WATERLOO WELLINGTON LOCAL HEALTH INTEGRATION NETWORK

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1 WATERLOO WELLINGTON LOCAL HEALTH INTEGRATION NETWORK Finance and Audit Committee SUMMARY REPORT TO BOARD OF DIRECTORS DATE: November 23, 2011 From: D. Small, Chair of Finance and Audit Committee The Finance & Audit Committee met on Wednesday, November 23, 2011 New Business 1. St. Mary s General Hospital Hospital Improvement Plan Staff shared recommendations and a supporting analysis of St. Mary s General Hospital s Improvement Plan. Analysis suggests that further work needs to be completed by the Hospital to better mitigate the risks of a small number of initiatives. At a system level, the Hospital s high profile as a provider of cardiac services needs to be further explored. Additional steps have been identified to ensure the Performance Factor is dealt with sustainably. Staff recommended recourse to a cash advance, a short-term measure that will allow the Hospital to better prepare its Plan. Recommendation will be made under item 13.0 of the Board of Directors meeting of December 1, 2011 THAT the Finance and Audit Committee recommend that the Board of Directors: I. Accept as incomplete the Hospital Improvement Plan submitted by St. Mary s General Hospital; II. Direct St. Mary s General Hospital to: a. report back to the WWLHIN by January 30, 2012, on the internal and external preparatory steps taken specifically to ensure the successful implementation and mitigation of risks associated with the: i. planned weekend closure of the inpatient surgical unit; and ii. planned reduction in 10 medical beds; b. collaborate with Grand River Hospital and the Waterloo Wellington Community Care Access Centre, as appropriate, to identify and enact integration opportunities related to community-based solutions to Emergency Department pressures, discharge planning, clinical resources, and operational business practices, and report back on progress to the WWLHIN by February 28, 2012; and c. develop additional Improvement Plan initiatives subject to WWLHIN review and acceptance to fully mitigate against the risk that extra-lhin Page 1 of 5

2 base operating resources may not be appropriated or allocated for improved cardiac service provision, and report back to the WWLHIN by March 30, Staff reviewed the cash advance request from St. Mary s General Hospital. The Hospital identified to the LHIN in September 2011 its need for an in-year cash advance to assist it to manage the pressures associated with its projected in-year deficit. The financial analysis conducted by the LHIN confirmed the Hospital s compliance with policy expectations. Recommendation will be made under item 13.0 of the Board of Directors meeting of December 1, 2011 THAT the Finance and Audit Committee recommend that the Board of Directors approve a cash advance to St. Mary s General Hospital for fiscal 2011/12 in the amount of $11 million. 2. WWLHIN Operations -- Financial Report -- October YTD Staff advised that on a YTD basis, operations show a surplus of $313K, while onetime funding initiatives show a surplus of $50K. Recommendation THAT the Board receive the report of WWLHIN Operations Financials year-todate for October Behavioural Supports Services Staff identified Behavioural Support Services as a key priority across all LHINs, and outlined the action taken by the Ministry of Health and Long-Term Care beginning in January 2010 to develop and implement a principle-based Framework for Care. With the recent completion of the Framework, the Ministry undertook further action in 2011 as part of the Behaviour Supports Ontario (BSO) project, which draws in all 14 LHINs. The project is intended to implement the Framework and better service older adults with responsive behaviours across the province. The Ministry s investment in WWLHIN for these purposes is $2,416,600 in annualized funding. Additionally, the WWLHIN has identified annualized base funding of up to $200,000 for operational expenses not covered through provincial funding. Recommendation will be made under item 14.0 of the Board of Directors meeting THAT the WWLHIN Board approve annualized base funding of $2,416,600 for personal support workers, nurses, and additional healthcare personnel to be allocated as follows: Page 2 of 5

3 New Service Capacity Prorated Allocation for 2 months (Feb 2012) Annualized Base Funding, Beginning RN/RPNs to be employed by Long Term $152,700 $916,400 Care home licensees Personal Support Workers to be employed $120,000 $720,000 by Long-Term Care Home licensees Additional Healthcare Personnel, employed $130,000 $780,200 by HSPs in our community to implement behavioural services Total $402,700 $2,416,600 THAT the WWLHIN Board of Directors approve annualized base funding of up to $200,000 for additional expenses related to the Waterloo Wellington Behavioural Supports Services Program not covered through provincial funding Authorize the WWLHIN CEO to amend Health Service Provider Service Accountability Agreements to support associated service and performance obligations with a report back to the WWLHIN Board of Directors on final details by February ALC / Transitional Care Program Staff provided an update on the Transitional Care Program, which was established in 2009 to enhance bed capacity to support achievement of the Emergency Department (ED)/ALC strategy objectives. The Program includes Restorative Care beds and Interim Long-Term Care (iltc) beds, funded annually through Aging at Home/LHIN Urgent Priorities Funding. Staff undertook a review of both the Restorative Care beds and iltc beds, and found that both have high occupancy rates and contribute to the achievement of the ED/ALC strategy objectives. Recommendation will be made under item 11.0 of the Board of Directors meeting THAT the WWLHIN Board of Directors approve the following planned funding allocations for fiscal year 2012/13: $2,055,680 in one-time funding for the Restorative Care Program; $3,139,534 in one-time funding for the 74 Interim Long-Term Care (iltc) beds; Page 3 of 5

4 Authorize the WWLHIN CEO to amend Health Service Provider Service Accountability Agreements to support associated service and performance obligations. 5. Rural Health Investments Staff shared their approach to calculating the value of investments made by the WWLHIN in rural areas following the acceptance of the Rural Health Strategy in January Various types of direct and indirect investments were outlined on a geographic basis, including the specific actions to serve rural communities in the context of the Integrated Assisted Living Program, telemedicine, base funding increases to hospitals and other health service providers, and other investments made by the Ministry of Health and long-term Care. 6. Telemedicine Telemedicine is a way of delivering health care at a distance using telecommunication and information technologies. It helps eliminate distance barriers between the consumer and care providers and helps improve access to medical services. The Ministry of Health and Long-term Care requested the LHINs to submit business plans to expand the use of telemedicine services in the province in association with the Ontario Telemedicine Network. The WWLHIN submitted a business plan that proposed a coordinated and integrated approach to the delivery of telemedicine within the LHIN. The Ministry approved the WWLHIN plan and allocated permanent base funding to support the WWLHIN plan. The WWLHIN has worked diligently to identify a preferred organization St. Joseph s Health Centre, Guelph to lead the implementation of the service. Health service providers and service providers will be expected to develop Memoranda of Understanding to define the participation terms and expectations for funding. To mitigate the risk that some providers may not wish to participate, as they are not LHIN-funded, the decision of the LHIN is to support firmly St. Joseph s in its integration leadership to establish this service. Recommendation will be made under item 18.0 of the Board of Directors meeting THAT the Finance and Audit Committee recommend to the WWLHIN Board of Directors to allocate a prorated amount of $583,538 for 2011/12 and planned funding of $933,820 in 2012/13 to St Joseph s Health Centre to establish and operate a Coordinated Telemedicine Service within the WWLHIN as described in the approved Telemedicine Program Business Plan 2011/12 and 2012/13. THAT the Finance and Audit Committee recommend to the WWLHIN Board of Directors to allocate one-time funding of $250,000 over two fiscal periods starting in 2011/12 to St Joseph s Health Centre to establish a Coordinated Telemedicine Page 4 of 5

5 Service within the WWLHIN as described in the approved Telemedicine Program Business Plan 2011/12 and 2012/13. Recommendation THAT the Board receive the report of WWLHIN Operations Financials year-todate for October THAT the Board receive the minutes of the September 21, 2011, and October 19, 2011, Finance & Audit Committee meetings for information. THAT the Board receive this report of the Finance & Audit Committee meeting held on November 23, 2011, for information. Page 5 of 5

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