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The Extensive Needs Service (ENS) is a program that provides vital wrap-around services for children and youth with urgent and extensive needs in Ontario who have co-occurring urgent medical, physical and developmental complexities and/or social vulnerabilities.

This integrated pathway helps streamline the process for children and families to access help in support of optimal health outcomes. The service is designed to reduce barriers to accessing timely, evidence-based, and trauma-informed treatment for some of the most vulnerable children in Ontario. See the program criteria below to see if your child is eligible.

Holland Bloorview, the Children’s Hospital of Eastern Ontario and McMaster Children’s Hospital are the three sites in Ontario leading this prototype program funded by Ontario’s Ministry of Health and the Ministry of Children, Community and Social Services. 

Expanding ENS to more families in the GTA

In an effort to provide ENS to more families closer to where they live, Holland Bloorview has partnered with three organizations across the Greater Toronto Area: Michael Garron Hospital, Grandview Kids and the Children’s Treatment Network. These three organizations deliver the ENS program in their local communities. Additionally, Surrey Place provides dedicated service coordinators who work closely with families to access ENS at Holland Bloorview. They also provide expert support with navigating the health and social service sector for families with complex and urgent needs.

We are continuing to actively work to expand this service so that we can reach out to more eligible families to provide the necessary support and assistance.

Please check back regularly for updates and additional information on how to access our program.

Referrals to Holland Bloorview

Toronto families interested in the Extensive Needs Service program and who are not currently receiving care at Holland Bloorview can:

  • Receive a referral from their community physician/health professional (referral forms below for health-care providers)
  • Refer themselves by connecting with Surrey Place, Toronto’s designated SmartStart Hub, online or by calling 1-833-575-KIDS (5437) to inquire about their eligibility to access these supports. The SmartStart Hub acts as a clear point of entry to children’s developmental services for families and caregivers.


For families living in East Toronto or outside of Toronto, please see below for information to refer to ENS partner organizations.

Holland Bloorview Inaugural Extensive Needs Partners


Holland Bloorview logoGrandview Kids logoMichael Garron Hospital logo
Surrey Place logoSurrey Place logo

Extensive Needs Service Tri-Agency Lead Partners


CHEO logoHolland Bloorview logoMcMaster Children's Hospital logo

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Serves children and youth up to 18 years with extensive needs.

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Specialized and individualized services and supports to clients and their families.

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A trauma informed and evidence based approach to care.
Contact us
Kathryn Decker, Director, Extensive Needs Service