publicly funded school board must establish a Special Education Advisory
Committee (SEAC) that advises the school board on special education issues. It is important for
the CCAC case manager to liaise with this Committee for information sharing and planning
purposes.
School principals should be aware of service issues and the needs of children/youths in order to
be partners in the provision of CCAC school services and personal support school services.
Parents/guardians and teachers must be aware of these issues as there may be times when they
are directly/indirectly involved with service provision or act as mediators on behalf of the
pupil.
9.9.2 Agencies Providing Service to Preschoolers
Preschool-aged children with special needs may be clients of early intervention programs,
Easter Seal Society, day care centres, public health units, specialty clinics, hospitals or others.
The CCAC and their contracted service providers must liaise with these organizations in order
to ensure a smooth transition from the pre-school agency to CCAC school services when the
child becomes school-aged and to avoid duplication of services.
Note: Children attending day care or nursery schools are not eligible for the provision of
CCAC school services in the day care or nursery school settings as these are not “schools” as
defined under the Education Act (EA).
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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Community Groups
CCAC staff must liaise with community groups in order to promote a comprehensive range of
school services. For example, the CCAC in conjunction with local school boards, children’s
services planning bodies, and parent groups could work together to ensure that available
resources are being efficiently utilized and services are working well together as well as to
develop service priorities and plans based on local needs.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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9.10 Other Service Delivery Models
Children/youths with health needs may also receive services in the school setting from four
other agencies
9.10.1 Children’s Care and Treatment Facilities and Correctional Facilities
Some children/youths are unable to attend school because of their need for treatment or the fact
that they are incarcerated. Services in children’s mental health treatment programs and
correctional service programs for young offenders are provided by the Ministry of Children and
Youth Services (MCYS). Where the child/youth resident in any of these types of facilities are
unable to attend school, the facilities provide space for an education program to be provided by
a local school board. Children/youths in these facilities are not eligible for Community Care
Access Centre (CCAC) professional school services or personal support school services.
9.10.2 Children’s Treatment Centres
There are six children’s treatment centres (CTCs) with school boards attached in Ontario.
These centres have their own volunteer school boards and provide education programs for the
children who attend the centres. The CCAC may provide specialized nursing services in these
settings. Other health services are provided by the CTC.
9.10.3 First Nations Schools
The federal government, through Indian and Inuit Affairs Canada, funds special education
programs for First Nations children/youths living on reserves. Health Canada may fund the
provision of health services in school for children/youths attending schools on First Nations
reserves.
Children/youths residing in First Nations communities are eligible for CCAC services. The
CCAC must first assess whether these individuals require CCAC services if similar services are
provided through the First Nations community. CCAC services should co-ordinate with and
complement services available in the First Nations community rather than duplicate those
services. To achieve this goal, CCAC staff need to be aware of the services available in First
Nations communities within their service area.
First Nations may purchase services from the CCAC or contracted service providers. In remote
northern areas, First Nations may also purchase services from Integrated Services for Northern
Children (ISNC), a program administered by the MCYS.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
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Note: First Nations children/youths attending public schools off reserves may receive CCAC
school services if they meet the eligibility criteria. The CCAC must assess requirements and
determine eligibility for services on the same basis as any other Ontario resident. The
MOHLTC provides funding to some aboriginal organizations to provide home and community
care services to aboriginal people both on and off reserve. The types and availability of services
vary across the province.
9.10.4 Integrated Services for Northern Children (ISNC)
The ISNC program is a commitment made by the MCYS, the MOHLTC, the Ministry of
Education and Training (EDU), and the Ministry of Northern Development and Mines to
provide a range of health, mental health and education services to children/youths living in
rural and remote areas across northern Ontario.
Since ISNC provides services similar to CCAC professional school services and personal
support school services, the CCAC and ISNC must negotiate roles and responsibilities locally.
For additional information, visit the ISNC website at:
[http://www.children.gov.on.ca/CS/en/programs/SpecialNeeds/integratedServicesforNorthernC
hildren.htm] or call (705) 474-3540 ext. 218 or (705) 564-8153 ext. 341.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
September 2006
29
CCAC Client Services Policy Manual
Chapter 9
CCAC School Services
9.11 Responsibilities in Emergencies
As the management of an emergency situation while a child/youth is attending school or a
school-related activity is the responsibility of the school or home school instructor, it is the
responsibility of the school or home school instructor to arrange any required ambulance
service or any other response to an emergency.
In regards to the payment of ambulance service, a child/youth receiving in-home services as
well as school services is eligible for a fee waiver relating to ambulance services. A child/youth
receiving school services only is not eligible for a fee waiver.
* Note: Current regulations under the Long-Term Care Act, 1994 distinguish between “school services” (which are
professional services (i.e., nursing, therapies, etc.) and “personal support school services.” To provide clarity in this manual
“school services” are referred to as “professional school services” and “personal support school services” are referred to as
“personal support school services.” When referring to both these services, the term “school services” is used.
September 2006
30