The following are the highlights of the Champlain Local Health Integration Network Board of Directors meetings held in Ottawa, Ontario on March 22 and March 28, 2017.
Home and Community Care
In December 2016, the Ontario Legislature passed the Patients First Act, 2016. The Act focuses on a number of health system transformation efforts, including merging Local Health Integration Networks (LHINs) with Community Care Access Centres (CCACs).
In anticipation of the upcoming transition, Champlain CCAC CEO Marc Sougavinski presented to LHIN Board members on the current status of community and home care in the region, and shared his recommendations for the future. He described specific issues that will require attention in the coming months, such as accurately predicting client demand over time, implementing Ontario’s Special Needs Strategy, facilitating self-directed care, and providing uniform levels of care across the region.
“Home care for complex patients — that is the way of the future,” stressed Mr. Sougavinski, adding the delivery of services in a multi-team approach is also crucial. In fact, the Champlain CCAC’s Action Plan and Quality Improvement Plan include a number of initiatives to support patients with increasingly high-needs at home.
In addition, Mr. Sougavinski said the Champlain LHIN and Champlain CCAC have always enjoyed a close working relationship, which has helped to prepare for a stable transition, and will assure the continuity of quality services following the amalgamation. “We are very lucky in this region. We have a very good LHIN and CCAC, and it is no wonder this transition is happening as smoothly as can be expected,” he concluded.
Champlain CCAC Board Chair, Dr. Denise Alcock,
presents the Champlain CCAC’s Transition Booklet
to Board Chair, Jean-Pierre Boisclair.
Next, Dr. Denise Alcock (Champlain CCAC Board Chair), presented a handbook to the LHIN Board that will serve as a resource on governance issues. The document includes tools to assist in the oversight and decision-making of the Champlain LHIN Board in its new responsibilities.
Dr. Alcock also emphasized the value of client stories and the CCAC’s Patient and Caregiver Council, which have helped to keep the Board grounded in its work by better understanding the challenges and service gaps through people’s experiences.
The Champlain LHIN Board passed a resolution to acknowledge and appreciate the support, goodwill and quality of work by the Board, leadership and staff at the Champlain CCAC in the transition process, as well as their contribution to date to the successful implementation of the Patients First Act, 2016. “I haven’t, in my career, seen a more exemplary situation in how to move forward in the right way,” said Champlain LHIN Board Chair Jean-Pierre Boisclair.
Patients First Act, 2016 Implementation
Chantale LeClerc (CEO), Jean-Pierre Boisclair (Board Chair)
and Board Members after signing the Declaration of Readiness
To ensure responsible oversight and due diligence, the Champlain LHIN Board of Directors identified 10 questions that would need to be fully answered to determine that the organization would be ready to assume the roles, responsibilities and functions of the Champlain CCAC, and fulfill its expanded mandate under the Patients First Act, 2016.
Topics included organizational and governance capacity, harmonized policies and procedures, sub-region development, and assured continuity of LHIN and CCAC business.
Champlain LHIN CEO Chantale LeClerc discussed each question in detail, affirming that all are being appropriately addressed. For example, the organizational structure of the new LHIN preserves the knowledge and skill sets of the two organizations to support smooth continuity of services. This is echoed in LHIN governance, which is comprised of varied experiences and skill sets, including four members with a clinical background and two former board members of the CCAC.
Following this discussion, LHIN Board members were satisfied that the Champlain LHIN is ready for the merger with the Champlain CCAC, which will occur after the Minister of Health and Long-Term Care's Order for Health System Integration.
2017-18 Annual Business Plan
The Champlain LHIN prepares an Annual Business Plan (Plan) to outline the resources and initiatives in the coming year to achieve its strategic priorities.
The Plan aligns with the Champlain LHIN’s Integrated Health Service Plan 2016-19, and the priorities of the Ministry of Health and Long-Term Care, including the Patient’s First Action Plan. It also advances the LHIN’s strategic directions of integration, access and sustainability.
Forty-three initiatives are included in the 2017-18 Annual Business Plan. As the LHIN is in the second year of its three-year strategic plan, many of the initiatives from the previous year will continue into the 2017-18 fiscal year. For example, the LHIN will
- Continue to implement its sub-acute capacity plan for patients requiring rehabilitation or complex continuing care
- Significantly grow the 10 existing Health Links for those that require highly coordinated care for their complex conditions
- Sustain its efforts to reduce wait times for MRI and CT scans, and
- Develop Indigenous wellness centres.
New interventions include developing a lung health strategy and addressing the needs of people with acquired brain injuries who require community-based rehabilitation services.
The Board passed a resolution to approve the draft 2017-18 Annual Business Plan. It will be submitted to the Ministry of Health and Long-Term Care for review and return to the Board for final approval.
2017-18 Service Accountability Agreements
Every year, the Champlain LHIN works with each heath service provider to finalize a service accountability agreement. The agreements, to be in effect April 1, 2017, set the obligations and requirements between the LHIN and its funded providers. Agreements align with the strategic directions and performance expectations of the LHIN to support an accountable health system.
Elizabeth Woodbury (Champlain LHIN Director of Health System Accountability) presented an update on the status of the agreements. She explained that the Champlain LHIN has negotiated extended and amended accountability agreements in the long-term care, community and hospital sectors. In some cases, unique obligations were included for specific providers to drive various health system improvements.
The majority of the agreements have been finalized. In the long-term care sector, all agreements have been completed. In the community health sectors, 94 of 96 agreements are completed; the remaining 2 require a short extension for further review.
Lastly, in the hospital sector, 16 of 20 agreements are near to completion. The other four hospitals require short-term extensions for further review and negotiation. Of those four, two were discussed by Board members in detail. Specifically, for one hospital anticipating a deficit in the coming year, the Board approved a motion to execute its agreement on condition that the hospital provide a strategy by June 2017 to achieve a balanced operating budget. The Board passed a second motion for another hospital to submit a plan by mid-May 2017, providing greater detail about mitigation strategies to manage risk.
Auditor General 2015 Report
In 2015, the Office of the Auditor General of Ontario conducted a review of four LHINs in the province. The findings of this review produced 20 recommendations which are included in the Auditor General’s 2015 Annual Report. Nine recommendations that related to quality improvement, patient satisfaction and performance measures were directed to the LHINs, and the remaining recommendations were addressed to the Ministry of Health and Long-term Care.
In response to this report, the LHINs developed a checklist of actions that address each recommendation. Eric Partington (Champlain LHIN Senior Director, Health System Performance) reported that the Champlain LHIN has already implemented a majority of actions. Initiatives are underway to address the few that remain. For example, the LHIN is working with Health Quality Ontario to improve patient care through the use of Quality Improvement Plans by provider agencies.
In the same year, the Auditor General’s Office also conducted two reviews of Community Care Access Centres. Deryl Rasquinha (Vice President, Performance and Strategy, Champlain CCAC) presented the efforts undertaken by the Champlain CCAC to address these recommendations. He reported that over 50 per cent of the recommendations have been fully implemented and work is in progress by the Champlain CCAC and the Ministry of Health and Long-Term Care to address the remaining actions.
The Board advised that it will continue to monitor the LHIN’s efforts to action the Auditor General of Ontario’s recommendations.