NOTICE OF BOARD MEETING OPEN TO PUBLIC. WEDNESDAY February 27, :00pm- 3:00pm St. Elizabeth School of Thought 100 Allstate Parkway, Markham

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1 NOTICE OF BOARD MEETING OPEN TO PUBLIC WEDNESDAY February 27, :00pm- 3:00pm St. Elizabeth School of Thought 100 Allstate Parkway, Markham AGENDA ITEMS TO INCLUDE: Approval of Minutes Chairman and CEO Report Ministry Funding Allocations LHIN Funding Allocations NOTICE OF CLOSED SESSION WEDNESDAY February 27, :30pm 4:00pm St. Elizabeth School of Thought 100 Allstate Parkway, Markham AGENDA ITEMS TO INCLUDE: Review of Minutes Business Arising New Business Items for Information Agenda is subject to approval or amending at the meeting Meeting notices, agenda and minutes will be posted on the Central LHIN website at: Light refreshments will be provided

2 AGENDA BOARD OF DIRECTORS February 27, :00pm- 3:00pm St. Elizabeth School of Thought, 100 Allstate Parkway, Markham Agenda Item Tab No. Time Presenter 1.0 MEETING CALLED TO ORDER 1:00 Mr. John Langs 2.0 NOTICE/RECOGNITION OF A QUORUM 1 Mr. John Langs 3.0 APPROVAL OF AGENDA 2 Mr. John Langs 3.1 Welcome members of the public 4.0 DECLARATION OF CONFLICTS OF INTEREST Mr. John Langs 5.0 APPROVAL OF CONSENT AGENDA 3 1:10 Mr. John Langs 5.1 APPROVAL OF MINUTES OF THE PREVIOUS MEETING 3 Mr. John Langs January 30, CEO S REPORT ITEMS FOR APPROVAL 3 Ms. Kim Baker /14 Hospital Service Accountability Agreement Template /14 Transfer of Funds for St. Josephs Private Hospital and Infirmary to Toronto Central LHIN /14 Long-Term Care Funding for Interim and Convalescent Care Beds CHAIRMAN S REPORT Mr. John Langs 6.1 Ministry of Health Announcements 7.0 CEO REPORT ITEMS FOR APPROVAL /14 Multi-Sector Service Accountability Agreements 7.2 Base Funding for the At Home/Chez Soi Supportive Housing Project 8.0 CEO REPORT ITEMS FOR INFORMATION 5 Ms. Kim Baker 9.0 OTHER BUSINESS (Additions to the Agenda) Mr. John Langs 10.0 FUTURE MEETINGS Mr. John Langs Wednesday March 27, :00pm 3:00pm School of Thought 100 Allstate Parkway 11.0 BOARD DEVELOPMENT AND EDUCATION 6 Mr. John Langs 11.1 Humber River Regional Health Centre Capital Dr. Rueben Devlin Development and Hospital Transition Update 12.0 MOTION MOVING INTO A CLOSED SESSION 7 Mr. John Langs 12.1 Approval of Minutes of the Previous Meeting 8

3 January 30, Business Arising Health Service Provider Updates 12.3 For Information LHIN Leadership Council Workgroup Update CEO Perfomance 13.0 RECESS/PUBLIC DIALOGUE Mr. John Langs 14.0 CHAIRMAN S REPORT OF A CLOSED SESSION (IF REQUIRED) Mr. John Langs 15.0 MOTION OF TERMINATION 4:30 Mr. John Langs 2

4 ` Item CENTRAL LHIN BOARD OF DIRECTORS BRIEFING NOTE 2013/14 HOSPITAL SERVICE ACCOUNTABILITY AGREEMENT TEMPLATE PROPOSED RESOLUTION: FEBRUARY 27, 2013 WHEREAS the current Hospital Service Accountability Amending Agreements expire on March 31, 2013; and WHEREAS a provincial process has been developed by which LHINs and hospitals can negotiate and sign Hospital Service Accountability Agreements by March 31, 2013; and WHEREAS updated Hospital Service Accountability legal agreements for public and private hospitals are currently under development and have not yet been finalized; and WHEREAS an extension or amending agreement or letter may be required if a new Accountability legal agreement is not finalized before the end of the current fiscal year; and WHEREAS Central LHIN management is currently in the process of developing local LHIN obligations for the 2013/14 Hospital Service Accountability Agreements; and WHEREAS the Central LHIN will enter into a Hospital Service Accountability Agreement with West Park Healthcare Centre in accordance with the Local Health System Integration Act to fund services in Central LHIN; BE IT RESOLVED THAT: The Central LHIN Board of Directors: 1. Delegates authority to the Central LHIN CEO to approve the templates for the Hospital Service Accountability legal agreements for public and private hospitals or the templates for extensions or amending agreements should these be required; and 2. Delegates authority to the Central LHIN CEO to approve local LHIN obligations to be included in the 2013/14 Hospital Service Accountability Agreements or agreement extensions or amendments as may be required; and 3. Approves Central LHIN to enter into a Hospital Service Accountability Agreement with West Park Healthcare Centre based on due diligence performed by Central LHIN staff including a review of the health service provider Board approved Hospital Annual Planning Submission. ANALYSIS: Hospital Service Accountability Legal Agreements No further communication has been received as to the status of the updated legal agreement for the public or private Hospital Service Accountability Agreements ( Agreement ). It is expected that once the template is Page 1

5 ` available, it will require consent from a majority of LHINs to approve the template as the legal agreement for the 2013/14 H-SAAs. Given the timing of the H-SAA process, it is anticipated that this approval may be sought prior to the next Central LHIN Board meeting. Should the situation arise where the new legal agreement is not completed before the end of the current fiscal year an extension or amendment to the current agreement will be required. Local LHIN Obligations Central LHIN management is in the process of developing local (LHIN-specific) obligations to be included in the 2013/14 H-SAAs. Local obligations included in current H-SAAs include: ehealth: In support of the Provincial ehealth strategy the Hospital will comply with any technical and information management standards set by the Ministry or the LHIN within the established timeframes. Compliance requirements will be rolled out reasonably and the level of available resources will be considered in any required implementations. In addition, each hospital is required to appoint the most senior staff responsible for ehealth decision making as a member of the Central LHIN ehealth Steering Committee. Decisions made by this committee will be binding for all Central LHIN hospitals. Quality: Hospitals are required to submit a copy of their Quality Improvement Plan to the LHIN concurrently with or prior to the submission to Health Quality Ontario for information purposes. Community Engagement and Health Equity: The Hospital will provide the LHIN with an annual Community Engagement Plan and a biennial Health Equity Plan. Peer Accountability, Integration and Long-Term Solutions to Advance the Local Health System: The Hospital will continue to work collaboratively with other hospitals, health service providers and with Central LHIN to advance the strategic direction of the local health system as outlined in the Integrated Health Service Plan. The Hospital will consult with Central LHIN as appropriate when developing plans and setting priorities for the delivery of its health services. From time to time, the LHIN may establish special purpose committees or working groups to support the advancement of Central LHIN and provincial priorities for which equitable representation from the Hospital will be sought. Capital Initiatives: When planning for capital initiatives, the Hospital will comply with the requirements outlined in the Ministry of Health & Long-Term Care s Capital Planning Manual (1996) and MOHLTC- LHIN Joint Review Framework for Early Capital Planning Stages (2010), as may be updated or amended from time to time. In this context, capital initiatives refer to initiatives of the Hospital in relation to the construction, renewal or renovation of a facility or site. As outlined in the 2010 Joint Review Framework document, the approval process and eligibility criteria for Own Funds capital initiatives (those projects that require no capital from the Ministry or the LHIN) are currently determined by the Ministry. Ontario Renal Network: The Hospital will collaborate with the Ontario Renal Network and comply with their requirements related to dialysis services and funding. Page 2

6 ` Incremental Volumes: The hospital will perform incremental volumes funded by the LHIN in an effort to achieve the 90th Percentile Wait Time targets. West Park Healthcare Centre During fiscal 2012/13, Central LHIN funded West Park Healthcare Centre $1.15 million for transitional care beds for patients requiring ventilation. To comply with the Local Health System Integration Act, Central LHIN will enter into an H-SAA with West Park for this funding and related service deliverables. CURRENT STATUS: On February 1, 2013 a joint LHIN/Ontario Hospital Association education session was held to outline the approach to the 2013/14 Hospital Annual Planning Submission (HAPS) and Hospital Service Accountability Agreement (H-SAA) processes. This approach is the same as that presented to and approved by the Central LHIN Board of Directors in January Information has been sent to all Central LHIN public hospitals with details of planning assumptions as approved by the Central LHIN Board of Directors for the development of hospital specific HAPS. These planning submissions are due to the Central LHIN on February 22, 2013 and will provide input to the H-SAAs. Similar information has been provided to the three Central LHIN private hospitals. NEXT STEPS: Central LHIN staff will continue to engage with the hospitals to finalize the HAPS related H-SAA targets. Hospital-specific H-SAA performance targets will be brought to the Central LHIN Board of Directors for approval at the March 27, 2013 meeting. Central LHIN management will also provide an update on local LHIN obligations in the March 2013 CEO Report. Page 3

7 Item CENTRAL LHIN BOARD OF DIRECTORS BRIEFING NOTE 2013/14 TRANSFER OF FUNDS FOR ST. JOSEPH S PRIVATE HOSPITAL AND INFIRMARY TO TORONTO CENTRAL LHIN PROPOSED RESOLUTION: FEBRUARY 27, 2013 WHEREAS the Central LHIN receives transfer payment funding for St. Joseph s Private Hospital and Infirmary ( the hospital ), through the Ministry-LHIN Performance Agreement (MLPA); and WHEREAS in April 2007 Minister Smitherman approved the relocation of the hospital to 2 O Conner Drive in Toronto; and WHEREAS the location of the new premise is within Toronto Central LHIN; and WHEREAS the hospital has notified the LHIN that construction of the facility is complete, and it plans to move to the new premise by March 31, 2013; BE IT RESOLVED THAT: The Central LHIN Board of Directors approves the transfer of $1,506,000 in base funds and $1,600 in one-time funds to Toronto Central LHIN, effective April 1, 2013, for the purposes of funding St. Joseph s Private Hospital and Infirmary. ANALYSIS: Funding The Ministry of Health and Long-Term Care provides transfer payment funding to the Central LHIN to fund its health service providers. These dollars are included as part of the Ministry-LHIN Performance Agreement (MLPA). Included in the MLPA are base (recurring) funds of $1,506,000 for St. Joseph s Private Hospital and Infirmary ( the hospital ). The LHIN also received a funding letter in November 2012 to fund Central LHIN hospitals with chronic care beds to provide continued high quality of care and accommodation to patients for the period of July 1, 2012 through June 30, St. Joseph s Private Hospital and Infirmary was allocated $1,600 for the period of April 1, 2013 through June 30, Relocation Under the Private Hospitals Act, section 22, the Minister of Health must approve any construction or renovation of premises for a private hospital. April 2007, Minister Smitherman approved the construction of a new Motherhouse which included the transfer of the 35 ministry-funded beds to the new location for the hospital. This project was just underway in 2007 when the approval was given. The hospital has since notified Central LHIN staff that the hospital plans to move in early March 2013and will vacate their current premises by March 31, Page 1

8 The new premises are located at 2 O Conner Drive in Toronto, which would now locate the hospital in Toronto Central LHIN. NEXT STEPS: The Ministry and Toronto Central LHIN are aware of the relocation. The Ministry has requested that any inter- LHIN program transfers occur effective April 1, 2013 to avoid mid-year transfers. The current accountability agreement between the Central LHIN and the hospital expires March 31, Upon Central LHIN Board of Directors approval of the funding transfer, the Ministry will amend the Central LHIN MLPA to reflect the decreased transfer payment funds effective April 1, Toronto Central LHIN will then enter into an accountability agreement with the hospital. Page 2

9 Item CENTRAL LHIN BOARD OF DIRECTORS BRIEFING NOTE 2013/14 LONG-TERM CARE FUNDING FOR INTERIM AND CONVALESCENT CARE BEDS PROPOSED RESOLUTION: FEBRUARY 27, 2013 WHEREAS Central LHIN has dedicated base dollars for specific initiatives such as Aging at Home and Alternate Level of Care; and WHEREAS the LHIN has invested these dollars to provide increased Long-Term Care Home capacity in the creation of 84 interim beds and 54 convalescent care beds using the dedicated funds; and WHEREAS due to Ministry of Health and Long-Term Care processes, the funds for these beds can only be provided on a one-time basis, and must be renewed annually; and WHEREAS due to high occupancy in Long-Term Care beds, these beds will be required to be in service for BE IT RESOLVED THAT: The Central LHIN Board of Directors: a) Approves the following one-time funding allocations for fiscal Health Service Provider Beds Bed Type funding Southlake Residential Care Village 32 Interim $1,342,678 Mackenzie Health Long-Term Care 20 Interim $40,122 Mackenzie Health Long-Term Care 32 Interim $1,328,317 Unionville Home Society 15 Convalescent $669,626 Maple Health Centre- Regional Municipality of York 15 Convalescent $660,154 Hawthorne Place 24 Convalescent $981,786 Total 138 $5,022,683 Page 1

10 ANALYSIS: The Central LHIN has funded additional Long-Term Care beds through initiative funds (such as Aging at Home funds and Alternate Level of Care funds) since This has improved access to Long-Term Care Home beds for residents of the Central LHIN, and in doing so, reduced the Alternate Level of Care (ALC) days for residents in hospitals awaiting beds. As a result of this investment, the Central LHIN continues to maintain its target for ALC days in our Ministry of Health and Long-Term Care ( the Ministry )-LHIN Performance Agreement. Interim beds are awarded a temporary licence and as such funding for these beds can only be set up as one-time. Management recommends the continuation of funding for these beds to ensure access in our Central LHIN, and to maintain our ALC targets. The funds for each home are calculated individually, based on a Ministry Funding Formula that sets rates on 15 separate funding envelopes. The rates for each envelope are set by the Ministry and may change throughout the year. The differences in funding levels on the beds the LHIN funds are due to the following: For the 32 interim beds at Southlake Residential Care Village and the 32 interim beds at Mackenzie Health, the Central LHIN is required to fully fund the government share of the costs, as these beds have been LHIN created ; For the 20 Interim beds at Mackenzie Health, the majority of the funds are within the LHINs MLPA envelope and transferred to this facility; the Central LHIN must fund any incremental costs that are over and above the transferred amount; For the 54 convalescent care beds, some of the funds are through the Central LHINs MLPA envelope for Long-Term Care, however, these beds receive a premium due the increased care needs of the clients, and the clients do not have a co-payment amount due to the short-term nature of these beds. The Central LHIN must therefore fund the convalescent care premium and resident revenue portion of these beds. Ministry funding changes requiring the LHIN to augment the approved funds will be approved by the Central LHIN CEO in accordance with the delegation of authority policies. NEXT STEPS: Upon Central LHIN Board of Director approval funds, Central LHIN staff will execute the funding letters for the providers. Any funding formula changes will be implemented and communicated to the providers. Page 2

11 CENTRAL LHIN BOARD OF DIRECTORS BRIEFING NOTE MULTI-SECTOR SERVICE ACCOUNTABILITY AGREEMENTS Item 7.1 FEBRUARY 27, 2013 PROPOSED RESOLUTION: WHEREAS the Multi-Sector Service Accountability Agreements do not have performance targets for the fiscal year; and WHEREAS on January 30, 2013, the Board approved the principles and process for reviewing the Community Accountability Planning Submissions to inform the performance targets; and WHEREAS on January 30, 2013, the Board approved Central LHIN to enter into Multi-Sector Service Accountability Agreements with Baycrest Centre for Geriatric Care, Carefirst Seniors and Community Services Association and LOFT Community Services; and WHEREAS Central LHIN staff has reviewed the Community Accountability Planning Submissions according to the Board approved principles; and WHEREAS in a letter communicated by the Ministry of Health and Long-Term Care dated January 18, 2013, the Ministry directed the LHINs to require Community Health Centres to develop a Quality Improvement Plan beginning in fiscal under the service accountability agreement; BE IT RESOLVED THAT: The Central LHIN Board of Directors: a) Approves the funding, volume and performance targets for the following thirty-six health service providers: i. To be updated in the respective Multi-Sector Service Accountability Agreements with these providers: 1. Abuse Program of York Region 2. Across Boundaries - An Ethnoracial Mental Health Centre 3. Alzheimer Society of York Region 4. Aphasia Institute 5. Bernard Betel Centre for Creative Living 6. Better Living at Thompson House 7. Better Living Health and Community Services 8. Black Creek Community Health Centre 9. Canadian Mental Health Association, York Region Branch 10. Caritas School of Life 11. Chai-Tikvah Foundation 12. Chippewas of Georgina Island 13. Circle of Home Care Services (Toronto) 14. City of Toronto, Long-Term Care Homes and Services (Cummer Lodge) 15. Downsview Services for Seniors Inc. 1

12 16. Etobicoke Services for Seniors 17. Friuli Benevolent Corporation 18. Hazel Burns Hospice 19. Jane/Finch Community and Family Centre 20. Markham Stouffville Hospital 21. North York General Hospital 22. North York Seniors Centre 23. PalCare Network for York Region 24. Regional Municipality of York 25. St. Clair West Services for Seniors Inc. 26. St. Demetrius Supportive Care Services 27. The Canadian Hearing Society - Simcoe County 28. The Canadian Hearing Society - York Region 29. The Canadian National Institute for the Blind, York Branch 30. The Lance Krasman Memorial Centre for Community Mental Health 31. The Vitanova Foundation 32. Vaughan Community Health Centre 33. Yee Hong Centre For Geriatric Care ii. To be included in the new Multi-Sector Service Accountability Agreements with these health service providers: 34. Baycrest Centre for Geriatric Care 35. Carefirst Seniors and Community Services Association 36. LOFT Community Services b) Delegates authority to the Central LHIN Board Chair and the Chief Executive Officer to execute the Multi-Sector Service Accountability Agreements for Baycrest Centre for Geriatric Care, Carefirst Seniors and Community Services Association and LOFT Community Services c) Approves the inclusion of the development of a Quality Improvement Plan as a LHIN-specific performance obligation for Black Creek and Vaughan Community Health Centres ANALYSIS: Community Accountability Planning Submissions Central LHIN has received all fifty seven Health Service Provider Board approved Community Accountability Planning Submissions and has performed reviews based on the Board approved principles and process. As of February 11 th 2013, the submissions of thirty-six health service providers met the following criteria: A balanced budget for the third year of the Agreement Administrative expenses do not exceed 20% of LHIN funding Functional Centre budgets of $100,000 or more have a budgeted cost per unit of service that is within an acceptable range of the Central LHIN average cost per unit of service The following table highlights key 2013/14 volume and performance targets for these thirty-six health service providers: 2

13 Health Service Providers 2013/14 Unique Service Activity Budget Individuals Served Visits Resident Days Attendance Days Meals Delivered Hours of Care Abuse Program of York Region $88, , Across Boundaries - An Ethnoracial $1,944, , Mental Health Centre Alzheimer Society of York Region $1,662,411 1,485 10,359-15, Aphasia Institute $913, ,930-7, Baycrest Centre for Geriatric Care $94, , Bernard Betel Centre for Creative $745,782 4,200 67,000-10,000 30,000 - Living Better Living at Thompson House $294, , ,750 - Better Living Health and Community $2,351,374 1,900 37,668-3,250 32,700 16,500 Services Canadian Mental Health Association, $8,736,473 1,568 69,348 10, York Region Branch Carefirst Seniors and Community $362, ,475 3, Services Association Caritas School of Life $389, , Chai-Tikvah Foundation $413, ,920 2, Chippewas of Georgina Island $204, ,496-1,404-2,652 Circle of Home Care Services $3,475,940 4,267 84,924 5,460 7,700 72, ,626 (Toronto) City of Toronto, Long-Term Care $465, , Homes and Services (Cummer Lodge) Downsview Services for Seniors Inc. $2,871,427 2,803 16,610 18,020 13,580 33,700 17,000 Etobicoke Services for Seniors $2,974, ,032 49,331 13,710-5,106 Friuli Benevolent Corporation $509, ,200 13, Hazel Burns Hospice $199, , Jane/Finch Community and Family $623, ,900-15, Centre LOFT Community Services $6,047,451 2,031 67,685 99, Markham Stouffville Hospital $609, North York General Hospital $4,469, , North York Seniors Centre $2,101,566 3,374 29,500 31,200 5,800-14,000 PalCare Network for York Region $747,993 2,494 22, Regional Municipality of York $5,667,524 1,033 4,358 57,895 11, St. Clair West Services for Seniors $2,803,307 1,750 22,175 27,000 23,950 30,068 2,200 St. Demetrius Supportive Care $699, , The Canadian Hearing Society - $173, , Simcoe Region The Canadian Hearing Society - York $364, , Region The Canadian National Institute for $394, , the Blind, York Branch The Lance Krasman Memorial Centre $657,377 1,260 1, for Community Mental Health The Vitanova Foundation $612, , Yee Hong Centre For Geriatric Care $768, ,

14 Performance Indicators Black Creek Community Health Centre Vaughan Community Health Centre 2013/14 Budget $5,356,896 $3,291,391 Unique Individuals Served 3,500 4,000 Number of Active Clients 6,300 4,000 Individual Encounters (Face to Face & Telephone) 16,020 22,000 Cervical Cancer Screening (PAP tests) 73.5% 86.5% Colorectal Screening Rate 31.7% 67.5% Inter-professional Diabetes Care Rate 81.0% 91.5% Influenza Vaccination Rate 8.5% 39.3% Breast Cancer Screening Rate 39.4% 76.0% Periodic Health Examination 40.1% 70.2% Vacancy Rate for NPs and Physicians 25.0% 25.0% Targets for Percentage ALC Days, Repeat Unscheduled Emergency Visits Within 30 Days for Mental Health Conditions and Repeat Unscheduled Emergency Visits Within 30 Days for Substance Abuse Conditions On January 30, 2013, the Board approved the use of the provincial Target and Corridor Setting Guideline to negotiate the performance indicator targets and corridors for the three indicators listed above. As such, the targets for these indicators are as follow: Target for Percentage ALC Days will be 15.00%. This indicator is applicable to all Community Health Service Providers Target for Repeat Unscheduled Emergency Visits within 30 Days for Mental health Conditions will be 17.53%. This indicator is applicable to Community Mental Health and Addiction Health Service Providers. Target for Repeat Unscheduled Emergency Visits within 30 Days for Substance Abuse Conditions will be 20.19%. This indicator is applicable to Community Mental Health and Addiction Health Service Providers. Quality Improvement Plan requirement for Community Health Centres In August 2012, the Ministry hosted a Quality Roundtable with stakeholders to assist in setting a vision for quality in primary care. The quality improvement program for primary care includes a requirement for Ontario s Community Health Centres to develop and submit a Quality Improvement Plan every fiscal year for review and feedback by Health Quality Ontario. In a letter dated January 18, 2013, the Ministry of Health and Long-Term Care (the Ministry ) informed the LHIN about the introduction of Quality Improvement Plans to the primary care sector. Subsequent to the Ministry s announcement, in an dated February 1, 2013, the provincial M-SAA Steering Committee recommended that the LHINs include the Quality Improvement Plan requirement as a LHIN-specific performance obligation. 4

15 CURRENT STATUS: Twelve of the remaining Community Accountability Planning Submissions meet the Board approved principles of a balanced budget and administrative expenses which do not exceed 20% of LHIN funding; however, the cost per unit of service for various functional centres exceeds the acceptable range established by the LHIN. Three of the remaining Community Accountability Planning Submissions include administrative expenses in excess of 20% of LHIN funding and one Health Service Provider will provide administrative expenses information to the LHIN. In addition, five other Health Service Providers have provided incomplete information. NEXT STEPS: Central LHIN staff is working with those health service providers who did not submit an acceptable Community Accountability Planning Submission, to assist them in aligning with the Central LHIN principles. The remaining M-SAAs that staff recommend for approval, will be brought forward for Board approval in March Any health service provider s Community Accountability Planning Submission which remains outside of the principles will be brought forward for individual consideration by the Board in March also. The M-SAA for existing health service providers will be amended through a letter including the updated schedules and signed by the LHIN CEO. A letter template has been provided by LHIN legal services. A signback by health service providers is due to the LHIN no later than March 31, Service Accountability Agreements using the existing template will be sent to the three new providers for signature. Upon receipt of the provider Board approved and signed M-SAAs, the Central LHIN Board Chair and Chief Executive Officer will execute the Agreements by March 31,

16 Item 7.2 CENTRAL LHIN BOARD OF DIRECTORS BRIEFING NOTE BASE FUNDING FOR THE AT HOME /CHEZ SOI SUPPORTIVE HOUSING PROJECT PROPOSED RESOLUTION: FEBRUARY 27, 2013 WHEREAS funding from the Mental Health Commission of Canada for the At Home/Chez Soi project terminates as of March 31, WHEREAS in a letter dated February 12, 2013 the Ministry of Health and Long-term Care ( the Ministry ) allocated $80,000 in one-time funding in to support the transfer of services from the Mental Health Commission of Canada (the Commission) and $2.5M in base funding for to provide supportive housing services (At Home/Chez Soi Project). BE IT RESOLVED THAT: The Central LHIN Board of Directors approves the following allocation of one time funding for 2012/13 and base funding for 2013/14 to provide supportive housing services at COTA Health, Toronto North Support Services and Across Boundaries) and delegates approval of the associated deliverables to the Central LHIN CEO: BACKGROUND: HSP One-time Funding Annual Funding COTA Health $40,000 $1,200,000 Toronto North Support Services $20,000 $600,000 Across Boundaries $20,000 $700,000 The At Home/Chez Soi is a 4-year research demonstration project funded by the Commission to find ways to help the growing number of homeless people living with a mental illness. The aim of the project was to generate strong evidence to guide the policy and program approaches to ending homelessness for people with mental illness in Canada. The project follows the Housing First model for supportive housing. Housing First is based on client choice and gives homeless people with mental illness immediate access to both permanent, independent housing through rent subsidies and access to mental health supports such as an Assertive Community Treatment team (ACT) or Intensive Case Management (ICM) depending on their needs. Toronto was one of four sites chosen by the Commission and was launched on November 23, The target population is people with serious mental illness, who are homeless and from diverse ethno-cultural backgrounds. The funding is to continue the ACT team and intensive case management services which will support 240 individuals living in supportive housing and incorporate At Home/Chez Soi into the mental health system. The specific deliverables are still being negotiated with the providers and will be brought forward to the Central LHIN CEO for approval. The Ministry will also be directly providing rent supplement funding to COTA Health. Page 1

17 ALIGNMENT TO IHSP This program is aligned with the Central LHIN s Integrated Health Service Plan and Annual Business Plan. The initiatives are targeted towards enhancing community services, increasing access to community mental health services and at reducing repeat emergency department visits. NEXT STEPS 1. Confirm deliverables and obtain Central LHIN CEO approval before distributing funding letters to the health service providers and amending their respective MSAAs. Page 2

18 Central LHIN CEO Report- Items for Information Table of Contents CEO HIGHLIGHTS HEALTH LINKS FRENCH LANGUAGE SERVICES UPDATES UPCOMING HEALTH INDICATOR REPORT CONVALESCENT CARE PROGRAM EXPANSION (CCP) CENTRAL LHIN STOCKTAKE REPORT 2012/13 THIRD QUARTER UPDATE (APPENDIX A) /13 WAIT TIME STRATEGY IN-YEAR REALLOCATION (INTRA-LHIN) CENTRAL LHIN COMMUNITY CARE ACCESS CENTRE PERFORMANCE UPDATE MARIANN HOME BASE FUNDING AND SERVICE TRANSFER CONTINUATION OF BASE FUNDING TO HEALTH SERVICE PROVIDERS IN 2013/ LONG-TERM CARE COMMUNITY SECTOR FUNDING ALLOCATIONS DELEGATED AUTHORITY (APPENDIX B) ONTARIO TELEMEDICINE NETWORK EQUIPMENT LHIN SHARED SERVICES OFFICE (LSSO) Q3 AND JANUARY REPORT (APPENDIX C) COMPLIANCE DECLARATION (APPENDIX D) ANNUAL BUSINESS PLAN (ABP) SERVICE ACCOUNTABILITY AGREEMENTS FOR APPROVAL (MSAA, HSAA) CAPITAL PLANNING UPDATE COMMUNITY FUNDING Central LHIN Board of Directors Page 1 CEO Report February 27, 2013

19 Central LHIN CEO Report- Items for Information CEO HIGHLIGHTS Capacity Planning 8.1 Health LINKS The MOHLTC held an Early Adopter day on January 25, 2013 to provide the Health Links partners with information and resources that will help them establish their service delivery hubs. On January 28, 2013 a Business Planning Workshop was held with the Central LHIN Early Adopter Health Links to assist them in identifying gaps in care delivery and areas for improvement to focus their Health Links activities. The business plans from the two early adopter health links (South Simcoe Northern York Region and North York Central) were received on February 19, The deadline for receipt by the Ministry is February 22, Components of the business plan include identification of the population profile for the area, key commitments that the Health Link will focus on and related indicators that will be tracked as well as resource requirements. The Ministry has identified 11 indicators that will be tracked for the Health Links. Key areas of focus for the two early adopters are as follows: South Simcoe Northern York Region: - Single coordinated care plan that is shared across sectors and with the patient - Redesign and streamline care coordination - Discharge planning and follow up - Self-management programs North York Central: - Individual care plans - Focus on primary care as the foundation for care planning - Mental health - Awareness of support services - End of life planning 8.2 French Language Services Updates On Wednesday February 6, 2013 The French Language Health Service Planning Entity 4 submitted its Final Advisory Report ( the Report ) for 2012 which is consistent with its obligations as per the French Language Services Act, to the Central, Central-East and North Simcoe Muskoka LHINs. The Report outlines the recommendations that Entité 4 made to each of the three LHINs from December 2011 to November 30, To date Entité 4 has made eighteen recommendations to the Central LHIN. Seventeen of the eighteen recommendations relate to the Annual Joint Action Plan which is a document developed by the French Language Health Planning Entity and one recommendation pertains to the implementation of the Central LHIN Board of Directors Page 2 CEO Report February 27, 2013

20 Central LHIN CEO Report- Items for Information 2016 Integrated Health Service Plan (IHSP). It is important to note that of the seventeen recommendations, fifteen recommendations have been fully implemented or are in progress. Key initiatives where Central LHIN sought the input of Entité 4 include though not limited to: - Engagement of the Francophone community for the development of the Strategic Framework for the IHSP; - Comments on the Draft Integrated Health Service Plan; - Feedback on the 2012 Health Service Provider French language services Report template; and - Participation on the Annual Business Plan Planning Day. The Joint Action Plan for 2013/2014 is presently being developed and will guide the activities and initiatives to be jointly carried out by the partners over the next fiscal year. The Plan aligns with the strategic framework and the priority areas of the Integrated Health Service Plan. 8.3 Upcoming Health Indicator Report The Canadian Institute for Health Information (CIHI) is set to release two health indicator reports over the next few months: 1. The Canadian Hospital Reporting Project, scheduled to be released to the media on March 5, 2013 and to the public on March 6, This report will include performance on 21 clinical indicators and six financial indicators for all Canadian acute care hospitals. Central LHIN staff will work with hospitals to understand and follow-up on any areas of concern highlighted in the report. 2. Health Indicators 2013, scheduled to be released to the public at the end of May Jointly produced by Canadian Institute for Health Information ( the Institute ) and Statistics Canada, Health Indicators 2013 reports on a broad range of measures related to health system performance and the health status of Canadians. Health Indicators 2013 will show results at the LHIN level based on where patients live. 8.4 Convalescent Care Program Expansion (CCP) The Central LHIN submitted through an Expression of Interest (EOI) an application for 15 CCP beds at Villa Colombo Home for the Aged located in Central North York. The two other homes under consideration to submit applications withdrew prior to the submission date. (Specialty Care Bradford Valley and Aurora Resthaven LTC Home). Both initially expressed interest, and have since decided that their homes needed to focus on other priorities. Villa Colombo s application was not approved for Phase One. They have been asked to re-submit their application for Phase Two (due on May 1 st 2013) with supplementary information on their staffing model and required renovations to accommodate the program. Due to the overwhelming response to Phase One the MOHLTC has increased the original number of CCP beds from 100 to 250 and added an additional phase for applications. Central LHIN Board of Directors Page 3 CEO Report February 27, 2013

21 Central LHIN CEO Report- Items for Information System Accountability and Performance 8.5 Central LHIN Stocktake Report 2012/13 Third Quarter Update (Appendix A) In mid-february 2012, Central LHIN received its third quarter Stocktake Report performance results from the Ministry of Health and Long-Term Care ( the Ministry ). These indicators include Ministry LHIN Performance Agreement ( Agreement ) metrics such as emergency department wait times, alternate level of care days, surgical and diagnostic wait times, as well as other non-agreement indicators. Central LHIN has met all the LHIN-specific Agreement targets. This denotes that the Central LHIN result is within acceptable performance range, or 10% of target. Progress is being made with Central LHIN hospital Alternate Level of Care (ALC) performance with a significant reduction in the number of patients waiting in hospital for Long Term Care. This is related to the new discharge philosophy common to all Central LHIN hospitals called There s No Place Like Home which is helping patients and their families make informed choices about care that allow them to return home after a hospital treatment instead of going directly to Long Term Care. With the reduction in Alternate Level of Care patients waiting for Long Term Care, there has been a corresponding increase in Alternate Level of Care patients waiting to go home with Community Care Access Centre services, however the wait time for Community Care Access Center services is not as long. Central LHIN staff will be working with Community Care Access Centre staff to closely monitor this shift in discharge destination for these Alternate Level of Care patients. Further analysis is underway in preparation to submit a completed Stocktake Report to the Ministry at the end of February Please see Appendix A for summary results as of February /13 Wait Time Strategy In-Year Reallocation (Intra-LHIN) On November 23, 201, the Ministry of Health and Long-Term Care (the Ministry ) began the 2012/13 Wait Time Strategy In-Year reallocation exercise, giving LHINs the opportunity to review volume allocations and identify: a) If the LHIN can complete all cases provided to them, and/or; b) If allocations need to be redistributed within the LHIN to use funding provided for 2012/13; c) If LHINs have any surplus capacity to take on additional cases to help reduce wait times within the LHIN or neighbouring LHINs. Through the Ontario Wait Time Strategy intra-lhin (within LHIN) reallocation process, Central LHIN is able to transfer the majority of cases between its hospitals and retain funding within the LHIN. All excess MRI hours available for transfer between hospitals due to the strict qualification criteria of Ontario Breast Screening Program (OBSP) MRI hours were kept in Central LHIN. Across the province hospitals that were allocated OBSP MRI hours were not able to complete the required volumes and in turn the Ministry has allowed all LHINs to transfer OBSP MRI hours to regular MRI hours. Central LHIN Board of Directors Page 4 CEO Report February 27, 2013

22 Central LHIN CEO Report- Items for Information All hip and knee revision volumes (8 cases) and funding were also retained in Central LHIN. General and Paediatric Surgery each returned $100 to the province for reallocation. 8.7 Central LHIN Community Care Access Centre Performance Update As of November 2012, the Central Care Access Center (CCAC) incurred a $3.46 million deficit driven by Service Provider expenses. Central LHIN continues to work with the CCAC to balance its budget by year-end. Overspending in Personal Support Services has been driven by both an increase in clients served and utilization, both of which are exceeding 2011/12 and budgeted levels. The CCAC continues to manage service levels for client populations while ensuring that client needs are appropriately prioritized. Waitlists The waitlist for high-need clients requiring Personal Support Services has grown to 505. Waitlists for high-need clients requiring other services have declined slightly. School children waitlisted for Therapy Services was 1,285 at the end of November 2012 (including 864 for Speech Therapy, 67 for Physiotherapy and 343 for Occupational Therapy). 1,100 Wait List with Priority Levels as of November 30, , Number of Clients Nov'12 Oct'12 Nov'12 Oct'12 Nov'12 Oct'12 Nov'12 Oct'12 Nov'12 Oct'12 Nov'12 Oct'12 Nov'12 Oct'12 Nursing Visiting Personal Support Social Work Nutrition Speech Physiotherapy Occupational Therapy High Medium Low Service Months by Service Types In December 2012, the CCAC began to serve high-need waitlisted clients with the funding approved by the Central LHIN Board in November As a result, the waitlist for high-need clients requiring Central LHIN Board of Directors Page 5 CEO Report February 27, 2013

23 Central LHIN CEO Report- Items for Information Personal Support Services declined to 437 at the end of December. Further declines are expected to the end of the fiscal year. A survey conducted by the Ontario Association of Community Care Access Centers showed that of the eleven CCACs that responded, six are utilizing waitlists in order to manage increased demand. 8.8 Mariann Home Base Funding and Service Transfer In fiscal year 2009/10, Central LHIN funded Mariann Home for $268,752 for an Aging At Home project for Day Program services. In fiscal 2012/13 Mariann Home requested a transfer of the funding and accountabilities to other health service providers. Central LHIN facilitated the transfer of base funding of $98,363 to North York Seniors Centre along with the associated volume obligations effective November 1, The remaining base funding for this program in the amount of $170,389 will remain with Mariann Home until March 31, 2013, at which time the Agreement between Central LHIN and Mariann Home will be terminated. Central LHIN staff has established a process to identify a potential health service provider to deliver the services and receive the funding. A call for proposals for the Day Program Services will be released in February Continuation of Base Funding to Health Service Providers in 2013/14 Consistent with last year, LHINs have received directions from the Financial Management Branch of the Ministry of Health & Long-Term Care ( the Ministry ) to roll-over prior year base funding to 2013/14. The objective is to continue to provide funding to Health Service Providers at the level of the previous year base funds to enable programs and services to continue to be delivered. In fiscal 2012/13, Quality Based Procedures were carved out of hospital and CCAC base funds and converted into one-time funding. This has resulted in $32.8 million less being rolled over to hospitals than in previous years. Central LHIN has raised this concern with the Ministry. It is expected that the Ministry will provide confirmation of funding for fiscal year 2013/14 after the provincial budget is released Long-Term Care Status of L-SAA Compliance Indicators Q3 2012/2013 The compliance indicator of the Long-Term Care Service Accountability Agreement (L-SAA) is triggered when a home is chronically non-compliant in one or more key risk areas. Chronically non-compliant is defined as two or more findings by a Ministry of Health and Long-Term Care Inspector of noncompliance with requirements of the Long Term Care Home Act, 2007 or Ontario Regulation 79/10 under the Act in the same key risk area. According to the Q3 2012/2013 report from Health Data Branch, all 46 homes in Central LHIN were in compliance with respect to the L-SAA compliance indicator. Central LHIN Board of Directors Page 6 CEO Report February 27, 2013

24 Central LHIN CEO Report- Items for Information Policy Changes for Funding Flexibilities for Long-Term Care Homes As outlined in the November 2012 Central LHIN CEO Report, the Ministry of Health and Long-Term Care implemented policy changes for funding flexibilities for long-term care homes effective January 1, As per a letter dated December 19, 2012 from the Ministry, the Ministry-LHIN Performance Agreement will be amended for funding increases to support funding flexibility within the current funding structure. The dollar amount has not yet been determined Community Sector Community Health Centre 2012/2013 In-Year Revision of Performance Indicators In August 2012, the Provincial M-SAA Steering committee provided each LHIN with historical data for their respective Community Health Centres covering the period from January 1, 2011 to June 30, Central LHIN staff negotiated the 2012/2013 Community Health Centre performance targets and standards using the principles approved by the Central LHIN Board of Directors on September 25, The performance targets were set based on the historical data and the standards were determined by applying the provincial technical guidelines. These resulting targets and standards will be incorporated into Schedule E2b which will amend the Multi-Sector Service Accountability Agreements with Vaughan Community Health Centre Corporation and Black Creek Community Health Centre. Vaughan CHC Black Creek CHC Indicator Name Target Performance Standard Target Performance Standard Cervical Cancer Screening Rate 86.5% >69.2% 73.5% >58.8% Colorectal Screening Rate 67.5% 54.0%-81.0% 31.7% 25.3%-38.0% Inter-professional Diabetes Care Rate 91.5% 73.2%-100% 81.0% 64.8%-97.1% Influenza Vaccination Rate 39.3% 31.4%-47.2% 8.5% 6.8%-10.1% Breast Cancer Screening Rate 76.0% 60.8%-91.1% 39.4% 31.5%-47.2% Periodic Health Examination 70.2% 56.1%-84.2% 40.1% 32.1%-48.1% Vacancy Rate for NPs and Physicians 25.0% 20.0% -30.0% 25.0% 20.0% -30.0% Central LHIN Board of Directors Page 7 CEO Report February 27, 2013

25 Central LHIN CEO Report- Items for Information Other Updates 8.12 Funding Allocations Delegated Authority (Appendix B) Description details of the funding delegations approved by LHIN staff since the last Board meeting in February are indicated in Appendix B Ontario Telemedicine Network Equipment Ontario Telemedicine Network (OTN) Equipment Allocations Mental Health and Addictions OTN Task Force. Telemedicine is one key component of the provincial government s strategy to help people access addictions services and treatment. In March 2012, the government allocated $1.75 million to the OTN for purchase of telemedicine equipment. To allocate the telemedicine equipment to organizations that operate within Ontario s publicly funded health care sector, the LHIN Senior Directors created a Mental Health and Addictions Ontario Telemedicine Network Task Force in April 2012 to develop a framework and criteria to effectively deploy telemedicine equipment across the province to best meet the needs of people with addictions and related mental health conditions. Provincially, the first phase of equipment was allocated in October 2012 to the following Central LHIN Health Service Providers: Addictions Services for York Region, Georgina Nurse Practitioner Clinic and Humber River Regional Hospital to increase access to addictions services, treatment and counseling. In the second phase both Across Boundaries and the Vitanova Foundation were allocated OTN equipment LHIN Shared Services Office (LSSO) Q3 and January report (Appendix C) LHIN Shared Services Office released the third quarter report on LHIN Collaborative (LHINC) and LHIN Shared Services Office (LSSO); the full report is included in Appendix C. LHINC continues to provide support to a variety of Service Accountability Agreement committees and work groups. In addition to this, 2013 work plans for the Leadership and Chair Councils were approved, and include the plans for 2-3 new Leadership Council work groups and support to 4 Chair Council work groups. LSSO notes that the Request for Proposals for IT Managed Services has been issued and contract negotiations are underway with the vendor to have transition complete by June LSSO is also reviewing business requirements and planning for deployment of SharePoint extranet to be in place by the end of 2013/14. The report noted that one LHIN had raised a concern with respect to the audit Request for Proposals, which would be addressed in advance of issuing the next Request for Proposal in There has also been a concern regarding indemnity related to the LHINs insurance provider, Healthcare Insurance Reciprocal of Canada (HIROC). It is currently under investigation and more information will follow. Central LHIN Board of Directors Page 8 CEO Report February 27, 2013

26 Central LHIN CEO Report- Items for Information 8.15 Compliance Declaration (Appendix D) The Compliance Declaration for January 2013 is included in the appendices. On The Horizon 8.16 Annual Business Plan (ABP) The Annual Business Plan is part of the LHIN s reporting cycle with the Ministry and is usually submitted to the Ministry in draft form by the end of January. However, due to the cycle coinciding with submission of the Integrated Health Service Plan , the submission deadline for the ABP was extended to March 31, Key components of the ABP include the context, program implementation, LHIN staffing and operations and the communications plan. To assist with the establishment of priorities for the ABP, an engagement session was held on December 11, Delegates from health service provider and patient organizations attended to provide input to areas where the LHIN should focus its efforts in the first year in order to achieve its health system objectives, as described in the IHSP Key areas of focus included health links, care coordination for frail elderly and high needs groups, evaluation and better utilization of community support services, discharge planning, language needs, and electronic sharing of information across the continuum. Health Links will be critical to implementing the key initiatives to begin transformation and will form the basis of the ABP , bringing together the four Quality Based Strategic Directions in the IHSP : Appropriateness, Access, Integration and Person-Centredness Service Accountability Agreements for Approval (MSAA, HSAA) Staff will be bringing forward the public and private hospital Accountability Agreements for Board approval in March. The community sector Accountability Agreements which were not approved in February, including the CCAC, will also be brought forward for approval in March. There have been no further Ministry announcements with respect to funding planning assumptions for the hospital sector. Education sessions with respect to Health Based Allocation Model (HBAM) results for fiscal 2011/12 with projections for fiscal 2013/14 have now been scheduled by the Ministry. Individual hospital funding announcements will follow when the Ministry has determined next fiscal year s mitigation strategy Capital Planning Update There are several capital redevelopment planning initiatives underway at Central LHIN hospitals. These initiatives are at various stages of approval and completion. The following table provides a summary of the status of each project. Central LHIN Board of Directors Page 9 CEO Report February 27, 2013

27 Central LHIN CEO Report- Items for Information Hospital Description Status Next Steps Southlake Regional Health Centre Stronach Regional Cancer Centre expansion of radiation services Combined precapital/stage 1 proposal in process Waiting for Ministry approvals North York General Hospital Fit out 7 th and 8 th floors as inpatient units Stage 2 Part A/B submission under review by LHIN Waiting for response to comments by North York General Hospital North York General Hospital Create a redevelopment Master Plan State 1 parts A/B received by Ministry and LHIN Waiting for Ministry acknowledgement letter Stevenson Memorial Hospital Redevelop the emergency department and operating rooms Pre-capital submission received by the LHIN LHIN review to be completed by the end of May Mackenzie Health Redevelopment for a future Mackenzie Vaughan hospital Stage 2 submission under development by Mackenzie Health Mackenzie Health to submit a Stage 2 proposal by the end of April Humber River Regional Hospital New 656 bed facility Construction started. Due to open September 2015 N/A Markham Stouffville Hospital Facility expansion including 100 new inpatient beds; 8 new operating rooms; expanded emergency department, ambulatory clinics and diagnostic imaging centre Due to open March 1, 2013 N/A 8.19 Community Funding In a letter dated February 13, 2013 the Ministry announced new annualized base funding of $1,134,800 for Central LHIN, effective April 1, The funding is to be used to provide services in home care and community services to support seniors and other Ontarians to receive services closer to home and reduce ER/ALC and avoidable hospital readmissions. Central LHIN Board of Directors Page 10 CEO Report February 27, 2013

28 Central LHIN CEO Report- Items for Information The funding is subject to the following conditions: The increase is to be allocated to community health service providers to enhance and expand home and community services through additional service volumes and/or new services; and The LHINs will be required to demonstrate the positive impact of this new investment towards the Ministry s Action Plan commitments to shift service delivery focus to home care and community services. The Ministry-LHIN Performance Agreement will be amended to reflect the increase in base funding. It is anticipated the allocation of this funding will fall within the LHIN CEO delegation of authority. Central LHIN Board of Directors Page 11 CEO Report February 27, 2013

29 Central LHIN CEO Report- Items for Information This page is intentionally left blank. Central LHIN Board of Directors Page 12 CEO Report February 27, 2013

30 Central LHIN Stocktake Performance Summary February 2013 Stocktake Category Indicators MLPA indicator? Target C LHIN Performance ONT Performance Better than ONT? 90P ER LOS for Admitted Patients (Q3 12/13) LHIN Ranking* 90P ER LOS for Non Admitted Complex Patients (Q3 12/13) P ER LOS for Non Admitted Minor/Uncomplicated Patients (Q3 12/13) P Time to Inpatient Bed (Decision to Admit to Left ER) (Q3 12/13) 29.3** *** Increase ER Capacity/Performance 90P Time to Physician Initial Assessment (Q3 12/13) Percent positive rating to the patient satisfaction survey question: Overall, how would you rate the care you received in the Emergency Department (Q1 12/13) No Target No Target 2.8 Improved from Baseline 82% Improved from Baseline 3.2*** 3 N/A Number of ER Unscheduled Visits by quarter per 1000 population (Q2 12/13) No Target 65 ~106**** 1 a NLOT Unscheduled ER visits/1,000 active LTC residents High Acuity (Q2 12/13) NLOT Unscheduled ER visits/1,000 active LTC residents Low Acuity (Q2 12/13) NLOT # of Unscheduled ER Visits/1,000 active LTC residents resulting in an inpatient admission (Q2 12/13) No Target No Target No Target 178 Improved from Baseline 17 Within 10% of Baseline 89 Improved from Baseline Percentage ALC Days (Q2 12/13) 15% 15.2% 13.1% 11 N/A N/A N/A Improve Bed Utilization Reduce Repeat ER Visits within 30 Days for Mental Health and Substance Abuse Excellent Care for All 90P Time for CCAC In Home Services Application from Community Setting to first CCAC Service (excluding case management) (Q2 12/13) Number of Days from ALC designation to discharge by discharge destination (Q2 12/13) Repeat Unplanned ER Visits within 30 days for mental health conditions (Q1 12/13) Repeat Unplanned ER Visits within 30 days for substance abuse conditions (Q1 12/13) a No Target 30 N/A 17% 17.4% 18.3% 8 a 18.7% 19.8% 30.1% 1 30 Day Readmission Rate for selected CMGs (Case Mix Groups) (Q1 12/13)) 15.0% 15.4% 16.4% 4 Proportion of Primary Unilateral Hip or Knee Joint Replacement patients discharged home (Q2 12/13) Average Length of Stay (days) of primary unilateral Hip or Knee Joint Replacement patients discharged home (Q2 12/13) 90% +/ 9% 87.6% N/A N/A 90P Wait Time for Cancer Surgery (Q3 12/13) a 90P Wait Time for Cataract Surgery (Q3 12/13) P Wait Time for Cardiac By Pass Procedures (Q3 12/13) a Surgical and Diagnostic Imaging Wait Times 90P Wait Time for Hip Replacement (Q3 12/13) P Wait Time for Knee Replacement (Q3 12/13) P Wait Time for Diagnostic MRI Scan (Q3 12/13) P Wait Time for Diagnostic CT Scan (Q3 12/13) b The Number of ALC open cases (in hospital) by Inpatient Service Acute and Post Acute Care The Number of ALC Patients in hospital staying 30 days and longer by Inpatient Service Acute and Post Acute Care Supplementary Percentage of Hospital Inpatient Discharges before 11:00 am Transitional Care Program (TCP) Average Length of Stay (ALOS) by Program Type * 1 = Best Performer, 14 = Worst Performer ** 10% Improvement on FY 11/12 baseline of 32.5 hours *** Based on ER Pay For Results Operational Report_ (DoN) **** Performance Available by LHIN but ONT n/a; calculated as an average from Quarterly Stocktake Provincial View Report a Central LHIN tied with one other LHIN b Central LHIN tied with two other LHINs L:\C. Operations (LHIN Activities)\Strategic Alignment Stocktake & Ministry Reports\Stocktake Reports\2012 Stocktake Round 16 (Feb 2013)\Feb2013_Stocktake_Summary_of_Indicators.xlsx