Alberta Council of Disability Services

Complex Support Needs


According to Persons with Developmental Disabilities (PDD), individuals with complex support needs are people who "struggle with a combination of a developmental disability as well as other challenges like mental illness, behavioural issues, addictions, and/or involvement with the criminal justice system. These individuals may pose a risk to themselves, others or property."

While the type of services available to most individuals with developmental disabilities is adequate to meet their specific needs, individuals with complex support needs (CSN) require diverse support networks that include

  • natural supports such as family members and friends
  • formal and/or external supports such as paid staff, psychologists, the legal system and the Office of the Public Guardian
  • individual-specific support that can be provided by medical supports and therapeutic approaches
  • human resources support for staff that may include on-call support
  • skilled and experienced case managers who can
    • coordinate services, supports, and activities, including emotional support
    • oversee risk management strategies
    • plan ahead and prepare for extraordinary demands and security issues
    • facilitate communication between the various supports

Individuals with complex needs also require

  • environments that can be modified quickly and efficiently to accommodate sudden changes in their needs
  • staff who have received a higher degree of training supplemented with ongoing mentoring 

To help service providers implement and be recognized for their work in supporting individuals with complex support needs, ACDS offers the Complex Support Needs Designation (CSND) as a component of the Creating Excellence Together (CET) Standards.

Service Tiers

In 2017, ACDS introduced Service Tiers to help service providers determine what level of complex needs supports they require to serve individuals with complex needs. Our Service Tiers Tool describes the three tiers as well as what training is required for each one.

Purpose for Pursuing CSND and What it Means to Achieve the Designation

With proper support, individuals who have both a development disability and complex medical and/or behavioural needs can be given a chance to overcome personal or social disadvantages, such as 

  • injuries to themselves or others
  • risk of hospitalization/institutionalization
  • loss of or threat of loss of their homes or livelihood
  • involvement in the justice system
  • rejection by others in the community
  • alienation of family and friends

By achieving the Designation, service providers can be confident that

  • they are fully equipped to help individuals with complex support needs overcome these disadvantages
  • they have highly trained and skilled staff 
  • their staff will be less likely to receive personal injuries
  • they can offer solutions to individuals and/or guardians who do not find sufficient support with traditional service or treatment options alone
  • they can manage increases in the use and/or intensity of restrictive procedures 
  • they can avoid liability issues

The CSND Review Process

A CSND review

  • can be done in conjunction with either a CET Level 1 or a Level 2 site survey
  • uses the same format as a CET survey (i.e., having conversations with individuals with complex support needs, doing documentation reviews) and
  • incorporates the very specific Additional Indicators for the Complex Support Needs Designation

Successful achievement will be acknowledged with a CSND certificate.