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CEO REPORT TO THE BOARD Mississauga Halton LHIN

February 2015

2 | P a g e February 2015

The following is a compilation of the major activities/events undertaken during this period in support of the Mississauga Halton LHIN’s Strategic Directions;

Accessible and Sustainable Health Care

Improve access to services to improve consumer flow, quality and safety Support consumers, families and health care professionals to navigate the health care

system Improve sustainability of the health care system

Family Health Care When You Need It

Improve access to family health care Increase linkages between family health care and other health care providers to improve

communication, coordination and integration across the continuum of care

Enhanced Community Capacity

Enable people to stay in their homes longer Provide integrated services that bring care closer to home

Optimal Health – Mental and Physical

Increase healthy habits and prevention of disease Build partnerships for healthy communities

High Quality Person - Centred Care

Support and foster a quality culture across the continuum of care Value people’s experiences to support system improvement Apply a health equity lens for the delivery of health care services

CONTENTS: MINISTRY OF HEALTH AND LONG-TERM CARE UPDATE 3 ANNUAL BUSINESS PLAN PRIORITIES 2013/14 5 Highlights 6 Accessible and Sustainable Health Care 7 Family Health Care When You Need It 12 Enhanced Community Capacity 14 Optimal Health – Mental and Physical 17 High Quality, Person-Centred Care 18 MEASUREMENT AND PERFORMANCE 20 Ministry-LHIN Performance Agreement Targets 20 NOTABLE SECTOR ENGAGEMENT 23 Accountability Agreements 24 COMMUNICATIONS 26

MOHLTC Updates Annual Business Plan Priorities

Measurement and Performance

Notable Sector Engagement Communications


MINISTRY OF HEALTH AND LONG-TERM CARE UPDATES

Mental Health and Addictions Mental Health and Addictions (MH&A) continues to be a major focus for the Ministry of Health. A special advisory panel has been constituted to provide advice to the Government on how to improve MH&A services in the province. An update communications deck is attached to this report (see attachment A) which contains a high level review of the progress to date and near term priorities for the Government. It also lists the members of the Panel. This information was reviewed at the most recent LHIN CEO Council meeting and it was agreed that the LHINs collectively need to determine how to share best practice information for future investments in increased MH&A services. Fiscal Outlook The LHIN CEOs received a briefing from the Ministry on the general fiscal outlook for the province and the impact on the Ministry of Health. Overall, the fiscal picture remains constrained for the next two to three years. The Government is undertaking a full review of all programs and services across all of the Provincial Government. There is a continuing strong commitment to balancing the budget by 2017.

In short this means a continuing commitment to focusing on increased efficiencies as almost all new funding will be directed to new services to meet growth pressures. Deputy Minister Bob Bell Visit On February 5, 2015, the Mississauga Halton LHIN in partnership with Central West LHIN was pleased to invite health sector leaders including members of the Community Capacity Steering Committee to an evening with Dr. Bob Bell, Deputy Minister of Health and Long-Term Care, and members of his senior leadership team including Susan Fitzpatrick and Nancy Naylor. This important evening enabled a meaningful exchange of ideas and information that highlighted the challenges we collectively face when it comes to exponential growth and capacity planning across local communities. The following day, Dr. Bob Bell and members of his senior leadership team had an opportunity to tour local health service provider India Rainbow and then join us for the afternoon to learn about key activities and achievements in our LHIN.





Patients First: Action Plan for Health Care Government of Ontario's next phase of its Action Plan for Health Care, Patients First was released by Minister of Health and Long-Term Care Dr. Eric Hoskins. The Patients First: Ontario’s Action Plan for Health Care strengthens the province’s commitment to put people and patients first by improving the health care experience. The new plan outlines how the province will increase access to better and more coordinated care, and ensure the health care system is sustainable for generations to come. This plan focuses on four key objectives: Access: Improve access – providing faster access to the right care. Connect: Connect services – delivering better coordinated and

integrated care in the community, closer to home. Inform: Support people and patients – providing the education,

information and transparency they need to make the right decisions about their health.

Protect: Protect our universal public health care system – making decisions based on value and quality, to sustain the system for generations to come.




http://health.gov.on.ca/en/ms/ecfa/healthy_change/docs/rep_patientsfirst.pdf



http://health.gov.on.ca/en/ms/ecfa/healthy_change/docs/rep_patientsfirst.pdf�


PROGRESS ON ANNUAL BUSINESS PLAN PRIORITIES 2014/15

ACCESSIBLE AND SUSTAINABLE HEALTH CARE FAMILY HEALTH CARE WHEN YOU NEED IT ENHANCED COMMUNITY CAPACITY OPTIMAL HEALTH – MENTAL AND PHYSICAL HIGH QUALITY PERSON-CENTRED CARE





REPORT HIGHLIGHTS A successful Healthy Holidays initiative leads to LHIN year

round strategy named myhealth365. Congestive heart failure QBP work to conclude in spring 2015. Two IDEAS projects completed with remarkable improvement

noted Regional Rehabilitative Care Review Report - Phase One

finalized one-Link launched 1949 hosted telemedicine events in Q2 with top 3 topics -

mental health, gynecology and primary care. A regional approach to the collection of delirium indicators for

hospitals being developed No Wrong Door launch March 2015 will celebrate early

adopters, share best practices and collaborate RM&R: THP to integrate Meditech with CHRIS for the Acute

to CCAC pathway - data flowing by March Primary Care Advisors set to support primary care with

navigation of the health system Primary Care Clinic Day is being planned for March 27, 2015 an eCompendium is being developed to provide a listing of all

specialists practicing within the Mississauga Halton LHIN - targeting 70% participation before launch

81 Primary Care Providers and 17 specialists recruited for eConsult initiative in the Mississauga Halton LHIN

Trillium Health Partners and related system partners Improving Transitions through Electronic Hospital and Emergency Discharge Project received the Hazel McCallion Award in Quality of Care for Sustained Improvement in December 2014

Halton Hills, Milton, South Etobicoke and South West Mississauga Health Links have submitted business plans. East

Mississauga Health Link (early adopter) has enrolled 137 patients and data show reduction in ED visits and hospitalizations

Community Capacity Study: Meeting Senior Care Needs Now and in the Future: A Community Capacity Plan for the Mississauga Halton LHIN was released to steering committee on February 13, 2015

Caregiver Respite Program has completed the development of targeted services and 2015/16 fiscal year will see refinement of current processes

Health Equity Inventory Survey results to be shared at Health Equity Symposium on March 23, 2015

Five-day Mental Health First Aid training course in French held for a Francophone trainer

The Mississauga Halton LHIN participated in the creation of the "Coalition pour Aînés Francophones" de Peel-Halton (CAF)

All of the qualified Mississauga Halton LHIN organizations targeted to implement IAR are now complete

The completed Health Service Providers, Board approved CAPS refresh, have been submitted for LHIN review

Amended 2015/16 M-SAA include one (1) new indicator related to Governance specified within Schedule E3 Performance Obligations

The LHIN has already communicated its’ intent to enter into a new H-SAA for the 2015/16 fiscal year

The next Community Quarterly Sector Meeting will be held on April 10, 2015

The LHIN endorsed the CCAC to declare a priority status in support of a regional hospital flow crisis related to hospital patients waiting for long-term care beds.





ACCESSIBLE AND SUSTAINABLE HEALTH CARE

Mississauga Halton LHIN Healthy Holiday Strategy The regional Healthy Holidays initiative for 2014 has come to its conclusion post-holiday season. An initial evaluation of the communication strategy yielded positive results. The highlights were as follows:

• The iamsick.ca mobile app was used 1,992 times – Android ranked #7 of Canadian Health apps and iPhone ranked #13 of Canadian Health apps

• 976 visits to feelbetterfaster.iamsick.ca website • 782 app downloads • Clinics were engaged and updating their hours to reflect

changes in their schedules – even on Christmas day, and data was immediately displayed in real-time on website and apps

• Received holiday information from 200 healthcare providers • 394,500 social media views, shares, likes, visits of

Mississauga Halton LHIN Healthy Holidays tips and resources in a 10-day span.

A sample of residents in the Mississauga Halton LHIN was engaged to determine if the pilot project should continue. Residents reported they felt like their feedback from earlier initiatives was heard. Of note, residents appreciated that the information was correct, up-to-date and that it was accessible on their smartphones where ever they were during the holiday season.

Because of the uptake in the Mississauga Halton LHIN for the healthy holidays strategy, work is being done in partnership with Acclaim Health and iamsick.ca for a year-round approach. The strategy will closely follow Ontario’s Patients First Action Plan for Health Care with a strong focus on access, connection and information with high quality person-centred care at the centre. The year-round strategy will be called myhealth365.





Health System Funding Reform (HSFR) In the context of mobilizing effort to implement Health System Funding Reform (HSFR), a regional group of health service providers convenes at the HSFR Local Partnership Committee to discuss local impacts, implications and risks associated with the implementation, and related mitigation strategies for Quality Based Procedures (QBPs). The Committee recommended a comprehensive work plan for fiscal 2014/15 and 2015/16. The work plan encompasses several areas of focus including:

• Evaluating the performance of all QBPs where clinical handbooks exist;

• Informing volume management policy; and • Knowledge transfer, including the integration of “Improving &

Driving Excellence Across Sectors (IDEAS)” locally. In January 2015, hospital partners reported their progress to date for both Congestive Heart Failure and Hip Fracture. Regional improvement work related to congestive heart failure commenced in September 2014 and will be concluded in early spring 2015, with the system goal of improving a patient’s acute length of stay while in hospital by implementing a consistent care pathway and physician order sets for this patient cohort. The hip fracture QBP was identified for regional improvement work in November 2014 and will continue into 2015/16 with a focus on the patient’s journey from the emergency to post-rehabilitation continuum in the community.

Improving and driving excellence across sectors (IDEAS) is a provincial initiative, co-sponsored by Health Quality Ontario (HQO) and the Institute for Health, Policy, Management and Evaluation at the University of Toronto. IDEAS was initiated to complement the implementation of HSFR, with the goal of introducing and sustaining quality improvement science across Ontario. The Mississauga Halton LHIN has had congestive heart failure commenced in September 2014 and will be concluded in early spring 2015, with two projects directly related to HSFR implementation. Two projects, Total Joint Replacement Ambulatory Rehabilitation, and Stroke Rehabilitation were successfully completed with remarkable improvement noted. Regional implementation continues with respect Ambulatory Rehabilitation and Stroke care in our region. Capital Developments Trillium Health Partners Master Plan The combined Stage 1 Proposal and Stage 2 Functional Program of the proposed Courtyard Project was endorsed by the Mississauga Halton LHIN Board on January 15, 2015. A letter to this effect was provided to the Ministry of Health and Long-Term Care. Mississauga Halton LHIN staff continue to work with Trillium Health Partners on their review of the Stage 1 Master Plan submitted March 2014. Both redevelopment proposals are not Ministry approved projects at this point.





Community Capital An environmental scan of community-based hub models is under way to inform the potential development of integrated community health hubs in Mississauga Halton. Mississauga Halton LHIN staff are reviewing available data to determine areas of opportunity, with a particular focus on health and social service needs, and will be looking to broader stakeholders engagement over the next several months. Regional Program for Rehabilitative Care & Complex Continuing Care Services The Mississauga Halton LHIN, in partnership with its health service providers has worked towards developing a regional rehabilitative strategy incorporating Rehabilitative Care Alliance directions, best practices and stakeholder feedback to enhance patient access and flow through the system, improve patient experience and outcomes, and improve system integration. Following the completion of phase one analysis of the current model of delivery of Rehabilitative Care in the Mississauga Halton LHIN, the Mississauga Halton Rehabilitative Care Steering Committee finalized the Regional Rehabilitative Care Review Report - Phase One in January 2015. This report summarizes findings from a systematic review, secondary data analyses (specifically focusing on stroke care within the LHIN as a proxy), and stakeholder consultations, and proposes recommendations for the development of a regional strategy based on a best practices model for regional Rehabilitative Care. An analysis

of the impact of adopting the Provincial Rehabilitative Care Alliance Definitions Framework for Bedded Levels of Care was also completed. The Rehab Care Alliance has been approved by the pan-LHIN CEOs to move forward on a second mandate, which will be implementation of the proposed Definitions Framework and articulation of a work plan to advance this work. The LHIN will be awaiting these recommendations to move forward in alignment with the provincial direction.





Enhancing Access to Mental Health and Addictions Services Through the work of the Brand Workgroup and marketing group as well as feedback and approval from the Steering Committee, the System Access Model, referred to as SAM over the past year is now officially one-Link.

one-Link Shared Purpose “Mississauga Halton LHIN’s one-Link enables equitable access and coordinated care to make it possible for people to receive the right addictions and mental health care, at the right time and in the right place.” Mississauga Halton LHIN Telemedicine Strategy The Telemedicine Advisory Committee continues to meet to advance its goal to increase the number of health service providers and clients using telemedicine technologies to provide and access care. To date we have 31 active sites and 64 active systems within the Mississauga Halton LHIN. Second quarter reports indicate 1949 hosted events (1391 clinical, 100 educational and 458 were administrative) with

8678 participants. Of these events, the top three were mental health, gynecology and primary care. The committee is looking to work with OTN to review utilization and refresh local goals, work plan, and committee membership to reflect the advances in telemedicine and the enhanced collaboration with the Ontario Telemedicine Network (OTN). Seniors’ Strategy The Seniors’ Strategy Steering Committee met in January to review the Region of Peel Aging Population Terms of Council Priorities and Halton Regions' Older Adult Plan. Results of the Collaborative Community Capacity Study will be reviewed at the next meeting. The results, along with Region reports and provincial reports will be used to help determine the priorities for planning for care for seniors in our communities. The Committee wants to ensure clear alignment with various seniors' care plans. The Senior Friendly Hospital Working Group continues to meet to develop a regional approach to the collection of delirium indicators for all hospitals within the Mississauga Halton LHIN. The Specialized Geriatric Services program participated in a regional planning day to determine priorities for Year 1. Planning day observations and comments were captured and summarized to determine how the regional program might fill identified gaps to improve efficiencies.




Confidential referrals to the support


“Every Door is the Right Door” Service System The Mississauga Halton LHIN System Integration Group for Mental Health and Addictions (SIGMHA) has revised and updated the Every Door is the Right Door or No Wrong Door (NWD) Protocol document. The No Wrong Door Working Group will be developing a NWD champion’s team, establish a charter of NWD member agencies and plan a NWD launch celebrating early adopters, sharing best practices and build collaborations. ConnectingGTA ConnectingGTA (cGTA) is a regional solution that supports the delivery of provincial electronic health records by linking and integrating electronic patient information from across the care continuum and making it available at the point-of-care to improve the patient and clinician experience. ConnectingGTA is currently planning the first workshop with Wave 2 organizations. Project kick off invitations will be sent out mid February and workshop invitations will follow in March. Halton Healthcare Services will be participating as a data contributing organization and we have four (4) other organizations within the Mississauga Halton LHIN that will be receiving “view only” access to the ConnectingGTA data.

Resource Matching and Referrals (RM&R) Cluster 2 The goal of the RM&R BTI program is to provide a way to streamline the complex patient referral environment across Ontario.

Within the Mississauga Halton LHIN, Trillium Health Partners (THP) and Halton Healthcare Services (HHS) are implementing the Provincial Referral Standards (PRS). The PRS for Acute to LTC (both hospitals) is complete; the PRS for Acute to Community Care Access Centre (CCAC) HHS is complete.

THP has completed the work to integrate Meditech with CHRIS for the Acute to CCAC pathway and data will begin to flow before the end of February. The balance of work in this fiscal will be to implement the PRS for Acute to Rehab/Complex Continuing Care (CCC).





FAMILY HEALTH CARE WHEN YOU NEED IT

Primary Care Integration Strategy The Primary Care Integration strategy, designed to improve access to primary care and increase linkages between primary care and other health care providers, is working towards initiatives that will build awareness of health care system resources and capacity within the Primary Care sector. Primary Care Advisors The five Primary Care Advisors, who will be engaging with individual Primary Care Providers in their office environments, are partaking in an intensive orientation of the Mississauga Halton LHIN. To address the needs of physicians effectively, they will need to be familiar with the range of resources available. The PCAs have started limited engagements with Primary Care Providers launching with “warm” contacts that are familiar with the Primary Care Integration strategy. The learning from this role is already becoming apparent as the physicians ask questions seeking support in navigating. These questions/requests for support have a wide range, including the availability of needed services to clinical questions. Full launch of this role into the broader community is planned for March 2015. Primary Care Clinic Day The second annual Primary Care Clinic Day is being planned for March 27, 2015. Open to all Primary Care Providers across the LHIN this event aims to increase capacity through clinical education sessions, a health service provider information fair, an opportunity to

showcase regional programs and initiatives specifically targeting Primary Care. eCompendium of Specialty Care In partnership with the Mississauga Halton CCAC, an eCompendium is being developed to provide a listing of all specialists practicing within the Mississauga Halton LHIN. This resource will support the Primary Care Providers to make referrals to the appropriate specialist with the necessary work up to enable the specialist to begin the consultation immediately. The platform for the resource has been developed within the Mississauga Halton CCAC’s HealthLine website. The final step within this project is to populate the database with content from the individual specialists’ practices targeting 70% participation before launching the platform. eConsult Through the Ministry of Health and Long-Term Care’s Provincial eConsult Initiative, the Mississauga Halton LHIN has partnered with Champlain LHIN as their regional partner to further evaluate their existing eConsult service model. The Mississauga Halton LHIN was asked to recruit at least 50 Primary Care Providers and 4 specialties within this pilot by December 2014. These targets were successfully reached. Both primary care and specialty care providers continue to register for the program with 98 physicians now engaged (81 Primary Care and 17 Specialists). Ontario MD is conducting a baseline assessment of physician practices related to consultations which will





form the basis for the evaluation of the various models being explored. Primary Care Improving Transitions through Electronic Hospital and Emergency Discharge The improving transition through electronic hospital and emergency discharge project aims to improve the communication process between hospitals and primary care providers and the Mississauga Halton Community Care Access Centre (CCAC) as soon as a patient is admitted to the hospital or discharged from the hospital. This project has come to completion. Trillium Health Partners and other related system partners received the Hazel McCallion Award in Quality of Care for Sustained Improvement regarding the implementation of this project at Credit Valley Hospital in December 2014. Health Links Health Links in Business Planning Phase The LHIN has now received Business Plans from four Health Links: Halton Hills, Milton, South Etobicoke and South West Mississauga for review and submission to the Ministry of Health and Long-Term Care. It is anticipated the remaining two health links, Oakville and North West Mississauga will submit their business plans by the end of February. As of January 20, 2014, the East Mississauga Health Link (early adopter) has enrolled 137 patients. Early quantitative data review shows reductions in ED visits and hospital readmissions for individuals served by the East Mississauga Health Link. A qualitative

review of patient and provider experiences with Health Links is nearing completion. Hospital Report Manager (HRM) Implementation OntarioMD's Hospital Report Manager (HRM) enables physicians using EMRs to receive direct electronic hospital reports into their patient's medical record within 30 minutes of transcription. The implementation of HRM through the ConnectingGTA pathway for Trillium Health Partners (THP) remains on hold. William Osler Health System (WOHS) is currently testing their data feed to HRM through ConnectingGTA and working through issues discovered in the testing phase. By mid-February, we will have a better idea if testing will resume for THP based on the success of WOHS.





ENHANCED COMMUNITY CAPACITYThe Community Capacity Study The Mississauga Halton and Central West Local Health Integration Networks and Community Care Access Centres (CCACs) jointly contracted with Preyra Solutions Group to develop a community health services capacity plan for each LHIN to meet the needs of the LHINs' growing and aging populations. The objective of the study was to evaluate the level and mix of health services required by the growing and aging populations in each LHIN, including a comprehensive assessment of current and future capacity and need for community-based health services for seniors. After extensive data analysis, review of other jurisdictions, and discussions with multiple organizations and stakeholders, the findings from the study are almost ready to be shared. On November 18, over 90 stakeholders gathered for the Community Capacity Study session. At the session, the consultant team reviewed the study results and asked for feedback from those in attendance to ensure that the most important areas were adequately considered and to share further questions and discussion to further enrich the study and develop the final report. A draft report has been shared with the Steering Committee for review. The final report, Meeting Senior Care Needs Now and in the Future: A Community Capacity Plan for the Mississauga Halton LHIN was released to the steering committee on February 13, 2015.

Caregiver Respite Program The Caregiver Respite Program is moving forward with its’ agenda. The Caregiver Respite Program has completed the development of targeted services under the Program for this 2014/15 fiscal year (ie: short stay respite – two (2) beds funded at Oakville Seniors Residence; opening of evening respite hours at three (3) health service providers; utilization of educators to train caregivers; respite advisors in place and part of Central Intake). The 2015/16 fiscal year will see refinement of current processes including: • intake and referral • booking into services • use of Respite Advisors • coordination of educators

for in-home and in-class teaching of caregivers

• determination of funding allocation for the 15/16 fiscal year

• booking of short stay respite

• integration of Adult Day Services into the full Respite Program

• development of the potential for overnight respite in Adult Day

• plans for bringing the service online with the Program and in what funding year

• work and completion of the Resource and Standards manuals.

Funding of short stay respite beds remains open for exploration if other viable sites identified. The Program’s in-home respite service has a long wait list and will need discussion at the Steering Committee for funding priority.





Advancement of Community Practice The Steering Committee is revising the Terms of Reference, finalizing a Purpose Statement, and discussing needed actions in 2015/16. The Committee has elected a new Chair and orientation will ensue. All of the collaboratives are operational with five of the six having extensive work completed. One collaborative is being highlighted in this report (see below and Regional Learning Centre). The ACP Coordinator is in place and developing a thorough understanding of the initiative in order to provide support. A Collaboratives Facilitator position was posted with recruitment targeted for mid to late March. This position is the administrative support for the ACP initiative and in particular the Collaboratives and the Steering Committee.





Mississauga Halton LHIN Regional Learning Centre Educational Update

Education Initiative

Resource and Outcomes

PSW Education Update

PSW modules for the winter term (2015) are delivered 7 days per week PSWs receive certificates and a resource folder for all modules attended January 2015 courses included: Infection Control, Professionalism, Safety & Risk, CPR Number of Participants: 200+ Number of Health Service Providers: 9 Off-site Training: 2 off-site sessions delivered on Professionalism and Safety and Risk February 2015 The Regional Learning Centre now has a Skills Lab for development and implementation of the following modules; Personal Care, Lifts and Transfers Gentle Persuasive Approaches (full course & refresher) and Cardiopulmonary Resuscitation- CPR March 2015 Modules Include: Enhanced Skills, Medication Management, Gentle Persuasive Approaches, Mental Health, and Documentation

Mental Health & Addictions Education Needs Assessment

Education Needs Assessment Survey created for Mental Health & Addictions Health Service Providers. The survey will be complete in the spring of 2015.

Building Technology

Regional Learning Centre technologies initiatives: 1. Survey Monkey 2. WebEx 3. Teleconferencing 4. iClickers 5. Eventbrite electronic registration. 6. Registered domain name www.mhlhinrlc.ca for future website development. Established @mhlhinrlc.ca email

address




http://www.mhlhinrlc.ca/


OPTIMAL HEALTH – MENTAL AND PHYSICAL Regional Integrated Chronic Disease Prevention and Management Strategy The Mississauga Halton LHIN Chronic Disease Prevention & Management (CDPM) Regional Advisory Working Group has created an alignment model of provincial and regional initiatives that impact and enable the work done in the CDPM portfolio. The working group is in the process of creating a strategic plan report that will inform the development of the operational plan for the 2015-2016 year. The working group is also reviewing its Terms of Reference, electing new co-chairs and engaging members from the community support sector to provide feedback on the Mississauga Halton LHIN CDPM model that was developed by the working group, and will look to the community support sector on best practices to implement the model.





HIGH QUALITY PERSON-CENTRED CAREMississauga Halton LHIN Health Equity To aid in the development of understanding health inequities within Mississauga Halton, the Mississauga Halton System Planning Advisory Committee on Health Equity is participating in the dissemination of a Health Equity Inventory Survey. The purpose of this integral survey is twofold:

1. To better understand the types of socio-demographic data currently being collected by Health Service Providers and Community Partners in Mississauga and Halton; and

2. To establish a foundational framework based on the findings, which will help inform the development and implementation of a standardized data collection tool.

Survey findings will be shared at the Health Equity Symposium on March 23, 2015. French Language Services (FLS) French Language Service Capacity The Mississauga Halton LHIN provided a five-day Mental Health First Aid training course in French for a Francophone trainer. The trainer will then be able to provide training within the Francophone community. This initiative was the result of a partnership between the Canadian Mental Health Association (CMHA) Halton Region, the Centre de services de santé de Peel and Halton (CSSPH-Francophone community based organization) and the Mental Health Peel Services collaborative for youth led by the Centre for Addictions and Mental Health (CAMH). The overall goal of this project was to enhance the

community capacity for French Language Services within the Mississauga Halton LHIN by increasing the number of cultural and linguistic appropriate education programs for Francophones. Francophone Community Engagement The Mississauga Halton LHIN participated in the creation of the "Coalition pour Aînés Francophones" de Peel-Halton (CAF) in partnership with the Central West LHIN and Réflet Salveo. Members of this coalition are Francophone seniors groups and organizations providing services in French in the regions of Peel and Halton. The new group recognizes that each organization will keep its own mandate, structure and activities but it will provide the opportunity for these organizations to work on common goals. The long-term goal is to create an Elderly Persons Centre that will coordinate a broad range of French-Language programs and services. In the short term, the coalition's priority is to improve access to activities available for Francophone seniors and promote existing programs and activities.





Community Care Information Management (CCIM) /Integrated Assessment Record (IAR) The strategic vision of Community Care Information Management (CCIM) is to provide seamlessly-integrated, community-based client care where all service providers can securely share and access consistent and accurate information electronically. Assessment projects include Integrated Assessment Record (IAR), Ontario Common Assessment of Need (OCAN), Community Support Services Common Assessment Project (CSS CAP) and InterRAI Community Health Assessment (CHA). The Integrated Assessment Record (IAR) is an application that allows authorized users to view a consenting client’s assessment information to effectively plan and deliver services to that client. All of the qualified Mississauga Halton LHIN organizations targeted to implement IAR are now complete. IAR, now in sustainment mode, will work on reporting for the LHINs and support adoption where possible.





MEASUREMENT AND PERFORMANCE

Ministry-LHIN Performance Agreement (MLPA) Targets The Mississauga Halton LHIN achieved the target within a 10% corridor in 10 of 15 indicators with an average provincial rank of six (previous 7) out of 14 LHINs. Five (5) indicators, emergency department length of stay for admitted patients, Magnetic Resonance Imaging (MRI), Computerized Tomography (CT), Knee Surgery wait time and Repeat emergency department visits for substance abuse, experienced performance outside of the 10% corridor. Based on increased and sustained emergency department demand at both Halton Healthcare Services and Trillium Health Partners, and the limited post-acute options available for transitioning patients from hospital to Long-Term Care, a Priority 1A status was declared to initiate crisis placement for medical and surgical patients in the hospitals. Both diagnostic indicators, CT and MRI continue to experience exceptional growth and as a result, the wait times for low priority procedures continue to increase. Initiatives are focused on improving data quality for all priority levels and increasing hours by partnering with the Regional Cancer Centre for additional support for oncology patients.

Repeat emergency department visit for substance abuse rate remained stable over eight quarters at 25%. There are a number of LHIN-wide Mental Health and Addiction strategies being developed to support this patient cohort using a two-pronged approach:

1) Peer support infrastructure and development of programs and services; and

2) Addictions, investing in the options for withdrawal management including coordinating with cross-LHIN residential withdrawal management; and community addiction advisors working directly within the emergency department.





Provincial Quarter Actual Performance (Q3 2014/15)

Adm I-III IV-V Cancer Cardiac Cataract Hip Knee MRI CT MH SA

Erie St Clair 24.78 6.93 3.97 97% NA 95% 85% 77% 21% 96% 23.22% 16 16.60% 16.69% 23.34%

South West 25.30 6.23 3.55 92% 100% 88% 82% 83% 27% 72% 8.58% 20 18.19% 18.88% 19.19%

Waterloo Wellington 15.88 6.30 4.25 99% 100% 96% 89% 85% 31% 69% 13.56% 11 16.94% 14.39% 25.81%Hamilton Niagara Haldimand Brant

34.00 7.15 4.57 89% 100% 84% 84% 77% 44% 78% 17.40% 22 16.35% 20.15% 25.52%

Central West 32.30 7.22 3.50 94% NA 89% 50% 37% 14% 86% 6.11% 23 14.80% 24.20% 28.95%

Mississauga Halton 39.20 6.32 3.58 98% 98% 94% 98% 77% 18% 52% 9.90% 23 15.69% 17.28% 25.95%

Toronto Central 27.62 7.75 4.47 95% 99% 92% 90% 94% 39% 59% 8.14% 25 19.02% 27.13% 44.76%

Central 33.70 6.52 3.42 100% 98% 100% 96% 92% 35% 89% 13.65% 27 15.12% 19.63% 23.11%

Central East 33.13 6.10 3.97 97% NA 97% 97% 96% 47% 92% 13.95% 21 17.29% 19.19% 27.34%

South East 26.22 6.67 4.23 99% 100% 94% 68% 72% 38% 96% 15.44% 28 15.41% 21.62% 26.46%

Champlain 25.15 7.45 4.48 97% 75% 90% 90% 88% 31% 76% 12.33% 55 15.57% 18.18% 27.48%

North Simcoe Muskoka 25.18 6.10 3.85 100% NA 98% 92% 84% 10% 60% 17.05% 54 16.74% 16.16% 25.17%

North East 30.87 5.40 3.85 84% 100% 90% 79% 73% 43% 69% 20.35% 64 19.16% 17.62% 34.18%

North West 30.52 6.97 3.87 93% NA 95% 73% 69% 33% 89% 22.54% 32 17.03% 17.29% 33.91%

Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q2 14/15 Q2 14/15 Q1 14/15 Q2 14/15 Q2 14/1514.00 6.00 4.00 5.00 3.00 6.00 1.00 8.00 12.00 14.00 4.00 5.00 4.00 4.00 6.00

Measures %ALC DaysRe-Admits

Provincial 29.52 6.78 4.00 95% 97% 93% 88% 83% 33% 79% 13.32% 28 16.86% 19.95% 31.71%Maximum 39.20 7.75 4.57 100% 100% 100% 98% 96% 47% 96% 23.22% 64 19.16% 27.13% 44.76%Minimum 15.88 5.40 3.42 84% 75% 84% 50% 37% 10% 52% 6.11% 11 14.80% 14.39% 19.19%Variance 23.32 2.35 1.15 16% 25% 16% 48% 58% 37% 45% 17.11% 53 4.36% 12.75% 25.57%

Color coding reflects LHIN relative performance from better 1to 2

worse 3

% within Access TargetHours

LHIN%ALC CCAC CMG

Repeat Visits

Surgical & Diagnostic Wait TimesERLOS Repeat ED Visits

Access to Health Care ServicesIntegration &

Coordination of CareQuality & Improved Health

Outcomes

MOHLTC Updates Annual Business Plan

Priorities Measurement and

Performance Notable Sector

Engagement Communications


Board Quality Board Quality Report (Balanced Scorecard)

MOHLTC Updates Annual Business Plan

Priorities Measurement and

Performance Notable Sector

Engagement Communications


NOTABLE SECTOR ENGAGEMENTMulti-Sector Sector Accountability Agreement (M-SAA) 2015/16 Schedule Refresh

The 2015-16 CAPS and M-SAA Refresh Update The completed Health Service Providers, Board approved CAPS refresh, have been submitted for LHIN review. Approximately 25 Health Service Providers required funding adjustments. However, all of the Mississauga Halton LHIN Health Service Providers were required to open and close the new CAPS template in order for them to be able to utilize the new template going forward. We have received the amended 2015/16 M-SAA with the updated schedules from the MSAA Planning & Schedules Work Group and the MSAA Advisory Committee for implementation into the refresh process. There is one (1) new indicator related to Governance specified within Schedule E3, Mississauga Halton LHIN Specific Performance Obligations.

Below are the key steps and estimated timelines for the 2015-16 M-SAA refresh for completing the 2015/16 CAPS & MSAA Schedule refresh.

Green indicates completed activities, yellow indicates in progress and blue is yet to be completed.

Activity Target Date

CAPS 60 Day Issuance Notice to HSP’s Oct. 17, 2014

Pan LHIN Community Lead Education Oct. 31, 2014

CAPS Launch onto SRI for HSPs Nov. 4, 2014

HSP Training Materials Available Nov. 4, 2014

LHINs Complete Local HSP Q&A Session Nov. 13, 2014

Completed HSP Board approved CAPS refresh submitted through SRI to LHINs by January 9, 2015

Nov. 4, 2014 – Jan. 9, 2015 (9 WEEKS)

LHIN review of CAPS refresh, consultations on MSAA refresh indicators, population of Schedules, and final MSAA Schedule amendments

Jan. 9– Feb16, 2015 (5 WEEKS)

2015/16 MSAA Schedule amendment letters provided to HSPs Feb 16, 2015

HSP Board Approval of 2015/16 MSAA Schedule amendments March 9, 2015

LHIN Board Approval of 2015/16 MSAA Schedule amendments March 9 – April 1, 2015

Year 2 of the current 2014-17 MSAA comes into effect April 1, 2015





Hospital Sector Accountability Agreement (H-SAA) 2014/15 The Mississauga Halton LHIN has fully executed the Hospital Service Accountability Agreements (H-SAA) with Trillium Health Partners and Halton Healthcare Services. The Mississauga Halton LHIN continues to work with hospitals on determining performance, volume and financial targets for 2014/15. With funding letters received late December 2014, the Mississauga Halton LHIN will set performance targets and expectations in collaboration with hospital partners. 2015/16 A new approach for the H-SAA will unfold for fiscal 2015/16 whereby the hospital annual planning submission submitted to the LHIN in the winter 2015 with the goal of having fully executed agreements by March 31, 2015. The LHIN has already communicated its intent to enter into a new H-SAA for the 2015/16 fiscal year. A new, multi-year 2015-18 H-SAA has been circulated to the Ontario Hospital Association for their memberships’ review and feedback. With the prospective endorsement of this agreement, the LHINs and hospitals will work through an approach to refresh performance targets, funding and volume annually. In the interim, an extension agreement will be forthcoming for the beginning of the 2015/16 fiscal year with a maximum term of six (6) months. Community Quarterly Sector Meeting The next Community Quarterly Sector Meeting is on April 10, 2015.

Mississauga Halton Community Care Access Centre The Mississauga Halton Community Care Access Centre (CCAC) received Mississauga Halton LHIN approval in late January to further support hospital surge by increasing additional resources to enable the avoidance of admission to the hospital and/or safe discharge of patients to the community.

The LHIN also endorsed the CCAC to declare a priority status in support of a regional hospital flow crisis related to hospital patients waiting for long-term care beds between December 15, 2014 and January 12, 2015. The priority status, as described in the Long-Term Care Home Act, Regulation 171, Section 3, shifts priority of placement to those patients waiting in hospital versus those waiting in the community. The regional efforts of all partners enabled 44 people to be placed in long-term care compared with an average of 20 without priority status in place.

Quality Improvement Workshops The Mississauga Halton LHIN in conjunction with the Central West LHIN has collaborated with the Metamorphosis Community Health Network to support two half-day workshops on quality improvement for board members and senior leaders of community based HSPs. These workshops are based on similar workshops offered to community support service HSPs in September 2014 as part of the Ontario Community Support Association’s (OCSA) Quality Advantage Project.





Quality Improvement Workshops – cont’d The targeted HSPs were Mississauga Halton LHIN community mental health and addictions HSPs who were not eligible to participate in September’s workshops and those community support HSPs who were unable to attend. The workshops were held on February 3 and 18 and covered topics such as leadership for quality and quality improvement plans.





COMMUNICATIONS Media Relations Engaging with our media partners includes the development and distribution of news stories through either Mississauga Halton LHIN news releases or repurposing information shared by our health service providers or the Ministry of Health. Several news releases and media stories referenced Mississauga Halton LHIN from January to March 2015. News Releases Health Link Releases:

• Halton Hills – MPP Naidoo-Harris Ontario Improving Care for Patients with Greatest Needs in the Mississauga Halton LHIN

• South Etobicoke - MPP Peter Milczyn • South West Mississauga – MPP Charles Sousa.

News Coverage – Mississauga Halton LHIN

New Health Link to benefit patients in southwest Mississauga – Mississauga News – February 13, 2015

Halton equitable drug strategy gets $149k OTF grant to help build ‘made-in Halton drug strategy’ - Oakville Beaver – February 8, 2015

Improving Care for Patients with Greatest Needs – chrgonline.com - February 5, 2015

Linking care to the community - Milton Canadian Champion – January 30, 2015

Oakville Mayor Rob Burton to chair Halton police board — again – Oakville Beaver – January 30, 2015

Linking care to the community - Georgetown Independent Free Press – January 30, 2015

Lifetsyle changes can reduce cancer risk: Mississauga Halton/Central West Regional Cancer Program – Oakville Beaver – January 1, 2015.

Engagement

Website The Mississauga Halton LHIN website continues to be a primary vehicle for both communication and engagement with our stakeholders. Translation of website content is now fifty per cent complete and on target to go live in early March 2015. Visual Identity We are introducing an important update to the LHIN Visual Identity. The new pan-LHIN visual identity has been completed and approved. The improvements include an expanded use of imagery to include various types of illustrations, social media guidelines, recommendations to emphasize each LHIN’s local and regional character and AODA compliant templates.




http://www.mhlhin.on.ca/Page.aspx?id=821C7B1645604074A845C2D6F09A1470

http://www.mhlhin.on.ca/Page.aspx?id=821C7B1645604074A845C2D6F09A1470

https://www.google.com/url?rct=j&sa=t&url=http://www.mississauga.com/news-story/5338323-new-health-link-to-benefit-patients-in-southwest-mississauga/&ct=ga&cd=CAEYACoSMzA2NDIwODcyOTAwNjAxMjE1Mhk1NTkyMzBhMzdhOGEzNzRhOmNhOmVuOkNB&usg=AFQjCNF7_bZZCy_FIlMI6Gp8nwDH1Rvf-A

http://www.insidehalton.com/community-story/5326779-halton-equitable-drug-strategy-gets-149k-otf-grant-to-help-build-made-in-halton-drug-strategy-/

http://www.insidehalton.com/community-story/5326779-halton-equitable-drug-strategy-gets-149k-otf-grant-to-help-build-made-in-halton-drug-strategy-/

https://www.google.com/url?rct=j&sa=t&url=http://www.chrgonline.com/detail_news.php%3FID%3D515796%26titre%3DImproving%2BCare%2Bfor%2BPatients%2Bwith%2BGreatest%2BNeeds%26cat%3D%3B31&ct=ga&cd=CAEYACoUMTAzMjQ4MjE4ODY0NjMwMDMzNzcyGTVhMGQ3ZWVmYWNiYzk2YjY6Y2E6ZW46Q0E&usg=AFQjCNGY0jFuKIBv1UQgs5OuhWZP-mfpxw

http://www.insidehalton.com/news-story/5295713-linking-care-to-the-community/

https://www.google.com/url?rct=j&sa=t&url=http://www.insidehalton.com/news-story/5294944-oakville-mayor-rob-burton-to-chair-halton-police-board-again/&ct=ga&cd=CAEYACoTNzU5NzM0Mzg4NzkwMDE2NzM5OTIZMjlhMDY1MTc5ODE2ODVmMTpjYTplbjpDQQ&usg=AFQjCNF0ja71KWow-m3zcSFmiGreM7gOQg

http://www.theifp.ca/news/linking-care-to-the-community/

https://www.google.com/url?rct=j&sa=t&url=http://www.insidehalton.com/community-story/5237633-lifetsyle-changes-can-reduce-cancer-risk-mississauga-halton-central-west-regional-cancer-program/&ct=ga&cd=CAEYACoUMTM5Mjg3OTYzODc0Mzc2NDcyMjQyGjA0ZWJkYTY5ZWY2OGZjZTg6Y29tOmVuOlVT&usg=AFQjCNFfXzdHKIWEda5XJlEGMcdvgGUy3w

https://www.google.com/url?rct=j&sa=t&url=http://www.insidehalton.com/community-story/5237633-lifetsyle-changes-can-reduce-cancer-risk-mississauga-halton-central-west-regional-cancer-program/&ct=ga&cd=CAEYACoUMTM5Mjg3OTYzODc0Mzc2NDcyMjQyGjA0ZWJkYTY5ZWY2OGZjZTg6Y29tOmVuOlVT&usg=AFQjCNFfXzdHKIWEda5XJlEGMcdvgGUy3w


One of the most notable changes is the replacement of the former wave graphic with the arc graphic, a government wide design motif. Communications has launched the new visual identity internally providing staff with various templates and guidelines for use. Mississauga Halton LHIN materials requiring updating have been identified and are in the process of renewal. Patient Experience Survey The new Patient Experience Survey was launch on January 31 and supports the ongoing commitment of the LHINs to use patients/families/caregivers and community engagement to inform decision-making. The survey was developed by patients and families, for patients and families. The survey is accessible through Mississauga Halton LHIN website through the top rotating banner and a box on the home page. To help build awareness, a poster was created and shared with local health service providers. This Patient Experience Survey is a way to measure:

• How easy it is for patients to access the care they need and navigate their local health system

• The overall quality of care patients receive • How satisfied patients are with the care they receive • Ways we can improve our health care system.

The survey closes on February 26. The feedback will help us to identify priorities, allocate resources and plan for appropriate services to improve the health care system for everyone.

Local Government Leaders Bill MacLeod and Graeme Goebelle continue to meet with local government leaders to discuss the Mississauga Halton LHIN priorities and any emerging local healthcare issues. During the month of January, meetings were held with Halton MPP Naidoo-Harris and our new Etobicoke--Lakeshore MPP Peter Milczyn. Press Conferences Health Link Announcements - Mississauga Halton LHIN hosted media events to announce three new Health Links. Halton Hills Health Link Standing inside Georgetown District Hospital, Halton MPP Indira Naidoo-Harris announced a new initiative, Halton Hills Health Link. MPP was joined by Halton Hills Mayor Rick Bonnette Denise Hardenne (HHS President and CEO), Graeme Goebelle (LHIN Board Chair), Kiran Cherla (Halton Hills FHT), and Kate Power (CEO, Links2Care).




http://www.mhlhin.on.ca/


South Etobicoke Health Link LAMP CHC hosted Etobicoke-Lakeshore MPP Peter Milczyn as he announced two new initiatives that will impact South Etobicoke’s most complex patients.

(Left to Right) Dr. Michael Kates (Summerville Family Health Team), Bill MacLeod (Mississauga Halton LHIN CEO), Ruth Mary James (Patient Representative), MPP Peter Micyzn, and Russ Ford (LAMP Community Health Centre Executive Director).

South West Mississauga Health Link Mississauga Halton LHIN vice-chair Ron Haines welcomed Mississauga South MPP Charles Sousa who announced the South West Mississauga Health Link lead by Mississauga Halton CCAC

(Left to Right) Angie Burden, Mississauga Halton CCAC, Ron Haines, Vice Chair Mississauga Halton LHIN, Karen Ras, Ward 2 Councillor, MPP Charles Sousa – Mississauga South, Caroline Brereton, CEO, Mississauga Halton CCAC, Bill MacLeod, CEO, Mississauga Halton LHIN.




Health Links • Health Links have expanded to 67 in

communities across Ontario. • A study found that 75 per cent of seniors with

complex conditions who are discharged from the hospital receive care from six or more doctors.

• There are seven Health Links in Mississauga Halton LHIN


Government and Community Services Fair The Mississauga Halton LHIN participated in the 10th Annual Government and Community Services Fair at Cloverdale Mall on February 21, 2015. Handing out clementines and sharing information, the Mississauga Halton LHIN spoke with local residents about partnering with our communities for a healthier tomorrow. We joined more than 100 exhibitors who filled the community in on the bounty of local activities, business networks, specialty shopping, volunteer opportunities and government initiatives that take place all the time in our local community.

Left to Right: Tom Miller, Central West LHIN, Christelle Bony, Mississauga Halton LHIN, MPP Yvan Baker, Maureen Buchanan, Mississauga Halton LHIN, Andrea Skacolzai, Central LHIN, Monica Scott, Toronto Central LHIN

The Government and Community Services Fair was co-hosted by MPP Etobicoke Centre Ivan Baker and Etobicoke--Lakeshore MPP Peter Milczyn.

Reports

Community Capacity Study The Community Capacity Study conducted by Preyra Solutions Group, Meeting Senior Care Needs Now and in the Future: A Community Capacity Plan for the Mississauga Halton LHIN, was submitted to the Community Capacity Study Steering Committee on February 13, 2015. Mississauga Halton LHIN is preparing communications strategy to identify, engage and inform a variety of internal and external stakeholders. Mississauga Halton LHIN has prepared an executive summary document which includes highlights and key recommendations from the report.




Mental Health and Addictions Strategy: Phases 1 and 2 Overview

Slide Deck #1 Mental Health and Addictions Leadership Advisory Council Meeting February 6, 2015

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Attachment A

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Table of Contents:

Section 1: Overview of Mental Health & Addictions Landscape in Ontario

• Impact

• Cross-sectoral involvement

• Complex system delivery and funding

• Challenges

Section 2: Ontario’s Mental Health & Addictions Strategy

• Strategy overview

• Phase 1 overview

• Phase 2 overview

• Initial implementation priorities

• Mental Health and Addictions Leadership Advisory Council

• Aboriginal engagement

• Performance measurement

• Initiatives

3

Mental health and addictions issues impact Ontarians:

Overall prevalence:

30% of the Ontario population aged 15+ will experience a mental health or substance abuse problem at some point during their life.

Prevalence of mental health issues:

• Almost 5% of Ontario adults reported experiencing symptoms of major depression in 2012 (StatsCan), and 2.2% reported suicidal ideation in the last 12 months (CAMH).

• Mental health conditions are often co-occurring. For example, almost 50% of Ontarians with schizophrenia also report a substance abuse problem.

Prevalence of substance abuse & addictions:

• 18.8% of adults reported exceeding low-risk alcohol guidelines in the past year. 6.8% of adults and 19.8% of students report binge drinking.

• 2.8% of adults and 12.4% of high school students reported using prescription opioids for non-medical use in 2013.

• 4.7% of Ontarians report having a gambling problem.

Cost to the province:

Mental illness and addictions cost Ontario’s economy an estimated $38.1B a year. These costs include: • health care costs. • law enforcement costs. • research and prevention • other direct costs (e.g. fire, accidents). • indirect costs (lost productivity due to disability and premature mortality).

Socials costs to Ontarians:

• Alcohol-related crash fatalities: 255 deaths in 2009 (MADD).

• Suicides: 8.1 per 100,000 (2011 StatsCan).

• Burden of disease on young adults: Alcohol and drug addictions are most prevalent in the 25-34 age bracket.

Examples of Populations at Risk:

Many populations are at higher risk of either developing a mental health issue, or of being marginalized from participating in mental health services. For example:

• First Nations population: First Nations youth commit suicide about five to six times more often than non-Aboriginal youth (Health Canada).

• Individuals with dual diagnosis: Roughly 44 % of the 18-64 year old cohort of Ontarians who have a developmental disability also have a mental illness (HCAARD).

• Children and youth: Mental health problems among children and youth are predicted to increase by 50 per cent by the year 2020.

MH&A Landscape

4

MH&A are complex, and cut across many different sectors and levels of government:

MH&A Clients

Health

Education

Housing

Jobs and Training

Children and Youth

Federal Gov’t

Municipal Gov’t

Justice

Social Services

Implications: Confusion/frustration for clients: • System navigation is complicated by

the number of players in the MH&A sector.

Resources not maximized: • Lack of coordination and alignment

across and between sectors/providers.

• Competing priorities across the sector.

Hard to make the case for results and investments: • Overlap in clients served makes it

difficult to approximate total government spend or cost per MH&A client.

• Different data systems are in use and/or key gaps exist in the data (e.g. wait times, demand).

MH&A Landscape

Service Collaboratives Health Links MCYS Lead Agencies

5

Delivery system, accountability/governance mechanisms, and funding structures are very complex (see MOHLTC example below):

MOHLTC: $3.1B 2013-14 expenditure on mental health and addictions

LHINs OHIP Drugs

MH&A Community Supports: 300+ Service Providers

Physicians and Specialists

Hospitals

Mental Health Units

Specialty Psych

$913.7M

Ontarians with MH&A issues

Provincial Supports

$994.4M

$47.4M

$1.9B $656.4M $500.9M

Refer to Landscape Report for more detail

OMA Negotiations

MLPA

H-SAA

M-SAA

Legend: Purple: Delivery system Grey: Accountability/governance Green: Funding

Ontario Drug Benefit Programs Exec Officer

MH&A Landscape

6

Despite best efforts by all parties, significant challenges remain:

Limited focus on prevention and early

intervention:

Limited focus on public health and health

promotion

Self-help options not maximized

Limited training for providers about early

identification

Unmet need:

Access to services

Supportive housing

Employment supports

Justice transition and diversion

Gaps in services:

Uncoordinated care

Many parties involved

Poor transitions through care

Funding issues:

Funding based on historical allocations

No standardization of funding across

providers

Funding not tied to outcomes

Weak data collection and performance measurement

Inconsistent data collection

Limited performance reporting

Minimal provincial public reporting

Minimal service cost data

MH&A Landscape

7

Ontario’s Mental Health and Addictions Strategy:

• Launched in 2011, Open Minds, Healthy Minds is Ontario’s comprehensive mental health and addictions strategy, which aims to address these systemic issues.

• Strategy vision statement: Every Ontarian enjoys good mental health and well-being throughout their lifetime, and all Ontarians with mental illness or addictions can recover and participate in welcoming, supportive communities.

• The Strategy is divided into two phases:

Phase 1: Launched 2011

Phase 2: Launched 2014

• Led by MCYS. • Focused on children and youth mental health. • Ongoing transformation in children and youth mental health system will be be aligned

with Phase 2.

• Led by MOHLTC. • Expanded scope and scale of Phase 1 to focus on adults,

transitional aged youth, addictions, transitions, funding reform, and performance measurement across the system.

Strategy Overview

8

Phase 1 made significant progress: Strategy: Phase 1

9

• Building on the foundational work in the first three years of Open Minds, Healthy Minds, the Moving on Mental Health (MOMH) plan was launched in 2012.

• The plan will result in a simplified and improved experience for children and youth with mental health problems and their families so that, regardless of where they live in Ontario, they will know:

• What mental health services are available in their communities; and • How to access the mental health services and supports that meet their needs.

• To achieve the goals of MOMH, MCYS is leading and coordinating efforts to:

• Create and support clear pathways to care; • Define core services; • Establish lead agencies in every Ontario community that will be responsible for the

planning and delivery of services; • Develop a transparent, equitable funding model; and • Put in place appropriate legislative, regulatory, and accountability tools.

• In August 2014, MCYS announced the first 14 lead agencies for child and youth mental

health.

Phase 1 key initiative: Moving on Mental Health Strategy: Phase 1

10

• Identified agencies will take a leadership role in convening and coordinating partnerships within the child and youth mental health service sector as well as across other sectors such as health and education in order to provide clarity for children, youth, and their families about how to access mental health services within those service areas.

• As a first step, lead agencies will be developing an initial core services delivery plan with other child and youth mental health service providers and working towards the development of an initial community mental health plan with the broader child-serving sector.

• There will be a phasing-in of lead agency responsibilities over the next two to three years, in recognition of the fact that lead agency role and functions are new and that capacity to carry them out will vary across the province. MCYS will be providing a range of supports to lead agencies to assist them in building the necessary capacity.

• The identification process for a lead agency in Toronto was launched on September 12, 2014.

• The remaining lead agencies are expected to be announced in 2015.

Phase 1 key initiative: Moving on Mental Health (cont’d) Strategy: Phase 1

11

Phase 2 is guided by key outcomes to be achieved, and work across five strategic pillars:

Right service, right time, right place

Ensure early identification

and intervention

Fund based on need and

quality

Promote resiliency &

well-being in Ontarians

Expand housing, employment supports &

diversion and transitions from

the justice system

Phase 2: Strategic Pillars

Pillar 1: Pillar 2: Pillar 3: Pillar 4: Pillar 5:

Establish and strengthen the critical functions of provincial quality, oversight and accountability

of mental health and addictions services

Integrated system planning and system accountability:

Open Minds, Health Minds Vision: Every Ontarian enjoys good mental health and well-being throughout their lifetime, and all Ontarians with mental

illness or addictions can recover and participate in welcoming, supportive communities

• Better service experiences for people and their families

• Improved access to services • More people stably housed • Fewer avoidable hospital

admissions or readmissions

• More people identified and served through integrated primary care and community services

• Reduced reliance on emergency departments

• Improved transitions of youth to adult system

• More people receiving evidence-based programs

• More students graduating high school

• Reduced absenteeism at work • More people feel safe,

engaged and supported at work

By 2020, the strategy will support the following outcomes:

Strategy: Phase 2

12

There are three initial implementation priorities for Phase 2:

Enhance oversight and accountability: Establish Mental Health and Addictions Leadership Advisory Council to advise the Minister and to report on Phase 2 progress, and establish a dedicated Aboriginal engagement process.

Improved performance measurement: Work with Health Quality Ontario (HQO) and the Institute for Clinical Evaluative Sciences (ICES) developing a scorecard and evaluation framework to measure progress and outcomes.

New initiatives and funding investments: $138 million over three years through the 2014 Budget to community service agencies to help increase access to services such as peer support groups, treatment programs, and crisis and early intervention initiatives.

1.

2.

3.

Strategy: Phase 2

13

The MH&A Leadership Advisory Council has been established:

• In November 2014, the Minister of Health and Long-Term Care announced the creation of the Mental Health and Addictions Leadership Advisory Council.

• The members of the new Mental Health and Addictions Leadership Advisory Council represent diverse sectors that work on mental health and addictions issues. A membership list can be found in Appendix 1.

• The Council will meet 3 times per year, and will be supported by a Secretariat from the Ministry. The Council will also establish working groups as required.

• The Council has the following key deliverables:

• System-level priority setting, problem identification and work planning. 1. Strategic Planning

• Advice on allocation of government investments in mental health and addictions.

2. Advice on Strategic Provincial Investments

• External oversight and accountability of key strategic initiatives; cross-sector champions. 3. Implementation of the Strategy

• Author annual progress report (w/ ICES and HQO). 4. Tracking Progress and Public Reporting

• Provide meaningful advice to the government on MH&A issues/initiatives. 5. Ad hoc Advice on MH&A Initiatives

Strategy: Phase 2

An Aboriginal engagement process is being established

14

• The MHA&A Aboriginal engagement process will building on the success of recent engagements by MCYS.

• Separate funding will be provided directly to First Nation, Métis and urban Aboriginal Provincial Territorial Organizations (PTOs) (and associated governance / discussion tables) who will then conduct / coordinate engagements of their own design with their respective membership and report back with results.

• Details of linkages between the Council and this engagement process are still to be determined.

Chiefs of Ontario

Assoc. of Iroquois &

Allied Indians

Indepen-dent First Nations

Union of Ontario Indians

Grand Council

Treaty #3

Nishnawbe Aski Nation

Métis Nation of Ontario

Ont. Fed. of Indigenous Friendship

Centres

Ontario Native

Women’s Association

Chiefs Committee on Health / TFNHSOC* Table

Keewatin (Northern) Trilateral Health Table

Urban Aboriginal Health Table

(in development)

*TFNHSOC is Trilateral First Nations Health Senior Officials Committee

funding

funding

Advice to Minister of Health and Long-Term

Care

Advice to MH&A Leadership Advisory

Council

Details are TBD in terms of content, format and timing of advice to government

Strategy: Phase 2

Social, Health and Education (SHE) Directors Committee

• A strategy scorecard and evaluation framework is being developed to measure progress and outcomes in against each of the pillars of Phase 2.

Building on the scorecard and framework developed for Phase 1.

In collaboration with ICES, HQO, partner ministries, Council.

• To support this work, MOHLTC is also leading a cross-ministry data integration project on broad social determinants.

• A Quarterly Initiative Tracking process has also been established to track different MH&A initiatives that are underway in each ministry against each of the pillars.

Performance Measurement for Phase 2:

15

Draft Logic Model for Performance Measurement

Pillar 1: Pillar 2: Pillar 3: Pillar 4: Pillar 5:

Strategy Vision

Desired system change





Aligned initiatives

Performance/outcome measures where possible, contextual indicators and process/output measures as proxies if

required

Strategy: Phase 2

• Investments of $138M over three years to be invested in proven local mental health and addiction initiatives that align with the Strategy’s five strategic pillars.

• $2.75M to improve access to mental health care and reduce wait times at four speciality psychiatric hospitals:

• Centre for Addiction and Mental Health (Toronto)

• Waypoint Centre for Mental Health (Penetanguishene)

• The Royal (Ottawa)

• Ontario Shores Centre for Mental Health Services (Whitby)

• $16M to create 1,000 more supportive housing spaces over the next three years, as part of the Poverty Reduction Strategy.

• Improving supports for youth with eating disorders through a pilot program with Ontario Shores, which has opened a new 12-bed paediatric residential treatment unit treating 32 patients per year.

• Creation of a province-wide inpatient bed registry that will allow hospitals to access information about the availability of inpatient psychiatric beds in Schedule 1 facilities across Ontario.

• Partnering with the province's public health units to increase awareness, address stigma and promote mental health in schools and in the workplace.

Several key new MOHLTC initiatives are already underway:

16

Strategy: Phase 2

17

Appendices

18

Appendix 1: MH&A Leadership Advisory Council Membership List

1. Susan Pigott - Chair of Ontario's Mental Health and Addictions Leadership Advisory Council; has previously held senior positions with the Centre for Addiction and Mental Health and St. Christopher House

2. Pat Capponi - Psychiatric survivor with lived experience of poverty; part-time member, Consent and Capacity Board

3. Gail Czukar - CEO, Addictions and Mental Health Ontario 4. Dr. Suzanne Filion - Director, Strategic Initiatives, Mental Health and Addictions, Hawkesbury & District General

Hospital 5. Arthur Gallant - Mental health advocate 6. Carol Hopkins- Executive Director, National Native Addictions Partnership Foundation; 7. Mae Katt - Nurse Practitioner 8. Dr. Kwame McKenzie - CEO, Wellesley Institute 9. Dr. Ian Manion - CEO, Provincial Centre for Excellence for Child and Youth Mental Health, Children's Hospital of

Eastern Ontario 10. Louise Paquette - CEO, North East Local Health Integration Network (LHIN) 11. Camille Quenneville - CEO, Canadian Mental Health Association - Ontario 12. Dr. William Reichman - President and CEO, Baycrest 13. Aseefa Sarang - Executive Director, Across Boundaries: An Ethnoracial Mental Health Centre 14. Dr. Kathy Short - Mental Health ASSIST lead, Hamilton-Wentworth Board of Education 15. Peter Sloly - Deputy Chief, Community Safety Command, Toronto Police Services 16. Adelina Urbanski - Commissioner, Community and Health Services, Regional Municipality of York 17. Victor Willis - Executive Director, Parkdale Activity and Recreation Centre 18. Eric Windeler - Founder and Executive Director, Jack.org 19. Dr. Catherine Zahn, CEO, Centre for Addiction and Mental Health

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