Information for Referring Sources

“I cannot express in words the excellent support and dedication from the Central Registry in assisting the OTMH team with the complex discharges from our unit. The team goes above and beyond and we feel privileged to have their continued support. We would not be able to transition these complex clients back into the community without them.”

- Jane Loos, Discharge Planner, Halton Healthcare Services

Who is eligible for services

Target population

High risk seniors with complex needs who are able to continue living in their own homes with access to frequent, urgent and intense personal supports available throughout a 24-hour period.

Eligibility criteria

• 65+ years of age
• Has a valid Ontario Health Insurance Plan (OHIP) health card
• Demonstrates a need for intermittent personal support services provided throughout a 24 hour period
• Requires multiple daily visits or the availability of on-call services
• Scores a MAPLe 3 or higher from the interRAI-CHA or interRAI-HC
• Medically stable or able to have medical needs met by professionals in the community (i.e. CCAC, family physician, etc.)
• Is able on their own or through a readily available substitute decision maker to direct own service/care
• Agreeable with and able to comply with their customized service plan
• Need for personal support exceeds the need for homemaking services
• Can be left alone between visits (i.e. does not need constant supervision)
• Can manage with average of 1.5 hours/day of care and support

We cannot accept seniors into the program who:

• Need 24 hour supervision
• Need either more or less support than the Supports for Daily living minimum/maximum service limits
• Pose a risk to themselves and/or others
• Need specialized mental health/behavioural supports
• Are medically unstable (i.e. needs medical care that cannot be provided in the community)
• Are unable to comply with service plan
• Can have needs better met through other service options (i.e. Community Support Services, CCAC)

Supports for Daily Living:

• Does not perform medical tasks (i.e. diagnosing, assessing, dispensing medications, etc.)
• Is not available to seniors living in retirement or long-term care homes
• Is not a housekeeping service (only light homemaking as it relates to the care being provided)
• Does not provide constant supervision (seniors must be able to manage at home between visits)
• Is not available to seniors who need specialized care (i.e. mental health or behavioural supports, etc. and is not provided where services cannot be delivered safely.