NL Integrated
Youth Services

FAQ: Frequently Asked Questions

NL-IYS Youth Hubs Initiative

NL-IYS is an initiative of Choices For Youth, Newfoundland and Labrador Health Services, The Government of Newfoundland and Labrador, and a dedicated group of philanthropic partners. We’re all committed to improving services for young people by supporting the expansion of the IYS model in Newfoundland and Labrador. 

This collaborative IYS effort has been developed and informed by:

  • the Health Accord for Newfoundland and Labrador,
  • over four years of active engagement with over 1,000 youth, 300+ service providers and 32 communities across Newfoundland and Labrador. This deep engagement includes over four years of collaboration with eight dedicated steering committees
  • our partners in government, community and philanthropy, and,
  • significant sharing of learning from other jurisdictions across Canada.

The NL-IYS Initiative is the implementation of a network of Integrated Youth Service delivery hubs representing the establishment of a system of comprehensive supports for youth and young families across Newfoundland and Labrador. This fundamentally shifts the delivery of services (mental health, addictions, housing, primary health care, training and employment, etc.) from a fragmented set of systems supports to one geared towards coordination, effective responses, and high impact. 

Yes, there is already an existing Integrated Youth Services (IYS) hub in St. John’s, located at Carter’s Hill Place operated by Choices for Youth. This hub serves as a central site for delivering wrap-around services to youth in the region. Currently, expansion efforts are underway to establish additional hubs in rural communities across Newfoundland and Labrador.  

For more information on these services, you can visit the following websites: 

  • General information about the IYS model and RFP in NL: nliys.ca  

The Integrated Youth Services Concept

IYS hubs provide low-barrier, integrated services for young people and their families in a “one-stop-shop” model.

The intent of IYS hubs is to bring together mental health, addictions services, primary care, peer support, and other social services into a single, easy to access location or access point.

IYS hubs require a network of organizations and service providers to work closely together to provide integrated services, across the continuum of care, in a youth-friendly manner and environment.

Where and when feasible, this involves the co-location of youth-focused services.

“Integrated Youth Services,” (IYS) is a pan-Canadian and international movement that aims to build effective, youth-focused and integrated services for mental health, substance use and related issues that are brought together to treat and support a young person holistically, whatever their needs may be.

The following are important principles of the Newfoundland and Labrador IYS model:

  • Integration of services (mental health, Indigenous programming, substance use support, primary care, peer support, and social services) at a single, easy-to-access youth hub
  • Inclusion of youth and family members as co-creators in the design, implementation and evaluation of services, systems and processes
  • A collaborative governance model for the youth hub, with a clearly established Lead Agency and core Governance Partners who, together with other stakeholders, govern the hub
  • Accessible, low-barrier services that are clearly identifiable in the community
  • Integration of Indigenous and Western models of health care
  • Evidence-based clinical interventions matched to the level of need, with supported transitions to specialized care services when necessary
  • Use of standardized assessment, data collection, and outcome evaluations
  • Use of a common brand identity and participation in common communications efforts (e.g., social media, marketing and advertising, and branded assets)

These services work collaboratively together with shared pathways for information sharing and coordinated support and care. There is a growing interest in the IYS model both in Canada and internationally.

Based on the vision and funding model for the NL-IYS, the Lead Agency will be expected to play a role in both implementation and coordination of the partnerships and integrated service delivery model, as well as direct service delivery.

While Choices for Youth (CFY) offers guidance in capacity building, the Lead Organization retains agency over employment-related decisions, including hiring, payroll, and role determination for Hub staff. This autonomy means that Hubs can tailor staff roles to their organizational structure and community needs, but they collaborate with CFY on best practices that align with the IYS model. Operational budgets will indeed be developed collaboratively and approved by CFY’s Backbone team to ensure alignment with funding and service requirements, but ultimate responsibility for staff employment remains with the Lead Organization. 

The staffing requirements for an IYS hub depend on the size, service scope, and demand within the community it serves. Generally, IYS hubs require a multidisciplinary team to support integrated care services, including: 

  • Mental Health Professionals:
    • Psychologists, counselors, and social workers to provide mental health and addiction services. 
  • Primary Care Staff:
    • Nurses, nurse practitioners, and potentially physicians, especially if primary care services are part of the hub’s offerings. 
  • Peer Support Workers:
    • Individuals with lived experience to provide peer support, mentorship, and advocacy. 
  • Operational and Administrative Staff:
    • Facility managers, intake coordinators, and administrative support staff. 
  • Specialized Support Staff:
    • For additional services such as educational or employment counseling, as needed by the hub’s user population. 


Each IYS hub might also employ part-time part-time, or contract staff based on specific community needs and demand fluctuations.  

Newfoundland and Labrador Health Services through Family Care Teams include a core team of health professionals which includes primary care provider (PCP) such as physicians or, nurse practitioners, nurses), clinical and social navigators, It is important to know that the level and complement of resources may not be consistent through teams based on the maturity of the team and the ability to recruit positions based on needs and available resources in each area, Family Care Teams may also include allied health professionals (e.g. physiotherapists, occupational therapists, pharmacists, social workers, etc.). These team members may be embedded into the core team and report directly to the manager of the FCT or may be an extended part of the team, in other words, a team member who can be accessed through pathways to other program areas (e.g. Public Health, Community Support). Family Care Teams will work with programs and services within Public Health, Community Support and Mental Health and addictions, Developmental Health, Adult Speech and Hearing, and other outpatient services to better integrate and strengthening communication and teamwork.  Learners from various disciplines are also an important part of the team.

The recommended staff-to-service user ratio varies based on the services offered and the intensity of support provided. A general guideline for integrated youth services is 1 staff member for every 5-10 youth on-site during active service hours. This allows for personalized support and helps ensure that youth receive timely access to services. Ratios may need adjustment based on specific program demands, community needs, and the nature of individual support sessions, such as group versus one-on-one counseling. 

This will look differently in each Hub based on regional needs. Operational hours for IYS hubs are generally structured to maximize accessibility for youth, often including evening and weekend hours. A typical schedule might be: 

  • Total Operational Hours:
    • Will vary based on regional needs. Generally, 40-50 hours per week, which can vary by location. 
  • Staff Shifts:
    • To maintain flexibility, staff might work in shifts, to cover the full operational schedule and ensure service coverage across all hours. This could include staggered shifts to balance the need for diverse services and manage peak demand times. 

Depending on service demand and hours of operation, the number of on-site staff can vary: 

  • Minimum Staffing (Small Hubs or Off-Peak Hours):
    • 3-5 staff members, including one mental health professional, one primary care provider (if applicable), and support staff. 
  • Maximum Staffing (Larger Hubs or Peak Hours):
    • 10-15 staff members to ensure availability across services, including multiple mental health professionals, peer support workers, primary care staff, and administrative support. 

This range allows flexibility, enabling hubs to scale staff numbers based on demand while maintaining service quality. 

Choices for Youth: The Backbone Organization

Across Canada, each province has an IYS backbone organization. The backbone organization provides guidance and support for IYS hubs in that province. In Newfoundland and Labrador, Choices for Youth is the backbone organization. The core leadership for the backbone team is positioned within Choices for Youth as a distinct operational arm of the organization, collectively referred to as NL Integrated Youth Service. This team will manage all aspects of the start-up and development work, as well as take on operational leadership for the network of hubs.

While the IYS hubs will have local management and community involvement, having CFY provide these foundational services will help streamline operations and maintain quality standards across the hubs. This partnership approach allows for shared resources and expertise while fostering community engagement and self-management at the local level.  

Choices for Youth will guide and support the following: 

  • Planning and operating IYS hubs in Newfoundland and Labrador.
  • Helping all hubs stay true to the IYS vision and principles. This will ensure high-quality services that meet youth and family needs. 
  • Partnering with government departments, community organizations, and other stakeholders. 
  • Coordinating fund development and communications efforts
  • Providing Human Resources and Finance supports to all hubs
  • Conducting research and evaluation on NL-IYS services

Supporting capacity building” for IYS Hubs encompasses several areas where Choice for Youth (CFY), acting as the Backbone Agency, provides guidance, resources, and expertise to help Hubs operate effectively and sustainably. This support includes: 

  • Finance and Administration:
    • CFY assists Hubs with setting up financial systems, budget planning, and administration that align with the IYS funding and operational guidelines. This could involve training on financial requirements, budget forecasting, or reporting practices to streamline financial management and ensure accountability. 
  • Human Resources (HR):
    • CFY supports Hubs in HR matters such as recruitment, onboarding, training, and staff development. This includes sharing best practices, facilitating staff orientation to the IYS model, and providing resources for continuous staff support and engagement. 
  • Implementation and Operations Planning (including Pathways of Care):
    • CFY and Newfoundland and Labrador Health Services (NL Health Services) collaborates with Hubs to define clear service delivery models, pathways of care, and operational workflows. This planning ensures consistency in care quality and seamless integration across services such as mental health support, addictions services, and primary care. 
  • Renovation Support:
    • CFY provides guidance on facility renovations required to host the Hub, ensuring spaces meet the necessary requirements for accessibility, safety, and multi-service integration. This might involve recommendations on layout, furnishings, or technical upgrades to optimize the Hub for multi-service delivery. 

The role of Choices for Youth (CFY) in the implementation plan and branding strategy for the Integrated Youth Services (IYS) model is multifaceted and involves several key components:  

  • Site implementation – CFY will support the implementation of sites, including the project management of the renovation process, supporting the development of finance, data, and human resources systems and processes, and onboarding staff on supports model.   

 

  • Branding – CFY will take the lead in developing and promoting the IYS brand, ensuring it reflects the values and goals of the initiative. This process will involve actively seeking community input to ensure that the brand resonates with local populations and captures their needs and aspirations. The established brand of Lead Agencies will remain intact, but it will be complemented by recognizing the specific spaces as IYS sites. This dual branding helps maintain organizational identity while integrating the broader IYS initiative. 

IYS in NL

Key components will be: 

  • Services that are supportive, respectful, and culturally safe: 
    • Within IYS hubs, all youth and families will feel welcome, safe, and supported.

Collaboration and community partnerships: 

  • A local IYS network will operate each hub. Each IYS network will be made up of partner agencies.
  • Each IYS network will name a Lead Agency. The Lead Agency will manage the IYS hub.
  • The other members of the network will be called Partner Agencies. Partner Agencies will be involved in several ways. For example, each Partner Agency will assign one or more staff to provide services at the IYS hub.
  • All these service providers will integrate their services. This will make it quicker and easier for youth to access services.

 Co-designing services with youth and caregivers: 

  • At each IYS hub, an advisory committee will give input on services, programs, and policies.
  • The committee will be comprised of Youth, Families, Government & Community Leaders, and Mental Health and Addictions Professionals
  • There will also be two province-wide committees, NL-IYS Guidance Council and the NL-IYS Youth Advisory Council.

Quality, evidence-based services: 

  • IYS hubs keep track of the services offered and how effective they are.
  • This information helps staff know what’s working well, and what needs to change.
  • The research and evaluation carried out in Newfoundland and Labrador will be part of the IYS Pan-Canadian Learning Health System.  

Family Care Teams are an innovative approach to re-imagine and re-design the health system in Newfoundland and Labrador. Family Care Teams aim to improve access and continuity of primary health care (PHC) for individuals and families in their community. They represent a significant shift from solo-based community practice and program-based models of service delivery to an interdisciplinary team-based model. Family Care Teams offer seamless access to multiple health care professionals that focus on meeting the health and social needs of individuals and families.” Family Care Teams. A Health Policy Framework for Newfoundland and Labrador, 2023 

In terms of staffing for the Integrated Youth Services (IYS) hubs will not be required to supply all staff, such as physicians and nurses, directly. Instead, there will be a partnership with Newfoundland and Labrador (NL) Health Services to enable access to key healthcare professionals, including physicians, nurses, and others. It is crucial to ensure an understanding of health resources available to support the hub and capacity of teams through discussion with a Family Care Team representative. In-kind support (with specifics) should be in the form of a letter of support  

The Lead Agency will still need to ensure operational staff, such as youth support workers and center management. These staff members can be funded through the operational funding provided as part of the Newfoundland and Labrador IYS initiative. This funding will help fill gaps in the service delivery model after all partners, including NL Health Services, contribute their resources. 

Family Care Teams in communities across Newfoundland and Labrador are aware that they are an integral partner in the Integrated Youth Services (IYS) initiative. This includes their role in providing essential healthcare and social services within the IYS hub model. These teams, which include professionals such as physicians, nurses, and social workers, are part of the broader coordination efforts to deliver integrated care.  

 

Lead Agencies will not need to inform them of the initiative itself but will be responsible for collaborating and coordinating with these teams to ensure their capacity to participate and provide health care resources to support the hub. While they are aware of their role, it may still be necessary to engage them directly to solidify partnerships and streamline the delivery of services within the IYS model.

Based on the Newfoundland and Labrador (NL) Integrated Youth Services (IYS) model and funding structure, the role of the Lead Agency (which could be you, if you’re managing the hub) involves more than just supplying the facility. Here’s how responsibilities are typically divided:  

  • Facility and Coordination:
    • Yes, as the Lead Agency, you are responsible for supplying the facility where the IYS hub will operate. This includes ensuring that the space meets the necessary criteria (youth-friendly, accessible, etc.) and possibly overseeing capital improvements using available funding. Please note that funding is available to upgrade or renovate your space to support this.  

 

  •  Coordination Role:
    • Your organization will also be responsible for coordinating the service delivery model, ensuring that the integrated services—such as mental health, addictions support, primary care, and peer support—are offered in a seamless, youth-friendly manner. This coordination means working closely with different service providers who may come from:  
      • NL Health Services (physicians, nurses, healthcare professionals provided as in-kind contributions if requested and within Family Care Team’s ability)  
      • Local partners, external service providers, and your own organization for other essential roles (counselors, youth peer support, administrative staff).  
  •  Staffing Collaboration:
    • You will not be responsible for directly hiring every professional (such as physicians or nurses), as those may be offered through in-kind contributions from NL Health Services. However, you will need to ensure that roles such as the ones listed below are covered.  These positions will be funded through the operational funding provided as part of the NL IYS initiative.  
    • Support workers   
    • Administrative staff  
    • Peer support roles  

Summary:  

  • You are responsible for providing the facility and ensuring it meets IYS standards, with the option to use capital funding for renovations.  
  • You will coordinate staffing but will not need to supply all staff on your own. Healthcare professionals (physicians, nurses) will likely come from NL Health Services as in-kind support. Family Care Team staff are paid by Newfoundland and Labrador Health Services.
  • Other staffing needs (e.g. support workers, admin staff, etc.) will be covered through operational funding, which is provided to help fill gaps in the service model.  
       

If your hub is selected, you’ll work closely with other IYS partners and NL Health Services to ensure that the required staff are in place and the services are delivered according to the IYS vision.  

When evaluating whether your facility could serve as an ideal Integrated Youth Services (IYS) hub, it’s important to consider a few key factors based on what the NL-IYS model aims to deliver.   

 

Here are the primary considerations that can help determine if your facility meets the needs of a hub:  

 

Please note, there are capital funds available to support the renovation of new hub sites to help address some of the criteria below.  

 

A. Space and Layout  

  • An IYS hub should have a layout that supports a variety of services under one roof or within close proximity. This includes: 
    • Private consultation rooms for mental health, primary care, and addiction services.  
    • Group spaces for peer support sessions or workshops.  
    • Common areas that feel welcoming and youth-friendly, where young people can drop in without feeling like they’re in a clinical or institutional setting.  
    • Flexible spaces that can accommodate different services and activities. 
    • Sufficient workspace for new staff members  
  •  Question to ask yourself: Does your facility have enough private rooms and flexible spaces that can accommodate a range of youth-friendly services?  

 Accessibility

  • The hub should be easily accessible to young people and their families. 
  • This means:  
    • Being centrally located or easily reachable by public transportation.  
    • Having accessible features for individuals with physical disabilities (e.g., ramps, elevators, accessible bathrooms).  
  • Question to ask yourself: Is your facility easy to reach for youth and families, and does it meet accessibility standards?  
       

Youth-Friendly Environment 

  • The space should not feel too formal or clinical. It should be designed in a way that makes young people feel comfortable and welcome. Some features could include: 
    • Bright, welcoming décor.  
    • Spaces where young people can relax, hang out, or access support without feeling pressured.  
    • Signage that is clear and easy to understand.  
         
  • Question to ask yourself: Does your facility offer a youth-friendly atmosphere where young people feel comfortable, supported, and safe?

Co-location of Services

  • One of the key goals of IYS hubs is to integrate a variety of services (mental health, addictions, primary care, peer support) in one location. Co-location of these services enables ease of access for young people.  
  • Question to ask yourself: Can your facility accommodate the co-location of multiple services, including medical care, mental health services, and social supports?  

Partnerships with Service Providers

  •  The facility should be able to support partnerships with other local service providers who may need to use the space. These partnerships could include healthcare providers, social workers, addiction counselors, and others. 
  • Question to ask yourself: Does your facility have the infrastructure to support partnerships with external service providers, and can these providers easily access and work from your site?  

In addition to the factors mentioned above, funding is available for capital improvements to help ensure that your facility meets the requirements of an IYS hub. This can include modifications to create more private spaces, accessibility upgrades, or other enhancements needed to align with the IYS model.  To assess whether your facility is a suitable option for an IYS hub, you can use the Readiness Assessment Tool. This tool will guide you through important considerations and help determine your facility’s alignment with the IYS hub vision.  

You can access the Readiness Assessment Tool here: Readiness IYS RFP 2024 

In the context of the Newfoundland and Labrador Integrated Youth Services (IYS) Request for Proposals (RFP), “rural” is defined as any community outside of the Metro St. John’s area in NL.  

 

Definition of Metro St. John’s:  

  • Metro St. John’s typically includes the city itself and several surrounding municipalities that are part of the urban area. The communities generally considered part of Metro St. John’s include:  
    • St. John’s  
    • Mount Pearl  
    • Paradise  
    • Conception Bay South (CBS)  
    • Torbay  
    • Portugal Cove-St. Philip’s  
    • Logy Bay-Middle Cove-Outer Cove  
    • Petty Harbour-Maddox Cove  
    • Pouch Cove  
    • Flatrock  

Rural Newfoundland and Labrador:  

  • Anything outside of these communities is considered rural for the purposes of this RFP. Rural communities tend to have fewer resources and service availability, which is why the IYS model is particularly important in those areas. The intent of the Newfoundland and Labrador IYS is to extend youth services to rural and remote communities where access to healthcare, mental health, and social services is more limited than in the urban areas of Metro St. John’s.  

IYS hubs need sufficient space to support various service types, ideally designed to accommodate both individual and group activities. Generally, recommended sizes range from: 

  • Minimum Size:
    • Around 2,500 square feet, suitable for smaller, rural hubs offering basic mental health, primary care, and peer support services. 
  • Larger Hubs:
    • Larger or urban hubs may require 4,000-5,000 square feet or more to facilitate additional services like educational workshops, group counseling rooms, and private spaces for healthcare delivery. 

The layout should include private counseling rooms, multi-purpose rooms, waiting areas, and administrative offices. 

Appendix A - Terminology and Definitions

Integrated Youth Services: A global movement, aimed at transforming how youth, young people and their families find and access the resources, services and supports they need. In an IYS hub, different organizations offer services in the same location. Everyone works together to make the services accessible and responsive.  

IYS Youth Hub/Sites: The physical, purposefully built spaces established in communities, through which Lead Agencies and partners operate and offer services. IYS Youth Hub and Integrated Youth Service sites are used interchangeably.  

Newfoundland and Labrador (NL-IYS) IYS: Inclusive term for the overall provincial IYS initiative. Also refers to the model that applies the IYS concept to our provincial context. 

Administrative Host: An organization or agency identified to drive innovation and systems transformation by providing comprehensive support to the implementation, evaluation, continuous improvement, and overall administration of NL-IYS. Choices For Youth is fulfilling this role.

Backbone Team: A team of staff, employed by the Administrative Host, responsible for providing comprehensive support that drives all aspects of the IYS transformation, the successful establishment of the IYS hubs, stakeholder engagement, clinical service innovation, communication and research, evaluation, and reporting.

Co-location: Youth can get everything they need under one roof; a comprehensive array of services. Being co-located in close physical proximity helps ensure that service providers participate in frequent informal consultations, develop mutual knowledge, and information-sharing, strengthen interpersonal relationships, and work collaboratively. Furthermore, co-location increases availability of service providers and improves the organizational culture which enhances safety and quality of services. 

Lead Agency: An organization contracted to lead the establishment and operations of an IYS Youth Hub in a Newfoundland and Labrador community. Lead Agencies sign an Operating Agreement with Choices For Youth for the delivery of services. 

Partners: A term used to refer to all organizations and people working within the NL-IYS network. Typically, local partnerships are held and led by Lead Agencies, while provincial partnerships are held and led by the backbone. 

NL-IYS Guidance Council: Provides technical advice, subject matter expertise, and guidance to the backbone team in areas that align with the strategic direction for IYS by supporting the backbone team in the foundational work necessary to implement and operationalize the endorsed IYS model for Newfoundland and Labrador. 

NL-IYS Youth Advisory Council: The Newfoundland and Labrador Integrated Youth Services (NL-IYS) Youth Advisory Council (YAC) is a dynamic group of young people from across our province. With diverse ages and living experience, their knowledge is unique to their communities and guides all that we do with Integrated Youth Services. This council plays a crucial role in shaping and guiding the work of IYS, ensuring that youth perspectives and needs are at the heart of our initiatives. The fingerprints of YAC are clear in everything we do. Their insights and experiences help us create a system where youth have low-barrier access to a comprehensive range of services and supports. They define our efforts to keep them relevant and effective to the peoples and communities we serve by amplifying the voices and needs of young people throughout Newfoundland and Labrador.

Service provider: Person or organization that provides individualized health and/or social services to young people and their circle of care. 

Youth/young people: Within the Newfoundland and Labrador Integrated Youth Services model “youth” and “young people” refer to individuals ages 12–29 and the two are used interchangeably.

Holistic approach: An approach to wellness that simultaneously addresses the physical, mental, emotional, social, and spiritual components of health.

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With humility and respect we acknowledge that the land, sea and sky, with which we gather today was the ancestral home of the Beothuk [Bee-Oth-Uck], whose culture, stories and knowledge have been lost forever. We acknowledge the island of Ktaqmkuk [uk-dah-hum-gook], which we refer to as Newfoundland, as the unceded and traditional territory of the Beothuk and Mi’kmaq [mee-gum-maq] as well as acknowledge Labrador as the traditional and ancestral homelands of the Innu [in-new] of Nitassinan [ne-tass-eh-nen], the Inuit [in-new-eet] of Nunatsiavut [nu-nut-si-a-voot], and the Inuit of Nunatukavut [nu-nah-tahk-ah-vut]. We recognize the ancestors of all First Peoples, the knowledge they have passed down generations, the First Peoples who still carry that knowledge today, and recognize our responsibility to the Seven Generations to come. We do so by carrying open hearts and minds to the lessons of the past, the wisdom of the present and the hope of the future.

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