Transcript Document

South East Local Health Integration Network
Vision for Health and Health Care in the South East
Presented to:
Regional Family Council Networking Meeting
Region 10
Date:
Tuesday, May 13, 2008
Suzanne McGurn
Senior Consultant Planning and Integration
South East Local Health Integration Network
Overview
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The Canadian Context
The Ontario Context
The Local Health Integration Networks (LHINs)
The South East LHIN
Long Term Care Homes
Questions
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Canada spends
$160,000,000,000*
on Health Care
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Canada Health Act
The Five Principles
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Universality
Comprehensiveness
Accessibility
Portability
Public Administration
Accountability ??
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Relative Age of Society, 2004
Canada
UK
Japan
Italy
% over 65 years of age
Germany
France
US
0
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10
15
20
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The Difference Age Makes
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Ontario Composition of Revenue
2006/07
Other Taxes
4% $3.7 B
Ontario Health
Premium
3% $2.6 B
Gasoline and Fuel
Taxes
4% $3.0 B
Employer Health Tax
5% $4.3 B
Other Non-Tax
Revenue
8% $7.0 B
Income from
Government
Enterprises
5% $3.9 B
Corporations Tax
11% $9.8 B
Federal Payments
16% $13.6 B
Retail Sales Tax
19% $16.2 B
Personal Income Tax
25% $21.7 B
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Ontario Composition of Program
Expense 2006/07
Justice Sector
4% $3.2 B
Children's and Social
Services Sector
13% $10.3 B
Training, Colleges
and Universities
7% $5.2 B
Resources, General
Government and
Other
15% $11.5 B
Education
15% $12.0 B
Health Sector
46% $35.4 B
1 - Program expense equals total
expense m inus interest on debt
2 - Includes Tachers' Pension Plan
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Ontario Composition of Total Expense
2006/07
Resources, General
Government and
Other
12% $11.5
Justice
4% $3.2 B
Children's and Social
Services
12% $10.3 B
Training, Colleges
and Universities
6% $5.2 B
Eduction *
14% $12.0 B
Interest on Debt
11% $9.4 B
Health Care
41% $35.4 B
* Includes Teachers' Pension Plan
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Ontario Composition of Program
Expense 2006/07
Health Expenditure by Use of Funds
in Ontario (2005)
Administration, $2,221
Public Health, $3,848
Other Health
Spending, $3,459
Hospitals, $16,006
Capital, 2589.5
Drugs, $10,486
Other Professionals,
$6,104
Other Institutions,
$5,047
Physicians, $7,822
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Developing a New System
Key Considerations
• Canada spends more money on health care than most countries
• Canada does not receive the best outcomes
• Canada is the youngest country of the G7
• Canada’s population is aging at a fast rate
• Older countries (e.g. UK) did not see their health systems collapse
as they aged
• All other Provinces devolved health care – moved to some form of
regionalization
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Ontario’s Response
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14 Local Health Integration Networks (LHINs) have been set up
throughout all of Ontario
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Somewhat similar to Regional Health Authorities in all other Canadian
Provinces, but also very different
– Similar characteristics
• Devolved regionalization, including decision making and funding
• Focus on system integration
– Different characteristics
• All Boards continue to exist
• Focus on system management
• Provincial system and local system linked
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Local provider boards continue to exist and provide leadership to their
organizations
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LHINs are responsible for managing the system, not operating services
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Transformation of the Ontario System
The New LHIN Environment
Province is in control
Province is steward
Acute Care is the hub
Primary Healthcare is the hub
System is fragmented
System is seamless
Accountability focuses on blame
Accountability focus on outcomes
and improvement
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Government’s Vision
The Hon. George Smitherman, Minister of Health and
Long-Term Care:
“A health care system that helps people
stay healthy, delivers good care to them
when they are sick, and will be there for
their children and grandchildren.”
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LHIN Geographic Boundaries
LHIN Areas:
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Erie St. Clair
South West
Waterloo Wellington
Hamilton Niagara
Haldimand Brant
Central West
Mississauga Halton
Toronto Central
Central
Central East
South East
Champlain
North Simcoe Muskoka
North East
North West
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Populations and Initial Funding Estimates
Local Health Integration Networks (LHINS)
Local Health Integration Network
Population Est.
(2006)
Initial Funding
Estimates
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Erie St. Clair
647,600
853,699,200
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South West
931,100
1,762,173,900
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Waterloo Wellington
708,400
774,896,300
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Hamilton Niagara Haldimand Brant
1,371,300
2,214,490,500
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Central West
779,200
531,533,600
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Mississauga Halton
1,092,200
997,387,700
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Toronto Central
1,159,400
3,773,405,100
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Central
1,604,900
1,417,156,400
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Central East
1,484,300
1,665,979,000
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South East
482,400
853,584,600
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Champlain
1,188,800
1,945,980,600
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North Simcoe Muskoka
431,400
520,520,000
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North East
567,800
1,085,773,900
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North West
238,000
504,658,400
12,687,000
18,901,239,200
Provincial Total
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The Mandates of LHINs
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Community Engagement
Integrated Health Services Planning
Integration
Performance and Accountability Agreements
Performance Measurement
Funding (true devolution of decision making)
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Local Health Integration Networks
• LHSIA - Local Health Services
Integration Act
• MLAA – Ministry/LHIN Accountability
Agreement
• IHSP – Integrated Health Services Plan
• ASP – Annual Services Plan
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The South East LHIN
Where are we…
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The South East LHIN
Where are we…
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The South East LHIN
Where are we…
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Linking Geography and Population
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Funding of South East LHIN Health Service
Providers by Sector, 2007/08
Add 20% for
Physicians
Services
A ddic t io ns
$5,765,968 (0.7% )
M e nt a l H e a lt h
$27,943,584 (3.2% )
H o s pit a ls
C o m m unit y H e a lt h
C e nt re s
$586,135,172 (68.1% )
$12,438,700 (1.4% )
C o m m unit y S uppo rt
S e rv ic e s
$18,751,494 (2.2% )
C o m m unit y C a re
A c c e s s C e nt re
$83,349,557 (9.7% )
Total Funding
Allocation 2007/08:
$861,189,939
Lo ng- T e rm C a re
$126,805,464 (14.7% )
Note: Hospital Sector funding total includes one-time and in-year priority program announcements;
includes funding for municipal taxes
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The Integrated Health Services
Plan (IHSP)
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specific plan for the South East
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intended to provide an initial perspective
– vision, priorities, strategies for enhancing health care through
advanced vertical and horizontal integration of services
– 3 year horizon (2007/08 to 2009/10)
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involved all sectors
– hospitals, home care, long term care, community support services,
mental health, addictions, community health centres
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used both quantitative and qualitative data and analyses
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community engagement
– included 22 communities, 109 meetings, over 1,000 people contributed to
the discussions
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led to seven areas of priority
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7 Priorities for Change
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Access to:
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Advance engagement with
aboriginal communities
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Advance the availability of
French language health
services
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Advance availability and use of
e-Health
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Develop a regional health
human resources plan
Primary Care
Specialized medical care
Mental health services
Addiction services
Rehabilitation services
Transportation to and from
care
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Improve availability of long
term care services
3.
Integration of services making
it easier for patients and
professionals to move between
services and service providers
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A Vision for Health Care
in the South East
• In March, a new vision for health care was
articulated for the South East LHIN region
Achieving better health through proactive,
integrated and responsive health care in
partnership with an informed community.
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A Vision for Health Care
in the South East
• Breaking down the vision
Achieving better health (the end goal for health care consumers)…
through proactive (taking the initiative; speaks to a change in
provider behaviour and overall system responsiveness),…
integrated (speaks to changes in service delivery and the ideal end
state)…
and responsive health care… (answers and flexibility; speaks to a
change in provider behaviour and overall system responsiveness),…
in partnership (speaks to the “how;” means change is a collaborative
effort)…
with an informed community (means communications is key)
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LHINs &
Long Term Care Homes
• LHINs will be responsible for:
– participating as appropriate in preparation and submission of requests
related to long-term care homes through the Ministry annual planning
cycle
– establishing a process to monitor performance of long-term care
homes for compliance with service agreements and Service
Accountability Agreements
– monitoring utilization of long-term care home beds and related
funding
– monitoring long-term care home performance through pre-established
indicators (e.g., occupancy)
– adjusting long-term care home funding according to long-term care
home performance (e.g., convalescent care program)
– identifying operating funds to be recovered from long-term care home
operators through the annual reconciliation process and recovering
funds as appropriate.
– responsible for conducting financial audits
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Geographic Summary
Total
Total
Total
# Of
Long Stay
Short Stay
Homes
Beds
Beds
Northumberland
1
49
0
Quinte West
2
153
1
South Hastings
4
521
4
Centre Hastings
2
159
0
North Hastings
1
108
2
Prince Edward
5
346
2
Lennox Addington
6
454
2
South Frontenac
5
871
6
Central Frontenac
0
0
0
North Frontenac
0
0
0
Leeds Grenville
7
693
0
Lanark
3
358
1
36
3712
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Totals
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MOHLTC &
Long Term Care Homes
For long-term care homes, the Ministry retains
current responsibility for:
– compliance inspection, enforcement and sanctions
– licensing and approval, including the setting of fees
for licensing
– approvals of
• changes of ownership, sale of businesses and
amalgamations of providers for purposes of licensing
• management contracts
• setting ministry program and long-term care home
standards
• selected funding programs
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MOHLTC &
Long Term Care Homes
• The mandate of compliance inspection, enforcement and licensing
of long-term care homes is in the Compliance Inspection and
Enforcement Unit of the Health System Accountability and
Performance Division. Their mandate includes:
– the development, implementation and management of a
comprehensive program that ensures Long-Term Care Homes are in
compliance with legislation, regulations, and program standards
– safeguarding residents’ rights, safety, security, quality of life and
quality of care
– inspecting, monitoring and evaluating the performance of all long-term
care homes on a regular and ad hoc basis against ministry standards
and where necessary, use enforcement measures to achieve
compliance Ministry standards
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MOHLTC &
Long Term Care Homes
• The Ministry will exercise its statutory authority use of enforcement
remedies, including use of sanctions, for long-term care homes to
achieve compliance. When sanctions are to be applied, MOHLTC
will
– inform LHINs on proposed actions/ decisions
– for financial sanctions, direct LHINs to withhold funds
– keep LHINs up-to-date on issues that arise from the application of
sanctions
• Funding
– CIEU shall continue to be responsible for ensuring the appropriate
management of resident trust funds. In addition, some current
Ministry funding programs will continue to be administered by the
Ministry (e.g. High Intensity Needs Funds & Lab costs; Exceptional
Circumstance Funding)
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Working Together
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The LHINs and the Ministry respect each others’ responsibilities in the
transformation and management of health care in Ontario, and will ensure
that in fulfilling their respective responsibilities
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Each local CIEU service area office has a Compliance Manager who will
be assigned as the point of contact for compliance inspection and
enforcement related issues. Regular meetings are held between the CIEU
and the LHIN to ensure up-to-date information exchange
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Moving Forward
Focus is on change, integration
and
improving the current good system . . .
to make it even better !
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Thank you for your time
Questions?
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