Central LHIN Community Governance Council Meeting May 23 & 30, 2012
Agenda Wl Welcome and dit Introductions ti Central LHIN Overview Draft ftstrategic t Vision i and dprinciples i Community Sector Optimization Community Engagement Funding Key Accomplishments Governance Roundtable Discussion/Feedback i Challenges in Current Environment Governance Level Priorities and Opportunities 2
A look inside Central LHIN Population trends and challenges More than 1.7 million residents 13.2% of Ontario s population; largest among LHINs By 2020, our population over the age of 65 will increase by 110,000000 Culturally diverse: about 48% of our population pp is newcomers highest proportion among the LHINs 3
Our health service providers 7 public hospitals and 3 private hospitals 46 long-term care homes 33 community support service providers 20 mental health and addiction service providers 1 community care access centre (CCAC) 2 community health centres 4
Central LHIN s core values What we stand for 1. Collaboration and partnerships 2. System responsiveness and quality 3. People and community focused 4. Openness and transparency 5
Action Plan for Health Care A road map for the transformation to smarter, more efficient health services leading to better health outcomes Provide people with the right care in the right setting at the right time Integrating gplanning for family health care into the LHINs to leverage our expertise in helping patients navigate the health system Investing more in community care for families and seniors 6
Vision and Strategic Principles Vision /Mission To enable people in our diverse communities to receive the right care, in the right place, at the right httime through ha high-quality, h person-centered, sustainable, integrated system of care Strategic Principles Enable a system that will support seniors and others who are high risk (avoidable hospitalizations and readmissions). Collaborate to enable more timely access to care within and across different systems of care, including hospital, community, long-term care and primary care and those providers beyond the health system, and focus efforts to improve system navigation. Advance the delivery of integrated, regional health care programs that support comprehensive, efficient and effective delivery of services. Build capacity in the community to support moving appropriate services to the community, closer to home, while achieving the same or better standard of care. Integrate planning for primary care to improve care transitions. 7
Regional Program Development New Regional Program models currently in development across the province with the goal to: Provide a single point of entry to improve patient navigation and access to service, manage and reduce wait times, and reduce assessment burden Reduce duplication of administrative resources Clarify roles and responsibilities of providers along the continuum Make decisions based on needs of people and the system, rather than individual organizations Examples: Bh Behavioural lsupports Ontario Regional Palliative Care Networks 8
Community Sector Optimization What is it? Taking the opportunity to ensure the right community services are being delivered in the right place and at the right time Tki Taking the opportunity to optimize the Community Sector as the enhanced role of the CCAC is implemented 9
Community Sector Optimization Background Agencies and services were established by the Ministry before the creation of the LHINs Formal review of agencies and services has not been performed by the LHIN There is no formal quality reporting for the Community Sector Funding is gradually shifting from the hospital sector to the community sector The healthcare environment is becoming increasingly regulated M-SAAs are being refreshed in fiscal 2012-13 10
Community Sector Optimization Design principles and outcomes The client is at the centre of system design Access will be improved by increasing services Services will be aligned with IHSP3 priorities i i and local l system needs Best value for money for taxpayers by providing high quality services at efficient costs Community health service providers will be high performing agencies held accountable to quality and other standards The LHIN will be a skilled system manager and strong gpartner 11
Focus on Community Support Services 33 agencies funded to dli deliver 28different services Menu of Community Services Services Acquired Brain Injury Services Arrangement/Coordination Assisted Living Services Personal /Homemaking/Respite Personal /Independence Training Psycho Geriatric Agencies deliver from Caregiver Support Psychology Case Management one to 12 services Crisis Intervention and Support Day Services EmergencyResponse Foot Care General Geriatrics Hearing Care Homemaking Overnight Stay Respite Short Term Crisis Beds Social andcongregate Dining Speech Language Pathology Support Service Training Transportation Agencies are funded by the LHIN from $173,000 Emergency Response Social and Congregate Dining to $8.1 million Vision Impaired Care Funding from other Meals Delivery Visiting Hospice Palliative Care sources ranges from <1% to 99% Visiting Social and Safety 12
Focus on Community Support Services Specialized Services High risk seniors, including frail elderly Medically complex, physically disabled, developmentally disabled, ABI Mental health, addictions, dual diagnosis Alhi Alzheimer s/other / h severe cognitive ii impairments Culture/language/interpretation (hearing, speech/aphasia) Other (HIV/AIDS, FLS, Aboriginal) Client-centric care Meals Transportation Shopping Snow Shoveling Friendly home calling Adult Day programs Homemaking Caregiver supports 13
Discussion and Next Steps What criteria should be used to review current and new Health Service Providers? Are there other community support services that should be provided? What risks are faced by Community Support Service sector agencies? Now and in the future How do you see the enhanced role of the CCAC effecting community services? 14
Community engagement A legislated responsibility and a core function of the LHINs
Community engagement Areas of focus: 2012-2013 1. Advancing health system quality 2. Strengthening integrated health care to improve transitions 3. Advancing physician i and primary care provider engagement 4. Collaborating with aboriginal and francophone populations 5. Enhancing cross-ministry/lhin engagement 6. Supporting development of the Integrated Health Service Plan 2013-2016 16
Funding
Our health service providers: $1.8 billion funding allocation 7 public hospitals/ 3 private hospitals $ 1.1B 46 long-term care homes $ 311M 38 community support service providers $ 72M 21 mental health and addiction service providers $ 67M 1 community care access centre (CCAC) $ 224M 2 community health centres $ 9M 18
LHINs Making a difference Achieving results in our communities
Central LHIN: Key accomplishments 2011-12 Performance Indicators 2010/11 2011/12 Performance Indicator (PI) LHIN Starting Point or Baseline LHIN Target 13 May 11 LHIN Starting Point or Baseline LHIN Target 12 Aug 11 14 Nov 11 10 Feb 12 11 May 12 SURGICAL AND DIAGNOSTIC WAIT TIMES 90th Percentile Wait Times for Cancer Surgery 1 47 47 41 46 47 41 43 41 38 MLPA INDICATORS 90th Percentile Wait Times for Cardiac By Pass Procedures 1 63 63 61 64 63 64 63 53 40 90th Percentile Wait Times for Cataract Surgery 1 102 102 89 102 102 76 87 78 80 90th Percentile Wait Times for Hip Replacement 1 139 139 150 150 139 140 151 146 131 90th Percentile Wait Times for Knee Replacement 1 154 154 167 162 154 184 158 165 150 90th Percentile Wait Times for Diagnostic MRI Scan 1 136 112 127 147 112 122 109 102 66 90th Percentile Wait Times for Diagnostic CT Scan 1 44 38 30 37 34 28 35 28 26 20
Central LHIN: Key accomplishments: Reducing ALC Home First Central LHIN was one of the first LHINs to fully implement Home First across all of its hospitals and CCAC More than 1,200 clients have been served by the Home First Program 68% of Home First clients are able to remain in the community with regular CCAC services, thus reducing the need for long-term care Home First has diverted 18,306 ALC days acute hospital care-a $15.6M cost to the health care system 21
Central LHIN: Key accomplishments: Reducing ALC West Park Transitional Ventilation Program 4 new beds at West Park Healthcare Centre provides assessment and rehabilitation i support for ALC patients in ICU who require mechanical ventilation and are unable to be discharged to the community 4 LHINs served plus 1 direct admission from CCAC Has brought 14 people home and created greater capacity of about 2,428 days in hospital ICU, enabling local health system to provide $3.5 million of additional health services 22
Central LHIN: Key accomplishments: Reducing ALC Cummer Lodge Behavioural Supports Ontario 8-bed pilot project received LTC specialized unit designation Partnered with Central CCAC, Baycrest, Ontario Shores, CAMH, North York General, Humber River Regional, Toronto EMS and police 14 admissions from 3 LHINs; 6 discharges (ALOS 3.5 months) Aligned with Behavioural Supports Ontario (BSO) project that is now being implemented Approximately 25 local health service providers deliver over 30 programs that support people with specialized behavioural needs and their families 23
Central LHIN: Key accomplishments: ED Diversion Emergency Department Diversion Program North York General Hospital (NYGH), Saint Elizabeth Health Care, Access 1 and Toronto North Support Services partnership Seamlessly connects people with mental health issues, who do not need hospitalization, with the appropriate communitybased services 91% of people who used NYGH s program had no mental- health related return visits within 28 days, representing a 53% reduction in ED revisit reduction rates. Program has been expanded to Humber River Regional Hospital 24
Central LHIN: Key accomplishments: Centralized access to mental health services York Support Services Network/Access 1 A Central LHIN first that is being explored across the GTA LHINs York Region residents (through York Support Services Network) ) and North York and Scarborough residents (through Access 1) now have a single point of access to reach mental health supports by phone, fax, email, online or walk-in One common application form, one waiting list for all services Other GTA LHINs exploring adoption of program (CW, TC) 25
Central LHIN: Key accomplishments: Anti-stigma program goes national Opening Minds An anti-stigma workshop developed in Central LHIN has been used din other jurisdictions idi i such as British iihcolumbia and dhas now been adopted by the Mental Health Commission of Canada (MHCC) Proven to be effective at reducing stigma, Central LHIN is now partnering with the MHCC to develop an anti-stigma pilot program called Understanding Stigma Phase II: Building Operational Capability and Driving Sustainable Change Project aims to improve the experience of people living with mental illness by enhancing health care professionals knowledge and understanding 26
Health System Accountability and Performance Ontario s LHINs are: Measuring health care performance Setting targets based on these measures Holding organizations accountable for achieving these targets Publicly reporting performance results, and Achieving targets which are improving the lives of patients 27
Governance The LHIN Board of Directors
Board of Directors The role of the LHIN Board of Directors is to oversee, advise on and govern the strategic direction and priorities of the LHIN. Members appointed by an Order-in-Council and appointed itdfor a term of one to three years, subject tto two terms up to a six-year maximum. The Board of Directors is accountable, through the Chair, to the Minister of Health and Long-Term Care for the LHIN s use of public funds, and for its results in terms of goals and performance of the local lhealth hsystem. They are also the final funding approvers. Board Chairman: John Langs 29
Thank you It is a fact that in the right formation, the lifting power of many wings can achieve twice the distance of any bird flying alone. Author unknown
Roundtable Discussion/Feedback Challenges in Current Environment Governance Level Priorities and Opportunities Together, We re Better 31