LHIN Priority Projects & Aging at Home Strategy

Kate ReedSenior Integration Consultant

May 2008

Agenda• Central East LHIN Overview

• Community Engagement: What We have Done

• The Integrated Health Service Plan (IHSP)

• Aging at Home Strategy

• How to Get Involved

LHIN Overview

Ontario’s LHINs manage approx $21 Billion in Health Care Expenditures

LHIN

• Public and Private Hospitals• Long-Term Care Homes• CCAC• Community Mental Health and

Addictions• Community Health Centres• Community Support Service

Agencies e.g. Meals on Wheels

LHIN

• Public and Private Hospitals• Long-Term Care Homes• CCAC• Community Mental Health and

Addictions• Community Health Centres• Community Support Service

Agencies e.g. Meals on Wheels

Provincial:

• OHIP & Doctors• Family Health Teams • Other Practitioners• Provincial Drug Programs• Trillium GoL / organ donations• Ontario Drug Benefit• Public Health• Private Labs• Ambulance Services • Independent Health Facilities• Provincial Networks / Programs

Provincial:

• OHIP & Doctors• Family Health Teams • Other Practitioners• Provincial Drug Programs• Trillium GoL / organ donations• Ontario Drug Benefit• Public Health• Private Labs• Ambulance Services • Independent Health Facilities• Provincial Networks / Programs

What Do LHINs Do?

Patient Centred Integration &

Service Coordination

Community Engagement

Local HealthSystemPlanning

Funding & Allocation

Accountability& Performance

Monitoring

Who is the Central East LHIN?

The LHIN Organization• A Board of 9 and staff of

20!

The LHIN:• The community of over 180

health service providers, patients, residents & stakeholders in the region.

Where is the Central East LHIN?• Vast Geography

• Large Population – Nearly 1.5 million people

• Current Spending – Over $1.7 Billion

• Broad Diversity – Language– Culture– Geography

$1.7 billion in healthcare spending (excluding physician

payments, drug benefits, public health)

Figure 1: 2007/2008 selected LHIN health care expenditures

65%19%

5%11%

Hospitals $1,096,741,000

Long-Term Care Homes $330,487,202

CCAC $181,221,610

CTCs & Other Community Programs $92,025,660

• 9 Hospitals + 1 specialty mental health hospital

• 1 Cancer Centre• 68 Long-Term Care Homes• 1 Community Care Access Centre• 25 Mental Health Services• 8 Community Health Centres• 48 Community Support Services• 6 Substance Abuse Programs• 17 Supportive Housing Services

A snapshot of Central East LHIN funding

• Health system experienced as a coordinated system: People will get the right treatment at the right time by the right provider

• Seamless flow of information that supports patient care

• A system that begins with primary care providers with an equal focus on prevention and health maintenance

• Create timely access to quality services by aligning people, processes and resources

• Elimination of wasteful and time consuming duplication

• Involvement of patients, residents, family and informal caregivers

Integration: In simple language…

How Do We Do It?

Transformation of our health care system cannot be achieved through a singular

focus on “structure” or hierarchic

“control”

Success depends on our ability to engage new relationships

and models of thinking, as well as our ability to build, leverage

and align local capacity for planning, engagement and

service coordination in local health communities.

Control Partnership

Funding and Accountability• People have the right to expect accountability from their

governments– To that end, Central East LHIN has entered into an

accountability agreement with MoHLTC. That sets out the mutual understandings and performance obligations of both parties in the period from April 1, 2007 to March 31, 2010

• The public also have the right to expect that their health service providers will be accountable for the quality of services they provide– To that end, part of CE LHIN mandate is to negotiate

Service Accountability Agreements (SAAs) with health service providers

Priority Setting and Decision Making in the CE LHIN

Establishes the long-term goal of the CE LHIN Organization

Sets overall strategic directions for the CE LHIN organization

and the entire Central East LHIN

Sets health system priorities for change, common enablers,

objectives, action planning and performance monitoring

framework

Includes CE LHIN planning partnerships,

decision making tools, and expectations for

planning and integration proposals

Project Management Methodology and

Health Service Improvement Pre-Proposal (HSIP)

Vision

Strategic Directions

Integrated HealthService Plan

Framework for Community Engagement & Local Health

Planning

Business Solutions

Community Engagement

Engagement: What We Have done

Priority Networks– Mental Health and Addictions – Seamless Care for Seniors– Chronic Disease Prevention and

Management

Enabler Task Groups– Primary Care Working Group– Emergency Department Task Group– Rehabilitation Task Group– Alternate Level of Care Task Group– EHealth Steering Committee

Engagement: What We Have Done

9 Planning Areas, each with its own local advisory

teams or Collaboratives

Peterborough Collaborative(County and City) Membership includes:

Community Services / Hospital Services / Physician / Citizens

The Integrated Health Service Plan (IHSP)

The Integrated Health Service Plan (IHSP)

• Provides a snapshot of the CE LHIN region population profile, including health status & access to health services

• Sets out health care Priorities for Change as identified through extensive community engagement and analysis.

• Establishes short and long term goals for the local health system.

The Integrated Health Service Plan:Creating Alignment ofHealth Care Strategy, Innovation and Resources to Improve Quality and Access

Our First Priority Projects

Our First Priority ProjectsSeamless Care for Seniors• Geriatric Emergency Management (GEM)• Supportive Housing • Community Support Services Review• Caregiver Supports and Well Being• Rural Transportation • Home at Last (HAL)

Mental Health and Addictions• Early Intervention for Youth Strategy with

Mental Health and/or Addiction Needs• Addictions Environmental Scan • Disordered Eating

Chronic Disease Prevention and Management

• Stroke System for Central East • Chronic Kidney Disease and End Stage

Renal Disease System • Self Management Training for

Consumers/Caregivers • Diabetes Clinical Practices Rollout

Primary Care• Timely Discharge Information System

Demonstration Project

Other• Culture, Diversity and Equity • Rehabilitation • Project Management Office • Hospital Clinical Services Planning

Project Management:Disciplined and EffectivePlanning

Aging at Home Strategy

Provincial AAH Strategy: Recap

$702M over 3 years to be invested in communityservices to enable seniors to age at home with dignityand independence.

• First-Year Planning for LHINs $3,000,000• Assistive Devices Program Funding $40,000,000• Provincial Priorities

$66,000,000• Allocations to LHINs

$593,000,000

Process: Values and Objectives Respect the extensive, inclusive community

engagement that is a cornerstone of the LHIN.

Respect that the LHIN is moving forward with implementation of its IHSP, having already established Seamless Care for Seniors as a priority.

Recognize the opportunity that the funding represents in moving forward a number of specific priority projects embedded in the IHSP as well as providing some impetus to system change.

Community Support Services: Year 1CHARTERS & RELATED PROJECTS

3 Charters & Related Projects

$200,000

EMERGENCY RESPONSE SYSTEMS:

1 Initiative - Haliburton

$10,900

HOME AT LAST:

1 LHIN-wide initiative with several locations

$501,642

SENSORY (hearing and vision):

2 Initiatives

$201,200

TRANSPORTATION:

3 Initiatives - Haliburton, Durham, Scarborough

$92,700

COMMUNITY PALLIATIVE CARE:

1 Initiative – Scarborough

$250,000

MEAL ON WHEELS; WHEELS TO MEALS:

6 Initiatives - Haliburton, Durham, Scarborough

$162,700

HEALTH PROMOTION (WELLNESS) EDUCATION:

2 Initiatives – Scarborough, Peterborough

$120,000

DEMENTIA: First Link

1 Initiative - LHIN-wide

$205,000

Base = $986,342

One-Time = $757,800

CSS Total = $1,744,142

Caregiver Support and Well Being: Year 1

CHARTERS

1 Charter-

$100,000

IN-HOME RESPITE:

5 Initiatives – several LHIN zones

$299,200

ADULT DAY PROGRAM:

9 Initiatives – several LHIN zones

$585,275

EDUCATION & TRAINING:

1 Initiative - Scarborough

$100,000

Base = $731,975

One-Time = $352,500

CS Total = $1,084,475

Supportive Housing: Year 1

CHARTER

1 Charter –

$100,000

SUPPORTIVE HOUSING:

5 Initiatives – well spread across the LHIN

$1,915,450

Base = $1,815,000

One-Time = $200,450

SH Total = $2,015,450

Aging at Home: Next Steps

• Process Year 1 allocations: May – June 08

• Design Year 2 process: May – June 08

– Specialized Geriatric Services

– Falls Prevention

• Draft Year 2 Recommendations – Sept. 08

• Finalize for LHIN Board – October 08

How Can You Get Involved?• Join the Seamless Care for Seniors Network and attend

our June Symposium – be a part of the solution building.• Nominate a member of the Regional Family Council to

be a member of the Caregiver Support and Well Being Project Team.

• Help facilitate the coming together of leadership of LTC Homes in the LHIN.

• Let Kate know if there is any interest in being involved in Specialized Geriatric Services and Falls Prevention work.

• www.centraleastlhin.on.ca – My Page