MINUTES OF BOARD OF DIRECTORS MEETING Date: Wednesday, October 10, 2012 Location: Burlington Art Centre 1333 Lakeshore Road, Burlington, ON PRESENT: B. Alexander (Vice-Chair), V. Bayley, B. Brownlow, S. Hosking, G. Nakamura (Treasurer), G. Ostofi, D. Ringler, C. Ward, (Chair) PRESENT VIA TELECONFERENCE: L. Lifchus, B. McIntosh REGRETS: J. Lawlor GUESTS: STAFF: Mr. Tom Ahlin; Mr. Rick Menassa, President, icare Home Health Services Inc.; A. Szasz D. Arseneau, B. Busing, M. Miles, T. Peirce, M. Siegner, D. Kowal (Recorder) 1. CALL TO ORDER C. Ward, Chair, noting that quorum was present, called the meeting to order at 4:05 p.m. ADDITIONS TO/ APPROVAL OF AGENDA T. Peirce added Item 4.7 Declaration of Compliance MOTION: THAT the Agenda for the meeting of October 10, 2012 be approved as amended. McINTOSH/OSTOFI DECLARATION OF CONFLICT OF INTEREST No conflict of interest was declared. REVIEW OF THE VISION, MISSION, VALUES C. Ward referenced the Corporation s Vision, Mission and Values. Burlington Branch Site - Update M. Miles advised that a water pipe broke at the Burlington Branch office (5 th floor) on October 6, 2012. Barbara Busing [Business Continuity Plan (BCP) Incident Commander], Mary Siegner (Communications Director), Andrew Szasz (IT Director) and Maureen Kitson (Branch Director) worked throughout the holiday weekend as the BCP for the CCAC was activated/implemented. This required the relocation of 180 staff from the Burlington Branch to the other CCAC Branches.
Page 2 of 8 Burlington Branch Site Update (cont d) A. Szasz and his team moved equipment /computers from the Burlington Branch and set up computers at the other four sites. This was difficult due to the fact that, for a short period of time, all power including the generator was lost and his team was literally working in the dark. M. Miles commended A. Szasz, Director of IT and his Department and Maureen Kitson, Director Client Services for completing all the necessary work required to ensure it was business as usual that day (Saturday) for the Weekend Teams, and Tuesday morning for the full workforce. M. Miles confirmed that restoration work at the Burlington branch continues and regular updates are being provided to all staff. It was suggested that the Business Continuity Plan in the context of this incident, be presented at a future Board Education session. D. Arseneau/ A. Szasz 2. Board Education Session Delivering Quality and Value in Home Care M. Miles, CEO, referenced the Board Education slide deck as precirculated in the Board package, noting that this month s education session will focus on the sector s Quality and Value in Home Care (QVHC) initiative which is a collaborative effort between the OACCAC and Service Provider Associations. M. Miles highlighted some of the key components: i) change driver funding reform; ii) transformation to outcome based care; iii) quality and value in home care; iv) varied pace of change and v) performance indicators. The Executive Team responded to questions posed by Board members per; i) pricing advising that it will take time to collect and analyze our data to determine the cost of best practice care, that is delivered via the outcome based care pathways; ii) timeframe advising that the timeframe for implementation is approximately two years, noting the pace of change will be determined by local priorities and capacity and will be influenced by provincial direction; iii) HNHB contracts advising that all 23 HNHB CCAC contracts have been signed over to the new template; iv) dual process advising that all clients will continue to receive CCAC services, noting that as new contracts are put in place for consolidated services, some providers will be using the current system (fee for service) and some providers will be using the new system (outcome based care); v) training advising that we are learning from the first wave of CCACs that are currently implementing outcome based procedures/ reimbursement for wound care, noting that the
Page 3 of 8 2. Board Education Session Delivering Quality and Value in Home Care (cont d) OACCAC is providing project management resources; and vi) success advising that there will be both the outcome based model and fee for service model in process for some time. 3. APPROVAL OF MINUTES D. Ringler noted that S. Hosking had sent her regrets to the September 12 th Board meeting, thus had not approved a motion as indicated. MOTION: THAT the minutes of the Meeting of the Board of Directors held on September 12, 2012 be approved as amended to reflect name change per motion 3.0 Approval of Minutes. RINGLER/NAKAMURA MOTION: THAT the minutes of the Special Meeting of the Board of Directors held on September 12, 2012 be approved as presented. LIFCHSU/RINGLER 4. MATTERS FOR DISCUSSION AND/OR APPROVAL 4.1 Report of the Chair C. Ward advised that her Report will be discussed in the In- Camera session. 4.2 OACCAC Update 4.2.1 OACCAC Board Meeting Update C. Ward advised that there is no Report. 4.2.2 OACCAC Governance Committee Update L. Lifchus advised that there is no Report. 4.2.3 OACCAC Quality & Safety Committee Meeting B. Alexander advised that the OACCAC Quality & Safety Committee is currently working on the OACCAC Annual Conference for 2013. 4.3 Report of the CEO M. Miles referenced the Report of the CEO as pre-circulated in the Board package, noting that the HNHB CCAC received $8M in new funding of the $14.7M available to the broader community sector. M. Miles advised that the branch-specific 2012 Awards of Excellence/ Seasonal Events have been scheduled to occur
Page 4 of 8 4.3 Report of the CEO (cont d) In December. Board Members are asked to note their interest/availability for attendance at these events on the attached form and return to D. Kowal. B. Alexander inquired if the form per the seasonal events and the form per Item 5.6 Volunteer Hours can be forwarded to D. Kowal electronically. ACTION: A. Szasz will look for a solution to effect same and report back to the Board as soon as possible. A.SSzasz D. Ringler thanked N. Dojcsak and A. Szasz on behalf of the Board for providing ipad training for all Board members, noting that the sessions were successful and that the process went very smoothly. MOTION: THAT the Report of the CEO be received as presented. RINGLER/OSTOFI 4.4 Report of the CFO D. Arseneau referenced the Report of the CFO as precirculated in the Board package, noting that as outlined in the CEO Report, we received $8M funding from the LHIN. D. Arseneau confirmed that the CCAC does expect to balance at year-end, and will retain and/or put in place appropriate measures to ensure that this requirement under the MSAA with the LHIN is met. MOTION: THAT the Report of the CFO be received as presented. BROWNLOW/OSTOFI 4.5 Quality & Safety Update T. Peirce referenced the Quality & Safety Report as precirculated in the Board package, noting that the HNHB CCAC uses the Client Event Management System to ensure reporting, follow-up and trending of all client events including risk events, adverse events, compliments, complaints and near misses. In response to a question posed by a Board member, T. Peirce advised that the Client Event Management System is incorporated in the Staff Orientation Program held for all new employees, noting that there is also a policy and procedure entitled Client Event Management.
Page 5 of 8 4.5 Quality & Safety Update (cont d) B. Busing advised that the Client Event Management System was one of the presentations provided, by HNHB CCAC staff, at the Annual OACCAC Conference held in June, 2012. MOTION: THAT the Quality and Safety Update Report be received as presented. LIFCHUS/BAYLEY 4.6 HNHB LHIN ACTION Plan M. Miles referenced the slide deck per the HNHB LHIN ACTION Plan as pre-circulated in the Board Package, advising that the LHIN is developing a five-year Strategic Health System Plan with an overall objective to achieve, through integration, a sustainable health system where individuals will experience care that is coordinated, of the highest quality and results in better outcomes for the population. M. Miles highlighted the LHIN s provincial priorities, reviewed the proposed Strategic Directions as outlined, and shared the four questions on which the LHIN would like feedback: i) will this get us where we need to go? ii) is there anything missing? iii) what advice would you give the LHIN CEO around this plan? and iv) what role could you and other stakeholders play in implementing this plan? M. Miles advised that: i) Physician Networks; ii) Provider Networks; iii) Citizen Reference Panels; and iv) Consumer Focus Groups have all been consulted on the Plan. The Executive Team responded to questions posed by Board members per; i) have physicians been included advising that Dr. Valerie Jaeger, Medical Officer of Health, Niagara Region, is a member of the Steering Committee and other physicians have been part of consultation sessions; ii) support of government/ MOHLTC advising that the government has made a strong commitment to support goals associated with this Plan as outlined in the Minister s Plan which aims to: keep people healthy; ensure faster access to family health care; and provide right care, at the right time, in the right place. Suggestions from the Board included: i) need a communications strategy from the outset; ii) need to ensure the involvement of primary care in a leadership capacity;
Page 6 of 8 4.6 HNHB LHIN ACTION Plan (cont d) iii) need to clarify the respective roles of all involved including who has the authority to make funding/ service changes; iv) need to quickly evolve ehealth as an enabler to ensure that client information is available in real-time to all involved in the circle of care and ideally evolve to the point that the patient could carry his/her own information; v) need to look at the governance structure the zone-specific management team is accountable to whom for what; vi) need to be bold this may be a phased approach to regionalization; vii) need to differentiate between the LHIN s commissioning function and the CCAC s direct service provider procurement/ performance [service quality] management function; viii) require a LHIN-wide human resource strategy to be developed at the outset; ix) build on existing strengths/ infrastructure; x) need to consider how best to capitalize on organizations like the CCAC that have moved from five to one organizational structure already and harmonized clinical processes, functions and administrative structures want to optimize where clinical practices have been standardized and variation has been minimized and not make moves that are retrogressive; xi) need to consider how to incorporate infrastructure and technology platforms that support patient care (e.g. provincial CCAC IT systems) and data / information management as well as provincial (Ministry) requirements for standardized practices and processes across defined populations significant efficiencies and gains have been realized. MOTION: THAT the HNHB LHIN ACTION Plan Report be received as presented and comments as identified be forwarded to D. Cripps, LHIN CEO, as per her request. NAKAMURA/BROWNLOW It was requested that D. Cripps, LHIN CEO, be invited to an upcoming Board meeting to discuss health system plans for FY 2012-13/2013-14. M. Miles M. Miles 4.7 Declaration of Compliance T. Peirce referenced the Report of the Declaration of Compliance Report as circulated, noting that the Board must attest to the fact that the HNHB CCAC is compliant with the following: 1. Section 4.8 of the MSAA as it relates to adherence to the Supply Chain Guidelines of the Ontario Government for purchasing;
Page 7 of 8 4.7 Declaration of Compliance (cont d) 2. The Local Health System Act; and, 3. The Compensation Restraint to Protect Public Services Act. In response to a question posed by a Board member, D. Arseneau advised that: Item 1. refers to all goods and services, confirming that we are compliant. Item 2. refers to all legislation that the HNHB CCAC must adhere to, confirming that we are compliant. Item 3. refers to the two-year wage freeze, confirming that we are compliant. MOTION: THAT it be resolved that in light of the information provided by the Chief Executive Officer (CEO), that the Board direct the Chair to submit to the HNHB LHIN, a declaration of compliance for the period April 1, 2012 through September 30, 2012 in the format prescribed within the LHIN-CCAC MSAA. LIFCHUS/NAKAMURA 5. Consent Agenda At the request of Board members, the following items were removed from the Consent Agenda by C. Ward, Chair, and moved to the regular Agenda: Item 5.1 (D. Ringler) and Item 5.3 (G. Ostofi). 5.1 ED/ALC Monthly Report D. Ringler thanked T. Peirce for including the Discharge Abstract Database (DAD) data. T. Peirce advised that we are moving toward to the LHIN targeted rate of 11%. It is noted that the target includes a performance corridor of 10%, effectively making the target range 9.9% to 12.1%, noting that we are currently at 12.7%. MOTION: THAT the ED/ALC Monthly Report be received as presented. RINGLER/BAYLEY 5.3 Client Services Statistical Report In response to a question posed by a Board member, B. Busing confirmed that when a client is in an Assess and Restore bed, that the client continues on the CCAC caseload and may be discharged to the care of HNHB CCAC for inhome services, if needed.
Page 8 of 8 5.3 Client Services Statistical Report MOTION: THAT the Client Services Statistical Report be received as presented. OSTOFI/McINTOSH MOTION: THAT disposition per the items listed/referred to in the Consent Agenda be as follows: 5.2 Report of the Finance Committee be received as presented 5.4 Report of the Governance Committee be received as presented 5.5 Communications Report be received as presented 5.6 Volunteer Hours for the month of September, 2012 be completed and returned to D. Kowal. BROWNLOW/NAKAMURA 6. IN-CAMERA SESSION The open session adjourned at 5:47 p.m. and moved into the In- Camera session to approve minutes from the last meeting, to discuss matters related to provider contracts, and to discuss Board/CEO matters. The In-Camera session adjourned at 6:35 p.m. and returned immediately to the open session for the Meeting Evaluation. 7. MEETING EVALUATION Members were asked to complete the Meeting Evaluation on-line survey that will be sent to all Board members immediately following the Board meeting. 8. DATE AND TIME OF SCHEDULED MEETINGS The next meeting will be held on November 14, 2012 at the Burlington Branch, 440 Elizabeth Street, Burlington, 4:00 6:00 p.m. 9. ADJOURNMENT There being no further business, the meeting adjourned at 6:35 p.m. C. Ward, Board Chair M. Miles, Secretary :dk