Resize Text plus minus

The Behavioural Supports Ontario (BSO) initiative was created to enhance health care services for older adults in Ontario with complex and responsive behaviours associated with dementia, mental health, substance use and/or other neurological conditions. The initiative also provides enhanced family caregiver support in the community, in long-term care or wherever the patient and/or caregiver(s) reside.

In 2010, the Ministry of Health and Long-Term Care announced $40 Million of funding toward the development of an evidence and experience-based framework to enhance the availability of supports and services to persons living with responsive behaviours (Ontario Behavioural Support System Project Team, 2010). In Phase 1, the ‘Framework for Care’ was developed in consultation with family caregivers, clinicians and administrators from across Canada (see ‘Behaviours Have Meaning’ Report). In this phase, the project’s target population, system model and evaluation framework were also defined. Leadership was provided by the North Simcoe Muskoka Local Health Integration Network, Health Quality Ontario, the Alzheimer Society of Ontario, the Alzheimer Knowledge Exchange (AKE) (now called the brainXchange) and the Ministry of Health and Long-Term Care (Gutmanis, Snyder, Harvey, Hillier & LeClair, 2015). The principles, service delivery, core model elements and implementation strategies of the BSO framework are organized under three foundational pillars related to system coordination and management, intersectoral and interdisciplinary service delivery, and capacity building for health care teams (See ‘Provincial Framework of Care’).

“While many dementia care programs and services already existed along the care continuum, the aim of this initiative was to realign and enhance the system in a manner that both facilitated collaboration and partnerships among like or complementary services and leveraged existing resources” (Gutmanis et al., 2015, p.49).

The core elements of BSO’s integrated service delivery include:

  1. Mobile interdisciplinary behavioural support outreach teams that provide support to professional care providers and informal family caregivers;
  2. Case management and transitional supports to ensure care continuity and integration across sectors, as well as dementia day programs and respite care; and
  3. Specialized short- and long-stay residential care for those with particularly complex and challenging health issues (Gutmanis et al., 2015).

It is important to note that BSO was not designed to be a new program but rather, was implemented to leverage existing resources to enhance system coordination across the continuum of care. The components of BSO differ across the province and may consist of: specialized geriatric services, geriatric mental health outreach teams, community support services, geriatric emergency management nurses, inpatient geriatric assessment units, primary care-based memory clinics, adult day programs, Alzheimer Society education, counselling, and a variety of support programs (Gutmanis et al., 2015).

In Phase 2 (Fall 2011), the initiative saw the launch of 4 early adopter Local Health Integration Networks (North Simcoe Muskoka, Central East, Hamilton Niagara Haldimand Brant and South East) which were selected to demonstrate and test the BSO framework. In February 2012, the remaining 10 LHINs implemented the BSO framework. The original Coordinating and Reporting Office (CRO) ensured fiscal accountability and coordinated province-wide LHIN-based implementation. Skill-building tools, including assessment tools that encouraged new insights into why people may exhibit responsive behaviours, were developed and shared along with the dissemination of various care pathways and approaches to clinical integration (Gutmanis et al., 2015). Funding for the CRO ended in March 2013 (Behavioural Supports Ontario, 2013).

In Phase 3 of BSO (April 2015), a provincial coordinating body re-emerged to support and facilitate the work of the initiative. The Provincial Coordinating Office is currently located in the North East Local Health Integration Network at the North Bay Regional Health Centre.

To contact the Provincial Behavioural Supports Ontario (BSO) Coordinating Office, please e-mail or call 1-855-BSO-NE13 (1-855-276-6313).