Client-Centred Service Approach

Introduction

To respond to the demographic and health changes in our client population, Veterans Affairs Canada (VAC) adopted a service philosophy built on best practices in Client Services in place across the Department, one that identifies individual client’s needs and then determines how best to provide assistance. The implementation of the Client-Centred Service Approach helps us meet the diverse and complex needs of Veterans as well as other clients.

Philosophy of the Client-Centred Service Approach

The adoption of the Client-Centred Service Approach (CCSA) as the philosophy of VAC’s Client Services helps ensure that all our clients with complex needs receive the right service at the right time by the right person.

VAC Service Philosophy

Veterans Affairs provides a range of programs and services to more than 200,000 Canadian Veterans and members of the Canadian Forces. As a result of CCSA, VAC’s Client Services have shifted from a program-centred to a Client-Centred focus to improve service to all our Veterans.

In a Client-Centred Approach to Service:

  • The individual needs of the Veteran are identified and then it is determined how best to provide assistance, through internal or a coordination of departmental and community resources;
  • A partnership exists between the Veteran and the Department as demonstrated through direct Veteran involvement in all aspects of their case planning decisions;
  • Staff work with the Veteran to meet all their needs, not just to determine their eligibility for Departmental services and benefits;
  • Delivery of services with or without VAC benefits is legitimized.

Why CCSA?

Shifts in client demographics and health needs made it clear that further evolution in VAC Client Services was required to enable us to meet changing Veteran needs. Some factors driving the changes included:

  • Changing Veteran profile - with a higher number of Canadian Forces Veterans with complex service needs and a decreasing number of wartime Veterans, a more personalized and caring service approach is required;
  • Increasing and changing staff workloads resulting from changes in our Veterans’ life situations required that services and benefits be organized and delivered differently;
  • A lack of service standards across the organization to ensure that Veterans receive a consistent quality and level of service regardless of where they live in Canada.

Adoption of a service philosophy that emphasizes Veteran self-determination, autonomy, informed choice and an orientation that tries to build on Veteran strengths and resources will meet the goal of improving the quality of life for the Veterans and their families;

A Client-Centred approach capitalizes on opportunities to integrate our service delivery within the Client Service Delivery Network.

CCSA - What’s it all about?

  • CCSA is about Veterans; it is not about the future of VAC.
  • CCSA is about fairness to all Veterans; it is not about offices doing their own thing.
  • CCSA is about teamwork; it is not about individual career aspirations.
  • CCSA is about meeting the needs of Veterans; it is not about fulfilling "wants".
  • CCSA is about improving our ability to do our jobs; it is not about devaluing the work of the past.
  • CCSA is about using the resources that we have to improve services and expand our Veteran base; it is not about downsizing or protecting jobs.
  • CCSA is about improving Client Services and the consistency of these services; it is not about specific tools or processes.
  • CCSA is about making it easier to do our work; it is not about a system.
  • CCSA is about meeting client needs through partnerships; it is not about VAC doing everything.

Principles

The Client-Centred Service Approach is built upon the following principles which we strive to promote for our Veterans:

Independence:
being able to live in one’s own home, in one’s own community with as little help as possible. The requirements for independence are health, wealth and social integration.
Autonomy:
the maintenance of identity and values and having control over decisions regarding oneself. Autonomy can be maintained even when one is dependent on others because of frailty or disability.
Holistic:
rather than dealing with a Veteran as a candidate for one of a vast array of departmental services and benefits, we take into account all of a person’s needs. We try to integrate our services in light of the total person. As well, we share all information about a Veteran with them and encourage them to make their own decisions.

Client-Centered Service Delivery Model

Our adoption of CCSA is based on a model for service delivery that:

  • Promotes national standards for Client Services;
  • Builds on best practices from across the organization;
  • Supports all of VAC’s programs and services.

The Client-Centred Service Delivery Model outlines the steps that VAC staff will follow in providing service to Veterans from a Veteran’s first point of contact through to follow-up and monitoring, as required. An explanation of the individual components demonstrate how this is carried out from both the Veteran and staff perspective.

Screening and Assessment

CCSA is based on needs; therefore, screening to identify problems and Veteran needs assessment are critical components of this service approach.

Veterans are screened to ensure that problems and changes in circumstances are identified and are not overlooked. A one-year study of various screening methods has shown the most effective strategies for identifying Veteran problems. Assessment is a process to identify unmet Veteran needs, Veteran strengths and the outcomes to be achieved together. The assessment is used to develop a case plan to link needs with programs and services both inside the Department as well as resources in the community.

Screening

Inquiries are received and/or initiated by the Department via several modes - telephone, face-to-face, electronic and through written correspondence. The majority of Veteran contacts involve applications for benefits, requests for assistance with health or social problems or social contact and support. Veterans are screened when they make contact with the Department, and staff also screen whenever they contact a Veteran.

The screening process:

  • Ensures a more consistent service and standardized approach to identifying any changes in Veteran status, problems, or potential problems;
  • Captures Veteran information and biographical data upon entry of a client file or service number, the reason for the call and prompts for the screening question and recording structure;
  • Uses an integrated on-line tool that forms part of the Department`s case management system to help ensure that case managers in the field are aware of what involvement other staff in the Department may have had with the Veteran;

Assessment

Significant work was undertaken to develop a flexible, Client-Centred assessment tool that:

  • Is variable in length and based on Veteran needs;
  • Is appropriate to Veteran needs;
  • Transcends program requirements and has the capacity to provide data required for administration of specialized benefits;
  • Facilitates more client-focused case management. The tool will encourage more in-depth probing of the Veteran’s situation;

The assessment process collects information to determine the Veteran’s overall degree of functioning, identify needs and issues that are causing a barrier to transition, or challenges in the life of the Veteran and/or family. Completion of an assessment is not limited to the case manager. In most complex cases, assessments are also completed by internal and external health professionals and specialists. Assessments always occur early in the case management process and at various times depending on the Veteran’s changing condition, needs and issues. Social patterns and structures play a big part in determining overall health and in helping people stay well. VAC utilizes a holistic approach and considers the five key determinants of health, as recognized by the World Health Organization:

  • Personal factors - the unique qualities and abilities we have, the way we respond to things
  • Social environment - the support we get from family and friends
  • Economic environment - our financial resources
  • Physical environment - such as safe and stable housing
  • Health services environment - access to health services we need

The Client-Centred Case Plan

The purpose of the Client-Centred Case Plan is to develop strategies directed at meeting identified unmet needs and validating the client/caregiver’s contributions to the goal of improving their quality of life. The effectiveness of these strategies is monitored on an ongoing basis to determine if the final outcomes are effectively meeting the Veteran’s unmet needs and stated goals. The Case Plan is developed between the Case Manager and Veteran and in consultation with the Client Service Team as appropriate.

Following an assessment of the Veteran, if the Case Manager has determined that there are one or more unmet needs that will not be met by the provision of programs alone, including the Veterans Independence Program, then a Case Plan is developed. A Case Plan is a set of organized interventions/actions accompanied by a chronological listing of scheduled follow ups and monitoring, which respond to the unmet needs and desired goals of the Veteran.

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