Enhanced In-Home Disability Supports Pilot Project (EIHDS)

Enhanced In-Home Disability Supports (EIHDS) is a pilot project designed to support families of children with disabilities who are in crisis or at risk of being moved to a residential placement. Through the pilot, supports needs are identified and new and innovative ways to provide respite and support are tested. The project is helping families build confidence in caring for a child/youth living with disabilities. It is helping increase the quality of life for families to stay together.

Innovation Summary

Innovation Overview

Community Services’ Disability Support Program (DSP) serves Nova Scotians living with disabilities. The program strives to deliver supports that allow Nova Scotians living with disabilities to have more control over their lives and decisions, as well as supports that increase their social inclusion and quality of life. To help achieve this, DSP piloted the Enhanced In-Home Disability Supports Project (EIHDS) to address the unidentified, evolving, and potentially overlooked needs of families caring for and living with children or youth with disabilities. This is in recognition that supports should be made available not just for Nova Scotians living with disabilities, but also for the family members who support and care for them.

DSP conducted a consultation with relevant stakeholders and DSP at-risk families who care for a child or youth living with disabilities at their home to identify key gaps in services and challenges that would need to be addressed to avoid residential placement. Consultations revealed the following gaps/opportunities for improvement: holistic support planning for the family, finding and coordinating skilled respite support, lack of capacity and skills in caring for a child or youth with special needs, and financial support to help caring for a child with disability.
• Holistic or individualised support plan was identified as a key need by families. By having an individualised support plan, a family will be empowered to make decisions that best serve their needs and unique to their situation, with the support from the department.
• Respite support was seen as a key need, both in finding the right type needed as well as the coordination of it. Respite provides a break from care-giving responsibilities and allows family members to take care of their health and their needs. Nova Scotia’s respite navigation service was identified as needing improvements to meet the needs of these families.
• Lack of care-giving capacity and skills was identified as another need for these families. As needs change, so will the skills needed for the family members to meet them. Families struggle to navigate through the change without professional help and as a result, may suffer from caregiver burden and deteriorating mental health.
• Financial support was needed as the cost of caring for and treating children with special health care needs can be costly. When available, sources of financial supports can have limiting criteria for how funds should be allocated or used.

The pilot was designed to increase the department’s ability in meeting these identified needs. The implementation was done by prototyping solutions with participating families who have self-identified to be in crisis and urgent need for interventions. Based on the findings from the consultations, the project team developed and trialled four enhanced in-home supports and services (prototypes) to address the gaps.

Intensive Family Support Planning (IFSP)
This prototype involved care coordinators and service providers working more intensely with the family to develop and action a comprehensive and structured plan for the whole family. The goal was to improve care planning and matching of services to the child and family needs, by including families in decision making, goal setting and action planning and providing a wrap-around support system.

Outreach Supports (OS)
Aligned with the IFSP, this prototype activated diverse professional outreach teams to increase capacity and expertise to support for children with disabilities and their families in their homes. This included occupational therapists, behavioural interventionists, psychologists, and registered nurses. The goal was to build the family’s capacity in supporting their child, by working within the comfort and specificity of their home and routine to develop and implement recommendations.

Disability Needs Funding (DNF)
Aligned with the IFSP, this prototype provided access to additional funding to address areas related to the child’s disability needs. This may include food allowance, social activities including transportation, items for reward system, specialised interactive toys, or skilled respite providers. The goal was to reduce financial barriers, and improve physical environment and inclusion in community.

Agency Delivered Respite (ADR)
Aligned with the IFSP, this prototype provided funding to service providers in contract with the Department to coordinate and provide skilled respite services that best meet the needs of the families, both in and out of the home. The goal was to reduce the burden felt by families in finding and coordinating skilled respite services.

The EIHDS pilot project tested these enhanced supports and services for a 6-month period. This prototyping method has allowed the department to validate ideas and assumptions and adopt an agile approach in making improvements based on feedback from families, care coordinators and service providers.

Innovation Description

Innovation Development

Innovation Reflections

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Year: 2019
Level of government: Regional/State government


  • Evaluation - understanding whether the innovative initiative has delivered what was needed
  • Diffusing Lessons - using what was learnt to inform other projects and understanding how the innovation can be applied in other ways

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