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Mississauga Halton LHINCSS and MH&A

Quarterly Sector Meeting

December 14, 2011

AgendaWelcome and Agenda Review Angela Jacobs 5 min

Specialized Geriatric Services Priti Patel – Clinical Manager, Seniors’ Health Services Trillium Health Centre

15 min

Community MH & A Investments• ADAPT• HHS• THC• Support & Housing Halton• Highlight on STRIDE

Angela JacobsIan Stewart, Executive DirectorClaudia Barning, Mgr Outpatient Mental Health,Mary Lynn Porto, Mgr Outpatient Mental HealthJohn Smith, Executive DirectorAnita Lloyd, Executive Director & Jan McCabe,

Program Manager

35 min

Corporate Communications – LHIN AcknowledgementUpdate on Healthcare Landscape

Janine DeVito 20 min

Surge Capacity Protocol Kristina Hall/Judy Bowyer 15 min

Break 15 min

Finance Updates Paulette Zulianello 10 min

“6 Minute Updates” Selected HSPs 40 min

Information Highways and Forms Module (CCIM) Judy Bowyer & Lisa Gammage 20 min

CCIM Shared Assessment Protocols Monica Gabriel 30 min

Closing Angela Jacobs 5 min

Next Meeting: March 2012

Specialized Geriatric ServicesPriti Patel

Clinical Manager, Seniors’ Health ServicesTrillium Health Centre

Seniors’ Health Services

CSS and MH&A Quarterly Sector MeetingDecember 14th, 2011

What are Specialized Geriatric Services

Specialized Geriatric Services are:A range of health care services, which diagnose, treat and rehabilitate frail elders with complex and multiple medical, functional and psychosocial needsProvided on a consultative basis by an interdisciplinary team of health professionalsProvided in a variety of home, ambulatory, acute care, long-term care and rehabilitation hospital settingsAimed at reducing the burden of disability by detecting and treating reversible conditions and recommending optimal management of chronic conditionsSGS include both direct services by geriatricians and/or geriatric psychiatrists and services provided in affiliation with one of these medical specialists.

Reference: Regional Geriatric Program of Toronto

Target Population for SGS

65 years of age or older (or age-related needs), frail with complex and multiple medical, functional and psychosocial needsIssues that may prompt a need for SGS:

Unexplained changes in health statusRecent decline in managing day-to-day activitiesMultiple ER visits or admissions to hospitalPolypharmacy or medication managementChange in cognition Incontinence or constipationPsychosocial (e.g. caregiver/family issues, future planning)Recent or multiple fallsMobility or gait issues

Services We Provide

Central intake and triage** Seniors’ health clinic (includes urgent clinic**)Continence Program (clinics, home visits & public education)**Medical outreach service (home visiting)**Falls Prevention and Bone Health Program**

Falls clinicFalls education and exercise program

Geriatric consultation service for hospital patients Hospital Elder Life Program (HELP)** for hospital patientsGeriatric emergency management (GEM) nurse in the Emergency Room

** New and/or expanded services through Aging at Home funding


Community

Corporate Wide Clinical Programs & Initiatives

In-Patients

Knowledge utilizationCNA certification workshopSeniors’ health bulletinsLHIN representation

Internal consultation team (ICT)Hospital Elder Life Program (HELP)Geriatric emergency managementCentre-wide program initiatives

Regional Outreach • Medical outreach• Continence home visits

Ambulatory Clinics• Routine & urgent assessment• Continence (regional)• Falls & Strong &

Steady program

Partnership Evaluation

Knowledge RelationshipsCare/Practice

Our Goals

Maintain / enhance quality of life

Prevent disability

Maximize health and function to help frail seniors live safely at home as long as possible

Central Intake & Triage

Central Intake and Triage

Enhanced staffing including 0.5 FTE RN

Screens and triages referrals for:Trillium’s ambulatory clinics (Seniors’ Health Clinics - routine and urgent, Continence Clinic and Falls Clinic)Regional Seniors Health Outreach to the entire LHIN* Continence services (community-based clinics and home visits) to the entire LHIN*

*The Mississauga Halton Local Health Integration Network (LHIN) catchment area which includes the communities of Halton Hills, Oakville, Milton, Mississauga, and South Etobicoke.

Referral Criteria

Referrals received for individuals 65 years of age or older who are frail, have complex health needs, are experiencing geriatric syndromes, have had two or more hospital admissions within the past year, and/or have frequent ER visits

Include any recent relevant clinical information e.g. medical history, labs, DI reports, consult reports with the completed (and signed) referral form

To obtain a referral form, please contact our office at 416-521-4090. This form can also be downloaded from our website at www.trilliumhealthcentre.org.

http://www.trilliumhealthcentre.org/

Seniors’ Health Clinics

Seniors Health Clinics

This outpatient Clinic provides comprehensive geriatric assessment and treatment to older adults who live in the community. This includes those living in retirement homes or long-term care homes, as long as they are able to come to the clinic

Frail older adults can also be seen urgently for medical/functional issues. Please indicate the urgent designation on the referral form

A medical referral is required

Regional Continence Program

Regional Continence Program for Seniors

Three components:Continence clinicsContinence home visitsPublic education

Clients seen by a Nurse Continence Advisor (NCA)RN with a specialty in continence promotion

Specialize in conservative treatment of incontinence issues

Will provide written communication to family physician and specialist

Continence Clinics

For adults 65 years of age or older who are mildly frail but cognitively able and who:

Go to the bathroom often, day or nightLeak urine with activity or with a strong urgeHave frequent UTIsHave problems with constipation or with bowel controlNeed to learn to use a catheter

Self referral or referral by health care professional

No cost to the patient

Usually 2-3 visits for initial and follow up assessments

Continence Clinic: Locations

Oakville: Oakville Senior Citizen’s Residence

North Mississauga: Heritage Glen Community for Seniors

Milton: Allendale Long Term Care Home

Mississauga/Etobicoke: Trillium Health Centre-West Toronto (this location accepts clients of all ages)

Continence Program: Home Visiting

For the frail elderly unable to access clinics

Target Mississauga Halton (MH) CCAC populations: Stay at Home, Wait at Home, Frail Seniors

Referrals only from physicians, MH CCAC or the Regional Seniors’ Health Outreach service

Continence Education

Ongoing education to the public and health care professionals

Increase knowledge regarding incontinence issuesand options available to manage, cure and treat incontinence

Sessions cover such topics as the types of incontinence, the factors contributing to incontinence, conservative treatment of incontinence and healthy bladder habits

Encourage individuals to seek help

Regional Seniors’ Health Outreach Service

Regional Seniors’ Health Outreach Services

Enhanced staffing increased FTE from 1.0 FTE (2006 – 2008) to 5.8 FTE (2010-2011)

Current team includes Nurse Practitioners, Occupational Therapists, Social Workers and Pharmacist

Provides medical outreach service for the entire MH LHIN*Medical referral is requiredSeen by outreach team followed by clinic visit with geriatrician at THC or HHSExpansion to CVH in process

*The Mississauga Halton Local Health Integration Network (LHIN) catchment area which includes the communities of: Halton Hills, Oakville, Milton, Mississauga, and South Etobicoke.

Regional Seniors’ Health Outreach

Provides specialized geriatric services within the person’s home (including retirement homes)

Incorporates communication & collaboration with the family physician and community partners

Referrals are triaged to the Regional Seniors’ Health Outreach Team if:Client is houseboundClient needs suggest a home visit would be beneficial

accessibility (e.g. mobility, frailty)functional/safety assessment within their homemedication adherence and managementcognitive performance assessmentcaregiver and client supportive counselingrecent or multiple ER visits or admissions to hospital

Falls Prevention & Bone Health Program

“Strong and Steady”

Strong and Steady

Falls Prevention and Bone Health Program includes:Initial assessment at the clinic by a physiotherapist and a nurse practitioner and/or a geriatrician Two-hour education and exercise session, twice a week for six weeksFollow up visit three months after program completion

Eligibility:are well enough to be physically activecan walk 25 meters, with a walking aid if neededare able to learn new informationare able to get to and from program

Physician referral required to attend

Thank You

For more information contact:


Phone: 416-521-4090 OR toll free 1-888-271-2742

Fax: 416-521-4116

Community MH&A Investments• MH LHIN Angela Jacobs• ADAPT Ian Stewart, Executive Director• Halton Healthcare Services Claudia Barning, Manager,

Outpatient Mental Health• Trillium Health Centre Mary Lynn Porto, Manager,

Out-patient Mental Health• Support & Housing Halton John Smith, Executive Director• Highlight on STRIDE Anita Lloyd, Executive Director and

Jan McCabe, Program Manager

2011-2012 Investment in Community Mental Health & AddictionsAs part of the targeted priorities for base funding investments for the community sector, MH LHIN will be

investing in the enhancement of services for youth and young adults with mental health & addictions.

Community Mental Health & Addictions

Health Service Provider Initiatives Base Funding - $

ADAPT TAY Addictions Workers 168,000

Halton Healthcare Services

Expansion of Child/Adolescent support services for TAY

175,295

STRIDE TAY rehabilitation & employment program expansion

215,171

Support & Housing Halton TAY coordinator for the LHIN; TAY case manager for a Group Home

130,000

Trillium Health Centre TAY program expansion and development of internet based interventions modeled on clinics in Australia

324,000

TOTAL: 1,012,466

New MH LHIN Funding for MH&A Services

•Community MH&A Investments

New MH LHIN Funding for MH&A Services (cont’d)

2011-2012 9,000 Nurses Commitment FundingThis is a workforce stabilization strategy that forms the cornerstone of Ontario’s Comprehensive Nursing Strategy. It is a key component of the province’s health resources strategy, HealthForceOntario which aims to ensure that

Ontario has the right number and mix of qualified health care professionals now, and in the future.

Community Mental Health & Addictions

Health Service Provider Initiatives Base Funding - $

Trillium Health Centre Telemedicine Nurses for MH&A $211,847


Early Psychosis Intervention Program Nurses

$170,042


Eating Disorder Program $116,700

TOTAL: $498,589

Community MH&A Investments

Transitional Aged Youth Services

Providing the Best Journey into Adulthood


What we hope to achieve

The ADAPT TAY Services will be developed to meet the overarching objectives of:

Collaboration Capacity Building System Navigation Information & Education Increased Accessibility


How will we do this Collaboration: through formal & informal

partnerships Capacity Building: through increased

community service expansion System Navigation: through case planning

& management Information & Education: through

knowledge exchange Increased Accessibility: through linking

with providers who encounter these young people- post secondary, employment, service providers


Where will we begin?

Hire 2 Addictions Specialists with mental health experience to be added to existing Youth Services at ADAPT (presently in the interview process)

Involve the new hires in the Transitional Aged Youth planning table for harder to serve clients

Work directly with other agencies who have received funding


What will the program shape be Provide specialized assessment, intensive counselling and

case management services to youth 16-24 who have substance use and mental health concerns (individual, group and family work)

Work directly with other service providers (education, employment, housing, mental health, justice, recreation etc) to build capacity and assets of these young people and to reduce legal involvements and hospital admissions

Provide additional supports to provide a more seamless bridge to and from other programs such as CWMS, CCDP, Crisis.

Provide an additional resource to assist with the transition between youth and adult services


Some creative program ideas Provide a group program that not only addresses

the substance use concerns but also builds opportunities to practice skills to assist with independence. Increase developmental assets and life skills for clients served.

Provide opportunity for volunteerism and community involvement

Provide a group educational program for parents of young adults. Parenting is changing and we need to respond.

Work with other service providers to share these opportunities


Where will referrals come from

Youth themselves Parents, guardians and caregivers Youth and Adult Justice systems Secondary and Post Secondary Schools All formal and informal partners who serve

this population Internal ADAPT referrals (CWMS,

Concurrent and Days Ahead programs)


What are the service targets

Services will be provided in Oakville, Milton, Georgetown, Acton and West Mississauga

Each counsellor will have provided service to 60 clients after one year =1200 visits total

Each counsellor will have provided services to 60 parents/caregivers after one year=600 visits total


Outcomes

Pre and post data will be collected to determine where change has occurred related to substance involvement

Determinants of health will provide guidelines to outline success

Hospital admission and legal involvement data will be collected


Comments/Questions

Specific program questions will need to be forwarded to Jennifer Speers and she will respond

Thank-you



Claudia BarningManager Outpatient Mental Health


Transitional Age Youth Program

Mary Lynn PortoManager Outpatient Mental Health

Trillium Health Centre

Transitional Age Youth Program

Mary Lynn Porto MHScManager

Child and Adolescent Mental HealthAdult Mental Health

Community Mental Health


Vision: Healthy, resilient youth and young adults aged 16-24

Mission: To provide treatment, support and outreach to youth and young adults experiencing mental illness, and their families, in order to promote healthy development, positive relationships and full social participation.


Program Goals:

To improve the functioning of youth and young adults experiencing mental illness

To promote healthy family functioning for youth and their families living with mental illness


Principles of Care

We recognize the uniqueness of the individual and his/her family. To be responsive, supports, services and treatment offered will be individualized and comprehensive.

We recognize and value the involvement of the natural support systems of youth, including their family, friends and significant others in supporting developmental growth.

We value youth centered care, and recognize the importance of the youth’s interests, dreams, and strengths in driving the care.

We value youth participation in the planning and delivery of services and promote youth–run groups and/or activities.

We recognize the importance of a system of care in supporting the developmental and transitional needs of youth. This system of care includes the coordination and involvement of educational, employment, housing and financial resources.


Current Program Transitional Age Youth Committee:

Shared Management (Child and Adult Mental Health Staff)

Dedicated Resources


New Investment 3 FTEs (Social Worker, Occupational

Therapist, Case Manager) Additional Sessionals Chat room


Update Recruitment Chat Room


Support and Housing - Halton

John SmithExecutive Director


The overall objective of the TAY Project is to provide a person centred approach to the transitioning of youth into the adult M.H.&A. system in Mississauga-Halton via the TAY Protocol process

Transitional Aged Youth (TAY)Youth Centred Systems Integration

Mississauga – Halton


• Four month pilot project to transfer youth to adult M.H. & A. sector

• Co lead by youth & adult sector• Multi sector community involvement• New partnerships established• 22 youth transferred, 2 fast tracked



• 6 - 8 youth per month would be transitioned into the adult MH & A system via the TAY Protocol process

• Short term transitioning support to individuals “as necessary”• Protocol and process to be promoted within the youth and adult system • Educating both youth and adult sectors on the needs of the TAY • Administrative support to transitioning sub groups and Steering Committee • Develop enhanced strategies and linkages with appropriate partners • A refined evaluation tool be developed and implemented • Develop an early identification and planning toolkit to assist youth and the

youth system in transitioning


Key Outcomes – 1 FTE


• Purchase of a home via Region of Halton –Halton Housing Task Force

• Shared living model for 5 youth at risk• Renovations funded by CMHC – Home Depot• No additional program support

LifeHouse Acton Youth House

Intensive Case Management/Life Skills Support


• Intensive case management/life skills support for 5 youth • Housing stabilized – no homelessness• 75% direct service – approximately 1365 units of service• Reduced admissions to emergency rooms & hospitalization• Regain positive & trusting relationships with family & friends• Supported to move independently into the community, when

ready, & provided with transitioning support into the adult system & a more independent living situation.

LifeHouse1 FTE – Life Skills Coordinator

Key Outcomes


Meeting the Employment Needs of the Community

Supported Training & Rehabilitation in Diverse Environments


WHAT IS STRIDE . . .


STRIDE ON EMPLOYMENTSTRIDE recognizes that employment and earning power

contribute significantly to a person's sense of dignity, personal recovery goals, independence and quality of life

It has been estimated that 85% of people experiencing mental health issues are

unemployed or under employed

Experience has shown that for many of these individuals their lives can be transformed by something most of us take for granted - a job

STRIDE is committed to creating opportunities for people facing mental

health issues to gain meaningful employment


ADMISSION CRITERIA


Must have a mental illness or disability / impairment that is continuous or recurring that

results in a substantial barrier to competitive employment

Must demonstrate a willingness to become involved in the STRIDEemployment programs

Must have the ability to set and work towards achievement of

employment goals

Must possess a desire to decrease social

assistance dependency

Individuals can self-refer!

Referred by friends, family members or by a health

care professional

•


STRIDE SERVICES OFFEREDSTRIDE ODSP OWoffers a variety of job readiness services to individuals who are living with or recovering from mental illness and who are ready to either develop their careers in new areas or to return to a field in which they have had previous experience.

STRIDE is an approvedOntario Disability Supports Program –

Employment Supports service provider.

STRIDE is an approved Ontario Works –

Employment Supports service provider.


EMPLOYMENT CONNECTIONS PROGRAM

The Employment Connections Program:The client and Employment Specialists work in cooperation and consultation to assist in securing a job that reflects the

client's abilities and work skills

Employment Preparation activities include: Employment planning Assessments and community supports coordination Employment preparation activities

e.g. resumes, interview practice Job development which identifies available positions that match

the abilities and career desires of individual clients Job search training Negotiation of employment, unpaid work placements and

wage subsidies Job coaching and long-term job retention support


SUCCESSFUL PLACEMENTS

Kitchen Help Customer Service Rep

Piano Instructor

Shelf Stocker Light Duty Cleaner

Shipper-Receiver

Admissions Coordinator

Personal Support Worker

General Labourer


WORKSITE TRAINING PROGRAMThe Worksite Training Program:

Our largest area of service is the operation of our Worksite Training Programs in North and South Halton. At these facilities, individuals

develop their work skills in an environment which closely reflects what they will experience in a competitive workplace.

The benefits of our Worksite Training program: Preparation for competitive employment Realistic work environment with flexible

work scheduling Learning and practicing vocational life skills

in a supported workplace Increased self-esteem and independence Learning marketable skills such as Shipping & Receiving,

quality control and Health & Safety Earning a training allowance Client work performance reviews completed Team Leader Training


TAYTRANSITIONAL AGED YOUTH PROGRAM

STRIDE has received funding from the Mississauga Halton LHIN to develop a new Transitional Aged Youth Employment Service

Our objective is to expand our existing program services, to hire a Program Coordinator, two Youth Vocational Support Workers and two Youth Employment

Specialists to create the new STRIDE Youth Employment Program that will assist youth facing barriers to employment, develop the broad range of skills, knowledge

and work experience they will need to participate in todays job market.

The responsibilities of this program include: Developing youth outreach activities Developing a planned process to connect with youth and engage them in the communityClient-centered program designed to assess and respond to individual needs of youth facing

barriers to employment Increase awareness of Transitional Aged YouthEngage with youth to determine their employment needs and interestsProvide information for youth who may not be ready to deal with their employability issues,

referrals to alternate supportive services such as other mental health and addiction programs

Work with families, service providers and other support systems to provide the information needed to create an inclusive system whereby barriers are broken down and the right door opened to assist youth to transition successfully into the community


Please Visit us online atWWW.STRIDE.ON.CA

Please Contact us at(905) 693-4252

Get STRIDE working for you!


LHIN Acknowledgement and Update on Healthcare Landscape

Janine DeVitoCommunications Lead

MH LHIN

Liberal Platform Update: Making Ontario the Healthiest Place In North America to Grow Up and Grow Old• Will continue building on strong foundation to reach goal of

ensuring that every Ontarian who wants family care can access it.

• Will ensure that Ontario keeps the shortest surgical wait times in the country and that hospitals continue to reduce waits for the 2.5 million Ontarians who rely on our Emergency Rooms each year.

• Will continue investing in new hospitals and renovating existing facilities.

• Will build on successful Aging at Home strategy to reform the health care system to provide Ontarians, and especially our seniors, with the tools they need to receive care in the dignity of their own homes.

Liberal Platform Update: Making Ontario the Healthiest Place In North America to Grow Up and Grow Old• Create Home Health Care• Make it easier for family health givers• Make home life safe and affordable for seniors• Give seniors a place – Active Aging Strategy• Keep people healthy• Give Ontarians better food choices• Better prepared to fight cancer• Smoke Free Ontario• Healthier children• Tackling Mental Health

Caring for our Aging Population and Addressing

Alternate Level of Care:Dr. Walker Report

Improve Access to Care Through Community Investments

Improve Patient Flow Across the System Optimize and Differentiate Capacity

Primary Care • Early identification and management

of high-risk frail seniors• Integration of primary care sector• LHIN primary care lead

Community Care • Enhance and Align CCAC and CSS• Assisted Living model of care• Acute Home Care ‘Virtual Wards’

Improve System Coordination• Improve care for special needs

(seniors with MHA)• Integrated Care • Improved Transitions

Assess and Restore • Restore functioning of frail elderly so

they can return home after hospitalization

• Increase CCC and rehab capacity, give ALC patients priority

• Employ short-term stays in LTC before return home

Role of Acute Hospitals in Seniors Care • Promote Senior Friendly Strategy• Community rehab capacity

improvement • ALC transitional best practice

LTC Capacity• Improve focus relating to transitions,

restorative capacity and respite care• Create better environments for

seniors with special needs (MHA)• Increase supply of beds

Enablers: MOH identifies provincial goals, LHINs ensure accountability, meet targets and objectives set by MOH, align incentives with outcomes and provide regional planning and forecasting models. HHR, IT, System wide efficient focus.

Upcoming Game-Changers• Drummond Report – January 2012• LHIN Review – Spring 2012• IHSP 3 – Fall 2012

Community Holiday and Surge Capacity

Kristina HallDirector, Health System Performance Management

Judy BowyerSr. Lead, Health System Performance Management

Mississauga Halton LHIN


Anticipating a high holiday volume of hospital patients

Hospitals are already at capacity

Need to increase where appropriate, flow out of

hospital



• Is your agency Administration open over the holidays (December 23 to January 3)?

• Is your agency providing service over the holidays (December 23 to January 3)?

• Will you be taking on new clients over the holidays (December 23 to January 3)? Will this allow capacity in your service?

• Are you planning to discharge any clients the week of December 18 to 24?



Next Steps

• Compile and share information with everyone on questions• Information shared with CCAC

Next Steps

• Wherever possible, see if discharges can occur – make room to assist with flow

• Provide suggestions for assisting with flow

Coming Up

• Committee volunteers needed for LHIN Community Surge Capacity • Looking at identifying strategies for holidays, outbreak, hospital

backup and overflow


Break! 15 Minutes

MH LHIN Financial Update

December 14, 2011Paulette Zulianello

Manager, Finance & Risk

Finance Update – MH LHIN Finance TEAM

Paulette Zulianello - Manager, Finance and Risk

Mirella Semple - Senior Lead Funding and Allocation

TBD-Senior Lead Funding and Allocation (Hospital and MH & Addictions)

Dominic Sloan- Manager, Corporate Services

Chak Lee - Finance Clerk

Maria Fernandes – Program Assistant

Monisha Kumar – Receptionist/Admin Assistant to Corporate Services

OHRS/MIS due January 31/12 Quarterly WERS – Q3 CATLite due Feb. 7 /12

Finance Update

Q3 Reporting Deadline Dates

In-Year Forecast Form -2011/12

To be submitted by December 19th

Final opportunity to re-allocate surplus $ to other HSP within our LHIN before the year end.

Last year a total of approx. $1 million was clawed back and reallocated.

Form must be signed by your Executive Director or Chief Executive Officer.

Surplus funds will be recovered from your regular February and March subsidy payments

Questions?

“6 Minute Updates”Selected HSPs

Joint Venture Agreement between Peel Senior Link; CANES Community Care;

and the Etobicoke Services for Seniors

Ray ApplebaumChief Executive Officer

Peel Senior Link

“6 Minute Updates”

Joint Venture/Voluntary Integration CANES, Etobicoke Services for Seniors, and Peel Senior Link

MH LHIN Quarterly MeetingDecember 14, 2011

•“6 Minute Updates”

Overview

•Welcome•Walk through the agenda

Value Proposition

•Definition & Draft Statement

Business Case

•Definition & Case Statement •Risks and Benefits of the Business Case

Next Steps•What are our next Steps


A project undertaken by two or more parties to achieve a mutual objective. (coentreprise)

source: www.fin.gc.ca/finserv/gloss-eng.asp


http://www.google.com/url?ei=FrfjTOPnBc-mnQf42YiNDw&sig2=SAyplpgIoy8bL1aaHu6Vtg&q=http://www.fin.gc.ca/finserv/gloss-eng.asp&sa=X&ved=0CCEQpAMoCg&usg=AFQjCNHIIV3jIyI6qxPa8TVUaW_qc_fZGg

Merger Consolidation

Parent Corporation

Management Service Organization

Joint Venture or Partnership


Does the value proposition fit with the Boards strategic priorities and directions?

Does the business case fit with the Boards strategic priorities and directions?

What opportunities and risks present themselves through this proposed joint venture?


DefinitionProposal

Thoughts from the Group


a business's promise to deliver the expected experience with their product or service; a description of what, how and why a product or service is important to a customer; an answer to why a consumer should buy a business's product or service

Source: www.cecausa.com/general_marketing_glossary.htm


http://www.google.com/url?ei=76zjTLqkNcuXnAf32amZDw&sig2=BRc16kipRgY5YOPoPxesMQ&q=http://www.cecausa.com/general_marketing_glossary.htm&sa=X&ved=0CBgQpAMoBw&usg=AFQjCNESZyn7LvpiceSsdcf6O1F8bkdvdQ

Proposed:

To enhance the service capacity, infrastructure, and sustainability of partner organizations in acquiring and retaining revenue streams consistent with common vision, mission and values


Does the value proposition fit with the Boards strategic priorities and directions?


DefinitionCase Summary

Response to the Case


Structured proposal that justifies a project for decision-makers. Includes an analysis of business process performance and requirements, assumptions, and issues. Also presents the risk analysis by explaining strengths, weaknesses, opportunities, and threats.

Source: www.blm.gov/wo/st/en/prog/more/bea/Glossary.html


http://www.google.com/url?ei=463jTPaxGcmVnAeOzqnhDg&sig2=FPZJ6dAaXZ7hpKoPCXtf3g&q=http://www.blm.gov/wo/st/en/prog/more/bea/Glossary.html&sa=X&ved=0CBoQpAMoCg&usg=AFQjCNF_b6xYuPNsFgYYxbWioCXVmA7rqA

Partners•Who is

involved• Rational

Combined Offering•What we bring

to the venture• Common

Characteristics•Work to date

Proposed Service Offerings• Anticipated

Client• Service

Offerings

Management of the Agreement• Governance

Responsibility•Management

Responsibility


CANES Community Care

Etobicoke Services for Seniors

Peel Senior Link


• Leading System Integration Opportunity

• New/Enhanced Revenue Stream-Sustainability

• Respond to Contracts trending towards Bundled Services and One Source Provider

• Preparing for changes in political landscape Municipal/Provincial/Federal


CANES ESS Peel Senior LinkFormed in 1982 Formed in 1983 Formed in 1981107 Employees 84 Employees 130 EmployeesMission/VisionExcellent seniors support services, community living safely with dignity, lead through partnerships

Mission/Vision Committed to supporting seniors, @home/community, safely client centered, dignity, Leadership, excellence of operations, innovation, partnerships

Mission/VisionQuality & valued seniors services, independence, dignity & respectExcellence, leadership, integration & innovation

$5.2M Operating $3.8 M Operating $4.5M Operating150,000 units of service

83,000 units of service 74,000 units of service


CANES ESS Peel Senior Link

Accreditation Canada Accreditation Canada Accreditation Canada

CW LHIN and CCAC Central LHIN & CCAC MH LHIN and CCAC

Lead Agency in CW LHIN for Home at Last, Seniors Ride Connect + CW CCAC contracts

Lead Agency CLHIN for Transportation, agency partnerships in 4 LHINs, AFP Award-Excellence Fundraising

Lead Agency MH LHIN -ASSIST, CSP Portal, SDL; MIS/CSS & and GPDynamics/HRIS; Best Small & Medium Employer in Canada; and Metamorphosis

Home at Last, Home Maintenance, Transportation, Supportive Housing, Caregiver Support, Family Health Team

Adult Day Services,Supportive Housing, Transportation, In-Home Respite, Chronic Disease Self- Management, Home Help, 24-7 Short Stay, Caregiver Support

24-7 Personal Support and Homemaking (SDL), Medication Assistance, Essential Transportation, Foot Care, Active Living, Caregiver Support

12 Board Members 12 Board Members 12 Board Members


Partnership/Collaboration Orientation Entrepreneurial Culture of Excellence Recognized as Leaders and Innovators of

Service/Change Similar governance structures, and

management team style Excellent and Engaged governance Boards


• March 30, 2010 CEOs Initiated Conversation

• Joint Senior Management Session

• Miller Thompson, LLP drafted agreement

• Board Chairs/Executive Committee Engagement

• MH, CW, and Central LHINs approve Voluntary Integration Dec 2011


Accreditation Canada awards accreditation status

Partners Pre-Qualified with the OACCAC Joint Venture Agreement – Draft 1 reviewed

by CEOs Draft 2 shared amongst joint Executive

Committee members Board Chairs met and agreed on next steps 3 Boards review and approve final joint

venture agreement and common resolution


Language and content consistent with current CCAC contract requirements

Autonomy remains for providers independence

CANES Community Care serves as ‘participant in charge’ for OACCAC pre-qualification document


Advisory Services, e.g. legal and consultants shared equally amongst partners

Steering Committee – to govern and manage the joint venture agreement

Contract Management Teams – established for each CCAC contract awarded


Large scale CCAC contracts in three distinct catchment areas: Central, Central West and Mississauga-Halton

Larger projects focused on seniors that spread across boundaries and are funded by one or more of the 3 LHINs

New opportunities of a large scale funded by Federal/Provincial/Municipal governments to address the projected explosive growth in seniors over next 10 years


Does the business case fit with the Boards strategic priorities and directions?


Opportunities and Risks


In learning about the joint venture

What opportunities does this present?

What risks does this present?

What are the next steps of interest to you?


What are the next steps for the team?


Initiatives, Successes & SituationsIrene ZivkoManager ACTT

Summit Housing and Outreach


Update on T.E.A.C.H. & Peer Support Groups for Concurrent Disorders

Lee HelmerDirector of North Halton Supports/TEACH



Information Highways and Forms Module (CCIM)

Judy BowyerSr. Lead, Mississauga Halton LHIN

Lisa GammageCo-Executive Director, Nucleus Independent Living

The Information HighwayTechnology Working as an Enabler

• Technology needs to work for the frontline clinician

• Technology needs to work for those making decisions about healthcare

• Technology needs to enable the sharing of information to encourage knowledge transfer and new knowledge acquisition

“An investment in knowledge pays the best interest” ~ Benjamin Franklin

•Information Highway & Forms Module (CCIM)

The Information HighwayTechnology Working as an Enabler


The Information HighwayApplicability to Current and Future Projects and Other Stuff


CCIM Shared Assessment Protocols

Monica GabrielProject Manager, CCIM

Shared Assessment Framework

Monica Gabriel

What We’ve Learned

Assessments Increased sharing

IAR

Shared Assessment Model / Business Process Mapping

Common Privacy

Framework

Joint Assessment

and IAR implementation

Technology

How to Share

Common Consent

Processes

Outcome and approach going

forward:

•123

Community Support Services Common Assessment Project (CSS CAP) Vision

Identifying Changing Needs

CSS Entry

AssessmentSupport For

Independent Living

Easy Movement Between CSS

Easy Movement Across Sectors

Client

Integrated Assessment Record


CSS Shared Assessment Model

• Client at the centre of care

• Referrals can come from anywhere

• Health service providers providing service contribute to all assessments (e.g., interRAI CHA)

• Hospitals may not provide community services but may contribute to common assessments

• Constant collaboration and communication

• Electronic viewing(e.g., IAR, other LHIN-based initiatives)

• Detailed business processes and rules

Underlying Assumptions:

Integrated Assessment

Record

Integrated Assessment

Record

Provide Service

Contribute to Common

Assessment

Client LeadAssessor

Provide Service


Assessment

Provide Service


Assessment


Assessment

•Communicate •Communicate

•Communicate •Communicate

•CSS •CCAC

•Other HSPs •Hospita

l

•CSS Shared Assessment Flow

Assessment Completion & Overall

Care PlanningService Planning

& Delivery

Care Planning

Care Coordination &Collaboration

Program-Related Assessment

(Optional)

Service Plan Development

Service Provision andSupport for Independent

Living

•Integrated Assessment Record


With

Par

tner

HSP

Invo

lvem

ent

CSS Entry

Client

Determinationof Lead Assessor

Assessment(From Service Provider HSPs and Others Involved in Care)

Shared Assessment Guideline

Area HighlightsGovernance • LHIN CSS planning tables should

address shared Assessment as part of work plans

• Resource allocation considered at LHIN level to support shared Assessment

Shared Assessment Guidelines

Area HighlightsPrivacy / Consent

• Organizations responsible for policies on privacy and consent

• LHIN planning tables consider supports such as the Common Privacy Framework and data sharing agreements


Area HighlightsClient Role / Participation

• Client choice should be considered as part of determining the Assessor Lead

• Client at the centre of the assessment process

•Client


Area HighlightsResponsibilities • Provincial

• LHIN / Regional Coordination –local guidelines

• HSP• Lead Assessor• Contributing Community Support

Services Provider


Area HighlightsAssessment Process

• A single comprehensive assessment will be conducted and shared within circle of care

• All assessment users will be competent in conducting and interpreting assessments

• Clients have the right to decide the level of assessment that they will accept


Area HighlightsConflict Resolution / Agreement Mechanism

• LHIN Steering Committee and health service providers will consider their own policies and guidelines for conflict resolution / agreement mechanism

• Standard conflict resolution processes


Area HighlightsTransfer Mechanism

• The Lead Assessor can change at any time during an episode of care


Area HighlightsReporting Structure

• Ministry and LHIN will have access to relevant reports

• Organizations will have access to relevant reports for all the clients they support

Shared Assessment Working Group Guidelines (Part 2)Determination of Lead• Lead Assessor is determined by established criteria, including:

– Input from the client– HSP completes the most comprehensive assessment– HSP completes assessment as per legislation – HSP most involved with client

(e.g., # of services, medical / care complexity, length of service)– HSP completes assessment having sufficient resources: human, financial,

technical– HSP inputs assessment information and shares with other providers– HSP coordinates input from other providers in to the assessment

Contributing HSP• Contributing HSP will be:

– A service provider that is not the Lead Assessor– Participating in the assessment and reassessment process – Communicating a significant change in need that might trigger reassessment – Actively participating in development, execution of care plan and service delivery

QUESTIONS?

• Next Meeting – March 2012

mississauga halton lhin css and mh&a quarterly sector meeting€¦ · provided on a...

Documents