Transcript www.centraleastlhin.on.ca

Performance Contract and
Allocation Overview
17/07/2015
What LHINs Do
IHSP:
Setting the
Course
Community Engagement
Accountability
& Performance
Monitoring
Accountability
Agreements:
Executing the
Course
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Patient Centred
Integration &
Service
Coordination
Funding & Allocation
Local Health
System
Planning
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What does this look like?
Performance
Monitoring
Accountability
Agreements:
Executing the
Course
3
Accountability
& Allocation
• What has
changed as of
April 01, 2007?
• Accountability
• Tool kit
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Video clip
Video Clip
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What changed as of April 1?
• World on April 2 was much the same as it was
on March 31, 2007
• Transformation will be evolutionary not
revolutionary
• Health Service providers will want to prepare for:
– An increased emphasis on accountability
– A focus on integration & improved service
coordination
– new approaches to everything from funding to health
system planning
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5 main areas where changes will
be felt…
1. Increased integration and improved
service coordination
2. Increased local decision-making about
funding and allocation
3. Greater emphasis on local health system
planning
4. Increased community engagement
5. Enhanced Accountability
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1. Increased integration & improved
service coordination
• After April 01, health service providers will:
• Be responsible for aligning their service planning
within the CE LHIN IHSP
• Implement the directions for integration laid out
in the accountability agreements with CE LHIN
• Demonstrate continuous improvement in service
integration & coordination (LHIN will help facilitate
shared best practices through our Comm Engagement
structures)
• Take part in agreements and initiatives designed
to further provincial objectives in areas such as
access, quality, safety and efficiency
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2. Increased local decision-making about funding
& allocation
•
•
•
•
CE LHIN will…
Assess priorities at local
level
Determine service
configuration based on
priorities
Allocate funds
accordingly
Monitor fiscal
performance &
contribution of providers
to ensure integration &
system sustainability
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Health Service Providers
will…
• Submit business and
service plans as required
by their accountability
agreements (same tools
for now)
• Be responsible to CE
LHIN for delivering
programs and services on
budget
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Integration Initiatives/Ideas/Proposals
1. Was it vetted by your Planning
Partners?
2. Is it aligned with the IHSP?
3. Is it evidence-based and can it be
measured & monitored? (ie., Decision
Support & Performance Monitoring)
4. Who shares accountability for its
accomplishment? (ie., agreements &
funding)
5. How will it be resourced?
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3. Greater emphasis on local health system
planning
CE LHIN will…
• Identify and determine
local health care priorities
• IHSP to reflect local
priorities & link with
provincial strategic
directions
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Health Service Providers
will…
• Continue to participate in
CE LHIN Planning
exercises
• Align strategic plans with
those of CE LHIN
• Provide input and info
necessary for CE LHIN
Plans
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5. Greater Accountability
• People have the right to expect accountability
from their governments
– To that end, CE LHIN has entered into an
accountability agreement with MoHLTC
• Patients have the right to expect that their health
service providers will be accountable for the
quality of services they provide
– To that end, part of CE LHIN mandate is to negotiate
Service Accountability Agreements (SAAs) with health
service providers
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Accountability Framework
STEWARD
MANAGER
PROVIDER
CCAC
LHIN 1
∙∙∙
∙∙∙
∙∙∙
∙∙∙
Hospitals
LTC Homes
LHIN 2
MOHLTC
....
LHIN 14
CSS
MH&A
CHC
OTHER
Strategies and Directions
- Tools and processes are
being developed
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Operationalizing Policy/Direction
-Tools/processes NEED
to be developed
Ministry of Health & Long-Term
Care & the Central East LHIN
Accountability Agreement
2007-2010
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Primary Agreement
• Purpose
– Supports the collaborative relationship between the
MOHLTC and LHIN to carry out the made in Ontario
solution to improve the health of Ontarians
– To set out the mutual understandings between the
MOHLTC and the LHIN of their respective
performance obligations in the period from April 1,
2007 to March 31, 2010
• The Primary Agreement was previously
reviewed and approved in principal in
November 2006
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Agreement Components
• Primary Agreement
• Schedule 1 General
• Schedule 2 Community Engagement, Planning and
Integration
• Schedule 3 Local Health System Management
• Schedule 4 Information Management Supports
• Schedule 5 Financial Management
• Schedule 6 Financial Processing Protocols
• Schedule 7 Local Health System Compliance Protocols
• Schedule 8 Integrated Reporting
• Schedule 9 Allocations
• Schedule 10 Local Health System Performance
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Where are we at?
Building Blocks for YEAR 1
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Times have changed:
Environmental Scanning is secondary to community
engagement, it quantifies what we heard.
What We Heard
What we Found
What We Will Do
(Engagement)
(Environment Scan)
(Our Plan)
1.
Priority 1:
•
Seamless care
for Seniors
Seniors
2.
3.
Number of
seniors in CE
LHIN and its
Planning Zones
Population
Growth of
Seniors
1.1 Improve access to LTC
home services
Seniors
Estimate of
dementia cases
in seniors
Our mantra: “Heard, Found, Do”
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1.2 Enhance coordination
of services
1.3 Reviewing and building
specialized geriatric
services
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We Own This Now!
WISDOM
How to make programs work together to improve
health outcomes for a given population
Very limited use
of data to inform
operations and
planning.
KNOWLEDGE
How agency provides service, other similar services, total
units of service in an area related to population.
INFORMATION
Profile of agency, type of service, location, number of
clients
DATA
Raw counts of units of service, or total expenditures.
Databases.
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Central East LHIN Planning Zones
Environmental Scan Overview—Our Population:
• The CE LHIN geography stretches from the culturally diverse and
densely populated Scarborough planning zones to the rural and less
populated areas of Haliburton Highlands, and northern sections of the
City of Kawartha Lakes and Peterborough Counties.
• The population is mainly concentrated in the South West area of the
LHIN, with almost 50% of the population in Scarborough.
• The area is characterized by rapid population growth for certain age
groups and the second highest percent of those over 65 in the
province. The 85+ age group will increase by over 91% between 2001
and 2016, and the 14-17 age group will decrease by 0.5% for the
same period.
Haliburton Highlands
Central East Planning Zone Populations (% ) for 2006
Durham North /
Central
3%
Scarborough Cliffs Scarborough Center
26%
Peterborough City & County
Durham West
24%
Scarborough
Agincourt - Rouge
19%
Kawartha Lakes
Haliburton Minden
0.3%
Peterborough
8%
Northumberland
Havelock
4%
Kawartha
3%
Population Growth Rates for CE LHIN
100.0%
% Growth from 2001 Base Year
80.0%
60.0%
Youth (14-17)
Adult (18+)
65-74
75+
85+
Total
40.0%
20.0%
0.0%
2001
2002
2003
2004
2005
2006
2007
2008
2009
-20.0%
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Year
2010
2011
2012
2013
2014
2015
2016
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Example: Historical Wait-time Trending
Diagnostic Imaging - CT Scan
Wait-Time in Days (90% Completed Within)
120
100
Peterborough Regional Health Centre
Lakeridge Health Corporation
Rouge Valley Health System
Scarborough Hospital
CE LHIN Avg
Target (28 Days)
80
60
40
20
0
Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb07
07
06
06
06
06
06
06
06
06
06
06
06
06
05
05
05
05
05
05
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How we Approach Performance
Trend Analysis CE LHIN MRI Trend All Data
130
120
March 2008
Estimated WT
for MRI = 115
Projected February 2007 to August
2008
Wait Times
110
100
90
June 2006 to Jan. 2007
80
70
60
Months
It takes people to bend this curve
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Example of Health System Goal Managed by LHINs
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Strategy Map
Improve patient-centredness, integration and quality of health services
Health System Scorecard
Performance measure
• Total number of days percentage alternative level of care (ALC)
Score
9.3%
MLAA -negotiation
MLAA -negotiation
MLAA -negotiation
LHIN (1) Scorecard
LHIN (2) Scorecard
LHIN (3) Scorecard
Performance measure
• Total number of days ALC
• Target
Score
7.72%
7.72%
Performance measure
• Total number of days ALC
• Target
Score
10.30%
8%
Performance measure
• Total number of days ALC
• Target
Average across Ontario
11.04%
Score
11.04%
9%
LHIN (2) negotiates service agreements with its hospitals on an individual basis regarding strategies for
managing alternative level of care patients: e.g. conducting a daily utilization review to determine
appropriateness of admission and readiness of discharge; developing closer relationships with community
agencies, etc.
Hospital (A) Report
Performance measure
• Total number of days ALC
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Score
10.55%
Performance measure
• Total number of days ALC
Score
3.85%
Performance measure
• Total number of days ALC
Average across LHIN (2)
12.09%
10.55%
Hospital (C) Report
Hospital (B) Report
10.30%
5.27%
Score
12.09%
3.85%
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The “Toolkit”: Accountability Agreements
 HSP Service Agreements
 HAPS/HAA
 Funding Proposals
 Capital/PCOP
 Risk Management
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The “Toolkit”: Population-based Funding
 Funding Letters
- Summer 2007
 In-Year Pressures
- Late Summer 2007
 Transfer Payment & Allocation
Management
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A pessimist sees the
difficulty in every
opportunity; an optimist
sees the opportunity in
every difficulty.
- Sir Winston Churchill
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Discussion
And
Questions
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