CE LHIN Board Ontario Shores Update January 19, 2010 Glenna Raymond, President and CEO
Ontario Shores: The Journey Begins 2 Divestment from Government March 27, 2006 a standalone public hospital Creation of a Community-based board of directors New infrastructure Human Resources Finance IT Public Affairs Quality and Safety Interprofessional Practice Consultations, engagement and dialogue with key stakeholders: patients, employees, community members, healthcare providers to identify needs Development of mission, vision, values, strategic directions and site development plan New name Ontario Shores Centre for Mental Health Sciences announced June 10, 2009
Our Name and Tagline 3
Ontario Shores Today ~ At a Glance ~ 4 A teaching hospital specializing in comprehensive mental health care and addiction services for those with complex and serious mental illness 1,200 employees 329 inpatient beds, extensive outpatient programs 56,550 outpatient visits (2008/09) Collaborative Recovery Model of care - promotes inclusion and empowerment of patients and treatment options that are tailored to the individual needs of patients and families Provincial mandate 61% of inpatients and 74% of outpatients are from the CE LHIN
Tertiary Mental Health Care 5 ~ One Core Business ~ Specialized mental health and addiction services for adolescents to seniors with complex and serious mental illness Assessment, Stabilization, Diagnosis, Treatment, Rehabilitation, Community Reintegration Clinical expertise supporting other caregivers, families, homes for special care and partners beyond MOHLTC/LHIN funded agencies Research to advance the discipline of mental health care, knowledge transfer and improved care Education and support for Health Human Resources
Our Mission 6 We provide leadership and exemplary mental health care through specialized treatment, research, education and advocacy.
Our Vision Recovering Best Health Nurturing Hope Inspiring Discovery 7 Our vision is bold and transforming. Ontario Shores Centre for Mental Health Sciences is recognized by many as having an approach to mental health care and unique services that are focused on recovery, hope and inspiration through discovery. Recovering Best Health Our specialized care focuses on individual paths to recovery and mental wellness. Our highly skilled staff are leaders in promoting optimum well-being. Our comprehensive services and innovative practices are integrated with our community partners. Nurturing Hope Our advocacy with the community eliminates the stigma of mental illness. Our commitment to care extends beyond the scope of client recovery to educating and informing our families and communities. We proudly embrace diversity and offer individualized care. Inspiring Discovery We are avidly leading new developments and research in collaboration with other organizations. We lead the international mental health care community in safety and innovative practices. Our relationships with the private sector provide unique opportunities to be innovative.
Our Core Values 8 We aim for Excellence - through leadership and learning, we achieve exceptional performance in all we do, while fostering an environment of optimism, hope and recovery. We encourage Innovation - through research and creative approaches, we support the advancement of mental health care. We value Safety - we provide a safe and healing environment for our clients and a sense of security for our patients families, our employees and the community at large. We Respect all individuals - encouraging diversity and treating everyone with dignity, while embracing the rights, beliefs, opinions and contributions of others. We are a Community - we work together as one team, and with families, providers and the public as our partners, while maintaining mutual trust, transparency and shared purpose to enhance our patients quality of life.
Complexity of Care ~ Diagnosis on Admission ~ 9 Ontario Shores 2008-09
Our Patient Population ~ Mental Illness Affects All Ages ~ 10 Ontario Shores 2008-09
Status on Admission 11 Ontario Shores 2008-09
Range of Services 12 Mood and Anxiety Cognitive Behavioural Clinic Seniors Mood Clinic Memory Clinic Metabolic and Weight Management Clinic Dental Services ECT Programs Forensics Outpatients Homes for Special Care Transitional Discharge Clinic Women s Clinic Neuropsychiatry Virtual Emergency Room Residential Support Vocational Rehab Assertive Community Treatment Teams Mental Health Support Unit (DRPS, DMHS)
Financial Track Record 13
Occupancy Rate Occupancy Rate has been over 95% since 2007/8 Ontario Shores Centre for Mental Health Sciences Occupancy Rate 100 90 % occupancy Divestment 80 Q1 2006/7 Q2 2006/7 Q3 2006/7 Q4 2006/7 Q1 2007/8 Q2 2007/8 Q3 2007/8 Q4 2007/8 Q1 2008/9 Q2 2008/9 Q3 2008/9 Q4 2008/9 Q1 2009/10 Q2 2009/10 Oct-09 Nov-09 % Occupancy January 2010 14
Average Length of Stay 15 Length of stay of our patients has continued to drop since divestment. Ontario Shores Centre for Mental Health Sciences Average LOS 200 175 ALOS 150 125 100 2005/6 2006/7 2007/8 2008/9 2009/10 YTD January, 2010 Divestment ALOS
Ambulatory Care Visits 16 There has been a steady increase in the # of outreach and clinic visits since divestment. Ontario Shores Centre for Mental Health Sciences Ambulatory Care Visits 60,000 50,000 40,000 Visits 30,000 20,000 10,000 - Divestment 2005/6 2006/7 2007/8 2008/9 2009/10 Projected Ambulatory Care Visits January 2010
Accomplishments 17 Improved access as a result of using LEAN methodologies RAU Rapid Assessment Unit (RAU) Innovation and Quality Awards Academic Community Affiliation with the University of Toronto Nursing Residency Program MEDITECH 6.0 National Mental Health Commission demonstration projects
CE LHIN Clinical Services Plan ~ Moving Forward ~ 18 Ontario Shores Board Motion supporting CSP March, 2009: Whereas, the Board of Directors of Whitby Mental Health Centre are committed to leveraging its expertise in mental health We resolve to provide leadership to the Clinical Services Plan and support its directions around system integration and coordination for mental health services in the Central East LHIN. Launched Centralized Intake to improve access to services and referrals One number, one process, one form Meeting with Schedule 1 hospitals to engage in dialogue November, 2009 Planning meeting and roundtable discussions with key adolescent stakeholders Creation of new Vice-President role to provide leadership and work in partnership with CE LHIN and others to build an accessible, effective and efficient Mental Health and Addictions system Data exercise has begun to identify service gaps and opportunities using an evidence-based approach
Integration Building System Capacity ~Taking Action ~ Ontario Shores Board policy on system integration December 2008 Numerous integration and partnership activities completed* Psychogeriatric consultation (Alzheimer s Society) Proposal for voluntary integration with NHH to be brought to CE LHIN Board shortly Virtual Emergency Room Metabolic and Weight Management Clinic Mental Health Support Unit Provision of geriatric mental health in partnership with Durham Access to Care Community Governance concepts introduced 2007/08 *See handout for additional information
CE LHIN IHSP 20 Ontario Shores will actively help the CE LHIN achieve its two aims. Reducing time spent in the ED by 1 million hours and 10% reduction in cardiovascular disease Ontario Shores has supported IHSP through: Coordination of ACCT team referrals and back-up for case load admissions Crisis management plans for discharged clients Code white and staff safety leadership Metabolic and Weight Management Clinic Increasing the capacity of local primary care providers to care for mentally ill patients Clinical support to alternative primary care services for the Nurse Practitioner Clinic with CMHA Participation in IHI ED Avoidance Coalition
Provincial Mental Health Strategy 21 Source: Every Door is the Right Door, Discussion Paper. Pg. 25
National Mental Health Commission ~ Goals ~ 22 1. People of all ages living with mental health problems and illnesses are actively engaged and supported in their journey of recovery and well-being. 2. Mental health is promoted, and mental health problems and illnesses are prevented wherever possible. 3. The mental health system responds to the diverse needs of all people in Canada. 4. The role of families in promoting well-being and providing care is recognized, and their needs are supported. 5. People have equitable and timely access to appropriate and effective programs, treatments, services and supports, that are seamlessly integrated around their needs. 6. Actions are informed by the best evidence based on multiple sources of knowledge, outcomes are measured, and research is advanced. 7. People living with mental health problems and illnesses are fully included as valued members of society. Ontario Shores is currently working with the Commission on two demonstration initiatives (TAMI, Nursing Residency Program). Source: Toward Recovery & Well Being A Framework for a Mental Health Strategy for Canada November, 2009
Approach to a Balanced Budget 23 1. Board-determined budget principles 2. Making Choices Framework 3. Commitment to Benchmarking and Lean 4. Decentralized Budget Accountability 5. Support and central finance expertise 6. Broad consultation and fiscal advisory input
Financial Risks 2010/11 Budget Deficit 24 Ontario Shores is forecasting a $4M deficit at a 0% funding increase (driven entirely by inflation) no new programming or activity: Salaries & Wages 3,375 Benefits 631 Supplies 605 Total Inflation 4,611
Financial Risks 25 Stabilization funding for Ontario Shores of $2.6M was included in planning documents shared with the CE LHIN and Ontario Shores a critical element to our financial stability has not been received Growth Funding Ensuring that specialized hospitals are included in MOHLTC HBAM calculations Increased demand for services
Risks Land and Building 26 Ontario Shores does not own either its land or buildings. These are the property of the ORC and Ontario Shores is a tenant. Negotiations since divestment have resulted in marginal progress. Current economic conditions pose a significant risk to the integrity of this incredible health asset The building while beautiful has considerable financial liability which has not been appropriately addressed.
ALC Days 27 April 1, 2009 we started to collect ALC days based on the same criteria as the Wait Time ALC strategy Barriers to discharge are primarily waiting for housing and Long-Term Care beds Ontario Shores Centre for Mental Health Sciences ALC Days ALC Days 2,200 2,000 1,800 1,600 1,400 1,200 1,000 Apr May June Jul Aug Sept Oct Nov ALC Days 1,753 1,675 1,737 2,100 2,037 1,891 1,947 2,004 Avg Per Day 58 56 58 70 68 63 65 67 80 60 40 20 Patients Per Day ALC Days Avg Per Day January 2010
Opportunities 28 Greater integration between Schedule 1 facilities, community mental health and Ontario Shores Developing expertise in concurrent disorders and expansion of addictions Expertise on co-morbid conditions Health Information Systems Opportunities under provincial and federal mental health strategies Implementation of Limited Master Plan Development of best-practice standards for staff and patient safety Ways to consolidate/coordinate services across the CE LHIN to streamline costs
We need your Support 29 1. Protection of mental health care funding 2. Stabilization funding 3. Land, Building and Capital Investment 4. Support for a leadership structure to move CSP forward 5. Continued leadership for collaborative governance initiatives