Wednesday, May 23, 2012 | Telephone: 905.527.5092 RSS | | Print | Problems?

Partnership Application for Third Party Professionals and Paraprofessionals, including the District Mental Health Strategy

HWDSB Partnership Application for Third Party Professionals and Paraprofessionals including the District Mental Health Strategy

This application form must be completed for any professional or paraprofessional providing services to HWDSB students and/or staff on HWDSB property. This includes: Social Workers, Child and Youth Workers, Child and Youth Counselors, Occupational Therapists, Physiotherapists, Speech and Language Pathologists, Communication Disorder Assistants, Nursing, Psychologists and Psychological Consultants, Behaviour Therapists, and others) who are not employees of HWDSB and whose agency's or organization's partnership with HWDSB is not mandated by the Ministry of Education.

* All items in red are required.


Applicant information
Name of Organization:  
Address:
 
Telephone Number:  
Fax Number:
Email Address:  
Website Address:
Describe Your Organization:

Briefly describe your organization and mandate in two or three sentences:  

Date Your Organization was established:   Month-Day-Year
Is your organization incorporated?
Information About the Activity/Service Offered:
Contact Person:  
Title of Contact Person:  
Activity/Service Title:  
Start Date: Month-Day-Year ex 10-01-2011  
End Date: Month-Day-Year ex 10-02-1011  
Activity/Service Description:

Please describe the purpose of your activity/service:  

Describe the core elements of this activity/service:  

Describe the target population that will be served:  

(include, gender, age range)

Total number of students to be served through this activity/service:  

* Type unlimited if you are not sure.
Student Achievement

Please describe how this activity/service positively impacts on student achievement:  

Implementation Strategy

Please outline the implementation strategy and identify the resources and services requested of the HWDSB:  

Similar Projects Operating in Community

Please identify any similar projects in the Hamilton community. What makes this project different, and what service gaps will be addressed by your project?  

Services Offered Through HWDSB

Please identify how this activity/service works in conjunction with services/programs offered through HWDSB.  

Level of Involvement

Please indicate the level of involvement your service will offer within the school?








Evidence of Effectiveness

Please outline the evidence that supports the effectiveness of the activity/service:  

Please outline your plan to evaluate the effectiveness of the activity/service:  

Capacity Building

Does this activity/service build the capacity of HWDSB staff and if so please outline how this occurs:  

Instructional Time and Curriculum

Is this activity/service offered during instructional time? If so please outline how does this meet and/or support the Ontario Curriculum:  

Terms of Partnership Requiring Additional Information:

Please provide information with respect to the following categories:

Supervision Procedures

Please outline the staff supervision procedures in place.  

Staff Qualifications

Please outline the qualifications of the staff that will be carrying out the activity/service.  

Informed Consent

Please identify your process and expectations with respect to obtaining all appropriate informed consents.  

Payment/Fees

Please identify how the proposed activity/service will be funded.  

Confidentiality

Please identify how you will maintain confidentiality with respect to information obtained, including reports etc.  

Risk Management

Please identify any risks associated with the service/activity and outline your plan to manage the risks  

**Proof of vulnerable persons screening must be provided prior to having direct contact with a student or group of student.**

Space and Resources

Please outline your space and resource requirements.  

Terms of Partnership Required by HWDSB

Duplication of Board Services

The services that third party professionals/paraprofessionals are proposing to provide are not to be in conflict with any provisions of collective agreements with Hamilton-Wentworth District School Board staff. Third party professionals/paraprofessionals are expected to demonstrate how the services to be provided enhance, but do not duplicate, current services provided by Hamilton-Wentworth District School Board.

Equity

Hamilton-Wentworth District School Board is committed to ensuring that all policies, guidelines, and operating practices actively demonstrate a respect for the principles of anti-classism and socio-economic equity. Pleave view our Equity Policy.

Respect for all HWDSB Policies and Contracts

All third party professionals/paraprofessionals that provide services on HWDSB property are required to review and comply with HWDSB Code of Conduct Policy. View our Respectful Working and Learning Environments.

Liability Insurance

HWDSB requires proof of insurance against civil litigation alleging incompetence, professional error, omissions or charges laid by professional colleagues, parents/guardians or students. A copy of the insurance must be provided to the Board once the proposal has been approved.

Conflict Resolution

The student’s progress and well-being must be the primary focus of all parties. It is essential that any conflict that arises during the process be communicated to the school principal in a timely manner, such that conflicts can be addressed and resolved quickly. Effective communication is the key to resolving conflicts as they arise. If the conflict cannot be resolved at the school level, system level staff may also be called upon to provide assistance.

Conditions

In addition to adhering to policies outlined in their own agency, any person entering a school to provide services to students are accountable to the school principal in regards to their professional conduct and interactions with students, teachers, parents and other educational staff. Ultimately, as outlined in Regulation 298 in the Education Act the principal will ultimately be responsible for the activities of the third party professional/paraprofessional.

While operating within the school, agency personnel shall abide by relevant protocols, including: Hamilton-Wentworth District School Board Human Rights Policies, Abide by Duty to Report Suspected Child Abuse, and School Code of Conduct. More information can be found here.

A partnership is a mutually beneficial, reciprocal supportive arrangement between a school or school board and a community service provider. Partnerships are the relationships that add human or material resources through services/supports that ultimately lead to improved student learning. Through partnerships we seek to improve school programs, school climate as well as providing services to our families and students. Ultimately, well functioning, healthy individuals are able to make contributions to the betterment of our community.

Termination Procedure

Partnership agreements can be terminated by any of the partnering organizations with appropriate notice of termination. Specifics related to the termination of partnerships must be detailed in the partnership agreement. The process and time frame for termination of a partnership will be included in the written partnership agreement. (refer to HWDSB’s A Guide to Educational Partnerships pg. 66).

I the undersigned, declare that:

  • The information in this application is accurate and complete
  • The application is made on behalf of the organization named on page one (1) with its full knowledge and consent;
Name of person with signing authority:  
Initials of person with signing authority:  
Position  
Date: Month-Day-Year  

Please note if you have any questions that have not been answered in the “District Mental Health Strategy and Professional and Paraprofessional Application Form” you may contact David Hoy at david.hoy@hwdsb.on.ca or via telephone at 905.527.5092 ext 2448