The Youth Centre & Oshawa Community Health Centre Facilitated Integration Update Central East LHIN Board Meeting September 24, 2014 James Meloche Senior Director, System Design and Implementation
Purpose To provide an update to the Board of Directors on the Facilitated Integration Process between The Youth Centre (TYC) and Oshawa Community Health Centre (OCHC). 2
Commitment The Central East LHIN supports the Community Health Centre model of care and continues to actively pursue the ultimate goal of expanding services to more residents in Durham. We remain committed to the needs of youth and young adults in the community. 3
Durham CHC Integration Plan BACKGROUND 4
Community Health Centre Board Decisions The Youth Centre and Oshawa Community Health Centre Integration: Final Integration Plan (December 11 th, 2013) was led by a joint leadership committee and working groups made up from both Community Health Centres. The process was facilitated. The Youth Centre (TYC) rejected the Final Integration Oshawa CHC approved the Final Integration. The Central East LHIN Board cannot consider components of the Integration Plan as it was not approved by both organizations. 5
CHC Composition The Youth Centre Oshawa CHC Mission (summary) Accessible to all youth of Ajax and Pickering. Offers health and wellness programs in a nonjudgmental environment. Provides youth the opportunity to make informed Empowers residents to improve their physical, emotional and social well being. Dedicated to building a strong and healthy Oshawa. choices towards their personal growth and well being. Geography Served Ajax, Pickering Oshawa focus, some Durham and LHIN wide services Total Funding / CE LHIN Funding $3.93M 96% $ 5.1M 66% Head Count / FTE 32 29.9 87 54.15 Front Line $ / FTE $2.7M 24. 17 FTE $3.9M 42.48 FTE Back Office $ / FTE $1.2M 5.73 FTE $1.24M 14.4 FTE Services Primary Healthcare and Promotion Health Promotion Young Parent Supports Information & Referral Youth Outreach Advocacy Nutritional Services Mental Health Services Community Development Counselling 6 Primary Healthcare and Promotion Hepatitis C Treatment Foot Care Diabetes Education & Support Health Promotion Primary Care Counselling Information & Referral Aboriginal Outreach Social Supports Early Years Programs Youth Programs Food Security Child Care Respite Advocacy Community Development Counselling Recreational Programs Transportation
CHC Composition While TYC specializes in youth services, this does not represent a material difference to the youth services provided by OCHC. The differences between TYC services and OCHC services are based primarily on what TYC does not offer Adult primary health care services. 7
Integration Plan: Vision The existing services will be retained and cross pollinated to be offered to clients/communities where it was not previously available. The tradition of both organization of reaching out and serving young people will be strengthened and will reflect a joint commitment to excellence and best practices in ensuring effective access to programming that meets their health needs. In the future, the goal is for services to be extended to address current service gaps. Knowledge gained from evidence based best practices will be shared and be the foundation for the organization s aspiration for service excellence (Final Integration Plan, Dec 2013). 8
AIM: Improve Access to High Quality Services No risk or barrier to the integration of front-line services Existing services to be maintained Identified Quick Wins or short term opportunities to expand services at little to no extra costs, include Paediatrics; psychiatry; therapy Nursing; wait lists; walk-in services Hepatitis C; Aboriginal engagement Long term benefits would follow a comprehensive planning /needs assessment to be undertaken by new CHC. Expected to include: CHC Services in Whitby Enhancement of: Youth Services; Oral Health; Mental Health and Addictions; New Immigrant / Non-insured persons; LGBTQ; Obesity Prevention 9
AIM: Create Readiness for Future Health System Transformation (1) The Integration Planning process found no imminent risk or barrier to the integration of governance and leadership functions, as well as human resources, financial and information management support systems. Overall, opportunities where identified to further strengthen all areas of organizational leadership and operations. Analysis of: Leadership and Governance Human Resources / Employee Enrichment Financial Management Information Management / Information Technology 10
AIM: Make the Best Use of the Publics Investment (1) Funding for the agencies do have some differences TYC obtains its funding predominantly from the Ministry of Health and Long Term Care (MOHLTC) and Ministry of Child and Youth Services (MCYS). TYC does not have fundraising as part of their funding model. OCHC s funding is acquired from MOHLTC, the MCYS and multiple funders as acquired by the Resource Development and Communications department. In our analysis, we compared: Current and Short Term Operating Budget Long Term Service Expansion 11
Durham CHC Integration Plan CURRENT STATUS 12
Central East LHIN Decision Making On February 26, 2014, at the open Board meeting, the following options were outlined for next steps related to integration and the Final Integration Plan of December 2013: The Central East LHIN Board should retain and consider this Integration Plan for future strategic planning and implementation. While the LHIN Board does not have the authority to require a merger or amalgamation of the two CHCs, it does have the following legislative authority: Do nothing; Transfer all, or part, of the current LHIN funded services from one CHC to another; Transfer all, or part of, future LHIN/government funded services including capital (e.g., Satellite locations) Build on the infrastructure of one of the existing CHCs to expand primary care services more broadly across Durham. 13
Central East LHIN Position Following a review of the Final Integration Plan, the Central East LHIN sees significant merit to the value to the establishment of a single South Durham CHC as outlined in the Final Integration Plan. The Central East LHIN has invested in bringing both organizations together to achieve the value of a unified CHC structure in South Durham on behalf of current and future primary care needs within the region. Therefore, the Central East LHIN has taken a vested interest by exploring options that will achieve the outcomes, as outlined in the Final Integration Plan, including resuming integration discussions with both CHCs. 14
Steps Taken June-August: Engagement with both Board delegates from each CHC to discuss the Integration Plan, outstanding barriers to integration, and outline the LHINs position. We provided three options for the CHCs to consider: Option 1: A single integrated CHC to be formed to serve South Durham with the Central East LHIN committed to working with TYC and OCHC to pursue this Vision. If there was no agreement to pursue Option 1 by either TYC or OCHC, the LHIN would then consider Option #2 and 3 below: Option 2: Target new investments in comprehensive primary care and community development services (as they become available) in one existing CHC to expand service in South Durham. Option 3: In conjunction with either Option #1 or Option #2, the Central East LHIN will notify the Ministry of Health and Long-Term Care and TYC of the need to re-examine the functional plan and previous approvals for the TYC Pickering Satellite so that it may accommodate other patient populations. 15
Progress Update Received confirmation from TYC and OCHC Boards that they would pursue Option 1. The LHIN will now facilitate the achievement of the value proposition as outlined in the Final Integration Plan (Dec 2013). LHIN Facilitator met with the Chairs and accompanying Governance Representatives on September 17, 2014 to outline and gain consensus on next steps. The expedited facilitated process will focus on resolution of barriers to integration, namely Human Resources, Finances/Budget, Transitional Structure and Legal Issues pertaining to integration. Report back to the Board with the resolution is anticipated for December 2014. 16