Mr. David Sudbury (Vice-Chair) Mr. Chuck Powers (Member) Ms. Margaret Risk (Member) Ms. Samantha Singh (Member) Ms. Joanne Hough (Member)

Transcription

1 Harwood Plaza 314 Harwood Avenue South, Suite 204A Ajax, ON L1S 2J1 Tel: Fax: Toll Free: Harwood Plaza 314, avenue Harwood Sud Bureau 204A Ajax, ON L1S 2J1 Téléphone : Sans frais : Télécopieur : BOARD APPROVED MINUTES BOARD OF DIRECTORS MEETING Wednesday, September 18, 2013 Scarborough Room, Central East LHIN 314 Harwood Avenue South, Ajax ON 9:00 AM 3:00 PM Directors Present: Director Regrets: Staff Present: Mr. Wayne Gladstone (Chair) Mr. David Sudbury (Vice-Chair) Mr. Chuck Powers (Member) Ms. Margaret Risk (Member) Ms. Samantha Singh (Member) Ms. Valmay Barkey (Member) Ms. Joanne Hough (Member) Ms. Deborah Hammons (Chief Executive Officer) Mr. James Meloche (Senior Director, System Design & Implementation) Mr. Paul Barker (Senior Director, System Finance & Performance Management) Ms. Kate Reed (Team Lead, Integration/Implementation) Ms. Jai Mills (Integration Lead, System Design and Implementation) Ms. Emily Van de Klippe (Senior Analyst, Performance) Ms. Marilee Suter (Decision Support Lead) Ms. Katie Cronin-Wood (Communications Lead) Ms. Karen O Brien (Public Affairs) Ms. Sheila Rogoski (Executive Coordinator) Ms. Jennifer Persaud (Governance Coordinator, Minutes Recorder) Mr. Gladstone of the Central East Local Health Integration Network (the Central East LHIN ) Board of Directors chaired the meeting. 1.1 MEETING CALLED TO ORDER Mr. Gladstone called the meeting to order at 9:10 am and welcomed the members of the public to the Central East LHIN Open Board Meeting. Mr. Gladstone commended staff for their efforts in preparing the new office space acquired at 314 Harwood Avenue South. Constitution of Meeting/Quorum Notice of the meeting having been properly given to the public and to each Board member, and a quorum of Board members being present at the meeting, Mr. Gladstone declared the meeting duly constituted for the transaction of business. 1

2 2.1 CONSENT AGENDA Prior to introducing the motion, Mr. Gladstone asked if there were any items requiring further discussion as listed on the consent agenda. There were no items raised for discussion. By Be it resolved that the consent agenda of the September 18, 2013 meeting of the Central East LHIN Board of Directors be approved. Included are the following items for approval: - Board meeting agenda: September 18, Board meeting minutes: July 24, Board Correspondence Report Ms. Risk 2.2 DECLARATION OF CONFLICTS OF INTEREST Mr. Gladstone requested that those in attendance declare any conflicts of interest. Mr. Sudbury declared that he will be recusing himself from item 5.1 related to The Scarborough Hospital and Rouge Valley Health System facilitated integration. 4.1 BUSINESS ARISING FROM LAST MEETING OF JULY 24, 2013 Mr. Gladstone asked for any business arising from the Board meeting on July 24, There were no other items of business arising raised by members of the Board. 4.2 UPDATE ON THE IMPLEMENTATION OF PHYSIOTHERAPY Mr. Gladstone welcomed Ms. Kate Reed, Team Lead, Integration/Implementation, who provided an update on the current implementation activities for physiotherapy in the Central East LHIN. Community-based Physiotherapy Clinic Stream LHINs have received a number of Episodes of Care to allocate and 11 previously designated physiotherapy clinics in the Central East LHIN have been working through a transition to the 2

3 new funding model. A total of 79 applications have been received for new or expanding clinics across the Central East LHIN and will be reviewed by the Ministry and LHIN staff. Long-Term Care Homes All Central East Long-Term Care Homes have received additional funding to support physiotherapy exercise activities and have a contract in place with a provider for services to continue. In-Home Physiotherapy The in-home physiotherapy stream is being coordinated by the Central East Community Care Access Centre (CECCAC). The CECCAC will be assessing the nearly 2800 clients for timelimited, goal-oriented physiotherapy services. It was stated that staff expect an in-flow of referrals to occur for exercise and falls prevention classes following the completion of these assessments. Physiotherapy in Primary Care setting Approximately $2 million has been set aside by the Ministry of Health and Long-Term care for this stream to enable Family Health Teams and Primary Care settings to have physiotherapy augmented or introduced into their practices. A total of nine proposals have been received, and the Ministry along with LHIN staff will review and decide on where the designated funding will be allocated to increase access in Primary Care settings. Exercise and Falls Prevention The eight (8) lead agencies will be moving into the expansion phase to apply funding to new and or expanded locations for exercise or falls prevention. The Ministry has provided indirect funding that can be applied to offset some of the extraordinary expenses incurred by the lead agencies throughout the implementation phase. There are over 80 physiotherapy sites and over 120 classes being offered in the Central East LHIN. A list of the classes will be circulated to members of the Board once finalized. Staff at the lead organizations were commended for their exemplary job in getting the classes and clients transitioned to the new structure in a short period of time. The lead agencies include: Scarborough: Carefirst Seniors & Community Services Association and Transcare Community Support Services; Durham: Oshawa Senior Citizens Centres and Community Care Durham; Northeast: Community Care Northumberland, Community Care Peterborough, Community Care City of Kawartha Lakes and Community Care Haliburton. Staff will come back to the Board in October before moving forward with the locations. 3

4 4.3 THE SCARBOROUGH HOSPITAL & SCARBOROUGH CENTRE FOR HEALTHY COMMUNITIES SEXUAL ASSAULT CLINIC VOLUNTARY INTEGRATION Ms. Jai Mills, Integration Consultant, System Design & Implementation, provided an overview of The Scarborough Hospital (TSH) and Scarborough Centre for Healthy Communities (SCHC) Sexual Assault Clinic Voluntary Integration. The proposal is to keep the acute care services related to this program in the hospital and transfer the after-care services into the community with the Scarborough Centre for Healthy Communities hosting these services. Ms. Mills confirmed that a strong community consultation process was carried out by TSH and monitored by Central East LHIN staff. The Integration Proposal has addressed the need to preserve the specialized training of the staff involved in this program and ensure that the space where the services are being offered in the community remain accessible, confidential, safe while also meeting the needs of the community. A letter was received on September 17, 2013 from the Ontario Network of Sexual Assault/Domestic Violence Treatment Centres. Staff indicated that issues outlined in the letter were reviewed by staff and TSH. This proposal will provide more readily access to resources for sexual assault victims. The Board requested that a report back be delivered in no more than six months on the implementation of the integration. By Be it resolved that the Central East LHIN Board of Directors not stop the proposed voluntary integration between The Scarborough Hospital (TSH) and Scarborough Centre for Healthy Communities (SCHC) for the Sexual Assault Clinic and that staff report provide a report back to the Board on the progress in no more than six (6) months of this decision. Mr. Sudbury 5.1 THE SCARBOROUGH HOSPITAL/ROUGE VALLEY HEALTH SYSTEM HOSPITAL SERVICES FACILITATED INTEGRATION UPDATE Mr. Gladstone welcomed Mr. Robert Biron, President and CEO at The Scarborough Hospital (TSH) and Mr. Rik Ganderton, President and CEO at Rouge Valley Health System (RVHS) to report on the facilitated integration discussions between the two hospital corporations. 4

5 Mr. Ganderton and Mr. Biron indicated that there has not been a decision to merge at this point, the Boards are committed to completing their due diligence. Merger does not mean closure of any of the four (4) hospital sites and all emergency departments will remain open and the Ajax- Pickering site will not have services moved as a result of this process. The siting and sizing will not be completed at this point; however, following the completion of the integration plan, this may be reviewed. A report was provided on the community engagement process which included the launch of a new website Leading for Patients ( Consultation with internal and external stakeholders is underway followed by a fulsome review on feedback received through the online workbooks by the co-leads involved from the hospitals. A number of town hall meetings have been scheduled, including a telephone town hall meeting. An online survey was launched which was translated into languages of the communities, including Tamil and Chinese. A Stakeholder Engagement Report will be submitted to the LHIN Board in November. Members of the Board thanked Mr. Biron and Mr. Ganderton for providing a report and for embracing the facilitated integration strategy. Ms. Hammons indicated that the LHIN has been involved at the Integration Planning Table and Ms. Hammons participates in the Integration Leadership Council. Communications Lead and Public Affairs staff from the LHIN also participate in the Communications Working Group. The tremendous amount of work that has gone into this integration was commended. The LHIN emphasized on the importance of Community Engagement and Physician Engagement. The Board noted that the integration plan will be presented to the Central East LHIN Board in November. 5.2 COMMUNITY MENTAL HEALTH PROGRAMS VOLUNTARY INTEGRATION BETWEEN CAMPBELLFORD MEMORIAL HOSPITAL, NORTHUMBERLAND HILLS HOSPITAL AND ONTARIO SHORES CENTRE FOR MENTAL HEALTH SCIENCES Ms. Mills tabled a proposal for the Board s consideration on a voluntary integration between Campbellford Memorial Hospital (CMH), Northumberland Hills Hospital (NHH) and Ontario Shores Centre for Mental Health Sciences (OSCMHS) involving their community mental health programs. A request was received to expand on the existing mental health community program integration between OSCMHS and NHH to now include CMH. This collaboration aims to reduce fragmentation and improve access to services, it is anticipated that 74% more clients will be served by this partnership in the CMH catchment area. A report back to the Board will be provided by staff within six months on the progress of the integration. By Ms. Risk Be it resolved that the Central East LHIN Board of Directors not stop the proposed voluntary integration of Community Mental Health Programs 5

6 between Campbellford Memorial Hospital (CMH), Northumberland Hills Hospital (NHH) and Ontario Shores Centre for Mental Health Sciences (OSCMHS). And further, be it resolved that the Board of Directors of the Central East LHIN congratulates all three organizations for their focus on improving mental health care and supports in the Northeast Cluster of the Central East LHIN. And further, be it resolved that the Board of Directors receive a report back from staff in no more than six months of this decision. 5.3 COMMUNITY HEALTH SERVICES INTEGRATION Sunrise Seniors Place Inc. and Community Care Durham Transition Plan Ms. Mills reported on the Transition Plan between Sunrise Seniors Place Inc. and Community Care Durham that is being tabled for the Board s approval in relation to Supportive Housing and Congregate Dining. The transition plan was submitted to the LHIN on August 16, 2013 with approval by the Boards of Sunrise Seniors and Community Care Durham. Ms. Mills reported on the transition milestones including the transfer of staff and clients that took place on September 1, The approval of a Memorandum of Agreement was signed on August 31, 2013 outlining a working relationship for the congregate dining and supportive housing. Staff will report back to the Central East LHIN Board in April 2014 with regards to the progress of the integration. Members of the transition team and Central East LHIN staff were congratulated for their efforts and commitment to the clients which resulted in a favourable position. By Mr. Powers Be it resolved that the Central East LHIN Board of Directors approve the transition of supportive housing and congregate dining from Sunrise Seniors Place Inc. to Community Care Durham as outlined in the Transfer of Supportive Housing and Congregate Dining Services from Sunrise Seniors Place (Oshawa-Durham) Inc. to Community Care Durham (August 12, 2013) with the following conditions: funding ($457,954) and annualized funding ($785,075) commencing in with the continuation of existing service levels (250) be assigned to Community Care Durham Multi-Service Accountability Agreement effective September 1,

7 That Community Care Durham will ensure the continuity of services during the transition; Compensation for final transition costs will be subject to future LHIN approval and further staff will report back to the Board on the service impacts in April Durham North Zone Partnership and Strategic Alliance Mr. Meloche introduced Mr. Ron Ballantyne, Executive Director, Brock Community Health Centre to present on behalf of the four organizations being represented in the North Durham Zone Partnership Agreement. Mr. Ballantyne reported that stakeholder engagement was completed by each organization. The Guiding Principles and the Strategic Directions were developed to include: High Quality Rural Community Health Care; Client Focused Service and Capacity; Partnerships and Integrations; Cost Effective Services and Collaboration and Coordination. Next steps include the development of additional goals in details, assess and evaluate the process and pursue new opportunities presented by the partnership as well as formulate a balanced scorecard. By Mr. Powers Be it resolved that the Central East LHIN Board of Directors does not oppose the proposed Durham North Zone Partnership and Strategic Plan collaboratively developed between Brock Community Health Centre, Community Care Durham, VON for Canada (Ontario Branch, Durham Region Site) and the Regional Municipality of Durham, Social Services Department (Long-Term Care and Services for Seniors). Annually, the Partnership will provide a Progress & Implementation Report to the Central East LHIN, including annual accomplishments and upcoming priorities for next fiscal year (i.e ) by April 30. Ms. Sudbury Members of the Board thanked Ron and members of the group for their efforts in preparing the partnership plan. 7

8 Scarborough/Peterborough update Mr. Meloche reported on the kick-off for the Peterborough and Scarborough Community Health Services Integration processes that are underway. The organizations are currently engaged in mapping out the current state models and a Governor Liaison meeting for each group has been booked on September 25 (Scarborough) and October 1 (Peterborough). Changes to this process will include a Strategy Session for Board representatives of the organizations to provide input on the directional planning in October and November, and a compressed project plan to meet the March 2015 implementation completion milestone. Regular updates will be reported to the LHIN Board throughout the process for both Scarborough and Peterborough. Staff were directed to report back on Lessons Learned from the Integration initiatives to date in the Central East LHIN. Staff were commended by the Board for the work involving integration to improve client access to high-quality services, ensure system readiness for future health system transformation and make the best use of the public s investment. 5.4 HOSPITAL SERVICE ACCOUNTABILITY EXTENDING AGREEMENT Ms. Emily Van de Klippe, Senior Consultant, Performance along with Mr. Paul Barker, Senior Director System Finance Performance Management presented the Hospital Service Accountability Extending Agreement and reviewed the indicators of all hospitals in the Central East LHIN. Meetings with hospitals were conducted to examine fiscal challenges and review mitigation strategies, leading to a refresh of their Accountability Agreement. By Ms. Risk Be it resolved that the Central East LHIN Board of Directors approves the proposed 2013/14 Hospital Service Accountability Amending Agreement (H- SAA), effective as of the 1st day of October, 2013, which amends the H-SAA by extending its term to March 31, 2014; and Be it further resolved that the Central East LHIN Board of Directors authorizes the Board Chair and LHIN CEO to execute the H-SAA Amending Agreement on behalf of the LHIN with the following hospitals. Campbellford Memorial Hospital (CMH) Haliburton Highlands Health Services (HHHS) Lakeridge Health (LH) Northumberland Hills Hospital (NHH) Ontario Shores Centre for Mental Health Sciences (OSCMHS) Peterborough Regional Health Centre (PRHC) Ross Memorial Hospital (RMH) Rouge Valley Health System (RVHS) 8

9 The Scarborough Hospital (TSH) Mr. Powers By Be it resolved that the Central East LHIN Board of Directors approves the proposed 2013/14 Private Hospital Service Accountability Amending Agreement (PH-SAA), effective as of the 1st day of October, 2013, which amends the PH-SAA by extending its term to March 31, 2014; and Be it further resolved that the Central East LHIN Board of Directors authorizes the Board Chair and LHIN CEO to execute the PH-SAA Amending Agreement on behalf of the LHIN with Bellwood Health Services (BHS). Mr. Powers 5.5 HOSPITAL WORKING FUNDS DEFICIT QUARTERLY REPORTS (Q1) Mr. Barker reported on the quarterly attestations submitted by Central East LHIN hospitals participating in Hospital Working Funds for 2013/14, this includes Ross Memorial Hospital, Peterborough Regional Health Centre and Lakeridge Health. The reports were signed off by the Board Chairs and CEOs of each hospital and with the Central East LHIN Board s endorsement of this submission, staff will forward a copy to the Ministry. By Ms. Risk Be it resolved that the Central East LHIN Board of Directors receive the quarterly working capital update from Lakeridge Health and approve that a letter of support will be sent to the Ministry of Health and Long-Term Care. By Be it resolved that the Central East LHIN Board of Directors receive the quarterly working capital update from Peterborough Regional Health Centre 9

10 and approve that a letter of support will be sent to the Ministry of Health and Long-Term Care. Mr. Sudbury By Ms. Risk Be it resolved that the Central East LHIN Board of Directors receive the quarterly working capital update from Ross Memorial Hospital and approve that a letter of support will be sent to the Ministry of Health and Long-Term Care. Mr. Powers 5.6 URGENT PRIORITY FUNDING Mr. Meloche provided a refresher on current initiatives under the Urgent Priority Funding in the Central East LHIN. New funding allocations will be tabled for the Board s approval in October, this will include community sector increase funding, urgent priority funding and an update on physiotherapy. The following motions were tabled based on previous LHIN approvals for reoccurring one-time funding initiatives. These projects are in implementation phases and are currently meeting the milestones with no issues to resolve. In some instances, these initiatives will move from onetime to base funding initiatives because of their recognized sustainable values. Staff will report back to the Board if there are any changes to the base funding in FY for two year funding approvals. By Be it resolved that the Central East LHIN Board of Directors approve that the Rouge Valley Health System receive a funding allocation of $1,001,418 in both the FY and for the Cardiovascular Rehabilitation Program Ms. Risk 10

11 By Mr. Powers Be it resolved that the Central East LHIN Board of Directors approve that The Scarborough Hospital receive a funding allocation of $180,000 in both the FY and for additional vascular surgeries. By Ms. Risk Be it resolved that the Central East LHIN Board of Directors approve that Peterborough Regional Health Centre receive a funding allocation of $180,000 in both the FY and for additional vascular surgeries. By Be it resolved that the Central East LHIN Board of Directors approve that The Scarborough Hospital receive a funding allocation of $201,070 in both the FY and for Geriatric Activation services. Ms. Risk By Mr. Powers Be it resolved that the Central East LHIN Board of Directors approve that The Scarborough Hospital receive a funding allocation of $154,600 in both the FY and for the Central East Project Management Office. Ms. Risk By Mr. Powers Be it resolved that the Central East LHIN Board of Directors approve that Community Care Durham receive a funding allocation of $317,383 in the FY for additional community services in support of the Home First philosophy. 11

12 By Ms. Risk Be it resolved that the Central East LHIN Board of Directors approve that Ontario Shores Centre for Mental Health Sciences receive a funding allocation of $64,500 in the FY in support of the Central East LHIN Mental Health Bed Registry. 5.7 CENTRAL EAST LHIN BOARD BALANCED SCORECARD Ms. Marilee Suter, Decision Support Lead presented on the Health Service and System Integration quadrant, there two domains (access and integration) and there are a total of 14 indicators under this quadrant which are compared against provincial targets, Central East LHIN targets (FY13/14) and current performance. The current status, trend direction and percentage of change were reviewed for each indicator. Ms. Suter reported that we are currently meeting 12 out of 14 indicators with the exception of the indicator for the 90 th Percentile Wait Time from Hospital Discharge to Service Initiation and Hospital Discharge and Percentage (%) Alternative Level of Care days. Initiatives that are aimed at decreasing the Emergency Department Length of Stay (ED-LOS) and maximizing Patient Satisfaction include Home First, Health Links and Resource Matching and Referral. A report back on the other LHINs will be presented at a future meeting along with the Ministry- LHIN Performance Agreement (MLPA) dashboard, Central East LHIN remains in the top quartile of LHINs. Strategic Aims Ms. Suter provided a final report on the Strategic Aims of the Integrated Health Service Plan ( ). The projections included FY 2013/14 as it was determined that activities initiated would have a lag effect in the years to follow based on the work completed. A significant growth in Emergency Department visits was noted and the number of hours spent in the Emergency Department was drastically reduced despite this challenge. Aim: Save 1,000,000 hours of time spent in the Emergency Department (ED) by Result: 542,990 hours as of April 2013 (866,721 hours by April 2014) Aim: Reduce the impact of Vascular Disease by 10% in the Central East LHIN by Target: 10,000 Days by 2014 Result: 37,870 days as of April

13 Staff were commended for their work in achieving progress on the aims and encouraged to move ahead with initiatives in the IHSP in pursuit of reaching the four new aims on seniors, mental health, vascular and palliative care. 5.8 CEO REPORT Q & A Ms. Hammons presented the CEO report for review and questions. raised a question in relation to correspondence received regarding surgical wait times. The common theme in the correspondence was that The Scarborough Hospital s joint replacement volumes were significantly reduced because of a lack of funding and that individuals were waiting for service for longer periods of time. Staff reported that in FY 2012/13, Quality-Based Procedures (QBPs) were implemented in hips, knees and cataract surgeries. A group of clinical and financial leaders from all hospitals met in 2012 to determine any issues related to shifts in the volumes of service. Responses have directed correspondents to the provincial wait times website and encouraged ongoing discussion with their primary care provider if an earlier date for surgery is preferred. To address the concerns regarding reductions in volume, the Central East LHIN was able to pull the data from the Surgical Utilization Booking Management Information Tool (SUBMIT). Communication from the CEO of The Scarborough Hospital (TSH) to patients indicated that there are other surgeons at The Scarborough Hospital to have the service done much quicker. Compared to other LHINs, we are the fourth best in the province and Scarborough is the best performing area. We have advocated with the Ministry for additional service volumes. Staff will request that TSH report back on how the wait list will be managed. By Be it resolved that the Central East LHIN Board receive the September 18, 2013 report of the Central East LHIN CEO for information. Mr. Sudbury 5.9 CHAIR REPORT Q & A Mr. Gladstone tabled the Chair s report for questions and discussion. Mr. Gladstone commented on his recent attendance at the HF Nurse Practitioner-Led Clinic, the Minister commended the LHIN for their hard work. 13

14 By Mr. Powers Be it resolved that the Central East LHIN Board receive the September 18, 2013 report of the Central East LHIN Chair for information OTHER NEW BUSINESS There were no items of other new business raised. 6.0 CLOSED SESSION By Mr. Powers Be it resolved that the Board of Directors move into closed session, pursuant to Section 9, subsection 5 of the Local Health System Integration Act (LHSIA) to: consider a matter that would prejudice legal proceedings consider a matter that concerns personnel consider a matter concerning personal or public interest And that Deborah Hammons, James Meloche, Paul Barker, Sheila Rogoski, Jennifer Persaud, Katie Cronin-Wood and Karen O Brien join the Board in the closed session. Ms. Risk 12.1 REPORT ON CLOSED SESSION Upon reconvening to the open session, Mr. Gladstone reported that during the in-camera session the Board discussed details pertaining to personnel and matters that could prejudice legal proceedings. By Mr. Sudbury Be it resolved that the Chair s report of the September 18, 2013 closed session be received and approved, and further that there will be follow up on the actions discussed. Mr. Powers 14

15 12.2 MOTION OF TERMINATION By Ms. Risk Be it resolved that the September 18, 2013 Central East LHIN Board meeting be adjourned. Mr. Wayne Gladstone 15