3RD REPORT OF THE

COMMUNITY ADVISORY COMMITTEE ON DEARNESS SERVICES

Meeting held on June 8, 2006, commencing at 4:OO p.m.

PRESENT: M. Ellington (Chair), F. Bright, W. Chmiel, V. Fitchett, B. Loveless, S. Turner, and S. Vendel and H. Lysynski (Secretary).

ALSO PRESENT: R. L. Fair, B. Hines, J. Hignett, A. Morrisson, L. Adamson L. Bishop, M. J. MacDougall and J. Rymal.

REGRETS: E. McNicol, M. Richards, and G. Williams.

I YOUR COMMITTEE RECOMMENDS:

Appointment 1, to the CACDS

That an exemption to the Council policy requiring that appointees to Advisory Committees of the Municipal Council must be a resident of the City of London BE GRANTED to enable the Nominating Committee to bring forward a recommendation for the appointment of Ms. Dorothy Worrall to the Community Advisory Committee on Dearness Services for the term ending November 30, 2006; it being noted such an exemption is warranted as Ms. Worrall has a long- standing relationship with the Dearness Home, both as a volunteer and as the daughter of two of the Dearness Home’s current residents; it being pointed out that the appointment of Ms. D. Worrell was unanimously supported by the CACDS.

of D. Worrell

I1 YOUR COMMITTEE REPORTS:

Local Health 2, That the Community Advisory Committee on Dearness Services (CACDS) heard the attached presentation from J. McEwen with respect to the Local Health Integration Network (LHIN). The CACDS was advised of the following: .

integration Network

the LHIN is not a hierarchy, everyone one is at the same level;

performance agreement or an accountability agreement; there will be 14 LHINs, with the composition of its Board to be 9 members; the remaining 3 members will be hired in June; Family Health Teams are not under its purview; the Southwestern Ontario LHlN is the third largest in the Province; when the LHlN was established 16 hospitals had deficits; now there are 3 hospitals with deficits; the LHlNs are in the process of developing an Integrated Health Services Plan; the LHlNs are not part of a bureaucratic system the Ministry of Health offices are being downsized and will be disbanded by the end of March, 2007.

. the LHlN requires the organizations that it works with to sign either a . . . . . . . . Tour of 3.

Room and Viewingofa

That the Community Advisory Committee on Dearness Services (CACDS) was provided with a tour of the Snoezelen Room and the operation of a ceiling lift by L. Adamson, Manager, Dearness, Community and Program Services.

The CACDS was advised of the following with respect to the ceiling lift:

. . .

Snoezelen

Ceiling Lift

there are 11 ceiling lifts per Unit; it is mandatory to have two staff per resident when operating the ceiling lift; the resident is measured to ensure the proper size of sling is used; and . the Staff is being trained on the proper use of the lift.

The CACDS was advised of the following with respect to the Snoezelen Room: . . the Snoezelen Room is a multi-sensory experience; the Room is currently being used by the Day Program, but more programs are being added;

CACDS - 2

Review of CACOS Mandate

Future Administration Reports to CACOS

Quallty Report - First Quarter Results

201h Annual Refresher Day in Geriatric Medicine

0 if a resident is agitated, they are able to use the Snoezelen Room and the Staff will use the facilities in the room to assist in calming the resident; if a resident needs to be uplifted, the Staff is also able to assist in making the resident feel better; the room has been designed to stimulate all of the senses; and most residents are accompanied by a Staff member in the room, the largest ratio would be three residents to one Staff member.

4. (2) That the Community Advisory Committee on Dearness Services (CACDS) received a Municipal Council resolution adopted on May 15, 2006 with respect to the request of the CACDS to review its mandate. The CACDS was advised that the Dearness Services Staff will provide the CACDS with a draft report at its next meeting with respect to its Mandate.

5. (3) That the Community Advisory Committee on Dearness Services (CACDS) received a Municipal Council resolution adopted on May 15, 2006 with respect to future Dearness Home Administration reports to the CACDS. The CACDS was advised that the Dearness Services Staff will provide the CACDS with a draft report at its next meeting with respect to the format of its future reports.

6. (5) That the Community Advisory Committee on Dearness Services (CACDS) received the Quality Report, First Quarter Results dated March 31, 2006 from 8. Hines, Acting Director, Long-Term Care Division. The CACDS discussed the “Day Program Utilization” section of the Report and was advised that transportation is of the utmost concern to Day Care Programs in the City.

7. (7) That the Community Advisory Committee on Dearness Services (CACDS) heard verbal updates from V. Fitchett and S. Vendel with respect to the 20th Annual Refresher Day in Geriatric Medicine, “Quality Care in Later Life: Realistic Approaches”.

The CACDS was advised of the following by V. Fitchett:

HosDice Program

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. 0

the presenter discussed the journey from the stage of diagnosis to the time of passing and how the client and the person assisting them navigate through the journey; it was emphasized that it is the client‘s decision whether or not to take treatment and how they wished to deal with the later stages of the disease; and

has Power of Attorney needs to be aware of what the client‘s wishes are. . it was indicated that if the client can not make the decision, the person that

Best Practices Guideline Session

the guidelines are impressive.

Medication for Geriatric Patients

a series of resources have been assembled to ensure ease of access to the information; and

. the updated medication information was impressive and a copy of the information was provided to J. Rymal, Manager 111, Nursing Services.

The CACDS was advised of the following by S. Vendel:

Palliative Care . the presenter provided the following advice:

o you are providing many different services to the people that require your services, (eg. if you are bathing a person, you are providing a service; if you are helping them with a problem, you

CACDS - 3

Appointment to the LNPLTCFC

Thank You to J. Hlgnett & M. J. MacDougall

Future Dearness Home Administrator

Assistant Manager of Nursing Position

2nd Report of the CACDS

Amendment to Clause 4 of the 2nd Report of the CACDS

Advisory Committee Reporting

Next Meeting

are acting as a mediator; if they require someone to listen to, you are providing them with a friend); listen well, be a good companion, walk beside the person, not in front of them or behind them, don’t lead the person; and there are 7 motifs of dying, either people fight the motifs, or they accept them, and you must be mindful of how you fulfill that person’s needs.

o

o

Delirium

0

0

0

delirium needs to be diagnosed and dealt with quickly; a Genesis protocol has been established to assist with dealing with the disease quickly; and it is recommended that instead of giving the client a sleeping pill, give them warm milk, herbal tea or a back rub to get them to sleep.

8. (8) That the Community Advisory Committee on Dearness Services (CACDS) appointed W. Chmiel as its representative to the London Non-Profit Long-Term Care Facilities Council: it being noted that the next meeting will be held on September 5,2006 at 1O:OO a.m. at the Dearness Home.

9. That the Community Advisory Committee on Dearness Services (CACDS) wholeheartedly thanked J. Hignett, Administrator, Dearness Services, and M. J. MacDougall, Manager 111, Resident Care, for their years of exceptional service to the residents of the Dearness Home.

IO. That the Community Advisory Committee on Dearness Services (CACDS) welcomed A. Morrisson as the new Dearness Home Administrator effective August 1, 2006.

11. That the Community Advisory Committee on Dearness Services (CACDS) was advised by the Dearness Home Staff that the new Assistant Manager of Nursing position; it being noted that:

0 J. Rymal, Manager 111, Nursing Services, and another person to be hired, will be assuming these duties;

to 3:OO p.m.;

Nurses in the Units:

Management will be available 16 hours of the day.

. the need is not sufficient to have two people during the hours of 7:OO a.m.

this position assists the Registered Nurses and the Registered Practical

the hours have not been determined at this time; and

.

. 0

12. (CACDS) received and noted the following:

(a) 2006;

(b) respect to an amendment to clause 4 of the 2nd Report of the CACDS; and

That the Community Advisory Committee on Dearness Services

(1) the 2nd Report of the CACDS from its meeting held on April 12,

(4) a Municipal Council resolution adopted on May 15, 2006 with

(c) respect to Advisory Committee reporting.

13. hold its next meeting on September 14, 2006.

(6) a communication dated May 3, 2006 from the City Clerk with

That the Community Advlsory Committee on Dearness Services will

The meeting adjourned at 6:45 p.m.

South West Local Health Integration Network(LH I N)

I South We51 Local Health Integration Network

The Vision

I A health care svstem that he lm

1

Soulh West Local Health Integration Network

The Principles

I * Patientfocus * Transparency I I - Strategic partnership Fostering change through incentives I - Stakeholder engagement

- Evidence-based approach * Provider boards

* Partnership of equals

South Wedl Local Health Integration Network

The Responsibilities The following health service providers will be accountable to the LHlN and receive funding through the LHlN from April 2007:

Public and private hospitals * Community Care Access Centres (CCACs) * Community support service organizations (e.g.,

personal assistance services, homemaking, friendly visiting) Community mental health and addiction agencies CommJnity Health Centre

2

Soulh WeatLocal Health lntegratlon Nehuork

The LHlN is not responsible for:

* Physicians 0 Public Health - Ambulance Services (emergency and non-emergency)

6 Laboratories * Provincial drug programs

Soulh Weal Local Health Integntlon Nshvork

Achieving an Integrated System

.- . ' . ... Integration outcomes: * Seamless experience for user,

where boundaries between oroanizations minimized

COMMUNITY ' ., I m, , ENGAGEMET p,,, .,... ! ! /! >, -

* Improved match between single

needs of clients, patients and services provided and the multiple

families

* Effective and efficient use o f system resources and capacity

LTH

3

South West Local Health Intagration Network

South West Profile

I South West Local Health In tspt lon Netwan

Characteristics of the South West LHlN One of the largest LHlNs in Ontario - Home to 920,000 people, or 7.5% of the population of Ontario

* A significant rural population with many small communities scattered throughout the geographic area of the LHlN

* A large urban population within the City of London Greater proportion of seniors and a much smaller proportion of immigrants

* 5 First Nations reserves - French LangLage Services d

4

...,. ~, . .. ..I "...I ).

Soulh West Local Health Integration Netwoh

South West LHlN Service Providers

20 hospitals (2 teaching hospitals, 7 community hospitals, 10 small hospitals and 1 private hospital) 6 Community Care Access Centres

28 Mental Health Agencies 14 Addictions Agencies 2 Community Health Centres (3 in development)

- 65 Community Support Services

Soulh Weal Local Health integration Network

South West LHlN Partners

15 Family Health Teams

Patients and Families

6 Public Health Units

- Health Professionals

- Municipalities

I

5

South West Local Health Integration Network

Southwest LHlN Funding 2005/06

Total Funding $1,591 M

CommunivHaslth Centres -$SM

0.3%

I LmB-TBTm care Facilities -$226M 7

Community Engagement

Three Geographic Areas:

* To enable broad based engagement To leverage the tremendous work that has already occurred To effectively engage local consumers and providers - To understand the local

South West Local Health Integration Network

NORTH

Bruce county, Grey County.

CENTRAL Huron County, Penh County

Clty of London, Mlddlesex, Oxford, Elgln,

&Norfolk' Counties

. MuniUpaiily is pa&m iocsred wirhin soutb wesr LHIN

needs and differe

6

South West Local Health lntegratim Nshuork

Community Engagement Our Approach:

I .NFORM& CONSULT $, EDUCATE <

Savh West Local Health lntsgration Network , . , .

I_

Community Engagement

Methods to Involve Our Partners: I :y * Website

* Partner forums and workshops - Advisory and reference groups - Open houses * Focused discussion groups and

interviews * Newsletters - Written submissions - Regular Meetings with Our Partne

Web Survey

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South West Lacs1 Heallh Integration NehvoN

Our First Integrated Health Service Plan (IHSP)

A foundational plan with the opportunity to fine tune our directions and strategies annually

* 3-year view planning for 2007-2010 .

-\-:-.. - Aligns with provincial priorities as we‘ll . ,. :,.*-. our unique local integration prioritie&e$:.. and initiatives “W ,C +4

-.

. . . .<:,

- The plan will inform the MOHLTC ..,*

* The plan will fundamentally guide our “4”

Strategic Plan 36’

South West Local Health Integration Nelwork

Developing the Draft IHSP

The Strategic Advisory Group is cross-sectoral and created to support the development of the IHSP MAY JUN JUL

t f t t * Finalize the Evaluate Provide input on tST Drafl lHSP

Decision Making Integration Action Planning Endorsed by Criteria Opportunities for integration South West

Priorities and LWlN Board Performance

Indicators

Strategic Advisory Group c

8

.. . ,., . . . ,, .. .. . ...

Soulh Was1 Lacs1 Health Intagration Network

Delivering t he Final IHSP JULY AUG SEP OCT

Final IHSP lsT Drafl IHSP Endorsed by Workshops across the Endorsed by

South West LHlN Board LHlN Board

' t .

South West South West LHIN --\I\

Targeted consultations with

> Online tools to review & respond to draft IHSP

Souih West Local Health InlegratIan NetwolX

Thank you

9

South West LOCAL HEALTH INTEGRATION NETWORK

LAST SURIIMER WE WERE PRIVILEGED

to be chosen to lead the South West Local Health Integration Network, one of the fourteen LHlNs established across Ontario. Since that t ime we have had the opportunity to meet with many individuals, community groups, health care providers and organizations as we set out to better understand the health care challenges facing our community.

This year much has happened. We’ve moved into our office at 201 Queens Avenue, Suite 700, in London. Also Bill 36, the Local Health Integration Act 2006, was passed by the Ontario legisla ture and received royal assent, giving the South West LHlN the mandate to plan, integrate and, in the future, fund local health services. During this time w e have continued to build partner- ships wi th health care providers throughout the LHlN communities.

We have been thoroughly impressed with the ability of all providers across our community to deliver health care to nearly 1 million people. And their commitment to working with us on the transformation agenda has been extremely encouraging. At the recent Celebrating innovations in Healfh Gale Expo inToronto, there were many excel- lent presentations by organizations and groups from across our LHIN, which

reflects a strong commitment to innova- tion, collaboration and partnership that we have seen on an on-going basis.

Now our collective task is to ensure this innovation and excellence continues to be the basis for the advancement and delivery of health care, so that people‘s needs are SeNed effectively, efficiently and compassionately.

(See lntegration at work page 3)

We believe that the success of the LHlN depends on our abil ityto share ideas and points of view.This newsletter i s one way in which we will create and maintain an exchange between users of the health care system and providers, and we are delighted with this opportu- nity to update you on our progress.

This first issue of South West LHlN Exchange includes updates on our planned Community Engagement Framework and the development of our first Integrated Health Services Plan, as well as introductions to the members of the Board of Directors of the South West LHIN.

Building strong and collaborative relationships with our health care providers and members of the public is the cornerstone of our community engagement and integration strategy.

We would like t o thank al l the resi- dents and members of the South West health communities for your courtesy, encouragement and advice and we look forward to working with you as we build the integrated health care system we all want to see.

We welcome your questions and suggestions. Please feel free to contact us at 1-866-294-5446 or 519-672-0445.

Norm Gamble [I.) Chair, South West LHlN

Tony Woolgar IR) CEO, SouthWest LHIN

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The South West l..lilN Cainniunity Engagement Framewarlc

By Kelly Glllls, Senior Director, Planning. Integration &Community Engagement

COMRRUNITV E N G A G E M E N T is the term used to describe the process ofworking coliaboratively with communities to achieve common goals.These "communities" may share similar expertise. concerns, interests and characteristics, or they may live in the same area.The fourteen LHlNS in Ontario wil l use the community engage- ment process to connect with individuals and organizations in their areas to identify health care needs and priorities and to develop action plans to meet those needs.

In our area, we will work with our partners -community members, health profes- sionals, provider organizations and others - t o understand and respond to the specific concerns and issues people have about their health services and to find innovative ways to improve access and quality in ail areas, f rom prevention and diagnosis to treatment and care.

We are committed t o ongoing and meaningful conversations with our partners and to a collaborative decision making process.The success of the South West LHIN in meeting the needs of our community is rooted in a partnership approach to the planning and the development of our integrated system.

THE GOALS O F ' I N E S O U T H WEST LHIRI C O M M U N I T Y E N G A G E M E N T F R A M E W O R K

AttE TO:

Focus on the people who use health care -We will work in partnership wi th health care providers to build a system that places the consumer at the centre and engage with those that are the most knowledgeable about their needs, their experience and their satisfaction wi th health care services.

0 Enhance local accountability- We will enhance accountability by providing opportunities for direct input by our partners into the planning and decision making process and fostering a sense of mutual responsibility for achieving goals.

0 Balance priorities -We will work to ensure that the full diversity of voices in the community are heard and to build a shared sense of responsibility for achieving balance among competing priorities.

0 Develop system capacity and sustainability - We will draw on the knowledge and capacity of our partners to identify needs and help develop sustainable, long-term local solutions.

TIiE SPECIFIC OnJECTIVES OF OUR C O M M U N I T Y ENGAGEMENT FRAMEWORK ARE TO:

* Provide communities and providers wi th balanced and objective information to promote an understanding of the South West LHlN mandate and the responsibil- ities and expectations of al l partners;

Obtain feedback and recommendations on community needs, service gaps and opportunities for service coordination and integration;

@ Work directly wi th our partners to ensure that all Community concerns are understood and considered; and

)* Build and strengthen relationships throughout the South West LHlN to identify and develop integrated service delivery solutions.

The next few months wili be a busy time for the South West LHiN. We will be vigor- ously pursuing Community engagement activities in the coming months as we develop our first Integrated Health Services Plan. We look forward to your input and participation in this important LHiN planning process - one that wil l set the course for integrated health care delivery that is focused on the needs of our communities.

WHAT IS A N INTEGRATED HEALTH

SER\/ICES PLAN?

EACI i LI-llhl IS AESPONSlsLE for creating a plan that wil l guide the integration and delivery of health services in i t s region.While the Ministry of Health and Long-Term Care has specified the format and the elements that need to be included in the plan, the specific content is the responsibility of each individual LHlN and their local partners - this is why we are called Local Health Integration Networks. Our Integrated Health Services Plan wil l be based on a solid analysis of our current strengths and chal- lenges and will be shaped through our community engagement activi- ties.The final plan will be shared locally and with the Ministry in the fal l of 2006.

The South West LHlN Integrated Health Services Plan will include an overview and analysis of the current health services within the South West LHIN, an identification of community needs and service gaps, as well as integration priori- ties and specific action plans for our area.The first Integrated Health Services Plan wil l have a three-year time frame and will be revisited and revised annually.Together, the fourteen Individual Integrated Health Services Plans will influence the development of the ten-year Provincial health care system Strategic Plan that will be released by the Ministry in the spring of 2007.

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INTEGRATION AT WORK

There are many successful examples of integrated activities already underway with- in our LHIN, and we are learning how we can work together to build upon them.

0 Patient and public information - In collaboration with local Community Care Access Centres, the health care Web portal www.thehealthiine.ca was expanded t o provide comprehensive information about health care providers and services across our LHIN.

0 Advancing primary care reform - New partnerships and collaboration between health care professionals, community organizations and voluntary organizations resulted in the establishment of five new Family HealthTeams for the South West LHlN in addition to the ten Family HealthTeams already approved.

e Province-wide cancer care strategy - Cancer care provider organizations now work under a common accountability agreement based on cooperation across the South West and Erie-St. Clair LHINs.The South West Regional Cancer Services Alliance Is planning the coordinated delivery of cancer care services t o the residents of both LHINs.

* Crossing organizational boundaries - By taking the step of crossing organi- zational boundaries, the Grey Bruce lntergated Health Care Coalition and Grey Bruce Health Network have committed t o integrating and improving health care services throughout their geographic area.The important issues of continuity of care, chronic-disease management, implementation of end- of-life strategy, acute care service planning and joint education for health care professionals have all been identified as key deliverables for the upcoming year.

0 Using information to support decision making -The South Huron Hospital invited the LHlN to participate in discussions on the development of its information systems to ensure that technology solutions and software applications support the integration of health care delivery across the LHIN.

* E-health strategy-As the South West LHlN begins to develop its approach to service integration and seamless health care delivery, an e-Health Steering Committee has been formed t o define and develop the long-range strategic directions for e-health and shorter-term project deliverables for the South West LHIN.

EXECUTIVE T E A M

Tony Woolgar - CEO, South West LHlN Tony Woolgar spent over 30 years in health care management in the UK, including ten years as a CEO in both academic health sciences cantree and communlty hospltais.Tony has conalderable experience introducing new Integrated health care networks across local communities and for many years was involved in policy development a t the national level in the UK.Tony participated in a number of consulting projects associated with the Ontario government's health reform agenda prior to taking up his position as CEO of the South West LHIN.

S ~ u t h West LHlN Spring Forum:

Laying t&re ~~~~.~~~~~~~~~ far C h i W I ~ ~ ~ ~ ~ On M A Y 12, 2006. the Southwest LHlN is hosting its spring forum, Laying the Foundation for Change.The purpose of this event is to give local health care providers an update on what the LHlN has been doing and to share and get input on our Community Engagement Framework. We will identify and dis- cuss expectations, potential priorities and the process for developing the Integrated Health Services Plan.

We are pleased to announce that The Honourable George Smitherman wil l speak to us at the morning session to set the provincial context for the development of LHlNs and the future of health care in Ontario.

LOCATION:

The London Convention Centre

TIME:

8:30 a.m. t o 430 pm.

For further information, please contact Debbie Deichert at 1-866-294-5446 or 519-672-0445 or by email: debbie.deichert@lhins.on.ca

Kelly Gillis - Senior Director, Planning,. integration and Community Engagement Kelly Gillis has more than ten years of leader- ship experience within the health care emtor focuelng on stratoglc planning and aystom integration within southwestern Ontario. Most recently. Kelly worked for the London Hospitals as Director of Medical Affairs, She has also worked as the systems integra tion leader for the Huron Perth Hospitals Partnership and as a senior health planner with the Huron Perth andThamesValley District Health councils. Prior to joining the District Health Council system. Keiiy worked in the long-term care, mental health and addictions sectors.

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c&6,.tj2 LjjjN Team The Board of Directors and staff of the Southwest LHiN are a dedicated team of people with a broad range of leadership and management experience.There are currently six members on the board; the remaining three members, who will be appointed in the near future, will also be residents of the LHiN area.

Norm Gamble - Chair (Mesfordl Norm Gamble was the Chief Administrative Omcer for the Corporation of the County of Grey from 1990 until 2005. Previously, he held various positions with the Corporation of the City of Cambridge. including Director of Operations, Commissioner of Administrative Services and acting Chief Administrative Officer. Norm has been involved with numerous community organ- 'izations and has served as a board member of the Cambridge FamilyYMCA and the Cambridge and North Dumfries United Way.

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Janet McEwan - Vice-Chair /London) Janet McEwen has been a board member on the Women's Christian Association of London since 1993 and served as board chair from 2002-2004. She is a board member of the St. Leonard's Society of London and was board chair from 1997-2002. Since 1999, Janet has chaired the Dearness Home Redevelopment Committee. She has ais0 held positions as a board member of St. Joseph's Health Care in London and a member of the Salvation Army Advisory Committee.

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Robert Habkirk - Director (Ayirnerl Before his retirement, Bob Habkirk worked as a quality analyst and piant service mainte- nance coordinator for Ford Canada. From 1994-2003 he was mayor of theTown of Ayimer. In this capacity he served on several boards and committees including as chair of Eigin Health System Planning Committee, member of theThamesVaiiey District Health Council and the Hospital Operations Planning Process Review Committee. He previously chaired the Aylmer Community Foundation, the OldTown Hall Restoration Committee and the Ayimer Performing Arts Council.

Dr. Kerry Blagrave - Director llistowel) Kerry Blagrave is a partner and co-owner of the Listowel Veterinary Clinic. He is a past chair of the Ontario Association of Bovine Practitioners and founding chair of the Huron Perth Hospitals Partnership. Kerry was a board member and chair of the Listowel Memorial Hospital before being appointed to the board of the South West LHIN.

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Anne Lake - Director (Fullarton) Anne Lake worked for the Avon Maitland District School Board as a community liaison and information officer. From 1988-1999 she was Executive Director and founder of the Foundation for Enriching Education. She worked in hospitals in Canada and England as a medical laboratory technologist and was Executive Coordinator forTranspiant International Canada. Anne's community voiunteer service and exDerience is extensive.

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JohnVan Bastelaar - Director (Port ElginJ JohnVan Bastelaar worked for Ontario Hydro for 30 years as a Human Resources Officer, Training Supervisor, SafetyTraining Technician and ChemicaiTechnician. He was also a main- tenance and communication specialist at Bruce Power for two years. Now retired, he volunteers with the Grey Bruce Regional Health Board. He was mayor for theTown of Port Elgin for five years. deputy mayor of the amaigamatedTown of Saugeen Shores for one year and a council member for four years with theTown of Port Elgin.

CONTACT f N FORMATION

South West Local Health Integration Network

201 Queens Avenue, Suite 700 London. ON N6A 1J1

Phone: 519-672-0445 Toll Free: 1-866-294-5446 Facsimile: 519-672-6562 Ernail: SOUthweBt~ihinS.On.ca