March 24, Ms. Angela Robertson Executive Director Central Toronto Community Health Centres 168 Bathurst Street Toronto, ON M5V 2R4

Size: px

Start display at page:

Download "March 24, Ms. Angela Robertson Executive Director Central Toronto Community Health Centres 168 Bathurst Street Toronto, ON M5V 2R4"

Miranda Melton
5 years ago
Views:

1 425 Bloor Street East, Suite 201 Toronto, ON M4W 3R4 Tel: Fax: Toll Free: March 24, 2016 Ms. Angela Robertson Executive Director Central Toronto Community Health Centres 168 Bathurst Street Toronto, ON M5V 2R4 Dear Ms. Robertson, Re: Multi-Sector Accountability Agreement When the Toronto Central Local Health Integration Network (the LHIN ) and the Central Toronto Community Health Centres (the HSP ) entered into a service accountability agreement for a three-year term effective April 1, 2014 (the MSAA ), the budgeted financial data, service activities and performance indicators for the second and third year of the agreement (fiscal years 2015/16 and 2016/17) were indicated as To Be Determined (TBD). The LHIN would now like to update the MSAA to include the required financial, service activity and performance expectations for 2016/17 fiscal year to the applicable Schedules listed in Appendix 1. Subject to the HSP s agreement, the MSAA will be amended with effect April 1, 2016, by adding the amended Schedules that are included in Appendix 1 to this letter. To the extent that there are any conflicts between the current MSAA and this amendment, the amendment will govern in respect of the Schedules. All other terms and conditions in the MSAA will remain the same. Please indicate the HSP s acceptance of, and agreement to this amendment, by signing below and returning one copy of this letter to Kelly Cronin-Cowan, Administrative Assistant Management within one week. If you have any questions or concerns please contact Chris Sulway, Acting Director, Management at , or chris.sulway@lhins.on.ca.

2 Toronto Central LHIN appreciates your team s collaboration and hard work during this 2016/17 MSAA refresh process. We look forward to our continued work together. Sincerely, Susan Fitzpatrick Chief Executive Officer Toronto Central LHIN c: Kelly Myers, Board Chair, Central Toronto Community Health Centres Angela Ferrante, Board Chair, Toronto Central LHIN Bill Manson, Senior Director, Management, Toronto Central LHIN Chris Sulway, Acting Director, Management, Toronto Central LHIN encl.: Appendix 1 AGREED TO AND ACCEPTED BY: Central Toronto Community Health Centres By: Angela Robertson, Executive Director on July 12, 2016 I have the authority to bind Central Toronto Community Health Centres And By: Kelly Myers, Board Chair on July 12, 2016 I have the authority to bind Central Toronto Community Health Centres

3 APPENDIX 1 Schedule B1 Total LHIN Funding Schedule B2 Clinical Activity Summary Schedule E1 Core Indicators Schedule E2a Clinical Activity Detail Schedule E3a LHIN Local Indicators and Obligations

4 Schedule B1: Total LHIN Funding Health Provider: Central Toronto Community Health Centres LHIN Program Revenue & Expenses Row # Account: Financial (F) Reference OHRS Version /2015 Plan 2015/2016 Plan 2016/2017 Plan REVENUE LHIN Global Base Allocation 1 F $6,832,930 $6,832,930 $6,781,560 HBAM Funding (CCAC only) 2 F Quality-Based Procedures (CCAC only) 3 F MOHLTC Base Allocation 4 F MOHLTC Other funding envelopes 5 F LHIN One Time 6 F MOHLTC One Time 7 F Paymaster Flow Through 8 F $60,000 $45,000 $48,333 Recipient Revenue 9 F to $170,000 $170,000 $170,000 Subtotal Revenue LHIN/MOHLTC 10 Sum of Rows 1 to 9 $7,062,930 $7,047,930 $6,999,893 Recoveries from External/Internal Sources 11 F 120* $8,000 $8,000 $8,000 Donations Other Funding Sources & Other Revenue F 140* F 130* to 190*, 110*, [excl. F 11006, 11008, 11010, 11012, 11014, 11019, to 11090, 131*, 140*, 141*, 151*] $371,125 $361,100 $360,135 Subtotal Other Revenues 14 Sum of Rows 11 to 13 $379,125 $369,100 $368,135 TOTAL REVENUE FUND TYPE 2 15 Sum of Rows 10 and 14 $7,442,055 $7,417,030 $7,368,028 EXPENSES Compensation Salaries (Worked hours + Benefit hours cost) 17 F 31010, 31030, 31090, 35010, 35030, $2,967,394 $2,854,232 $2,864,805 Benefit Contributions 18 F to 31085, to $684,357 $713,558 $716,201 Employee Future Benefit Compensation 19 F 305* Physician Compensation 20 F 390* $1,928,806 $1,928,806 $1,877,697 Physician Assistant Compensation 21 F 390* Nurse Practitioner Compensation 22 F 380* $446,015 $446,015 $446,015 Physiotherapist Compensation 23 F 350* Chiropractor Compensation 24 F 390* All Other Medical Staff Compensation 25 F 390*, [excl. F 39092] $168,621 $168,621 $124,677 Sessional Fees 26 F Costs Med/Surgical Supplies & Drugs Supplies & Sundry Expenses F 460*, 465*, 560*, 565* F 4*, 5*, 6*, [excl. F 460*, 465*, 560*, 565*, 69596, 69571, 72000, 62800, 45100, 69700] $108,500 $598,290 $108,500 $657,226 $100,500 $547,390 Community One Time Expense 29 F Equipment Expenses 30 F 7*, [excl. F 750*, 780* ] $36,500 $36,500 $36,500 Amortization on Major Equip, Software License & Fees 31 F 750*, 780* $30,500 $30,500 $39,491 Contracted Out Expense 32 F 8* $207,351 $207,351 $337,022 Buildings & Grounds Expenses 33 F 9*, [excl. F 950*] $296,221 $296,221 $317,221 Building Amortization 34 F 9* $194,220 $194,220 $229,000 TOTAL EXPENSES FUND TYPE 2 35 Sum of Rows 17 to 34 $7,666,775 $7,641,750 $7,636,519 NET SURPLUS/(DEFICIT) FROM OPERATIONS 36 Row 15 minus Row 35 ($224,720) ($224,720) ($268,491) Amortization - Grants/Donations Revenue 37 F 131*, 141* & 151* $224,720 $224,720 $268,491 SURPLUS/DEFICIT Incl. Amortization of 38 Sum of Rows 36 to 37 FUND TYPE 3 - OTHER Total Revenue (Type 3) 39 F 1* $138,631 $173,435 $83,900 Total Expenses (Type 3) 40 F 3*, F 4*, F 5*, F 6*, F 7*, F 8*, F 9* $138,631 $173,435 $106,944 NET SURPLUS/(DEFICIT) FUND TYPE 3 41 Row 39 minus Row 40 ($23,044) FUND TYPE 1 - HOSPITAL Total Revenue (Type 1) 42 F 1* Total Expenses (Type 1) 43 F 3*, F 4*, F 5*, F 6*, F 7*, F 8*, F 9* NET SURPLUS/(DEFICIT) FUND TYPE 1 44 Row 42 minus Row 43 ALL FUND TYPES Total Revenue (All Funds) 45 Line 15 + line 39 + line 42 $7,805,406 $7,815,185 $7,720,419 Total Expenses (All Funds) 46 Line 16 + line 40 + line 43 $7,805,406 $7,815,185 $7,743,463 NET SURPLUS/(DEFICIT) ALL FUND TYPES 47 Row 45 minus Row 46 ($23,044) Total Admin Expenses Allocated to the TPBEs Undistributed Accounting Centres 48 82* Plant Operations * $317,221 Volunteer s * Information Systems Support * $221,940 General Administration * $557,218 Admin & Support s * $1,155,712 $1,140,758 $1,096,379 Management Clinical s Medical Resources Total Admin & Undistributed Expenses 56 Sum of Rows (included in Fund Type 2 expenses above) $1,140,758 $1,096,379

5 Schedule B2: Clinical Activity-Summary Health Provider: Central Toronto Community Health Centres Category Budget Diagnostic and Therapeutic s (Community Health Centres) OHRS Framework Level 3 Full-time equivalents (FTE) Visits Not Uniquely Identified Recipient Hours of Care Inpatient / Resident Days Individuals Served by Functional Centre Attendance Days Faceto-Face Sessions Meal Delivered- Combined Participant Attendances Provider 72 4* , Primary Care- Clinics/Programs * ,756 3,176 5, ,413 Mental Health Sessions Provider Health Promotion and Education ,630 13, ,996 18,176 Category Budget Diagnostic and Therapeutic s (Community Health Centres) OHRS Framework Level 3 Full-time equivalents (FTE) Visits Not Uniquely Identified Recipient Hours of Care Inpatient / Resident Days Individuals Served by Functional Centre Attendance Days Faceto-Face Sessions Meal Delivered- Combined Participant Attendances Provider 72 4* Mental Health Sessions Provider Primary Care- Clinics/Programs * ,874 3, , Health Promotion and Education ,039 17,510 6, ,229 21, Category Budget Diagnostic and Therapeutic s (Community Health Centres) OHRS Framework Level * Full-time equivalents (FTE) Visits Not Uniquely Identified Recipient Hours of Care Inpatient / Resident Days Individuals Served by Functional Centre Attendance Days Faceto-Face Sessions Meal Delivered- Combined Participant Attendances Provider Mental Health Sessions Provider Primary Care- Clinics/Programs * , , Health Promotion and Education ,000 1, ,209 16,

6 Schedule E1: Core Indicators Health Provider: Central Toronto Community Health Centres Indicators 2014/ / /2017 *Balanced Budget - Fund Type % >=0 0.00% >=0 0.00% >=0 Proportion of Budget Spent on Administration 15.10% 15.1% % 14.93% 14.9% % 14.36% 14.4% % **Percentage Total Margin 0.00% >=0% 0.00% >=0% -0.30% >=0% Percentage of Alternate Level of Care (ALC) days (closed cases) 9.46% <=10.41% Variance Forecast to Actual Expenditures 0.00% <5% 0.00% <5% 0.00% <5% Variance Forecast to Actual Units of 0.00% <5% 0.00% <5% 0.00% <5% Activity by Functional Centre Number of Individuals Served Refer to Schedule E2a Refer to Schedule E2a - Refer to Schedule E2a - Refer to Schedule E2a - Refer to Schedule E2a - Refer to Schedule E2a Alternate Level of Care (ALC) Rate 12.70% <=13.97% - - Cost per Unit (by Functional Centre) Explanatory Indicators Cost per Individual Served (by Program//Functional Centre) Client Experience Budget Spent on Administration - AS General Administration Budget Spent on Administration - AS Information System Support Budget Spent on Administration - AS Volunteer s Budget Spent on Administration - AS Plant Operation * Balance Budget Fund Type 2: HSP's are required to submit a balanced budget **No negative variance is accepted for Total Margin

7 Schedule E2a: Clinical Activity-Detail Health Provider: Central Toronto Community Health Centres OHRS Description & Functional Centre ¹These values are provided for information purposes only. They are not Accountability Indicators. Diagnostic and Therapeutic s 72 4* (Community Health Centres) LAB Pre/Post Analysis ¹Full-time equivalents (FTE) n/a 1.00 n/a Hours of Care ,513 1,362-1,665 Individuals Served by Functional Centre ¹Total Cost for Functional Centre $83,210 n/a $83,210 n/a Provider Primary Care- Clinics/Programs * Clinics/Programs - General Clinic ¹Full-time equivalents (FTE) n/a n/a n/a Not Uniquely Identified Recipient Hours of Care ,091 29,847-32,334 16,860 16,017-17,703 Individuals Served by Functional Centre ,403 2,163-2,643 2,513 2,262-2,764 3,000 2,700-3,300 Attendance Days Face-to-Face ,744 3,370-4,118 ¹Total Cost for Functional Centre $3,385,807 n/a $3,348,170 n/a $3,419,888 n/a Provider ,803 7,413-8,193 18,395 17,475-19,315 19,866 18,873-20,859 Clinics/Programs - Therapy Clinic ¹Full-time equivalents (FTE) n/a Not Uniquely Identified Recipient Hours of Care ,434 19,412-21,456 Individuals Served by Functional Centre ,010 Sessions ¹Total Cost for Functional Centre $1,117,982 n/a Participant Attendances

8 OHRS Description & Functional Centre ¹These values are provided for information purposes only. They are not Accountability Indicators Provider ,598 6,268-6,928 Provider Therapy Clinic ¹Full-time equivalents (FTE) n/a Not Uniquely Identified Recipient Hours of Care ,065 17,162-18,968 Individuals Served by Functional Centre Attendance Days Face-to-Face ,158 1,042-1,274 Sessions ¹Total Cost for Functional Centre $1,100,007 n/a Participant Attendances Provider ,315 2,083-2,546 Clinics/Programs - Therapy Clinic - Foot Care ¹Full-time equivalents (FTE) n/a Hours of Care Individuals Served by Functional Centre ¹Total Cost for Functional Centre $54,096 n/a Provider , ,100 Clinics/Programs - Therapy Clinic - Counselling ¹Full-time equivalents (FTE) n/a Hours of Care Individuals Served by Functional Centre ,010 Sessions ¹Total Cost for Functional Centre $1,074,777 n/a Participant Attendances Provider ,598 6,268-6,928 Provider Clinics/Programs Oral Health Clinic ¹Full-time equivalents (FTE) n/a 3.70 n/a 3.70 n/a

9 OHRS Description & Functional Centre ¹These values are provided for information purposes only. They are not Accountability Indicators. Not Uniquely Identified Recipient Hours of Care ,600 5,320-5,880 4,580 4,122-5,038 Individuals Served by Functional Centre Attendance Days Face-to-Face ¹Total Cost for Functional Centre $373,032 n/a $333,182 n/a $347,551 n/a Provider ,500 1,350-1,650 Health Promotion and Education COM Health Prom/Educ. & Com.Dev. Community Engagement and Capacity Building ¹Full-time equivalents (FTE) n/a 4.00 n/a 3.68 n/a Hours of Care ,508 5,233-5,783 Individuals Served by Functional Centre Sessions ¹Total Cost for Functional Centre $393,863 n/a $393,863 n/a $352,320 n/a Participant Attendances Provider Health Prom/Educ. & Com. Dev.- Chronic Disease Education, Awareness and Prevention- Diabetes ¹Full-time equivalents (FTE) n/a 2.00 n/a 2.00 n/a Hours of Care ,620 3,258-3,982 Individuals Served by Functional Centre Attendance Days Face-to-Face Sessions ¹Total Cost for Functional Centre $213,200 n/a $213,200 n/a $213,200 n/a Participant Attendances Provider , Provider Health Prom/Educ.& Com. Dev Personal Health and Wellness ¹Full-time equivalents (FTE) n/a 1.65 n/a 1.30 n/a Not Uniquely Identified Recipient

10 OHRS Description & Functional Centre ¹These values are provided for information purposes only. They are not Accountability Indicators Hours of Care ,880 2,592-3,168 Individuals Served by Functional Centre Attendance Days Face-to-Face Sessions ¹Total Cost for Functional Centre $203,052 n/a $203,052 n/a $175,831 n/a Participant Attendances ,615 1,454-1,777 2,935 2,642-3,229 2,784 2,506-3,062 Provider Provider CHC Client Support s ¹Full-time equivalents (FTE) n/a 3.00 n/a 3.79 n/a Not Uniquely Identified Recipient ,921 1,729-2,113 2,000 1,800-2,200 Hours of Care ,502 5,227-5,777 Individuals Served by Functional Centre Attendance Days Face-to-Face , ,124 Sessions ¹Total Cost for Functional Centre $175,349 n/a $215,573 n/a $274,315 n/a Participant Attendances Provider , ,207 3,541 3,187-3,895 3,541 3,187-3,895 Provider Health Prom/Educ. & Com. Dev.- Chronic Disease Education, Awareness and Prevention- Hepetitis C / HIV/AIDS ¹Full-time equivalents (FTE) n/a 3.30 n/a 3.63 n/a Not Uniquely Identified Recipient Hours of Care ,000 12,350-13,650 Individuals Served by Functional Centre ,178 5,869-6,487 6,069 5,766-6, Attendance Days Face-to-Face ,738 11,151-12,325 Sessions ¹Total Cost for Functional Centre $358,823 n/a $368,040 n/a $359,671 n/a Participant Attendances

11 OHRS Description & Functional Centre ¹These values are provided for information purposes only. They are not Accountability Indicators Provider ,692 15,857-17,527 16,692 15,857-17,527 Provider Total Administration Expenses Administration and Support s 72 1* ¹Full-time equivalents (FTE) 72 1* 5.93 n/a 6.00 n/a 5.00 n/a Individuals Served by Functional Centre 72 1* 9,952 9,454-10,450 ¹Total Cost for Functional Centre 72 1* $1,155,712 n/a $1,140,758 n/a $1,096,379 n/a Undistributed Accounting Centres 82* 12,582 11,953-13,211 ¹Total Cost for Functional Centre 82* $224,720 n/a $268,491 n/a Total Full-Time Equivalents for All F/C Total Cost for All F/C $7,442,055 $7,641,750 $7,636,519

12 Schedule E2b: CHC Sector Specific Indicators Health Provider: Central Toronto Community Health Centres Indicators Cervical Cancer Screening Rate (PAP Tests) 75% > 60% Colorectal Cancer Screening Rate 34% 27% - 41% Inter-professional Diabetes Care Rate 84% 67% - 100% Influenza Vaccination Rate 20% 16% - 24% Breast Cancer Screening Rate 46% 37% - 55% % > 52% 40% 32% - 48% 84% 67% - 100% 20% 16% - 24% 48% 38% - 58% % > 54% 50% 40% - 60% 84% 67% - 100% 35% 28% - 42% 50% 40% - 60% Periodic Health Exam Rate (Applicable to only) 55% 44% - 66% N/A - Vacancy Rate (For NPs and Physicians - Replaced in with Retention Rate) Access to Primary Care 95% 85% - 100% 18% <=22% N/A - 68% 61% - 75% N/A - N/A - 62% 56% - 68% Retention Rate (For NPs and Physicians) N/A - Explanatory Indicators Non-Insured Clients Client Satisfaction Access Third Next Available Appointment (3NAA) 100% > 80% 100% > 80%

13 Schedule E3a: LHIN Local Indicators and Obligations Health Provider: Central Toronto Community Health Centres TC LHIN Tables: Participate in applicable initiatives endorsed by the Sector and Cross-Sector Tables, and approved by TC LHIN. TC LHIN s Strategic Plan: Support the implementation of TC LHIN s Strategic Plan. In addition to the multiple initiatives underway related to Strategic Plan , TC LHIN looks to its Health Providers (HSPs) for a commitment to the specific initiatives outlined below. Participate in the following TC LHIN specific initiatives related to: Planning and implementation of the primary care strategy including complex patients. Implementation of a regional palliative care program. Continue to actively support TC LHIN Health Equity initiatives through: Support approaches to service planning and delivery that: a) improve existing health disparities and, b) actively seek new opportunities to reduce health disparities. For Community Health Centres only: Collect and submit demographic/equity data with the goal of covering more than 75% of new clients and existing clients accessing the system by March The expectation is that this data is linked to clinical outcomes and is made available for clinical application by health care professionals. Apply the Health Equity Impact Assessment (HEIA) tool and its supplement(s) in program and service planning. Collect Health Card information on clients receiving LHIN funded services. Record the number of clients receiving LHIN funded services that do not have a Health Card. Participate in the Quality Table initiatives, including compliance with reporting requirements and participation in sector specific and cross-sector quality improvement efforts. As a subset of the work to support the Quality Table, it is required that the following activities related to the measurement of patient experience be conducted: Measure patient, client, resident, and family experience at a minimum annually. Measure patient experience in a comparable manner to peers, as applicable. Report on patient experience results to clients and/or to the public. Participation in the Indigenous and Francophone Cultural Competency Initiatives. Participation in French Language (FLS) planning: For identified HSPs that provide services in French, develop a FLS plan and demonstrate yearly progress towards meeting designation criteria.

14 Schedule E3a: LHIN Local Indicators and Obligations HSPs that are not identified for the provision of FLS, the expectation is to identify their French-speaking clients. This information is to be used by the HSP to help with the establishment of an environment where people s linguistic backgrounds are collected, linked with existing health services data and utilized in health services and health system planning to ensure services are culturally and linguistically sensitive. Adopt Digital Health and Information Management initiatives that encompass both provincial and local level priorities as identified by TC LHIN. This specifically includes, where applicable: Submission of data to Integrated Decision Support tool (IDS) and/or Community Business Intelligence (CBI). Participate in initiatives to increase emergency preparedness and response levels at your organization, within your sector and the system overall, including those guided by the TC LHIN Emergency Management Implementation Committee. All health service providers will provide an annual attestation that an internal patient and/or client complaints policy and procedure is in place, and followed. The attestation will be submitted at Q4 consistent with the time of reports contained in Schedule C Reports. Ministry/LHIN Accountability Agreement (MLAA): TC LHIN is developing a system-wide plan to improve performance on its MLAA indicators including embedding performance targets in the Accountability Agreements. In addition, HSPs will contribute to the achievement of the TC LHIN MLAA Indicators related to ALC and ED performance through the following specific initiatives: All HSPs approved to deliver Case Management services will commit to collecting the following information with the intention of establishing a baseline in 2016/17 against which future reports and indicators will be measured: Record the number of client visits to hospital emergency departments, and admission to hospital. Record the number of repeat client visits and re-admissions to hospital that occur within 30 days of a previous visit or admission. Provide a report at Q4 consistent with the timing of reports contained in Schedule C - Reports. All Community Support s HSPs will register their moderate and high needs clients receiving LHIN funded services, using the RAI Tool or Health Links criteria, to the Community Agency Notification. s include eadp, Attendant Outreach programs, Supportive Housing services, Assisted Living s for High Risk Seniors and Right Place of Care program.

January 29, Andria Spindel President / Chief Executive Officer March of Dimes Canada 6 Glenwood Place Unit 6 Brockville, ON, K6V 2T3

January 29, Andria Spindel President / Chief Executive Officer March of Dimes Canada 6 Glenwood Place Unit 6 Brockville, ON, K6V 2T3 71 Adam Street Belleville, ON K8N 5K3 Tel: 613 967-0196 Fax: 613 967-1341 Toll Free: 1 866 831-5446 www.southeastlhin.on.ca 71 rue Adam Belleville, ON K8N 5K3 Téléphone: 613 967-0196 Télécopieur: 613 967-1341