Waterloo Wellington Local Health Integration Network. Board of Directors MINUTES. Thursday, May 22, 2008

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1 Waterloo Wellington Local Health Integration Network Board of Directors MINUTES Thursday, The following are the minutes of the Regular Meeting held at 7:00 p.m. on Thursday, May 22, 2008 at Marden Community Centre, 7366 Wellington Road 30 in Guelph, Ontario. Members Present: Regrets: Staff: Also present for item 10.0: Recording Secretary: K. Durst, Chair; P. Truex, Vice-Chair; P. Holyoke, Secretary; M. D Alton, B. Schieck, K. Whyte D. Ross, G. Heggie S. Hanmer, O. D Souza, S. Sutley S. MacDonald, Deloitte & Touche K. Borthwick 1.0 Welcome K. Durst welcomed the Board and guests to the meeting. 2.0 Education Session K. Durst introduced the presentation by H. Porter, BScN, PhD,. J. Tindale, PhD, University of Guelph, and K. Mark, MSc Candidate, University of Guelph. The purpose of the presentation was to explain what work had been done in relation to the study of the merger of four CSS agencies to become an agency called, Community Support Connections Meals on Wheels and More (CSC). At the initial stages of her work, Dr. Porter developed a document called, Journey to Merger, that tells the story of how the merger took place, and it was submitted to WWLHIN in July The next step in the project was to explore the feasibility of coordinating a research study to evaluate the project. The availability of quantitative data was a challenge and it was decided that a qualitative study would be undertaken. The study was undertaken by H. Porter and Dr. J. Tindale, with K. Mark as a research assistant. The methodology for the study was explained noting that CSS board members, staff and clients were included in the sample interviewed. A report of the study is currently a work in progress and will include a thorough explanation of the methodology, a literature review and a data analysis. The report will be complete by June 30, Dr.. Porter noted the strong support from CSC throughout the project.

2 WWLHIN Board of Directors Page Call to Order K. Durst called the meeting to order at 7:38 p.m. 4.0 Approval of Agenda In the interest of the presenter s schedule, it was agreed that item # 10.0 would be presented following item 5.0 Moved by B. Schieck Seconded by K.Whyte (adopted) THAT the amended agenda be approved. 5.0 Declaration of Conflict of Interest There were no declarations of conflict interest made in relation to the matters to be dealt with. 6.0 Minutes of Previous Meeting April 24, 2008 Moved by P. Holyoke Seconded by B. Blackie (adopted) THAT the minutes of the previous meeting held on April 24, 2008, be approved as written and circulated. 7.0 Matters Arising from Minutes None. 7.1 H-SAA S. Hanmer provided an update on the Hospital Service Accountability Agreement Negotiations. Agreements have been reached with five hospitals and negotiations are ongoing with three hospitals.

3 WWLHIN Board of Directors Page 3 REPORTS 8.0 Chair s Report K. Durst congratulated S. Hanmer as she was the recipient of the inaugural Chapter Award for Distinguished Service from the Hamilton and Area Chapter of the Canadian Council of Health Service Executives (CCHSE). This award is presented to individuals who demonstrated excellence and leadership in College initiatives. At the time of the meeting, K. Durst advised that board members, whose terms expire in 2008 and are seeking reappointment to this Board, have been reappointed by an Order in Council, with the exception of K. Durst. Notification of K. Durst s reappointment is still outstanding Motion No Moved by K. Durst Seconded by B. Blackie (adopted) THAT the verbal report presented by the Chair be received for information. 9.0 CEO s Report S. Hanmer provided a written report in the agenda package circulated prior to the meeting. The report noted a meeting with the MOHLTC, held on May 16, 2008, to negotiate performance targets for 2008/09 and S. Hanmer advised that an agreement on the targets was reach. Staff worked with our health service providers to determine appropriate targets. The amending Ministry-LHIN Accountability Agreement, which includes revised schedules 1, 3, 5, 7, 8, 9 & 10, will be presented at the June board meeting. It was recently announced that the Waterloo Wellington LHIN s proposal for the Canada Health Infoway grant was accepted. Our e-health Lead, Glenn Holder will be working with all 9 Family Health Teams across the WWLHIN on this project. The work on this project is now underway and details will be provided to the Board as progress is made. The e-health symposium held on May 14 th was a great success which included an address by Gail Paech, Assistant Deputy Minister, outlining the provincial direction by e- Health. The event also showcased WWLHIN health service providers innovative e- Heatlh initiatives. S. Hanmer participated in a panel for the KW Chamber of Commerce, Networking Breakfast, theme was Healthy, Wealthy and Wise. This event was an opportunity to share and explain about the role of the LHIN as part of a vibrant community. S. Hanmer was interviewed by a writer from The Grand Magazine which will be featured in an upcoming issue.

4 WWLHIN Board of Directors Page 4 Motion No Moved by B. Blackie Seconded by P. Truex (adopted) 10.0 Finance and Audit Committee THAT the verbal report presented by the CEO be received for information. S. MacDonald, Deloitte & Touche, attended the meeting to report on the audit for WWLHIN. The audit report was presented in detail, by the auditors, at the Finance & Audit Committee meeting on May 15, The results of the audit were excellent with no substantive reportable issues. In addition to the report from S. MacDonald, O. D Souza presented a detailed overview of the financial statements presented in the audit report. The notes that were new this fiscal year were brought to the attention of the board. Motion No Moved by P. Truex Seconded by B. Schieck (adopted) THAT the 2007/08 audit report and financial statements be approved. Staff submitted a certificate of compliance with statutory obligations for the period, April 1, 2007 to March 31, This certificate, signed by S. Hanmer, had been reviewed by the Finance & Audit Committee and was reported by the Committee as being satisfactory and complete. Motion No Moved by P. Truex Seconded by P. Holyoke (adopted) THAT the CEO Certificate of Compliance with statutory obligations for the period April 1, 2007 to March 31, 2008 be accepted. Motion No Moved by P. Truex Seconded by M. D Alton (adopted) THAT the WWLHIN Board of Directors appoint Deloitte & Touche as the auditors for the WWLHIN for the fiscal year, April 1, 2008 to March 31, On behalf of the Finance and Audit Committee, P. Truex expressed appreciation of the work of the auditors and noted the valuable role of their work. In addition, thanks and recognition were extended to the staff of the WWLHIN and their work to prepare for the audit and throughout the year. Motion No Moved by P. Truex Seconded by M. D Alton (adopted) 11.0 Governance Committee THAT the verbal presentation by P. Truex be accepted for information.

5 WWLHIN Board of Directors Page 5 The focus of discussion at the most recent meeting of the Governance Committee was the Board and Senior Team Retreat planned for June 12 & 13. Board members will receive an agenda package for the retreat which will outline the objectives for the session. There will be a meeting on June 3 rd for Board members to receive the results of their self-evaluation survey and the governance survey conducted across all LHINs. Motion No Moved by M. D Alton Seconded by K. Whyte (adopted) THAT the verbal report by M. D Alton be received for information. NEW/OTHER BUSINESS 12.0 WWLHIN Vascular Program S. Sutley presented background information, steps accomplished to date and a recommendation towards the creation of a WWLHIN Vascular Services Program. A copy of the presentation is included in these minutes in, Attachment 1. The presentation highlighted the legal context of the proposal to create a WWLHIN Vascular Services Program, which would require an integration decision by the WWLHIN board of directors. The proposed program would be considered the outcome of a facilitated integration and all of the legal requirements related to that type of integration would have to be followed. The recommended proposal was the result of a process that was initiated by a report issued by the Hay Group, that recommended that two associate sites for vascular surgery be established in each of Waterloo Wellington LHIN and Hamilton Niagara Haldimand Brant LHIN. Following the Hay Group report recommendation, an RFP process took place between December 2006 and May 2007 to identify the lead for a LHIN-wide vascular services program and the siting of elective vascular services. There were two respondents to the RFP, Grand River Hospital and Guelph General Hospital, and following evaluation of the proposals it was recommended that a LHIN-wide vascular services program be established led by Guelph General Hospital. In his presentation, S. Sutley provided graphs showing the actual and projected volumes for in-patient and out-patient vascular cases. The volumes have increase and this has implications for the need to attract vascular surgeons to WWLHIN. The presentation also noted that the clinical practice of vascular surgery is changing, which has an impact on the program design. Following the presentation, Board members asked questions about the proposal and provided comments. The proposal included a period for public submissions about the proposed integration decision to be invited.

6 WWLHIN Board of Directors Page 6 Motion No Moved by P. Truex Seconded P. Holyoke (adopted) THAT the Board of Directors, exercising its discretion under the Local Health System Integration Act, 2006, serve public notice of its intention to issue an integration decision to establish a LHIN-wide vascular services program led by Guelph General Hospital. AND THAT the proposed integration decision read, as follows: Pursuant to section 26 of the Local Health System Integration Act, 2006, the Waterloo Wellington Local health Integration Network (WWLHIN) finds that it is in the public interest to require Cambridge Memorial Hospital, Grand River Hospital, Groves Community Memorial Hospital, Guelph General Hospital, North Wellington Health Care, St. Joseph s Health Centre Guelph, and St. Mary s General Hospital to proceed with the integration described in this decision and the parties are therefore ordered to take the following actions by July 1, (a) The purpose of this integration decision is to designate Guelph General Hospital as the lead for the WWLHIN vascular services program and to transfer to it all elective vascular services currently being provided in Waterloo Wellington, with the exception of vascular access services to be provided for dialysis patients at Grand River Hospital and thoracic vascular services to be provided at St. Mary s General Hospital; (b) Cambridge Memorial Hospital, Grand River Hospital, Groves Community Memorial Hospital, Guelph General Hospital, North Wellington Health Care, St. Joseph s Health Centre Guelph and St. Mary s General Hospital are parties to this integration decision; (c) Guelph General Hospital is to provide for all elective vascular services in Waterloo Wellington, with the exception of vascular access services to be provided for dialysis patients at Grand River Hospital and thoracic vascular services to be provided for patients at St. Mary s General Hospital; both Guelph General Hospital and Grand River Hospital are to share the provision of emergency vascular services in Waterloo Wellington and referrals from CritiCall; Cambridge Memorial Hospital, Groves Memorial Community Hospital, North Wellington Health Care, and St. Joseph s Health Centre Guelph are not to take any action that results in the provision of vascular services; (d) Grand River Hospital, Guelph General Hospital and St. Mary s General Hospital are required, as deemed necessary in consultation with the Waterloo Wellington Local Health Integration Network, to develop a human resources adjustment plan in respect of the integration; and

7 WWLHIN Board of Directors Page 7 (e) The effective date of the transfer of elective vascular services to Guelph General Hospital from Grand River Hospital is July 1, AND THAT the Board of Directors invite any person to make written submissions about the proposed integration decision to the WWLHIN no later than June 24, Closed Session Motion No Moved by M. D Alton Seconded by P. Holyoke (adopted) THAT the meeting adjourn and go into closed session to deal with the minutes of the closed Board meetings held on April 24, 2008 and May 2, 2008, and to deal with new matters of such a nature that the desirability of avoiding public disclosure in the public interest outweighs the desirability of adhering to the principle that Board meetings be open to the public under section 9(5) (a) of the Local Health System Integration Act, The meeting adjourned at 9:38 p.m. Motion No Moved by M. D Alton Seconded by P. Holyoke (adopted) That the closed meeting adjourn. The open meeting reconvened at 10:10 p.m. Motion No Moved by P. Holyoke Seconded by B. Schieck (Adopted) K. Durst reported that in the closed meeting of the Board, the minutes of the closed Board meetings held on April 24, 2008 and May 2, 2008 were approved and that there was discussion relating to matters of such a nature that the desirability of avoiding public disclosure in the public interest outweighs the desirability of adhering to the principle that Board meetings be open to the public under section 9(5) (a) of the Local Health System Integration Act, 2006.

8 WWLHIN Board of Directors Page 8 Motion No Moved by P. Truex Seconded P. Holyoke (adopted) THAT, to enable the continuation of funding at the 07/08 base funding level and to allow additional time to negotiate new hospital service accountability agreement (the "H-SAAs") with each of the Hospitals, each of the hospital accountability agreements currently in effect between the WWLHIN and Cambridge Memorial Hospital, North Wellington Health Care, and Guelph General Hospital be extended to the earlier of August 31, 2008 and the date of the signing of a acceptable hospital service accountability agreement (the "H-SAAs") with each of the Hospitals Next Meeting The next meeting will be held on June 26, 2008 at a location, to be determined, in Palmerston, ON. The meeting will start at 4:00 p.m Adjourn There being no further business, on a motion by M. D Alton and seconded by B. Schieck the meeting adjourned at time 10:20 p.m. Original signed by, Original signed by, K. Durst, P. Holyoke Chair Secretary

9 WWLHIN Board of Directors Page 9 ATTACHMENT 1

10 WWLHIN Board of Directors Page 10 ATTACHMENT 1

11 WWLHIN Board of Directors Page 11 ATTACHMENT 1

12 WWLHIN Board of Directors Page 12 ATTACHMENT 1

13 WWLHIN Board of Directors Page 13 ATTACHMENT 1

14 WWLHIN Board of Directors Page 14 ATTACHMENT 1

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